ASSESSING BONE TURNOVER BIOMARKERS IN PERIODONTITIS: A LITERATURE REVIEW
Abstract
Background: Chronic periodontitis is a prevalent inflammatory condition affecting the supporting structures of teeth, including alveolar bone. Bone turnover markers (BTMs) have gained recognition as potential indicators of the dynamic interplay between bone resorption and formation in chronic periodontitis. This literature review aims to provide a comprehensive analysis of the current state of knowledge regarding the use of BTMs in understanding the pathogenesis, diagnosis, and monitoring of chronic periodontitis. The review begins by elucidating the pathophysiology of chronic periodontitis, highlighting the intricate interactions between microbial agents, host immune response, and local inflammation that contribute to alveolar bone loss. Subsequently, the biochemical basis of bone turnover is explored, with a focus on the roles of osteoclasts, osteoblasts, and their signalling pathways in bone metabolism. The main section of the review discusses various BTMs that have been investigated in the context of chronic periodontitis. These markers include both bone resorption markers (e.g., Cathepsin K, Receptor activator of nuclear factor Kappa-B ligand, NTx and ICTP) and bone formation markers (e.g., osteocalcin, Alkaline phosphatase, Osteopontin (OPN) and Periostn). The potential of BTMs to provide insights into disease severity, treatment response, and risk assessment for bone loss is critically evaluated. In conclusion, this literature review underscores the significance of bone turnover markers in advancing our understanding of the complex relationship between chronic periodontitis and alveolar bone metabolism. A comprehensive grasp of the role of BTMs in this context could have far-reaching implications, ranging from improved diagnostic approaches to the development of novel therapeutic interventions targeting bone health in chronic periodontitis.
Keywords: bone turnover biomarkers, chronic periodontitis, oral-fluid diagnostics, bone resorption, bone formation
