الفهرس 
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Abstract
In our study a total of 40 subjects were divided according to their periodontal status into the three groups; 15 patients diagnosed with chronic periodontitis (group 1), 15 patients diagnosed with aggressive periodontitis (group 2) and 10 healthy controls (group 3). Periodontitis group received instruction in self performed plaque control measures, clinical periodontal examination including plaque index, papillary bleeding index, probing pocket depth and clinical attachment level was carried out. Salivary as well as GCF samples were optained from each individual , and all samples stored at -80 °C until analysis using Enzyme-Linked ImmunoSorbent Assay (ELISA) techniques to assess the levels of the biomarkers. Three biomarkers had been chosen in our study which are specific for the three aspects of periodontitis: IL-6 for inflammation, MMP-8 for collagen degradation and Osteoprotegerin for bone turnover phase.
The result of the IL-6, MMP-8 and OPG concentrations in both saliva and GCF were compared between the three groups. The study showed that the mean concentrations of the three biomarkers were higher in both GCF and saliva in periodontitis patients compared to healthy controls.
The IL-6 concentrations in the saliva and GCF of patients with periodontitis were significantly elevated. In chronic periodontitis patients IL-6 level showed statistically significant increase in saliva as well as GCF. The GCF showed higher IL-6 mean value than saliva , although the difference was statistically non-significant. In aggressive periodontitis patients , IL-6 levels showed statistically significant increase in saliva as well as in GCF. and the saliva showed statistically non significant higher IL-6 mean value than GCF.
The matrix metalloproteinase-8 concentrations in the saliva and GCF of patients with periodontitis were significantly elevated. In chronic periodontitis patients MMP-8 level showed increase in saliva as well as GCF. The saliva showed higher MMP-8 mean value than GCF , and the difference was statistically significant. In aggressive periodontitis patients , MMP-8 levels showed increase in saliva as well as in GCF. and the saliva showed statistically significant higher MMP-8 mean value than GCF.
Osteoprotegerin concentrations in the saliva and GCF of patients with periodontitis were significantly elevated. In chronic periodontitis patients OPG level showed statistically significant increase in saliva as well as GCF. The saliva showed higher OPG mean value than GCF , and the difference was statistically non significant. In aggressive periodontitis patients , OPG levels showed statistically significant increase in saliva as well as in GCF. and the saliva showed statistically significant higher OPG mean value than GCF. In GCF as well as saliva, there was no statistically significant difference in the level of the three biomarkers between aggressive and chronic periodontitis groups.
Results showed that the three biomarkers were elevated in saliva with no statistical significant difference than gingival crevicular fluid, as in IL-6, as regard MMP-8, saliva recorded the higher level than the GCF and the difference was statistically significant. Saliva also recorded a higher OPG levels than GCF , the difference was statistically non significant as in CP or statistically significant as in AgP.
These data confirm that, saliva was an adequate fluid to assess biomarkers in periodontitis and we can rely on saliva as a diagnostic fluid in periodontal disease. It can be easily collected through non-invasive methods, without specialized equipment or personnel, is readily available, and contains locally derived and systemically derived markers, also whole saliva represents a pooled sample from all periodontal sites, giving an overall assessment of disease status thereby assessing subject- level (as opposed to site-level) risk or status.