Receptor Activator of Nuclear Factor-Kappa B Ligand/Osteoprotegerin Ratio in Sites of Chronic Periodontitis of Subjects With Poorly and Well-Controlled Type 2 Diabetes

Background: The aim of this study is to evaluate the levels of osteoclastogenesis-related factors (soluble receptor activator of nuclear factor-kappa B ligand [sRANKL] and osteoprotegerin [OPG]) in gingival crevicular fluid (GCF) from subjects with poorly and well-controlled type 2 diabetes and chronic periodontitis before and after periodontal therapy. Methods: Eighteen subjects with well-controlled diabetes (glycated hemoglobin [HbA1c] levels <= 8%) and 20 subjects with poorly controlled diabetes (HbA1c levels >8%) were enrolled in this study. All subjects were submitted to non-surgical periodontal therapy. GCF sampling and clinical periodontal parameters were assessed at baseline and 3 and 6 months post-therapy. Total amounts and concentrations of sRANKL and OPG in GCF were analyzed by enzyme-linked immunosorbent assay (ELISA). Results: Total amounts and concentrations of sRANKL and RANKL/OPG ratios were higher in poorly controlled subjects than in well-controlled subjects at baseline and 3 and 6 months post-therapy (P<0.05). In addition, RANKL/OPG ratios decreased in well-controlled subjects (P<0.05) but not in poorly controlled subjects (P>0.05) at 3 months post-therapy. Almost all clinical parameters improved significantly for both groups post-treatment (P<0.05). Conclusion: RANKL/OPG ratios in untreated and treated periodontitis sites may be negatively influenced by poor glycemic control in subjects with type 2 diabetes. J Periodontol 2010;81:1455-1465.