1982;53:334C5

1982;53:334C5. criteria are often insufficient for determining sites of active disease, for monitoring the response to therapy, or for measuring the degree of susceptibility to future disease progression. Saliva, CP 375 as a mirror of oral and systemic health, is a valuable source for clinically relevant information because it contains biomarkers specific for the unique physiologic aspects of periodontal diseases. This review highlights the various potentials of saliva as a diagnostic biomarker for periodontal diseases. a totally noninvasive approach, has long been recognized as the potential treatment for these limitations.[1] Saliva provides an easily available, noninvasive diagnostic medium for a rapidly widening range of diseases and clinical situations.[2] In the field of periodontology, traditional clinical criteria are often insufficient for determining sites of active disease, for monitoring the response to therapy or for measuring the degree of susceptibility to future disease progression. Saliva as a mirror of oral and systemic health is a valuable source for clinically relevant information because it contains biomarkers specific for the unique physiological aspects of periodontal diseases. PERIODONTAL DISEASE CP 375 Periodontal disease is usually a chronic disease of the oral cavity comprising a group of inflammatory conditions affecting the supporting structures of the dentition.[3,4] The natural history of periodontitis follows a discontinuous pattern of exacerbation and remission characterized by disease activity and inactivity.[5,6] Periodontitis is usually a multifactorial disease which is usually affected by both genetic and environmental factors.[7] Clinical parameters such as probing depth, attachment level, bleeding on probing, plaque index, and radiographic CP 375 assessment of alveolar bone loss provide information on the severity of periodontitis but they do not measure disease activity, whereas microbiological assessments, analysis of host response, and genetic analyses have been proposed in an effort to monitor and identify patients at increased risk for periodontitis.[6,8] SALIVA AS A DIAGNOSTIC FLUID IN PERIODONTAL DISEASES Proposed salivary diagnostic markers for periodontal diseases have included serum and salivary molecules such as immunoglobulins, enzymes constituents of gingival crevicular fluid, bacterial components or products, volatile compounds, and phenotypic markers, such as epithelial keratins.[2,8] COLLECTION OF SALIVA The fluid mostly collected for salivary diagnostic purpose is expectorated whole saliva, a mix composed largely of the secretions from ATP2A2 the major salivary glands along with the modest contributions from the minor salivary glands and gingival crevicular fluid. Unstimulated or resting saliva is usually collected by passive drooling into a graduated tube or preweighed vial so that flow rate per unit time can be measured.[2] When volume measurement is not required, saliva can be collected on cotton swabs, cotton rolls, gauze or filter paper strips, then eluted or centrifuged or aspirated directly from the floor of the mouth with plastic pipettes.[2] When large volumes of saliva are required for analytical purposes, saliva is stimulated by a masticatory or gustatory stimulus, expectorated and handled in a similar manner as the unstimulated fluid. Softened paraffin wax or a washed rubber band are the usual masticatory stimuli and 2% citric acid applied directly to the tongue is the standard gustatory stimulus.[2] Many a occasions secretions from individual glands are preferred and this can be accomplished in a noninvasive manner with suitable collecting devices. Parotid saliva is best collected with plastic modifications of a single cup first introduced by Carlson and Crittenden in 1910. Now disposable and individualized collectors have been introduced for this purpose. SubmandibularCsublingual saliva can be collected by customization of a basic plastic collector or by aspiration from CP 375 the duct openings with micropipettes [Physique 1].[2] Open in a separate window Determine 1 Biomarkers seen in saliva SALIVARY MARKERS OF PERIODONTAL DISEASES The various salivary biomarkers are as follows. Markers CP 375 affecting the dental biofilm Specific markers Immunoglobulins (Ig) are important specific defense factors of saliva. The predominant immunoglobulin in saliva is usually secretory IgA (sIgA), which is derived from plasma cells in the salivary glands..