Diagnosing the persistent but not clinically pronounced inflammation in periodontal tissues often is an important clinical problem. Measurement of Nitrite-anion concentration in saliva is informative in diagnosing the periodontal pathology at different stages of its development as well as in differentiation of superficial inflammation of periodontal tissues in the case of gingivitis and profound destruction of gums and bone in case of periodontitis.
Aim of our investigations was the examinations of Nitric oxide level in saliva of patients with periodontal pathology by measuring accumulation of Nitrite anion.
Materials and methods. Were examined 47 patients (20-40 years old), including 28 persons with generalized inflammatory diseases of the gums: chronic simple (14) and hypertrophic gingivitis (14) and 19 patients with chronic generalized periodontitis. The level of Nitrite anion in salive of patiens was meassured. Saliva was obtained in the quantity of 1 ml from each patient on an empty stomach.
The method of analysis was as follows: 0,2 ml of sodium hydrocarbonate was added to 0,2 ml of saliva and stored in ice for 10 min, than 0,4 ml of distilled water and 1,2 ml of 4% ZnS04 were introduced into this solution. The mixture was centrifuged for 20 min and 1,2ml of translucent supernatant was separated from it and mixed with 1,2ml of Gries reactive. Results were obtained within 15 min in a spectrophotometry method (λ = 550 nm).
Results. In the patients with simple chronic gingivitis the level of Nitrite anion in saliva differs significantly from the control samples only in the group with exacerbation of simple chronic gingivitis (51,9±2,4 pmoI/L). In the patients with chronic hypertrophic gingivitis amounts of Nitrite anion in saliva were 11,6 ±1,6 pmol/L, but in the case of exacerbation they were increased 4-5 times as much as 56,1 ±2,7 pmol/L. Levels of Nitrite anion increased considerably in the exacerbation of both forms of gingivitis and amounted to 51,9 ±2,4 pmol/L and 56,1 ±2,7 pmol/L, respectively. These results indicate that level of NO synthesis in saliva doesn’t depend on the type of inflammation in the gums (simple or hypertrophic).
All the patients with chronic generalized periodontitis were tested at the active stage of disease and at the stage of remission. Increased amounts of nitrite anion in saliva of the patients with chronic generalized periodontitis were reported at the active stage of chronic
PhOL Ripetska, et al. 681 (pag 680-689)
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generalized periodontitis (84,9 ± 3,8 pmol/L), which exceeds the healthy control group more than 10 times.
Remission in the patients with generalized periodontitis was attained after complex treatment, which included surgical pocket elimination and was characterized with absence of pockets, inflammation and gums bleeding on probing. Levels of nitrite anion in saliva were lowered to 8,5 ±0,7 pmol/L, which makes an insignificant difference with healthy persons (4,9 ±0,6 pmol/L).
Conclusion. The level of nitric-anion which depicts the level of Nitric oxide in the saliva probably depicts not only the activity of periodontal inflammatory process, but also the aggressiveness of alveolar bone destruction.
All human studies were conducted in compliance with the rules of the Helsinki Declaration of the World Medical Association "Ethical principles of medical research with human participation as an object of study". Informed consent was obtained from all participants.
Keywords: gingivitis, periodontitis, Nitric oxide, levels of Nitrite anion in saliva