Date of Award



Department of Orthodontics

First Advisor

Marie M. Tolarová

First Committee Member

Mirek Tolar


OBJECTIVES. Studies on quantitative relationships between magnitude of force applied to a tooth root and formation of gingival crevicular fluid (GCF) biomarkers (volume, concentrations of cytokines, enzymes, etc.) in clinical settings are lacking. This study aims to answer the question: What can analysis of GCF flow dynamic characteristics inform us about orthodontic tooth movement in a patient treated by Invisalign? METHODS. In three participants, two GCF samples were collected from five maxillary and five mandibular teeth during start, middle and end of Invisalign treatment. Plaque index and pocket depths were determined. Periopaper strips (Oraflow) were used for collection of GCF, volume was measured by Periotron 8000 (Oraflow). All collections of GCF (1200 periostrips) were performed by the same person at the same time in the week and day (IRB#2021-61). Patients were examined by CBCT before start of treatment, one patient also at the end. iTero digital models were obtained at the start and end of treatment. Aligners were changed every week. RESULTS. Predictors of force applied to tooth roots were obtained from ClinCheck website and crown movements were directly measured on iTero digital model. GCF volume dynamics was described by two variables – normalized GCF flow and aligner ratio. Significant differences were found between unmoved and moved teeth in the same patient. Magnitude of variables increased at the start and duration of Invisalign treatment and declined back at the end of treatment corresponding with the start and end of force application to a tooth. CONCLUSIONS. Our results suggest that there is a quantitative relationship between normalized GCF flow and aligner ratio variables and applied orthodontic force by Invisalign. Analysis of GCF flow and aligner ratio dynamics can contribute to deeper understanding of a quantitative relationship between force and PDL tissue responses in patients treated with Invisalign.