Estimation and Comparison of Salivary Calcium, Phosphorous, Alkaline Phosphatase and pH Levels in Periodontal Health and Disease: A Cross-sectional Biochemical Study

Evaluation of oral health status in pregnant women and its correlation with calcium and phosphate levels

AIM

This study aimed to analyze the oral health conditions of pregnant women. The analysis involves evaluating two key indices: the decayed, missing, and filled teeth (DMFT) index and the basic erosive wear examination (BEWE) index. Furthermore, this study investigated potential correlations between calcium (Ca) and phosphate (P) levels within specific time intervals and the aforementioned oral health indices.

Periodontal index and salivary Ph in first trimester´s pregnant women: A cross-sectional study

Background

Recent reviews have suggested a possible association between periodontal disease and increasing risks during pregnancy, such as newborn low weight, premature birth, gestational diabetes mellitus and preeclampsia. Besides, being saliva a valuable source of information on general and buccal health, it is necessary to know its parameters associated with periodontal diseases; in order to help odontologists to better understand this disease, and provide a sound clinical treatment. Therefore, this research sought to assess the correlation between periodontal index, and salivary pH on first trimester pregnant women.

Material and Methods

71 pregnant women were evaluated by observational, transversal and correlational study, using the community periodontal index and salivary pH-meter. The Spearman coefficient was employed, considering a p value of 0.05.

Results

A correlation was found between periodontal index and salivary pH in first trimester pregnant women (p=0.039). According to age, correlations were found to be very weak in age group 18 to 24 years (p=0.605), and age group 25 to 35 years (p=0.071). Similarly, no strong correlation was found when pairing based on number of pregnancies (primiparous p=0.239 and multi pregnancy p=0.114). Also, 36.6% of pregnant women showed periodontal pockets smaller than 5 mm.

Conclusions

With lower salivary pH, the periodontal index in pregnant women gets lower; however, no correlation could be found between age group and number of pregnancies. Key words:Periodontal index, periodontal pocket, periodontal diseases, saliva, pregnancy, pregnant women.

Adjunctive systemic antibiotic effect on periodontal state, salivary enzyme activity, and glycemia imbalance in type-2 diabetics after non-surgical periodontal management

AIM

The current study aimed at analyzing the effect of non-surgical periodontal treatment accompanied by systemic antibiotics on salivary enzyme activities, periodontal parameters, and glycemic control in type-2 diabetic (T2D) patients with chronic periodontitis.

METHODS

The study included 125 type-2 diabetic patients with chronic periodontitis who had good glycemic control (T2Dc), 125 type-2 diabetics who had bad glycemic control (T2Dpc). The 125 T2Dpc were divided randomly into two groups. The first one enrolled 63 T2Dpc and received a non-surgical periodontal treatment (T2Dpc + NST). The second group enrolled 62 T2Dpc and received the non-surgical treatment accompanied by systemic antibiotics (T2Dpc+NST+A). HbA1c, periodontal indices, and salivary enzyme activities were assessed for all groups. The Glycated hemoglobin (HbA1c) was assessed. The Salivary alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransaminase (ALT), lactate dehydrogenase (LDH), and creatine kinase (CK) activities were measured.

RESULTS

The T2Dpc were characterized by the highest probing depth (PPD) and clinical attachment loss (CAL) periodontal scores, as well as ALP, AST, and ALT enzymatic activities. However, BOP did not differ significantly between T2Dc and T2Dpc. Whereas the rest of clinical parameters PI, GI, and OHI-S did not significantly differ between groups. The Pearson's analysis revealed three correlations between ALP-PPD, ALP-CAL, and ALP-BOP (bleeding on probing) in both T2Dc and T2Dpc (P < 0.05). Interestingly, a significant decrease in periodontal indices, salivary enzyme activities, and HbA1c was recorded in T2Dpc+NST+A group.

CONCLUSION

The increase in ALP, AST, and ALT activities reflects the impact of uncontrolled T2D on periodontal tissue alteration. The ALP activity increase was associated with the severity of periodontal status in diabetic patients. In comparison to non-surgical treatment alone, the adjunct use of systemic antibiotics improves periodontal state, enzyme activity, and glycemic control.

Inflammatory Responses in Periodontitis with or Without Rheumatoid Arthritis Alter Salivary Metallothionein and Zinc

Periodontitis (PD) and rheumatoid arthritis (RA) are causally linked by their common inflammatory responses, yet it is largely unknown if these inflammatory responses might have an impact on salivary metallothionein (MT), zinc (Zn), and calcium (Ca) content. In this study, we analysed salivary concentrations of pro-inflammatory (IFN-γ, IL-6, and IL-17) and anti-inflammatory (IL-4 and IL-10) cytokines, as well as MT, Zn, and Ca in four groups of participants, namely control (without PD or RA, n = 21), PD (n = 21), RA (n = 21), or RAPD (n = 19). As expected, an increased amount of salivary pro-inflammatory cytokines were observed in the PD, RA, and RAPD groups. While Ca concentration was not significantly different between the groups, Zn concentration was lower in the PD, RA, and RAPD groups compared to the control group (p < 0.05). These groups also expressed higher MT/Zn ratios compared to the control group (p < 0.05). Unlike the control group, concentrations of inflammatory cytokines, MT, Zn, and Ca correlated with each other in the PD, RA, and RAPD groups (p < 0.05). Additionally, comorbidity of PD and RA appears to have a cumulative immuno-pathological impact that warrants further investigation. This study suggests that, in addition to inflammatory cytokines, salivary MT and Zn could reflect the severity of PD with or without RA, hence providing an important biomarker for diagnosis.

Salivary and Dental Plaque Composition in Disabled Children Who Require Home Care: A Cross-sectional Investigation

Aims

The purpose of this study was to compare salivary and dental plaque (DP) composition between disabled children who require home care (DCHC) and a control group (CG) and to correlate it with oral and systemic health factors.

Materials and Methods

This cross-sectional study included 15 DCHC and 15 healthy children (aged between 4 and 10 years). The caregivers answered a questionnaire on disease diagnosis, medical history, dental history, and oral hygiene routine. In addition to clinical examination, saliva and DP samples were collected and analyzed using attenuated total reflection-Fourier transform infrared spectroscopy. Data were collected between January and December 2019. Student's t and Kendall correlation tests were used.

Results

Calculus (46.7%), bleeding on toothbrushing (53.3%), and gingival hyperplasia (40.0%) were prevalent in DCHC. The saliva of DCHC presented a higher amount of lipids and collagen and a lower amount of carbohydrates than that of the CG (P < 0.05). DP components were similar in DCHC and CG.

Conclusion

DCHC presented oral comorbidities and changes in salivary composition, compared with the CG.

Age-dependent oral manifestations of neurofibromatosis type 1: a case-control study

Introduction

Most craniofacial manifestations of neurofibromatosis type 1 (NF1) are considered as a result of tumor compression. We sought to determine salivary changes, caries, and periodontal complications in NF1 patients without tumors in the oral cavity.

Objective and methods

Eleven NF1 patients without tumors in the oral cavity and 29 matched controls without NF1 were enrolled in this case–control study. Demographic information, medical history, and data of intraoral examinations, including the Decayed, Missing, and Filled Teeth (DMFT) scores and Russel’s periodontal index (PI), were recorded. The functional salivary analysis was performed for sialometry, salivary pH values, and amylase activity. Ingenuity Systems Pathway Analysis (IPA) was conducted to identify mutually activated pathways for NF1-associated oral complications.

Results

NF1 patients were associated with periodontitis (OR = 1.40, 95% CI = 1.06–1.73, P = 0.04), gingivitis (OR = 1.55, 95% CI = 1.09–2.01, P = 0.0002), and decreased salivary flow rates (OR = 1.40, 95% CI = 1.05–1.76, P = 0.005). Periodontal destruction, salivary changes, and dental caries in NF1 patients were age-dependent. Subgroup analyses based on age stratification suggested that salivary flow rates and salivary amylase activities were significantly low in NF1 patients aged over 20 years and that salivary pH values, PI and DMFT scores were significantly high among NF1- controls aged over 20. All oral complications were not significantly presented in NF1 patients aged below 20 years. IPA analyses suggested that cellular mechanisms underlying NF1-associated oral complications involved chronic inflammatory pathways and fibrosis signaling pathway.

Conclusion

NF1 patients without tumors in the oral cavity presented a comparatively high prevalence of age-dependent oral complications, including periodontal destruction and salivary gland dysfunction, which were associated with chronic inflammatory pathogenesis.

Correlation of Blood and Salivary pH Levels in Healthy, Gingivitis, and Periodontitis Patients before and after Non-Surgical Periodontal Therapy

Periodontitis is an infectious illness which leads to the inflammation of protective tissues around the teeth and the continuous loss of alveolar bone and conjunctive tissue. Biomarker analysis in serum and saliva helps in the evaluation of disease progression and activity. It is also established that every inflammatory change along with resultant damage of tissues ends up in altered pH values in the fluids and tissues. Aim: To correlate the connection of pH levels in both blood as well as saliva in healthy, periodontitis, and gingivitis patients. Materials and Methods: The current research involved 145 subjects amidst the age of 20 and 55 years. The subjects were split into three different groups: healthy (Group A), gingivitis (Group B), and finally chronic periodontitis (Group C). The recording of clinical parameters was done by gingival index (GI), probing depth (PD), and plaque index (PI). pH of saliva and blood was analyzed with the help of digital single electrode pH meter. Subjects have gone through scaling and root planning (SRP) coupled with the instructions of oral hygiene. They were recalled post 4 weeks, and saliva and blood samples were gathered for analyzing pH. Results: Clinical parameters GI and PI were statistically important in both group C as well as group B post SRP. A crucial change has been observed in attachment levels (AL) and PD in the case of periodontitis group post SRP. The difference in the salivary pH values were significant between group B vs. C and A vs. C before the treatment because the values for group C were acidic, whereas in groups B and A the pH was alkaline. After the treatment, the values were still significant because the pH has become more alkaline compared to preoperative value in both group B and C. Saliva’s pH levels have demonstrated a statistically significant reduction in group C post SRP. Conclusion: Salivary pH levels and blood evidently became alkaline in the group C patients post SRP and there is a positive correlation between them and the clinical parameters.

Longitudinal assessment of salivary vitamin D binding protein during orthodontic tooth movement

Background

Vitamin D is critical for bone physiology. In this study, we quantified Vitamin D Binding Protein (VitDBP) levels in saliva as a measure of Vitamin D during orthodontic tooth movement.

Methods

In this longitudinal study, saliva samples were collected from 73 orthodontic patients for 4 timepoints for the first six months of orthodontic treatment, along with dental casts at the beginning and the end of the study period. The saliva was measured for VitDBP as a biological marker for bone apposition and clinical tooth movement. We used the absolute change in Little's Irregularity Index as a quantitative measure for alignment. In addition, we measured the levels of alkaline phosphatase (ALP) in saliva as a marker of bone turnover.

Results

Both low (< 2.75 ng/ml) and high (> 6.48 ng/ml) VitDBP levels were associated with reduced tooth movement. Significant (p < 0.05) seasonal changes in VitDBP using a two-season year model were found with lower levels observed in the summer (Apr–Sept) than in the winter (Oct–Mar).

Conclusions

Clinically significant orthodontic tooth movement is associated with an optimal range of VitDBP in saliva. Normal levels of VitDBP correlated with more orthodontic tooth movement, suggesting a "normal" range of salivary content of VitDBP. Given the strong trend that is independent of the confounding factors (ex. age, race or gender), the predictive value or salivary VitDBP for tooth movement should be studied in larger cohorts in future studies.

The Impact of Pregnancy and Menopause on the Correlation Between Salivary Calcium Levels, Calcium Intake, and Bleeding on Probing (BOP)

Aims:

Evaluate the impact of pregnancy and menopause on the correlation between salivary calcium levels, calcium intake, and bleeding on probing (BOP), so it can be used as indicators to determine the oral health status of pregnant and menopausal women.

Materials and Methods:

This was a descriptive study using a cross-sectional approach. Participants included 26 menopausal women, 24 pregnant women, and 35 control subjects. Salivary calcium levels were measured using an atomic absorption spectrophotometer, and calcium intake was assessed using a semi-quantitative food frequency questionnaire. Other supporting data included height, weight, blood pressure, blood glucose level, salivary pH, and volume.

Results:

The mean salivary calcium levels of pregnant women (0.72 ± 0.61 mmol/L) were lower than those of control subjects (1.69 ± 0.81 mmol/L), but the mean salivary calcium levels of menopausal women were higher (1.99 ± 1.24 mmol/L). Most of the subjects in all three groups had inadequate calcium intake. The mean BOP values of pregnant and menopausal women were higher than those of the control subjects. This study found the only variable that correlated with the salivary calcium level was the menopausal group’s blood glucose level (P = 0.009).

Conclusions:

Pregnancy and menopause did not have an impact on the relationship between salivary calcium levels and BOP but had an impact on the relationship between salivary calcium levels and calcium intake. Calcium intake did not affect salivary calcium levels in both conditions when compared with the control group.

Oral Diagnostic Methods for the Detection of Periodontal Disease

Periodontitis is a common immune-inflammatory oral disease. Early detection plays an important role in its prevention and progression. Saliva is a reliable medium that mirrors periodontal health and is easily obtainable for identifying periodontal biomarkers in point-of-care diagnostics. The aim of this study is to evaluate the effectiveness of diagnostic salivary tests to determine periodontal status. Whole saliva (stimulated/unstimulated) from twenty healthy and twenty stage III grade B generalized periodontitis patients was tested for lactoferrin, alkaline phosphatase, calcium, density, osmolarity, pH, phosphate, buffer capacity, salivary flow rate and dynamic viscosity. A semi-quantitative urinary strip test was used to evaluate markers of inflammation in saliva (erythrocytes, leukocytes, urobilinogen, nitrite, glucose, bilirubin, and ketones), clinical periodontal parameters and pathogenic bacteria. Concentrations of lactoferrin, hemoglobin, and leukocytes were found to be significantly higher in the stimulated and unstimulated saliva in periodontitis patients compared to healthy patients, whereas alkaline phosphatase levels were higher in unstimulated saliva of periodontitis patients (p < 0.05). Periodontal biomarker analysis using test strips may be considered rapid and easy tool for distinguishing between periodontitis and healthy patients. The increase in lactoferrin, hemoglobin, and leucocytes-determined by strip tests-may provide a non-invasive method of periodontal diagnosis.

The Effect of Long-Term Antihypertensive Therapy on the Change in Secretion and Calcium, Bicarbonate and Phosphate Ion Concentration in Non-Stimulated and Stimulated Saliva

Objective

The aim of this study was to evaluate the amount of saliva secreted and calcium, bicarbonate, and phosphate ion concentration in patients receiving antihypertensive for five years or over five years (patient group) and in healthy patients (control group).

Material and methods

The patient or experimental group included 31 subjects who were admitted to a cardiovascular clinic and had been receiving an antihypertensive drug therapy for more than five years. The control group included 31 healthy subjects. The measured amount of saliva was further used to determine the calcium, phosphate and bicarbonate ion concentration values. Calcium and phosphate ions were determined spectrophotometrically, while bicarbonate ions were determined by titration.

Results

A two-way-test (Student's test) was used to compare the values of variables. The amount of excreted saliva was statistically significantly lower in the patient group in non-stimulated (1.739 mL/5 min) and stimulated saliva (3.594 mL/5 min). Calcium ion concentration was statistically significantly lower in patient group in resting saliva (6.143 mg/dL). Bicarbonate and phosphate ion concentration in patient group was statistically significantly higher in non-stimulated (bicarbonate ion = 14.041 mmol/L, phosphate ion = 2.818 μmol/L) and stimulated saliva (bicarbonate ion = 10.872 mmol/L, phosphate ion = 1.454 μmol/L), respectively.

Conclusion

A reduced amount of saliva and calcium ion concentration indicates the possibility of a higher frequency of hard dental tissue demineralization process. On the contrary, the increase in the phosphate and bicarbonate ion concentration in the patient group affects the regulation of acid-base balance, thus having a preventive effect.

Mammalian-like type II glutaminyl cyclases in Porphyromonas gingivalis and other oral pathogenic bacteria as targets for treatment of periodontitis

The development of a targeted therapy would significantly improve the treatment of periodontitis and its associated diseases including Alzheimer’s disease, rheumatoid arthritis, and cardiovascular diseases. Glutaminyl cyclases (QCs) from the oral pathogens Porphyromonas gingivalis, Tannerella forsythia, and Prevotella intermedia represent attractive target enzymes for small-molecule inhibitor development, as their action is likely to stabilize essential periplasmic and outer membrane proteins by N-terminal pyroglutamination. In contrast to other microbial QCs that utilize the so-called type I enzymes, these oral pathogens possess sequences corresponding to type II QCs, observed hitherto only in animals. However, whether differences between these bacteroidal QCs and animal QCs are sufficient to enable development of selective inhibitors is not clear. To learn more, we recombinantly expressed all three QCs. They exhibit comparable catalytic efficiencies and are inhibited by metal chelators. Crystal structures of the enzymes from P. gingivalis (PgQC) and T. forsythia (TfQC) reveal a tertiary structure composed of an eight-stranded β-sheet surrounded by seven α-helices, typical of animal type II QCs. In each case, an active site Zn ion is tetrahedrally coordinated by conserved residues. Nevertheless, significant differences to mammalian enzymes are found around the active site of the bacteroidal enzymes. Application of a PgQC-selective inhibitor described here for the first time results in growth inhibition of two P. gingivalis clinical isolates in a dose-dependent manner. The insights gained by these studies will assist in the development of highly specific small-molecule bacteroidal QC inhibitors, paving the way for alternative therapies against periodontitis and associated diseases.

How Fluoride Protects Dental Enamel from Demineralization

Introduction:

How fluoride (F^–) protects dental enamel from caries is here conveyed to dental health-care providers by making simplifying approximations that accurately convey the essential principles, without obscuring them in a myriad of qualifications.

Materials and Methods:

We approximate that dental enamel is composed of calcium hydroxyapatite (HAP), a sparingly soluble ionic solid with the chemical formula Ca₁₀(PO₄)₆(OH)₂.

Results:

The electrostatic forces binding ionic solids together are described by Coulomb’s law, which shows that attractions between opposite charges increase greatly as their separation decreases. Relatively large phosphate ions (PO₄^3–) dominate the structure of HAP, which approximates a hexagonal close-packed structure. The smaller Ca²⁺ and OH^– ions fit into the small spaces (interstices) between phosphates, slightly expanding the close-packed structure. F^– ions are smaller than OH^– ions, so substituting F^– for OH^– allows packing the same number of ions into a smaller volume, increasing their forces of attraction. Dental decay results from tipping the solubility equilibrium Ca₁₀(PO₄)₆(OH)₂ (s) ⇔ 10Ca²⁺ (aq) + 6PO₄^2– (aq) + 2OH^– (aq) toward dissolution. HAP dissolves when the product of its ion concentrations, [Ca²⁺]¹⁰×[PO₄^3–]⁶×[OH^–]², falls below the solubility product constant (Ksp) for HAP.

Conclusion:

Because of its more compact crystal structure, the Ksp for fluorapatite (FAP) is lower than the Ksp for HAP, so its ion product, [Ca²⁺]¹⁰×[PO₄^3–]⁶×[F^–]², must fall further before demineralization can occur. Lowering the pH of the fluid surrounding enamel greatly reduces [PO₄^3–] (lowering the ion products of HAP and FAP equally), but [OH^–] falls much more rapidly than [F^–], so FAP better resists acid attack.

Bone Turnover Markers in Chronic Periodontitis: A Literature Review

Chronic periodontitis (CP) is a multifactorial oral inflammatory disease characterized by progressive destruction of bone and ultimate tooth loss. The alarming rise in the prevalence of periodontitis has led to the development of innovative diagnostic techniques. Several quantifiable biomarkers in the gingival crevicular fluid (GCF) and saliva of chronic periodontitis patients have been detected in the field of oral fluid diagnostics. Bone turnover biomarkers hold a valuable diagnostic potential in determining the extent of alveolar bone destruction and the risk of future bone loss. This review article highlights the importance of bone turnover markers in facilitating earlier detection, accurate diagnosis, and effective treatment strategies, leading to optimal clinical management of chronic periodontitis.

Advance of Nano-Composite Electrospun Fibers in Periodontal Regeneration

Periodontitis is considered to be the main cause of tooth loss, which affects about 15% of the adult population around the world. Scaling and root-planning are the conventional treatments utilized to remove the contaminated tissue and bacteria, but eventually lead to the formation of a poor connection-long junctional epithelium. Therefore, regenerative therapies, such as guided tissue/bone regeneration (GTR/GBR) for periodontal regeneration have been attempted. GTR membranes, acting as scaffolds, create three-dimensional (3D) environment for the guiding of cell attachment, proliferation and differentiation, and play a significant role in periodontal regeneration. Nano-composite scaffolds based on electrospun nanofibers have gained great attention due to their ability to emulate natural extracellular matrix (ECM) that affects cell survival, attachment and reorganization. Promoted protein absorption, cellular reactions, activation of specific gene expression and intracellular signaling, and high surface area to volume ratio are also important properties of nanofibrous scaffolds. Moreover, several bioactive components, such as bioceramics and functional polymers can be easily blended into nanofibrous matrixes to regulate the physical-chemical-biological properties and regeneration abilities. Simultaneously, functional growth factors, proteins and drugs are also incorporated to regulate cellular reactions and even modify the local inflammatory microenvironment, which benefit periodontal regeneration and functional restoration. Herein, the progress of nano-composite electrospun fibers for periodontal regeneration is reviewed, including fabrication methods, compound types and processes, and surface modifications, etc. Significant proof-of-concept examples are utilized to illustrate the results of material characteristics, cellular interactions and periodontal regenerations. Finally, the existing limitations of nano-composite electrospun fibers and the development tendencies in future are also discussed.

Localized Delivery of Amifostine Enhances Salivary Gland Radioprotection

Radiotherapy for head and neck cancers commonly causes damage to salivary gland tissue, resulting in xerostomia (dry mouth) and numerous adverse medical and quality-of-life issues. Amifostine is the only Food and Drug Administration-approved radioprotective drug used clinically to prevent xerostomia. However, systemic administration of amifostine is limited by severe side effects, including rapid decrease in blood pressure (hypotension), nausea, and a narrow therapeutic window. In this study, we demonstrate that retroductal delivery of amifostine and its active metabolite, WR-1065, to murine submandibular glands prior to a single radiation dose of 15 Gy maintained gland function and significantly increased acinar cell survival. Furthermore, in vivo stimulated saliva secretion was maintained in retrograde-treated groups at levels significantly higher than irradiated-only and systemically treated groups. In contrast to intravenous injections, retroductal delivery of WR-1065 or amifostine significantly attenuated hypotension. We conclude that localized delivery to salivary glands markedly improves radioprotection at the cellular level, as well as mitigates the adverse side effects associated with systemic administration. These results support the further development of a localized delivery system that would be compatible with the fractionated dose regimen used clinically.

Murine Salivary Functional Assessment via Pilocarpine Stimulation Following Fractionated Radiation

Hyposalivation is commonly observed in the autoimmune reaction of Sjögren's syndrome or following radiation injury to the major salivary glands. In these cases, questions remain regarding disease pathogenesis and effective interventions. An optimized technique that allows functional assessment of the salivary glands is invaluable for investigating exocrine gland biology, dysfunction, and therapeutics. Here, we present a step by step approach to performing pilocarpine stimulated saliva secretion, including tracheostomy and the dissection of the three major murine salivary glands. We also detail the appropriate murine head and neck anatomy accessed during these techniques. This approach is scalable, allowing for multiple mice to be processed simultaneously, thus improving the efficiency of the work flow. We aim to improve the reproducibility of these methods, each of which has further applications within the field. In addition to saliva collection, we discuss metrics for quantifying and normalizing functional capacity of these tissues. Representative data are included from submandibular glands with depressed salivary gland function 2 weeks following fractionated radiation (4 doses of 6.85 Gy).

Relationship between Physicochemical Properties of Saliva and Dental Caries and Periodontal Status among Female Teachers Living in Central Iran

Objectives:

There are inconsistent data about the association between saliva properties, dental caries, and periodontal status. In this study, we tried to examine the association between dental caries and periodontal status with salivary viscosity, flow rate, pH, and buffering capacity in adults.

Methods:

In the present cross-sectional study, 450 female teachers were randomly selected from schools located in Yazd, Iran. Oral examinations were conducted, and unstimulated saliva samples were collected. Salivary viscosity, flow rate, pH, and buffering capacity were assessed. The salivary physicochemical properties were compared among teachers with different types of oral health. Analyses were done using the Statistical Package for the Social Sciences version 16.

Results:

In total, 431 female teachers aged 40.45 ± 8.18 years were included in the study. Salivary flow rate, buffering capacity, pH, and viscosity, community periodontal index status were not significantly different in participants with and without tooth caries. There was a reverse linear association between salivary pH and flow rate with the decayed, missed, and filled teeth index (P < 0.05). The saliva buffering capacity was not significantly related to dental properties. Those with bleeding on probing had lower salivary pH, and buffering capacity compared to those with healthy gum. However, the salivary resting flow rate was not different in participants with bleeding on probing and healthy participants.

Conclusion:

Based on our results, saliva properties might be important predictors in oral health status. This means that any change in saliva combination might affect periodontal and dental diseases. Future prospective studies are recommended to confirm these results.

Comparative Analysis of Salivary Alkaline Phosphatase in Post menopausal Women with and without Periodontitis

INTRODUCTION

Alkaline phosphatase is an intracellular destruction enzyme in the periodontium, and it takes part in the normal turnover of the periodontal ligament, alveolar bone, and root cementum formation and maintenance.

AIM

The aim of this case control study was to evaluate the enzyme Alkaline Phosphatase (ALP) level in saliva of post menopausal women with and without chronic periodontitis.

MATERIALS AND METHODS

In this study, 40 individuals, satisfying the study inclusion and exclusion criteria, were recruited. They were categorically divided, on the basis of gingival index, probing pocket depth and clinical attachment level, into two groups: Group I (post menopausal women with a clinically healthy periodontium, n=20); and Group II (post menopausal women with generalized chronic periodontitis, n=20). Clinical parameters assessed were Plaque Index (PI), Gingival Index (GI), Clinical Attachment Level (CAL) and Probing Pocket Depth (PPD). Unstimulated salivary samples were obtained in which the ALP concentration was measured using p-Nitrophenylphosphate, and 2-amino-2-methyl-1-propanol reagents in Beckman and Coulter, AU 480 auto analyser. Mann-Whitney U test was used to find statistical difference with respect to all clinical parameters such as PI, GI, CAL, PPD and salivary ALP levels.

RESULTS

The mean ALP in saliva was found to be higher in Group II compared to Group I and the difference was statistically significant with the p-value of 0.008.

CONCLUSION

A noteworthy increase in the ALP concentration was seen in saliva in our study (Group II) may be due to increased periodontal inflammation in post menopausal women. Thus salivary ALP can be taken as an additional biomarker to early diagnosis, development and progression of periodontitis especially among post menopausal women.