Effects of periodontal and bisphosphonate treatment on the gingival crevicular levels of sclerostin and dickkopf‐1 in postmenopausal osteoporosis with and without periodontitis

Abstract Objective and Background Both periodontitis and osteoporosis are associated with osteoclast‐related bone resorption. Bone metabolism is regulated by wingless‐type MMTV integration site family (WNT), and WNT/β‐catenin signals are controlled by physiological antagonists including dickkopf‐1 (DKK‐1) and sclerostin (SOST). This study examined the effects of periodontal and bisphosphonate (BP) treatment on the gingival crevicular fluid (GCF) sclerostin (SOST) and dickkopf‐related protein‐1 (DKK‐1) levels in osteoporotic and systemically healthy postmenopausal women with and without periodontitis. Materials and Methods A total of 48 postmenopausal women were divided into 4 groups ( n = 12) according to periodontal health and osteoporosis status, as follows: Group OP/P: subjects with both osteoporosis and periodontitis; Group P: systemically healthy subjects with periodontitis; Group OP: periodontally healthy subjects with osteoporosis; Group H: systemically and periodontally healthy controls. Clinical data and GCF SOST and DKK‐1 levels of the participants were collected at baseline and at 6 and 12 months following the initiation of periodontal and/or BP treatment in the experimental groups. GCF SOST and DKK‐1 data were obtained by ELISA. Results Clinical improvements were observed in all experimental groups. GCF SOST and DKK1 baseline levels varied significantly between groups due to periodontal disease ( p < .001). Following treatment, significant increases in SOST and DKK‐1 concentrations and significant decreases in total amounts of SOST were observed in both periodontitis groups (OP/P, P). However, while total amounts of DKK‐1 decreased in Group OP/P, in Group P, these amounts had significantly increased at 12 months post‐treatment ( p < .05). At both 6 and 12 months post‐treatment, SOST and DDK1 total amounts in Groups OP/P, OP, and H were similar ( p > .05), whereas significant differences were observed between Groups H and P, indicating a deviation from periodontal health in Group P ( p < .01). Conclusions Significant changes in GCF SOST and DKK‐1 levels were observed among women with osteoporosis who received both periodontal and BP treatment. A more detailed examination of how these treatment protocols can be combined may lead to new therapeutic approaches towards periodontal disease.