Effect of Periodontal Surgery on the Osteoimmunological Mediators in Patients with Chronic and Aggressive Periodontitis

Background and Aim: Increased levels of receptor activator of nuclear factor kappa-B ligand (RANKL) and RANKL/OPG (osteoprotegerin) ratio in untreated periodontitis have been presented. However, current knowledge of periodontal treatment on osteoimmunological results is scarce. This study, aims to determine the RANKL, OPG, interleukin-1 beta (β), interleukin-10 levels in gingival crevicular fluid before and after surgical periodontal treatment in chronic and aggressive periodontitis. Subjects and Methods: Sixteen chronic periodontitis patients, 10 localized and 13 generalized aggressive periodontitis patients and 18 periodontally healthy controls were included. Clinical periodontal parameters were recorded and gingival crevicular fluid was collected at baseline and 3 months after open flap surgery. RANKL, OPG, interleukin-1β, interleukin-10 levels were analysed by enzyme linked immunosorbent assay. Results: RANKL total amount and RANKL/OPG ratio were higher in disease groups than controls at baseline. RANKL/OPG, Interleukin1β/Interleukin-10 ratios did not change after treatment for all periodontitis groups while Interleukin-1β total amount decreased (p<0.05). RANKL total amount was significantly decreased in generalized aggressive periodontitis group (p<0.05) while remaining similar in other groups. Conclusions: Increased RANKL total levels and RANKL/OPG ratio in untreated chronic and aggressive periodontitis groups supported its role in periodontal bone destruction. Even though the surgical periodontal treatment improved periodontal clinical parameters significantly, the present findings suggested that, it did not seem to have a meaningful effect on osteoimmunological mediators except interleukin-1β.