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

Sherifa Ghaleb, Nazla Tamish, Walid ElKenany, Myriam Guindi, Sherifa Ghaleb, Nazla Tamish, Walid ElKenany, Myriam Guindi

Abstract

Background: The purpose of this 2-arm-parallel split-mouth trial was to evaluate and compare the extent of possible root resorption using dentin phosphoprotein levels in gingival crevicular fluid between controlled continuous and intermittent orthodontic force groups.

Materials and methods: A sample of 16 maxillary first premolars from 8 patients requiring bilateral extractions of the upper first premolars as part of their orthodontic treatment were recruited. A buccally directed continuous force of 150 g, reactivated after 28 days, was applied to the upper first premolar on one side for 8 weeks. On the contralateral first premolar, a buccally directed intermittent force (21 days on, 7 days off) of the same magnitude was applied for the same period. Gingival crevicular fluid samples were collected at the beginning of the study, 1st, 3rd, 4th and 5th week, and at the end of the study to quantify and compare dentin phosphoprotein levels in both groups.

Results: Dentin phosphoprotein levels showed a higher concentration in the continuous force group than the intermittent force group in week 4 and 8 of sample collection; where the differences were statistically significant (95% CI 0.007-0.14; P < .04) and (95% CI 0.02-0.17; P < .04) respectively. No harm was observed.

Conclusions: Dentin phosphoprotein was found to be a useful early biomarker to detect and monitor root resorption, showing that the application of an intermittent orthodontic force caused less root resorption than a continuous force.

Trial registration: NCT04825665 ClinicalTrials.gov. Registered 1 April 2021-Retrospectively registered, https://ichgcp.net/clinical-trials-registry/NCT04825665 .

Keywords: Continuous force; Dentine phosphoprotein; Gingival crevicular fluid; Intermittent force; Root resorption.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Experimental appliance
Fig. 2
Fig. 2
a Force application periods, b time points for collection of gingival crevicular fluid
Fig. 3
Fig. 3
Resorption crater
Fig. 4
Fig. 4
Measurement of buccal movement of premolars. a Line demonstrating median palatine raphe; distances of (b), the right premolar and c the left premolar to the (a) line
Fig. 5
Fig. 5
CONSORT flow chart showing patient flow during the trial
Fig. 6
Fig. 6
Dentin phosphoprotein biomarker levels at different time points in the two study groups
Fig. 7
Fig. 7
Mean root resorption crater volumes in the two study groups

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