Preliminary Study of Aspartate Aminotransferase Activity in Gingival Crevicular Fluids During Orthodontic Tooth Movement

Effects of Platelet-Rich Plasma Injections on Periodontal Health During Accelerated Orthodontic Tooth Movement

BACKGROUND

The interplay between orthodontics and periodontics is crucial for successful orthodontic treatment. Accelerating orthodontic tooth movement (OTM) can enhance treatment efficiency, but it is important to assess the impact of such methods on periodontal health. Platelet-rich plasma (PRP) has emerged as a promising adjunct in accelerating OTM, but its effects on periodontal health require further investigation.

OBJECTIVE

This study aimed to evaluate the impact of PRP injections on periodontal health during accelerated OTM by comparing clinical and biochemical parameters between a PRP-enhanced orthodontic treatment group and a conventional orthodontic treatment group.

METHODS

In this randomized controlled trial, 40 participants with anterior teeth crowding were divided into two groups: the PRP group (n = 20), which received standard orthodontic treatment with PRP injections, and the control group (n = 20), which received standard orthodontic treatment alone. Periodontal parameters, including periodontal probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BOP), and gingival recession (GR), were recorded at baseline, four, eight, and 12 weeks. Salivary aspartate aminotransferase (AST) levels were measured at baseline, one hour, 24 hours, seven days, and 14 days post treatment.

RESULTS

No statistically significant differences were found between the PRP and control groups regarding periodontal parameters (PPD, CAL, BOP, and GR) and AST enzyme levels throughout the study period. Both groups exhibited slight increases in PPD, CAL, GR, and BOP over time, consistent with typical orthodontic effects. AST levels showed fluctuations but no significant differences between the groups.

CONCLUSION

PRP injections did not demonstrate significant advantages over conventional orthodontic treatment in terms of periodontal health or AST enzyme levels. This suggests that PRP is a safe and non-inferior method for accelerating OTM without adversely affecting periodontal tissues. Further research with larger sample sizes and longer follow-ups is recommended to validate these findings and explore the long-term effects of PRP.

The Role of Cellular Metabolism in Maintaining the Function of the Dentine-Pulp Complex: A Narrative Review

The cellular metabolic processes ensure the physiological integrity of the dentine-pulp complex. Odontoblasts and odontoblast-like cells are responsible for the defence mechanisms in the form of tertiary dentine formation. In turn, the main defence reaction of the pulp is the development of inflammation, during which the metabolic and signalling pathways of the cells are significantly altered. The selected dental procedures, such as orthodontic treatment, resin infiltration, resin restorations or dental bleaching, can impact the cellular metabolism in the dental pulp. Among systemic metabolic diseases, diabetes mellitus causes the most consequences for the cellular metabolism of the dentine-pulp complex. Similarly, ageing processes present a proven effect on the metabolic functioning of the odontoblasts and the pulp cells. In the literature, several potential metabolic mediators demonstrating anti-inflammatory properties on inflamed dental pulp are mentioned. Moreover, the pulp stem cells exhibit the regenerative potential essential for maintaining the function of the dentine-pulp complex.

Effect of orthodontic forces on levels of enzymes in gingival crevicular fluid (GCF): A systematic review

Objective:

Orthodontic force application releases multiple enzymes in gingival crevicular fluid (GCF) for activation, resorption, reversal, deposition of osseous elements and extracellular matrix degradation. The current systematic review critically evaluated all existing evidence on enzymes in orthodontic tooth movement.

Methods:

Literature was searched with predetermined search strategy on electronic databases (PubMed, Scopus, Embase), along with hand search.

Results:

Initial search identified 652 studies, shortlisted to 52 studies based on PRISMA. Quality assessment further led to final inclusion of 48 studies (13 moderately and 35 highly sensitive studies). Primary outcomes are significant upregulation in GCF levels of enzymes-aspartate aminotransferase (AST), alkaline phosphatase (ALP), matrix metalloproteinases (MMPs), lactate dehydrogenase (LDH), β-glucuronidase (βG), tartrate resistant acid phosphatase (TRAP), acid phosphatase (ACP) and down regulation in cathepsin B (Cb). Site specificity is shown by ALP, TRAP, AST, LDH, MMP9 with levels at compression site increasing earlier and in higher quantities compared with tension site. ALP levels are higher at tension site only in retention. A positive correlation of LDH, ALP and AST is also observed with increasing orthodontic force magnitude.

Conclusions:

A strong evidence of variation in enzymes (ALP, AST, ACP TRAP, LDH, MMPs, Cb) in GCF is found in association with different magnitude, stages and sites of orthodontic force application.

Evaluation of enzyme activity and rate of tooth movement in corticotomy-accelerated tooth movement - A randomized clinical trial

BACKGROUND:

This study was undertaken to evaluate the enzyme activity profiles in human saliva and gingival crevicular fluid (GCF) in accelerated tooth movement when compared with normal orthodontic tooth movement (OTM) in extraction cases.

MATERIALS AND METHODS:

Twenty patients who required premolar extractions were treated with MBT mechanotherapy. They were divided into two equal groups: conventional (Group I) and corticotomy (Group II) which was performed on both the jaw sides before initiating retraction. GCF was collected from mesial and distal aspects of canine before initiation of retraction and at 7^th, 14^th, 21^st, and 28^th days, and then at fifth and sixth weeks and third and sixth months after retraction. A total of 5 mL of unstimulated saliva was collected from the subjects after 90 min of nonoral activity (subjects were refrained from eating and drinking).

RESULTS:

The results showed that in Group I, the peak of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) enzyme activity occurred on the 14^th day of force application. In Group II, the enzyme activity progressively increased from day 0 to 6 weeks, peaking at the sixth week, and then a decline in enzyme activity was observed on third and sixth months. When ALP and AST activities in GCF and saliva were compared between Groups I and II, no statistically significant difference was observed on days 0, 7, and 14.

CONCLUSION:

Corticotomy-accelerated tooth movement is a promising technique that has many applications in orthodontic treatment of adults as it helps overcome many of the current limitations of this treatment. The enzymatic activity signifies osteoclastic and osteoblastic activities, so ALP and AST from the saliva and GCF may potentially be used as biomarkers for monitoring corticotomy-assisted OTM.

Changes in human pulp blood flow during canine retraction

AIM

To evaluate the effects of maxillary canine retraction on pulpal blood flow (PBF) in humans as recorded by laser Doppler flowmetry (LDF).

METHODS

Maxillary canines of 24 participants were divided into two groups (n = 12 each). Teeth in the study group underwent maxillary canine retraction using mini-implants as anchorage for approximately 4 months, with 100 g of force applied via coil springs. Subjects in the control group received no orthodontic treatment. LDF measurements were recorded at baseline (T0); during retraction, at 24 hours (T1), 3 days (T2), 7 days (T3) and 1 month (T4); and at the end of retraction (T5) in the study group and at similar time-points in control subjects. Data were analyzed using the Friedman, Wilcoxon signed rank and Mann-Whitney U tests, with the significance level set at 0.05.

RESULTS

No significant changes in PBF perfusion units (PU) were observed in the control group over the course of the study. However, PBF in the study group increased significantly from T0 (3.6 ± 0.2 PU) to T1 (3.7 ± 0.2 PU, p < 0.001) and decreased severely from T1 to T2 (3.3 ± 0.1, p < 0.001). PBF in the study group was still significantly lower at T3 (3.4 ± 0.1 PU, p < 0.001) in comparison to T0; however, at T4 and T5, PBF was found to have returned to pre-retraction levels.

CONCLUSION

The fact that PBF values returned to initial levels within one month of the initiation of retraction despite short-term, hyperaemic, regressive changes demonstrates that the changes observed in PBF during canine retraction are reversible.

Aspartate aminotransferase activity in the pulp of teeth treated for 6 months with fixed orthodontic appliances

Objective

To measure aspartate aminotransferase (AST) activity in the pulp of teeth treated with fixed appliances for 6 months, and compare it with AST activity measured in untreated teeth.

Methods

The study sample consisted of 16 healthy subjects (mean age 25.7 ± 4.3 years) who required the extraction of maxillary premolars for orthodontic reasons. Of these, 6 individuals had a total of 11 sound teeth extracted without any orthodontic treatment (the control group), and 10 individuals had a total of 20 sound teeth extracted after 6 months of orthodontic alignment (the experimental group). Dental pulp samples were extracted from all control and experimental teeth, and the AST activity exhibited by these samples was determined spectrophotometrically at 20℃.

Results

Mean AST values were 25.29 × 10^-5 U/mg (standard deviation [SD] 9.95) in the control group and 27.54 × 10^-5 U/mg (SD 31.81) in the experimental group. The difference between these means was not statistically significantly (p = 0.778), and the distribution of the AST values was also similar in both groups.

Conclusions

No statistically significant increase in AST activity in the pulp of mechanically loaded teeth was detected after 6 months of orthodontic alignment, as compared to that of teeth extracted from individuals who had not undergone orthodontic treatment. This suggests that time-related regenerative processes occur in the dental pulp.

Crevicular Alkaline Phosphatase Activity and Rate of Tooth Movement of Female Orthodontic Subjects under Different Continuous Force Applications

Purpose. This study is aimed to compare the effects of two different orthodontic forces on crevicular alkaline phosphatase activity, rate of tooth movement, and root resorption. Materials and Methods. Twelve female subjects of class II division 1 malocclusion participated. Maxillary canines with bonded fixed appliances acted as the tested teeth, while their antagonists with no appliances acted as the controls. Canine retraction was performed using nickel titanium coil spring that delivered forces of 100 gm or 150 gm to either side. Crevicular fluid was analyzed for ALP activity, and study models were casted to measure tooth movements. Root resorption was assessed using periapical radiographs before and after the force application. Results. ALP activity at the mesial sites peaked at week 1 for 150 gm group with significant differences when compared with the 100 gm group. Cumulative canine movements were significantly greater in the 150 gm force (2.10 ± 0.50 mm) than in the 100 gm force (1.57 ± 0.44 mm). No root resorption was in the maxillary canines after retraction. Conclusions. A force of 150 gm produced faster tooth movements and higher ALP activity compared with the 100 gm group and had no detrimental effects such as root resorption.

Proteomic analysis of saliva identifies potential biomarkers for orthodontic tooth movement

Orthodontic treatment has been shown to induce inflammation, followed by bone remodelling in the periodontium. These processes trigger the secretion of various proteins and enzymes into the saliva. This study aims to identify salivary proteins that change in expression during orthodontic tooth movement. These differentially expressed proteins can potentially serve as protein biomarkers for the monitoring of orthodontic treatment and tooth movement. Whole saliva from three healthy female subjects were collected before force application using fixed appliance and at 14 days after 0.014'' Niti wire was applied. Salivary proteins were resolved using two-dimensional gel electrophoresis (2DE) over a pH range of 3-10, and the resulting proteome profiles were compared. Differentially expressed protein spots were then identified by MALDI-TOF/TOF tandem mass spectrometry. Nine proteins were found to be differentially expressed; however, only eight were identified by MALDI-TOF/TOF. Four of these proteins-Protein S100-A9, immunoglobulin J chain, Ig alpha-1 chain C region, and CRISP-3-have known roles in inflammation and bone resorption.

Molecular markers of dental pulp tissue during orthodontic tooth movement: a pilot study

Three specific orthodontic tooth movement genes, that is, FCRL1, HSPG2, and LAMB2 were detected at upper first premolar (with appliance) dental pulp tissue by using GeneFishing technique as compared to lower first premolar (without appliance). These three differentially expressed genes have the potential as molecular markers during orthodontic tooth movement by looking at molecular changes of pulp tissue.

Cellular and molecular changes in orthodontic tooth movement

Tooth movement induced by orthodontic treatment can cause sequential reactions involving the periodontal tissue and alveolar bone, resulting in the release of numerous substances from the dental tissues and surrounding structures. To better understand the biological processes involved in orthodontic treatment, improve treatment, and reduce adverse side effects, several of these substances have been proposed as biomarkers. Potential biological markers can be collected from different tissue samples, and suitable sampling is important to accurately reflect biological processes. This paper covers the tissue changes that are involved during orthodontic tooth movement such as at compression region (involving osteoblasts), tension region (involving osteoclasts), dental root, and pulp tissues. Besides, the involvement of stem cells and their development towards osteoblasts and osteoclasts during orthodontic treatment have also been explained. Several possible biomarkers representing these biological changes during specific phenomenon, that is, bone remodelling (formation and resorption), inflammation, and root resorption have also been proposed. The knowledge of these biomarkers could be used in accelerating orthodontic treatment.

Change in dental pulp parameters in response to different modes of orthodontic force application

OBJECTIVES

(1) To evaluate dental pulp sensitivity by electrical pulp testing and measure aspartate aminotransferase activity in the pulp after 14 days of orthodontic intrusion, and (2) to compare those measurements with measurements obtained in teeth after 7 days of intrusion and 7 days of rest.

MATERIALS AND METHODS

The study sample included 13 subjects (mean age = 16.5 +/- 2.7 years). For every subject, before extraction, two contralateral premolars were included in a spring and loaded by a force. Two study groups were formed: Group A, teeth with 14 days of mechanical load, and Group B, teeth with 7 days of mechanical load plus 7 days of rest. Electrical pulp testing and aspartate aminotransferase activity measurements were performed after 14 days in all tested teeth. After extraction, aspartate aminotransferase activity in the pulp was determined spectrophotometrically at 20 degrees C.

RESULTS

Mean aspartate aminotransferase activity values were 0.21 U/mg (SD = 0.15) in Group A and 0.27 U/mg (SD = 0.17) in Group B. Mean electrical pulp testing readings were 38.92 microA (SD = 24.61) in Group A and 36.77 microA (SD = 26.84) in Group B. Mean values of the intrusive force magnitude did not differ in both groups.

CONCLUSIONS

Different durations of orthodontic intrusion, defined as 14 days of load and 7 days of load followed by 7 resting days, were not reflected by electrical pulp testing or by aspartate aminotransferase activity levels in the pulp of the affected teeth. However, the response threshold to electrical pulp stimulation was elevated in all tested teeth.