Effects Of Self-ligating Bracket Appliance On The Expression Of Il-1β And TNF-α In GCF Of Orthodontic Patients With Periodontosis

Objective: To analyze the expressions of the interleukin-1β(IL-1β) and the tumor necrosis factor-α(TNF-α) in the gingival crevicular fluid(GCF) of orthodontic patients with periodontosis before and after wearing the traditional and self-ligating appliance respectively,using the method of enzyme linked immunosorbent assay(ELISA). To investigate the impact of different brackets types on periodontal health, and to provide theoretical basis to help the orthodontics in choosing more applicable bracket for patients with periodontosis.Methods: 12 orthodontic patients who visited the Department of the second hospital of Hebei Medical University between January to October, 2014, with periodontitis from mild to moderate, were involved in this study(4 men and 8 women; median age, 23.5 years; range, 21-45). The including criteria were defined as: healthy, nonsmoking; non-pregnant women or lactating; no dental caries or tooth decay has been filled; alveolar resorption less than 1/2 root length; no pulp and periapical lesions; thorough periodontal treatment before orthodontic procedure; good oral hygiene; no obvious oral habits;no medication use of antibiotics and steroids; routine oral hygiene instructions before orthodontic treatments including tooth brushing three times a day.12 patients with periodontitis were divided into two groups based on the use of different brackets of self-ligating bracket(group A) and traditional one(group B). The amount of Gingival crevicular fluid(GCF) and the concentration of IL-1β and TNF-α in GCF were measured for all the 12 patients at four different times: before the placement of orthodontic appliances(T0, as control), after that of one week(T1), two weeks(T2), and 4 weeks(T3), respectively. The stainless steel ligation wire was used for the traditional bracket group. The patients treatment and samples selection were performed by the same clinician, and the bracket bonding were carried out utilizing the same adhesive and method. The initial phase of orthodontic treatment were aligning and leveling and the GCF was obtained from four incisors of 11, 21, 31, and 41.GCF were collected at mesial and distal side of each incisor. Collected specimens were wrapped with aluminum foil immediately,and stored at the-70 ℃refrigerator until needed. GCF collection processes were completed by the same researcher. The analysis for GCF was carried out according to the instructions recommended by the manufacture.Statistics and analysis was performed using SPSS19.0 statistical software to compare the patient’s GCF volume, IL-1β and TNF-α concentration in gingival sulcus fluid for both the two groups in this study(ANOVA, α= 0.05; significant difference, P <0.05).Results:1 Comparative analysis for T0 group IL-1β Concentration: F=0.031, P=0.865>0.05;TNF-α Concentration: F=3.384, P=0.075>0.05; Amount of GCF: F=0.044, P=0.838>0.05;No significant differences were found in groups of T0.2 The amount of GCF from periodontal patients wearing different fixed orthodontic appliances both have a trend of increase in a certain extent at 1、2、4weeks after bonding brackets, and significantly increased following the prolonged wearing time of fixed appliance(P<0.05). Additionally, the amount of GCF from the patients wearing traditional bracket presented significantly higher than that wearing self-ligating bracket(ANOVA, P<0.05).3 The concentration of IL-1β and TNF-α both significantly increased after fixed appliances wearing(P<0.05). There were significant differences for IL-1β and TNF-α were also found between the traditional bracket group and the self-ligating bracket group, the difference of IL-1β level and TNF-α level between each two time points was also statistically significant(P<0.05). Both the IL-1β level and TNF-α level of self-ligating bracket patients were lower than that of traditional bracket patients.(P<0.05).Conclusion:1 For the patients with periodontitis, the GCF volume and level of IL-1β and TNF-α in GCF statistically increased when the fixed orthodontic appliances were wore. Thus we suggest that in the initial orthodontic stage, some damage will occur on the periodontal tissue resulting in a probable exacerbation of periodontitis.2 Compared with the traditional bracket appliance, the self-ligating bracket is more advantageous for orthodontic patients with periodontitis to maintain the oral hygiene and periodontal status due to its special structure and light force mechanism. This fixed appliance will be helpful for orthodontists to provide reliable treatment for the patients with periodontal disease.