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. 2021 Jun 28;22(13):6967.
doi: 10.3390/ijms22136967.

MMPs and TIMPs Expression Levels in the Periodontal Ligament during Orthodontic Tooth Movement: A Systematic Review of In Vitro and In Vivo Studies

Christian Behm  1   2 , Michael Nemec  1 , Fabian Weissinger  2 , Marco Aoqi Rausch  1   2 , Oleh Andrukhov  2 , Erwin Jonke  1
Affiliations

MMPs and TIMPs Expression Levels in the Periodontal Ligament during Orthodontic Tooth Movement: A Systematic Review of In Vitro and In Vivo Studies

Christian Behm et al. Int J Mol Sci. .

Abstract

Background: During orthodontic tooth movement (OTM), applied orthodontic forces cause an extensive remodeling of the extracellular matrix (ECM) in the periodontal ligament (PDL). This is mainly orchestrated by different types of matrix metalloproteinases (MMPs) and their tissue inhibitors of matrix metalloproteinases (TIMPs), which are both secreted by periodontal ligament (PDL) fibroblasts. Multiple in vitro and in vivo studies already investigated the influence of applied orthodontic forces on the expression of MMPs and TIMPs. The aim of this systematic review was to explore the expression levels of MMPs and TIMPs during OTM and the influence of specific orthodontic force-related parameters. Methods: Electronic article search was performed on PubMed and Web of Science until 31 January 2021. Screenings of titles, abstracts and full texts were performed according to PRISMA, whereas eligibility criteria were defined for in vitro and in vivo studies, respectively, according to the PICO schema. Risk of bias assessment for in vitro studies was verified by specific methodological and reporting criteria. For in vivo studies, risk of bias assessment was adapted from the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional study. Results: Electronic article search identified 3266 records, from which 28 in vitro and 12 in vivo studies were included. The studies showed that orthodontic forces mainly caused increased MMPs and TIMPs expression levels, whereas the exact effect may depend on various intervention and sample parameters and subject characteristics. Conclusion: This systematic review revealed that orthodontic forces induce a significant effect on MMPs and TIMPs in the PDL. This connection may contribute to the controlled depletion and formation of the PDLs' ECM at the compression and tension site, respectively, and finally to the highly regulated OTM.

Keywords: matrix metalloproteinases; orthodontic tooth movement; periodontal ligament; tissue inhibitor of matrix metalloproteinases.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Flow Diagram presenting the systematic search results.
Figure 2
Figure 2
Risk of bias assessment of all included in vitro studies. Risk of bias was evaluated by assessing various methodological (a) and reporting (b) criteria, which was adapted from Samuel et al., 2016.
Figure 3
Figure 3
Risk of bias assessment of all included in vivo studies. Risk of bias was evaluated by assessing specific criteria, which was adapted from the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional study.
See this image and copyright information in PMC

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