The effect of treatment on the activity of salivary proteases and glycosidases in adults with advanced periodontitis.

Enzyme activity in whole saliva of trypsin-like protease, elastase-like protease, general protease, and three glycosidases was measured by colorimetric assays, using synthetic substrates. A study group of 24 adults with advanced periodontitis was compared to a control group of 25 subjects with healthy periodontium. Clinical parameters and levels of enzyme activity were assessed at baseline, after non-surgical periodontal therapy (at 8 months), following the maintenance phase or periodontal surgery (at 15 months), and after the maintenance phase with or without systemic chemotherapy (at 20 months). The mean values of the proteolytic enzymatic activity and the activity of two glycosidases in whole saliva were significantly higher in the study group than in the control group at baseline. After the initial treatment phase at 8 months, all three proteases were reduced significantly, but the glycosidases were still high. After all treatment phases at 20 months, the activity of both the proteases and glycosidases approximated the values of the healthy group. In the saliva samples collected prior to treatment and following non-surgical periodontal therapy, the activity of salivary elastase correlated significantly with the number of deep gingival pockets (PD > or = 6 mm) and with either gingival index (GI) or the percentage of bleeding sites (BOP%). The enzyme activity in whole saliva appears to reflect the status of periodontal health. Salivary elastase shows good potential to serve as a novel adjunct to detect destructive periodontal inflammation and to follow periodontal healing after treatment.