Gingival crevicular fluid osteocalcin level as a biomarker for periodontitis stage III grade B and C response to periodontal treatment after 6 months follow up of Egyptian population sample- Controlled Clinical trial.

Abstract

Objectives: Periodontitis is characterized by an increased alveolar bone turnover with dominance of bone resorption over bone formation leading to alveolar bone loss and loss of attachment. Osteocalcin is the major noncollagenous calcium-binding single chain protein of bone and dentin matrix and it is a bone marker whose concentration in circulation has been used as a reflector of bone turnover.The present study was conducted to evaluate osteocalcin levels in healthy and diseased periodontium and to correlate the changes in its levels with the changes in the clinical and radiographic parameters before and after treatment. Materials & Methods: Double blind clinical randomized trial, 40 patients divided into 3 groups; 15 patients diagnosed as periodontitis stage III grade B, 15 patients diagnosed as periodontitis stage III grade C, 10 healthy cases as control. Clinical parameters namely plaque index (PI), Gingival index (GI), Pocket depth (PD), Clinical attachment loss (CAL), radiographic examination, beside gingival crevicular fluid (GCF) samples collection for Osteocalcin level, tested at 3 time points 1 before and 2 after periodontal treatment, which included phase I therapy, and respective periodontal surgery accompanied by systemic antibiotics protocol. Results: revealed a positive correlation in the changes of osteocalcin levels in relation to probing depth, clinical attachment level, plaque index and gingival index and a negative correlation with the changes in bone density although these correlations were insignificant. Conclusions: Osteocalcin in gingival crevicular fluid as marker for diagnosis , prognosis, and follow up of the periodontitis infection activity, As a second conclusion cumulative non surgical, surgical and systemic antibiotic medication have high ability in the control of periodontal infection which could be measured clinically and radiographically. Clinical relevance: Osteocalcin would be suitable for diagnosis and follow up of the disease, but not suitable for the prognosis of periodontal disease infection.