is the Sclerostin Marker of Chronic Periodontitis

Study Overview
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Brief Summary
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Reviewed literature suggests that sclerostin will inhibit the bone formation and ultimately leads to chronic periodontitis. Estimation of Sclerostin levels in the serum of periodontitis patients before and after intervention could explore the effectiveness of therapy and also give a more detailed insight into its diagnostic and prognostic potential as a biomarker of periodontal disease.

Detailed Description
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Advances during the last decade provided relevant information on the regulation of Sost/sclerostin and its mechanism(s) of action. Several stimuli have been reported to regulate Sost/Sclerostin expression, however how these factors interplay to regulate the expression of this gene in a spatiotemporal manner is unknown. Animal studies demonstrate that sclerostin is key for skeletal homeostasis, and required for the bone anabolic response to mechanical loading although appears dispensable for PTH-induced bone gain. The knowledge provided by preclinical investigations resulted in clinical trials based on the neutralization of sclerostin activity as a novel osteoanabolic therapeutic approach. It is now clear that sclerostin is capable of uncoupling bone formation and bone resorption, by inhibiting osteoblast function while stimulating osteoclast function, as the bone gain achieved by pharmacologic inhibition of sclerostin results from stimulation of osteoblast activity and inhibition of bone resorption. Furthermore, the recent observations show that activation of βcatenin in osteocytes increases bone resorption and Rankl production in a sclerostin-dependent manner. Anti-sclerostin therapy has shown beneficial skeletal outcomes in osteoporotic patients, however more recent evidence shows that the anabolic effects of this therapy attenuate with time and that after discontinuation BMD returns to pretreatment levels over time. The new evidence showing increased levels of Sost/sclerostin (and Dkk1) after activation of Wnt-βcatenin signaling suggest that sclerostin (and Dkk1) act as a negative feedback limiting bone formation stimulated by this pathway. In this study is there any alterations in sclerostin levels in serum response to periodontal therapy was checked. Periodontal therapy alters the inflammation pathway is a proven fact.

Official Title
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Comparative Evaluation of Serum Sclerostin in Chronic Periodontitis Patients Before and After Surgical Periodontal Therapy in Conjunction With Nonsurgical Periodontal Therapy

Conditions
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Periodontitis

Intervention / Treatment
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* Other: non surgical and surgical periodontal therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria:• Systemically healthy individuals with more than 50% remaining natural teeth All the patients who are diagnosed as having generalized chronic periodontitis based on the American Academy of Periodontology (AAP) classification. Probing Pocket Depth (PPD)/ Clinical Attachment Loss(CAL) ≥ 5mm Patients indicated for periodontal surgery Exclusion Criteria:• The patients who have aggressive periodontitis/localized periodontitis Patients having any other systemic diseases Patients taking high-dose steroid therapy, radiation or immunosuppressive therapy and any other drug history. Pregnant and lactating woman. History of smoking within the past five years. Patients who had undergone periodontal therapy in the last six months. Intellectual disability

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Screening
Intervention Model: Sequential Assignment
Interventional Model Description: interventional prospective study
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: interventional prospective study<br>nonsurgical periodontal therapy(scaling and root planing) surgical therapy( flap surgery) | Other: non surgical and surgical periodontal therapy<br>* scaling and root planing periodontal flap surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| sclerostin level response to only scaling and root planing | measuring serum sclerostin levels in pg/ml(Pico grams per milli liter), | 4 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| sclerostin level response to periodontal surgery | measuring serum sclerostin levels after surgery in pg/ml(Pico grams per milli liter) | 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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periodontitis, sclerostin, periodontal surgery, scaling and root planing