Korean J Orthod.  2022 Mar;52(2):142-149. 10.4041/kjod.2022.52.2.142.

Evaluation of periodontal parameters and gingival crevicular fluid cytokines in children with anterior open bite receiving passive orthodontic treatment with a spur

• Anjos Tou GAd
• Alves Diniz IM
• Lucas Ferreira MV
• Mesquita RA
• Yamauti M
• Silva TA
• Macari S

• KMID: 2527458
• DOI: http://doi.org/10.4041/kjod.2022.52.2.142

Abstract

Objective
To evaluate clinical parameters and gingival crevicular fluid (GCF) cytokines in children with anterior open bite receiving passive orthodontic treatment with spurs.
Methods
Twenty children with indications for interceptive orthodontic treatment, an anterior open bite, and good oral hygiene and periodontal health were included in this study. GCF samples were collected from the mandibular and maxillary central incisors before (baseline) and 24 hours and 7 days after spur bonding. Clinical and periodontal examinations and cytokine analyses were performed.
Results
At 7 days after spur attachment, gingival bleeding in the mandibular group was increased relative to that in the maxillary group. Visible plaque was correlated with gingival bleeding at 7 days and the GCF volume at 24 hours after spur attachment. Compared with those at baseline, interleukin (IL)-8 levels in the maxillary group and IL-1β levels in both tooth groups increased at both 24 hours and 7 days and at 7 days, respectively. At 24 hours, IL-8, IL-1β, and IL-6 levels were higher in the maxillary group than in the mandibular group. Cytokine production was positively correlated with increased GCF volume, but not with gingival bleeding, visible plaque, or probing depth.
Conclusions
Although orthodontic treatment with spurs in children resulted in increased gingival bleeding around the mandibular incisors, IL levels were higher around the maxillary incisors and not correlated with periodontal parameters. Increased cytokine levels in GCF may be associated with the initial tooth movement during open bite correction with a passive orthodontic appliance in children.

Keyword

Passive orthodontic treatment; Cytokines; Gingival crevicular fluid; Open bite

Figure

• 

  Figure 1 A, Representative image of an 8-year-old boy with anterior open bite. B, Removal of tongue interposition after spur bonding allowed teeth eruption and bone remodeling with an increase in cytokine levels. The same participant shows some correction of the malocclusion at 1 year after attachment of the spur. C, The spurs are attached to the central regions of the lingual surfaces of the mandibular incisors (white arrows indicate the cervical regions of the mandibular incisors).

• 

  Figure 2 Cytokine levels in the gingival crevicular fluid (GCF) collected from mandibular and maxillary incisors (n = 20 patients per time point) at baseline (before spur bonding) and 24 hours and 7 days after spur attachment for anterior open bite correction in children. The data are expressed as mean ± standard deviation. Different letters indicate a difference between time points. Asterisks (*) indicate the difference between the maxillary and mandibular incisors. The nonparametric Wilcoxon test was used at each time point, and the Mann–Whitney test was used to compare differences between the mandibular and maxillary incisors. p < 0.05. IL, interleukin; B, baseline.

• 

  Figure 3 A, Representative image of tongue interposition between the mandibular and maxillary incisors in a child with anterior open bite. B, After spur attachment (black triangles bonded to the lingual surface of the mandibular incisors), the tongue moved backward, and the upper lip exerted pressure on the central incisors with effects on alveolar bone remodeling and tooth eruption at 24 hours after the attachment.

Reference

References

1. Rosa M, Quinzi V, Marzo G. 2019; Paediatric orthodontics part 1: anterior open bite in the mixed dentition. Eur J Paediatr Dent. 20:80–2. DOI: 10.23804/ejpd.2019.20.01.15. PMID: 30919650. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85062957150&origin=inward.

2. Pithon MM, Magno MB, da Silva Coqueiro R, de Paiva SM, Marques LS, Paranhus LR, et al. 2019; Oral health-related quality of life of children before, during, and after anterior open bite correction: a single-blinded randomized controlled trial. Am J Orthod Dentofacial Orthop. 156:303–11. DOI: 10.1016/j.ajodo.2019.04.022. PMID: 31474260. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85071466832&origin=inward.

3. Regalo SCH, de Lima Lucas B, Díaz-Serrano KV, Frota NPR, Regalo IH, Nassar MSP, et al. 2018; Analysis of the stomatognathic system of children according orthodontic treatment needs. J Orofac Orthop. 79:39–47. DOI: 10.1007/s00056-017-0117-x. PMID: 29330612. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85041836010&origin=inward.

4. Lambrechts H, De Baets E, Fieuws S, Willems G. 2010; Lip and tongue pressure in orthodontic patients. Eur J Orthod. 32:466–71. DOI: 10.1093/ejo/cjp137. PMID: 20089572. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=77954981291&origin=inward.

5. Ling HTB, Sum FHKMH, Zhang L, Yeung CPW, Li KY, Wong HM, et al. 2018; The association between nutritive, non-nutritive sucking habits and primary dental occlusion. BMC Oral Health. 18:145. DOI: 10.1186/s12903-018-0610-7. PMID: 30134878. PMCID: PMC6106723. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85052086101&origin=inward.

6. Ruan WH, Chen MD, Gu ZY, Lu Y, Su JM, Guo Q. 2005; Muscular forces exerted on the normal deciduous dentition. Angle Orthod. 75:785–90. DOI: 10.1043/0003-3219(2005)75[785:MFEOTN]2.0.CO;2. PMID: 16279824.

7. Valentim AF, Furlan RM, Perilo TV, Motta AR, Casas EB. 2016; Relationship between perception of tongue position and measures of tongue force on the teeth. Codas. 28:546–50. DOI: 10.1590/2317-1782/20162015256. PMID: 27683827. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84999106784&origin=inward.

8. Gonzalez P, MartInez MB, Sierra V, Rueda ZV, Botero-Mariaca P. 2019; Tongue position assessment during oral phase deglutition in children with anterior open bite and normal vertical overbite. J Indian Soc Pedod Prev Dent. 37:167–71. DOI: 10.4103/JISPPD.JISPPD_333_18. PMID: 31249181.

9. Dias FA, Assis Urnau FD, Pedron Oltramari PV, Lupion Poleti M, Freire Fernandes TM, Rodrigues de Almeida M. 2019; Stability of early treatment of anterior open bite: clinical performance of bonded lingual spurs. J Orthod. 46:68–73. DOI: 10.1177/1465312519827601. PMID: 31056074. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85061177326&origin=inward.

10. Brylka LJ, Schinke T. 2019; Chemokines in physiological and pathological bone remodeling. Front Immunol. 10:2182. DOI: 10.3389/fimmu.2019.02182. PMID: 31572390. PMCID: PMC6753917. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85072784254&origin=inward.

11. Ren Y, Vissink A. 2008; Cytokines in crevicular fluid and orthodontic tooth movement. Eur J Oral Sci. 116:89–97. DOI: 10.1111/j.1600-0722.2007.00511.x. PMID: 18353001. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=40849140978&origin=inward.

12. Tuncer BB, Ozmeriç N, Tuncer C, Teoman I, Cakilci B, Yücel A, et al. 2005; Levels of interleukin-8 during tooth movement. Angle Orthod. 75:631–6. DOI: 10.1043/0003-3219(2005)75[631:LOIDTM]2.0.CO;2. PMID: 16097233.

13. Madureira DF, da Silva JM, Teixeira AL, Abreu MH, Pretti H, Lages EM, et al. 2015; Cytokine measurements in gingival crevicular fluid and periodontal ligament: are they correlated? Am J Orthod Dentofacial Orthop. 148:293–301. DOI: 10.1016/j.ajodo.2015.03.030. PMID: 26232838. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84938341563&origin=inward.

14. Başaran G, Ozer T, Kaya FA, Hamamci O. 2006; Interleukins 2, 6, and 8 levels in human gingival sulcus during orthodontic treatment. Am J Orthod Dentofacial Orthop. 130:7.e1–6. DOI: 10.1016/j.ajodo.2005.12.027. PMID: 16849065. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=33745837459&origin=inward.

15. Bergamo AZ, Nelson-Filho P, Romano FL, da Silva RA, Saraiva MC, da Silva LA, et al. 2016; Gingival crevicular fluid volume and periodontal parameters alterations after use of conventional and self-ligating brackets. J Orthod. 43:260–7. DOI: 10.1080/14653125.2016.1221214. PMID: 27607519. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84986222574&origin=inward.

16. Dudic A, Kiliaridis S, Mombelli A, Giannopoulou C. 2006; Composition changes in gingival crevicular fluid during orthodontic tooth movement: comparisons between tension and compression sides. Eur J Oral Sci. 114:416–22. DOI: 10.1111/j.1600-0722.2006.00387.x. PMID: 17026508. PMID: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=33749518682&origin=inward.

17. Grant M, Wilson J, Rock P, Chapple I. 2013; Induction of cytokines, MMP9, TIMPs, RANKL and OPG during orthodontic tooth movement. Eur J Orthod. 35:644–51. DOI: 10.1093/ejo/cjs057. PMID: 22987319.

18. Uematsu S, Mogi M, Deguchi T. 1996; Interleukin (IL)-1 beta, IL-6, tumor necrosis factor-alpha, epidermal growth factor, and beta 2-microglobulin levels are elevated in gingival crevicular fluid during human orthodontic tooth movement. J Dent Res. 75:562–7. DOI: 10.1177/00220345960750010801. PMID: 8655760.

19. Teixeira CC, Khoo E, Tran J, Chartres I, Liu Y, Thant LM, et al. 2010; Cytokine expression and accelerated tooth movement. J Dent Res. 89:1135–41. DOI: 10.1177/0022034510373764. PMID: 20639508. PMCID: PMC3318047.

20. Kapoor P, Kharbanda OP, Monga N, Miglani R, Kapila S. 2014; Effect of orthodontic forces on cytokine and receptor levels in gingival crevicular fluid: a systematic review. Prog Orthod. 15:65. DOI: 10.1186/s40510-014-0065-6. PMID: 25487828. PMCID: PMC4259981.

21. Aliaga-Del Castillo A, Vilanova L, Miranda F, Arriola-Guillén LE, Garib D, Janson G. 2021; Dentoskeletal changes in open bite treatment using spurs and posterior build-ups: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 159:10–20. DOI: 10.1016/j.ajodo.2020.06.031. PMID: 33221096.

22. van Gastel J, Quirynen M, Teughels W, Coucke W, Carels C. 2011; Longitudinal changes in microbiology and clinical periodontal parameters after removal of fixed orthodontic appliances. Eur J Orthod. 33:15–21. DOI: 10.1093/ejo/cjq032. PMID: 20671070.

23. Pejda S, Varga ML, Milosevic SA, Mestrovic S, Slaj M, Repic D, et al. 2013; Clinical and microbiological parameters in patients with self-ligating and conventional brackets during early phase of orthodontic treatment. Angle Orthod. 83:133–9. DOI: 10.2319/010412-8.1. PMID: 22765511. PMCID: PMC8805529.

24. Naranjo AA, Triviño ML, Jaramillo A, Betancourth M, Botero JE. 2006; Changes in the subgingival microbiota and periodontal parameters before and 3 months after bracket placement. Am J Orthod Dentofacial Orthop. 130:275.e17–22. DOI: 10.1016/j.ajodo.2005.10.022. PMID: 16979483.

25. Ren Y, Hazemeijer H, de Haan B, Qu N, de Vos P. 2007; Cytokine profiles in crevicular fluid during orthodontic tooth movement of short and long durations. J Periodontol. 78:453–8. DOI: 10.1902/jop.2007.060261. PMID: 17335368.

26. Nunes L, Quintanilha L, Perinetti G, Capelli J G Junior. 2017; Effect of orthodontic force on expression levels of ten cytokines in gingival crevicular fluid. Arch Oral Biol. 76:70–5. DOI: 10.1016/j.archoralbio.2017.01.016. PMID: 28131911.

27. Motyl S, Manfredini D, Oruba Z, Bugajska J, Sztefko K, Stós W, et al. 2021; Evaluation of interleukin-1 beta and the ratio of interleukin-1 beta to interleukin-1 receptor antagonist in gingival crevicular fluid during orthodontic canine retraction. Dent Med Probl. 58:47–54. DOI: 10.17219/dmp/132954. PMID: 33756073.

28. Kaya Y, Alkan Ö, Kömüroglu AU, Keskin S. 2021; Effects of ibuprofen and low-level laser therapy on orthodontic pain by means of the analysis of interleukin 1-beta and substance P levels in the gingival crevicular fluid. J Orofac Orthop. 82:143–52. DOI: 10.1007/s00056-020-00254-2. PMID: 33097977.

29. Meyer-Marcotty P, Kochel J, Stellzig-Eisenhauer A. 2013; The impact of spur therapy in dentoalveolar open bite. Aust Orthod J. 29:145–52. PMID: 24380133.

30. Canuto LF, Janson G, de Lima NS, de Almeida RR, Cançado RH. 2016; Anterior open-bite treatment with bonded vs conventional lingual spurs: a comparative study. Am J Orthod Dentofacial Orthop. 149:847–55. DOI: 10.1016/j.ajodo.2015.11.026. PMID: 27241995.