Identification and comparative evaluation of bone morphogenetic Protein 4 (BMP4) in the saliva during the stages of fixed orthodontic therapy

Background: Orthodontic tooth movement (OTM), a fundamental aspect of orthodontic therapy aiming to achieve proper tooth alignment, can be monitored through salivary proteomic analysis.Specifically, the evaluation of bone morphogenetic protein-4 (BMP-4) levels in saliva offers a potential tool to assess changes occurring during OTM.Aim: This study aims to identify and evaluate the BMP-4 in the saliva of individuals at various periods undergoing fixed orthodontic appliances involving extraction of the first premolar. Materials and Methods:This present observational study investigated BMP-4 levels in the saliva of malocclusion patients undergoing orthodontic treatment compared to a control group.Twenty-two participants aged 15-35 years were divided into two groups: orthodontic treatment (n=15) and non-orthodontic (n=7).Saliva samples were collected at six time points across the alignment (Days 1, 7, 30) and retraction (Days 0, 30, 60 post-extraction) phases.BMP-4 levels were measured using ELISA.Data were statistically analyzed with a significance level of p < 0.05.Results: Salivary BMP-4 levels in the treated group progressively increased during alignment (Day 1: 1214.51 ± 615.16 pg/ml; Day 7: 1523.01 ± 577.43 pg/ml; Day 30: 1922.39 ± 397.26 pg/ml; p = 0.004) and retraction (Day 0: 206.58 ± 151.43 pg/ml; Day 30: 634.89 ± 175.39 pg/ml; Day 60: 1318.58 ± 277.70 pg/ml; p = 0.001).Statistical significance (p = 0.001 and 0.008) was noted for overall BMP-4 differences between the groups during both alignment and retraction periods.Conclusion: Within the limitations of this study, it was found that the levels of BMP-4 increased post-lag period and this can be used to assess and improve the outcome of orthodontic treatment.To elucidate the role of BMP-4 in OTM, future studies should investigate its expression patterns throughout the treatment and post-treatment phases.