Advances in periodontal diagnosis. 9. Potential markers of cell death and tissue degradation

This paper describes the potential markers of cell death and connective tissue degradation which might serve as markers of periodontal disease activity. The first section deals with enzymes released by dead and degenerating cells. Firstly, it describes how these pass from the periodontal tissues into gingival crevicular fluid (GCF) and explains that these enzymes have been used as markers of cell death in medicine for several decades. It then discusses the main enzymes in this group, aspartate amino transferase (AST) and lactate dehydrogenase (LDH) and reviews those studies which have attempted to relate these enzymes to periodontal disease severity and activity. Secondly, it describes the potential markers of connective tissue degradation, fibronectin, hydroxyproline-containing peptides and glycosaminoglycans (GAGs) and explains how these are produced. Finally, it describes the only commercial test kit for markers in this group (GCF-AST).