Background: Altered immune response and improper neutrophils chemotaxis, phagocytosis, and adhesion might be the principal causative factor for increased susceptibility to periodontal pathogens and oral complications in diabetic patients. This study aimed to determine the relationship between C-reactive protein and salivary IgA with periodontal disease and the severity of dental caries with the glycemic control state of patients with diabetes mellitus. Patients and Methods: This study was carried out on 91 subjects, 61 patients with diabetes mellitus, and 30 apparently healthy subjects (as a control group). The patient groups were regularly attended Duhok Diabetes Center, Duhok City, Kurdistan Region (Iraq) for diabetes management. The healthy controls were recruited from the staff and sub staff of Azadi Teaching Hospital. Fasting plasma glucose, HbA1c, and serum high sensitivity C-reactive protein (Hs-CRP) were measured. The whole saliva collection was performed by an unstimulated method for five minutes in a graduated test tube to recognize the salivary secretion rate and then stored at -20 0 C for IgA estimation. Periodontal Index was used to determine the periodontal disease status. Each tooth was scored according to the condition of the surrounding tissues. Results: Significantly higher Hs-CRP (9.2 vs 3.3 µg/ml), fasting plasma glucose (215.4 vs 98.9 mg/dl) and HbA1c (8.5 vs 4.9 %), (P < 0.001 for all parameters, together with lower hemoglobin (13.6 vs 14.5 gm/dl, P=0.03) levels were found in diabetic patients compared to control group, A significantly higher mean salivary IgA level in diabetic patients compared to controls (312.4 vs 177.3 mg/dl, P<0.001), associated with a significant high periodontal index (1.68 vs 0.81, P = 0.003). Conclusion: Elevated serum Hs-CRP and salivary IgA in patients with diabetes mellitus as inflammatory response sequences raise inflammation potential in the periodontium. Further, the results confirm that periodontal index was associated with poor glycemic control.

Background: Saliva is a fluid secreted by the salivary glands and it is divided in to serous and mucus components. Despite its physiological roles in lubricating the oral cavity and digestion, it also acts as a simple diagnostic tool reflecting body's systemic diseases. The aim of the present study is to determine malondialdehyde (MDA) levels in saliva and serum of apparently healthy individuals and to find if there is an association between dental caries, periodontal disease and salivary MDA. Subject and Methods: This cross sectional study involved sixty fourparticipants who were medical students attending Duhok College of Medicine. Clinical information and all relevant data were obtained according to a questionnaire. Both salivary and serum MDA levels were measured manually in unstimulated saliva and sera of participants using Thiobarbuturic acid method. Results: Malondialdehyde is measurable in saliva of apparently healthy individuals and was significantly lower than serum MDA level (p<0.001). There was a statistically highly significant positive correlation between both salivary and serum MDA levels (p=0.0007). Moreover, both Salivary and serum MDA levels were significantly positively correlated with weight and BMI (p=0.03, p=0.03 and p= 0.04 and 0.05) respectively. There were no significant correlations between salivary MDA with dental caries index (dmft score) and periodontal disease index. Conclusions: Based on the current results, salivary MDA is significantly positively correlated with serum MDA, weight and BMI. No significant association of salivary MDA with dental caries and periodontal disease were observed.

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