TITLE
SCREENING PREGNANT WOMEN FOR PERIODONTITIS BY
ANALYSING SALIVARY ALKALINE PHOSPHATASE AND LACTATE
DEHYDROGENASE
INTRODUCTION
Periodontal disease can induce systemic inflammatory and immune responses and may be associated with an increased risk of systemic diseases such as cardiovascular disease and rheumatoid arthritis.1–3
Periodontal disease is common in pregnant women4 and increases the risk of adverse pregnancy outcomes including preterm birth, low birth weight, and preeclampsia.5–8 The disease is curable and improving periodontal health during pregnancy may prevent or reduce the occurrence of these adverse outcomes.910 Periodontal disease is initiated by an overgrowth of oral flora with a majority of Gramnegative and anaerobic bacteria, which results in inflammation in gingival and periodontal tissue. Periodontal diseases refer to gingivitis and periodontitis and are defined by observing calculus and gingival hemorrhage, and probing the periodontal pockets. Clinical attachment level (CAL) and probing depth (PD) are widely accepted measures of periodontal disease13 though they are timeconsuming and can not be applied to the screening of large population groups. The Community Periodontal Index of Treatment Needs
(CPITN) was developed for the purpose of screening large population groups by the World Health
Organization14 and has been widely adopted by public health services for the middleage in India because of its simplicity and speed. With these traditional diagnostic methods, the presence of periodontal pockets has been considered indicative of periodontitis and the probing conducted by a dentist is indispensable. If pregnant women wish to check their oral health, they have to visit a dental care service. But this is troublesome for pregnant women and the majority do not receive a dental check during pregnancy, remaining unaware of the risk caused by periodontitis.
There seems to be a lack of
References: 3.Henry, R.J. et al.. Clinical Chemistry , Principles andTechniques, 2nd Ed., Harper and Row, Hagerston (MD) pg 819831 (1974). 7. Tietz, N.W., (ed): Study Group on Alkaline Phosphatase. A Reference Method for measurement of alkaline phosphatase activity in Human Serum. Clin. Chem. 29:751 (1983) Clin Periodontol. 1999; 26:1908. (s) 12. Gao J, Symons AL, Haase H and Bartold PM. Should cementoblasts express alkaline phosphatase activity? Preliminary study of rat cementoblasts in vitro. J Periodontol. 1999; 70(9):9519. (s) 13. Shibata Y, Yamashita Y, Miyazaki H, Ueno S, Takehara T. Effective method of discriminating between oral bacterial and human alkaline phosphatase activity. Oral Microbiol Immunol. 1994; 9:359. periodontal treatment. Chung Hua Kou Chiang Hseueh Tsa Chin. 1995; 30: 25566. (s) 15. Nakashima K, Roehrich N, Cimasoni G. Osteocalcin, prostaglandin E2 and alkaline phosphatase in gingival crevicular fluid: their relations to periodontal status. J Clin Periodontol. 1994; 21:32733. (s) 16. Binder TA, Goodson JM, Socransky SS. Gingival fluid levels of acid and alkaline phosphatase. J alpha2macroglobulin and alkaline phosphatase in crevicular fluid from implants with and without periimplantitis. Clin Oral Implants Res. 2002; 13:22733. (s) 18. Gibert P, Tramini P, Sieso V, Piva MT. Alkaline phosphatase isozyme activity in serum from patients with chronic periodontitis. J Periodontal Res. 2003;38:3625. (s) 19. Perinetti G, Paolantonio M, D’Attilio M, et al. Alkaline phosphatase activity in gingival crevicular fluid during human orthodontic tooth movement. Am J Orthod Dentofacial Orthop. 2002; 122:54856. enzymes and periodontal disease. Med Oral Patol Oral Cir Bucal. 2006; 11:E1159. (s) 21. Daltaban O, Saygun I, Bal B, Balos K, and Serdar M.Gingival Crevicular Fluid Alkaline Phosphatase Levels in Postmenopausal Women: Effects of Phase I Periodontal Treatment. J Periodontol. 2006;77:6772. (s) Patients with Chronic Periodontitis; a Clinical and Biochemical Study. The Internet Journal of Dental Science. 2009 Volume 8 Number 1. Screening of periodontitis with salivary enzyme tests. Journal of oral science, Vol. 48, No. 4, 177183, 2006. Interleukin1 Genotypes in Japanese Patients with Chronic Periodontitis. Journal of Periodontology, March 2007, Vol. 78, No. 3, Pages 498503(doi:10.1902/jop.2007.060216)