Detection of orthodontically induced inflammatory root resorption-associated biomarkers from the gingival crevicular fluid by proteomics analysis: a randomized-controlled clinical trial.

Orthodontically induced inflammatory root resorption (OIIRR) is an undesirable complication of orthodontic treatment (OT) with an ambiguous aetiologic mechanism. This study aimed to identify OIIRR-associated biomarkers in the gingival crevicular fluid (GCF) using proteomic analysis. In this randomized clinical trial, the upper first premolars (UFP) were exposed either to light or heavy force. The GCF was collected at 1 h, 1 day, 7 days, 14 days, 21 days, and 28 days following force application. After extraction of UFP, roots were imaged and resorption premolar, was used to deliver either light forcecraters were measured. Proteomic analysis of GCF was performed using 2D gel electrophoresis with MALDI-TOF/TOF MS/MS. Results were further analyzed by bioinformatics analyses showing the biological functions and predicted pathways. The predicted canonical pathways showed that the expression of immunoglobulin kappa (IGKC), neutrophil gelatinase-associated lipocalin (NGAL), neurolysin mitochondrial (NEUL), keratin, type II cytoskeletal 1 (K2C1), S100-A9, and the extracellular calcium-sensing receptor (CASR) were significantly associated with a range of biological and inflammatory processes. In conclusion, up-regulation of S100A9, CASR, and K2C1 suggested a response to force-related inflammation, chemotactic activities, osteoclastogenesis, and epithelial cell breakdown. Meanwhile, the up-regulation of IGKC, NGAL, and K2C1 indicated a response to the inflammatory process, innate immunity activation, and epithelial cell breakdown. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03572-5.

The Effect of Nano Calcium Carbonate and/or Recombinant Bone Morphogenetic Protein as a Biological Orthodontic Retainer on the Body Weight of Experimental Rat.

BACKGROUND: Retention after orthodontic tooth movement (OTM) is essential to prevent relapse. This study examined the effects of a fixed orthodontic device and Nano Calcium Carbonate (CaCO3) nanoparticles with or without recombinant human bone morphogenetic protein (rhBMP) on rat body weight. MATERIALS AND METHODS: OTM was administered for 21 days to 80 Wistar Albino rats. First molar mesialization was active then forming two 40-rat groups which were subdivided into four subgroups of 10 rats each. These subgroups received 5 µg/kg rhBMP, 75 µg/kg CaCO3, 80 µg/kg rhBMP-loaded CaCO3 and one control. The relapse rate was examined weekly over the second 21 days when the second group exhibited mechanical retention and the first did not. Group 1 rats were murdered after 21 days (day 42), whereas group 2 rats entered a third 21-day post-retention period and then murdered (day 63). BW and OTM were measured on days 1, 21, 28, 35, 42, and 63. RESULTS: Within each group, the animal body weight was reduced significantly after the intervention and continued over time with a higher average reduction in the 9-week group than the 6-week group. However, there were no significant (P-value ˃0.05) differences in the BW between the groups of the two (6-week and 9-week) sets and the subgroups of the 6-week set across each time point. In contrast, there was a significant (P-value ˂0.05) difference between the BW of the conjugate subgroup and the other three subgroups in the 9-week set, particularly on 63rd day. CONCLUSION: CaCO3 nanoparticles and/or BMP with orthodontic treatment collectively or individually cause a reduction of body weight in rats.

Salivary peptidome analysis and protease prediction during orthodontic treatment with fixed appliances.

Orthodontic tooth movement (OTM) occurs through proteolytic remodelling within the periodontium following the application of external force to the tooth. This study describes the first characterization of the salivary peptidome and protease profile during the alignment stage of fixed appliance orthodontic treatment. Unstimulated whole mouth saliva from 16 orthodontic patients (10 males, 6 females, mean (SD) age 15.2 (1.6) years) was collected prior to fixed appliance placement (T1), 1-h (T2), 1-week (T3) following fixed appliance placement and on completion of mandibular arch alignment (T4). Salivary peptides were extracted using filtration followed by mass spectrometry to identify amino acid sequences. Protease prediction was carried out in silico using Proteasix and validated with gelatin zymography and enzyme-linked immunosorbent assay. A total of 2852 naturally-occurring peptides were detected, originating from 436 different proteins. Both collagen and statherin-derived peptide levels were increased at T2. Proteasix predicted 73 proteases potentially involved in generating these peptides, including metalloproteinases, calpains and cathepsins. Changes in predicted activity of proteases over time were also observed, with most metalloproteinases showing increased predicted activity at T2-T3. Increased gelatinolytic activity and MMP8/MMP9 levels were detected at T3. Collectively, multiple protein targets and changes in protease-predicted activity during OTM have been identified.

Cephalometric Variables Prediction from Lateral Photographs Between Different Skeletal Patterns Using Regression Artificial Neural Networks.

OBJECTIVE: This study aimed to design an artificial neural network for the prediction of cephalometric variables via a lateral photo- graph in skeletal Class I, II, and III patterns. METHODS: A total of 94 patients were recruited for this prospective study, with an age range of 15-20 years (41 boys and 53 girls) seek- ing orthodontic treatment. According to cephalometric analysis, using AutoCAD 21.0, they were allocated into three groups. Thirty with skeletal Class I (14 boys and 16 girls), 34 with skeletal Class II (14 boys and 20 girls), and 30 with skeletal Class III malocclusion (13 boys and 17 girls) according to SNA, SNB, and ANB angles measured from cephalometric radiographs. The study includes (1) finding the correlation of the skeletal measurements between lateral profile photographs and cephalometric radiographs for the recruited patients and (2) designing a specific artificial neural networks for the assessment of skeletal factors via lateral photographs, these artificial neural networks are trained and tested with the total of 94 standard lateral cephalograms. RESULTS: This novel Network provided models of regression that can forecast the cephalometric variables through analogous photo- graphic measurements with excellent predictive power R = 0.99 and limited estimation error for each malocclusion (Class I, II, and III). CONCLUSION: This study suggests that artificial intelligence would be useful as an accurate method in orthodontics for the prediction of cephalometric variables and its performance was achieved by several factors such as proper selection of the input data, preferable generalization, and organization.

Salivary bacterial community profile in normal-weight and obese adolescent patients prior to orthodontic treatment with fixed appliances.

OBJECTIVES: The aim of this study was to compare the intra-oral bacterial profile of normal-weight and obese adolescents prior to orthodontic treatment with fixed appliances. MATERIALS AND METHODS: Nineteen adolescent patients were recruited into two groups based upon body mass index (BMI) and classified as normal-weight or obese. Unstimulated whole mouth saliva was obtained for 5 minutes. Bacterial DNA extraction was performed from saliva, and 16S rRNA gene sequencing of the V1-2 variable regions was undertaken followed by analysis using the mothur pipeline. RESULTS: Saliva from a total of 19 adolescent patients with mean (SD) age 15.6 (1.8) years were divided into 10 normal-weight with mean BMI of 19.4 (2.2) kg/m2 and 9 obese with mean BMI of 30.2 (3.5) kg/m2 . A total of 156 783 sequences were obtained from the 19 samples with no significant differences in richness or diversity between sample groups by obesity status or gender (AMOVA). The bacterial community in both groups was dominated by bacterial genera characteristic of the human mouth, which included Streptococcus, Porphyromonas, Veillonella, Gemella, Prevotella, Fusobacterium and Rothia. CONCLUSION: There were no differences in alpha or beta diversity of oral bacterial communities between normal-weight and obese orthodontic patients. Obese adolescents attending for orthodontic treatment had a similar microflora to their normal-weight counterparts.

Development of patient information leaflets for fixed, removable, and functional appliances for Arabic-speaking orthodontic patients.

OBJECTIVE: To develop Orthodontic Patient Information Leaflets (PILs) in Arabic. MATERIAL & METHOD: This study included five phases starting with Arabic translation of existing British Orthodontic Society leaflets; initial face validation with three orthodontists; content validation with ten orthodontists; final face validation with ten orthodontists, five postgraduate students, and ten patients; and re-translation to English prior to comparing the new documents with the original PILs to verify that all the necessary information were included. The content validity index (CVI) assessed item level (I-CVI) and scale level (S-CVI). RESULTS: The three Arabic PILs were face validated with inclusion of mini-screws, rapid maxillary expansion, and interproximal reduction. Content validity was perfect with no item I-CVI < 0.80. The S-CVI/Ave for PIL Fixed Appliances = 0.98, PIL Removable Appliances = 0.98 and PIL Functional Appliances = 0.97. In the final face validation, the three leaflets received 100% agreement from all observers for consistency of leaflet format and style, clarity, readability and use of adequate phrases. Finally, the leaflets were re-translated and the information was checked by native English speakers to ensure the completeness of information. There were no discrepancies and face validity was excellent. CONCLUSION: Valid PILs for Arabic-speaking patients undergoing orthodontic treatment with fixed, removable, and functional appliances have been developed.

The impact of obesity on orthodontic treatment outcome in adolescents: a prospective clinical cohort study.

INTRODUCTION: This prospective clinical cohort study investigated the potential influence of obesity on orthodontic treatment outcome. METHODS: A prospective cohort of adolescent patients undergoing routine fixed appliance treatment were recruited into normal-weight or obese groups based upon body mass index (BMI) centile and followed up until the completion of treatment. Primary outcome was treatment duration, and secondary outcomes included treatment outcome (occlusal change measured using peer assessment rating [PAR]), appointment characteristics, and compliance measures. RESULTS: A total of 45 patients mean age 14.8 (1.6) years were included in the final analysis. The normal-weight group included 23 patients with mean BMI 19.4 (2.4) kg/m2 and the obese group 22 patients with mean BMI 30.5 (3.8) kg/m2. There were no significant differences in baseline demographics between groups, except for BMI and pre-treatment PAR. The normal-weight group had a mean pre-treatment PAR of 25.6 (8.3) and the obese 33.3 (11.8) giving the obese group a more severe pre-treatment malocclusion (P = 0.02). There were no significant differences in treatment duration between groups (P = 0.36), but obese patients needed less time per each additional baseline PAR point compared to normal weight (P = 0.02). Obese patients also needed less appointments compared to normal-weight patients (P = 0.02). There were no significant differences between groups for appointment characteristics or compliance. Finally, obese patients were more likely to experience a great PAR reduction than normal-weight patients (relative risk = 2.6; 95% confidence interval = 1.2-4.2; P = 0.02). CONCLUSIONS: There were no significant differences in treatment duration between obese and normal-weight patients. Obesity does not appear to be a risk factor for negative orthodontic treatment outcome with fixed appliances.

Impact of assessing smile parameters as part of orthodontic treatment planning - a survey based analysis.

BACKGROUND: Smile forms an imporatnt aspect of facial analysis, as it contributes to overall facial esthetics. Many orthodontists pay more attention to cephalometric radiograph; and profile assessment to improve their patients' esthetics; however, the facial attractiveness of the individuals is obviously improved through enhancing their smiles. This study was aimed at evaluating the impact of analyzing certain smile esthetic parameters on diagnosis and treatment plan for individuals seeking orthodontic treatment. MATERIALS AND METHODS: An electronic questionnaire with 24 questions arranged on five main axes was designed. These axes included smile arc, smile line, buccal corridors, smile symmetry, and photographic analysis of the smile, with several questions in each axis. The electronic link of the questionnaire was sent to all members of the Iraqi Orthodontic Society in April 2019. The answers were collected after 4 weeks of questionnaire link distribution date. RESULTS: Among the surveyed orthodontists, there was a consistent agreement to assess the smile arc, smile line, buccal corridors, and smile symmetry, with main axes scores (4.14 ± 0.81, 4.1 ± 0.79, 3.86 ± 0.82, and 4.16 ± 0.86 respectively). Moreover, the participants prefer, with 3.89 ± 0.86 main axis score, to use the facial photograph for a less time-consuming and detailed evaluation of smile features. CONCLUSIONS: Smile parameters, for example, smile arc, smile line, buccal corridors, and smile symmetry are better to be analyzed using photographs during orthodontic diagnosis and treatment planning.

A cross-sectional cohort study of gingival crevicular fluid biomarkers in normal-weight and obese subjects during orthodontic treatment with fixed appliances.

OBJECTIVES: To investigate the effects of obesity on biomarker levels within lower incisor gingival crevicular fluid (GCF) in subjects undergoing routine fixed appliance orthodontic treatment. MATERIALS AND METHODS: This was a cross-sectional clinical cohort study. GCF was collected from normal-weight and obese subjects at completion of alignment at least 1 month after placement of 0.019 × 0.025-inch stainless-steel archwires. The primary outcome was the difference in GCF biomarker levels between groups. Secondary outcomes included differences in clinical parameters of plaque and gingival indices, unstimulated whole-mouth saliva, and GCF flow rates. RESULTS: Thirty-eight subjects (18 male, 20 female) with a mean age of 25.6 (SD, 6.3) years and mean body mass index (BMI) of 22.6 (1.6) in normal-weight and 32.4 (2.2) kg/m2 in obese groups were investigated. Apart from BMI (P < .0001), there were no statistically significant differences in essential demographics between groups. Significantly increased levels of the adipokine leptin (P < .009) and the tissue-remodeling biomarker matrix metalloproteinase-9 (MMP9; P < .020) were identified in the obese cohort. For the remainder of the biomarkers, including the RANKL bone-remodeling marker and several inflammatory markers, there were no significant differences between groups. No correlation was observed between plaque index or gingival index for any GCF biomarker for either group (P = .07-1.00). CONCLUSIONS: This study investigated the GCF biochemical profile of obese and normal-weight subjects undergoing fixed-appliance orthodontic treatment. Significantly increased levels of the adipokine leptin and the tissue-remodeling biomarker MMP9 were identified in the obese group. These data provide evidence of differences in GCF biochemistry between obese and normal-weight subjects undergoing fixed appliance orthodontic treatment.

The effect of obesity on orofacial pain during early orthodontic treatment with fixed appliances: a prospective cohort study.

Introduction: We have investigated orofacial pain in a prospective cohort of obese and normal-weight subjects undergoing fixed-appliance orthodontic treatment. Methods: Fifty-five subjects (27 males, 28 females) mean age 15.1 (1.6) years and mean body mass index 30.2 (3.5) in obese and 19.4 (2.2) kg/m2 in normal-weight groups were followed for 1 week after appliance placement. Primary outcome was maximum-pain measured using a 100-mm visual analogue scale. Secondary outcomes included mean pain and oral analgesic consumption. Results: Mean maximum pain for the total sample was 73.7 (standard deviation 14.8; 95% confidence interval 69.8-77.7) mm with no significant differences among groups (P = 0.247). However, mean maximum pain was higher at all time-points for the obese group and significant at 72 hours (P = 0.034). Total analgesia consumed by the obese group was also significantly higher than normal weight (P = 0.041). Multivariable regression found the only significant predictor for mean pain was time. After adjusting for confounding, obesity was associated with higher (+4.47 mm) mean pain at each time-point (P = 0.018). A significant association existed between obesity and total analgesic consumption (univariable-analysis, P = 0.035; multivariable analysis, P = 0.023). After accounting for confounders, obese patients were associated with taking a higher quantity of oral analgesics. Conclusions: We found a trend towards increased mean pain and an association with increased analgesic consumption in obese subjects during the first week following fixed-appliance placement.

The influence of different types of fixed orthodontic appliance on the growth and adherence of microorganisms (in vitro study).

Orthodontic appliances serve as different impact zones and modify microbial adherence and colonization, acting as foreign reserves and possible sources of infection. This study was conducted to investigate the effect of different types of fixed orthodontic appliances on the growth and adherence of microorganisms in oral flora which are Streptococcus mutans (S. mutans) and Candida albicans. Sixty-four of four different fixed orthodontic appliance-samples were used, divided into four groups of sixteen. Type I: Sapphire brackets- Coated wires, type II: Sapphire brackets- Stainless steel wires, type III: Stainless steel brackets- Coated wires and type IV: Stainless steel brackets- Stainless steel wires. Oral strains of S. mutans and Candida albicans were studied in the present study using biochemical test then microbial suspensions were prepared to do the tests of each microorganism including the antimicrobial effects of different appliance-samples on the growth of microorganisms and their adhesion tests. The results showed significant differences between the different appliances in terms of inhibition zone formation (P<0.001). The adhesion test, which is classified into low, medium and high, showed the adhesion of S. mutans, is low with type I and II, medium with type III and high with type IV, whereas the adhesion of Candida albicans is medium with both type I and II and high with both type III and IV with high significant differences (P<0.001). Appliance with high esthetic appearance, sapphire brackets and coated arch wire, showed the least adherence of S. mutans and Candida albicans in comparison to other appliances with less esthetic and more metal components. Key words:Orthodontic appliance, Adherence, Streptococcus mutans, Candida albicans.