Comparative evaluation of dickkopf-1 levels in gingival crevicular fluid before and after nonsurgical therapy in type 2 diabetics and smokers with periodontal disease.

BACKGROUND: Dickkopf-1 (DKK-1) is a Wnt signaling pathway inhibitor that plays a crucial role in bone metabolism and inflammation. Its level is influenced by systemic conditions such as diabetes and smoking, which are known risk factors for periodontitis. The study aims to estimate and compare the levels of DKK-1 in gingival crevicular fluid (GCF) before and after nonsurgical periodontal therapy (NSPT) in individuals with chronic periodontitis, type 2 diabetes mellitus (T2DM), and smoking habits. MATERIALS AND METHODS: A total of eighty participants were divided into four groups (n = 20 each): Group I (healthy controls), Group II (chronic periodontitis), Group III (chronic periodontitis with T2DM), and Group IV (chronic periodontitis with smoking). Clinical parameters including Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth, and clinical attachment level were recorded at baseline and 1 month after NSPT. GCF samples were collected using periopaper strips and analyzed for DKK-1 levels using the enzyme-linked immunosorbent assay. RESULTS: Baseline DKK-1 levels were significantly higher in periodontitis patients compared to controls (P < 0.001), with the highest levels observed in the diabetes and smoking groups. After NSPT, all groups demonstrated significant reductions in DKK-1 levels and clinical parameters (P < 0.001), although DKK-1 levels remained elevated in all groups after NSPT compared to controls. CONCLUSION: Elevated GCF DKK-1 levels in chronic periodontitis, particularly among smokers and diabetics, indicate its potential as a biomarker of disease severity and therapeutic response.