Effect of Non-Surgical Therapy on Receptor Activator Level of Salivary Nuclear Factor Kappa B Ligand and Osteoprotegerin in Chronic Periodontitis: A Prospective Cohort Study
Regeneration, Reconstruction & Restoration (Triple R),
Vol. 5 (2020),
24 March 2020
,
Page e25
https://doi.org/10.22037/rrr.v5i.32784
Abstract
Introduction: The receptor activator of NF-kB ligand (RANKL) and osteoprotegerin (OPG) are molecules that play a significant role in bone resorption. The aim of this study was to evaluate the effect of periodontal therapy on the salivary levels of RANKL, OPG, and their relative ratio in patients with chronic periodontitis.
Materials and Methods: This prospective cohort study was conducted and twenty-five patients with chronic periodontitis and 25 volunteers with healthy periodontium were recruited in this study. All the patients received scaling and root planing (SRP) combined with oral hygiene instructions (OHI). Five mL unstimulated saliva sample was collected from all individuals at baseline and four weeks after periodontal therapy. Salivary RANKL and OPG concentrations were determined by enzyme -linked immunosorbent assays (ELISA). Demographic and clinical vari¬ables were compared between the groups using Fisher’s exact test. Comparisons of indices and analyses between the test and control groups were performed by independent t-test and Mann-Whitney U test. The correlations between the salivary and periodontal parameters were evaluated by Spearman correlation coefficient test.
Results: SRP improved all examined clinical parameters, and the RANKL concentration and sRANKL/OPG ratio decreased significantly in the saliva after the treatment (p=0.012 and p=0.011). However, no significant change was found for OPG (p=0.840).
Conclusion: Our observations indicated that non-surgical periodontal treatment significantly reduced the RANKL and sRANKL/OPG levels. Salivary levels of RANKL and sRANKL/OPG reflected the disease response to therapy, which is suitable for monitoring the results of periodontal treatment.
Keywords:
- Chronic Periodontitis
- Osteoprotegerin
- Root Planing
- RANK Ligand
- Saliva
How to Cite
Alizadeh Tabari, Z. ., Alizadeh Tabrizi, M. A. ., Baharak Ghaedi, F. ., Nohekhan, A. ., Moslemi, H., & Shafiei, S. . (2021). Effect of Non-Surgical Therapy on Receptor Activator Level of Salivary Nuclear Factor Kappa B Ligand and Osteoprotegerin in Chronic Periodontitis: A Prospective Cohort Study. Regeneration, Reconstruction & Restoration (Triple R), 5, e25. https://doi.org/10.22037/rrr.v5i.32784
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18. Gursoy UK, Könönen E, Uitto VJ, Pussinen PJ, Hyvärinen K, Suominen‐Taipale L, et al. Salivary interleukin‐1β concentration and the presence of multiple pathogens in periodontitis. 2009;36(11):922-7.
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21. Boyle WJ, Simonet WS, Lacey DL. Osteoclast differentiation and activation. J Nature. 2003;423:337-42.
22. Mogi M, Otogoto J, Ota N, Togari A. Differential expression of RANKL and osteoprotegerin in gingival crevicular fluid of patients with periodontitis. J Dent Res. 2004;83(2):166-9.
23. Vernal R, Chaparro A, Graumann R, Puente J, Valenzuela MA, Gamonal J. Levels of cytokine receptor activator of nuclear factor κB ligand in gingival crevicular fluid in untreated chronic periodontitis patients. J Periodontol. 2004;75(12):1586-91.
24. Giannobile WV, Beikler T, Kinney JS, Ramseier CA, Morelli T, Wong DT. Saliva as a diagnostic tool for periodontal disease: current state and future directions. J Periodontol. 2009;50(1):52-64.
25. Jentsch H, Sievert Y, Göcke R. Lactoferrin and other markers from gingival crevicular fluid and saliva before and after periodontal treatment. J Clin Periodontol. 2004;31(7):511-4.
26. Kaufman E, Lamster IB. Analysis of saliva for periodontal diagnosis: a review. J Clin Periodontol. 2000;27(7):453-65.
27. Henskens YM, van der Weijden FA, van den Keijbus PA, Veerman EC, Timmerman MF, van der Veiden U, et al. Effect of periodontal treatment on the protein composition of whole and parotid saliva. 1996;67:205-12.
28. Thomas MV, Branscum A, Miller CS, Ebersole J, Al‐Sabbagh M, Schuster JL. Within‐subject variability in repeated measures of salivary analytes in healthy adults. J Periodontol. 2009;80(7):1146-53.
29. Armitage GCJAop. Development of a classification system for periodontal diseases and conditions. 1999;4(1):1-6.
30. Armitage GC. Periodontal diagnoses and classification of periodontal diseases. J Periodontol. 2004;34:9-21.
31. Navazesh M. Methods for collecting saliva. ANN NY ACAD SCI. 1993;694(1):72-7.
32. Tabari ZA, Azadmehr A, Tabrizi MAA, Hamissi J, Ghaedi FB. Salivary soluble receptor activator of nuclear factor kappa B ligand/osteoprotegerin ratio in periodontal disease and health. J Periodontal Implant Sci. 2013;43(5):227-32.
33. Lindhe J, Karring T, Lang NP. Clinical periodontology and implant dentistry; Volume 1+ 2. Blackwell; 2008. p. 329-30.
34. Crotti T, Smith MD, Hirsch R, Soukoulis S, Weedon H, Capone M, et al. Receptor activator NF κB ligand (RANKL) and osteoprotegerin (OPG) protein expression in periodontitis. J Periodontal Res. 2003;38:380-7.
35. Lu HK, Chen YL, Chang HC, Li CL, Kuo MP. Identification of the osteoprotegerin/receptor activator of nuclear factor‐kappa B ligand system in gingival crevicular fluid and tissue of patients with chronic periodontitis. J Periodontal Res. 2006;41(4):354-60.
36. Bostancı N, Ilgenli T, Emingil G, Afacan B, Han B, Töz H, et al. Differential expression of receptor activator of nuclear factor‐κB ligand and osteoprotegerin mRNA in periodontal diseases. J Periodontal Res. 2007;42(4):287-93.
37. Bostanci N, İlgenli T, Emingil G, Afacan B, Han B, Töz H, et al. Gingival crevicular fluid levels of RANKL and OPG in periodontal diseases: implications of their relative ratio. J Clin Periodontol. 2007;34(5):370-6.
38. Buduneli N, Bıyıkoğlu B, Sherrabeh S, Lappin DF. Saliva concentrations of RANKL and osteoprotegerin in smoker versus non‐smoker chronic periodontitis patients. J Clin Periodontol. 2008;35(10):846-52.
39. Bostanci N, Saygan B, Emingil G, Atilla G, Belibasakis GN. Effect of periodontal treatment on receptor activator of NF‐κB ligand and osteoprotegerin levels and relative ratio in gingival crevicular fluid. J Clin Periodontol. 2011;38(5):428-33.
2. Sánchez GA, Miozza VA, Delgado A, Busch LJJocp. Salivary IL‐1β and PGE 2 as biomarkers of periodontal status, before and after periodontal treatment. J Clin Periodontol. 2013;40(12):1112-7.
3. Faizuddin M, Bharathi S, Rohini NJJopr. Estimation of interleukin‐1β levels in the gingival crevicular fluid in health and in inflammatory periodontal disease. 2003;38(2):111-4.
4. Lamster IB, Kaufman E, Grbic JT, Winston LJ, Singer REJJop. β‐glucuronidase activity in saliva: relationship to clinical periodontal parameters. 2003;74(3):353-9.
5. Sexton WM, Lin Y, Kryscio RJ, Dawson III DR, Ebersole JL, Miller CS. Salivary biomarkers of periodontal disease in response to treatment. J Clin Periodontol. 2011;38(5):434-41.
6. Gonçalves LDR, Soares MR, Nogueira FC, Garcia C, Camisasca DR, Domont G, et al. Comparative proteomic analysis of whole saliva from chronic periodontitis patients. Journal of proteomics. 2010;73:1334-41.
7. Miller CS, King Jr CP, Langub MC, Kryscio RJ, Thomas MV. Salivary biomarkers of existing periodontal disease: a cross-sectional study. J AM DENT ASSOC. 2006;137(3):322-9.
8. Konopka Ł, Pietrzak A, Brzezińska‐Błaszczyk E. Effect of scaling and root planing on interleukin‐1β, interleukin‐8 and MMP‐8 levels in gingival crevicular fluid from chronic periodontitis patients. J Periodontal Res. 2012;47(6):681-8.
9. Pederson E, Stanke S, Whitener S, Sebastiani P, Lamberts B, Turner DJAoob. Salivary levels of α2-macroglobulin, α1-antitrypsin, C-reactive protein, cathepsin G and elastase in humans with or without destructive periodontal disease. 1995;40(12):1151-5.
10. Christodoulides N, Mohanty S, Miller CS, Langub MC, Floriano PN, Dharshan P, et al. Application of microchip assay system for the measurement of C-reactive protein in human saliva. 2005;5(3):261-9.
11. Christodoulides N, Floriano PN, Miller CS, Ebersole JL, Mohanty S, Dharshan P, et al. Lab‐on‐a‐chip methods for point‐of‐care measurements of salivary biomarkers of periodontitis. 2007;1098(1):411-28.
12. Gorska R, Nędzi-Góra MJAiete. The effects of the initial treatment phase and of adjunctive low-dose doxycycline therapy on clinical parameters and MMP-8, MMP-9, and TIMP-1 levels in the saliva and peripheral blood of patients with chronic periodontitis. 2006;54(6):419-26.
13. Miller CS, Foley JD, Bailey AL, Campell CL, Humphries RL, Christodoulides N, et al. Current developments in salivary diagnostics. BIOMARK MED. 2010;4(1):171-89.
14. Ng PYB, Donley M, Hausmann E, Hutson AD, Rossomando EF, Scannapieco FAJFI, et al. Candidate salivary biomarkers associated with alveolar bone loss: cross-sectional and in vitro studies. 2007;49:252-60.
15. Frodge BD, Ebersole JL, Kryscio RJ, Thomas MV, Miller CS. Bone remodeling biomarkers of periodontal disease in saliva. J Periodontol. 2008;79(10):1913-9.
16. Scannapieco F, Ng P, Hovey K, Hausmann E, Hutson A, Wactawski‐Wende JJAotNYAoS. Salivary biomarkers associated with alveolar bone loss. 2007;1098(1):496-7.
17. Tobón-Arroyave S, Jaramillo-González P, Isaza-Guzmán DJAoob. Correlation between salivary IL-1β levels and periodontal clinical status. 2008;53(4):346-52.
18. Gursoy UK, Könönen E, Uitto VJ, Pussinen PJ, Hyvärinen K, Suominen‐Taipale L, et al. Salivary interleukin‐1β concentration and the presence of multiple pathogens in periodontitis. 2009;36(11):922-7.
19. Lerner UH. New molecules in the tumor necrosis factor ligand and receptor superfamilies with importance for physiological and pathological bone resorption. Crit Rev Oral Biol Med. 2004;15(2):64-81.
20. Offenbacher SJAop. Periodontal diseases: pathogenesis. 1996;1(1):821-78.
21. Boyle WJ, Simonet WS, Lacey DL. Osteoclast differentiation and activation. J Nature. 2003;423:337-42.
22. Mogi M, Otogoto J, Ota N, Togari A. Differential expression of RANKL and osteoprotegerin in gingival crevicular fluid of patients with periodontitis. J Dent Res. 2004;83(2):166-9.
23. Vernal R, Chaparro A, Graumann R, Puente J, Valenzuela MA, Gamonal J. Levels of cytokine receptor activator of nuclear factor κB ligand in gingival crevicular fluid in untreated chronic periodontitis patients. J Periodontol. 2004;75(12):1586-91.
24. Giannobile WV, Beikler T, Kinney JS, Ramseier CA, Morelli T, Wong DT. Saliva as a diagnostic tool for periodontal disease: current state and future directions. J Periodontol. 2009;50(1):52-64.
25. Jentsch H, Sievert Y, Göcke R. Lactoferrin and other markers from gingival crevicular fluid and saliva before and after periodontal treatment. J Clin Periodontol. 2004;31(7):511-4.
26. Kaufman E, Lamster IB. Analysis of saliva for periodontal diagnosis: a review. J Clin Periodontol. 2000;27(7):453-65.
27. Henskens YM, van der Weijden FA, van den Keijbus PA, Veerman EC, Timmerman MF, van der Veiden U, et al. Effect of periodontal treatment on the protein composition of whole and parotid saliva. 1996;67:205-12.
28. Thomas MV, Branscum A, Miller CS, Ebersole J, Al‐Sabbagh M, Schuster JL. Within‐subject variability in repeated measures of salivary analytes in healthy adults. J Periodontol. 2009;80(7):1146-53.
29. Armitage GCJAop. Development of a classification system for periodontal diseases and conditions. 1999;4(1):1-6.
30. Armitage GC. Periodontal diagnoses and classification of periodontal diseases. J Periodontol. 2004;34:9-21.
31. Navazesh M. Methods for collecting saliva. ANN NY ACAD SCI. 1993;694(1):72-7.
32. Tabari ZA, Azadmehr A, Tabrizi MAA, Hamissi J, Ghaedi FB. Salivary soluble receptor activator of nuclear factor kappa B ligand/osteoprotegerin ratio in periodontal disease and health. J Periodontal Implant Sci. 2013;43(5):227-32.
33. Lindhe J, Karring T, Lang NP. Clinical periodontology and implant dentistry; Volume 1+ 2. Blackwell; 2008. p. 329-30.
34. Crotti T, Smith MD, Hirsch R, Soukoulis S, Weedon H, Capone M, et al. Receptor activator NF κB ligand (RANKL) and osteoprotegerin (OPG) protein expression in periodontitis. J Periodontal Res. 2003;38:380-7.
35. Lu HK, Chen YL, Chang HC, Li CL, Kuo MP. Identification of the osteoprotegerin/receptor activator of nuclear factor‐kappa B ligand system in gingival crevicular fluid and tissue of patients with chronic periodontitis. J Periodontal Res. 2006;41(4):354-60.
36. Bostancı N, Ilgenli T, Emingil G, Afacan B, Han B, Töz H, et al. Differential expression of receptor activator of nuclear factor‐κB ligand and osteoprotegerin mRNA in periodontal diseases. J Periodontal Res. 2007;42(4):287-93.
37. Bostanci N, İlgenli T, Emingil G, Afacan B, Han B, Töz H, et al. Gingival crevicular fluid levels of RANKL and OPG in periodontal diseases: implications of their relative ratio. J Clin Periodontol. 2007;34(5):370-6.
38. Buduneli N, Bıyıkoğlu B, Sherrabeh S, Lappin DF. Saliva concentrations of RANKL and osteoprotegerin in smoker versus non‐smoker chronic periodontitis patients. J Clin Periodontol. 2008;35(10):846-52.
39. Bostanci N, Saygan B, Emingil G, Atilla G, Belibasakis GN. Effect of periodontal treatment on receptor activator of NF‐κB ligand and osteoprotegerin levels and relative ratio in gingival crevicular fluid. J Clin Periodontol. 2011;38(5):428-33.
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