Effect of Corticosteroid Therapy on Tumor Necrosis Factor-Alpha during Orthodontic Tooth Movement with Self-Ligating Technique and Preadjusted Edgewise Technique and Alveolar Bone Loss in Partially Edentulous Patients

Abstract

Background: The recent bracket systems are passive self-ligating orthodontic appliance systems, which have been shown to have superior load transfer toward the fibers of periodontal ligament than the preadjusted edgewise (PEA) orthodontic appliance systems. Corticosteroids have been shown to affect bone turnover, therefore, it is crucial to know if they affect orthodontic tooth movement and cortical bone resorption in partially edentulous patients. Hence, the aim of the present study was to analyze the effect of corticosteroid therapy on tumor necrosis factor (TNF)-alpha during orthodontic tooth movement with PEA appliance and self-ligating technique and alveolar bone loss in partially edentulous patients. Materials and Methods: Ninety-two participants were included in the study. They were divided randomly into four different groups. Group A: PEA appliance, Group B: self-ligating appliance, Group C: partially edentulous patients, and Group D: healthy controls. The test groups were administered injections of corticosteroids, namely triamcinolone acetonide, intramuscularly in the preparation of 1 mg/kg/day each day for 7 days. Control group research participants received a placebo injection. Gingival crevicular fluid (GCF) sampling was done with Gapadent #30 ISO Paper Points according to the Offenbacher et al. technique (1986). A human TNF-Quantikine enzyme-linked immunosorbent assay kit was used to quantify TNF-α contents in the samples. The GCF collection was performed using the same techniques at baseline, 1 h, 24 h, and 168 h after the bracket installation samplings. Results: Concentration of TNF-α decreased in all groups at 1 h and 7 days when compared with the baseline. When there was a comparison between the groups, then it was observed that TNF-α decreased in all three test groups compared to baseline. The decrease was more in the preadjusted appliance as compared with the self-ligating appliance. The decrease in the concentration of TNF-α was greater in the preadjusted appliance as compared with the self-ligating appliance showing that inflammatory reaction was more reduced in the preadjusted orthodontic appliance, and the tooth movement was affected more in such appliance after corticosteroid therapy. Conclusion: There was also a significant decrease in the concentration of TNF-α in partially edentulous subjects after corticosteroid therapy.