Osteocalcin and N-telopeptides of type I collagen marker levels in gingival crevicular fluid during different stages of orthodontic tooth movement

Levels of Inflammatory and Bone Metabolic Markers in the Gingival Crevicular Fluid of Individuals Undergoing Fixed Orthodontic Treatment in Comparison to Those Utilizing Invisalign

Background and Objectives: Evaluation of the levels of cytokine and bone metabolic biomarkers (BMBs) in patients receiving fixed orthodontic therapy (FOT) and Invisalign. Materials and Methods: Sixty participants were enrolled after meeting the predefined inclusion criteria. Patients then underwent either FOT or Invisalign by allocating them randomly to each group (n = 30). The basic periodontal assessment was performed, including the plaque index (PI), gingival index (GI), and bleeding on probing (BoP), at baseline and again after 4 weeks. Gingival crevicular fluid (GCF) samples were taken from each individual at baseline and after 4 weeks. An enzyme-linked immunosorbent assay (ELISA) technique was used to determine the cytokine and BMB levels. An unpaired t-test compared the FOT and Invisalign group's means and SDs. Paired t-tests examined the difference between T0 baseline and T1. Results: Patients treated with either FOT or Invisalign presented no statistically significant difference in terms of periodontal parameters such as PI, GI, and BoP (p > 0.05). The levels of IL-6 were significantly higher in patients treated with FOT as compared to Invisalign at T1 (p < 0.05) The other tested cytokines, IL-10, 13, 17, and GM-CSF, were not significantly different in either the FOT or Invisalign group at baseline and 4 weeks follow-up (p > 0.05). Regarding BMBs, it was detected that NTx and OC levels in both of the investigated groups were not significantly different at baseline and after 4 weeks (p > 0.05). However, NTx levels rose significantly (p < 0.05) and OC levels fell from T0 to T1. Conclusions: FOT and Invisalign displayed comparable outcomes in terms of cytokine and BMB levels. However, only IL-6 and NTx were significantly different at week 4 from baseline.

Osteocalcin and cross-linked C-terminal telopeptide of type I collagen in gingival crevicular fluid during piezocision accelerated orthodontic tooth movement: A randomized split-mouth study

Background

Piezocision, a minimally invasive surgical procedure, has been used to accelerate tooth movement'' is appropriate as a background to the abstract section.

Aim

The aim of this randomized split-mouth study was to evaluate gingival crevicular fluid (GCF) osteocalcin (OC) and type I collagen cross-linked C-terminal telopeptide (ICTP) levels during canine distalization with and without piezocision acceleration.

Material and Methods

Fifteen systemically healthy subjects (M:F 7:8, 16.27 ± 1.14 years) requiring extraction of maxillary first premolars before retraction of canines were included in the study. Piezocisions were randomly carried out on one of the maxillary canines while bilateral canines served as controls. Canine distalization was conducted using closed-coil springs applying a force of 150 g/side by using miniscrews as anchorage. GCF sampling was performed from maxillary canine mesial and distal sites at baseline, 1, 7, 14, and 28 days. The GCF levels of OC and ICTP were detected by enzyme-linked immunosorbent assay (ELISA). The rate of tooth movement was evaluated at 2-week intervals.

Results

The amounts of canine distalization from baseline to 14 and 28 days in the piezocision group were significantly higher than the control group (P < 0.05). The GCF OC level of the piezocision group on the tension side and the ICTP level of the same group on the compression side were higher than the respective sides of the control group on day 14 (P < 0.05).

Conclusions

Piezocision was found to be an effective treatment procedure for accelerating canine distalization accompanied by increased levels of OC and ICTP.

Fluctuation of bone turnover markers' levels in samples of gingival crevicular fluid after orthodontic stimulus: a systematic review

BACKGROUND

The aim of the present study was to provide an overview of gingival crevicular fluid (GCF) bone turnover markers (BTMs) concerning the physiology of orthodontic tooth movement (OTM) and assess their potential contributions to regulating bone remodeling, that could prove useful in designing future approaches to modulating orthodontic tooth movement.

METHODS

Multiple electronic databases (MEDLINE/PubMed, Ovid MEDLINE, Ovid Embase, LILACS, and Cochrane Library) were searched up to October 1st, 2020. Randomized controlled trials (RCTs), controlled clinical trials, observational studies of prospective and retrospective designs, and cross-sectional studies reporting on levels of BTMs in GCF were eligible for inclusion. The quality of the included RCTs was assessed per the revised Cochrane risk of bias tool for randomized trials (RoB 2.0), whereas the risk of bias of the included cohort studies was assessed using the Risk Of Bias In Non-randomized Studies of Interventions tool.

RESULTS

Five RCTs, 9 prospective cohort studies, and 1 cross-sectional study fulfilled the inclusion criteria. The risk of bias was deemed as high for the RCTs and 4 of the prospective studies and moderate for the rest of the studies. The following biomarkers for bone formation were assessed: bone alcaline phosphatase (BALP), alcaline phosphatase (ALP), and osteocalcin (OC). For bone resorption, the following BTMs were assessed: deoxypyridinoline (DPD) and pyridinoline (PYD), N-terminal telopeptide (NTX), osteopontin (OPN), and tartrate-resistant acid phosphatase (TRAP). The follow-up period ranged mainly from baseline to 45 days, although one study had an expanded follow-up period of up to 16 months. The results of the included studies comparing different BTMs were heterogeneous and qualitatively reported.

CONCLUSIONS

Current evidence continues to support the potential for BTMs to provide clinically useful information particularly for adjusting or standardizing the orthodontic stimulus. The present systematic review has retrieved studies of high, overall, risk of bias, and has unveiled a substantial clinical and methodological heterogeneity among included studies. Further data of the relationships between the clinical assays and the physiological or pre-analytical factors contributing to variability in BTMs' concentrations are required.

SYSTEMATIC REVIEW REGISTRATION

CRD42020212056 .

Detection of Ostecalcin in gingival Crevicular fluid in a Group of Orthodontic Patients

Aim:

To detect osteocalcin (OC) in gingival crevicular fluid (GCF) and to monitor the concentration of OC at what stage inflammation and bone resorption reaches their maximum following orthodontic activation.

Materials and Methods:

GCF samples were collected from six adult orthodontic patients (mean age = 22.3, range 20–24 years) on 3, 7, 10, 14, 21, 28, and 35 days after activation of orthodontic appliance, from the tooth surface where bone resorption was expected to occur. A total of 330 GCF sample were collected using filter paper strip, the volume measured by weighing. OC was analyzed using Enzyme-Linked immunoassay technique. Data were analyzed using the Statistical Package for Social Sciences software, SPSS (SPSS Inc., Chicago, IL, USA) version 15.

Results:

An increase in GCF volume and flow rate was noted in the 10^th day after activation of the orthodontic appliance activation; however, due to high-standard deviation, the result was not significant. OC was detected in all GCF samples. The amount and concentration were quite variable. Increase in the amount of OC was observed between days 7 and 14.

Conclusion:

OC was detected in all samples. The quantity of OC increased at day 10 in a number of samples. There was no obvious association between OC concentration and time of collection.

Plasma levels of N-telopeptide of Type I collagen in periodontal health, disease and after treatment

Background:

To determine plasma concentrations of bone resorption marker cross-linked N-terminal telopeptide (NTx) of Type I collagen in periodontal health, disease and after nonsurgical periodontal therapy in chronic periodontitis group. In addition, to know the association between plasma NTx levels and the different clinical parameters.

Materials and Methods:

Thirty subjects were divided on the basis of their periodontal status and were categorized as Group I: Healthy, Group II: Gingivitis, and Group III: Chronic periodontitis. Group III subjects were treated with scaling and root planing, 6-8 weeks later blood samples were analyzed, and they constituted Group IV. NTx levels in plasma were analyzed by competitive - enzyme-linked immunosorbent assay. All data were analyzed using statistical software (SPSS) (α = 0.05).

Results:

All the samples tested positive for the presence of NTx. The mean NTx concentration was highest in Group III (18.77 nanomole Bone Collagen Equivalent [nm BCE]) and the lowest in Group IV (16.02 nm BCE). The values of Group I and Group II fell between the highest and the lowest values (16.23 nm BCE and 16.70 nm BCE, respectively). The difference in mean NTx levels in Group III and Group IV were statistically significant. NTx levels in all the groups positively correlated with the clinical parameters. All data were analyzed using statistical software (SPSS) (α = 0.05).

Conclusion:

Within the limits of this study, it may be suggested that plasma NTx levels may provide distinguishing data between periodontally healthy diseased sites and after nonsurgical therapy of diseased sites.

Biomarkers in orthodontic tooth movement

Tooth movement by orthodontic treatment is characterized by remodeling changes in the periodontal ligament, alveolar bone, and gingiva. A reflection of these phenomenons can be found in the gingival crevicular fluid (GCF) of moving teeth, with significant elevations in the concentrations of its components like, cytokines, neurotransmitters, growth Factors, and a arachidonic acid metabolites. GCF arises at the gingival margin and can be described as a transudate or an exudate. Several studies have focused on the composition of GCF and the changes that occur during orthodontic tooth movement (OTM). GCF component analysis is a non-invasive method for studying the cellular response of the underlying periodontium. Clinically, GCF can be easily collected using platinum loops, filter paper strips, gingival washings, and micropipettes. A number of GCF biomarkers involve in bone remodeling during OTM. The data suggest that knowledge of all the biomarkers present in the GCF that can be used to mark the changes in tooth that is undergoing orthodontic treatment may be of clinical usefulness leading to proper choice of mechanical stress to improve and to shorten treatment time and avoid side effects.

Slow and fast orthodontic tooth movement: an experimental study on humans

INTRODUCTION

The aim of this study was to investigate the variation in the amount of the orthodontically induced tooth movement in humans and potential associations between the amount of tooth movement with age and location in the mandible or maxilla.

SUBJECTS AND METHODS

This study included 11 participants (7 females, 4 males) with an age range of 11.3-28.6 years. In a standardized experimental orthodontic tooth movement protocol, two premolars of each participant were moved buccally during 8 weeks with the use of 1 N force. No functional or localized obstacles were affecting the displacement. Plaster models before and after the experimental tooth movement were constructed, digitized, and superimposed, to evaluate the amount of tooth movement of each tooth. Random effects linear regression analysis was performed to examine associations between tooth displacement, age, and tooth location.

RESULTS

The mean displacement of the teeth was 2.7±1.4mm. The range of tooth movement varied substantially between individuals (0.6-5.8mm). The displacement of the teeth within the same individual was highly correlated (R (2) = 0.78, P < 0.001). The tooth displacement decreased with age; however, this finding did not reach statistical significance (β = -0.11, 95% CI: -0.28, 0.05, P = 0.172). The tooth movement was higher in the maxilla than in the mandible (β = 0.47, 95% CI: 0.81, 0.86, P = 0.018).

CONCLUSION

Wide range of tooth displacement revealed slow and fast movers in this sample. Larger displacements were recorded in the maxilla compared to the mandible and in younger individuals.

Biomarkers of Orthodontic Tooth Movement in Gingival Crevicular Fluid: A Systematic Review

BACKGROUND

The analysis of gingival crevicular fluid (GCF) may be an acceptable way to examine the ongoing biochemical processes associated with bone turnover during orthodontic tooth movement. If it is possible to biologically monitor and predict the outcome of orthodontic forces, then the management of appliances could be based on individual tissue responses, and the effectiveness of the treatment could be improved.

METHODOLOGY

A literature search was carried out in major databases, such as medline, EMBASE, cochrane library, web of science, google scholar and scopus for relevant studies. Publications in English between 2000 and 2014 which estimated GCF markers as indicators of orthodontic tooth movement were included.

RESULTS

The list of biomarkers available to date was compiled and presented in table format. Each biomarker is discussed separately based on the available evidence.

CONCLUSION

Several sensitive GCF markers are available to detect the biomechanical changes occurring during orthodontic tooth movement. Further focused research might help to analyze the sensitivity and reliability of these indicators, which in turn can lead to the development of chairside tests to assess the outcome of orthodontic therapy.

Calcitonin gingival crevicular fluid levels and pain discomfort during early orthodontic tooth movement in young patients

OBJECTIVES

To investigate the previously unreported presence of calcitonin (CT) levels in gingival crevicular fluid (GCF), its variations during initial orthodontic tooth movement in both tension and compression sites, and its possible association with the experienced dental pain.

DESIGN

Fifteen children (mean age: 12.6 years) requiring orthodontic closure of the upper midline diastema were included. We collected GCF from the compression and tension sites of the upper right central incisor (experimental) and first bicuspid (control), before and after (1h, 24h, 7d, 15d) beginning of treatment. Calcitonin levels were determined by Western blot. Pain intensity was assessed using a visual analogue scale.

RESULTS

Calcitonin levels were higher in the compression site versus the control site at 7d (p=0.014). Intragroup comparisons showed an increment of CT between 1h and 7d (680.81±1672.60pg/30s, p=0.010) in the compression site. No significant changes were found in the tension and control sites. Calcitonin levels and pain intensity were negatively associated during the period from 24h to 15d (r=-0.54, p=0.05).

CONCLUSIONS

CT levels in the GCF significantly increased in the compression site after the short term after application of orthodontic forces. These changes were negatively associated with the perceived patient's dental pain during the period from 24h to 15d.