A review of biomarkers in peri-miniscrew implant crevicular fluid (PMICF)

Abstract

BackgroundThe temporary anchorage devices (TADs) which include miniscrew implants (MSIs) have evolved as useful armamentarium in the management of severe malocclusions and assist in complex tooth movements. Although a multitude of factors is responsible for the primary and secondary stability of miniscrew implants, contemporary research highlights the importance of biological interface of MSI with bone and soft tissue in augmenting the success of implants.The inflammation and remodeling associated with MSI insertion or loading are reflected through biomarkers in peri-miniscrew implant crevicular fluid (PMICF) which is analogous to the gingival crevicular fluid. Analysis of biomarkers in PMICF provides indicators of inflammation at the implant site, osteoclast differentiation and activation, bone resorption activity and bone turnover. The PMICF for assessment of these biomarkers can be collected non-invasively via paper strips, periopaper or micro capillary pipettes and analysed by enzyme-linked immunosorbent assay (ELISA) or immunoassays. The markers and mediators of inflammation have been previously studied in relation to orthodontic tooth movement include interleukins (IL-1β, IL-2, IL-6 and IL-8), growth factors and other proteins like tumour necrosis factor (TNF-α), receptor activator of nuclear factor kappa-B ligand (RANKL), chondroitin sulphate (CS) and osteoprotegerin (OPG).Studies have indicated that successful and failed MSIs have different concentrations of biomarkers in PMICF. However, there is a lack of comprehensive information on this aspect of MSIs. Therefore, a detailed review was conducted on the subject.ResultsA literature search revealed six relevant studies: two on IL-1β; one on IL-2, IL-6 and IL-8; one on TNF-α; one on CS; and one on RANKL/OPG ratio. One study showed an increase in IL-1β levels upon MSI loading, peak in 24 hours (h), followed by a decrease in 21 days to reach baseline in 300 days. A 6.87% decrease in IL-2 levels was seen before loading and a 5.97% increase post-loading. IL-8 showed a 6.31% increase after loading and IL-6 increased by 3.08% before MSI loading and 15.06% after loading. RANKL/OPG ratio increased in loaded compared to unloaded MSIs.ConclusionsCytokines (mainly ILs and TNF-α) and RANKL/OPG ratio showed alteration in PMICF levels upon loading of MSIs as direct or indirect anchorage.

Osteopontin and Periostin levels in peri-miniscrew implant crevicular fluid during Class III treatment

“…These are interleukins (ILs) (IL-1β, IL-2, IL-6, IL-8), growth factors and other proteins such as tumor necrosis factor (TNF)-α, receptor activator of nuclear factor kappaB ligand (RANKL), chondroitin sulphate (CS) and osteoprotegerin (OPG). 6,7 In a previous study, a rise in IL-1β levels was seen immediately after MI placement and 24 h after loading. 8 On the other hand, the levels of RANKL and OPG were measured in PMICF.…”

Expression of circulating cell-free nucleic acids around miniscrew implant during orthodontic tooth movement—a prospective study

“…The effectiveness and the clinical application of the MSI have been reported in the literature, but little is known about the biomolecular aspect of MSI stability. Tissue reactions to the applied forces must be known in order to predict the stability of MSIs [8]. Peri-miniscrew implant crevicular fluid (PMICF) is the inflammatory exudate that flows out via the MSI crevice [9].…”

“…Biomarkers in the PMICF are used to assess the host's response to mechanical forces. Like a natural tooth, orthodontic force initiates a cascade of inflammatory reactions around an MSI [8]. PMICF composition is similar to gingival crevicular fluid (GCF) consisting of inflammatory mediators (e.g., cytokines, host-derived enzymes and their inhibitors, antibodies, tissue breakdown products, and host response modifiers), which may show variation during orthodontic force application [9].…”

Evaluation of IL-1α and IL-1β, COX-2, and iNOS mRNA Expression in Orthodontic Patients Given Chitosan Mouthwash During Treatment with Miniscrew

“…[ 1 2 3 ] Host immune response plays a vital role in the success of the orthodontic miniscrew. [ 4 ] Immune responses in the early stage are mediated by inflammation as a host’s response from mechanical, chemical, and thermal exposure. [ 5 ] The balance between pro-inflammatory and anti-inflammatory molecules in response to stimuli due to orthodontic treatment plays an essential role in the success of orthodontic treatment.…”