Salivary Biomarkers in Patients with Periodontitis After Scaling and Root Planing

Journal of Clinical Medicine: Published on November 2022

Periodontitis is an inflammatory disease of multifactorial origin, characterized by periods of exacerbation and remission.

The main etiological factors for the disease include gram-negative anaerobic bacteria and a variety of facultative bacteria that reside in the subgingival biofilm.

Various diagnostic methods are available for the early detection and diagnosis of periodontitis. Saliva is commonly used for early diagnosis and detection of biomarkers. Saliva contains systemically and locally derived markers related to periodontal disease, thus serving as a specific biomarker for the assessment of periodontitis.

Salivary arginase and uric acid have been reported to play a significant role in periodontal disease. Salivary arginase levels seem to be raised in chronic periodontitis, suggesting its role in the inflammatory process.

One of the major antioxidants present in saliva is uric acid, which is the most dominant antioxidant. These biomarkers have both antioxidant and pro-oxidant properties in vitro by scavenging and producing reactive oxygen species and are known to have an impact during periodontal inflammation.

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This study aims to quantify salivary arginine and uric acid levels in participants with gingivitis (group II) and periodontitis (group III) compared with those with a healthy periodontium (group I), and evaluate the effects of non-surgical periodontal therapy on salivary arginase and uric acid levels.

Group II and group III showed improvement in clinical parameters following non-surgical periodontal therapy on the 90th day.

On day 0, at baseline, salivary arginase levels in group III and group II were higher than those in healthy subjects, whereas on day 0, salivary uric acid levels in group III and group II were lower than those in healthy subjects.

Both on day 0 and day 90, the salivary arginase level showed a positive correlation with the periodontal parameters, whereas the salivary uric acid level was positively correlated with the periodontal parameters on day 90.

Conclusion: The levels of salivary arginine and uric acid can serve as pro-inflammatory biomarkers in the early detection of periodontal inflammation and as indicators after periodontal therapy and may potentially be used to provide point-of-care screening, diagnosis, and monitoring of treatment efficacy.

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Abstract

Objectives: This study was conducted to evaluate the levels of salivary uric acid and arginase in patients with periodontitis, generalized gingivitis, and in healthy individuals. Then, the effects of non-surgical periodontal therapy on levels of salivary arginase and uric acid were also investigated.

Methods: A total of 60 subjects were divided into three groups based on periodontal health: group I comprised 20 healthy individuals; group II comprised 20 subjects who had generalized gingivitis; group III comprised 20 subjects who had generalized periodontitis. On day 0, the clinical examination of periodontal status was recorded, following which saliva samples were collected. Group II and group III subjects underwent non-surgical periodontal therapy. These patients were recalled on day 30 to collect saliva samples. The periodontal parameters were reassessed on day 90, and saliva samples were collected for analysis of salivary arginase and uric acid levels.

Results: Group II and group III showed improvement in clinical parameters following non-surgical periodontal therapy on the 90th day. The MGI score, PPD, and CAL showed improvement. On day 0, at baseline, salivary arginase levels in group III and group II were higher than those in healthy subjects, whereas on day 0, salivary uric acid levels in group III and group II were lower than those in healthy subjects. Both on day 0 and day 90, the salivary arginase level showed a positive correlation with the periodontal parameters, whereas the salivary uric acid level was positively correlated with the periodontal parameters on day 90.

Conclusion: the level of salivary arginase was a pro-inflammatory marker and a raised level of salivary uric acid was an anti-inflammatory marker following periodontal therapy, suggesting their pivotal role in assessing periodontal status and evaluation of treatment outcome.

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