Effect of Nonsurgical Periodontal Treatment on Apelin and Oxidative Stress Levels

Evaluation of the Effects of Nonsurgical Periodontal Treatment on Apelin and Oxidative Stress Levels in Individuals With Periodontitis

Periodontitis is a multifactorial, chronic inflammatory disease triggered by microorganisms in the dental biofilm. The limited data of clinical periodontal measurements in the diagnosis of periodontitis have led to the search for more reliable biomarkers that can be used in the diagnosis and follow-up of periodontal diseases. Apelin is another adipokine that has been investigated in a small number of studies so far; its receptor (apelin reseptor (APJ)) was first identified in 1993 and later isolated as a molecule in 1998. Studies have focused on this form of apelin-13 due to its high biological activity. Although apelin-13 is considered the most biologically active form, it has been shown that apelin-36 has a much higher binding affinity to APJ than apelin-13. Periodontitis is the most common cause of tooth loss in adults, and is associated with systemic conditions such as metabolic syndrome, diabetes mellitus, and cardiovascular disease. The elucidation of these possible interactions has been the focus of many studies. Apelin is associated with insulin secretion, as well as its effects on lipid and glucose metabolism. Studies in both humans and animals have shown that type 2 diabetes and obesity are typically associated with increased plasma apelin levels. Based on this observation, recent studies have shown that salivary and serum apelin levels are higher in individuals with chronic periodontitis and type 2 diabetes compared to healthy individuals. Considering all this information, the investigators considered that apelin may be a biomarker for periodontal diseases due to its inflammation-regulating effects as a result of the change in gingival crevicular fluid (GCF) apelin-13, apelin-36 and total oxidant status (TOS)/total antioxidant status (TAS) levels compared to the initial level after non-surgical periodontal treatment in systemically healthy and periodontitis individuals, considering the relationship of adipokines with periodontal disease in this study.

Study Overview

• Status: Completed
• Conditions: Periodontitis
• Intervention / Treatment: Procedure: non surgical periodontal therapy; Other: measurement of periodontal clinical parameters; Other: Gingival crevicular fluid samples will be collected

• Study Type: Observational
• Enrollment (Actual): 60

Contacts and Locations

Study Locations

• Turkey
  • Rize, Turkey, 53020
    • Recep Tayyip Erdogan University Faculty of Dentistry

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

periodontitis

Description

Inclusion Criteria:

• Being systemically healthy
• Not smoking
• Not using anti-inflammatory drugs in the last 3 months, antibiotics and systemic corticosteroids in the last 6 months
• Not being pregnant or lactating
• Not having received periodontal treatment in the last 6 months
• Having at least 20 teeth in the mouth
• Being diagnosed with periodontitis (Stage 1-2 and Stage 3-4) by the researcher

Working groups will be formed based on the 2017 Periodontal Disease Classification

Exclusion Criteria:

being periodontally healthy having systemic disease being pregnant and lactating smoking having periodontal treatment in the last 6 months having fewer than 20 teeth

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Stage 1-2 periodontitis group	Procedure: non surgical periodontal therapy; All participants will have their non-surgical periodontal treatments completed after samples are taken and periodontal measurements are taken at the beginning.; Other: measurement of periodontal clinical parameters; Periodontal measurements will be taken from all participants at baseline, 1 month, 3 months and 6 months; Other: Gingival crevicular fluid samples will be collected; Gingival crevicular fluid samples will be collected from all participants at baseline, 1 month, 3 months and 6 months
Stage 3-4 periodontitis group	Procedure: non surgical periodontal therapy; All participants will have their non-surgical periodontal treatments completed after samples are taken and periodontal measurements are taken at the beginning.; Other: measurement of periodontal clinical parameters; Periodontal measurements will be taken from all participants at baseline, 1 month, 3 months and 6 months; Other: Gingival crevicular fluid samples will be collected; Gingival crevicular fluid samples will be collected from all participants at baseline, 1 month, 3 months and 6 months

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Periodontal pocket depth	It will be calculated by measuring the distance between the gingival margin and the pocket base. Each tooth will be measured from six surfaces and averaged. higher scores indicate worse outcome.	at baseline, 1 month, 3 months and 6 months
clinical attachment loss	It will be calculated by measuring the distance between the cementoenamel border and the pocket base. It will be measured from the six surfaces of each tooth and the average will be taken. higher scores indicate worse outcome.	at baseline, 1 month, 3 months and 6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Apelin-13 level	Determination of the levels of apelin-13 from gingival crevicular fluid (GCF) samples will be done by ELISA method	at the beginning, at 1 month, at 3 months and at 6 months
Apelin-36 level	Determination of the levels of apelin-36 from gingival crevicular fluid (GCF) samples will be done by ELISA method	at baseline, 1 month, 3 months and 6 months
TOS (total oxidant status) level	Determination of the levels of TOS (total oxidant status) from gingival crevicular fluid (GCF) samples will be done by ELISA method	at baseline, 1 month, 3 months and 6 months
TAS (total antioxidant status) level	Determination of the levels of TAS (total antioxidant status) from gingival crevicular fluid (GCF) samples will be done by ELISA method	at baseline, 1 month, 3 months and 6 months

Collaborators and Investigators

• Sponsor: Hatice Yemenoğlu
• Collaborators: Recep Tayyip Erdogan University Training and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): August 16, 2024
• Primary Completion (Actual): May 14, 2025
• Study Completion (Actual): June 14, 2025

Study Registration Dates

• First Submitted: February 16, 2025
• First Submitted That Met QC Criteria: February 25, 2025
• First Posted (Actual): February 28, 2025

Study Record Updates

• Last Update Posted (Actual): July 30, 2025
• Last Update Submitted That Met QC Criteria: July 27, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Periodontitis
• Other Study ID Numbers: Recep TayyipErdoganUniversity

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: If deemed necessary, necessary information can be provided to protect patient confidentiality.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No