Comparison of cytokine level changes in gingival crevicular fluid between the aligner and pendulum appliance during early molar distalization : A single-center, prospective, observational study

There is currently a lack of evidence pertaining to gingival crevicular fluid cytokine levels in patients treated with the pendulum appliance. This study aimed to compare changes in cytokine secretion levels in gingival crevicular fluid (GFC) between the aligner and pendulum appliance in patients undergoing molar distalization.

GFC samples were collected from 28 participants with asymmetrical dental class II malocclusion who were undergoing molar distalization using aligners or pendulum appliances. An enzyme-linked immunosorbent assay was used to detect cytokine secretion levels during asymmetrical molar distalization for up to 14 days. Periodontal health indices and tooth movements were also assessed.

No significant difference was found for the distalization distance between the two appliances. The Silness and Loe Plaque Index and Lobene Modified Gingival Index increased in the pendulum group but not in the aligner group at 14 days. Interleukin-1β and tumor necrosis factor‑α were upregulated in both groups. In the pendulum group, receptor activator of nuclear factor kappa‑Β ligand and osteoprotegerin secretion levels were significantly upregulated and downregulated, respectively; smaller changes in these two cytokines were observed in the aligner group.

Pendulum appliances exert stronger forces than aligners, which cause more changes in the secretion of inflammatory mediators in young patients.