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Changes in biomarkers levels from gingival crevicular fluid in pre- and postmenopausal women undergoing orthodontic treatment

A systematic review

Veränderungen von Biomarkerkonzentrationen in der Sulkusflüssigkeit bei prä- und postmenopausalen kieferorthopädisch behandelten Frauen

Ein systematischer Review

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to verify whether there is a difference in biomarker levels in the gingival crevicular fluid between premenopausal and postmenopausal women undergoing orthodontic treatment.

Methods

As eligibility criteria, prospective or retrospective observational studies evaluating women undergoing orthodontic treatment (P), comparing postmenopausal (E) and premenopausal (C) women, and analyzing differences in gingival crevicular fluid biomarkers (O) were included. An electronic search was conducted in seven databases (PubMed, Scopus, Web of Science, LILACS, The Cochrane Library, Embase, and EBSCO: Dentistry & Oral Science) and one grey literature source (Google Scholar). All databases were searched from September 2022 to March 2023. After duplicate exclusion and data extraction, the Newcastle–Ottawa scale was applied to assess the quality and risk of bias, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool was used to verify the certainty of evidence.

Results

Three case–control studies that analyzed receptor activator of nuclear factor kappa‑B ligand (RANKL), osteopontin (OPN), and interleukin (IL)-17A levels were included. One study reported a significant difference for RANKL and another for OPN levels. A third study reported that there was a higher expression of IL17‑A in the postmenopausal group. However, the small number of articles limits our systematic review. The heterogeneity and imprecision in the study results cast doubt on the findings’ internal validity.

Conclusion

The studies reported alterations in biomarker levels but differed in their conclusions. Therefore, further studies must include other types of bone and inflammatory biomarkers in female patients who are pre- or postmenopausal and undergoing orthodontic treatment.

Registration

The review was registered at the Open Science Framework (https://doi.org/10.17605/OSF.IO/Q9YZ8).

Zusammenfassung

Zielsetzung

In dieser Studie sollte überprüft werden, ob es einen Unterschied in den Biomarkerkonzentrationen in der Sulkusflüssigkeit zwischen prämenopausalen und postmenopausalen Frauen gibt, die sich einer kieferorthopädischen Behandlung unterziehen.

Methoden

Als Auswahlkriterien wurden prospektive oder retrospektive Beobachtungsstudien einbezogen, in denen Frauen untersucht wurden, die sich einer kieferorthopädischen Behandlung unterzogen (P), in denen postmenopausale (E) und prämenopausale (C) Frauen verglichen wurden und in denen Unterschiede in den Biomarkern in der Sulkusflüssigkeit analysiert wurden (O). Es wurde eine elektronische Suche in 7 Datenbanken durchgeführt (PubMed, Scopus, Web of Science, LILACS, The Cochrane Library, Embase und EBSCO:Dentistry & Oral Science) und einer Quelle für graue Literatur (Google Scholar) durchgeführt. Alle Datenbanken wurden von September 2022 bis März 2023 durchsucht. Nach Duplikatsausschluss und Datenextraktion wurden die Newcastle-Ottawa-Skala zur Bewertung von Qualität und Bias-Risiko angewandt und das GRADE-Tool (Grading of Recommendations Assessment, Development and Evaluation) zur Überprüfung der Evidenzsicherheit.

Ergebnisse

Einbezogen wurden 3 Fall-Kontroll-Studien, in denen die Spiegel von RANKL („receptor activator of nuclear factor kappa‑B ligand“), OPN (Osteopontin) und IL(Interleukin)-17A verglichen worden waren. Eine Studie berichtete über einen signifikanten Unterschied bei den RANKL- und eine andere bei den OPN-Werten. Eine dritte Studie berichtete über eine höhere Expression von IL-17A in der Gruppe der postmenopausalen Frauen. Die geringe Anzahl von Veröffentlichungen schränkt jedoch unsere systematische Überprüfung ein. Die Heterogenität und Ungenauigkeit der Studienergebnisse lassen Zweifel an der internen Validität der Ergebnisse aufkommen.

Schlussfolgerung

Die Studien berichteten über Veränderungen der Biomarkerspiegel, kamen jedoch zu unterschiedlichen Schlussfolgerungen. Daher müssen weitere Studien andere Arten von Knochen- und Entzündungsbiomarkern bei prä- oder postmenopausalen Patientinnen einbeziehen, die sich einer kieferorthopädischen Behandlung unterziehen.

Registrierung

Der Review wurde beim Open Science Framework (https://doi.org/10.17605/OSF.IO/Q9YZ8) registriert.

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Data Availability

The data used to support the findings of this study are available from the corresponding author upon request.

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Acknowledgements

This work was supported by Research Pro-Rectory of Federal University of Pará (PROPESP, UFPA, Brazil), Brazilian National Council for Scientific and Technological Development (CNPq), Support Research Foundation from State of Pará (FAPESPA).

Funding

This study was supported in part by Coordination for the Improvement of Higher Education Personnel—Brazil (CAPES) Finance Cod 001.

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Authors and Affiliations

  1. Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Augusto Corrêa street n°1, Campus do Guamá, 66075-900, Belém, Pará, Brazil

    Deborah Ribeiro Frazão, Yago Gecy de Souza Né, Maria Karolina Martins Ferreira, Nathália Carolina Fernandes Fagundes & Rafael Rodrigues Lima Ph.D.

  2. School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada

    Nathália Carolina Fernandes Fagundes

  3. Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Guido Marañón-Vásquez, Lucianne Cople Maia & Matheus Melo Pithon

  4. Department of Orthodontics, State University of the Southwest of Bahia, Jéquie, Bahia, Brazil

    Matheus Melo Pithon

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  1. Deborah Ribeiro Frazão
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Contributions

DRF and YGSN performed the searches, data extraction, quality assessment, analysis of results, and manuscript elaboration. MKMF, NCFF, and GMV performed the interpretation of results and manuscript elaboration. LCM, MMP and RRL performed the analysis of results and manuscript elaboration. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Rafael Rodrigues Lima Ph.D..

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Conflict of interest

D.R. Frazão, Y.G.S. Né, M.K.M. Ferreira, N.C.F. Fagundes, G. Marañón-Vásquez, L.C. Maia, M.M. Pithon and R.R. Lima declare that they have no competing interests.

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Frazão, D.R., Né, Y.G., Ferreira, M.K.M. et al. Changes in biomarkers levels from gingival crevicular fluid in pre- and postmenopausal women undergoing orthodontic treatment. J Orofac Orthop (2024). https://doi.org/10.1007/s00056-024-00519-0

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