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Tissue-specific biomarkers in gingival crevicular fluid are correlated with external root resorption caused by constant mechanical load: an in vivo study

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This study investigated the association of changes in cementum protein-1 (CEMP-1), dentine phosphoprotein (DPP), and c-terminal cross-linked telopeptide of type I collagen (CTX-I) levels in human gingival crevicular fluid (GCF) under constant load with external root resorption volume and amount of tooth movement.

Materials and methods

In total, 11 healthy adult patients (mean age, 23.5 years [range, 18.3–37.7]; four men and seven women) were enrolled. GCF samples were obtained from premolars at T0, T1 (1 day), T2 (1 week), T3 (2 weeks), T4 (4 weeks), and T5 (8 weeks) under constant 100-gm buccal tipping force. Opposite premolars were used as controls. Teeth were extracted at T5, followed by quantification of external root resorption volume and histological analysis.


In the test group, T5/T0 ratios of CEMP-1 and DPP levels, differential CEMP-1 levels between T5 and T0, and differential DPP levels between T2 and T0 correlated positively with root resorption volume (r = 0.734, 0.730, 0.627, and 0.612, respectively, all p < 0.05). CEMP-1 levels at T0 and T3 correlated negatively with root resorption volume (r = −0.603 and −0.706; all p < 0.05). CTX-I levels at T5 correlated positively with the amount of tooth movement (r = 0.848, p < 0.01).


Alterations in CEMP-1 and DPP levels in human GCF at specific timepoints during orthodontic treatment may be associated with different degrees of external root resorption.

Clinical relevance

This study demonstrates that changes in the levels of tissue-specific biomarkers in GCF may facilitate early detection of external root resorption during orthodontic tooth movement.

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The study was supported by a faculty research grant of Yonsei University College of Dentistry for 2017-0012.

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Authors and Affiliations



Conceptualization: Kee-Joon Lee. Methodology: Kee-Joon Lee. Formal analysis: Gui-Yue Huang. Investigation: Kee-Joon Lee and Gui-Yue Huang. Validation: Kee-Joon Lee. Data curation: Kee-Joon Lee. Writing — original draft: Gui-Yue Huang. Visualization: Gui-Yue Huang. Writing — review and editing: Sung-Hwan Choi, Hwi-Dong Jung, Hyun Sil Kim, Chung-Ju Hwang, and Kee-Joon Lee. Resources: Kee-Joon Lee. Supervision: Kee-Joon Lee. Project administration: Kee-Joon Lee. Funding acquisition: Kee-Joon Lee.

Corresponding author

Correspondence to Kee-Joon Lee.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the institutional review board of Yonsei University Dental Hospital (No. 2-2017-0014).

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Written informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Huang, GY., Choi, SH., Jung, HD. et al. Tissue-specific biomarkers in gingival crevicular fluid are correlated with external root resorption caused by constant mechanical load: an in vivo study. Clin Oral Invest 25, 6321–6333 (2021).

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