스케일링이 치은열구액 내 치성 법랑모세포 단백질(ODAM)의 발현에 미치는 영향
The effect of scaling on odontogenic ameloblast-associated protein (ODAM) expression in the gingival crevicular fluid
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초록
ODAM은 치주염의 활성 상태를 반영하는 바이오마커로 질병의 정도나 민감도 및 특이성이 높아서 질병의 초기 단계를 정확하게 진단하고 치료 효과를 평가하는 데 유용한 물질로 알려져 있다. 본 연구는 GCF를 활용하여 스케일링 중재 후 치성 법랑모세포 단백질(ODAM) 변화를 비교하여 치주상태를 평가하고자 하였다. GCF 분석을 위하여 선정 기준 및 제외 기준에 따른 치은염 및 치주염 환자 총17명을 대상으로 스케일링 중재 전·후 치아 12∼20개 부위에서 총 76개의 GCF를 채취 후 효소 결합 면역흡착 분석으로 총 수준을 정량화하였다. GCF 채취 후 동일한 치아에서 치주탐침을 사용하여 PD, PI, CI, mSBI를 측정하였으며, 스케일링 중재 후 평가는 4주 후에 호전 기간을 두고 진행하였다. 스케일링 중재 전· 후에 따른 임상 매개변수(PD, PI, CI, mSBI)와 GCF 내 ODAM 차이를 알아보기 위해 Wilcoxon signed ranks test 분석을 실시하였다. 스케일링 전·후에 따라 PD, PI, CI, mSBI는 모두 유의한 차이가 있었다(p<0.001). 스케일링 전·후에 따른ODAM 농도를 비교한 결과 유의한 차이가 있었다(p<0.05). 스케일링 전·후 ODAM 발현 정도는 PD가 3 mm 이내인 치은염 환자보다 PD가 4 mm 이상인 치주염 환자에서 유의한 차이가 있었다. 연구 결과를 종합하면 스케일링 후 GCF 내 ODAM 변화가 있는 것으로 확인되었다. 향후 보완 연구를통해 치은염 환자의 GCF 내 ODAM 검출 기전에 대해 확인하고, PD가 4 mm 이상인 중등도 및 심한 치주질환 대상자를 포함하여 피험자에 따라 GCF 내 ODAM 농도가 큰 차이를 보인다면 ODAM은 치주질환 예방 및 관리 후 치주 개선 정도와 질환 활성화 상태를 객관적으로 평가할 수 있는 지표가 될 수 있을 것으로기대한다.
Abstract
This study aimed to evaluate periodontal status by comparing changes in odontogenic ameloblast-associated protein (ODAM) after scaling interventions utilizing samples of gingival crevicular fluid (GCF). For GCF analysis, a total of 76 GCF samples, collected from 12 to 20 teeth, from 17 patients with gingivitis and periodontitis before and after scaling were collected. The patients were selected based on inclusion and exclusion criteria The total GCF levels were quantified by enzyme-linked immunosorbent assay (ELISA). After GCF collection, PD, PI, CI, and mSBI were measured on the same teeth using a periodontal probe Furthermore, the post-scaling intervention evaluation was performed after a 4-week healing period. A Wilcoxon signed ranks test analysis was conducted to determine the differences in clinical parameters (PD, PI, CI, mSBI) and ODAM in gingival crevicular fluid before and after scaling intervention. PD, PI, CI, and mSBI were all significantly different before and after scaling (p < 0.001). There was a significant difference in ODAM concentration between pre- and post-scaling (p < 0.05). There was also a significant difference in the level of ODAM expression before and after scaling in periodontitis patients with a PD of 4 mm or more than in gingivitis patients with a PD of less than 3 mm. The present study confirmed changes in ODAM within GCF after scaling. ODAM is a biomarker that reflects the active state of periodontitis and has high sensitivity and specificity for the extent of the disease, making it useful for accurately diagnosing the early stages of the disease and evaluating the effectiveness of treatment. Our results confirmed changes in ODAM within GCF after scaling. In the future, further studies are warranted. If the mechanism of ODAM detection in the GCF of patients with gingivitis is confirmed and significant differences in ODAM concentrations in the GCF of subjects with moderate and severe periodontal disease with PD ≥ 4 mm, ODAM may be a potential objective indicator of periodontal disease activity. If GCF can be used as a biomarker to assess and monitor periodontal disease activities and periodontal changes following treatment, periodontal disease prevention and management may be further improved.
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