biomarkers found in saliva

1. PRESENTED BY : HARITHA . M
FINAL YEAR B.D.S

2. 
 INTRODUCTION
 BIOMARKER
 NEED FOR NEW BIOMARKER
 SALIVA AS A DIAGNOSTIC FLUID IN
PERIODONTAL DISEASE
 COLLECTION
 SALIVARY MARKERS OF PERIODONTAL
DISEASE
 CURRENT SALIVARY DIAGNOSTIC TEST
 FUTURE OF PERIODONTAL DISEASE USING
SALIVA

3. 
Early detection of disease plays a crucial role in
successful therapy.
Early diagnosis and management reduces the severity
and possible complications of the disease process.
To overcome this challenge , medical researchers are
devoted to finding molecular disease biomarkers that
reveal a hidden lethal threat before the disease becomes
complicated.
INTRODUCTION

4. 
Biomarker is a biological characteristic that objectively
measured and evaluated as an indicator of normal
biological or pathological processes or a response to
therapeutic intervention.
BIOMARKER

5. 
LIMITATIONS
 Lack of definitive molecular biomarkers for
specific diseases.
 Lack of an easy and inexpensive sampling method
with minimal discomfort.
 Lack of an accurate , easy- to -use , and portable
platform to facilitate early disease detection.
NEED FOR A NEW BIOMARKER

6. 
 Serum and salivary molecules
such as immunoglobulins
,enzymes ,constituents of
gingival cervicular fluid , bacterial
components ,volatile compounds
and phenotypic markers like epithelial keratins.
SALIVA AS A DIAGNOSTIC FLUID IN
PERIODONTAL DISESSES
 Readily accessible.
 Noninvasive diagnostic
medium for a readily widening of range disease and
clinical situations

7. 
 A mix composed largely of the secretions from
major salivary glands along with minor salivary
gland and from gingival crevicular fluid.
 Unstimulated saliva collected by passive drooling
into a graduated tube or preweighed so that flow
rate per unit can be measured.
 Saliva can be collected on cotton swabs , cotton rolls
,gauze or filter paper.
COLLECTION OF SALIVA

8. 
 large volumes , saliva is stimulated by gustatory or
masticatory stimulus .
 For individual secretions ,carlson and crittenden in
1910 introduced method of collection of parotid
saliva using plastic modifications of single cup.
 Sublingual or submandibular saliva collected by
customization of basic plastic collector or by
aspiration from the duct openings with
micropipettes .
COLLECTION OF SALIVA

9. 
SALIVAVARY MARKERS OF
PERIODONTAL DISEASES

10. 
Immunoglobulins
 predominant Ig in saliva is secretory IgA
 Lesser amount of IgG, Ig M
 Eggert et al reported that saliva from treated periodontitis
patient had higher IgA &IgG levels to porphyromonas
ginigivalis and treponema denticola compared to saliva
from control subjects
 Sandholam et al found increased concentration of salivary
IgG to aggregatibacter , actinomycetemcomitans in
patients of aggressive periodontitis
SPECIFIC MARKERS

11. 
SALIVARY ENZYMES
 Lysozymes : patient with low levels of lysozyme in
saliva are suspectible to plaque acuumulation ,risk
factor for periodontal disease
 Peroxidase : pateints with periodontal disease have
demonstrated high levels of this enzyme.
 Salivary ions : sewon et al reported a higher
concentration of Ca in periodontitis patients

12. 
 Mucins : decrease concentration of mucins leads to
increase concentration of A.actinomycetemcomitans
 Lactoferrin : high concentration seen in patients
with periodontal disease
 Histatin : it invovles in the inhibition of the release
of histamine from mast cells affecting their role in
inflammation
 Fibronectin : a glycoprotien , promotes selective
adhesion and colonisation of certain bacterial species
while inhibiting others
NON SPECIFIC MARKERS

13. 
 Cystatin : proteolytic enzymes originated from
pathogenic bacteria ,inflammatory cells, osteoblast
and fibroblast . Collagenolytic activity may cause
tissue destruction . May function by modulating
enzyme activity in the periodontium
 Platelet activating factor PAF : Garito et al found a
positive correlation between PAF and periodontal
inflammation
 Amino acids : no diagnostic significance for
periodontal disease

14. 
 Vascular endothelial growth factor ( VEGF): it is
multifunctional angiogenic cytokine important in
inflammation and wound healing .higher levels of
VEGF were detected from periodontitis patients
 Hormones cortisol : emotional stress is a risk factor
for periodontitis .elevated serum cortisol levels exert
a strong inhibitory effect on the inflammatory
process and immune response . Its higher level seen
in severe periodontitis

15. 
 Gelatinase : teng et al found atwofold increase in
mean MMP-9 levels in patient with attachment loss
 Telopeptide : carboxyterminal telopeptide of type 1
collagen shown to be a predictor of both future bone
loss and attachment loss

16. 
Currently , two salivary diagnostic test available
 One test identifies the type and concentration of
specific periodontal pathogenic organism
 Allows the clinician to determine the appropriate
antimicrobial therapy
 Another salivary detect genetic susceptibility to
periodontitis that allows the clinician to identify the
greater risk for the development of severe
periodontal destruction
CURRENT SALIVARY DIAGNOSTIC
TEST

17. 
 Detect the individual with
poor periodontal status based
on purely microbial or single
inflammatory based information
 A proprietary paper strip
containing gold-labeled
anti-human hemoglobin monocolonal
antibody is dipped into the saliva sample
 Magenta line is formed indicating
positive test result.
SALIVARY OCCULAR TEST

18. 
 Novel technologies such
as lab –on –a chip and
microfluid devices have
the potential to manage complex
oral fluid such as saliva and GCF
 To provide determination of a
patients periodontal disease –risk profile
,current disease activity and
response to therapeutic interventions

19. 
 Recent advances in transcriptomic high –throughput
technologies are shedding new light on salivary
biomarkers .
 Elevate salivary diagnosis of periodontal disease to higher
level
 Collection of transcripts ,mRNA is isolated from saliva
 By analyzing the transcriptome ,one can assess which
genes are turned off or on and difference in gene
expression between saliva from healthy and periodontal
diseased patients through a microarray
FUTURE OF PERIODONTAL
DISEASES DIAGNOSIS USING
SALIVA

20. 
 Disease –specific and significant
biomarkers are found and validated
 The oral fluid periodontal
health test uses combination of
validated markers to analyze and
display the patient’s periodontal status.

21. 
 Prototype electrochemical
devices such as oral fluid
periodontal health test may
provide accurate and real –time
assessments of periodontal diseases
for the general public at home or
at dental office .

22. 
Although challenges remain ahead , using saliva to
gauge periodontal health appears bright for future
application to aid in the diagnosis of periodontal
diseases and the prediction of periodontal treatment
outcomes
CONCLUSION