Post-Orthodontic Relapse Prevention through Administration of a Novel Synthetic Carbonated Hydroxyapatite-Chitosan Hydrogel Derived from Blood Cockle Shell (Anadara granosa L.)

Relapse during passive orthodontic treatment is a major issue, with 70-90% frequency. This study examines whether blood cockle shells may be used to extract carbonated hydroxyapatite (CHA)-chitosan (CS). This study also aims to analyze the effect of CHA-CS on orthodontic relapse in rats. This study utilized 18 male Wistar rats which were randomly divided into two groups: CHA-CS and the control group (CG). The rats were subjected to a 35 cN orthodontic force for a duration of 7 days, after which the rats were conditioned to be passive. During this phase, the CHA-CS group received daily administration of CHA-CS hydrogel derived from the blood cockle shell. Subsequently, the appliances were detached to facilitate relapse. The distance between the mesial tips was measured using a digital caliper at three consecutive time points: 1, 5, and 7 days after debonding. The number of osteoblasts, osteoclasts, and fibroblasts was examined using hematoxylin-eosin staining. The data were subjected to statistical analysis using a t-test. The relapse distance of the CHA-CS group was lower than that of the control groups on day 7. Histological examinations using hematoxylin-eosin (HE) staining showed a significant increase in osteoblasts, a decrease in osteoclasts, and an increase in fibroblasts during orthodontic relapse movement (p < 0.05). This study found that blood cockle shell-derived CHA-CS may reduce orthodontic relapse by increasing osteoblasts and fibroblasts and by reducing the osteoclast number in rats.