Uysal Ebru, Ersahan Seyda, Ozcelik Fatih, Hepsenoglu Yelda Erdem
Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey.
Department of Medical Biochemistry, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences Turkiye, Istanbul, Turkey.
Odontology. 2025 May 5. doi: 10.1007/s10266-025-01118-0.
This study examined the relationship between gingival crevicular fluid (GCF) and serum sclerostin and PGE2 levels and the inflammatory bone resorption associated with chronic apical periodontitis (AP) as well as the correlation between sclerostin regulation and RANKL and MMP-9 levels. Ninety participants were divided into three groups based on PAI scores, as follows: Group 1 (control group, PAI 1-2, n:35); Group 2 (PAI 3-4, n:35); Group 3 (PAI 5 in at least 1 tooth, n:55). Sclerostin, PGE2, RANKL, and MMP-9 levels were measured in the serum and GCF of all participants. GCF sclerostin, RANKL, and PGE2 levels of Group 3 were significantly higher than those of Groups 1 and 2 (75.8 ± 43.3, 37.0 ± 6.4 and 42.7 ± 8.2 ng/mL, p < 0.0001; 319 ± 167, 244 ± 41 and 248 ± 49 ng/L, p = 0.0029; 193 ± 87, 141 ± 90 and 137 ± 79 ng/L, p = 0.0028, respectively for Groups 3, 2, and 1). GCF MMP-9 levels of Group 3 were significantly higher than those of Group 1 (465 ± 162 and 384 ± 44 ng/mL, p = 0.0340). Group 3 also had elevated serum sclerostin and PGE-2 levels, but the differences between groups were less pronounced in serum than in GCF (p < 0.05). In the ROC analysis performed for the diagnostic performance of abscess formation in AP, the sensitivity of the GCF sclerostin and GCF PGE2 tests was determined as 65.5% and 72.7%, specificity as 98.6% and 68.6%, and AUC as 0.768 and 0.712, respectively (p < 0.0001). Both GCF sclerostin and PGE-2 independently showed close relationships with PAI-abscess scores used to determine AP severity and they can be used in combination for diagnosing and monitoring AP-related bone resorption.
本研究探讨了龈沟液（GCF）与血清硬化素和前列腺素E2（PGE2）水平之间的关系，以及与慢性根尖周炎（AP）相关的炎性骨吸收，还研究了硬化素调节与核因子κB受体活化因子配体（RANKL）和基质金属蛋白酶-9（MMP-9）水平之间的相关性。90名参与者根据牙周病活动指数（PAI）评分分为三组，具体如下：第1组（对照组，PAI 1-2，n = 35）；第2组（PAI 3-4，n = 35）；第3组（至少一颗牙齿PAI为5，n = 55）。测量了所有参与者血清和GCF中的硬化素、PGE2、RANKL和MMP-9水平。第3组的GCF硬化素、RANKL和PGE2水平显著高于第1组和第2组（第3组、第2组和第1组分别为75.8±43.3、37.0±6.4和42.7±8.2 ng/mL，p < 0.0001；319±167、244±41和248±49 ng/L，p = 0.0029；193±87、141±90和137±79 ng/L，p = 0.0028）。第3组的GCF MMP-9水平显著高于第1组（465±162和384±44 ng/mL，p = 0.0340）。第3组的血清硬化素和PGE-2水平也升高，但组间血清差异不如GCF明显（p < 0.05）。在对AP中脓肿形成的诊断性能进行的ROC分析中，GCF硬化素和GCF PGE2检测的敏感性分别确定为65.5%和72.7%，特异性分别为98.6%和68.6%，曲线下面积（AUC）分别为0.768和0.712（p < 0.0001）。GCF硬化素和PGE-2均独立显示与用于确定AP严重程度的PAI-脓肿评分密切相关，它们可联合用于诊断和监测AP相关的骨吸收。
