Evaluation of Salivary Procalcitonin Levels in Different Periodontal Diseases

Background: The present study aims to investigate the levels of salivary procalcitonin (ProCT) in patients with different periodontal diseases. Methods: Seventy‐two non‐smokers are included in this study: 21 individuals with chronic periodontitis (CP), 14 individuals with generalized aggressive periodontitis (GAgP), 18 individuals with gingivitis (G), and 19 periodontally healthy (H) participants. Clinical periodontal parameters, including probing depth (PD), clinical attachment level (CAL), plaque index, and gingival index (GI), were assessed in all participants. Saliva samples were collected and examined for evaluating ProCT levels. Results: It was found that the median (interquartile range) salivary ProCT level was lowest in the H group: 0.00 (0.09) ng/mL; followed by the G group: 0.09 (0.11) ng/mL; the CP group: 0.15 (0.29) ng/mL; and highest in the GAgP group 0.28 (0.68) ng/mL. These differences were statistically significant between the H group and the other groups (P <0.05). There were positive correlations between the mean salivary ProCT level and GI, CAL, and PD. Conclusion: According to the present results, ProCT might play a role during periodontal inflammation, and an elevated salivary ProCT level is suggested as a potential biomarker for periodontal diseases.     

Detection of Eight Periodontal Microorganisms and Distribution of Porphyromonas gingivalis fimA Genotypes in Chinese Patients With Aggressive Periodontitis

Background: The microbiologic feature of aggressive periodontitis (AgP) in Chinese patients has not yet been determined. This study aims to investigate the prevalence of eight periodontal microorganisms and the distribution of the Porphyromonas gingivalis fimA genotype in a cohort of Chinese patients with AgP. Methods: Saliva and pooled subgingival plaque samples were collected from 81 patients with AgP (25 with incisor–first molar type and 56 with generalized type [GAgP]) and 34 periodontally healthy controls. Eight periodontal microorganisms, including Aggregatibacter actinomycetemcomitans, P. gingivalis, Tannerella forsythia, Treponema denticola, Campylobacter rectus, Prevotella intermedia, Prevotella nigrescens, and Fusobacterium nucleatum were detected in these samples by the polymerase chain reaction (PCR). In addition, the distribution of fimA genotypes was assessed in P. gingivalis–positive individuals by PCR. Results: The prevalence of P. gingivalis, T. forsythia, T. denticola, C. rectus, P. intermedia, F. nucleatum, and A. actinomycetemcomitans in patients with AgP was significantly higher than that in healthy controls. The prevalence of A. actinomycetemcomitans in patients with GAgP was relatively low (30.4%) compared with other pathogens. Results of logistic regression analysis showed that younger patients were more likely to harbor A. actinomycetemcomitans (odds ratio = 2.85). Type II was the most prevalent fimA genotype of P. gingivalis in patients with AgP. Conclusions: P. gingivalis, T. forsythia, T. denticola, C. rectus, P. intermedia, and F. nucleatum were the predominant periodontal pathogens of patients with GAgP in China. Type II of fimA was the most prevalent genotype of P. gingivalis in patients with AgP. The prevalence of A. actinomycetemcomitans in patients with GAgP was relatively low.     

Lipid Peroxidation Levels and Total Oxidant/Antioxidant Status in Serum and Saliva From Patients With Chronic and Aggressive Periodontitis. Oxidative Stress Index: A New Biomarker for Periodontal Disease?

Background: In this study, levels of malondialdehyde (MDA), which is a significant product of lipid peroxidation (LPO), total oxidant status (TOS), total antioxidant capacity (TAOC), and the oxidative stress index (OSI), a novel value as a marker of periodontal disease activity, are investigated in serum and saliva from patients with chronic (CP) and generalized aggressive (GAgP) periodontitis. Methods: A total of 98 patients (33 with CP, 35 patients with GAgP, and 30 periodontally healthy controls) enrolled in the study. After clinical measurements and sample collection, the MDA level, TOS, and TAOC were measured by high‐performance liquid chromatography and a novel automatic colorimetric method. The OSI was calculated as [(TOS/TAOC) × 100]. Results: Although the salivary MDA levels and serum and salivary TOS and OSI values were significantly higher in the periodontitis groups than in the control group (P <0.05), the serum and salivary TAOC levels were significantly lower, and no significant difference in serum MDA levels was found (P >0.05). Furthermore, oxidative stress parameters were higher in the GAgP group than in the CP group (except the serum and salivary MDA levels and serum TAOC). Significant positive and negative correlations were observed between periodontal parameters and the MDA levels and TOS, TAOC, and OSI values (except serum MDA) (P <0.05). Conclusions: The present findings suggest that an increased TOS and decreased TAOC, rather than LPO, play important roles in the pathology of periodontitis and are closely associated with clinical periodontal status. Furthermore, the OSI may be a useful and practical parameter for evaluating periodontal disease activity.     

Periodontal Status and Whole Salivary Cytokine Profile Among Smokers and Never‐Smokers With and Without Prediabetes

Background: Whole salivary interleukin (IL)‐1β and IL‐6 in smokers and never‐smokers with prediabetes remains uninvestigated. The aim of this study is to assess the periodontal status and whole salivary IL‐1β and IL‐6 levels among smokers and never‐smokers with and without prediabetes (controls). Methods: Ninety‐five males (45 with prediabetes and 50 systemically healthy controls) were included. Twenty‐seven controls and 29 patients with prediabetes were smokers. Periodontal parameters (plaque index, bleeding on probing, probing depth, clinical attachment loss, and marginal bone loss) were measured, and the number of missing teeth were recorded. Fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) levels were recorded. Unstimulated whole saliva samples were collected, unstimulated whole salivary flow rate (UWSFR) was determined, and IL‐1β and IL‐6 levels were measured. P values <0.05 were considered statistically significant. Results: FBG (P <0.05) and HbA1c (P <0.05) levels were higher among patients with prediabetes than controls. All patients with prediabetes were hyperglycemic. UWSFR was significantly higher among controls than among patients with prediabetes (P <0.05). Periodontal parameters and whole salivary IL‐1β and IL‐6 levels were comparable among smokers and never‐smokers with prediabetes. Among controls, periodontal parameters and whole salivary IL‐1β and IL‐6 levels were higher among smokers than never‐smokers (P <0.05). Conclusions: Among controls, periodontal inflammation was worse, and whole salivary IL‐1β and IL‐6 levels are higher in smokers than never‐smokers. Among patients with prediabetes, periodontal inflammation and whole salivary IL‐1β and IL‐6 levels were comparable between smokers and never‐smokers.     

Non‐Surgical Periodontal Therapy Reduces Saliva Adipokine and Matrix Metalloproteinase Levels in Periodontitis

Background: Adipokines enhance the synthesis of proinflammatory cytokines and matrix metalloproteinases (MMPs), which play a role in extracellular matrix degeneration. The aim of this study is to determine the levels of some adipokines, proinflammatory cytokines, and MMPs in the saliva of patients with periodontitis and healthy individuals and to evaluate the changes after non‐surgical periodontal therapy (NSPT). Methods: Of 32 individuals included in the study, 17 had periodontitis and 15 had healthy gingiva. Saliva samples were obtained from all individuals. In patients with periodontitis, samples were recollected 3 and 6 months after NSPT. Visfatin, chemerin, progranulin, interleukin (IL)‐1β, IL‐8, MMP‐8, and MMP‐13 levels were measured using enzyme‐linked immunosorbent assay. Results: In patients with periodontitis, all of the parameters measured in the saliva were higher than those of healthy individuals. At 3 months, visfatin, progranulin, IL‐8, and MMP‐8 levels were significantly decreased compared with baseline values. The levels of other biochemical parameters, chemerin and IL‐1β, were significantly decreased compared with baseline values at 6 months, and the levels became similar to those in healthy individuals. In the periodontitis group, positive correlations were found among visfatin and IL‐8 (r = 0.909, P <0.01), MMP‐8 (r = 0.702, P = 0.02), and MMP‐13 (r = 0.781, P = 0.01); chemerin and IL‐8 (r = 0.913, P <0.01), MMP‐8 (r = 0.770, P <0.01), and MMP‐13 (r = 0.788, P <0.01); and progranulin and IL‐8 (r = 0.762, P <0.01), MMP‐8 (r = 0.845, P <0.01), and MMP‐13 (r = 0.813, P <0.01). Conclusion: Adipokines may contribute to the breakdown of periodontal tissue in periodontitis by stimulating the expression of proinflammatory cytokines and MMPs.     

Salivary Levels of NLRP3 Inflammasome‐Related Proteins as Potential Biomarkers of Periodontal Clinical Status

Background: Emerging evidence suggests that activation of inflammasomes plays a central mechanism in pathogenesis of periodontitis. This study aims to compare salivary levels of nod‐like receptor family pyrin domain containing protein (NLRP) 3, apoptosis‐associated speck‐like protein containing a caspase recruitment domain (ASC), cysteine aspartase (caspase)‐1, and interleukin (IL)‐1β from individuals with aggressive (AgP) or chronic periodontitis (CP) and healthy controls (HC), as well as elucidate its association with periodontal clinical status. Methods: Saliva samples from individuals with CP (n = 75), AgP (n = 20), and HC (n = 69) were collected. Periodontal status was assessed by measurement of probing depth, clinical attachment level, and extent and severity of disease. Salivary levels of analytes were analyzed by enzyme‐linked immunosorbent assay. Association between biomarkers with CP or AgP was analyzed using multivariate binary logistic regression models. Results: Significantly higher levels of NLRP3, ASC, and IL‐1β were detected in periodontitis groups in comparison to the periodontally HC group. However, no significant differences were observed for caspase‐1 levels between clinical groups, and only NLRP3 salivary concentration was significantly higher in AgP compared with CP patients. Also, positive significant correlations among NLRP3, ASC, and IL‐1β salivary concentrations and clinical parameters were observed. Logistic regression analyses revealed a strong/independent association of NLRP3, ASC, and IL‐1β salivary levels with CP and AgP. Conclusion: Although the concentration of caspase‐1 in saliva samples makes its determination useless for detection of periodontal disease and/or its severity, salivary levels of NLRP3, ASC, and IL‐1β may act as strong/independent indicators of amount and extent of periodontal breakdown in both CP and AgP and could potentially be used for prevention and therapy of this group of diseases.     

Total Oxidant Status and Bone Resorption Biomarkers in Serum and Gingival Crevicular Fluid of Patients With Periodontitis

Background: In this study, the relationships between total oxidant status (TOS) and receptor activator of nuclear factor‐κB ligand (RANKL) and osteoprotegerin (OPG) levels and RANKL/OPG ratios in serum and gingival crevicular fluid (GCF) are investigated in patients with chronic (CP) and generalized aggressive (GAgP) periodontitis. Methods: Thirty patients with CP, 30 patients with GAgP, and 28 periodontally healthy controls were included in the study. After clinical measurements and samplings, serum and GCF TOS, RANKL, and OPG levels were determined by a novel automatic colorimetric method and enzyme‐linked immunosorbent assays. Results: Serum and GCF TOS, RANKL, and RANKL/OPG values were higher in the periodontitis groups compared with controls, and they were also higher in the GAgP group than the CP group (except serum and GCF RANKL). Furthermore, serum and GCF OPG concentrations were lower in the periodontitis groups than in controls. Strong positive and negative correlations were observed between the periodontal parameters TOS and bone resorption biomarkers. Conclusions: The present results reveal that TOS, RANKL, and RANKL/OPG values are systemically and locally increased in periodontitis and that this increase is more evident in AgP than CP. These findings further suggest that oxidative stress is closely associated with the severity of periodontitis and bone resorption biomarkers.     

The Influences of Periodontal Status and Periodontal Pathogen Quantity on Salivary 8‐Hydroxydeoxyguanosine and Interleukin‐17 Levels

Background: Periodontitis is a biofilm‐initiated disease that is characterized by elevated inflammatory status. 8‐Hydroxydeoxyguanosine (8‐OHdG) and interleukin (IL)‐17 are highly associated with inflammation and bone resorption and therefore are regarded as potential biomarkers for periodontitis. In this study, the associations between salivary 8‐OHdG and IL‐17 levels and clinical and microbial parameters before and after non‐surgical treatment are investigated. Methods: Forty‐five patients with chronic periodontitis (CP) and 47 periodontally healthy volunteers were recruited for the study. Clinical parameters, including the probing depth (PD), clinical attachment level (CAL), sulcular bleeding index, and simplified oral hygiene index (OHI‐S), were examined for each participant. Microbial parameters including the quantities of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola in the subgingival plaque and saliva were determined by real‐time polymerase chain reaction at baseline and 1 and 3 months after the non‐surgical treatment. Salivary 8‐OHdG and IL‐17 levels were detected by enzyme‐linked immunosorbent assays. Results: Compared with healthy volunteers, CP group patients had significantly higher salivary 8‐OHdG and IL‐17 levels at baseline. Baseline salivary 8‐OHdG and IL‐17 levels were positively correlated with all clinical parameters as well as the quantities of T. forsythia and T. denticola. After non‐surgical treatment, baseline levels of salivary 8‐OHdG and IL‐17 were reduced significantly at both the 1‐ and 3‐month follow‐ups. The hierarchical linear model revealed that variations in the PD, CAL, and OHI‐S had significant positive effects on variation in the salivary 8‐OHdG level. However, variations in the PD; quantity of T. forsythia in the subgingival plaque; and quantities of P. gingivalis, T. forsythia, and T. denticola in saliva were associated significantly with variation in the salivary IL‐17 levels. Conclusions: There was a strong association between salivary 8‐OHdG and IL‐17 levels and periodontitis. Variation in the salivary 8‐OHdG level was correlated with variations in the clinical parameters, whereas variation in the IL‐17 level was correlated with variation in the microbial parameters.     

8‐Hydroxy‐Deoxyguanosine Levels in Gingival Crevicular Fluid and Saliva in Patients With Chronic Periodontitis After Initial Periodontal Treatment

Background: This study evaluates the effects of initial periodontal treatment on the gingival crevicular fluid (GCF) and salivary levels of 8‐hydroxy‐deoxyguanosine (8‐OHdG) as a marker of oxidative deoxyribonucleic acid (DNA) damage in patients with chronic periodontitis (CP). Methods: At baseline, clinical parameters were determined and GCF and saliva samples were obtained from 24 patients with CP and 24 individuals with clinically healthy periodontium. GCF, saliva samples, and clinical periodontal measurements were repeated at day 10, 1 month, and 3 months following initial periodontal therapy in patients with CP. 8‐OHdG levels of GCF and saliva samples were investigated by using an enzyme‐linked immunosorbent assay. Results: Statistically significant higher 8‐OHdG levels of GCF and a significant decrease after initial periodontal therapy were determined in the CP group (P <0.001). A significant positive correlation was found between 8‐OHdG levels of GCF and clinical periodontal measurements (P <0.001). However, salivary levels of 8‐OHdG did not differ between groups or during initial periodontal therapy (P >0.05). Conclusions: This study reveals that DNA injury and oxidative stress increase in tissue cells and especially in periodontal pockets in patients with CP, and the periodontal treatment results in a significant decrease of 8‐OHdG levels in the GCF samples. To the best of our knowledge, this study evaluates for the first time, 8‐OHdG levels in GCF, which is shown to be more useful as a biomarker than saliva. 8‐OHdG was found to be important and may reveal the severity of periodontal disease and the effect of periodontal therapy.     

氧化应激及抗氧化防御系统在慢性牙周炎中的作用

近年来研究发现,氧化应激与抗氧化防御系统的失衡在慢性牙周炎中发挥重要作用,牙周组织受到细菌刺激产生的过量活性氧可造成和加重牙周组织的损伤。本文就炎性条件下过量活性氧对牙周组织的损害,以及氧化应激与抗氧化防御系统在慢性牙周炎发生发展中的作用和机制作一综述。     

Association of Gingival Crevicular Fluid Cortisol/Dehydroepiandrosterone Levels With Periodontal Status

Background: The aim of the present study is to examine whether anxiety and depression scale scores change with regard to clinical periodontal status and to investigate the association between the levels of stress‐related hormones in gingival crevicular fluid (GCF) and extent/severity of periodontal disease. Methods: One hundred twenty participants who fulfilled the study inclusion criteria were chosen. Patients with chronic periodontitis (CP) and those with healthy periodontal tissues/mild gingivitis were included. The clinical examinations were performed on the day after the psychologic evaluations which included anxiety and depression measurements. GCF sampling was undertaken the following day. Commercially available enzyme‐linked immunosorbent assay kits were used to determine GCF cortisol and dehydroepiandrosterone (DHEA) levels. Study groups were assigned as follows: group 1, non‐periodontitis; group 2, localized CP; and group 3, generalized CP. Results: There were no significant differences with respect to age, sex, education, income level, occupation, or smoking history among the groups (P >0.05). There were no significant differences between the non‐periodontitis and CP groups for any of the psychosocial scales (P >0.05). Group 3 had significantly higher mean DHEA scores compared with group 1 (P <0.05); however, the median cortisol scores showed no statistically significant differences among the three groups (P >0.05). Conclusions: Anxiety/depression scores and GCF cortisol levels did not show any difference with regard to clinical periodontal status. However, a significant association was found between elevated levels of GCF DHEA and the severity of periodontitis.     

Effect of Initial Periodontal Therapy on Oxidative Stress Markers in Gingival Crevicular Fluid,Saliva, and Serum in Smokers and Non‐Smokers With Chronic Periodontitis

Background: The aim of this case‐control study with an intervention arm is to determine the effect of initial periodontal treatment on oxidative stress biomarkers in smokers and non‐smokers with chronic periodontitis (CP). Methods: The study included 47 patients with CP (24 smokers [S+P+] and 23 non‐smokers [S?P+]) and 46 periodontally healthy individuals (23 smokers [S+P?] and 23 non‐smokers [S?P?]) for a total of 93 participants. Gingival crevicular fluid (GCF), serum, and saliva samples were obtained and clinical periodontal measurements were recorded at baseline and at the first and third months after periodontal therapy. 8‐hydroxydeoxyguanosine (OHdG) and 4‐hydroxynonenal (HNE) and enzyme activity of glutathione peroxidase (GSH‐Px) were analyzed with enzyme‐linked immunosorbent assay. Results: The level of 8‐OHdD in GCF was found to be significantly higher in both periodontitis groups compared with both periodontally healthy groups. 8‐OHdG and GSH‐Px in saliva in both periodontitis groups were significantly increased compared with the S?P? group. In the S+P+ group, 4‐HNE in GCF was found to be significantly higher than in periodontally healthy participants. After initial periodontal treatment, the levels of 8‐OHdG in GCF and saliva were significantly decreased in both periodontitis groups. Conclusion: Initial periodontal therapy may be helpful for diminishing oxidative stress in periodontitis.     

Evaluation of Antioxidant Enzymes Activity and Malondialdehyde Levels in Patients With Chronic Periodontitis and Diabetes Mellitus

Background: The aim of this study is to investigate the impact of diabetes, a known risk factor for periodontitis, on activities of antioxidant enzymes superoxide dismutase (SOD), glutathione reductase (GR), and catalase (CAT) as well as levels of free radical damage marker malondialdehyde (MDA) in blood and saliva of individuals with chronic periodontitis (CP). Methods: Sixty patients with CP (30 patients with type 2 diabetes mellitus [DMCP] and 30 systemically healthy patients [CP]) and 60 periodontally healthy individuals (30 patients with type 2 diabetes mellitus and 30 systemically healthy patients [PH]) were included in this study. After clinical measurements, blood and saliva samples were collected. SOD, GR, and CAT activities in red blood cell lysate and saliva and MDA levels in plasma and saliva samples were spectrophotometrically assayed. An analysis of variance test followed by a post hoc test was used to compare the intragroup and intergroup variances among the study groups. Results: MDA levels in both the periodontitis groups were higher than in the periodontally healthy groups, but the difference between the CP and DMCP groups did not reach statistical significance (P >0.05). There was a highly significant difference between the CP and PH groups for all the enzymes studied except for SOD in blood. Only salivary SOD and GR activities were significantly different in the CP and DMCP groups. Conclusions: This study favors the role of oxidative stress in both diabetes and periodontitis. It shows that the compensatory mechanism of the body is partially collapsed because of excessive production of free radicals during periodontitis and is not able to cope with increased free radical generation attributable to diabetes, thereby worsening the situation.     

Using Evidence-Based Dentistry in the Clinical Management of Combined Periodontal Conditions

Objective

This report proposes a framework to integrate evidence-based dentistry (EBD) in a systematic approach in the clinical management of a patient diagnosed with drug-induced gingival hyperplasia combined with generalized aggressive periodontitis.This report illustrates the case of a 37-year-old female who presented to the Department of Periodontology at Tufts University School of Dental Medicine with enlarged, tender, bleeding gums, and loose teeth combined with a history of uncontrolled hypertension treated with calcium channel blockers.

非手术方法治疗侵袭性牙周炎临床疗效观察

目的探讨非手术方法治疗侵袭性牙周炎的临床效果。方法选择广泛型侵袭性牙周炎患者15例,进行口腔卫生宣教、龈上洁治、龈下刮治和根面平整,并蹲服罗红霉素和甲硝唑1周。分别于治疗前和治疗后3、6、12、18个月检查及记录出血指数、探诊深度和附着水平,并进行分析比较。结果出血指数、探诊深度和附着水平在治疗前分别为3．37±0．56、（5.83±1．68）mm．（6．78±1．50）mm,治疗后18个月下降为（0．69±0．48）mm、（2．15±0．45）mm、（4．60±0．78）mm,差异均有统计学意义（P=0.000）。结论广泛型侵袭性牙周炎患者经过牙周非手术治疗后可以取得良好的治疗效果,并且疗效较为稳定。     

Effect of Low‐Dose Doxycycline on Serum Oxidative Status,Gingival Antioxidant Levels,and Alveolar Bone Loss in Experimental Periodontitis in Rats

Background: Subantibiotic doses of doxycycline (low‐dose doxycycline [LDD]) have been widely used in periodontal treatment for enzymatic inhibition and related anti‐inflammatory properties. The aim of the present study is to verify the possible effects of LDD on oxidative stress in relation to periodontal attachment loss associated with ligature‐induced experimental periodontal disease in rats. Methods: Thirty female Wistar albino rats were divided into three study groups as follows: 1) control (C) rats; 2) rats with experimental periodontitis (PED); and 3) rats with PED that were treated with doxycycline (PED + LDD). PED was induced by placing ligatures around the cervix of the maxillary second molars for 21 days. The PED + LDD group was treated orally with doxycycline (6 mg/kg) for 21 days after the ligature was placed. After 21 days, the rats were euthanized, and samples of the right maxilla were defleshed and used for histologic and morphometric analyses. The gingival tissue of the left maxilla was used for the analysis of lipid peroxidation (malondialdehyde [MDA]) and antioxidant enzymes (catalase, glutathione peroxidase, and superoxide dismutase). Levels of serum total antioxidant status (TAS)/total oxidant status (TOS) and oxidative stress index (OSI) were also analyzed. Results: Alveolar bone loss was significantly higher in the PED group compared with the PED + LDD and C groups (P <0.05). Doxycycline exhibited the most prominent inhibition on gingival tissue levels of MDA and antioxidant enzymes (P <0.05). Doxycycline also significantly reduced TOS and OSI levels (P <0.05) but increased the TAS level. Conclusion: Doxycycline helps to prevent periodontal tissue breakdown by inhibiting local and systemic oxidative stress.     

Effect of non-surgical treatment on chronic and aggressive periodontitis: clinical, immunologic, and microbiologic findings

Background: Our goal was to examine differences in clinical, microbiologic, and immunologic responses to non‐surgical mechanical therapy in patients with generalized chronic periodontitis (GCP) and generalized aggressive periodontitis (GAgP). Methods: Twenty patients with GCP and 14 patients with GAgP were evaluated. Clinical data, gingival crevicular fluid (GCF), and subgingival plaque samples were collected at baseline and 3 months after non‐surgical periodontal treatment. Levels of 40 subgingival species were measured using checkerboard DNA‐DNA hybridization. GCF interleukin (IL)‐1β, ‐4, and ‐8 and interferon‐γ (IFN‐γ) were analyzed using a multiplexed bead immunoassay, and elastase activity was measured using an enzymatic assay. The significance of changes with time was examined using the Wilcoxon rank sum test. Changes in clinical, microbiologic, and immunologic parameters after therapy were compared between groups using the Mann‐Whitney U test. Results: After periodontal therapy, we found significant improvements for all clinical parameters in both groups. We also observed significant reductions in elastase activity in shallow and deep sites from the GAgP group and in deep sites from the GCP group. Microbiologic data showed significant reductions in proportions of orange and red complexes and an increase in proportions of Actinomyces species in both clinical groups. When the clinical, microbiologic, and immunologic responses after therapy were compared between groups, only minor differences were found. Conclusion: This study fails to show any significant differences between severe forms of GCP and GAgP in response to non‐surgical periodontal treatment.     

Lipid peroxidation levels and total oxidant status in serum, saliva and gingival crevicular fluid in patients with chronic periodontitis

OBJECTIVES: Increased levels of reactive oxygen species lead to oxidative stress. Recent data suggest increased lipid peroxidation (LPO) levels and oxidative stress in periodontitis. Malondialdehyde (MDA), a significant LPO product, increases in oxidative stress. In this study, MDA levels and total oxidant status (TOS) in serum, saliva and gingival crevicular fluid (GCF) were investigated in patients with chronic periodontitis (CP). MATERIALS AND METHODS: Thirty-six CP patients and 28 periodontally healthy controls were included in the study. Following clinical measurements and samplings, MDA and TOS levels were measured by high-performance liquid chromatography and a novel automatic colorimetric method, respectively. RESULTS: While the saliva and GCF MDA levels, and serum, saliva and GCF TOS values were significantly higher in the CP group than the control group (p<0.05), no significant difference in serum MDA levels was found (p>0.05). Strong positive correlations were observed between periodontal parameters and MDA and TOS levels (p<0.05). CONCLUSIONS: The results revealed that LPO significantly increased locally in the periodontal pocket/oral environment, while TOS displayed both systemic and local increases in periodontitis. The findings suggest that increased LPO and TOS may play an important role in the pathology of periodontitis, and are closely related to the clinical periodontal status.