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Cytokine levels in gingival crevicular fluid during orthodontic treatment with aligners compared to conventional labial fixed appliances: a 3-week clinical study
Abstract
Objective: To test the hypothesis that the levels of IL-1ß and TNF-α increased more and IL-1α, IL-2, IL-6, IL-8 increased less, after 3 weeks of treatment with conventional labial fixed appliance and with aligners.
Material and methods: Forty patients who were treated either with labial brackets (n = 20) or aligners (n = 20). Gingival crevicular fluid (GCF) samples were collected at baseline and after 21 days. Cytokine levels were evaluated by enzyme-linked immune sorbent assay (ELISA). Plaque index (PI), gingival index (GI), and bleeding on probing (POB) were also examined.
Results: The levels of IL-1α, IL-1ß, IL-2, IL-6, IL-8 and TNF-α in the GCF were significantly increased in both groups. The levels of IL-2, IL-6, IL-8 increased more in patients treated with aligners compared to those treated by labial fixed appliances. There was a statistically significant difference in change of the mean cytokine levels of IL-1α, IL-2, IL-6, IL-8 and TNF-α compared to labial fixed appliances and aligners.
Conclusions: The levels of the six studied cytokines in GCF (IL-1α, IL-1ß, IL-2, IL-6, IL-8 and TNF-α) increased after 3 weeks both after treatment with conventional labial fixed appliance and with aligners. IL-1ß and TNF-α showed a prominent increase compared to the other cytokines in the GCF of teeth by both the labial fixed appliance and aligners. However, there were only minor differences in the changes of the cytokine levels from baseline to 3 weeks between the two groups. There were no differences between the groups regarding PI, GI or POB.
... in the remodeling of the periodontium complex, which is required for the movement of the teeth. [1,3,6,11,12] A considerate understanding of the interactions and substantial changes in the secretion of these molecules is of utmost importance to decipher the factors affecting the bone formation during treatment and the investigations so far are attempting to apprehend the key molecules and the complex signalling pathways accountable for remodelling of the bone tissue for a ...
... [3,6,13,14] Due to the orthodontic treatment with different appliances, a variety of growth factors and chemokines are contemporary and continuously secreted in the saliva, which further contribute as molecular cues for the formation of the bone. [2,3,6,11,15,16] Relating the growth factor and chemokine levels within various appliances used for orthodontic treatments has delivered a valued information to advance and constantly invent and develop innovative designed orthodontic appliances keeping in mind the health of periodontium and aesthetics as well as there is growing demand for it. [2,8,10,17] In the present comparative analysis, we are making an effort to observe the growth factors and chemokines in the saliva of the subjects treated with two different approaches of orthodontic appliances. ...
... Orthodontic appliances are implicated many times on the onset and development of the periodontal diseases. [11,13,19,20] Observing these regulatory molecules will likely to give rise to a crucial data for the future of the novel orthodontic appliances. ...
Background:
Orthodontic appliances elicit the secretions of some cytokines, chemokines, and growth factors which further have some significances in the remodeling of periodontium tissues. The significant differential forces applied on the periodontium by different types of orthodontic appliances. The secretion of these factors is indirectly responsible for the proper resorption of bones of the periodontal region through molecular signaling, which further supports to facilitate organized movement of the teeth. Objective: In the present study, we carried out the assessment and comparative analysis of the growth factors and chemokines present in the saliva samples of the human subjects of orthodontic treatment with two different treatment modalities: conventional lingual and labial fixed orthodontic appliances.
Materials and methods:
Total 40 saliva samples were collected of which 20 subjects were treated with the conventional lingual appliances and 20 subjects with the labial fixed appliances. All the salivary samples were acquired from the subjects after 21 days treatment. Cytometric bead array was performed to assess the growth factors and chemokines in the saliva on the flow cytometer.
Results:
No significant differences were seen in the growth factor secretion in the saliva of both types of subjects. The same trend was observed for the chemokine secretion in the saliva except CXCL8, CCL11, CCL2, CCL5, and CXCL9.
Conclusion:
The similarity in chemokine and growth factor profile between labial and lingual fixed orthodontic appliances indicates that their molecular mechanisms and overall effect on the periodontium are analogous.
... [1][2][3] Because bone metabolism is the prime factor for tooth movement, recent studies have focused on delineating the molecular factors responsible for bone remodeling during orthodontic treatment. [2][3][4][5][6][7][8][9] Cytokines levels in the gingival crevicular fluid (GCF) are used as biochemical markers for bone metabolism during orthodontic treatment. Comparison of the cytokine levels between different orthodontic appliances has provided vital information on the differential effect induced on bone metabolism by varying the appliance design. ...
... Comparison of the cytokine levels between different orthodontic appliances has provided vital information on the differential effect induced on bone metabolism by varying the appliance design. [5,8] The demand for aesthetic in orthodontic treatments has led to the increasing use of lingual appliances. Unlike labial fixed appliance and aligners, not much information is available on the bone metabolism markers involved in the lingual fixed appliance. ...
... The sample site was standardized for all subjects to the proximal region of either of the maxillary canines. [5][6][7][8][9][10] Contamination at the sampling site was prevented by isolating the area with sterile gauze. A microcapillary pipette (Sigma-Aldrich, Inc., St. Louis, Missouri, United States) was placed at the gingival sulcus entrance to collect the GCF [ Figures 1 and 2]. ...
Objectives: The applied orthodontic force causes remodeling of the periodontium
through the selective release of cytokines causing resorption of bone, enabling
controlled movement of the tooth. This study compared the cytokine profile
between patients treated with conventional labial and lingual fixed orthodontic
appliances. Patients and Methods: The study included 80 patients in need of
orthodontic treatment, out of which 40 patients were treated by the labial fixed
appliance and 40 by the lingual fixed appliance. Gingival crevicular fluid (GCF)
specimens were gathered from both the groups using a microcapillary pipette.
The samples were collected at the beginning of the treatment and after 21 days.
Enzyme‑linked immunosorbent assay was performed to evaluate the cytokine levels.
Results: Interleukin (IL)‑1α, 1β, 2, 8, and tumor necrosis factor‑alpha (TNF‑α)
levels were significantly high (P < 0.001) in GCF of participants treated with
conventional labial fixed appliance. IL‑1α, 1β, 2, 6, 8, and TNF‑α levels were
significantly high (P < 0.001) in GCF of participants treated by the lingual fixed
appliance. The concentrations of TNF‑α and IL‑1β were increased higher than
other cytokines in both the treatment groups. Conclusion: Overall, the lingual
fixed appliance had higher cytokine levels than a labial fixed appliance. Analyzing
the GCF cytokine levels during orthodontic treatment could provide an ideal
platform for monitoring the progress of the treatment.
... Giannopoulou et al. (2008) reported an increase in the level of interleukin-8 during orthodontic tooth movement (12). Gujar et al. (2019) showed that the levels of cytokines (IL-1α, IL-1ß, IL-2, IL-6, IL-8, and TNF-α) increased in the GCF three weeks after conventional treatment with labial fixed appliance (13). Biological understanding of cytokines as a response to forces applied to orthodontic tooth movement is difficult due to complexity and variety of these cytokines (8). ...
... Giannopoulou et al. (2008) reported an increase in the level of interleukin-8 during orthodontic tooth movement (12). Gujar et al. (2019) showed that the levels of cytokines (IL-1α, IL-1ß, IL-2, IL-6, IL-8, and TNF-α) increased in the GCF three weeks after conventional treatment with labial fixed appliance (13). Biological understanding of cytokines as a response to forces applied to orthodontic tooth movement is difficult due to complexity and variety of these cytokines (8). ...
Background: Orthodontic tooth movement causes the release of various biomolecules such as interleukins. The aim of this study was to compare IL-8 expression in gingival crevicular fluid during early alignment stage of orthodontic treatment in adults and adolescents. Methods: The present study was done on 20 orthodontic patients, including 10 adolescents and 10 adults. Before bonding, gingival crevicular fluid (GCF) was collected with a paper strip in gingival sulcus of maxillary right central incisor on the distolabial aspect for 60 seconds, followed by bonding and insertion of initial 14 NiTi arch wire. GCF collection was repeated 24 hours, 7 days, and 28 days after bonding. The IL-8 levels was measured by the enzyme-linked immunosorbent assay (ELISA). Data were analyzed by SPSS version 21 using repeated measurement test. Statistically significant level was considered at P = 0.05. Results: In the present study, 14 patients (70%) were female and the rest were male. The mean age of the patients was 19.11 ± 6.23 years. The level of IL-8 at the baseline was higher than the other time periods, and on the first day after treatment, significantly decreased compared to the baseline. There was no statistically significant difference between age groups <19 years and ≥19, and also, gender in different time periods in terms of IL-8 level. Conclusion: The results of the present study revealed that the level of IL-8 significantly decreased on the first day of orthodontic treatment, and then, increased. There was no statistically significant difference between gender and age and IL-8 levels during treatment. Further studies with larger sample sizes and different treatment methods are recommended. © 2021, Kerman University of Medical Sciences. All rights reserved.
... At the same time, salivary levels of IL-17A showed a decrease from early to late phase and a further decrease in the log phase. A comparison of vitamin D3 levels between genders showed no significant differences, contrary to some previous studies potentially influenced by demographic variations [91]. The descriptive-analytical study by Marzieh Karimi-Afshar et al. investigates the dynamics of IL-8 levels in GCF during OT. ...
Aim: Cytokines are crucial low-molecular-weight proteins involved in immune responses. This systematic review highlights the need for in-depth studies on cytokines’ biological mechanisms, providing insights into disease onset and potential therapeutic strategies. Materials and methods: A comprehensive literature search identified 18 relevant articles, emphasizing the multifaceted role of cytokines in orthodontic treatment (OT). The quality assessment using the ROBINS-I tool ensures a rigorous evaluation of the included studies, contributing to the overall reliability of the findings. Results and Conclusions: This systematic review explores the intricate relationship between cytokines and OT. Cytokines exhibit different properties, influencing cellular activities through autocrine, paracrine, and endocrine activities. OT, aimed at achieving stable occlusion, induces tension and compression in the periodontal ligament (PDL), triggering cytokine release. Proinflammatory cytokines play a role in inflammation, influencing bone and soft tissue metabolism. Studies show elevated cytokine levels in gingival crevicular fluid (GCF) after orthodontic force application. The choice of orthodontic devices, such as self-ligating brackets, influences cytokine concentrations, indicating the importance of attachment design. Further research promises to enhance orthodontic practices, and optimize patient care.
... Despite this initial similarity, a noticeable temporal increase in NTx levels was observed in both groups within the 4-week timeframe. This observed phenomenon of NTx resorption is attributed to the distinctive amino acid sequences and organizational characteristics of the cross-linked alpha-2 N-telopeptide [29]. This finding is consistent with the outcomes of a study conducted by Alfaqeeh et al., further supporting the notion that NTx levels undergo a temporal increase, possibly reflecting the dynamic and responsive nature of bone remodeling processes in response to various stimuli or interventions. ...
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.
... This study also found some differences between aligners and brackets, but no clear tendency was found: some parameters, particularly interleukin (IL)-1a, IL-2, IL-6, and IL-8, were higher in aligner patients, whereas others like TNF-a and RANKL were increased in bracket patients [38]. Another study also reported an increase in several inflammatory markers in the gingival crevicular fluid of orthodontic patients after three weeks of treatment, with no difference between aligners and fixed appliances [39]. Some differences between our study and the literature data could be explained by different biological materials and time points after the therapy. ...
The transient worsening of oral health sometimes accompanies orthodontic treatment (OT), and the extent of this effect might depend on whether the patients are treated with traditional brackets or clear aligners. Saliva is an important tool for monitoring oral health and influences the functional properties of various oral cells. This study aimed to compare the effects of saliva from patients undergoing OT with Invisalign aligners and brackets on human gingival fibroblasts and oral epithelial cells in vitro. Unstimulated saliva was collected from 15 patients treated with Invisalign and 16 patients treated with brackets before and 3 and 6 months after therapy began. The saliva was used to stimulate primary human gingival fibroblasts and the oral epithelial Ca9-22 cell line, and the resulting cell response was investigated. Saliva did not exhibit any toxic effect on investigated cells, as shown by the proliferation/viability assay with the MTT method. In human gingival fibroblasts, saliva increased gene expression of various proinflammatory mediators, such as interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1, assessed by qPCR. In epithelial cells, saliva increased the production of IL-8 measured by ELISA and decreased gene expression of various proteins involved in the barrier function. During the therapy, the saliva-induced production of IL-8 tended to be decreased, and the saliva-induced decrease in the expression of barrier protein was partially improved. No difference between aligners and brackets was observed in either cell type. Saliva affects the functional properties of oral cells, but this effect is not influenced by the type of OT.
... 15,16 Selection of the sample site was done based on convenience and continued till the completion of the study. 17 The test area was isolated using sterile gauze to prevent saliva contamination. A microcapillary pipette was used for the collection of GCF (Figure 3). ...
Objective
To evaluate the effects of an electric toothbrush with vibrational frequencies of 125 Hz and 150 Hz on the orthodontic tooth movement (OTM) rate and the production of prostaglandin E2 (PGE2).
Methods
Out of thirty patients (aged 18–25 years; 16 females and 14 males), ten patients each formed Group A and B, who used electric toothbrushes with 125 Hz and 150 Hz vibrations, respectively. The remaining ten patients (Group C) served as the control group and did not use electric toothbrushes. The rate of OTM and levels of PGE2 using microcapillary pipettes were calculated before the start of retraction (T0), on the 30th day (T1), on the 60th day (T2), and on the 90th day (T3) from the start of retraction in all the groups.
Results
There was a statistically significant difference in the mean OTM values and PGE2 levels in all three groups at different time intervals, with the maximum difference seen in Group B compared to Group A and least in Group C at T1, T2 and T3.
Conclusions
The rate of OTM and levels of PGE2 were highest in patients who used an electric toothbrush with 150 Hz mechanical vibration compared to those who used an electric toothbrush with 125 Hz mechanical vibration and least in patients who did not use an electric toothbrush. Mechanical vibration led to an increase in the PGE2 levels and accelerated the OTM.
... Improving the quality, speed, and stability of orthodontic tooth movement is crucial for practical medicine. It is well known that pro-and anti-inflammatory cytokines are involved in the regulation of differentiation and activation of osteoclasts and osteoblasts, which ensures the maintenance of bone homeostasis, especially in response to aggressive external agents [23][24][25][26][27]. Moreover, the expression of inflammatory cytokines plays a crucial role in orthodontic movement, as they increase the safety of fixation systems with sustainable suspension [18,28]. ...
... Improving the quality, speed, and stability of orthodontic tooth movement is crucial for practical medicine. It is well known that pro-and anti-inflammatory cytokines are involved in the regulation of differentiation and activation of osteoclasts and osteoblasts, which ensures the maintenance of bone homeostasis, especially in response to aggressive external agents [23][24][25][26][27]. Moreover, the expression of inflammatory cytokines plays a crucial role in orthodontic movement, as they increase the safety of fixation systems with sustainable suspension [18,28]. ...
Background and Objectives: Orthodontic tooth movement (OTM) requires bone remodeling resulting from complex processes of aseptic inflammation. Recent studies have confirmed close interaction between the immune and skeletal systems. In addition, various orthodontic appliances including fixed systems affect the sublingual microbial composition, and the likelihood of developing inflammatory reactions of the gums is high, especially early in the treatment period. It is known that these systems have both positive and negative effects on the humoral and cellular immune responses. The main aim of the study was to evaluate the influence of self-ligating and conventional brackets on the salivary concentrations of cytokines (IL-6, osteoprotegerin (OPG), TNF-alpha, and IFN-gamma) and cortisol as a marker of stress. Materials and Methods: Forty patients were analyzed at baseline (T0) and 2 months (T2) after fixing self-ligating (Ormco Damond Q) and conventional brackets (Ormco Mini Diamond). Salivary cytokine and cortisol concentrations were evaluated by commercial ELISA kits. Results: Outcomes of our study showed that after two months of treatment with either of these brackets, IFN-gamma and IL-6 levels did not change. However, TNF-alpha decreased with self-ligating brackets (13.36 to 8.32, p = 0.002). The self-ligating bracket system also affects OPG concentration and cortisol levels 2 months after orthodontic activation. The level of OPG in the group of self-ligating brackets decreased significantly (8.55 to 2.72, p = 0.003). Cortisol concentration was significantly higher in the self-ligation group (25.72 to 48.45, p = 0.001) due to the effect of sustained strength movements. Conclusions: Thus, the use of self-ligating and conventional brackets has a different effect on the concentration of cortisol and cytokines (OPG and TNF-alpha) in saliva 2 months after their fixation. Further longitudinal studies are necessary to explore why OPG levels are decreased in case of self-ligating cases and how OPG levels are related to clinical improvement.
... From the initial 145 potential articles, finally only 12 (4,5,(8)(9)(10)(11)(20)(21)(22)(23)(24)(25) studies met the eligibility criteria. Four articles were excluded after the full text evaluation (26)(27)(28)(29), reasons are reported in Fig. 1. ...
Background:
The aim was to assess periodontal health maintenance and gingival recessions development in patients undergoing an orthodontic treatment with clear aligners (CA) and fixed appliances (FA).
Material and methods:
An electronic search in MEDLINE, Scopus, The Cochrane Library, and Web of Science was performed up to September 2022 to identify all potential articles. Two investigators independently selected the studies according to the inclusion criteria. Prospective and retrospective studies assessing the periodontal health status and gingival recession development during the orthodontic treatment with buccal FA and CA were included. Case series, cross-sectional studies, and studies with less than two months of follow-up were excluded. Two investigators independently extracted the data from included articles and assessed risk of bias across studies using the Cochrane Collaboration tool. Qualitative and quantitative analyses of the data were performed. Pairwise meta-analysis using a random-effects model were used to compare periodontal indices between FA and CA treatment in different follow-up periods.
Results:
From the 129 potential studies, finally 12 studies were included. Only 8 could be included in the quantitative analysis. CA seems to slightly maintain better periodontal health indices. Only plaque index in a mid-term follow-up (mean difference (MD): -0.99; 95%; Confidence interval (CI) [-1.94 to -0.03]; P=.04; I2=99%), and pocket probing depth at a long-term follow-up (MD: -0.93mm; 95% CI [-1.16 to 0.7]; P<0.0001) reported statistically significant results favoring CA.
Conclusions:
Up to the date there is not enough evidence to conclude that CA maintains better periodontal health during an orthodontic treatment than FA.
... The GI in this study at 1 month was not statistically sig-g g nificantly different from that at baseline. This result agrees with those of Dannan et al 7 and Gujar et al, 14 who also showed no statistically significant change in GI up to 1 month after orthodontic treatment when investigating the OH of healthy patients without periodontitis. The fact that there was no statistically significant difference in GI between baseline and 1 month indicates that the levels of OH were well maintained in this group of treated and stabilised periodontitis patients undergoing orthodontic treatment. ...
Purpose:
This prospective cohort study aimed to 1) determine whether oral hygiene (OH) is a factor affecting orthodontic pain and 2) reveal whether orthodontic pain affects OH practice during orthodontic treatment.
Materials and methods:
35 adults aged 22-59 years with treated and stabilised periodontitis were recruited. The pre-bonding (baseline) and 1-month post-bonding OH as well as periodontal status were recorded. The experience, duration and maximum intensity of orthodontic pain within the first week after bonding were documented. In addition, the concentrations of cytokines in the gingival crevicular fluid (GCF) were recorded at baseline, 1 day and 1 week after bonding.
Results:
Patients who experienced orthodontic pain in the first week of orthodontic treatment had a higher baseline gingival index (GI) than patients who never experienced orthodontic pain (p < 0.05), and patients who experienced a longer duration and higher intensity of orthodontic pain in the first week of orthodontic treatment also had a higher baseline GI (p < 0.05). Patients who experienced orthodontic pain in the first week of orthodontic treatment had statistically significantly higher concentrations of interleukin 1β (IL-1β) in GCF at 1 day post bonding than those who never experienced pain, while baseline GI was positively associated with cytokine concentrations in GCF at 1 week post bonding (p < 0.05). In addition, neither the experience of orthodontic pain nor its duration and intensity were associated with the level of post-bonding OH (p > 0.05).
Conclusions:
The finding that increased gingival inflammation accounted for the longer duration and higher intensity of orthodontic pain in treated and stabilised periodontal patient shows that oral hygiene instructions and supportive periodontal care are of great importance prior to and during adjunctive orthodontic treatment in periodontally compromised individuals.
... Interestingly, the level of IL-8 was higher in patients treated with aligners compared to those treated by labial fixed appliances. 30 The relation between the orthodontic mechanical forces and collagen turnover is important in tooth movement. In this respect, previous studies have demonstrated that orthodontic forces increased DNA synthesis, collagen synthesis, and ALP activity. ...
Purpose
To compare the microbial flora, alkaline phosphatase (ALP) and interleukin-8 (IL-8) levels during orthodontic treatment with self-ligating brackets versus conventional brackets.
Patients and methods
Forty patients were included in this study and distributed equally between two groups. One group received conventional edgewise brackets while the other group received DAMON self-ligating brackets. Periodontal parameters were recorded and biochemical and microbial analyses were conducted before bonding (baseline), and 14, 30, and 45 days after bonding. Paired t-test was performed to estimate the intergroup differences from the baseline at the various time points; unpaired t-test was used for intragroup comparisons.
Results
A significantly higher prevalence of gram-negative as well as gram-positive microorganisms was found in the group with conventional brackets than that with self-ligating brackets. Alkaline phosphatase (ALP) activity and interleukin-8 (IL-8) levels were significantly higher in the gingival crevicular fluid of the group with conventional brackets than that with self-ligating brackets.
Conclusion
The conventional bracket-ligature technique exhibited an increase in IL-8 levels, ALP activity, and microbial colonization compared with that of the self-ligature technique. Accordingly, self-ligating brackets are recommended in orthodontic patients to improve periodontal health and minimize damage outcomes of periodontal tissue interventions.
... In order to discern the factors influencing bone formation during treatment, an approachable understanding of the interplay and modifications in the secretion of these proteins is of foremost relevance and the studies so far are seeking to understand the principal molecules and the complicated signal transduction pathways necessary for remodelling the periodontal bone tissues for efficacious orthodontic procedures [8,9]. A number of cytokines are concurrent and actively secreted in saliva due to orthodontic procedure with distinct appliances, which therefore attribute as molecular signals for bone regeneration and remodelling [3,6,10]. Linking the levels of salivary cytokines and defensins within different appliances used for orthodontic treatments has presented practical experience to pursue and continuously achieve greater novel engineered orthodontic appliances that take into account the health of periodontium and aesthetics as well, as there is increasing demand for this [2,[11][12][13]. ...
The secretions of certain cytokines, chemokines and growth factors are triggered by orthodontic appliances, which often affect the remodelling of periodontal tissues. Critical cumulative forces are applied by various types of orthodontic appliances to the periodontium. The secretion of such molecules is probably responsible, through molecular and cellular communications, for the optimal resorption of hard tissues in the periodontal setting, which therefore enables the coordination of multiple movements of tooth. This study assessed and compared a wide range of cytokines, cellular marker analysis and defensins present in the saliva samples of human subjected to orthodontic treatment with two different treatment modalities, i.e., conventional lingual and labial fixed orthodontic appliances. A total 40 samples of saliva were obtained, of which 20 were treated with traditional lingual appliances and 20 were treated with labial fixed appliances. After 21 days of treatment, all salivary samples were collected from the subjects. In order to analyse a broad range of soluble cytokine levels in saliva by flow cytometry, a bead-based immunoassay was performed. Cell surface markers were analysed by flow cytometry. Protein levels of saliva for defensins were quantified by ELISA. Non-significant differences were observed in the cytokine levels in the saliva except for the significant effects for CCL2, IL-17A and IL-6. Cellular markers CD45 and CD326 showed high percentage in conventional lingual samples. Defensin levels were found to be lower in conventional lingual patients. Subjects with conventional lingual appliances had significantly higher salivary protein levels of IL-1β, CCL2, IL17A, and IL-6, higher CD45+ and CD326+ cells and lower defensin levels than subjects with fixed labial appliances. The current study provided a clear basis for the development of innovative methods to aid in the improvement of various procedural treatments and orthodontic equipment of next generation.
... IL-6 is active both in bone apposition and resorption processes. Therefore, it is a key factor in homeostasis and bone remodeling [4][5][6][7][8][9][10][11][12]. Ren et al. found that the interleukines IL-1β, IL-6, and IL-8 and the tumor necrosis factor (TNF-α) levels in gingival crevicular fluid were increased during orthodontic movement [13,14]. ...
Objective
To evaluate the effect of photobiomodulation (PBM) during the initial stage of orthodontic treatment, measuring levels of IL-6 in gingival crevicular fluid (GCF), and comparing to a control group of teeth.Materials and methodsForty-four first premolars were orthodontically treated with passive self-ligation Damon Q (Ormco, Orange, CA, USA) brackets and 0.014 CuNiTi archwires. Sides were randomly assigned to a non-irradiated control group and experimental group (n = 22) treated with 940 nm, 0.1 W, and 2 J for 20s/surface. Gingival crevicular fluid was obtained before treatment and 24 h after; a third sample was obtained immediately after a second laser irradiation. IL-6 concentration was measured by enzymatic immunoassay.ResultsThe basal concentration of IL-6 in the control group (3.194 ± 0.71 pg/μl) was higher than in the experimental group (2.923 ± 0.48 pg/μl) and was reduced 24 h after the initial archwire placement. In the experimental group of teeth, 24 h after and after the first laser application, the levels were lower. However, the values obtained following the second laser application, evaluating immediate effect, presented a mild increment. The difference between control and experimental groups after 24 h was significant.ConclusionPBM with 940 nm, 0.1 W, 4 J, 21.05 J/cm2, and 40 s per tooth is not able to produce statistically significant changes in the concentration of IL-6 in GCF, immediately or after 24 h of its application, during initial orthodontic treatment with light forces.
... IL1β is a key mediator, being involved both in the inflammation determined by orthodontic movements, and in various immune reactions. IL6 is a mediator of the bone remodeling, being in direct connection with the bone cells [12,[14][15][16]. ...
Background: The crevicular fluid analysis represents a useful diagnosis tool, with the help of which noninvasive cellular metabolic activity can be analyzed. The aim of the study is to investigate comparatively IL1β and IL6 in the gingival crevicular fluid of clinically healthy adolescents and young adults during the acute phase of orthodontic treatment. Methods: Gingival crevicular fluid was collected from 20 patients (aged between 11 and 28) undergoing orthodontic treatment. Measurements were taken before (T0) and after 24 h after distalization forces were activated (T1). IL1β and IL 6 were analyzed using Elisa tests. The statistical tests used were two-sided t tests. Results: Between the two time periods there was a significant raise both in the crevicular fluid rate (0.57 µL at T0 vs. 0.95 µL at T1, p = 0.001) and in IL1β levels (15.67 pg/µL at T0 vs. 27.94 pg/µL at T1, p = 0.009). We were able to identify IL6 only in a third of the sites. There is a significantly increased level of ILβ at T1 in adolescents, more than in young adults (42.96 pg/µL vs. 17.93 pg/µL, p = 0.006). Conclusions: In the early stage of orthodontic treatment, the periodontal tissues of adolescents are more responsive to orthodontic forces than those of young adults.
... Treatment with conventional labial fixed appliance and with aligners can affect GCF levels of inflammatory cytokines. Gujar et al. showed that GCF levels of IL-1α, IL-1ß, IL-2, IL-6, IL-8, and TNF-α increased after 3 weeks both after treatment with aligners and with conventional labial fixed appliance [126]. A surface sealant is a dental treatment proposed to inhibit tooth decay and enamel decalcifications in patients with fixed orthodontic appliances. ...
Pulpitis is known as a typical inflammation of dental pulp tissue, and microorganisms of the oral microbiome are involved in this opportunistic infection. Studies indicated that several factors related to host response have a crucial role in pulpitis. Among these factors, inflammatory mediators of the immune system such as cytokines and chemokines contribute to pulpal defense mechanisms. A wide range of cytokines have been observed in dental pulp and these small molecules are able to trigger inflammation and participate in immune cell trafficking, cell proliferation, inflammation, and tissue damage in pulp space. Therefore, the aim of this review was to describe the role of cytokines in the pathogenesis of pulpitis.
Objectives
To compare short-term changes in the levels of interleukin-8 (IL-8) and interleukin-6 (IL-6) in the gingival crevicular fluid (GCF) of individuals undergoing orthodontic treatment with clear aligners.
Materials and Methods
This study included 15 individuals. Each patient used clear aligners designed not to cause tooth movement in the GCF sampled teeth, to be changed every 10 days. GCF samples were collected from teeth 16 (upper right first molar) and 31 (lower left central incisor) at baseline and after the procedure at the first hour, third, seventh, 14th, and 21st days. In addition, clinical periodontal parameters for the full mouth and the teeth from which GCF was collected were recorded initially and on the 21st day.
Results
A statistically significant difference was observed between the levels of IL-8 before the procedure, on the third and seventh days, and on the 21st day (P < .01). The increase in IL-6 levels on the 14th and 21st days was significantly different compared to the levels before the procedure (P < .01). A positive correlation was detected between IL-8 and IL-6 levels at the first hour, a negative correlation on the third day, and a lower level of positive correlation on the seventh, 14th, and 21st days.
Conclusions
Within 21 days, the levels of IL-8 and IL-6 significantly increased in individuals undergoing orthodontic treatment with clear aligners. Within the limits of this study, the clear aligner material may affect the levels of IL-8 and IL-6 in the GCF.
Objective
Assess and evaluate the different indicators of oral health-related quality of life (OHRQoL) among patients treated with clear aligners (CAs) versus those treated with conventional fixed orthodontics (FAs).
Methods
An electronic search was performed on the database is Web of Science, Scopus, and Embase databases. Randomized and non-randomized control trials, cross-sectional, prospective cohort and retrospective trials were included. Quality was assessed with risk of bias tool and risk of bias in non-randomised studies. Meta-analyses were performed with random effects models, estimating the standardized and non-standardized mean differences, odds ratio and risk ratio as the measure of effect. The effect on time was determined using a meta-regression model.
Results
Thirty one articles were included in the qualitative synthesis and 17 in the meta-analysis. CAs had a significantly lower negative impact on QoL, with an “important” effect size, while the influence of time was not significant. Periodontal indicators plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing show significantly better values in patients treated with CAs, with moderate to large effect sizes. PI and GI have a significant tendency to improve over time. In microbiological indicators, CAs present a lower biofilm mass without differences in the percentage of patients with high counts of Streptococcus mutans and Lactobacilli bacteria. The risk of white spot lesion onset is ten times lower in carriers of CAs.
Conclusions
Patients wearing CAs show better periodontal indicators, less risk of white spot development, less biofilm mass and a better QoL than patients with FAs.
Objectives
Remodelling of alveolar bone in orthodontics is through optimal force application producing tissue reactions, thus releasing cytokines in gingival crevicular fluid (GCF). The present study compared the cytokine profile amid the treatments with lingual fixed appliances and the aligners.
Patients and Methods
80 participants with the requirement of orthodontic treatment were considered for the study. While 40 participants were treated with lingual fixed appliance, others were treated with the aligners. The gingival crevicular fluid specimens were collected pre-treatment and post 3 weeks of treatment from all the participants using a microcapillary pipette and subjected to enzyme-linked immunosorbent assay (ELISA) for cytokine profile assessment comprising of interleukins IL-1α, 1ß, 2, 6, 8 and tumor necrosis factor (TNF)-α.
Results
Paired t test expressed a significant (p < .001) augmentation of interleukins 1α, 1ß, 2, 6, 8 and tumour necrosis factor at baseline in the study groups. Independent sample t test displayed a statistically significant higher TNF-α, IL-1α and IL-1ß levels in GCF of teeth treated by lingual appliance than aligners (p=0.001).
Conclusion
Lingual fixed appliance showed higher cytokines levels than aligners.
Purpose:
To identify and assess differences in oral hygiene parameters in patients undergoing orthodontic treatment with clear aligners compared to fixed appliances.
Materials and methods:
Published and unpublished literature was searched in seven databases until May 31st 2021. Representative keywords included 'orthodontic aligner', 'fixed appliance', 'oral hygiene', 'plaque index', 'caries'. Study selection, data extraction, risk of bias and certainty of evidence assessment were undertaken independently by three reviewers. Random effects meta-analyses with respective confidence intervals (95% CI) were conducted, where applicable.
Results:
A total of 882 unique records were screened, with a final number of 21 articles being eligible for qualitative synthesis, while 4 of those contributed to meta-analyses. Risk of bias was rated within the range of low to high or serious overall, while certainty of evidence was low to very low according to GRADE. For periodontal parameters, adults undergoing aligner orthodontic treatment presented summary plaque scores 0.58 lower than those treated with fixed appliances, within the first 6 to 12 weeks (4 studies: mean difference: -0.58; 95%CI: -0.82, -0.34; p < 0.001; I2 squared: 71.3%), while no evidence of difference was recorded for inflammation indices. Microbiologic parameters such as presence of S. mutans and lactobacilli were more pronounced in patients with fixed appliances for the first 3 to 6 months (synthesised data from 2 studies).
Conclusions:
In the short-term after initiation of orthodontic treatment, patients treated with aligners and no additional attachments/adjuncts presented potentially higher levels of oral health overall. However, the evidence is supported by low to very low certainty.
PurposeThere is currently a lack of evidence pertaining to gingival crevicular fluid cytokine levels in patients treated with the pendulum appliance. This study aimed to compare changes in cytokine secretion levels in gingival crevicular fluid (GFC) between the aligner and pendulum appliance in patients undergoing molar distalization.MethodsGFC samples were collected from 28 participants with asymmetrical dental class II malocclusion who were undergoing molar distalization using aligners or pendulum appliances. An enzyme-linked immunosorbent assay was used to detect cytokine secretion levels during asymmetrical molar distalization for up to 14 days. Periodontal health indices and tooth movements were also assessed.ResultsNo significant difference was found for the distalization distance between the two appliances. The Silness and Loe Plaque Index and Lobene Modified Gingival Index increased in the pendulum group but not in the aligner group at 14 days. Interleukin-1β and tumor necrosis factor‑α were upregulated in both groups. In the pendulum group, receptor activator of nuclear factor kappa‑Β ligand and osteoprotegerin secretion levels were significantly upregulated and downregulated, respectively; smaller changes in these two cytokines were observed in the aligner group.Conclusions
Pendulum appliances exert stronger forces than aligners, which cause more changes in the secretion of inflammatory mediators in young patients.
Introduction:
The search for more aesthetic and comfortable orthodontic devices has led to an increase in the use of clear aligners.
Objective:
To increase knowledge on biological mechanisms of orthodontic tooth movement using Invisalign aligners.
Methods:
This study included 11 patients with a mean age of 23.6 ± 4.8 years. Cases planning included alignment and leveling of lower incisors using Invisalign aligners. Gingival crevicular fluid samples were collected from the lower incisors on the day of delivery of aligner number 1 (T0) and after 1 (T24h), 7 (T7d), and 21 (T21d) days. During the observation period of the study, the patients used only the aligner number 1. Levels of nine cytokines were quantified using Luminex's multi-analysis technology. Non-parametric tests were used for comparisons between cytokine expression levels over time.
Results:
Cytokine expression levels remained constant after 21 days of orthodontic activation, except those of MIP-1β, which presented a statistical difference between T24h and T21d with a decrease in the concentration levels. IL-8, GM-CSF, IL-1β, MIP-1β, and TNF-α showed the highest concentrations over time.
Conclusions:
The different behavior in the levels of the investigated cytokines indicates a role of these biomarkers in the tissue remodeling induced by Invisalign.
Abstract:
Background: In both states of health and disease, the integrity of connective tissue along with regulation
in formation of bones are well maintained by periostin (POSTN) which is a matricellular protein secreted by
fibroblasts. The present study aimed to assess the gingival crevicular fluid (GCF) POSTN levels in patients
with chronic periodontitis (CP) and aggressive periodontitis and to compare them with that of healthy controls.
Materials and Methods: A total of 39 individuals were recruited and allocated into the healthy group, and two
periodontitis groups (the chronic and the aggressive types) (13 in each group). The samples of GCF fluid were
collected using microcapillary pipette. The POSTN levels were estimated using the enzyme‑linked immunosorbent
assay. Results: The mean levels of total POSTN in GCF fluid (in pg/μl) were 182.41, 79.87, and 49.28 for the
healthy, CP, aggressive periodontitis groups, respectively. There was a statistically significant difference between
the groups with P < 0.05. Furthermore, there were statistically significant differences when compared among the
groups with P < 0.05. When all three groups were examined together, there were negative correlations between
GCF POSTN levels and clinical parameters. Conclusion: The GCF POSTN levels reduced with an increase in
the severity of the periodontitis. With the present study results, we could conclude that the GCF POSTN level
can be considered as a dependable marker in periodontal disease diagnosis, disease activity, and healing.
Background:
Aim was to systematically search the literature and assess the available evidence regarding the clinical effectiveness of the Invisalign® system.
Methods:
Electronic database searches of published and unpublished literature were performed. The reference lists of all eligible articles were examined for additional studies. Reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Results:
Three RCTs, 8 prospective, and 11 retrospective studies were included. In general, the level of evidence was moderate and the risk of bias ranged from low to high, given the low risk of bias in included RCTs and the moderate (n = 13) or high (n = 6) risk of the other studies. The lack of standardized protocols and the high amount of clinical and methodological heterogeneity across the studies precluded a valid interpretation of the actual results through pooled estimates. However, there was substantial consistency among studies that the Invisalign® system is a viable alternative to conventional orthodontic therapy in the correction of mild to moderate malocclusions in non-growing patients that do not require extraction. Moreover, Invisalign® aligners can predictably level, tip, and derotate teeth (except for cuspids and premolars). On the other hand, limited efficacy was identified in arch expansion through bodily tooth movement, extraction space closure, corrections of occlusal contacts, and larger antero-posterior and vertical discrepancies.
Conclusions:
Although this review included a considerable number of studies, no clear clinical recommendations can be made, based on solid scientific evidence, apart from non-extraction treatment of mild to moderate malocclusions in non-growing patients. Results should be interpreted with caution due to the high heterogeneity.
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 10th 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.
Background
The aim of this study was to evaluate the predictability of F22 aligners (Sweden & Martina, Due Carrare, Italy) in guiding teeth into the positions planned using digital orthodontic setup.
Methods
Sixteen adult patients (6 males and 10 females, mean age 28 years 7 months) were selected, and a total of 345 teeth were analysed. Pre-treatment, ideal post-treatment—as planned on digital setup—and real post-treatment models were analysed using VAM software (Vectra, Canfield Scientific, Fairfield, NJ, USA). Prescribed and real rotation, mesiodistal tip and vestibulolingual tip were calculated for each tooth and, subsequently, analysed by tooth type (right and left upper and lower incisors, canines, premolars and molars) to identify the mean error and accuracy of each type of movement achieved with the aligner with respect to those planned using the setup.
Results
The mean predictability of movements achieved using F22 aligners was 73.6%. Mesiodistal tipping showed the most predictability, at 82.5% with respect to the ideal; this was followed by vestibulolingual tipping (72.9%) and finally rotation (66.8%). In particular, mesiodistal tip on the upper molars and lower premolars were achieved with the most predictability (93.4 and 96.7%, respectively), while rotation on the lower canines was the least efficaciously achieved (54.2%).
Conclusions
Without the use of auxiliaries, orthodontic aligners are unable to achieve programmed movement with 100% predictability. In particular, although tipping movements were efficaciously achieved, especially at the molars and premolars, rotation of the lower canines was an extremely unpredictable movement.
Gingival crevicular fluid (GCF) is a biological exudate and quantification of its constituents is a current method to identify specific biomarkers with reasonable sensitivity for several biological events. Studies are being performed to evaluate whether the GCF biomarkers in growing subjects reflect both the stages of individual skeletal maturation and the local tissue remodeling triggered by orthodontic force. Present evidence is still little regarding whether and which GCF biomarkers are correlated with the growth phase (mainly pubertal growth spurt), while huge investigations have been reported on several GCF biomarkers (for inflammation, tissue damage, bone deposition and resorption, and other biological processes) in relation to the orthodontic tooth movement. In spite of these investigations, the clinical applicability of the method is still limited with further data needed to reach a full diagnostic utility of specific GCF biomarkers in orthodontics. Future studies are warranted to elucidate the role of main GCF biomarkers and how they can be used to enhance functional treatment, optimize orthodontic force intensity, or prevent major tissue damage consequent to orthodontic treatment.
Objective:
To evaluate the expression of receptor activator of nuclear factor-kappa ligand (RANKL), osteoprotegerin (OPG), osteopontin (OPN), interleukin 1β (IL-1β), and transforming growth factor ß1 (TGF-ß1) in the gingival crevicular fluid (GCF) of teeth subjected to orthodontic forces released by aligners.
Materials and methods:
A total of 10 healthy, adult patients were selected to participate in this split-mouth study. The treatment plan was designed to obtain only one movement with the first aligner: distalization of a second molar. GCF samples were obtained from pressure and tension sites of the test tooth and from the mesiobuccal and distobuccal sites of the control tooth. The GCF sample volumes were measured using a Periotron 8000. Levels of TGF-β, IL-1β, RANKL, OPG, and OPN were measured by enzyme-linked immunosorbent assay.
Results:
IL-1β showed a significant increase at the pressure sites after 1 week and 3 weeks with respect to baseline (P < .05) compared with control sites. The kinetics of TGF-1β and OPN were characterized by a significant increase at the tension sites of the test teeth (P < .05) after 3 weeks from the application of orthodontic force. The RANKL level was significantly increased at pressure and tension sites after 1 hour and after 1 week from the application of the orthodontic forces (P = .023 and P = .043, respectively).
Conclusions:
An increased concentration of bone modeling and remodeling mediators at the pressure sites (IL-1β, RANKL) and tension sites (TGF-1β, OPN) was observed. These scenarios are compatible with previous in vivo and in vitro studies investigating the biological effects of orthodontic tooth movement.
Background
Advances in orthodontics are leading to the use of minimally invasive technologies, such as transparent removable aligners, and are able to meet high demands in terms of performance and esthetics. However, the most correct method of cleaning these appliances, in order to minimize the effects of microbial colonization, remains to be determined.
Purpose
The aim of the present study was to identify the most effective method of cleaning removable orthodontic aligners, analyzing the growth of dental plaque as observed under scanning electron microscopy.
Methods
Twelve subjects were selected for the study. All were free from caries and periodontal disease and were candidates for orthodontic therapy with invisible orthodontic aligners. The trial had a duration of 6 weeks, divided into three 2-week stages, during which three sets of aligners were used. In each stage, the subjects were asked to use a different method of cleaning their aligners: 1) running water (control condition); 2) effervescent tablets containing sodium carbonate and sulfate crystals followed by brushing with a toothbrush; and 3) brushing alone (with a toothbrush and toothpaste). At the end of each 2-week stage, the surfaces of the aligners were analyzed under scanning electron microscopy.
Results
The best results were obtained with brushing combined with the use of sodium carbonate and sulfate crystals; brushing alone gave slightly inferior results.
Conclusion
On the basis of previous literature results relating to devices in resin, studies evaluating the reliability of domestic ultrasonic baths for domestic use should be encouraged. At present, pending the availability of experimental evidence, it can be suggested that dental hygienists should strongly advise patients wearing orthodontic aligners to clean them using a combination of brushing and commercially available tablets for cleaning oral appliances.
Objectives: The aim of this study was to investigate the effect of orthodontic loading on the expression of interleukin-1α (IL-1α) and tumor necrosis factor-α (TNF-α) in compressed gingiva. Materials and Methods: Twenty-four male Wistar rats were used with four rats as controls at day 0. In ten rats, corticotomy was performed on either left or right side and the re-maining side was served as control, and killed at 7 and 14 days. In the remaining ten rats, maxillary right and left first molars were moved orthodontically with a constant force of 20 g; appliance and appliance in conjunction with cortictomy (appliance-corticotomy) were sequentially alternated between left and right sides and euthanized at 7 and 14 days. Real time polymerase chain reactions of compressed gingiva excised from the euthanized rats was performed to measure mRNA expressions of IL-1α and TNF-α. Results: There were no significant differences in the expression of IL-1α between all the groups. On the other hand, TNF-α from the pressure side in the ap- pliance group and the appliance in conjunction with corticotomy group showed significant increase on the 7th day compared to that of either control or corticotomy group. Conclusions: Orthodontic loading induced the elevation of TNF-α in compressed gingiva
The purpose of this study was to explore the microbiological and periodontal changes occurring in adolescents during 12 months of orthodontic therapy with removable aligners and with fixed appliances.
During the years 2012-2013, 50 teenagers aged 10-18 years with similar initial orthodontic conditions participated in this trial in a university clinic in northern Italy. After receiving professional oral hygiene and instructions on a standardized oral hygiene protocol, the adolescents were randomly assigned to either orthodontic treatment with traditional fixed brackets (n = 25) or to treatment with Invisalign® aligners (n = 25). Subgingival microbiological samples, probing depth (PD), plaque index (PI), and bleeding on probing (BOP) were obtained and documented from the mesiovestibular subgingival sulcus of the upper right first molar and left central incisor at the beginning of treatment and 3, 6, and 12 months later. Compliance with oral hygiene procedures, full mouth plaque score (FMPS), and full mouth bleeding score (FMBS) were assessed at the beginning of treatment and 12 months later. Two sample independent t-tests and the χ(2) test were used to study whether the indices of periodontal health differed in the teenagers due to the experimental conditions.
None of the patients was positive for the periodontal anaerobes analyzed. The PI, PD, BOP, FMPS, and FMBS scores were significantly lower and compliance with oral hygiene was significantly higher in the group treated with Invisalign® than in the group treated with fixed brackets.
Teenagers treated with removable appliances display better compliance with oral hygiene, less plaque, and fewer gingival inflammatory reactions than their peers with fixed appliances.
Orthodontic treatment is as popular as ever. Orthodontists frequently have long lists of people wanting treatment and the cost to the NHS in England was £258m in 2010-2011 (approximately 10% of the NHS annual spend on dentistry). It is important that clinicians and healthcare commissioners constantly question the contribution of interventions towards improving the health of the population. In this article, the authors outline some of the evidence for and against the claims that people with a malocclusion are at a disadvantage compared with those without a malocclusion and that orthodontic treatment has significant health benefits. The authors would like to point out that this is not a comprehensive and systematic review of the entire scientific literature. Rather the evidence is presented in order to stimulate discussion and debate.
Periodontitis is a chronic inflammatory condition of the periodontium involving interactions between bacterial products, numerous cell populations and inflammatory mediators. It is generally accepted that periodontitis is initiated by complex and diverse microbial biofilms which form on the teeth, i.e. dental plaque. Substances released from this biofilm such as lipopolysaccharides, antigens and other virulence factors, gain access to the gingival tissue and initiate an inflammatory and immune response, leading to the activation of host defence cells. As a result of cellular activation, inflammatory mediators, including cytokines, chemokines, arachidonic acid metabolites and proteolytic enzymes collectively contribute to tissue destruction and bone resorption. This review summarises recent studies on the pathogenesis of periodontitis, with the main focus on inflammatory mediators and their role in periodontal disease.
SUMMARY This randomized split-mouth study aimed to examine the levels of matrix metalloproteinases (MMPs) -1, -2, -3, -7, -8, -12, and -13 in the gingival crevicular fluid (GCF) at different time points during orthodontic tooth movement. A total of 16 healthy orthodontic subjects (7 females, 9 males; mean age, 17.7 years) who needed their first upper premolars extracted were enrolled. One randomly chosen maxillary canine was subjected to a distalizing force and was considered to be the test side. The contralateral canine, which was not subjected to any force but was included in the orthodontic appliance, was used as a control side. GCF sampling was performed at both the mesial (tension) and distal (pressure) test and control sites at baseline, immediately before applying the orthodontic appliance, and after 1 and 24 hours and 7, 14, and 21 days. A multiplexed bead immunoassay was used to analyse the GCF samples. The mean levels of the MMP-1, -2, -3, -7, -8, -12, and -13 were not significantly different between the test and control groups in each time showed. The comparisons between the tension and pressure sites were also not significantly different at each individual time. A few variations focused on MMP-1 and -3, but the expression of MMP-8 was higher than that of the other MMPs. MMPs are released in sufficient quantities such that tooth movement occurs but with no significant increase in GCF levels.
Objective:
To compare the periodontal status of adults treated with fixed buccal orthodontic appliances vs removable orthodontic aligners over 1 year of active therapy.
Materials and methods:
The study population consisted of 42 subjects; 22 treated with fixed buccal orthodontic appliances and 20 treated with removable aligners. Clinical indices recorded included: plaque index (PI), gingival index (GI), bleeding on probing (BOP), and probing pocket depth (PPD). Plaque samples were assessed for hydrolysis of N-benzoyl-DL-arginine-naphthylamide (BANA test). Indices and BANA scores were recorded before treatment and at 6 weeks, 6 months, and 12 months after initiation of orthodontic therapy.
Results:
After 6 weeks, only mean PPD was greater in the fixed buccal orthodontic appliance group. However, after 6 months, the fixed buccal orthodontic appliance group had significantly greater mean PI, PPD, and GI scores and was 5.739 times more likely to have a higher BANA score. After 12 months, the fixed buccal orthodontic appliance group continued to have greater mean PI, GI, and PPD, while a trend was noted for higher BANA scores and BOP.
Conclusions:
These results suggest treatment with fixed buccal orthodontic appliances is associated with decreased periodontal status and increased levels of periodontopathic bacteria when compared to treatment with removable aligners over the 12-month study duration.
It is important that all members of the dental team understand the reasons for undertaking orthodontic treatment and the principal treatment options that are available to the patient, says Jayne Harrison, Consultant Orthodontist at Liverpool University Dental Hospital.
Unlabelled:
This randomized split-mouth study was aimed at evaluating whether an orthodontic appliance per se or orthodontic tooth movement can induce detectable changes in gingival crevicular fluid (GCF) volume, and thus whether GCF volume is a predictable biomarker for tissue remodelling incident to orthodontic tooth movement.
Materials and methods:
Sixteen healthy orthodontic patients (7 females and 9 males; mean age, 17.7 years; range, 13-27 years) with the need for extraction of the first upper premolars were enrolled. One randomly chosen maxillary canine was subjected to a distalizing force by a 0.017 × 0.025 inch titanium-molybdenum alloy archwire and considered as the test tooth (TT). The contralateral canine, which was not subjected to any force but was included in an orthodontic appliance, was used as a control (CT). GCF sampling was performed at both mesial and distal sites of the CTs and TTs at baseline, immediately before applying the orthodontic appliance, and after 1 hour, 24 hours, and 7, 14, and 21 days. A Periotron was used to measure the GCF volume. A modest but significant increase in the GCF volume over time was seen in both the CTs (mesial sites) and the TTs (both mesial and distal sites) with no differences between the experimental teeth. Subclinical tissue inflammation consequent to the placement of the orthodontic appliance might be responsible for these GCF volume changes. The GCF volume does not appear to be a reliable biomarker for tissue remodelling during orthodontic treatment.
Prostaglandin E2 (PGE2) is involved in several chronic inflammatory diseases including periodontitis, which causes loss of the gingival tissue and alveolar bone supporting the teeth. We have previously shown that tumor necrosis factor alpha (TNFalpha) induces PGE2 synthesis in gingival fibroblasts. In this study we aimed to investigate the global gene expression profile of TNFalpha-stimulated primary human gingival fibroblasts, focusing on signal pathways related to the PGE2-synthesizing enzymes prostaglandin E synthases (PGES), as well as the upstream enzyme cyclooxygenase-2 (COX-2) and PGE2 production.
Microarray and western blot analyses showed that the mRNA and protein expression of the inflammatory induced microsomal prostaglandin E synthase-1 (mPGES-1) was up-regulated by the cytokine TNFalpha, accompanied by enhanced expression of COX-2 and increased production of PGE2. In contrast, the expression of the isoenzymes microsomal prostaglandin E synthase-2 (mPGES-2) and cytosolic prostaglandin E synthase (cPGES) was unaffected by TNFalpha treatment. Using oligonucleotide microarray analysis in a time-course factorial design including time points 1, 3 and 6 h, differentially expressed genes in response to TNFalpha treatment were identified. Enrichment analysis of microarray data indicated two positively regulated signal transduction pathways: c-Jun N-terminal kinase (JNK) and Nuclear Factor-kappaB (NF-kappaB). To evaluate their involvement in the regulation of mPGES-1 and COX-2 expression, we used specific inhibitors as well as phosphorylation analysis. Phosphorylation analysis of JNK (T183/Y185) and NF-kappaB p65 (S536) showed increased phosphorylation in response to TNFalpha treatment, which was decreased by specific inhibitors of JNK (SP600125) and NF-kappaB (Bay 11-7082, Ro 106-9920). Inhibitors of JNK and NF-kappaB also decreased the TNFalpha-stimulated up-regulation of mPGES-1 and COX-2 as well as PGE2 production.
In the global gene expression profile, the enrichment analysis of microarray data identified the two signal transduction pathways JNK and NF-kappaB as positively regulated by the cytokine TNFalpha. Inhibition of these TNFalpha-activated signal pathways reduced the expression of mPGES-1 and COX-2 as well as their end product PGE2 in gingival fibroblasts. The involvement of the signal pathways JNK and NF-kappaB in the regulation of PGE2 induced by TNFalpha may suggest these two pathways as possible attractive targets in the chronic inflammatory disease periodontitis.
The epidemiological data on the prevalence of malocclusion is an important determinant in planning appropriate levels of orthodontic services. The occurrence of occlusal anomalies varies between different countries, ethnic and age groups. The aim of this study was to describe the prevalence of malocclusion among Lithuanian schoolchildren in the 7-9-, 10-12-, and 13-15-year age groups assessing occlusal morphology. The study included 1681 schoolchildren aged 7-15 years. The crowding, spacing, overbite, overjet, the relationship of the first upper and lower molars according Angle's classification, and posterior crossbite were assessed. The study demonstrated that only 257 children had normal occlusion, and 44 had undergone orthodontic treatment among them. The greatest overjet in the studied contingent was 11 mm, and the negative overjet - 3 mm. The overbite ranged between 0 and 6 mm with a mean of 2.29+/-1.23 mm. Posterior crossbite was recorded in 148 children (8.8%). This study showed that the prevalence of malocclusion among 7-15-year-old Lithuanian schoolchildren is 84.6%. The most common malocclusion was dental crowding. The upper dental arch crowding was registered for 44.1% and lower for 40.3% of all schoolchildren. The class I molar relationship was detected in 68.4% of the subjects, class II - in 27.7%, and class III - in 2.8%.
The objective of this study was to describe the prevalence of malocclusion in a population of Central Anatolian adolescents in relation to gender.
The sample comprised 2329 teenagers (1125 boys and 1204 girls), aged between 12 and 17 years (mean age: 14.6 yrs). Occlusal anteroposterior relationships were assessed using the Angle classification. Other variables examined were overjet, overbite, crowding, midline diastema, posterior crossbite, and scissors bite.
The results showed that about 10.1% of the subjects had normal occlusions, 34.9% of the subjects had Class I malocclusions, 40.0% had Class II Division 1 malocclusions, 4.7% had Class II Division 2 malocclusions and 10.3% had Class III malocclusions. Over 53.5% had normal overbites, and 18.3%, 14.4%, 5.6%, and 8.2% had increased, reduced, edge-to-edge or anterior open bite values, respectively. Overjet relationship was normal in 58.9%, increased in 25.1%, reversed in 10.4%, and edge-to-edge in 5.6%. A posterior crossbite registered in 9.5% and scissors bite in 0.3%. Anterior crowding was present in 65.2% of the sample and midline diastema in 7.0%. No clear gender differences were noted, except for normal overbite (most frequent in girls, P<.001) and increased overbite (most frequent in boys, P<.05).
Class II Division 1 malocclusion is the most prevalent occlusal pattern among the Central Anatolian adolescents and the high values (25.1% and 18.3%) of increased overjet and overbite were a reflection of the high prevalence of Class II malocclusion.
This article reviews the evolution of concepts regarding the biological foundation of force-induced tooth movement. Nineteenth century hypotheses proposed two mechanisms: application of pressure and tension to the periodontal ligament (PDL), and bending of the alveolar bone. Histologic investigations in the early and middle years of the 20th century revealed that both phenomena actually occur concomitantly, and that cells, as well as extracellular components of the PDL and alveolar bone, participate in the response to applied mechanical forces, which ultimately results in remodeling activities. Experiments with isolated cells in culture demonstrated that shape distortion might lead to cellular activation, either by opening plasma membrane ion channels, or by crystallizing cytoskeletal filaments. Mechanical distortion of collagenous matrices, mineralized or non-mineralized, may, on the other hand, evoke the development of bioelectric phenomena (stress-generated potentials and streaming potentials) that are capable of stimulating cells by altering the electric charge on their membrane or their fluid envelope. In intact animals, mechanical perturbations on the order of about 1 min/d are apparently sufficient to cause profound osteogenic responses, perhaps due to matrix proteoglycan-related "strain memory". Enzymatically isolated human PDL cells respond biochemically to mechanical and chemical signals. The latter include endocrines, autocrines, and paracrines. Histochemical and immunohistochemical studies showed that during the early places of tooth movement, PDL fluids are shifted, and cells and matrix are distorted. Vasoactive neurotransmitters are released from periodontal nerve terminals, causing leukocytes to migrate out of adjacent capillaries. Cytokines and growth factors are secreted by these cells, stimulating PDL cells and alveolar bone lining cells to remodel their related matrices. This remodeling activity facilitates movement of teeth into areas in which bone had been resorbed. This emerging information suggests that in the living mammal, many cell types are involved in the biological response to applied mechanical stress to teeth, and thereby to bone. Essentially, cells of the nervous, immune, and endocrine systems become involved in the activation and response of PDL and alveolar bone cells to applied stresses. This fact implies that research in the area of the biological response to force application to teeth should be sufficiently broad to include explorations of possible associations between physical, cellular, and molecular phenomena. The goals of this investigative field should continue to expound on fundamental principles, particularly on extrapolating new findings to the clinical environment, where millions of patients are subjected annually to applications of mechanical forces to their teeth for long periods of time in an effort to improve their position in the oral cavity.(ABSTRACT TRUNCATED AT 400 WORDS)
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 10th 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. © 2018 Journal of International Society of Preventive and Community Dentistry | Published by Wolters Kluwer - Medknow.
Objectives:
The objective of this study was to perform a systematic review of the orthodontic literature with regard to efficiency, effectiveness and stability of treatment outcome with clear aligners compared with treatment with conventional brackets.
Methods:
An electronic search without time or language restrictions was undertaken in October 2014 in the following electronic databases: Google Scholar, the Cochrane Oral Health Group's Trials Register, Scopus, CENTRAL, MEDLINE via OVID, EMBASE via OVID and Web of Science. We also searched the reference lists of relevant articles. Quality assessment of the included articles was performed. Two authors were responsible for study selection, validity assessment and data extraction.
Results:
Four controlled clinical trials including a total of 252 participants satisfied the inclusion criteria. We grouped the trials into four main comparisons. One randomized controlled trial was classified as level 1B evidence, and three cohort studies were classified as level 2B evidence. Clear aligners appear to have a significant advantage with regard to chair time and treatment duration in mild-to-moderate cases based on several cross-sectional studies. No other differences in stability and occlusal characteristics after treatment were found between the two systems.
Conclusions:
Despite claims about the effectiveness of clear aligners, evidence is generally lacking. Shortened treatment duration and chair time in mild-to-moderate cases appear to be the only significant effectiveness of clear aligners over conventional systems that are supported by the current evidence.
Objective:
The aim of this prospective study was to compare the periodontal health and the microbiological changes via real-time polymerase chain reaction (PCR) in patients treated with fixed orthodontic appliances and Invisalign(®) system (Align Technology, Santa Clara, California).
Materials and methods:
Seventy-seven patients were enrolled in this study and divided into three groups (Invisalign(®) group, fixed orthodontic appliances group and control group). Plaque index, probing depth, bleeding on probing were assessed. Total biofilm mass and periodontal pathogens were analyzed and detected via real-time PCR. All these data were analyzed at the T0 (beginning of the treatment) T1 (1-month) and T2 (3 months); and statistically compared using the Mann-Whitney test for independent groups.
Results:
After 1-month and after 3 months of treatment there was only one sample with periodontopathic anaerobes found in patient treated using fixed orthodontic appliances. The Invisalign(®) group showed better results in terms of periodontal health and total biofilm mass compared to the fixed orthodontic appliance group. A statistical significant difference (P < 0.05) at the T2 in the total biofilm mass was found between the two groups.
Conclusion:
Patients undergoing orthodontic treatment with the Invisalign(®) System show a superior periodontal health in the short-term when compared to patients in treatment with fixed orthodontic appliances. Invisalign(®) should be considered as a first treatment option in patients with risk of developing periodontal disease.
This article reviews the evolution of concepts regarding the biological foundation of force-induced tooth movement. Nineteenth century hypotheses proposed two mechanisms: application of pressure and tension to the periodontal ligament (PDL), and bending of the alveolar bone. Histologic investigations in the early and middle years of the 20th century revealed that both phenomena actually occur concomitantly, and that cells, as well as extracellular components of the PDL and alveolar bone, participate in the response to applied mechanical forces, which ultimately results in remodeling activities.
Experiments with isolated cells in culture demonstrated that shape distortion might lead to cellular activation, either by opening plasma membrane ion channels, or by crystallizing cytoskeletal filaments. Mechanical distortion of collagenous matrices, mineralized or non-mineralized, may, on the other hand, evoke the development of bioelectric phenomena (stress-generated potentials and streaming potentials) that are capable of stimulating cells by altering the electric charge on their membrane or their fluid envelope. In intact animals, mechanical perturbations on the order of about 1 min/d are apparently sufficient to cause profound osteogenic responses, perhaps due to matrix proteoglycan-related "strain memory".
Enzymatically isolated human PDL cells respond biochemically to mechanical and chemical signals. The latter include endocrines, autocrines, and paracrines. Histochemical and immunohistochemical studies showed that during the early places of tooth movement, PDL fluids are shifted, and cells and matrix are distorted. Vasoactive neurotransmitters are released from periodontal nerve terminals, causing leukocytes to migrate out of adjacent capillaries. Cytokines and growth factors are secreted by these cells, stimulating PDL cells and alveolar bone lining cells to remodel their related matrices. This remodeling activity facilitates movement of teeth into areas in which bone had been resorbed.
This emerging information suggests that in the living mammal, many cell types are involved in the biological response to applied mechanical stress to teeth, and thereby to bone. Essentially, cells of the nervous, immune, and endocrine systems become involved in the activation and response of PDL and alveolar bone cells to applied stresses. This fact implies that research in the area of the biological response to force application to teeth should be sufficiently broad to include explorations of possible associations between physical, cellular, and molecular phenomena. The goals of this investigative field should continue to expound on fundamental principles, particularly on extrapolating new findings to the clinical environment, where millions of patients are subjected annually to applications of mechanical forces to their teeth for long periods of time in an effort to improve their position in the oral cavity. Recently developed research tools such as cell culture techniques and immunologic probes, are the best hope for enhancing this development.
Piezoelectric currents in mechanically stressed bone were implicated in the activation of bone cells. The objectives of this experiment were to determine the usefulness of exogenous electric currents in accelerating orthodontic tooth movement and to study the effect of electric-orthodontic treatment on periodontal cyclic nucleotides. Maxillary canines were tipped in five cats by 80 g force. Two groups of five cats each were treated by an electric-orthodontic procedure to one maxillary canine for 7 and 14 days, respectively. Teeth treated by force and electricity moved significantly faster than those treated by force alone. Enhanced bone resorption was observed near the anode (PDL compression site), while bone formation was pronounced near the cathode (PDL tension site). Staining for cyclic nucleotides was increased when electric stimulation was added to the mechanical force. These results suggest that orthodontic tooth movement may be accelerated by the use of locally applied electric currents.
Objective:
To examine levels of matrix metalloproteinases (MMPs)-1, -2, -3, -7, -8, -12, and -13 in the gingival crevicular fluid (GCF) of periodontally compromised teeth at different time points during orthodontic movement.
Materials and methods:
Ten controlled periodontitis subjects were submitted to orthodontic treatment. One dental arch was subjected to orthodontic movement, and teeth in the opposite arch were used as controls. GCF samples were collected from the lingual sites of two movement and two control incisors 1 week before orthodontic activation (-7 d), immediately after orthodontic activation, and after 1 hour, 24 hours, and 7, 14, and 21 days. Multiplexed bead immunoassay was used to measure MMPs in GCF. Data were analyzed using Friedman and Wilcoxon statistical tests.
Results:
The only significant change found over time was in the levels of MMP-1 in the movement group (P < .05). When the two groups were compared after activation, the only statistically significant difference found was in levels of MMP-12 24 hours after activation (P < .05).
Conclusions:
Our findings suggested that the orthodontic movement of periodontally compromised teeth without active pockets did not result in significant changes in the GCF levels of MMPs.
Salmonella bacteria are the major cause of food-borne infectious diarrhea. There is great interest in understanding the pathogenesis and immunogenesis of Salmonella infection. Cytokines are key communicator molecules between host cells and the enteric pathogen Salmonella. Serum levels of IL-1, IL-lra, IL-6, IL-10, IL-12, TNF-α and IFN-γ were studied in a prospective controlled study including 36 patients at the acute stage of gastrointestinal salmonellosis. Correlation between them was investigated, as well as between cytokines, body temperature and serum levels of Na+, K+ and Cl−. The lowest correlation was found between TNF-α and IL-1ra. A significant and directly proportional correlation was established between IL-12 with IFN-γand TNF-α, as well as in TNF-α/IL-1 β and IL-1β/IL-1ra. The increased body temperature correlated significantly with IL-1β, TNF-α and IL-6. Significant but converse was the correlation between Na+ with IL-1β and IL-6, as well as between body temperature with Na+, K+ and Cl−. Our data imply evidence for the complicated network in which cytokines act with multiple potential synergistic and antagonistic effects between them participating in the main pathogenetic processes—intoxication and loss of fluids and electrolytes.
Summary BACKGROUND : Clear aligner treatment (CAT) has been cited as a safe and comfortable orthodontic procedure for adult patients. However, the available evidence is scarce.
To perform a systematic review of the existing literature in order to assess periodontal health during CAT.
Pubmed, Pubmed Central, National Library of Medicine's Medline, Embase, Cochrane Central Register of Controlled Clinical trials, Web of Knowledge, Scopus, Google Scholar, and LILACS were searched from January 1945 to September 2014 to identify all peer-reviewed papers potentially relevant to the review.
After duplicate selection and extraction procedures, the risk of bias was assessed according to the Centre for Reviews and Dissemination criteria, and a 3-point grading system, as described by the Swedish Council on Technology Assessment in Health Care (SBU), was used to rate the methodological quality of the selected papers. A PICOS table was used for data extraction.
Five relevant articles were selected from the 1247 identified articles. The level of evidence was moderate for all the studies. A significant improvement of the periodontal health indexes was revealed, in particular when CAT was compared to fixed appliances. No periodontal CAT adverse effects were observed in the selected studies.
Periodontal health indexes were significantly improved during CAT. The results of this review should be interpreted with some caution because of the number, quality, and heterogeneity of the included studies.
© The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Abstract
Background: Gingival Crevicular Fluid (GCF) changes occur during orthodontic tooth movement and this could serve as a potential indicator to the response to active treatment.
Aim: The objective of the study is to assess the changes in the GCF volume and the levels of Alkaline Phosphatase (ALP) during early phase of tooth movement.
Methods: 20 patients requiring all first premolar extractions were selected and treated with conventional straight wire mechanotherapy. Canine retraction was done using Nitinol closed coil springs. Maxillary canine on one side acted as experimental site while the contralateral canine acted as control. GCF was collected from around the canines before initiation of retraction, 1 hour after initiating canine retraction, 1 day, 7 days, 14 days and 21 days. GCF volume and the ALP levels were estimated and compared with the control side.
Results: The results showed statistically significant changes in the GCF volume and ALP levels on the 7th, 14th and 21st days at the experimental sides. The peak in the activity occurred on the 14th day of initiation of retraction. The GCF volume and ALP levels did not show any significant variations at the control sites where no retraction was done.
Conclusions: It can be concluded that GCF volume and ALP levels may serve as an indicator to assess tooth movement dynamics in orthodontic therapy. Based on the available data and further studies, ALP levels in GCF may aid in developing a reliable non-invasive chair side test for assessing the prognosis and progress of orthodontic therapy.
Background:
The aim of this study was to evaluate lactoferrin quantification as a sensitive and objective method of detecting the degree of periodontal inflammation, oxidative stress and to monitor the effects of periodontal therapy.
Methods:
Fifty subjects were divided into two groups based on gingival index, probing pocket depth, clinical attachment loss and alveolar bone loss: healthy group and periodontitis group with generalized chronic periodontitis. Non-surgical periodontal therapy was rendered and crevicular fluid samples collected at baseline and four weeks after therapy for lactoferrin quantification using enzyme linked immunosorbent assay. The correlation between clinical parameters and lactoferrin levels was drawn and analysed for both groups.
Results:
The mean level of crevicular lactoferrin in the periodontitis group was 1857.21 ng/ml. The mean level decreased to 1415.03 ng/ml after treatment. The lowest lactoferrin concentration was seen in the healthy group (75.34 ng/ml). All clinical parameters correlated positively with lactoferrin levels.
Conclusions:
The lactoferrin level was higher in the periodontitis group compared to the healthy group, and reduced with periodontal therapy. Higher levels were associated with higher values of clinical parameters, both before and after therapy. The data indicates that Lactoferrin plays an important role in periodontal disease and crevicular lactoferrin quantification can be a marker for detecting periodontal inflammation, oxidative stress and monitoring periodontal therapy.
Sex steroids are central to sexual development and reproduction, exerting pleiotropic effects on multiple tissues and organs throughout the lifespan of humans. Sex steroids are fundamental to skeletal development, bone homeostasis and immune function. The composite effect of sex-specific genetic architecture and circulating levels of sex-steroid hormones closely parallels differences in the immune response and may account for corresponding sex-related differences in risk for chronic periodontitis, with men exhibiting greater susceptibility than women. Age-associated reductions in sex steroids also provide insight into apparent temporal increases in susceptibility to periodontitis and alveolar bone loss, particularly among women. Chronic infection and inflammatory conditions, such as periodontal disease, provide a unique platform for exploring the interface of sex steroids, immunity and bone metabolism.
The purpose of this study was to evaluate the effects of a light continuous force and an interrupted force with weekly reactivation on interleukin-1β (IL-1β) and prostaglandin E2 (PGE2); possible interactions between these 2 potent mediators of the bone resorption process were assessed in vivo. Ten healthy young adults (mean age 20.6 years, 2 men, 8 women) with 4 premolars extracted were assessed. In each subject, 1 maxillary canine (E1) received continuous force with a nickel-titanium coil spring. The opposite canine (E2) received an interrupted force with a screw-attached retractor; the force was reactivated weekly by 2 turns of the screw. An antagonistic canine was used as a control. Gingival crevicular fluid was collected from the distal side of each tooth, 10 times in 3 weeks, and IL-1β and PGE2 levels were measured. For E1, the IL-1β level showed a significant elevation at 24 hours and then decreased and maintained an insignificant but high mean concentration, compared with the control site. The PGE2 level showed a significant elevation at 24 hours and then decreased. For E2, a significant elevation of IL-1β level was observed at 24 hours and a greater significant elevation at 24 hours after the first reactivation, compared with the control sites. The PGE2 level increased significantly at 24 hours and remained high for 1 week. The synergistic up-regulation of PGE2 by appliance reactivation and secreted IL-1β was not evident with either type of force after 1 week. Both experimental sites showed significant tooth movement compared with the control sites at 3 weeks; however, there was no significant difference between the 2 experimental sites. A well-controlled mechanical stress with timely reactivation can effectively upregulate IL-1β secretion, but there might be limitations in increasing the mediator levels, because of the feedback mechanisms in vivo. In addition, the analysis of crevicular fluid is a useful method for assessing cellular response to orthodontic force in vivo.
The purpose of this study was to examine gingival crevicular fluid (GCF) levels of two potent bone resorbing mediators, prostaglandin E (PGE) and interleukin-1β (IL-1β), during human orthodontic tooth movement. The study included 10 patients, each having one treatment tooth undergoing orthodontic movement and a contralateral control tooth. The GCF was sampled at control sites and treatment (compression) sites before activation and at 1, 24, 48, and 168 hours. Prevention of plaque-induced inflammation allowed this study to focus on the dynamics of mechanically stimulated PGE and IL-1β GCF levels. The PGE and IL-1β levels were determined with radioimmunoassay. At 1 and 24 hours, mean GCF IL-1β levels were significantly elevated at treatment teeth (8.9±2.0 and 19.2±6.0 pg, respectively) compared with control teeth (2.0±1.1 pg, p=0.0049, and 2.9±1.0 pg, p=0.0209, respectively). The GCF levels of PGE for the treatment teeth were significantly higher at 24 and 48 hours (108.9±11.9 and 97.9±7.3 pg) than the control teeth (61.8±7.2 pg, p=0.0071, and 70.8±7.4 pg, p=0.0021, respectively). The GCF levels of PGE and IL-1β remained at baseline levels throughout the study for the control teeth, whereas significant elevations from baseline in GCF IL-1β (24 hours) and PGE levels (24 and 48 hours) were observed over time in the treatment teeth (p≤0.05). These results demonstrate that bone-reorbing PGE and IL-1β produced within the periodontium are detectable in GCF during the early phases of tooth movement and return to baseline within 7 days.
Interleukin-6 (IL-6) is thought to be a major mediator of the host's defense against infection, and it regulates immune responses in inflamed tissue. In this study, we investigated the regulation of IL-6 production in human gingival fibroblasts (HGF) and human periodontal ligament fibroblasts (HPLF). Pro-inflammatory cytokines including interleukin (IL)-lα, IL-1β and tumor necrosis factor (TNF)-α stimulated IL-6 production in HGF and HPLF in a time- and dose-dependent manner. This IL-lα, IL-lβ, or TNF-α-induced IL-6 production was enhanced, but the cAMP accumulation they induced was inhibited by the addition of indomethacin. This result suggests that endogenous prostaglandin E2 (PGE2) partially inhibits IL-l or TNF-α-induced IL-6 production, and that the enhancement of IL-6 production by IL-l or TNF-α may not be caused through endogenous PGE2-induced cAMP-dependent pathway. Dexamethasone (DEX), a glucocorticoid which is a inhibitor of nuclear factor kappa B (NF-kB) activation, markedly inhibited IL-l (α or β) or TNF-α-induced IL-6 production; so this production may be partially mediated through NF-kB. IL-l (α or β) and TNF-α enhanced IL-6 production synergistically. IL-6 production in HGF or HPLF stimulated with IL-lβ was augmented by the addition of interferon (IFN)-(gama), but was slightly suppressed by the addition of IL-4. Endogenous IL-6 enhanced IL-l (α or β)-induced IL-6 production in the presence of IL-6 soluble receptor (IL-6sR). Accordingly, in inflamed periodontal tissues, gingival fibroblasts and periodontal ligament fibroblasts stimulated with pro-inflammatory cytokines such as IL-l or TNF-α, may produce IL-6, and this production can be differentially modulated by endogenous PGE2, IL-6sR, T cell-derived cytokines such as IFN-(gama) or IL-4, and glucocorticoids.
Objectives:
To investigate differences in the gingival crevicular fluid (GCF) composition between adolescent and adult patients undergoing orthodontic treatment with fixed appliances.
Materials and methods:
Ten adolescents (14.4 ± 1.43) and 10 adults (28.5 ± 7.83) with Class I malocclusions and minor upper incisor crowding were allocated to two different age groups. Brackets were bonded only in the upper arch over the 20-week period of the experiment. Samples of GCF were collected from the labial sides of the upper incisors (experimental sites) and lower incisors (control sites) of each subject at five time points. Aliquots from diluted GCF were screened for the presence of receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), interleukin-1 (IL-1), interleukin-1 receptor antagonist (IL-1RA), and metalloproteinase-9 (MMP-9) using a microarray technique. The values were statistically analyzed.
Results:
In adults, the ratio of IL-1 to IL-1RA decreased significantly (P = .033) in experimental sites 3 weeks after appliance placement and first archwire activation. In adolescents, the ratio of RANKL to OPG peaked 6 weeks after the insertion of the first rectangular archwire. This ratio peak found in adolescents was a consequence of a decrease in the mean concentration of OPG. No significant changes over time were observed in the concentration of MMP-9.
Conclusion:
This study demonstrates age trends in the GCF levels of IL-1, IL-1RA, RANKL, and OPG that may be used to track differences in tissue response between adults and adolescents undergoing orthodontic treatment.
The aim of this study was to investigate the effects of interferon (IFN)-γ on experimental tooth movement in mice using a murine experimental tooth movement model. An Ni-Ti closed-coil spring was inserted between the upper-anterior alveolar bones and the upper-left first molars in mice. We evaluated the relationship between local Ifn-γ mRNA levels and orthodontic tooth movement. In other experiments, IFN-γ was injected adjacent to each first molar every other day during tooth movement. After 12 days, the amount of tooth movement was measured. Tartrate-resistant acid phosphatase (TRAP)-positive cells at the pressure side of each experimental tooth were counted as osteoclasts. Local Ifn-γ mRNA expression increased with orthodontic tooth movement. The number of TRAP-positive cells increased on the pressure side of the first molar. In contrast, the degree of tooth movement and the number of TRAP-positive cells on the pressure side in IFN-γ-injected mice were less than those of control mice. IFN-γ was induced in experimental tooth movement, and could inhibit mechanical force-loaded osteoclastogenesis and tooth movement. These results suggest that IFN-γ might be useful in controlling orthodontic tooth movement because of its inhibitory action on excessive osteoclastogenesis during this movement.
Some of the present observations may be summarized as follows: Contraction of fibrous structures after tooth movement must be considered a normal tissue reaction. After a tipping movement this contraction may produce compressed cell-free areas on the traction sides. The ensuing undermining bone resorption may increase the relapse tendency.The mechanics involved in a bodily movement tend to favor a direct bone resorption on the pressure side.Following rotation, tension and displacement of supra-alveolar structures may persist even after retention. Early treatment or overrotation may, to a large extent, prevent relapse tendencies.
Objectives:
To measure the levels of pentraxin-3 (PTX-3) in gingival crevicular fluid (GCF) in orthodontic young and adult patients in the first 2 weeks after the orthodontic appliance to determine whether those changes occur during orthodontic treatment and if those values could be the expression of an inflammatory state.
Materials and methods:
GCF samples were collected with paper strips from 16 orthodontic young patients and 13 orthodontic adult patients from an upper canine requiring distalization as a test tooth. A contralateral canine was used as a control tooth. The absorbed volume was eluted in 100 µL phosphate-buffered saline (pH = 7.2). PTX-3 levels in GCF were determined using a commercial enzyme-linked immunosorbent assay kit, and the results were expressed in ng/mL.
Results:
The results showed an increase of GCF levels of PTX-3 from 1 hour before the orthodontic appliance to a maximum at 24 hours, followed by a decrease in both groups of adult and young patients.
Conclusions:
The results suggest PTX-3 involvement in periodontal orthodontic remodeling and the aseptic inflammation induced by the orthodontic forces.
Recent evidences prove that, release of potent lysosomal enzymes e.g. beta-Glucuronidase by degranulation of polymorponuclear leukocytes in host gingiva may contribute significantly to tissue destruction and the pathogenesis of periodontal disease. The purpose of the present study was to compare and correlate GCF beta-Glucuronidase with periodontal status among diabetic and non-diabetic patients with chronic periodontitis. A total number of 75 patients were equally divided into Group I (control group), Group II (non diabetic with chronic periodontitis) and Group III (diabetic with chronic periodontitis). Clinical parameters like Plaque index, Gingival index, Probing Pocket Depth and RBS were recorded. The beta-Glucuronidase level in GCF of all three groups was determined by spectrophotometric analysis. It was observed that the periodontitis patients irrespective of their diabetic status, showed increased periodontal destruction with elevated level of beta-Glucuronidase than the controls. Also, the diabetic patients showed increased severity of periodontal destruction and the elevated level of beta-Glucuronidase, thus indicating diabetics at a higher risk for progressive periodontal destruction.
Orthodontic forces deform the extracellular matrix and activate cells of the paradental tissues, facilitating tooth movement. Discoveries in mechanobiology have illuminated sequential cellular and molecular events, such as signal generation and transduction, cytoskeletal re-organization, gene expression, differentiation, proliferation, synthesis and secretion of specific products, and apoptosis. Orthodontists work in a unique biological environment, wherein applied forces engender remodeling of both mineralized and non-mineralized paradental tissues, including the associated blood vessels and neural elements. This review aims at identifying events that affect the sequence, timing, and significance of factors that determine the nature of the biological response of each paradental tissue to orthodontic force. The results of this literature review emphasize the fact that mechanoresponses and inflammation are both essential for achieving tooth movement clinically. If both are working in concert, orthodontists might be able to accelerate or decelerate tooth movement by adding adjuvant methods, whether physical, chemical, or surgical.
To investigate genetic, biologic, and mechanical factors that affect speed of human tooth movement. Setting and Sample Population - Sixty-six maxillary canines in 33 subjects were translated distally for 84 days.
Distal compressive stresses of 4, 13, 26, 52, or 78 kPa were applied to maxillary canines via segmental mechanics. Dental casts and gingival crevicular fluid (GCF) samples were collected nine to 10 times/subject over 84 days at 1- to 14-day intervals. Three-dimensional tooth movements were measured using a microscope and each subject's series of dental casts. GCF samples were analyzed for total protein, interleukin-1beta (IL-1beta), and interleukin-1 receptor antagonist (IL-1RA). Cheek-wipe samples from 18 subjects were typed for IL-1 gene cluster polymorphisms.
Average speeds of distal translation were 0.028 +/- 0.012, 0.043 +/- 0.019, 0.057 +/- 0.024, 0.062 +/- 0.015, and 0.067 +/- 0.024 mm/day for 4, 13, 26, 52, and 78 kPa, respectively. Most teeth moved showed no lag phase (63/66). Three factors significantly affected speed (p = 0.0391) and provided the best predictive model (R(2) = 0.691): Activity index [AI = experimental (IL-1beta/IL-1RA)/control (IL-1beta/IL-1RA)], IL-1RA in GCF, and genotype at IL-1B.
Increased AI and decreased IL-1RA in GCF plus having > or =1 copy of allele 2 at IL-1B(+3954) were associated with faster tooth movement in humans.
Orthodontic tooth movement is induced by mechanical stimuli and facilitated by remodeling of the periodontal ligament (PDL) and alveolar bone. A precondition for these remodeling activities, and ultimately for tooth displacement, is the occurrence of an inflammatory process.
This review covers current knowledge regarding the role of the receptor activator of nuclear factor-kappa (RANK), receptor activator of nuclear factor-kappa ligand (RANKL), and osteoprotegerin (OPG) in periodontal tissue reactions, in response to orthodontic forces.
It has been found that concentrations of RANKL in GCF increased during orthodontic tooth movement, and the ratio of concentration of RANKL to that of OPG in the GCF was significantly higher than in control sites. In vivo studies have shown the presence of RANKL and RANK in periodontal tissues during experimental tooth movement of rat molars, and that PDL cells under mechanical stress may induce osteoclastogenesis through upregulation of RANKL expression during orthodontic tooth movement. Conclusions: Considering the importance of RANK, RANKL, and OPG in physiologic osteoclast formation, it is reasonable to propose that the RANKL/RANK/OPG system plays an important role in orthodontic tooth movement.
Traditional clinical variables of periodontal pathology have only limited value as indicators for future disease progression in patients with adult periodontitis. Consequently, other aspects of the periodontal lesion are being examined for their diagnostic utility. Analysis of the host response in gingival crevicular fluid (GCF) is among the most intensely studied of these new diagnostic approaches. Specific indicators of the humoral immune response, cellular immune response, and acute inflammatory response have been identified in GCF. The relationship of indicators of the humoral immune response to active periodontal disease is equivocal. Specific indicators of the cellular immune response in GCF may ultimately prove to be important diagnostically, but the relationship of any specific marker to active periodontal disease has not been reported. In contrast, the acute inflammatory response in GCF has been extensively studied and a number of factors appear to be associated with an increased risk for future disease progression. Indicators of enhanced polymorphonuclear leukocyte activity, (lysosomal beta-glucuronidase, lysosomal collagenase), prostaglandin E2, and an indicator of acute tissue destruction (the cytoplasmic enzymes aspartate aminotransferase) have been associated with the occurrence of clinical attachment loss. An example of the application of a GCF marker in a periodontitis clinical trial is provided by describing the relationship of lysosomal beta-glucuronidase in GCF at baseline and 2 weeks following root planing and scaling to the occurrence of disease activity during the following 6 months. Persistently elevated levels of this enzyme were related to clinical attachment loss. The positive, negative, and total predictive values for beta-glucuronidase as an identifier of clinical attachment loss were 86%, 71%, and 76%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
The aim of the present investigation was to evaluate the relationship between the receipt of orthodontic treatment and subsequent periodontal health. Data from 417 children who were classified at baseline as having significant occlusal variations and who were present at the follow-up examination 3 years later were selected from an original cohort of 1015. One hundred fourteen of these children received orthodontic treatment over this time period and provided two groups of children for comparison in this study. Plaque indices, bleeding indices, and degree of dental irregularity were recorded for each incisor and canine tooth. There were significant reductions in the plaque and gingivitis scores on all tooth surfaces between the baseline and 3-year examination in the two groups of children. The children who had received orthodontic treatment had the greater reduction, but this appeared to be more related to behavioral factors than to improved tooth alignment.
This article described research aimed at testing the hypothesis that tissue remodeling during orthodontic tooth movement is modulated, at least in part, by factors derived from the nervous and vascular (immune) systems.
Specifically, the neurotransmitters SP and VIP and the cytokines IL-1α and IL-1β were localized immunohistochemically in paradental tissues of cat canines that had been treated by the application of an 80 g tipping force for 1 hour to 14 days. Increased staining (concentrations) of these agents were found in areas of PDL tension and compression at different time periods. Moreover, administration of SP and IL-1β to human PDL fibroblasts in vitro for 1 to 60 minutes resulted in significant increases in the levels of the intracellular “second messenger” cAMP, as well as of PGE2, a plasma membrane-associated fatty acid believed to serve as a local regulator of bone cell activity.
Taken together, these results tend to support the hypothesis that neurotransmitters and cytokines play a regulatory role in orthodontic force-induced alveolar bone remodeling. Consequently, determination of the cytokine synthetic activity by leukocytes of orthodontic patients may inform about their alveolar bone remodeling potential.