THE EFFECT OF INITIAL PERIODONTAL THERAPY ON SALIVARY PLATELET-ACTIVATING-FACTOR LEVELS IN CHRONIC ADULT PERIODONTITIS

PLATELET-ACTIVATING FACTOR (PAF), a potent phospholipid inflammatory m ediator, is increased in the mixed saliva of subjects with periodontal disease and correlates with the extent of oral inflammation. The pres ent study was designed to provide a longitudinal evaluation of the eff ect of initial periodontal therapy (home care instruction, prophylaxis , and scaling/root planing) on salivary PAF levels in chronic adult pe riodontitis patients (n = 15). Mixed saliva was collected prior to, du ring, and after initial therapy and was utilized to assess PAF levels after lipid extraction and fractionation as well as to histologically assess the number of polymorphonuclear leukocytes (PMN). PAF activity was determined in bioassay relative to authentic PAF 1-O-hexadecyl-2-a cetyl-sn-glycero-3-phosphocholine 16:0-alkyl-PAF). Initial salivary PA F levels (12.1 +/- 2.8 pmole equivalents of 16:0-alkyl-PAF/ml saliva; mean +/- SE) decreased following supragingival plaque control (9.6 +/- 2.4) and were further reduced following scaling and root planing (5.7 +/- 1.4). In parallel, salivary PMN levels were significantly reduced and clinical estimates of periodontal disease were significantly impr oved; i.e., there was a decrease in the percentage of sites with both bleeding on probing (from 46.1 +/- 4.6% of sites at pretreatment to 25 .9 +/- 2.6% after scaling and root planing) and probing depths greater than or equal to 4 mm (from 16.7 +/- 1.9% of sites to 10.3 +/- 1.2%). Thus, initial periodontal therapy reduced salivary PAF levels in conc ert with improvements in clinical estimates of marginal and submargina l periodontal inflammation suggesting that PAF may participate in infl ammatory events during periodontal tissue injury and disease.