Salivary and gingival crevicular fluid (GCF) protein biomarkers as proxies of root resorption following orthodontic tooth movement. A systematic review

Background: Orthodontically induced root resorption (OIRR) is a common complication of orthodontic treatment, characterized by inflammatory and remodeling processes. This systematic review (SR) aimed to evaluate the potential of salivary and gingival crevicular fluid (GCF) biomarkers as proxies for the early detection of an ongoing root resorption process during orthodontic tooth movement. Material and methods: Electronic searches were performed in multiple databases of published and grey literature, up to May 2023. Eligible studies included participants undergoing orthodontic treatment with reported biomarkers linked to root resorption against a control group. Analysis methods of the biomarkers such as ELISA, Western Blot, mass spectrometry, were utilized. Results: Seven studies met the inclusion criteria, with sample sizes ranging from 19 to 74 participants and varied study designs, with methodological heterogeneity. The detected proteins and biomarkers were dentin phosphoryn, dentin sialoprotein, dentin sialophosphoprotein, fetuin-A, IFN- γ, IL-10, IL-12p70, IL-7 p21-ARC, sIgA and these served as promising indicators of increased root resorption activity, during orthodontic treatment. Conclusions: Biomarkers and proteins in saliva and GCF demonstrated a potential for early detetction and monitoring of OIRR, offering a non-invasive alternative to radiographic techniques. However, standardization of protein and biomarker assessment protocols and development of large-scale studies seem imperative. Biomarkers, gingivial crevicular fluid, orthodontic treatment, root resorption, saliva, systematic review.