The Change Of Sclerostin In Gingival Crevicular Fluid Of Chronic Periodontitis Before And After Periodontal Initial Therapy

Chronic periodontitis is a common disease in human and plaque biofilms is a major etiological factor of the disease.Balance disturbance between oral microorganisms and host immune status leads to various degrees of periodontal tissue damage.Bone loss is a main characteristic of periodontitis,bone metabolism is a complex biological process regulated by many signaling pathways.Sclerostin,a secreted glycoprotein,is a product of the SOST gene.Sclerostin is mainly secreted by osteocytes.Sclerostin inhibits osteoblast differentiation by blocking the Wnt signaling pathway.Sclerostin plays a key role in bone metabolism.Objective: To investigate the change of sclerostin in gingival crevicular fluid(GCF)of periodontitis before and after periodontal initial therapy and the difference of sclerostin levels between patients with chronic periodontitis and healthy controls.Analyze the correlation between sclerostin in GCF and clinical parameters and explore the relationship between sclerostin and chronic periodontitis activity and pathogenesis.Assess the possibility of sclerostin in GCF as a diagnostic and prognostic biomarker for chronic periodontitis and provide new evidence that sclerostin is a potential therapy strategy for bone protection and regeneration.Methods:1 Twenty-eight subjects who visited the stomatology department of Bethune International Peace hospital from May 2016 to October 2016 were selected.They were categorized into two groups: chronic periodontitis group(n=15;group A,8 males and 7 females;age: 41.13±9.36years)and healthy control group(n=13;group B,7 males and 6 females;age: 40.15±8.80years).The selected individuals had a minimum of twenty natural teeth,there at least be one molar in maxillary and mandible respectively,excluding thirdmolars.Subjects had no history of periodontal therapy or drug therapy(non-steroid anti-inflammatory drugs,antibiotics,immunosuppressant drugs)for at least six months.Chronic periodontitis patients were defined by PD>4mm,CAL?3mm,positive BOP,radiographic evidence of bone loss involving at least one thread of root,and bone loss affecting >30% of the existing teeth.The healthy controls were defined by PD<3mm,CAL=0,no BOP and no bone loss evidenced by radiograph.2 PD and CAL were measured and PLI,BI and mobility were evaluated before periodontal initial therapy(base line)and six weeks after periodontal initial therapy.Examined and recorded clinical parameters of healthy control subjects.3 Patients with chronic periodontitis received periodontal initial therapy including plaque control,ultrasonic supragingival scaling,subgingival scaling,root planning and occlusal therapy.The patients received oral hygiene education every visiting time.4 Forty-eight hours before GCF samples were collected,clinical examinations had been completed.In the periodontitis group,GCF samples were collected before periodontal initial therapy(group A1),one week after ultrasonic supragingival scaling(group A2)and two week(group A3),four weeks(group A4),six weeks(group A5)after scaling and root planning.In the healthy group,GCF samples were collected from sites with no clinical inflammation only once.5 Sclerosin levels in GCF were quantified with ELISA.Results:1 The clinical parameters including PLI,BI,PD and CAL reduced after periodontal initial therapy(P<0.05),the difference was statistically significant.2 The concentration of sclerostin in GCF of healthy control subjects was76.12±8.98pg/ml.3 The concentration of sclerostin in GCF of patients with chronic periodontitis before therapy(group A1)was 179.67±19.18pg/ml.One week after ultrasonic supragingival scaling(group A2),the concentration reduced to125.04±14.71 pg/ml.Two weeks after scaling and root planning(group A3),sclerostin concentration was 80.49±11.75 pg/ml,four weeks after scaling and root planning(group A4),sclerostin concentration was 90.62±10.51 pg/ml,six weeks after scaling and root planning(group A5),sclerostin concentration was81.54±12.42 pg/ml.There was no significant difference in sclerostin concentrations between group A5 and healthy group(P>0.05).The level of sclerosin in GCF of subjects with periodontitis decreased wavily.4 The concentration of sclerostin in GCF was found to be positively correlated with PD(r=0.915,P<0.001).Positive correlation were found between concentration of sclerostin and CAL(r=0.817,P<0.001).The concentration of sclerostin in GCF was found to be positively correlated with BI(r=0.804,P<0.001).Conclusion:1 The sclerostin was detected in GCF in both of control group and chronic periodontitis group and the former is lower than the latter.2 In the process of periodontal treatment,sclerostin in GCF decreased wavily,and no significant differences were found in sclerostin levels between control group(group B)and six weeks after scaling and root planning(group A5).3 In periodontitis group,the concentration of sclerostin in GCF was found to be positively correlated with PD,CAL and BI.4 Sclerostin in GCF may be proved to be a diagnostic and prognostic biomarker for periodontal disease.