Fluctuation of bone turnover markers’ levels in samples of gingival crevicular fluid after orthodontic stimulus: a systematic review

Table 6 Summary of findings according to the GRADE approach. Population: orthodontic patients of any age and sex. Intervention: any type of removable or fixed orthodontic appliance resulting in OTM. Comparisons: any control group was accepted, i.e. untreated group, contralateral sides in split mouth design, control group with different type of orthodontic activations (i.e. force applied and constant or increasing forces)

Outcomes	Quality of the evidence (GRADE)	No. of participants (studies)	Comments
Alcaline phosphatase (ALP)	⊕OOO Very low ^a Due to inconsistency and indirectness	118 (6)
Osteopontin (OPN)	⊕OOO Very low ^b Due to indirectness	20 (2)	2 studies were excluded because they had different comparison groups
Osteocalcin (OC)	⊕OOO Very low ^c Due to indirectness	32 (2)	2 studies excluded due to the lack of comparison group
N-telopeptides (NTX)	⊕⊕OO Low ^d	20 (1)	One study was excluded due to the lack of comparison group
Tartate-resistant acid phosphatase (TRAP)	⊕OOO Very low ^e	19 (1)

^aDowngraded by two levels for bias due to high risk of bias for both included randomized studies and due to the inclusion of non-randomized studies with critical/serious risk of bias
^bDowngraded by two levels for bias due to high risk of bias for both included randomized studies
^cDowngraded by two levels for bias due to the inclusion of non-randomized studies with moderate/serious risk of bias
^dDowngraded because this is a non-randomized study
^eDowngraded by two levels for bias due to high risk of bias for both included randomized studies
Deoxypyridinol (DPD), bone alkaline phosphatase (BALP), and pyridinoline (PYD) are not included in the table since there is no comparison group in the included studies

ISSN: 2046-4053