Evaluation of inflammation during fixed orthodontic treatment

• The elevated hs-CRP level at month 3 indicates enhancement in inflammation during treatment.
• The elevation in the neutrophil: lymphocyte ratio supports increased inflammation three months after orthodontic therapy.
• Orthodontic therapy can affect the pattern and quality of feeding and the amount of nutrients ingested.

ObjectiveThe aim of this study was to assess effects of fixed orthodontic therapy on high-sensitivity C-reactive protein (hs-CRP) level, CBC parameters and levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), alkaline phosphatase (ALP), urea, creatinine, sodium (Na), potassium (K), calcium (Ca), total protein (TP), and albumin (Alb).DesignBlood samples (7 ml) were drawn at baseline, on days 1 and 7, and three months after placement of braces in the study group, while only one blood sample was drawn at baseline in the control group. Serum hs-CRP levels were measured by nephelometric method. Friedman two-way variance analysis was used to assess values with skewed distribution obtained at baseline, on days 1 and 7, in the third month. Wilcoxon rank sign test was performed if median values were unequal.ResultsDuring measurement periods, there were significant increases in hs-CRP level, WBC count and neutrophil count while a significant decrease in Na level (p < 0.05). K level was significantly decreased on the day 1. No significant differences were detected in other biochemical parameters evaluated.ConclusionElevation in serum hs-CRP levels and neutrophil: lymphocyte ratio within first 3 months indicates that a systemic immune response develops against therapy in patients undergoing fixed orthodontic therapy.