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Orthodontic tooth movement (OTM) is a meticulously regulated biological process that hinges on the remodeling of the alveolar bone and periodontal ligament in response to controlled mechanical forces. This complex interaction involves an orchestrated series of cellular responses, particularly involving osteoblasts and osteoclasts, and is mediated by a variety of biochemical signals such as prostaglandins, cytokines, and hormones. However, this delicate process can be significantly influenced by pharmacological agents .Patients undergoing orthodontic treatment often use medications either for general health conditions or for management of orthodontic-related symptoms such as pain or inflammation. Many of these drugs-ranging from nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids to bisphosphonates, hormones, vitamins, and immunosuppressants-have been found to impact bone metabolism, inflammatory response, and cellular activity involved in OTM. Some drugs, such as acetaminophen and vitamin D, may support normal or enhanced tooth movement without adverse effects, while others, like NSAIDs, bisphosphonates, and corticosteroids, may inhibit bone remodeling or introduce treatment complications. This review aims to provide a comprehensive overview of the effects of various commonly used drugs on orthodontic tooth movement. It highlights their mechanisms of action, potential side effects, and clinical implications for orthodontic practice. By understanding these drug interactions, orthodontists can make informed decisions regarding treatment planning, force application, and patient management, especially in patients on long-term or chronic medication regimens.
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