Abstract
Introduction: Orthodontically induced external root resorption (OIERR) is a frequent and unpredictable complication. Radiographic methods have limited sensitivity; therefore, biomarkers in saliva and gingival crevicular fluid (GCF) may enable early and non-invasive detection.
Objective: To analyze current evidence on oral biomarkers associated with OIERR, emphasizing their potential for early diagnosis of this condition.
Methods: Narrative review in accordance with SANRA criteria. Searches were conducted in PubMed, Scopus, Web of Science, Cochrane Library, and SciELO. Included studies were conducted in humans and animals and quantified biomarkers in saliva or GCF in the presence of orthodontically induced resorption versus controls. Short communications, letters, and literature without original data were excluded. Manual reference searching was added. A total of 28 studies were included.
Results: The available evidence suggests the involvement of multiple oral fluid biomarkers in OIERR. Dentin-derived proteins, such as dentin sialoprotein (DSP), were elevated in the GCF of teeth subjected to orthodontic forces with associated resorption. An increased RANKL/OPG ratio was observed in patients with OIERR, along with reduced levels of anti-resorptive cytokines. Bone remodeling enzymes, such as alkaline phosphatase, were elevated under intense orthodontic forces.
Conclusions: Dentin proteins appear to be the most promising candidates for early detection and potential severity stratification, whereas bone and inflammatory mediators lack diagnostic specificity. Longitudinal studies are needed to validate cutoff points, assess multimarker panels, and standardize sampling and quantification methods.
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