Cervicular fluid asparatate aminotransferase AST levels innon-insulin dependent diabetes mellitus

This study was carried out on 30 subjects their age ranged from 35-45 years. They were divided into three groups Group I: consisted of 10 non insulin dependent diabetes mellitus patients [NIDDM] with periodontitis, selected from the Outpatient Clinic of Diabetes, the duration of the disease not less than 5 years. Group II: consisted of 10 having adult periodontitis according to Page et al., [1983] 118 selected from the Oral Medicine and Periodontology Dept., faculty of Dentistry, Alexandria University. Group III: consisted of 10 matched age and sex healthy subjects, with clinically normal gingiva, GI < 1 [Loe and Silness, 1963][19], served as controls. All three groups were screened clinically and biophysically exclude other systemic diseases Clinical dental examination was performed to all subjects enrolled in the study including: Gingival index [GI] [Loe and Sliness, 1963][9]. Plaque index [PI] [Silness and Loe 1964][20]. Probing pocket depth using William's probe. Probing attachment level [Ramfjord 1974][21] Determination of Aspartate Aminotransferase [AST] Level in the Gingi- Val Crevicular Fluid: The site to be sampled was dried supragingival calculs was removed. After isolation a filter paper strip was inserted into the crevice and left for one minute. The filter strip was then placed in a vial containing 100 ul-Tris-Hcl pH 8.0 and AST assessment was performed according to the standardized method of Bergmeyer, et al., [1978][22]. The results of the present study revealed a relationship between diabetes and the severe periodontal disease. The mechanisms by which increased susceptibility to periodontitis in diabetes is not entirely clear. However, this is in partly due to the susceptibility of NIDDM patients to periodontal disease breakdown, due to increased salivary glucose that may arise besides abnormal PMN function including depressed chemotaxis phagocytosis and PMN-bacterial interaction. The biochemical analysis in this study showed significant statistical increased GCF AST level in both NIDDM patients and adult periodontitis as compared to controls Additionally, a significant increase was detected on comparing group I and group II. This shows that AST enzyme activity is associated with the extent of gingival inflammation and tissue destruction. The high levels of AST in GCF of diabetic patients in the present study possibly arise from local tissue destruction, this supports the concept that elevated GCF levels indicate concurrent or impending disease activity. Commonly used clinical parameters as plaque and gingival indices are correlated to each to other but are poor diagnostic indicators of periodontal deterioration. Furthermore plaque and gingival indices pocket depth and attachment measurements do not reveal concurrent or further disease activity Clinical enzymology is used nowadays to aid in the diagnosis of inflammatory destruction, so it could be concluded that AST activity may be more useful for the assessment of inflammatory periodontal disease Therefore, paired with clinical data crevicular fluid AST activity could provide valuable data about the periodontyal condition and likelihood disease activity. A significant relationship between AST level and the clinical parameters recorded has been demonstrated It could be concluded that AST enzyme level is one of the promising markers of tissue destruction. Biochemical enzyme analysis without clinical examination cannot be useful for the assessment of inflammatory disease Finally, GCF AST level can be used as a diagnostic adjunct for periodontal condition, to verify clinical methods to evaluate the combination of information gathered for initiation of periodontal therapy

Diagnostic characteristics of C reactive proteins in rapidly progressive periodontitis activity

This study was carried out on 20 patients suffering from rapidly progressive periodontitis [RPP] according to Page et al, [1983][3], selected from the Periodontology Department -Faculty of Dentistry Alexandria university. Their ages ranged from 23-34 years. They were divided into two groups Group I: included 10 RPP patients on active phase according to the criteria of Page et al., [1983][3]. The gingiva is extremely red and there is increased bleeding in the marginal gingival. Group II: included 10 RPP patients on inactive phase Page et al, [1983][3]. The gingival tissue appeared free from any signs of inflammation. Group III: included 10 normal healthy subjects of matched age and sex served as controls. Clinical Dental examination: To avoid errors duplicate initial recordings of clinical parameters were performed for all groups. Gingival index [Loe and Silness, 1963][22]. Probing pocket depth [Glavind and Loe1967][23]. Probing attachment level [Glavind and Loe 1967][23]. Laboratory Investigations including Rheumatoid factor to exclude rheumatoid arthritis Antinuclear factor to exclude lupus erythematosus C-reactive protein [CAP] test is periormed for all subjects enrolles in the study by Latex method [pepys, 1981][24]. Both clinical and C-reactive protein test is repeated after one month period to predict and confirm disease activity in RPP The results of the present study revealed that two out of 10 clinically active APP patients were negative for CAP initially and one month later these two cases proved to be clinically active and were still negative for CAP This indicates that they were going into inactive phase as early detected and confirmed by CRP In addition out of the 10 inactive APP patients, three were found to be positive for CAP initially, one month later only two of the three proved to be clinically active and still positive for CAP This indicates that they were going into active phase Whereas the third patient showed positive CAP initially and one month later, yet remained clinically in the inactive status From there results RPP is highly episodic and is in consistent with the concept of burst activity Also CAP is considered as a sensitive marker of APP activity as it preceded the clinical status in the previous results Therefore conclusively CRP could be used as a diagnostic test as it is a reliable indicator for RPP activity This is important to determine therapy the outcome of treatment decision and the relation between the treatment rendered and the underlying disease activity So in future it would be able to accurately predict future breakdown than rather correlate with current inadequate measures as traditional clinical parameters are not valid to predict PDA. CRP could be used in combination with clinical parameters to improve their predictive value as it is an available test safe practical and acceptable to the patient