---
title: Effect of Non-Surgical Periodontal Therapy on Salivary Biomarkers in Smokers and Non-Smokers With Periodontitis
nct_id: NCT07547202
overall_status: RECRUITING
phase: NA
sponsor: Al-Mustansiriyah University
study_type: INTERVENTIONAL
primary_condition: Periodontitis
countries: Iraq
canonical_url: "https://parkinsonspathways.com/agent/trials/NCT07547202.md"
clinicaltrials_gov: "https://clinicaltrials.gov/study/NCT07547202"
ct_last_update_post_date: 2026-04-23
last_seen_at: "2026-05-12T07:10:47.385Z"
source: ClinicalTrials.gov (mirrored, no enrichment)
---
# Effect of Non-Surgical Periodontal Therapy on Salivary Biomarkers in Smokers and Non-Smokers With Periodontitis

**Official Title:** The Significance of Non-Surgical Periodontal Therapy on Salivary Dkk-1, Sclerostin, and PLAP-1 Levels in Smoker and Non-Smoker Patients With Periodontitis: A Clinical Comparative Study

**NCT ID:** [NCT07547202](https://clinicaltrials.gov/study/NCT07547202)

## Key Facts

- **Status:** RECRUITING
- **Phase:** NA
- **Study Type:** INTERVENTIONAL
- **Target Enrollment:** 44
- **Lead Sponsor:** Al-Mustansiriyah University
- **Conditions:** Periodontitis, Smoking ( Cigarette)
- **Start Date:** 2026-01-01
- **Completion Date:** 2026-10-01
- **CT.gov Last Update:** 2026-04-23

## Brief Summary

This study evaluates the effect of non-surgical periodontal therapy on salivary biomarkers (Dkk-1, Sclerostin, and PLAP-1) and clinical periodontal parameters in patients with periodontitis. Periodontitis is a chronic inflammatory disease that destroys tooth-supporting tissues. Smoking is a significant risk factor that worsens periodontal destruction and reduces the effectiveness of standard therapies.

* The trial is a non-randomized comparative clinical study.
* It includes 44 adult patients diagnosed with Stage II and III periodontitis.
* The participants are divided into two equal groups: 22 current smokers and 22 non-smokers.
* Participants will undergo a baseline examination, followed by standardized non-surgical periodontal therapy consisting of scaling and root planing.
* A follow-up visit will be conducted six weeks post-therapy to repeat clinical measurements and saliva collection.
* The primary objective is to evaluate changes in salivary biomarker levels and clinical parameters (Plaque Index, Gingival Index, bleeding on probing, Probing Pocket Depth, Clinical Attachment Level) after treatment.

## Detailed Description

Smoking is known to adversely affect the periodontium by altering cytokine production, impairing neutrophil function, and causing vasoconstriction that masks clinical inflammation. Because conventional diagnostic methods primarily measure past tissue destruction, there is growing interest in utilizing salivary biomarkers for real-time monitoring of disease activity. Specifically, Dickkopf-1 (Dkk-1) and Sclerostin (SOST) are elevated in periodontitis and actively suppress bone formation by antagonizing the Wnt/β-catenin pathway. Conversely, Periodontal Ligament-Associated Protein-1 (PLAP-1) plays a protective role in maintaining the periodontal ligament, and its presence in saliva may indicate active degradation. The collective behavior of these biomarkers in response to therapy among smokers is not fully understood.

This non-randomized comparative clinical trial aims to investigate the impact of smoking on these salivary biomarkers before and after non-surgical periodontal therapy. A total of 44 systemically healthy adult participants with Stage II and III periodontitis will be enrolled. The participants will be divided into two groups of 22: current smokers and non-smokers (defined as having never smoked or quit \>5 years ago).

Study Procedures:

* Baseline Visit: Participants will provide written informed consent, followed by the collection of unstimulated whole saliva via passive drooling. A full-mouth clinical examination will then be conducted using a UNC-15 periodontal probe. Clinical measurements include Plaque Index (PLI), Gingival Index (GI), Gingival Bleeding Index (GBI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL).
* Treatment Phase: Patients will receive standardized non-surgical periodontal therapy. This involves scaling at the first visit, followed by root planing after one week.
* Follow-up Visit: Six weeks after completing the therapy, participants will return for a second saliva collection and a repeat of all clinical periodontal examinations.

Laboratory and Statistical Analysis:

* Saliva samples will be kept in an ice box, centrifuged at 3000 rpm for 10 minutes, and the supernatant stored at -40 °C.
* Salivary levels of Dkk-1, SOST, and PLAP-1 will be quantified using specific human ELISA kits.
* Statistical analysis will assess intra-group and inter-group changes using SPSS, with a statistical significance level set at p ≤ 0.05.

## Eligibility

- **Minimum age:** 18 Years
- **Sex:** ALL
- **Healthy Volunteers:** No

```
Inclusion Criteria:

* Systemically healthy.
* Diagnosed with Stage II and III periodontitis.
* Presence of ≥ 20 teeth (excluding third molars).
* Current smoker OR non-smoker

Exclusion Criteria:

* Presence of systemic diseases affecting the periodontium.
* Use of medications affecting inflammation.
* Received periodontal therapy in the past 6 months.
* Received antibiotic therapy in the last 3 months.
* Alcohol use.
```

## Arms

- **Smokers** (ACTIVE_COMPARATOR) — 22 adult patients with Stage II or III periodontitis who currently smoke. They will receive standardized non-surgical periodontal therapy.
- **Non-smokers** (ACTIVE_COMPARATOR) — 22 adult patients with Stage II or III periodontitis who have never smoked or quit more than 5 years ago. They will receive standardized non-surgical periodontal therapy.

## Interventions

- **Non-surgical periodontal therapy (Scaling and root planing)** (PROCEDURE) — Standardized non-surgical periodontal therapy performed over two visits (scaling at the first visit and root planing after one week).

## Primary Outcomes

- **Change in Salivary Dickkopf-1 (Dkk-1) Levels** _(time frame: Baseline and 6 weeks post-therapy.)_ — Salivary Dkk-1 levels will be quantified using a specific human Enzyme-Linked Immunosorbent Assay (ELISA) kit.
- **Change in Salivary Sclerostin (SOST) Levels** _(time frame: Baseline and 6 weeks post-therapy.)_ — Salivary Sclerostin (SOST) levels will be quantified using a specific human Enzyme-Linked Immunosorbent Assay (ELISA) kit.
- **Change in Salivary PLAP-1 (Asporin) Levels** _(time frame: Baseline and 6 weeks post-therapy.)_ — Salivary Periodontal Ligament-Associated Protein-1 (PLAP-1) levels will be quantified using a specific human Enzyme-Linked Immunosorbent Assay (ELISA) kit.

## Secondary Outcomes

- **Change in Probing Pocket Depth (PPD)** _(time frame: Baseline and 6 weeks post-therapy.)_
- **Change in Clinical Attachment Level (CAL)** _(time frame: Baseline and 6 weeks post-therapy.)_
- **Change in Plaque Index (PLI)** _(time frame: Baseline and 6 weeks post-therapy.)_
- **Change in Gingival Index (GI)** _(time frame: Baseline and 6 weeks post-therapy.)_
- **Change in Gingival Bleeding Index (GBI)** _(time frame: Baseline and 6 weeks post-therapy.)_

## Locations (2)

- Al-Sadr Specialized Dental Center, Baghdad, Baghdad Governorate, Iraq — _RECRUITING_
- Sadr Specialized Dental Center, Baghdad, Baghdad Governorate, Iraq — _RECRUITING_

## Recent Field Changes (last 30 days)

- `status.overallStatus` — added _(2026-05-12)_
- `status.primaryCompletionDate` — added _(2026-05-12)_
- `status.completionDate` — added _(2026-05-12)_
- `status.lastUpdatePostDate` — added _(2026-05-12)_
- `design.phases` — added _(2026-05-12)_
- `design.enrollmentCount` — added _(2026-05-12)_
- `eligibility.criteria` — added _(2026-05-12)_
- `eligibility.minAge` — added _(2026-05-12)_
- `eligibility.sex` — added _(2026-05-12)_
- `outcomes.primary` — added _(2026-05-12)_
- `outcomes.secondary` — added _(2026-05-12)_
- `armsInterventions.arms` — added _(2026-05-12)_
- `armsInterventions.interventions` — added _(2026-05-12)_
- `sponsor.lead` — added _(2026-05-12)_
- `results.hasResults` — added _(2026-05-12)_
- `locations.al-sadr specialized dental center|baghdad|baghdad governorate|iraq` — added _(2026-05-12)_
- `locations.sadr specialized dental center|baghdad|baghdad governorate|iraq` — added _(2026-05-12)_

---

*Canonical: https://parkinsonspathways.com/agent/trials/NCT07547202.md*  
*Source data (authoritative): https://clinicaltrials.gov/study/NCT07547202*  
*This page is a raw mirror with no AI summary, no editorial enrichment, and no Parkinson's-specific filtering.*