Association between bone turnover markers and periodontitis: A population‐based cross‐sectional study
Stefan Lars ReckelkammAnke HannemannThomas KocherMatthias NauckHenry VölzkeBenjamin EhmkeMartina RaunerZoheir AlayashSebastian‐Edgar BaumeisterMichael NoldeBirte Holtfreter
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Abstract:
To examine the associations between bone turnover markers and periodontitis in two cross-sectional population-based studies.We used data from two independent adult samples (N = 4993), collected within the Study of Health in Pomerania project, to analyse cross-sectional associations of N-procollagen type 1 amino-terminal propeptide (P1NP), C-terminal cross-linking telopeptide, osteocalcin, bone-specific alkaline phosphatase (BAP), fibroblast growth factor 23, wingless-type mouse mammary tumour virus integration site family member 5a (WNT5A), and sclerostin values with periodontitis. Confounder-adjusted gamma and fractional response regression models were applied.Positive associations were found for P1NP with mean pocket probing depth (PPD; eβ=1.008 ; 95% confidence interval [CI]: 1.001-1.015), mean clinical attachment loss (mean CAL; eβ=1.027 ; 95% CI: 1.011-1.044), and proportion of sites with bleeding on probing (%BOP; eβ=1.055 ; 95% CI: 1.005-1.109). Similar associations were seen for BAP with %BOP ( eβ=1.121 ; 95% CI: 1.042-1.205), proportion of sites with PPD ≥4 mm (%PPD4) ( eβ=1.080 ; 95% CI: 1.005-1.161), and sclerostin with %BOP ( eβ=1.308 ; 95% CI: 1.005-1.704). WNT5A was inversely associated with mean PPD ( eβ=0.956 ; 95% CI: 0.920-0.993) and %PPD4 ( eβ=0.794 ; 95% CI: 0.642-0.982).This study revealed scattered associations of P1NP, BAP, WNT5A, and sclerostin with periodontitis, but the results are contradictory in the overall context. Associations reported in previous studies could not be confirmed.Keywords:
Cross-sectional study
Bone remodeling
Association (psychology)
An association is present between periodontitis and rates of expression of certain microRNAs (miRNAs) in periodontal tissue. However, the association between periodontitis and miRNA levels in human serum is unknown. We performed a case-control study in patients with chronic periodontitis to investigate serum miRNA levels.We enrolled 30 healthy patients without periodontitis and 30 patients with chronic periodontitis. Participants underwent clinical examination, case selection, and a blood draw from the antecubital vein. Serum miRNA profiles were compared in samples from participants with and without chronic periodontitis using microarray and real-time PCR.Microarray demonstrated seven miRNAs that were expressed <1/1.5 or >1.5 in the control group compared to the periodontitis group (p < 0.05). Real-time PCR showed that hsa-miR-664a-3p, hsa-miR-501-5p, and hsa-miR-21-3p were higher in the periodontitis group than the control group (p < 0.05).Hsa-miR-664a-3p, hsa-miR-501-5p, and hsa-miR-21-3p are candidate serum biomarkers for chronic periodontitis.
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Bone remodeling is a fundamental mechanism of bone metabolism in tissue level. Bone remodeling demonstrates sequential phase of activation, resorption, reversal, and formation. Bone histomorphometry can make the quantitative assessment of the turnover in bone remodeling.
Bone remodeling
Bone remodeling period
Tissue Remodeling
Bone histomorphometry
Bone tissue
Bone Formation
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Objective To detect the distributions and expressions of Toll-like receptor-2(TLR-2)and TLR-4 in different kinds of periodontitis and different extent of the inflammation of gingival tissues and to discuss the roles of TLR-2 and TLR-4 in the progress of periodontal inflammation.Methods Gingival biopsies were divided into 5 groups:control group(n=10),chronic periodontitis group(n=10),chronic periodontitis clinically healthy group(n=10),aggressive periodontitis group(n=10),and aggressive periodontitis clinically healthy group(n=10).The distributions and expressions of TLR-2 and TLR-4 were detected by immunohistochemistry.Results TLR-2 and TLR-4 expressed in all layers of gingival connective tissues.TLR-4 was also observed in gingival epithelium.Compared to control group,expressions of TLR-2 and TLR-4 were significantly higher than those in the other 4 groups(P0.05).Expressions of TLR-2 and TLR-4 in chronic periodontitis group were significantly higher than those in aggressive periodontitis group(P0.05).Expression of TLR-4 in chronic periodontitis clinically healthy group was significantly higher than that in aggressive periodontitis clinically healthy group(P0.05).But expression of TLR-2 in chronic periodontitis clinically healthy group was significantly lower than that in aggressive periodontitis clinically healthy group(P0.05).Conclusion TLR-2 and TLR-4 might be involved in the progress of periodontal inflammation.But expressions of TLR-2 and TLR-4 in gingival tissues from different kinds periodontitis may be different.
Aggressive periodontitis
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BACKGROUND:
The biological functions of periostin, a matricellular protein, include the importance of it for connective tissue integrity in both health and disease along with regulation in formation of bones. The purpose of this present study was to assess the levels of periostin in gingival crevicular fluid of patients with chronic periodontitis and aggressive periodontitis and to compare them with that of healthy subjects.
MATERIALS AND METHODS:
A total of 39 individuals were enrolled in the study. Individuals were divided into three groups following clinical and radiographic examinations: the healthy group (n = 13), the chronic periodontitis group (n = 13) and the aggressive periodontitis group (n = 13). Gingival crevicular fluid samples were collected using microcapillary pipette and periostin levels were determined using the enzyme-linked immunosorbent assay.
RESULTS:
The mean levels of total periostin in gingival crevicular fluid were 182.41 pg/μl, 79.87 pg/μl and 49.28 pg/μl for the healthy, chronic periodontitis, aggressive periodontitis groups respectively. There was a statistically significant difference between the groups (p < 0.05). The mean levels of total periostin in gingival crevicular fluid were significantly lower in the chronic periodontitis and aggressive periodontitis groups than in the healthy controls. There was a statistically significant difference among healthy and chronic periodontitis groups (p < 0.05), among healthy and aggressive periodontitis groups (p < 0.05) and also among chronic periodontitis and aggressive periodontitis groups (p < 0.05). When all clinical groups were examined together, there were negative correlations between periostin levels in gingival crevicular fluid and age, mSBI, Plaque Index, CAL (r = -0.303, -0.788, -0.655, -0.691 respectively).
CONCLUSION:
The periostin levels in gingival crevicular fluid decreased with increased severity of the periodontal disease. When the results in the present study are considered in conjunction with those of previous reports, it might be concluded that the periostin level in gingival crevicular fluid can be considered as a reliable marker in the diagnosis of periodontal diseases and disease activity.
Periostin
Aggressive periodontitis
Matricellular protein
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Development of bone metabolism markers began about 35 years ago. Current by the osteoporosis and bone metabolism diseases diagnosis and treatment efficacy. In childhood and adolescence, bone formation and resorption were increased, but formation rate was exceeded resorption rate. To keep strength of bone, bone formation and resorption are balanced(remodeling)in the period of maturity, Bone mineral density greatly decreases and biochemical markers of bone turnover markedly increase in postmenopausal women, indicating accelerated bone remodeling because of estrogen withdrawal. On the other hand, pregnancy and breastfeeding affect bone metabolism. So, we gynecologists should be careful about bone health with understanding characteristic of bone metabolism markers.
Bone remodeling
Bone remodeling period
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Aim: The aim was to evaluate the levels of 8-Hydroxy deoxyguanosine levels, as a marker of oxidative stress in Chronic Gingivitis and Chronic Periodontitis individuals during the course of Phase 1 periodontal therapy in comparison with Periodontally healthy Individuals. Materials and Method: All the individuals were divided into 3 groups each including 16 subjects. Group 1 included healthy subjects and group 3 and 4 included subjects with chronic gingivitis and chronic periodontitis respectively. Saliva samples were collected and the 8-OHdG levels were assessed. Results: The levels reduced to 1.59±0.50 in chronic periodontitis group one month after scaling and root planing. A statistically non-significant value of 0.09 was recorded. The levels in chronic gingivitis group were 1.20±0.89. Conclusion: From the above study it can be concluded that 8-OHdG is an important biomarker of oxidative stress and is increased in patients with chronic gingivitis and chronic periodontitis.
8-Hydroxy-2'-deoxyguanosine
Deoxyguanosine
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Chronic Periodontitis, is a globally common oral problem. Lately, the association between periodontitis and cardiovascular disease has received greater attention, though there is paucity of database in local population. The objective of this study was to explore the possible association of chronic periodontitis with cardiovascular disease by elevating C-reactive proteins (C-RP), and to study any influence of gender, in the study population. Methods: This was an analytical cross-sectional study and involved 75 patients (46 males and 29 females) volunteering their blood samples, out of which 55% carried both cardiac and periodontal diseases, whereas 45% had periodontitis alone. Serum level of C-RP was assessed by performing sandwich ELISA. Results: In both genders C-RP was higher in case of mild periodontitis as compared to severe one. In males raised serum level of C-RP was noticed in patients of cardiovascular disease along with periodontitis in comparison to those who had only chronic periodontitis. Male and female patients who had chronic periodontitis alone showed significantly less concentration of C-RP as compared to patients with chronic periodontitis along with heart disease. Highest level of C-RP was seen in both genders, with cardiac disease accompanied with mild periodontitis rather than with severe periodontitis. Furthermore, in all categories females showed relatively low C-RP. Conclusion: Mild state of chronic periodontitis is more pronounced threat towards cardiovascular disease, especially among males.
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Background: Periodontitis is a chronic inflammatory disease which is multifactorial. Diabetes mellitus (DM) is one of the major systemic factors to influence the severity of chronic periodontitis. Numerous inflammatory markers are produced in the course of the disease which is secreted in saliva too. This study evaluates the salivary concentrations of interleukin-6 (IL-6) in periodontitis patients with type 2 diabetes. Materials and Methods: Whole saliva samples were collected from eighty patients who were further divided into four groups; healthy (control group; n = 20), untreated periodontitis (UPD; n = 20), DM (DM; n = 20), and UPD + DM (n = 20 groups). Salivary IL-6 concentrations were determined by standard enzyme-linked immunosorbent assay. Results: Results show that the UPD patients with and without DM exhibited higher concentrations of salivary IL-6 than the control group and diabetes groups. Further, the salivary IL-6 was correlated with glycosylated hemoglobin A levels in patients with diabetes. Conclusion: Concentration of salivary IL-6 was elevated in patients with periodontitis with and without diabetes. Thus, salivary IL–6 levels can be considered as an important biomarker in the diagnosis of periodontitis and diabetes.
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Periodontitis is a destructive inflammatory disease caused by a specific microorganism causing progressive damage to areas, especially the alveolar bone and periodontal ligament. Clinical manifestations of periodontitis are tooth mobility, pocket formation, and loss of attachment. Periodontitis is divided into two groups, namely aggressive and chronic periodontitis. The prevalence of chronic periodontitis in the world is around 50%. Meanwhile, the prevalence of chronic periodontitis in Indonesia, according to Riskesdas 2018 is 67.8%. Porphyromonas gingivalis is a bacterium that causes chronic periodontitis, which can form biofilm plaque and cause damage to periodontal tissue resulting in tooth loss. The formation of biofilm plaques due to accumulation of opportunistic bacterial species accompanied by increased gram-negative bacterial. These changes in composition affect the host's immune response so that periodontitis develops into a chronic inflammatory condition. Therefore, we conducted a literature search to analyze the effect of oral biofilms on chronic periodontitis.
Periodontal fiber
Clinical attachment loss
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Background and Objective Microbiological and immunological hypotheses have been raised to explain the differences in the clinical manifestations of aggressive periodontitis and chronic periodontitis. However, studies comparing the cytokine/chemokine profiles in gingival crevicular fluid between these two clinical conditions have so far not been compiled. This systematic review aimed to answer the following question: “Do subjects with aggressive periodontitis and chronic periodontitis have a different profile of cytokines/chemokines in the gingival crevicular fluid?” Material and Methods An electronic database search of M EDLINE/ P ubMed and E mbase was performed from 1990 up to and including A ugust 2013, using M e SH terms and other keywords. Titles and abstracts were screened and the papers that satisfied eligibility criteria were assessed. Results Of 1954 titles, 17 studies reporting the levels of 21 different cytokines/chemokines were included. Most studies did not find any significant differences in the gingival crevicular fluid levels of cytokines/chemokines between aggressive periodontitis and chronic periodontitis. Some studies demonstrated that the levels of specific proinflammatory and anti‐inflammatory cytokines/chemokines were higher ( n = 5) and lower ( n = 3), respectively, in aggressive periodontitis than in chronic periodontitis. The studies differed in the manner in which they reported the results (e.g. concentrations or total amounts). It was not clear in some studies whether the sample sites from both groups were matched for disease severity. Some studies did not take into account confounders, such as smoking. Conclusion The current weight of evidence is not sufficient to prove that there are distinct gingival crevicular fluid cytokine/chemokine profiles for patients with aggressive periodontitis and chronic periodontitis.
Aggressive periodontitis
Proinflammatory cytokine
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