Expression of growth mediators in the gingival crevicular fluid of patients with aggressive periodontitis undergoing periodontal surgery

• Published in: Clinical oral investigations Vol. 23; no. 8; pp. 3307 - 3318
• Main Authors: Rakmanee, T., Calciolari, E., Olsen, I., Darbar, U., Griffiths, G. S., Petrie, A., Donos, Nikolaos
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-08-2019; Springer Nature B.V
• Subjects: Aggressive Periodontitis - metabolism; Angiopoietin; Body fluids; Bone growth; Bone morphogenetic protein 2; Dentistry; Fibroblast growth factor 2; Gingival Crevicular Fluid - metabolism; Growth factors; Gum disease; Humans; Keratinocyte growth factor; Medicine; Metalloproteinase; Original Article; Osteoprotegerin; Periodontics; Periodontitis; Platelet-derived growth factor; Platelet-Derived Growth Factor - metabolism; Regeneration; Single-Blind Method; Surgery; Tissue inhibitor of metalloproteinase 1; Tissue Inhibitor of Metalloproteinase-1 - metabolism; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - metabolism; Periodontal surgery; Gingival crevicular fluid; Randomised controlled trial; Aggressive periodontitis
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-018-2752-z

Objectives
To describe changes in growth factor mediators in the gingival crevicular fluid (GCF) of patients with aggressive periodontitis (AgP) undergoing regenerative (GTR) and access flap (AF) surgery.
Materials and methods
This was a 12-month, single-blind, split-mouth RCT involving 18 AgP patients with a bilateral intrabony defect which was treated with GTR or AF. GCF was collected prior to surgery and at subsequent follow-up visits from 3 days to 12 months post-operatively, and the levels of angiopoietin-1 (Ang-1), vascular-endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), bone morphogenetic protein-2 (BMP-2), osteoprotegerin (OPG), tissue inhibitor of metalloproteinase 1 (TIMP-1), keratinocyte growth factor (KGF) and platelet-derived growth factor-AB (PDGF-AB) were measured. At baseline, 6 and 12 months post-surgery, periodontal clinical parameters were evaluated. ANOVA was applied to test for differences in the amount of mediators (
p
 < 0.05).
Results
Higher amounts of BMP-2 and OPG and a higher area under the curve (AUC) of KGF at the GTR versus AF sites were observed. The maximum change in the amount of KGF correlated significantly with periodontal clinical parameters at the GTR sites at 6 and 12 months. The AUC over 30 days of the amount of Ang-1, VEGF and KGF significantly correlated with periodontal clinical parameters at the AF sites at 6 months.
Conclusions
AF and GTR differentially affected the profile of the growth mediators in GCF, and significant correlations between certain GCF mediators and periodontal clinical outcomes were identified.
Clinical relevance
GCF components represent attractive prognostic markers for periodontal tissues undergoing repair or regeneration. However, the available evidence is not robust enough to suggest the use of a specific marker, and future adequately powered studies are warranted to identify the most relevant mediators that could be applied in clinical practice.