Comparison of levels of inflammatory mediators IL-1beta and betaG in gingival crevicular fluid from molars, premolars, and incisors during rapid palatal expansion.

INTRODUCTION: Previously, we reported fluctuation of the levels of the inflammatory mediators interleukin-1beta (IotaL-1beta) and beta-glucuronidase (betaG) in gingival crevicular fluid (GCF) from the maxillary first molars in adolescents undergoing rapid palatal expansion. In this study, we compared the responses of IL-1beta and betaG in the GCF of the maxillary first molars, first premolars, and central incisors during palatal expansion at the same patients. METHODS: Nine patients requiring palatal expansion were selected at the postdoctoral orthodontic clinic at Columbia University College of Dental Medicine. Each patient received periodontal prophylaxis and instructions in proper home care including rinsing with chlorhexidine. Four weeks after periodontal prophylaxis, a modified hyrax appliance was placed. The jackscrew was activated twice daily until the appropriate expansion was achieved. GCF samples were collected before and after periodontal prophylaxis and during passive wearing of the appliance, active orthodontic treatment, and retention. Fluid samples were collected with filter paper strips and analyzed by ELISA and time-dependent fluorometry for IL-1beta and betaG, respectively. The values recorded after periodontal prophylaxis were used as the baseline. Paired t tests were used to compare mediator levels at baseline with the levels obtained at each subsequent observation. RESULTS: The results validate that IL-1beta and betaG are present in the GCF of adolescents, and, although their level decreases after a strict regimen of plaque control, it increases during orthodontic or orthopedic movement. Moreover, this study demonstrates that both heavy and light forces evoke increased levels of IL-1beta and betaG, stronger forces cause higher levels of inflammatory mediators, and both IL-1beta and betaG respond to direct and indirect application of mechanical force to teeth. CONCLUSIONS: This investigation corroborates previous findings that an inflammatory process occurs during application of mechanical force to teeth. Although this inflammation is considered relatively aseptic, additional inflammation, such as that induced by plaque accumulation, must be avoided during orthodontic or orthopedic treatment.

Comparison between panoramic and intra-oral radiographs for the assessment of alveolar bone levels in a periodontal maintenance population.

BACKGROUND: Information about the agreement between intra-oral (I-O) and panoramic (OPG) radiographs is limited. AIMS: : (1) To assess the agreement between I-Os and OPGs for direct measurements of the distance between the cemento-enamel junction (CEJ) and the alveolar bone level (BL) as well as the proportional values in relation to the root length (CEJ-BL/root length), and (2) to explore the symmetry between the left- and right-side measurements. MATERIAL AND METHODS: I-Os and OPGs were studied in 292 periodontal maintenance subjects (mean age 55.5 years, SD+/-12.6) with on average 22.4 teeth (SD+/-4.1 range: 6-28). The images were measured using a PC software program. Site-based I-O and OPG values for CEJ-BL as well as CEJ-BL/root length were compared. OPG values of CEJ-BL/root length values between the left and right sides were also studied. RESULTS: A total of 11,395 linear distances (CEJ-BL plus CEJ-apex) from the I-Os and 21,462 linear distances from the OPGs were measured. The intra-class correlation coefficients (ICCs) between sets of readings of CEJ-BL varied between 0.80 and 0.89 (p<0.001), with the best agreement for tooth 22 (ICC: 0.89; 95% CI: 0.83-0.92). The ICCs for CEJ-BL/root length varied between 0.54 and 0.92. Mean differences between I-O and OPG values were in the 0.00-0.04 mm range for the CEJ-BL/root length comparisons. The maxillary anterior sextant demonstrated a 1.4 x enlargement by OPG for the CEJ-BL/root length comparisons. No distortions were observed for mandibular sextants. Left- and right-side symmetry of periodontal bone loss was demonstrated. ICC varied between 0.79 (95.00% CI: 0.71-0.84, p<0.01) and 0.53 (95.00% CI: 0.36-0.65, p< 0.01). CONCLUSIONS: I-O and OPG radiograph readings are in great agreement. Alveolar bone loss appeared to have a symmetrical distribution pattern. Hence for periodontal assessments, OPG radiographic readings may, at least in part, substitute for full-mouth periapical radiographic evaluation.