THERAPEUTIC AND ADVERSE ROLES OF WIDELY USED AGENTS IN MODULATING ORAL AND SYSTEMIC INFLAMMATION DURING ORTHODONTIC TREATMENT

Background: Orthodontic therapy is based on the application of the mechanical forces, which drives periodontal
ligament (PDL) remodelling and leads to alveolar bone resorption. But in addition to being necessary for the process
of tooth movement, these events create local and systemic inflammatory responses that can cause pain, gingival
inflammation and transient systemic changes. Several topical agents, including chlorhexidine, green tea extract,
nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids are common in orthodontic treatment as
inflammation modifiers. Such agents may have positive therapeutic effects, such as reduction in microorganisms and
gingival inflammation, but can lead to harmful consequences like delayed tooth movements, disturbed bone
metabolism and diminished stability of application.
Objectives: This work was to compare the therapeutic and adverse effects of some of pharmacological agents with
different natural substances. More precisely, the effects of chlorhexidine or green tea extract on oral and systemic
inflammation were contrasted with NSAIDs or corticosteroids impact on tooth movement, periodontal ligament
damage, and alveolar bone maintenance.
Methods:We used an integrated experimental and clinical approach. Orthodontic wires of stainless steel were exposed
to extracts of chlorhexidine, green tea, and black tea for evaluating the impact on corrosion behavior. surface roughness and tensile strength. Simultaneous preclinical animal models and human clinical trials were used to examine inflammatory biomarkers (IL-1β, TNF-α, CRP), gingival indices and tooth movement. Statistical analysis was
performed by ANOVA with Tukey’s post-hoc test (P < 0.05).
Results: Chlorhexidine and green tea extract significantly suppressed oral- and systemic-proinflammatory cytokines
without influence of tooth movement or alveolar bone remodeling. On the other hand, NSAIDs and steroids controlled inflammation efficiently, inducing inhibited OTM and transforming histological bone modification patterns.