PERIOSTIN AS A MARKER OF PERIODONTAL STATUS. A NARRATIVE REVIEW

Abstract

Periostin is a protein of the extracellular matrix, which belongs to the fasciclin-1 protein family, located on chromosome 13 and has 835 amino acids in its composition. Periostin is an inducer of fibrinogenesis and acts by stimulating the production of type I collagen. The excess production of periostin was observed in the processes of tissue regeneration of the injured organs and later associated with pathological fibrosis. In the oral cavity, periostin is present in various tissues, serum, saliva and in the crevicular fluid and is absent in enamel, dentin, cementum, dental pulp, and deep alveolar bone. Periostin participates in the processes of cell adhesion, migration, and proliferation, stimulating tissue regeneration. The expression of periostin in the crevicular fluid decreases as the severity of the periodontal disease increases. Periostin is detectable in saliva of patients with chronic periodontitis, its expression being negatively influenced by inflammatory processes. The values of the periodontal indices are correlated with the values of periostin in the crevicular fluid, observing lower values of the protein in conditions of inflammation, volumetric reduction of the dental support and in the presence of the microbial factor. Studies demonstrate records of the lowest values of periostin in patients presenting both chronic periodontitis and type II diabetes, compared to patients only affected periodontally and those showing no signs of periodontal disease. Therefore, periodontal diseases associated with general diseases majorly decrease the expression of periostin. The presence of TNF-alpha in the tissues has the effect of decreasing the expression of periostin, which is an indicator of the progression of periodontal disease. Periostin has a role in regulating the number of osteoclasts and in the rate of collagen degradation during the processes of ligament remodeling and bone resorption necessary in orthodontic treatment, delays in tooth movements being observed in experimental animals with no periostin. The presence of periostin in the endothelium of blood vessels from the periodontium indicates a probable role that this protein has in the processes of angiogenesis and repair of injuries. Periostin can represent a valuable biomarker in the diagnosis of periodontal disease and the assessment of its severity.

Keywords

• periostin
• biomarker
• periodontal disease
• gingival crevicular fluid