Estimation of Specific Salivary Enzymatic Biomarkers in Individuals with Gingivitis and Chronic Periodontitis: A Clinical and Biochemical Study

BACKGROUND: Host response to periodontal disease includes the release of different enzymes from stromal, epithelial or inflammatory cells. The enzymes which are produced from these cells are associated with cell injury and cell death like: Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP) and Blood urea nitrogen (BUN). Normal enzymatic activity of these enzymes is necessary for healthy functioning of gingiva and periodontium. The aim of the study is to estimate the levels of enzymes AST, ALT, ALP and BUN and to correlate the level of estimated enzymes with that of clinical parameters in the saliva of Healthy subjects, Gingivitis patients and patients with chronic periodontitis. METHODS: The study included a total of 40 male subjects within the age group of 21 to 50 years, and examined the activity of enzymes AST, ALT, ALP and BUN in saliva spectrophotometrically and compared their values between healthy subjects, gingivitis and chronic periodontitis patients. Clinical parameters like OHI – S (Oral hygiene index - Simplified, SBI (Sulcus Bleeding Index), PPD (Probing Pocket Depth), CAL (Clinical Attachment Level), and PI (Periodontal Index) were recorded. RESULTS: Obtained results showed statistically significant increases of activity of AST, ALT, ALP, and BUN in saliva from patients with periodontal disease (p<0.001) in relation to gingivitis and control groups. There was also an increase in periodontal parameters with an increase in salivary enzymes. CONCLUSION: The present study shows that the salivary enzyme activity can be used as biomarkers to determine periodontal tissue damage, which may be useful in diagnosis, prognosis and evaluation of post therapy effects in periodontal disease.