Gingival Crevicular Fluid Turnover Markers in Premenopausal vs Postmenopausal Women receiving Orthodontic Treatment

Abstract

Background: Orthodontic treatment is one of the commonly used dental treatments. Orthodontic forces act on the bone by modulating the biomolecules, chiefly the osteoprotegerin (OPG), osteopontin (OPN), receptor activator of nuclear factor kappa-B (RANK), and RANK ligand (RANKL) (OPG ligand). Hormonal changes are known to cause marked alteration in the levels of these biomolecules. Hence, we planned this study to evaluate the response of bone biomarkers in the gingival crevicular fluid (GCF) in postmenopausal women undergoing fixed orthodontic therapy. Materials and methods:This study included assessment of 50 subjects who underwent orthodontic treatment from June 2012 to July 2016. All the patients were divided into two study groups with 25 patients in each group: premenopausal group and postmenopausal group. Similar orthodontic wires were used for controlling the forces applied in subjects of both the study groups and their GCF levels of RANKL, and OPN was assessed at baseline and 24 hours after the activation of orthodontic forces. All the results were compiled, assessed, and analyzed by Statistical Package for the Social Sciences software version 16.0. Chi-square test, Student's t-test, and Mann-Whitney U test were used for the assessment of the level of significance. Gingival Crevicular Fluid Turnover Markers in Premenopausal vs Results:The mean values of RANKL and OPN in the premenopausal and postmenopausal groups were found to be 241.52 and 317.15 pg/µL respectively. The mean values of RANKL at baseline in the premenopausal and postmenopausal groups were found to be 7.15 and 3.84 pg/µL respectively. Nonsignificant results were obtained while comparing mean OPN and RANKL level alteration in between the two study groups. Conclusion:The mean alterations in the GCF levels of bone biomarkers are similar for both premenopausal and postmenopausal women.Clinical significance: For women with either premenopausal or postmenopausal status, orthodontic treatment appears to be equally safer.

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

“…Out of the 64 studies, another 49 studies were excluded after full-text assessment, leaving 15 studies fulfilling the inclusion criteria (Additional file 5 ). Five were RCTs [ 16 – 20 ], 9 were prospective, non-randomized studies [ 21 – 29 ] and 1 was of cross-sectional design [ 30 ] (Table 1 ). The process of final study inclusion in this review is presented in Fig.…”

“…None was rated at low risk of bias. Five of the included studies were rated at moderate risk of bias [ 21 , 22 , 24 , 27 , 28 ]. Two studies were rated at serious risk of bias [ 23 , 29 ] and another two at critical risk of bias [ 25 , 26 ].…”

“… Sequential repetitive loading of the periodontal ligament with small and controlled activations is effective for space closure as indicated by a significantly higher increase in the GCF alkaline phosphatase level if a retraction screw is used instead of active tie-backs. Bitra et al 2017 [ 21 ] Prospective OPN: Baseline: Premenopausal 241.52 pg/μl and postmenopausal 317.15 pg/μl 24 h after: Premenopausal 540.97 pg/μl and postmenopausal 492.73 pg/μl pg/μl No difference is observed in GCF levels of OPN while comparing the mean premenopausal and postmenopausal women. Orthodontic treatment appears to be equally safer for both premenopausal and postmenopausal subjects.…”

“…The other maxillary canine served as control [ 17 , 18 , 20 , 23 – 25 , 27 , 29 ]. Several studies detected the biomarkers in various teeth under orthodontic treatment with fixed appliances [ 21 , 22 , 26 , 28 ] or after the placement of separators [ 19 ]. One study evaluated the GCF of patients with aligners [ 16 ].…”

“…OPN was investigated in 4 studies [ 16 , 19 , 21 , 22 ]. Castroflorio et al reported that the kinetics of OPN was characterized by a significant increase at the tension sites of the test teeth after 3 weeks from the application of orthodontic force [ 16 ].…”