Abstract

Pathologic tooth migration is one of the most common sequels of periodontitis, which can be resolved using orthodontic treatment; however, this is not frequently recommended for periodontally compromised patients given that it could lead eventually to additional osteo-destruction. In this research, different molecular markers associated with alveolar bone resorption were analyzed in healthy patients after periodontal treatment, with periodontally compromised teeth affected by pathologic migration, before and during the orthodontic treatment. METHOD Moderate-to-severe chronic periodontitis patients, aged 30 to 65, affected by pathologic tooth migration of group 2 and/or 5 were treated using non-surgical periodontal therapy. After first periodontal control, conventional orthodontic treatment was performed. Gingival crevicular fluid samples were obtained from migrated teeth in at least 2 dental surfaces, depending on the movement made, and at different times: T0: Immediately before starting the periodontal therapy. T1: When periodontal treatment was concluded, immediately before orthodontic treatment. T2: 1 week of orthodontic treatment. T3: 1 month of orthodontic treatment. T4: 3 months of orthodontic treatment. Levels of the biomarkers RANKL, OPG and ICTP were quantified using ELISA. RESULTS The RANKL levels were significantly lower during the orthodontic treatment compared with levels detected before the periodontal therapy. In fact, the RANKL levels significantly decrease until T2, reaching plateau levels between T2 and T4. These changes were concomitant with the significantly lower levels of ICTP detected during orthodontic treatment, at T4 reaching levels ~50% of the levels detected before periodontal therapy. No differenc<es were detected in the OPG levels during the orthodontic treatment. CONCLUSIONS These results demonstrate that, in periodontally compromised teeth with pathologic migration, orthodontic treatment did not increase the levels of pro-bone resorption biomarkers RANKL and ICTP. In fact, the physiological decrement of the RANKL and ICTP levels associated with periodontal therapy was not affected by the orthodontic treatment.