GCF PLAP-1, Sclerostin and TNF-α Levels in Periodontitis
Condition: Periodontitis
MeSH terms: Periodontitis
Study type: Observational

Summary: 
      Periodontal ligament-associated protein-1 (PLAP-1) and sclerostin play an important role in
      the suppression of bone formation. Tumor necrosis factor-alpha (TNF-α) is an important
      proinflammatory cytokine involved in periodontal bone loss. This study aims to investigate
      gingival crevicular fluid (GCF) PLAP-1, sclerostin and TNF-α levels in individuals with
      periodontal disease. Totally 71 systemically healthy and non-smoker individuals consisting of
      stage 3 grade C periodontitis (n=23), gingivitis (n=24) and periodontally healthy (n=24) were
      enrolled. Periodontal status was evaluated by measuring the full-mouth clinical periodontal
      parameters. GCF PLAP-1, sclerostin and TNF-α total amounts were measured by ELISA. Data were
      analyzed using non-parametric statistical tests.
    

Detailed description: 
      According to the clinical and radiographic criteria outlined in the 2017 International
      Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions
      participants were categorized into three distinct groups based upon their periodontal status:
      1) 23 patients with stage 3 grade C (S3GC) periodontitis; 2) 24 patients with gingivitis; and
      3) 24 periodontally healthy individuals.

      Periodontal clinical parameters including probing depth (PD), clinical attachment loss (CAL),
      the dichotomous recording (present/absent) of bleeding on probing (BOP), gingival index (GI)
      and plaque index (PI) were recorded at six sites (mesio-buccal, mid-buccal, disto-buccal,
      mesio-lingual, mid-lingual, and disto-lingual) per tooth, except the third molars.

      GCF sampling was performed on the day following periodontal examination. GCF was sampled from
      the buccal aspects of non-adjacent proximal sites in two single-rooted teeth. Samples were
      obtained from two deepest pockets in periodontitis group and were taken from the sites with
      visible signs of inflammation in gingivitis group. GCF samples were collected from sites with
      no clinical inflammation in the healthy controls. Standardized paper strips were used for GCF
      sampling. The amount of collected GCF was measured by a precalibrated electronic device.

      PLAP-1, sclerostin and TNF-α levels in GCF samples were measured by the enzyme-linked
      immunosorbent assay (ELISA) via commercial kits, in line with the manufacturer's guidelines.
      GCF results for three analytes were expressed as total amounts (ng).

      All data analyses were carried out using a statistical package. Normality of the clinical and
      biochemical data was first checked by Shapiro Wilk's normality test. Comparisons of clinical
      parameters and GCF PLAP-1, sclerostin and TNF-α levels among the study groups were performed
      using Kruskal-Wallis test, followed by Dunn-Bonferroni post hoc test. The possible
      correlations of GCF biomarker levels with clinical periodontal parameters and also with each
      other were determined by Spearman rank correlation analysis.
    

Intervention name(s): Periodontal clinical measurements and GCF sampling
Intervention type(s): Other
Intervention description(s): Periodontal clinical parameters measurements probing depth (PD), clinical attachment loss (CAL), the dichotomous recording (present/absent) of bleeding on probing (BOP), gingival index (GI) and plaque index (PI) were recorded at six sites (mesio-buccal, mid-buccal, disto-buccal, mesio-lingual, mid-lingual, and disto-lingual) per tooth, except the third molars using a manual periodontal probe. A sterile paper strip was gently placed into the gingival sulcus/periodontal pocket until mild resistance was sensed and left in place for 30 seconds.
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        A total of 71 systemically healthy and never-smoker individuals (34 males and 37 females
        and; aged 27 to 46 years) were consecutively included for this cross-sectional study.
      
Biospecimen description: 
      Gingival crevicular fluid