Reliability of salivary biomarkers as skeletal maturity indicators: A systematic review

Changes in salivary biomarkers of pain, anxiety, stress, and inflammation related to tooth movement during orthodontic treatment: a systematic review

OBJECTIVE

This systematic review aimed to analyze the literature on changes in endogenous salivary biomarkers of pain, anxiety, stress, and inflammation related to tooth movement during orthodontic treatment of children and adolescents.

MATERIAL AND METHODS

An electronic search was performed in nine databases to identify quasi-experimental studies, without restricting publication language and year. Two reviewers extracted the data and assessed the individual risk of bias using the JBI tools, and the certainty of evidence using the GRADE tool.

RESULTS

The electronic search found 7,038 records, of which 12 met the eligibility criteria and were included in the qualitative synthesis. Most studies had a low risk of bias. Biomarkers were grouped into five categories: electrolytes, enzymes, hormones, immunoglobulins, and mediators. Electrolytes showed decreased Ca2+, Pi3+ and K+ levels, and increased Na+ and Cl- levels. All enzymes (ALP, LDH, MMP8, and MMP9) increased over time. Hormones presented a decrease in leptin and some fluctuations in daily cortisol levels. Immunoglobulins (IgA, IgG, IgM, IgD, and IgE) had no significant changes, and salivary IgA showed divergent results among studies. Mediators (sRANKL, OPG, IL-1β, and PGE2) showed fluctuations at different treatment stages, mainly after orthodontic activation.

CONCLUSIONS

Based on a very low certainty level, orthodontic tooth movement had little to no effect on endogenous salivary biomarkers.

A simplified protocol for deep quantitative proteomic analysis of gingival crevicular fluid for skeletal maturity indicators

Assessment of craniofacial skeletal maturity is of great importance in orthodontic diagnosis and treatment planning. Traditional radiographic methods suffer from clinician subjectivity and low reproducibility. Recent biochemical methods, such as the use of gingival crevicular fluid (GCF) protein biomarkers involved in bone metabolism, have provided new opportunities to assess skeletal maturity. However, mass spectrometry (MS)-based GCF proteomic analysis still faces significant challenges, including the interference of high abundance proteins, laborious sample prefractionation and relatively limited coverage of GCF proteome. To improve GCF sample processing and further discover novel biomarkers, we herein developed a single-pot, solid-phase-enhanced sample-preparation (SP3)-based high-field asymmetric waveform ion mobility spectrometry (FAIMS)-MS protocol for deep quantitative analysis of the GCF proteome for skeletal maturity indicators. SP3 combined with FAIMS could minimize sample loss and eliminate tedious and time-consuming offline fractionation, thereby simplifying GCF sample preparation and improving analytical coverage and reproducibility of the GCF proteome. A total of 5407 proteins were identified in GCF samples from prepubertal and circumpubertal groups, representing the largest dataset of human GCF proteome to date. Compared to the prepubertal group, 61 proteins were differentially expressed (31 up-regulated, 30 down-regulated) in the circumpubertal group. The six-protein marker panel, including ATP5D, CLTA, CLTB, DNM2, HSPA8 and NCK1, showed great potential to predict the circumpubertal stage (ROC-AUC 0.937), which provided new insights into skeletal maturity assessment.