DECREASE OF β-DEFENSIN-2 LEVEL IN THE GINGIVAL CREVICULAR FLUID AS A POTENTIAL PREDICTOR OF THE DEVELOPMENT OF INFLAMMATORY PERIODONTAL DISEASES

β-defensin-2 (HBD-2) is a peptide of innate immunity that provides the first line of defenсe of the oral mucosa from the introduction of the pathobionts. Under inflammatory conditions epithelial cells and gingival fibroblasts produce HBD-2. The defective defensin secretion may play a crucial role in the development of inflammatory periodontal diseases. The study aimed to compare the levels of HBD-2 in the gingival fluid and/or the content of the periodontal pockets in patients with dental plaque-induced gingivitis (PG), aggressive periodontitis (AgP), chronic generalized periodontitis (CP) and in the periodontally healthy subjects (Control). We examined 142 patients (45.0 ± 1.03 years) from Moscow, including 11 patients with PG (35.7 ± 3.69 years), 43 patients with AgP (35.4 ± 0.84 years), 71 patients with CP (54.4 ± 0.86 years) and 17 controls (36.1 ± 2.92 years). We determined the periodontal tissues condition in all patients during the periodontal and X-ray examination. The samples of the gingival crevicular fluid and periodontal pocket content were collected by paper points from the gingival sulcus and periodontal pockets at 8 teeth of both jaws. The concentration (C) of β-defensin-2 was determined by enzyme immunoassay (ELISA Kit for Defensin Beta 2, Cloud-Clone Corp., USA). Mann-Whitney U-test (U), the Kruskal-Wallis test (H) and the Dwass-Steel-Critchlow-Fligner post hoc test (W) determined the difference significance between the parameters. We estimated the parameter relationship and its strength using the Spearmanʼs rank correlation coefficient (rS). The critical significance level was p ≤ 0.05.The present study showed that the progression of the periodontal inflammation is accompanied by a sharp decrease in the concentration of HBD-2 in patients’ samples (H = 42.8, df =3, p < 0.001). Thus, the concentration of HBD-2 in the gingival crevicular fluid of the periodontally healthy subjects (control group) ranged from 225 to 1720 pg/ml (C = 738 [477; 1114] pg/ml). In patients with PG the median value of the peptide concentration was 242 [42.5; 610] pg/ml (Cmin = 19 pg/ml, Cmax = 1000 pg/ml). In patients with periodontitis it dropped to critically low levels: CAgP = 54 [3; 195] pg/ml (Cmin = 0, Cmax = 478 pg/ml) and ССP = 25.5 [0; 125] pg/ml (Cmin = 0, Cmax = 298 pg/ml). Thus, we can consider the level of HBD-2 in the gingival crevicular fluid – a potential predictor of the development of inflammatory periodontal diseases.

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Microbiological and biochemical characteristics of inflammatory tissues in the periodontium

Medicina ◽

10.3390/medicina44030026 ◽

2008 ◽

Vol 44 (3) ◽

pp. 201 ◽

Cited By ~ 2

Author(s):

Algimantas Šurna ◽

Jurgina Sakalauskienė ◽

Astra Vitkauskienė ◽

Viktoras Šaferis

Keyword(s):

Alkaline Phosphatase ◽

Gingival Crevicular Fluid ◽

Periodontal Diseases ◽

Venous Blood ◽

Molecular Genetic ◽

Individual Treatment ◽

Control Group ◽

Peripheral Venous Blood ◽

Periodontal Inflammation ◽

Crevicular Fluid

Objective. To investigate bacterial populations in subgingival and supragingival plaque samples of patients with inflammatory periodontal diseases and activities of the lysosomal enzymes – lysozyme, alkaline phosphatase, and b-glucuronidase – in peripheral venous blood, in gingival crevicular fluid, and mixed nonstimulated saliva. Methods and materials. The study included 60 patients with inflammatory periodontal diseases without any internal pathology and 24 periodontally healthy subjects. Molecular genetic assay (Micro-IDent plus, Germany) for complex identification of additional six periodontopathic bacteria was applied. The activity of lysozyme was determined turbidimetrically, the activity of alkaline phosphatase – spectrophotometrically with a “Monarch” biochemical analyzer, the activity b-glucuronidase – according to the method described by Mead et al. and modified by Strachunskii. Results. A statistically significant association between clinical and bacteriological data was found in the following cases: gingival bleeding in the presence of Eubacterium nodatum, Eikenella corrodens, Capnocytophaga spp. (P<0.01); pathological periodontal pockets in the presence of Peptostreptococcus micros (α≤0.05 and β≤0.2), Fusobacterium nucleatum (α≤0.05 and β≤0.2), Campylobacter rectus (α≤0.05 and β≤0.2), and Capnocytophaga spp. (P<0.05); and satisfactory oral hygiene in the presence of all microorganisms investigated (P<0.05). The activity of lysozyme in gingival crevicular fluid and mixed nonstimulated saliva indicates the severity of periodontal inflammation. Based on clinical data, in assessing the amount of lysozyme in mixed nonstimulated saliva, sensitivity and specificity of 100% was found. Increased activities of lysozyme, alkaline phosphatase, and b-glucuronidase were found in peripheral venous blood of patients with inflammatory periodontal disease as compared to control group. Conclusions. The main principles of the treatment of periodontal inflammatory diseases should be based on microorganism elimination, creation of individual treatment means affecting microflora in the mouth and immune system of macroorganisms.

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Using Salivary MMP-9 to Successfully Quantify Periodontal Inflammation during Orthodontic Treatment

Journal of Clinical Medicine ◽

10.3390/jcm10030379 ◽

2021 ◽

Vol 10 (3) ◽

pp. 379

Author(s):

Ionut Luchian ◽

Mihaela Moscalu ◽

Ancuta Goriuc ◽

Ludovica Nucci ◽

Monica Tatarciuc ◽

...

Keyword(s):

Orthodontic Treatment ◽

Gingival Crevicular Fluid ◽

Periodontal Treatment ◽

Control Group ◽

Clinical Parameters ◽

Periodontal Tissues ◽

Inflammatory Conditions ◽

Periodontal Inflammation ◽

Immune Mediated ◽

Crevicular Fluid

Periodontitis is one of the most common immune-mediated inflammatory conditions resulting in progressive destruction of periodontium. Metalloproteinase-9 (MMP-9), an enzyme that is involved in the degradation of gelatin and collagen and present in the gingival crevicular fluid, is markedly increased in periodontitis. The aim of the study is to evaluate the effects of periodontal treatment either alone or in combination with orthodontic treatment on MMP-9 levels. In this study, 60 individuals were subjected to periodontal treatment (PD) or periodontal treatment combined with orthodontic treatment (POD). Both periodontal and periodontal plus orthodontic treatments significantly improved clinical parameters and lowered MMP-9 levels compared to control group. However, the combination of periodontal with orthodontic treatment further improved clinical parameters and enhanced the lowering effect on MMP-9 levels compared to periodontal or control groups alone. Finally, the degree of malocclusion significantly affected the effect of the treatment on MPP-9 levels with PD treatment having the most pronounced effect. We concluded that salivary MMP-9 can serve to accurately predict the level of inflammation in affected periodontal tissues during orthodontic treatment that is also associated with the type of malocclusion, making it a viable diagnosis tool in monitoring the progression of the periodontium during orthodontic treatment.

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METHOD FOR TREATING CHRONIC GENERALIZED PERIODONTITIS OF LIGHT AND MEDIUM GRAPES

The actual problems in dentistry ◽

10.18481/2077-7566-20-16-2-53-58 ◽

2020 ◽

Vol 16 (2) ◽

pp. 53-58

Author(s):

Karen Karakov ◽

Emilia Khachaturyan ◽

Marat Uzdenov ◽

Laura Uzdenoba ◽

Nelli Vanchenko ◽

...

Keyword(s):

Photodynamic Therapy ◽

Treatment Regimen ◽

Treatment Time ◽

Periodontal Diseases ◽

Periodontal Pocket ◽

Control Group ◽

Moderate Severity ◽

Affected Area ◽

Periodontal Tissues ◽

Complex Therapy

Subject. The article presents the data of a comparative analysis of the traditional method of treating chronic generalized periodontitis of mild to moderate severity and with the use of periodontal dressings in combination with an antibacterial photodynamic system. The goal is to study the effectiveness of the methodology of complex therapy for the treatment of periodontal diseases using periodontal dressings and antibacterial photodynamic therapy. Methodology. We observed 120 patients with inflammatory periodontal diseases aged 18 to 55 years (men ― 52, women ― 68), who were divided into the control and main groups. In the control group, treatment was carried out according to the traditional scheme of drug therapy, in the main ― according to the method of complex therapy. The treatment regimen according to this technique included the use of periodontal dressings and an antibacterial photodynamic therapy system: photosynthesis was applied to the affected area of the periodontal pocket, after which the pathogenic microorganisms were stained for 1-3 minutes, then the liquid was thoroughly washed from the periodontal pockets and the laser affected the affected area for 60 seconds. Results. The proposed treatment regimen using an antibacterial photodynamic system in combination with periodontal dressings allows to achieve a pronounced and prolonged anti-inflammatory effect in periodontal tissues without local and systemic use of antibiotics, reduces treatment time for mild periodontitis by 29, average ― by 57 %, reduces the likelihood recurrence, lengthens the duration of remission. Findings. The use of complex treatment of periodontitis of mild to moderate severity allows the method to accelerate the restoration of periodontal tissues, relieve inflammation, saturate the tissues with oxygen, reduce the rate of relapse by 2.6 times and reduce the duration of relapse of this disease within 24 months. Our data allow us to implement this treatment regimen in practical healthcare.

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Biomarker for Asymptomatic Apical Periodontitis in Gingival Crevicular Fluid: aMMP-8

European Journal of Dentistry ◽

10.1055/s-0040-1709827 ◽

2020 ◽

Vol 14 (02) ◽

pp. 239-244 ◽

Cited By ~ 1

Author(s):

Teodora Karteva ◽

Neshka Manchorova-Veleva

Keyword(s):

Gingival Crevicular Fluid ◽

Apical Periodontitis ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Cross Sectional ◽

Significance Level ◽

Periodontal Tissues ◽

Diagnostic Potential ◽

Potential Biomarker ◽

Crevicular Fluid

Abstract Objectives Asymptomatic apical periodontitis (AAP) is one of the most widespread chronic inflammatory diseases in the field of dental medicine. Active matrix metalloproteinase (aMMP-8) previously demonstrated diagnostic potential as a biomarker for AAP in gingival crevicular fluid (GCF). The aim of this study was to determine the levels and diagnostic accuracy of aMMP-8 in GCF from teeth with AAP. Materials and Methods In this cross-sectional study, GCF samples were obtained from teeth with AAP (sample group, n = 31) and their contralateral teeth (control group, n = 31). Clinical and cone beam computed tomography (CBCT) parameters were used for the diagnosis and assessment of AAP and the determination of clinically healthy marginal periodontal tissues. One pool GCF sample per tooth was obtained from the whole crevice’s perimeter. aMMP-8 levels were determined by enzyme-linked immunosorbent assay (ELISA). Statistical Analysis Wilcoxon signed ranks test and Spearman rank correlation coefficient (rs) were used as statistical tools. The significance level was set at p < .05. Results The two groups demonstrated biomarker levels corresponding to a healthy marginal periodontal tissue. aMMP-8 levels were statistically and significantly higher in the samples collected from teeth with AAP. Lesions with greater volume showed correspondingly larger diameters. No statistically significant correlation between aMMP-8 levels and lesions’ volume or diameter was discovered. Conclusion GCF composition is modified by AAP only to a minimal extent. Further research is needed to substantiate the utilization of aMMP-8 as a potential biomarker for the diagnosis of the disease as well as to explore its relationship with other biomarkers.

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Comparative analysis of polymorphic variants of IL-17A and MMP-1 genes with the risk of developing chronic periodontitis in petrochemical workers

Russian Journal of Occupational Health and Industrial Ecology ◽

10.31089/1026-9428-2020-60-10-687-693 ◽

2020 ◽

Vol 60 (10) ◽

pp. 687-693

Author(s):

Iskander I. Zaidullin ◽

Denis O. Karimov ◽

Lilija K. Karimova ◽

Milyausha F. Kabirova ◽

Rasima R. Galimova ◽

...

Keyword(s):

Ethylene Oxide ◽

Chronic Periodontitis ◽

Periodontal Diseases ◽

Clinical Manifestations ◽

Control Group ◽

Periodontal Tissues ◽

Dental Examination ◽

Number Of Patients ◽

Increased Risk ◽

Harmful Substances

The susceptibility to the development and progression of inflammatory periodontal diseases, which depends on genetic and external factors (smoking, stress, oral hygiene), varies widely. In the development of these diseases, an important role is played not only by the presence of periodontal pathogenic microorganisms, but also by the presence of congenital or acquired immunodeficiency, immunoregulatory defects. The immune system plays a key role in the physiological and pathological processes of periodontal tissues. In this regard, IL17, produced by CD4+ Th cells, which has both Pro-inflammatory and protective activity, is of particular interest in the pathogenesis of periodontitis. The aim of study was to identify the relationship between polymorphic loci of the IL-17A (rs2275913) and MMP-1 (rs1799750) genes and clinical manifestations of chronic periodontitis in petrochemical workers. Dental examination was performed in 92 ethylene oxide production workers with chronic periodontitis and 74 patients with chronic periodontitis who did not come into contact with chemical factors (control group). Genotyping of polymorphisms rs2275913 of the IL17A gene and rs1799750 of the MMP1 gene was performed by allele-specific real-time polymerase chain reaction (PCR). Hygienic assessment of the degree of air pollution of the working area with harmful substances was carried out by gas chromatography according to the guidelines for the determination of harmful substances in the air № 5098-89, № 3119-84. When comparing the results of studies of both groups, there were no statistically significant differences in the frequency distributions of allelic variants and genotypes of the IL-17A and MMP-1 genes. The AA/AG genotypes of the IL-17A gene were associated with an increased risk of severe disease compared to the GG genotype in workers in the main group (OR=6.1; 95% CI 1.33-28.5; p=0.021) and in the control group (OR=7.26; 95% CI 1.34-39.25; p=0.016). Carriers of the A allele in the control group increased the risk of severe chronic periodontitis by 2.4 times compared to carriers of the G allele (OR=2.41; 95% CI 1.19-4.87; p=0.014). During the dental examination of employees of the ethylene oxide plant, the clinical course of periodontal diseases was more severe in comparison with the control group, and the number of patients with severe periodontitis was twice as high. It was found that the AA/AG genotypes of the IL-17A gene and the carrier of the A allele are associated with increased susceptibility to the development of severe chronic periodontitis. The association between the MMP-1 gene polymorphism and the risk of severe forms of chronic periodontitis has not been established. A risk factor for the development of inflammatory periodontal diseases in employees of the petrochemical complex is a complex of harmful production factors.

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Are Proteinase 3 and Cathepsin C Enzymes Related to Pathogenesis of Periodontitis?

BioMed Research International ◽

10.1155/2014/420830 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Oya Türkoğlu ◽

Elif Azarsız ◽

Gülnur Emingil ◽

Necil Kütükçüler ◽

Gül Atilla

Keyword(s):

Gingival Crevicular Fluid ◽

Periodontal Diseases ◽

Study Groups ◽

Aggressive Periodontitis ◽

Control Group ◽

Proteinase 3 ◽

Cathepsin C ◽

Probing Depth ◽

Inflammatory Processes ◽

Crevicular Fluid

Aim. Cathepsin C is the activator of the polymorphonuclear leukocyte-derived proteinase 3, which contributes to inflammatory processes. The aim of the present study was to investigate gingival crevicular fluid (GCF) proteinase 3 and cathepsin C levels in periodontal diseases.Design. Eighteen patients with chronic periodontitis (CP), 20 patients with generalized aggressive periodontitis (G-AgP), 20 patients with gingivitis, and 18 healthy subjects were included in the study. Periodontal parameters including probing depth, clinical attachment level, papilla bleeding index, and plaque index were assessed in all study subjects. GCF proteinase 3 and cathepsin C levels were analyzed by ELISA.Results. GCF proteinase 3 total amount was significantly higher in diseased groups compared to control group, after adjusting ageP<0.05. No differences were found in GCF cathepsin C levels among the study groupsP>0.05. Periodontal parameters of sampling sites were positively correlated with GCF proteinase 3 total amountsP<0.01but not with cathepsin C total amountsP>0.05.Conclusions. Elevated levels of GCF proteinase 3 in CP, G-AgP, and gingivitis might suggest that proteinase 3 plays a role during inflammatory periodontal events in host response. However, cathepsin C in GCF does not seem to have an effect on the pathogenesis of periodontal diseases.

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Innate Immune Response as a New Challenge in Periodontal Inflammation

10.5772/intechopen.96801 ◽

2021 ◽

Author(s):

Ana Marina Andrei ◽

Elena Cristina Andrei ◽

Elena Camelia Stănciulescu ◽

Mihaela Cezarina Mehedinți ◽

Mihaela Jana Țuculină ◽

...

Keyword(s):

Immune Response ◽

Innate Immune Response ◽

Periodontal Diseases ◽

Bacterial Species ◽

Innate Immune ◽

Beneficial Effects ◽

Periodontal Tissues ◽

Periodontal Inflammation ◽

Genetic And Environmental Factors ◽

Tlr Signalling

Gingivitis and periodontitis are induced by numerous pathogenic microbiota hosted in the subgingival biofilm that first trigger the innate immune response. Innate immune response is part of a homeostatic system which is the first line defence and defines the host inherited resistance to infection. Both genetic and environmental factors are involved in variable individual susceptibility to inflammation of periodontal tissues. That is why, although more than 600 bacterial species have been detected in the periodontal plaque, the type of bacteria incriminated in the development of the inflammation is still unclear. Moreover, in the last decade gene polymorphisms have been largely recognised as important conditions associated with increased susceptibility to periodontal diseases. Manipulating the immune response by the development of drugs that inhibit adverse host reactions and promote beneficial effects might be of therapeutic or prophylactic importance. This work intends to assess the importance of Toll-like receptors as main effectors of the innate immune response in the triggering, maintenance and progression of periodontal inflammation, as well as of the involvement of synthetic molecules targeting TLR signalling pathways in treating periodontal diseases.

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Gingival Crevicular Fluid Calprotectin, Osteocalcin and Cross-Linked N-Terminal Telopeptid Levels in Health and Different Periodontal Diseases

Disease Markers ◽

10.1155/2011/512580 ◽

2011 ◽

Vol 31 (6) ◽

pp. 343-352 ◽

Cited By ~ 18

Author(s):

Sema Becerik ◽

Beral Afacan ◽

Veli Özgen Öztürk ◽

Harika Atmaca ◽

Gülnur Emingil

Keyword(s):

Healthy Subjects ◽

Gingival Crevicular Fluid ◽

Periodontal Diseases ◽

Inflammatory Marker ◽

Aggressive Periodontitis ◽

Enzyme Linked Immunosorbent Assay ◽

Probing Depth ◽

Crevicular Fluid ◽

First Time

Aim:The aim of the present study was to investigate gingival crevicular fluid (GCF) calprotectin, osteocalcin and cross-linked N-terminal telopeptide (NTx) levels in health along with different periodontal diseases.Material and methods:Twenty chronic periodontitis (CP), 20 generalized aggressive periodontitis (G-AgP), 20 gingivitis and 20 healthy subjects were included. Probing depth, clinical attachment level, plaque index and papillary bleeding index was recorded. GCF calprotectin, osteocalcin and NTx levels were analyzed by enzyme-linked immunosorbent assay (ELISA).Results:CP, G-AgP and gingivitis groups had higher GCF calprotectin total amount compared to healthy subjects (p< 0.008). CP and G-AgP groups had similar, but higher levels compared to gingivitis groups (p< 0.008). CP and G-AgP groups had lower GCF osteocalcin total amount compared to gingivitis and healthy groups (p< 0.008). CP group had higher GCF NTx but lower osteocalcin total amount and osteocalcin/NTx ratio than the G-AgP group (p< 0.008)Conclusions:Our results suggest that elevated GCF calprotectin levels play a role as a reliable inflammatory marker in the pathogenesis of periodontal disease. Fluctuating GCF levels of osteocalcin and NTx might point out to the abnormal bone turnover in periodontitis. Our data document for the first time the role of NTx in the pathogenesis of different periodontal diseases.

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DISTURBANCE OF IRON METABOLISM AND ULTRASTRUCTURAL FEATURES OF THE GINGIVA IN PATIENTS WITH Β-THALASSEMIA MAJOR

Российский стоматологический журнал ◽

10.18821/1728-2802-2018-22-5-255-261 ◽

2018 ◽

Vol 22 (5) ◽

pp. 255-261

Author(s):

Ramida Vaqif qizi Shadlinskaya ◽

E. K Gasimov ◽

S. A Israfilova

Keyword(s):

Iron Metabolism ◽

Serum Iron ◽

Binding Capacity ◽

Periodontal Diseases ◽

Thalassemia Major ◽

Control Group ◽

Periodontal Tissues ◽

Metabolism Disorder ◽

Pathogenetic Factor ◽

Iron Binding Capacity

Introduction: β-thalassemia major is a hereditary blood disease, a main pathogenetic factor of which is the disruption of the synthesis of β-chains of hemoglobin. Inevitable metabolic disorders that occur during regular blood transfusion form an additional risk of damage and cellular modification of organs and tissues, including the oral cavity. Aim: determination of the pathogenetic role of iron metabolism disorder in the development of chronic inflammatory periodontal diseases in patients with β-thalassemia. Material and methods: 12 patients with β - thalassemia major who had periodontal diseases were examined in the Republican Center of Thalassemia in Baku (average age is 18 ± 1.3 years). The control group consisted of 16 somatically healthy individuals with intact gingiva tissues (the average age is 18.0 ± 0.7 years). Serum Iron, ferritin, hepcidin, total iron-binding capacity (TIBC), level of Il2, Il6, Il10, TNFα were measured from peripheral blood samples. To determine the ultra-structural study of the periodontal tissues in patients with β-thalassemia major, the method of electron microscopy studies of gingiva biopsies was used. Results of the study: The study revealed an increase in the level of serum iron and ferritin against the background of a progressively decreasing TIBC in patients with β-thalassemia major. Also activation of pro-inflammatory cytokines - TNFα, Il6, Il10 was observed in homozygous patients. Metabolic indicators are compared with ultrastructural features of cellular elements of a gum. Signs of accumulation of iron in cellular elements both of its own plate and of the epithelial cover were compared. The presence of iron was recorded in immunocompetent cells - macrophages and lymphocytes. Conclusion: Summarizing the data obtained, we can conclude that deproteinization of ferritin cores and their detection both in the cytoplasm and in the nucleoplasm of immunocompotent cells leads to irreversible degenerative changes in cellular elements of the gingiva. The authors link the development of the generalized inflammatory - degenerative process in the periodontium with revealed exchange -structural violations.

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Hair Mercury Levels in Periodontal Patients in Comparison with Healthy Individuals

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1281 ◽

2014 ◽

Vol 5 (3) ◽

pp. 166-169 ◽

Cited By ~ 1

Author(s):

Soraya Khafri ◽

Hamidreza Hasanjani Roushan ◽

Hadi Parsian ◽

Ramin Alijannia ◽

Abbas Mosapour

Keyword(s):

Chronic Periodontitis ◽

Healthy Subjects ◽

Periodontal Diseases ◽

Mercury Level ◽

Control Group ◽

P Value ◽

Healthy Individuals ◽

Hair Mercury ◽

Hair Samples ◽

The Difference

ABSTRACT Introduction The clinical manifestation of periodontal diseases (such as gingivitis and chronic periodontitis) results from a complex interplay between the etiologic agents such as bacteria that present in the dental plaque, genetic factors, systemic diseases, smoking and exposure of some heavy metals, such as mercury. In this study, we aimed to evaluate hair mercury levels in healthy subjects in comparison with periodontal patients. Materials and methods One hundred twenty subjects were enrolled in this study. The included persons were divided into 3 groups: healthy subjects (n = 40), gingivitis (n = 40) and chronic periodontitis patients (n = 40). Hair samples were collected from occipital area of head. Total mercury levels were determined by atomic absorption spectrophotometry. Results The difference between mercury levels in three groups were statistically significant (p-value < 0.001). Mercury level in periodontitis patients was greater than the gingivitis group (p-value < 0.001). In addition the differences between mercury levels in periodontitis patients vs healthy individuals was significant (p-value = 0.048). The gingivitis patients had lower levels of mercury than the control group, but the difference was not significant (p-value = 0.170). Conclusion The results showed that the levels of mercury are to some extent differed in periodontal diseases in comparison with the healthy individuals. A study with larger sample size is needed for clarification of this issue. How to cite this article Roushan HH, Parsian H, Alijannia R, Mosapour A, Khafri S. Hair Mercury Levels in Periodontal Patients in Comparison with Healthy Individuals. World J Dent 2014;5(3):166-169.

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