Resumo
Introdução: A reabsorção radicular externa induzida por ortodontia (RREO) é uma complicação frequente e imprevisível. Os métodos radiográficos apresentam sensibilidade limitada; por isso, biomarcadores presentes na saliva e no fluido crevicular gengival (FCG) podem possibilitar a detecção precoce e não invasiva.
Objetivo: Analisar criticamente as evidências atuais sobre biomarcadores orais associados à RREO, com ênfase no seu potencial diagnóstico precoce.
Métodos: Revisão narrativa conforme os critérios SANRA. Realizaram-se buscas nas bases de dados PubMed, Scopus, Web of Science, Cochrane Library e SciELO. Foram incluídos estudos com humanos e animais que quantificaram biomarcadores na saliva ou no FCG na presença de reabsorção induzida por ortodontia em comparação com controles. Excluíram-se comunicações breves, cartas e literatura sem dados originais. Adicionou-se busca manual. Foram integrados 28 estudos.
Resultados: As evidências sugerem o envolvimento de múltiplos biomarcadores em fluidos orais associados à RREO. Proteínas dentinárias como a sialoproteína dentinária apresentaram aumento no FCG de dentes submetidos a forças ortodônticas com RREO. Também foi observado um aumento na razão RANKL/OPG em pacientes com RREO, juntamente com uma diminuição de citocinas anti-reabsortivas. Enzimas relacionadas à remodelação óssea, como a fosfatase alcalina, mostraram níveis elevados sob forças ortodônticas intensas.
Conclusões: As proteínas dentinárias são os biomarcadores mais promissores para detecção precoce e possível estratificação de severidade, enquanto mediadores ósseos e inflamatórios apresentam baixa especificidade diagnóstica. São necessários estudos longitudinais que validem pontos de corte, avaliem painéis multimarcadores e padronizem métodos de coleta e quantificação.
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