Biomarkers in the gingival crevicular fluid used to detect root resorption in patients undergoing orthodontic treatment: A systematic review

Abstract

Objectives To evaluate whether changes in the concentration of different biomarkers in the gingival crevicular fluid (GCF) can be used to detect the root resorption process in adult or adolescent patients undergoing treatment with a fixed appliance, in comparison with untreated subjects or treated patients not showing signs of root resorption. Material and Methods The following databases were analysed in the period between June 2017 and March 2018, without any language and initial date restrictions: PubMed, EMBASE, Scopus, Web of Science and Cochrane Library. A quality assessment instrument (QAI) was developed to establish the risk of bias. Results A total of 1127 articles were analysed. Based on the inclusion and exclusion criteria, seven studies qualified for the final review. The QAI tool revealed that five articles were at a moderate risk of bias and two articles were at a low risk of bias. Conclusion Dentine phosphoprotein (DPP) may be considered a relatively useful marker for root resorption. Dentinal sialoprotein (DSP) could be a potential biomarker but is not highly helpful at detecting root shortening. Inflammatory cytokines (pro‐ and anti‐resorption), osteopontin (OPN), osteoprotegerin (OPG), RANKL and alkaline phosphatase (ALP) are useful biomarkers to explain the biological mechanisms that occur during orthodontic movement but are not specific enough. Further studies are required to clarify the role of GM‐CSF as a potential biomarker to distinguish subjects at a risk of severe root resorption in the early phase.

Collection, Storage and Protein Extraction Method of Gingival Crevicular Fluid for Proteomic Analysis

“…In orthodontics, clinicians claimed to get an ideal result with optimum force magnitude and minimum adverse effect with lower time of treatment. Many researchers have therefore studied the profile and the levels of various enzymes, cytokines, growth factors and proteoglycans, primarily in the oral fluids (GCF and saliva), in order to monitor orthodontic tooth movement with its subsequent reactions in humans without any invasive impact 2,17 .…”

The effect of two different types of forces on possible root resorption in relation to dentin phosphoprotein levels: a single-blind, split-mouth, randomized controlled trial

“…Results of a systematic review by Tarallo et al [ 20 ] compared different biomarkers in the GCF to detect root resorption in patients undergoing orthodontic treatment. They concluded that DPP was the most specific biomarker for early diagnosis of root resorption and suggested it to be used in future clinical trials.…”

“…Therefore, previous studies suggested that the most indicative markers for the diagnosis of root resorption were dentin specific proteins only. Proteins like dentin sialoprotein have been suggested to be less indicative, since they were found to be present in both the root cement matrix and the dentin [ 20 , 21 ]. Consequently, dentin phosphoprotein was selected as the biomarker for this study.…”

“…The Systematic review by Tarallo et al [ 20 ] suggested to design new clinical trials focusing on the ability of GCF to diagnose root resorption early and to prefer the DPP as a biomarker. Since the previous studies using DPP to detect root resorption were only two [ 13 , 15 ].…”

Assessing the level and diagnostic accuracy of osteopontin and oral health status in periodontitis patients with/without Type-2 Diabetes Mellitus

“…To the best of our knowledge, limited studies have investigated the OPN level in the GCF of the healthy control, which was lower compared to those who had periodontitis [25]. The later groups had the highest OPN expression beside a positive correlation with the clinical attachment loss and pocket depth in pre-periodontal treatment [26].…”