ORAL FLUID ELASTASE AS AN INDICATOR OF PERIODONTAL HEALTH

The study was designed to find out whether oral elastase activity coul d be used as a simple biochemical indicator of periodontal health. Bot h stimulated whole saliva and water rinse samples were collected from subjects with different degrees of adult periodontitis, gingivitis or healthy periodontium. In both sample types, elastase was mostly bound to insoluble fraction and preferred valine containing synthetic substr ate, similar to neutrophil elastase. The elastase measurement required very little manipulation or time and its reproducibility was found to be good. The elastase levels were found to be negligible in edentulou s subjects and usually very low in subjects with healthy periodontium. In about 85% of periodontitis cases having at least 1 deep periodonta l pocket (greater than or equal to 6 mm), clearly elevated elastases l evels were detected in both the saliva and rinse samples. In advanced periodontitis cases, the colour reaction took place in 0.5 to 2 h. In localized periodontitis cases, 2- to 18-h incubations were required fo r positive reaction. There was a good correlation between the elastase activity and the number of deep periodontal pockets and the average c ommunity periodontal index of the subjects. Elastase activity was not a good indicator of gingivitis. About 45% of gingivitis cases were pos itive with the elastase test, and the enzyme values were not significa ntly increased in experimental gingivitis. In a longitudinal study on advanced periodontitis cases, elastase levels dropped dramatically as a result of clinically successful therapy, close to the values of heal thy subjects. The oral elastase test could serve as a valuable adjunct in periodontal screening and assessment of treatment efficacy.