Association between interleukin-6, C-Reactive protein and periodontal inflamed surface area : a cross- Sectional investigation

2020 ◽  
Vol 12 (1) ◽  
pp. 20-28
Author(s):  
Deepanwita BDS ◽  
Hemalata Madaiah
Keyword(s):  
Surface Area ◽  
Chronic Periodontitis ◽  
Complex Disease ◽  
Systemic Disease ◽  
Serum Levels ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Periodontal Tissues ◽  
Periodontal Inflammation ◽  
Inflammatory Burden

Background and Objective: Periodontitis is a complex disease and is proven to be a risk factor for various systemic diseases by causing an inflammatory burden. CRP is an extremely sensitive marker for inflammation and its levels have been shown to be associated with periodontal inflammation. IL-6 has been shown to affect the production of CRP. To associate periodontal inflammation to any systemic disease it is necessary to quantify the amount of inflamed periodontal tissues. A new measure Periodontal Inflamed Surface Area (PISA) has been developed for the same. In the light of the above mentioned facts this study is designed to assess serum and GCF levels of CRP and IL-6 and correlate these with PISA in patients affected by chronic periodontitis. Materials and Methods: A total of 45 systemically healthy patients with chronic periodontitis participated in the study. Periodontal parameters, i.e BI, PI, CI, mean CAL and PISA (using spreadsheet by Huojel et al,2000) were recorded for all patients. GCF and serum samples were harvested from all subjects and samples were stored and analyzed for CRP and IL-6 using ELISA kits. Results: The PI, BI, CI and mean CAL had a positive correlation with PISA. BI and mean CAL had a significantly positive correlation with PISA (p<0.05). PISA also had a positive correlation with GCF levels of CRP (r=0.098, p=0.57), serum CRP levels (r=0.14, p=0.42), GCF IL-6 (r=0.89, p=0.61) and a significantly positive correlation was seen between PISA and serum levels of IL-6 (r=0.41, p=0.014). Also, there was a positive correlation between GCF and serum levels of CRP and IL-6. The serum levels of CRP and IL-6 had a significantly positive correlation (r=0.39, p=0.02). Conclusion: Higher PISA values were associated with higher serum levels of the inflammatory markers., thus proving that PISA could probably be used to correlate the local inflammatory burden with the systemic inflammatory burden.

scholarly journals Quantification of Chemokine CCL5 in Patients with Diabetes Mellitus Type 2 and/or Chronic Periodontitis: Preliminary Study

2017 ◽  
Vol 19 (2) ◽  
pp. 71
Author(s):  
Luis Sansores-España DDS ◽  
Arelly Carrillo-Avila DDS, MINE ◽  
Eduardo Sauri-Esquivel DDS, MO ◽  
Eugenia Guzmán-Marín MD, MSc, PhD ◽  
Marcela Hernández DDS, MSc, PhD ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Periodontitis ◽  
Gingival Crevicular Fluid ◽  
Systemic Disease ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Periodontal Tissues ◽  
Significant Difference ◽  
Student’S T

The purpose of the present study was to quantify the presence of chemokine CCL5 (RANTES) in gingival crevicular fluid (LCG) in patients with chronic periodontitis (PC) and / or type 2 diabetes mellitus (DM2). A comparative cross-sectional study was conducted in 40 patients. LCG was taken from periodontal pockets and gingival grooves from 4 patient groups (10 per study group); patients who received periodontal, antibiotic and anti-inflammatory treatment 6 months prior to the study or who had systemic disease other than DM2 were excluded. Concentrations of CCL5 were determined by LUMINEX® assays. Descriptive statistics, one-way ANOVA, Student's T, and Pearson's correlation were performed. The quantification of CCL5 was higher in the patients who presented both diseases, followed by the group with only PC, healthy and the group with only DM2. No significant difference was found between groups and there was no correlation between quantifications and glycemic indicators. Although the differences were not significant, the group of patients with both diseases had the highest CCL5 quantification. The expression of CCL5 in LGC should be considered as a potential inducer of periodontal destruction, its determination could be useful for monitoring the health/disease of periodontal tissues.

scholarly journals EVALUATION OF D-DIMER SERUM LEVELS AMONG PATIENTS WITH CHRONIC SPONTANEOUS URTICARIA AND ITS CORRELATION WITH DISEASE SEVERITY.

2020 ◽  
pp. 1-3
Author(s):  
Aditi Jaiswal ◽  
Kiran Godse
Keyword(s):  
Disease Activity ◽  
Disease Severity ◽  
Rank Correlation ◽  
Serum Levels ◽  
Analysis Data ◽  
Control Group ◽  
Tertiary Referral Centre ◽  
Cross Sectional ◽  
Positive Correlation ◽  
D Dimer

Aims: To evaluate D-Dimer serum levels in patients with chronic urticaria and its correlation with disease activity. Settings and Design: Single centre Cross sectional prospective observational age & sex matched case-control study at Dermatology OPD of a tertiary referral centre. Methods and Material: This study was conducted from January 2018 to June 2019. We in-cluded 33 patients with CU and 30 controls . They were recruited from urticaria clinic. All cases were subjected to history taking, general and dermatological examination. The serum levels of D-Dimer were measured by Semiquantitative, immunofiltration kits. Statistical analysis: Data was analysed by Statistical Package for Social Sciences (SPSS) ver-sion 21.0. Tests used were Independent t test/Mann-Whitney Test, Chi-Square test/Fisher’s Exact test, Spearman rank correlation coefficient, Kolmogorov- Smirnov test.. Results: Patients with active CU had elevated D-Dimer serum levels (p<0.0001) when com-pared with the control group (papulo-squamous disorder). Of 33 CSU patients, D-dimer level was elevated in 19 patients (57.58%). There was statistically significant positive correlation between disease severity (UAS7) and plasma D-dimer level (p <.0001, r =0.935). Conclusions: This study showed elevated D-dimer levels in more than half of Indian patients with CSU. There was a positive correlation between plasma D-dimer levels and the severity of disease activity. Investigation for plasma D-dimer level may be an alternative objective way to evaluate disease severity in patients with CSU. Limitations: Low sample size . Semi quantitative method was used instead of ELISA for D-Dimer.

scholarly journals Perawatan Kuretase Gingiva Gigi Anterior pada Periodontitis: Laporan Kasus

e-GIGI ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Johanna A. Khoman ◽  
Miranti A. Minanga
Keyword(s):  
Oral Hygiene ◽  
Chronic Periodontitis ◽  
Systemic Disease ◽  
Tooth Surface ◽  
Periodontal Inflammation ◽  
Root Planing ◽  
Probing Depth ◽  
Index Measurement ◽  
Region I ◽  
Bacterial Plaque

Abstract: In general, periodontal disease is caused by bacterial plaque on the tooth surface.  Bacterial elimination by curettage will reduce periodontal inflammation. This case report was aimed to review the immune response to chronic periodontitis as well as case management with curettage. We reported a 22-year-old female patient came to the Dental and Oral Hospital of University of Sam Ratulangi (Unsrat) with complaints of swollen front gum, frequent gum bleeding, and gum bleeding during tooth brushing. The gum bleeding had occurred since 6 months ago. Tartar cleaning was performed on her three weeks ago. Based on anamnesis, the patient did not suffer from any systemic disease. Intraoral examination revealed that there were reddish gingiva, swelling in region I, II, III, and IV, and probing depth of teeth 21-25 with a mean of 4 mm. Oral Hygiene Index measurement obtained a value of 1.7 (medium category). This case was diagnosed as chronic periodontitis. The treatment consisted of scaling, irrigation with NaCl solution and aquadest, root planing, gingival curettage, and periodontal pack application. At the first control (one week after gingival curettage), the patient did not complain of any pain on the curettage area, periodontal pack was loose. The objective examination still revealed redness, debris, and calculus, OHI-S: 0,8+0,3=1,1 (good category). The prognosis was good since the patient was cooperative, did not have any systemic disease, and had high motivation to maintain oral hygiene.Keywords: curettage, chronic peridontitis  Abstrak: Secara umum penyakit periodontal disebabkan oleh bakteri plak pada permukaan gigi. Eliminasi bakteri dengan kuretase akan menurunkan peradangan periodontal. Laporan kasus ini bertujuan untuk menjelaskan respon imun terhadap penyakit periodontitis kronis serta penatalaksanaan kasus dengan kuretase. Kami melaporkan kasus seorang pasien perempuan berusia 22 tahun datang ke Rumah Sakit Gigi dan Mulut Pendidikan Universitas Sam Ratulangi (Unsrat) dengan keluhan gusi bagian depan bengkak, gusi sering berdarah, dan perdarahan gusi saat menyikat gigi. Gusi berdarah sejak sekitar 6 bulan lalu dan pasien melakukan pembersihan karang gigi sekitar 3 minggu lalu. Dari hasil anamnesis didapatkan bahwa pasien tidak mempunyai riwayat penyakit sistemik. Pada pemeriksaan intraoral terdapat gingiva berwarna kemerahan dan pembengkakan di region I, II, III, IV, probing depthgigi 21-25 dengan rerata sebesar 4 mm. Hasil pengukuran Oral Hygiene Index(OHI) ialah 1,7 (kategori sedang). Diagnosis klinis kasus ini ialah periodontitis kronis. Tindakan yang dilakukan ialah scaling, irigasi dengan NaCl dan akuades, root planing, kuretase gingiva, dan pemasangan periodontal pek. Kontrol pertama dilakukan satu minggu pasca kuretase gingiva, dan pada pemeriksaan subjektif pasien tidak mengeluhkan rasa nyeri di daerah yang telah dilakukan kuretase gingiva, pek periodontal sudah terbuka malam hari pasca kuretase gingiva. Pemeriksaan objektif gingiva masih kemerahan, terdapat debris dan kalkulus, OHI-S: 0,8+0,3=1,1 (kategori baik). Prognosis baik karena pasien kooperatif, tidak memiliki riwayat penyakit sistemik, dan memiliki motivasi yang tinggi untuk menjaga kebersihan rongga mulut.Kata kunci: kuretase; peridontitis kronis

scholarly journals Prevalência da periodontite crônica em pacientes atendidos em uma clínica escola de odontologia

2020 ◽  
Vol 11 (1) ◽  
pp. 9
Author(s):  
Karolayne Da Silva Sousa ◽  
Lara Niely Bezerra Leal ◽  
João Lucas de Sena Cavalcante ◽  
Luciana Mara Peixoto Araújo
Keyword(s):  
Chronic Periodontitis ◽  
Medical Records ◽  
Tooth Loss ◽  
Systemic Disease ◽  
Smoking Habit ◽  
Complete Information ◽  
Cross Sectional ◽  
University Center ◽  
Informed Consent Form ◽  
Sex Type

INTRODUCTION: Chronic periodontitis is one of the most common oral pathologies, with high rates of tooth loss. OBJECTIVE: to identify the prevalence of chronic periodontitis in patients attended at a university center in the interior of Ceará. METHODOLOGY: This is a cross-sectional research, whose information of the researched population was obtained from the medical records of patients attended in the period from 2013 to 2018. It was included two thousand, eight hundred and twenty-one medical records that contained the complete information required for the study and the Informed Consent Form (ICF) duly signed. The variables analyzed were: age, sex, type of periodontal disease, systemic disease and smoking habit. RESULTS: Among the evaluated patients, it was observed that 21.5% of them had shown chronic periodontitis. The female had a higher prevalence with 55.8% and the age group most affected by this disease was between 30-44 years. Among the smoking patients, 29% developed periodontal pathology, and those with systemic changes, 25.2% had chronic periodontitis, with cardiovascular disease being the most prevalent with 57.2%. CONCLUSION: Among the evaluated patients, 21.5% had chronic periodontitis, and it is of great value to understand how the distribution and other factors are associated with this disease, thus this data can be used in planning actions aimed to public health.

Biomarkers of Hemolysis and Inflammation in Sickle Cell Disease Children: Association with Nasopharynx and Oropharynx Bacteria colonization

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2140-2140
Author(s):  
Larissa Rocha ◽  
Magda Seixas ◽  
Bruno A. V. Cerqueira ◽  
Valma Lopes ◽  
Mitermayer Reis ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Systemic Disease ◽  
Female Gender ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Initiation Factor ◽  
Nasopharyngeal Colonization ◽  
High Count ◽  
Cross Sectional ◽  
Alpha 1 Antitrypsin

Abstract Abstract 2140 Introduction: Nasopharynx and oropharynx bacterium colonization can be considered as initiation factor for local or systemic disease. The Streptococcus pneumoniae is a pathogen with epidemiological worldwide importance and it has been frequently associated with infection among SCD patients. The Staphylococcus aureus may also colonize the nasopharynx and has been associated with cause of infections in skin and soft tissue, pneumonia, sepsis, osteoarticulation. This study aimed to establish a profile of inflammation and hemolysis biomarkers of SCD individuals in association with the oropharyngeal and nasopharyngeal bacteria colonization. Patients and Methods: Biomarkers related to hemolysis and inflammation, including lipids and liver function, were determined by biochemical colorimetric reaction and also myeloperoxidase (MPO) gene polymorphisms were investigated with PCR and RFLP techniques. Medical history was obtained by patients' record. Thus, it was developed a cross-sectional study composed by 154 SCD children in a steady-state from the Bahia state, in Brazil, 68.2% (105/154) with HbSS genotype, and 31.8% (49/154) HbSC, in attendance of the outpatients clinic of the Foundation of Hematology and Hemotherapy of Bahia (HEMOBA). The study was approved by the Human research board from FIOCRUZ-BA and every official responsible signed an informed consent. Results: Nasopharynx and oropharynx colonization by S. pneumoniae was found in 14 (9.6%) SCD patients and by S. aureus in 81 (56.6%) patients, and both SCD genotypes had similar frequencies of these studied bacteria. It was not observed an increase in pneumococcal penicillin resistance. SCD patients with nasopharynx colonization by S. pneumoniae and S. aureus exhibited higher ferritin serum levels than patients with a normal microbiote respectively (p=<0.0001; p=0.0144, Mann-Whitney test). However, SCD patients with S. pneumoniae colonization had the highest ferritin serum levels. SCD patients with oropharynx colonization by S. pneumoniae exhibited the highest ferritin (p<0.0001), alanine transaminase (p=0.002) and aspartate aminotransferase (p<0.0001) serum levels when compared with SCD patients colonized by S. aureus and with normal microbiote. Evaluation of multivariate analysis models by logistic regression showed that the occurrence of infection was associated with a high number of total leukocytes (OR:3.41; CI:1.35–8.60; p=0.0092) in a model involving high levels of alpha 1-antitrypsin, antistreptolysin O, the mutant allele of myeloperoxidase gene, and nasopharynx colonization; infection was also associated in a model involving oropharynx colonization (OR:3.87; CI:1.43–10.50;p=0.008) and high leukocytes number (OR:10.13; CI:10.13–52.43; p=0.006), and high count of reticulocyte, platelets, and neutrophils. Pneumonia occurrence was associated with the HbSS genotype (OR:4.55; CI:1.56–13.31;p=0.006) in models involving oropharyngeal or nasopharyngeal colonization, and high count of reticulocyte, platelets, and neutrophils, and age less than 5 years old. Interestingly, when vaso-occlusive was analyzed, the involvement of oropharyngeal or nasopharyngeal colonization was not pivotal for this event, that was associated to high neutrophils counts (OR:11.75; CI:2.33–59.26; p=0.003) in the presence of high count of reticulocyte, platelets, leukocytes, female gender and age less than 5 years old. Conclusion: Ours result of SCD patients nasopharynx and oropharynx colonization with high ferritin serum levels may be associated with an increase of oxygen and nitrogen reactive species by bacteria presence, suggesting a pivotal role of the bacteria colonization in the modulation of hemolytic events, inflammation state, and infectious occurrence and a possible influence in the disease severity. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Evaluation of Galectin-3 as a Novel Diagnostic Biomarker in Patients with Heart Failure with Preserved Ejection Fraction

2020 ◽  
Vol 12 (02) ◽  
pp. 126-132
Author(s):  
Jyothirmayi Kanukurti ◽  
Noorjahan Mohammed ◽  
N. N. Sreedevi ◽  
Siraj Ahmed Khan ◽  
K.S.S. Sai Baba ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Area Under The Curve ◽  
Serum Levels ◽  
Preserved Ejection Fraction ◽  
Diagnostic Biomarker ◽  
Operating Characteristics ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Galectin 3

Abstract Background Heart failure is a complex cardiovascular disease with a variety of etiologies and heterogeneity. The N-terminal pro-B-type natriuretic peptide (NT-proBNP) value has limited usefulness in diagnosing heart failure with preserved ejection fraction (HFpEF). Aim The aim of the present study is to evaluate serum Galectin-3 as a diagnostic biomarker in patients with HFpEF and to compare Galectin-3 with NT-proBNP levels. Materials and Methods A cross-sectional case–control study including 63 cases of heart failure with ejection fraction ≥50% confirmed by echocardiography. NT-proBNP levels in serum were measured by electrochemiluminescence immunoassay and Galectin-3 levels in serum were measured by using an enzyme-linked-immunosorbent serologic assay kit. Results The median levels of serum Galectin-3 and NT-proBNP in patients were significantly higher than those of controls (26.59 vs. 5.27 and 927 vs. 49.3, p < 0.0001). A positive correlation was observed between serum levels of Galection-3 and NT-ProBNP (r: 0.21, p = 0.048). At cut-off values of 10.1 ng/mL and 160 pg/mL, serum Galectin-3 has 77.78% sensitivity, 95% specificity with an area under the curve (AUC) of 0.93, and serum NT-proBNP has 71.43% sensitivity, 100% specificity with an AUC of 0.87, respectively, for diagnosing HFpEF. The comparison of receiver operating characteristics curves showed that Galectin-3 has better AUC compared with NT-proBNP in diagnosing HFpEF. Serum Galectin-3 showed a positive correlation with NT-proBNP and lipid parameters. Conclusion Galectin-3 with higher sensitivity and AUC can be used as a valuable biomarker for the diagnosis of HFpEF. Simultaneous testing of both Galectin-3 and NT-proBNP can further improve the detection of patients with HFpEF.

Obesity worsens central inflammation and disability in multiple sclerosis

2019 ◽  
Vol 26 (10) ◽  
pp. 1237-1246 ◽  
Author(s):  
Mario Stampanoni Bassi ◽  
Ennio Iezzi ◽  
Fabio Buttari ◽  
Luana Gilio ◽  
Ilaria Simonelli ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Negative Impact ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Inflammatory Factors ◽  
Magnetic Resonance Imaging Scan ◽  
Plasminogen Activator Inhibitor 1 ◽  
Cross Sectional ◽  
Positive Correlation ◽  
Csf Levels

Background: Previous studies evidenced a link between metabolic dysregulation, inflammation, and neurodegeneration in multiple sclerosis (MS). Objectives: To explore whether increased adipocyte mass expressed as body mass index (BMI) and increased serum lipids influence cerebrospinal fluid (CSF) inflammation and disease severity. Methods: In this cross-sectional study, 140 consecutive relapsing-remitting (RR)-MS patients underwent clinical assessment, BMI evaluation, magnetic resonance imaging scan, and blood and CSF collection before any specific drug treatment. The CSF levels of the following cytokines, adipocytokines, and inflammatory factors were measured: interleukin (IL)-6, IL-13, granulocyte macrophage colony-stimulating factor, leptin, ghrelin, osteoprotegerin, osteopontin, plasminogen activator inhibitor-1, resistin, and Annexin A1. Serum levels of triglycerides, total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C) were assessed. Results: A positive correlation emerged between BMI and Expanded Disability Status Scale score. Obese RR-MS patients showed higher clinical disability, increased CSF levels of the proinflammatory molecules IL-6 and leptin, and reduced concentrations of the anti-inflammatory cytokine IL-13. Moreover, both the serum levels of triglycerides and TC/HDL-C ratio showed a positive correlation with IL-6 CSF concentrations. Conclusion: Obesity and altered lipid profile are associated with exacerbated central inflammation and higher clinical disability in RR-MS at the time of diagnosis. Increased adipocytokines and lipids can mediate the negative impact of high adiposity on RR-MS course.

Comparative assessment of bone mineral density levels in type 2 diabetic subjects with or without chronic periodontitis: A cross-sectional study

2021 ◽  
Vol 13 (1) ◽  
pp. 28-34
Author(s):  
Hira Ateeq ◽  
Afaf Zia ◽  
Qayyum Husain ◽  
Afshan Bey
Keyword(s):  
Diabetes Mellitus ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Chronic Periodontitis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Mineral Density ◽  
Cross Sectional ◽  
Positive Correlation

Background. This cross-sectional study investigated the bone mineral density (BMD) in type 2 diabetes mellitus (T2DM) subjects with or without chronic periodontitis (CP). Methods. A total of 120 subjects aged 35‒55, divided equally into four groups: i) T2DM with CP, ii) T2DM without CP, iii) CP alone, and iv) healthy patients, were included in this study. Clinical parameters like plaque index (PI), gingival index (GI), and probing pocket depth (PPD) were recorded. All the participants were evaluated for blood sugar levels using glycated hemoglobin (HbA1c) and BMD by Hologic dual-energy x-ray absorptiometry (DEXA) scan. The association of BMD with clinical periodontal parameters and HbA1c in all groups was investigated using linear correlation analysis (r). Results. The mean value of BMD (0.9020±0.0952 g/cm2) was lower in subjects with both T2DM and CP compared to T2DM and CP alone. BMD was weakly correlated with all the clinical periodontal parameters; a positive correlation was observed between BMD and GI in the T2DM and CP group (r=0.405, P=0.026) and the CP group (r=0.324, P=0.081). A weak positive correlation was observed in BMD and HbA1c in the T2DM group (r=0.261, P=0.13), T2DM and CP group (r=0.007, P=0.970), with a negative correlation to HbA1c in the CP group (r= -0.134, P=0.479). Conclusions: Diabetes mellitus impacts clinical periodontal status and bone mass, and the effect is accentuated when chronic periodontitis is present. Based on the present study, BMD is associated with T2DM and CP, but a weak correlation was observed between BMD and HbA1c and clinical periodontal parameters.

scholarly journals Estimation of Salivary Malondialdehyde Levels in Smokeless Tobacco Chewers with Chronic Periodontitis-A Cross Sectional Clinico Biochemical Study

2021 ◽  
pp. 356-365
Author(s):  
Shivaraj B. Warad ◽  
Jyoti Pattanashetti ◽  
Nagaraj Kalburgi ◽  
Arati Koregol ◽  
Subramaniam Rao
Keyword(s):  
Smokeless Tobacco ◽  
Chronic Periodontitis ◽  
Biochemical Study ◽  
Saliva Sample ◽  
Uv Spectrophotometry ◽  
Pocket Depth ◽  
Clinical Attachment Loss ◽  
Cross Sectional ◽  
Periodontal Inflammation ◽  
Salivary Malondialdehyde

Objective: Despite the reported effects of smokeless tobacco (ST) on the periodontium and high prevalence of ST use in rural populations and in males studies on this specific topic are limited. The purpose of this cross-sectional investigation was to measure lipid peroxidation (as an end product of oxidative stress) end product i.e. Malondialdehyde (MDA) in saliva of patients with gingivitis, chronic periodontitis and to assess the influence of smokeless tobacco on Salivary Malondialdehyde (S-MDA). Materials and methods: Total 30 patients with gingivitis, 30 with chronic periodontitis and 30 Smokeless Tobacco Chewers with Chronic Periodontitis and 30 periodontally healthy subjects were included in the study. Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PD), and Clinical Attachment Loss (CAL) were recorded followed by stimulated Saliva sample collection. Salivary MDA Levels were assessed by UV Spectrophotometry. Results: There was a statistically significant increase in the salivary MDA levels in gingivitis, chronic periodontitis and in smokeless tobacco chewers with chronic periodontitis when compared with healthy group. Conclusions: Higher salivary MDA levels in gingivitis group, chronic periodontitis, and smokeless tobacco chewers with chronic periodontitis reflects increasedoxygen radical activity during periodontal inflammation.

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