The effect of non-surgical periodontal treatment on Dickkopf-1 and secreted Frizzled-Related Protein 5 levels.

BACKGROUND Recent advancements in bone tissue biomarker research have identified 2 promising molecules: Dickkopf-1 and secreted Frizzled-Related Protein 5. This study aims to evaluate the levels of these biomarkers in gingival crevicular fluid in periodontal health, gingivitis, and periodontitis and to assess the effects of non-surgical periodontal treatment on these biomarkers. METHODS A total of 99 adult subjects were included in this study, divided into 3 groups: 33 periodontally healthy individuals, 33 with gingivitis, and 33 with periodontitis. Patients in the gingivitis and periodontitis groups received non-surgical periodontal treatment. Periodontal clinical parameters were recorded, and gingival crevicular fluid levels of biomarkers were analyzed by enzyme-linked immunosorbent assay at baseline and 6-8 weeks post-treatment. RESULTS Pre-treatment Dickkopf-1 levels were found to be highest in the periodontitis group (p < 0.001). Conversely, secreted Frizzled-Related Protein 5 levels were highest in the healthy group (p < 0.001). Post-treatment, a statistically significant reduction in Dickkopf-1 levels was observed in the gingivitis (p = 0.015) and periodontitis (p < 0.001) groups, while secreted Frizzled-Related Protein 5 levels significantly increased (respectively, p = 0.008 and p < 0.001). A statistically significant weak negative correlation was identified between total Dickkopf-1 and secreted Frizzled-Related Protein 5 levels (τ = -0.117, p = 0.027). Receiver operating characteristic curve analysis to assess diagnostic performance between periodontal health and periodontitis revealed an area under the curve of 0.938 for Dickkopf-1 and 0.803 for secreted Frizzled-Related Protein 5. CONCLUSIONS These biomarkers could serve as valuable biomarkers in the pathogenesis of periodontal disease. Non-surgical periodontal treatment significantly affects the levels of these biomarkers, indicating their potential utility in monitoring therapeutic outcomes. PLAIN LANGUAGE SUMMARY In the human body, bone tissue is in a state of constant balance of production and destruction. This balance supports the maintenance of the mechanical integrity of the skeleton and the regulation of calcium and phosphorus levels. Bone markers have been developed to monitor various bone diseases and the effect of treatments without any interventional procedures. Dickkopf-1 (Dkk-1) and secreted Frizzled-Related Protein 5 (sFRP5) are two of the current bone markers that play a role in the balance of bone formation and destruction in the human body. The presence of these molecules in periodontal diseases, which cause inflammation and bone destruction in the gingiva surrounding the teeth, is not yet clear. In this study, Dkk-1 and sFRP5 levels were investigated in periodontal diseases, and the effect of treatment of periodontal diseases on these molecules was evaluated. In the transition from periodontal disease to health, Dkk-1 levels decreased while sFRP5 levels increased. Consistent with these results, Dkk-1 levels decreased in all groups after treatment, while sFRP5 levels increased. In conclusion, Dkk-1 and sFRP5 may serve as valuable markers for the early diagnosis of periodontal disease, and non-surgical periodontal treatment may significantly affect the levels of these markers, demonstrating their potential utility in monitoring treatment outcomes.