Quantification and Comparison of Salivary Neutrophils in Periodontal Health and Disease

Abstract

Background: Neutrophils continuously migrate into the oral cavity from various sources like gingival crevicular fluid and saliva both in  health and in inflammation. The migration of the neutrophils into the various tissues and into the oral cavity occurs when the host  microbial interplay tips the balance favoring the initiation of the inflammatory and immune reactions which depending on the amount of  the microbial load results in the development of acute and chronic infections in the susceptible host.

Aim: The present study was  designed to quantify and compare the oral salivary neutrophil levels in patients with gingivitis and chronic and aggressive periodontitis  as well as in healthy controls, before and after scaling and root planing (SRP) and to compare the difference within the selected study groups.

Materials and Methods: Forty subjects were classified into four groups, that is, healthy controls, gingivitis, and chronic and  aggressive periodontitis. Oral rinse samples were collected using Hank's balanced salt solution from each patient before and after phase  I periodontal therapy. Cells in the rinse samples were stained with Acridine orange, and neutrophil counts were carried out using a  fluorescence microscope and a hemocytometer.

Results: Baseline oral salivary neutrophil levels were maximum in the chronic  periodontitis group followed by the aggressive group and then the gingivitis group. Oral salivary neutrophil levels also positively  correlated to probing pocket depth, plaque index, calculus index, and gingival index in all four study groups. Maximum reduction in the  oral salivary neutrophil levels after phase I periodontal therapy was seen in the gingivitis group.

Conclusion: From our study, we  conclude that the oral salivary neutrophil levels decreased significantly after SRP. Estimation of changes in the oral salivary neutrophil  levels has the potential to aid in monitoring treatment outcomes. Thus, it suggests that it could be used as a simple, noninvasive  laboratory technique to monitor the periodontal status and disease progression.