Apoptosis Markers in Aggressive Periodontitis
Condition: Molar-incisor Pattern Grade C Periodontitis ( Localized Aggressive Periodontitis); Generalized Grade C Periodontitis (Generalized Aggressive Periodontitis)
MeSH terms: Periodontitis; Aggressive Periodontitis; Aggression
Study type: Observational

Summary: 
      The aim of the present trial is to assess the gingival crevicular fluid level of caspase-3
      and apoptosis inducing factor (AIF) in Generalized versus Molar-incisor grade C
      periodontitis.

      The present study will be carried out on patients selected from those attending on the
      outpatient clinics of Department of Oral Medicine, Periodontology, Oral Diagnosis and Dental
      Radiology, Faculty of Dental Medicine, Al-Azhar University, Assiut.
    

Detailed description: 
      Periodontal diseases are inflammatory disorders that give rise to tissue damage and loss, as
      a result of complex interactions between pathogenic bacteria and host immune response.
      Gingivitis is generally regarded as a site-specific inflammatory condition initiated by
      dental biofilm accumulation and characterized by gingival redness and edema and the absence
      of periodontal attachment loss.(1,2) periodontitis, a disease characterized by gingival
      inflammation combined with connective tissue attachment and bone loss.

      Aggressive periodontitis is a form of periodontal disease characterized by rapid attachment
      loss, bone destruction, non-contributory medical history and family history of the cases
      Apoptosis is a fundamental and complex biological process that enables an organism to kill
      and remove unwanted cells during development, normal homeostasis and disease.

      Caspases are proteins implicated in the activation and execution of apoptosis was identified
      in humans as being crucial for this process. Caspases 3 appear to be activated in a protease
      cascade that leads to inappropriate activation or rapid disablement of key structural
      proteins and important signaling, homeostatic and repair enzymes and is essential for some of
      the characteristic changes in cell morphology and certain biochemical events associated with
      the execution and completion of apoptosis. However, the specific requirements of this caspase
      in apoptosis were until now largely unknown. Apoptosis-inducing factor (AIF) is a
      mitochondrion-localized flavoprotein with nicotinamide dinucleotide (NADH) oxidase activity
      is encoded by a nuclear gene. It has been shown to translocate from mitochondria to the
      cytosol as well as the nucleus when apoptosis is induced and mediate caspase-independent
      death because inhibition of caspase activation.

      Many authors view apoptosis as a process that is near-to-synonymous to massive caspase
      activation. The existence of a caspase-independent death effector thus does not fit the
      dominant scheme. During the last 2 years, several papers advocated the hypothesis that AIF is
      indeed a caspase-dependent death effector, meaning that the translocation of AIF from the
      mitochondrion (where it would be inert) to the nucleus (where it would induce apoptosis)
      would be caspase-dependent.
    

Intervention name(s): ELISA assessment of apoptosis markers in gingival crevicular fluid
Intervention type(s): Diagnostic Test
Intervention description(s): Gingival crevicular fluid (GCF) samples will be collected to assess the level of caspase-3,8,9 and apoptosis inducing factor (Aif)
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        The present study will carry out on fifty patients ranged in age from (18 - 75) years
        diagnosed as having aggressive periodontitis. All patients were selected from those
        attending at outpatient dental clinic of Oral Medicine, Periodontology, Oral Diagnosis and
        Dental Radiology Department, Faculty of Dental Medicine, Al-Azhar University, Assiut
        branch. Clinical and radiographic examination will be performed by two calibrated
        periodontists to confirm accurate diagnosis.