Salivary nitric oxide levels in inflammatory periodontal disease - A case-control and interventional study

Background: Biochemical markers of inflammatory periodontal disease present in saliva can partially determine the extent of periodontal disease. Furthermore, collection of salivary constituents is a simple and non-invasive procedure. Nitric oxide (NO) has been linked to etiopathogenesis of inflammatory periodontal disease and is expressed in saliva. This study was conducted with the objective of estimating salivary NO levels in inflammatory periodontal diseases (gingivitis and periodontitis) and comparing these levels with control subjects. A re-assessment of these levels was also made after providing appropriate treatment with a view to ascertain its diagnostic and prognostic values. Methods: This was a case-control as well as an interventional study including a total of 90 (30 control, 30 gingivitis and 30 periodontitis) subjects. Saliva samples were collected from each subject, and NO levels were assayed by Griess reaction. Results: NO levels were increased significantly in gingivitis and periodontitis subjects as compared with controls. There was a statistically significant decrease in the NO levels in each study group after the healing period (corresponding to the reduced clinical signs of inflammation). Our study also correlated probing pocket depths with salivary NO levels in periodontitis group where we found a positive correlation between the two. Conclusion: Salivary NO levels can be utilized as a good indicator of the inflammatory status of the periodontium, and evaluating its levels in saliva by Griess reaction on a photoelectric colorimeter is a reliable, accurate and faster method to estimate the level of inflammation in periodontal tissues.