Prediction of Onset and Progression of Periodontitis by Salivary Tests

Objectives: The purpose of this cohort study was to evaluate the biochemical and microbiological tests using saliva for prediction of onset and progression of periodontitis. Methods: Biochemical analyses of saliva, microbiological tests, and surveys concerning smoking and tooth brushing were carried out over a 3 year period. Results: In 2003, when the first year survey was carried out, the mean age of the 170 male subjects was 39.5 ± 10.0 years, the mean number of teeth was 27.3 ± 2.2 teeth (range, 21-32), and 62 subjects (36.5%) did not have any pockets exceeding 4 mm in depth (normal group), while 108 (63.5%) subjects did have one or more pockets whose depth exceeded 4 mm (periodontitis group). In the saliva tests performed in the first year, lactate dehydrogenase (LDH) , alanine aminotransferase (ALT), aspartate aminotransferase (AST), and the ratio of Porphyromonas gingivalis to the total oral bacteria population were significantly higher in the periodontitis group than in the normal group, and significant correlations were observed between all test values. All test values in normal group revealed no obvious changes in 3 years. LDH, ALT and AST activities increased in the periodontitis onset group and progression group in whom the depth of the pocket had progressed by 3 mm or more from the previous year. P.gingivalis ratio was significantly higher in the year prior to progression to periodontitis compared to other years.Conclusions: It is concluded that measurement of LDH, ALT, AST and P.gingivalis ratio is useful for predicting the onset and progression of periodontitis.