Abstract:
Periodontal disease refers to pathologic inflammatory response affecting the supporting
structures including alveolar bone, gingival connective tissue surrounding the teeth.
Characteristically it is chronic in nature, preceded by oral biofilm formation
accompanied with the deposition of bacterial plaque and calculus. Periodontitis is the
sixth leading cause of human chronic degenerative disease that increases the risk for
CVD’s due to the strong correlation between the subgingival microbiota and the
pathogens present in the vascular lesions. Periodontitis if left untreated, results in
alveolar bone loss and exfoliation of the involved teeth. Traditional periodontal
diagnostic methods included assessment of clinical parameters and radiographs. Though
efficient, these conventional techniques are inherently limited in that only a historical
perspective, not current appraisal, of disease status can be determined. Advances in the
use of oral fluids as possible biological samples for objective measures of current
disease state, treatment monitoring, and prognostic indicators have boosted saliva and
other oral-based fluids to the forefront of technology. Oral fluids contain locally and
systemically derived mediators of periodontal disease, including microbial, host response, and bone-specific resorptive markers. Amogst them most important
biomarkers in oral fluids are MCP-1 and sCD40 L that represent inflammatory
mediators, collagen degradation and bone turnover-related molecules that have emerged
as possible measures of periodontal disease activity. So this study has aimed to
determine the association between elevated levels of MCP-1 and sCD40 L in saliva and
Gingival Crevicular Fluid, of severely affected Chronic Periodontitis patients with well
established progression and acute precipitation of Cardio vascular disease. A total of 84
subject’s 42 cases and 42 controls between the age of 35- 68 with severe periodontitis
along with horizontal alveolar bone loss ( grade 4) having cardiac disease were selected
as cases and individuals with periodontitis without cardiac diseases were opted as
controls in the study. After informed consent detailed demographics, cardiovascular,
medical and family history of the patients, grading of alveolar bone loss, periodontal
and gingival status, probing depth, gingival index, plaque index, clinical attachment
level was carefully recorded on the evaluation form. GCF and Salivary samples were
extruded and the sCD40 L and MCP -1 levels were quantified in a solid phase, sand which technique using Elisa kit. This study identified a correlation of the bio molecular
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markers sCD40-L and MCP -1 that constitute an important pathway leading to
cardiovascular loads in chronic periodontal patients. The significant positive results
were observed that suggests that these two inflammatory mediators, soluble CD40
ligand (sCD40 L) and monocyte chemoattractant protein-1 (MCP-1) has been
established in progression and acute precipitation of CVD's and this pathway is
considered as one of the mechanisms that may lead to increasing severity of periodontal
disease and its systemic effects. Timely detection and diagnosis of disease significantly
affect the clinical management of periodontal patients by offering earlier, less invasive,
and more cost-effective treatment therapies. This study will also educate the patients to
look for a collaborative effort of health practitioner and dentists for early monitoring
and intervention along with appropriate oral hygiene care that will potentially reduce
systemic cardiac illness in chronically affected periodontal patients
