Platelet-activating factor (PAF), a potent
phospholipid inflammatory mediator, is increased in the mixed saliva of subjects with
periodontal disease and correlates with the extent of oral
inflammation. The present study was designed to provide a longitudinal evaluation of the effect of initial periodontal
therapy (home care instruction, prophylaxis, and
scaling/root planing) on salivary PAF levels in chronic
adult periodontitis patients (n = 15). Mixed saliva was collected prior to, during, and after initial
therapy and was utilized to assess PAF levels after
lipid extraction and fractionation as well as to histologically assess the number of polymorphonuclear leukocytes (PMN). PAF activity was determined in bioassay relative to authentic PAF (1-O-hexadecyl-2-acetyl-sn-glycero-3-
phosphocholine; 16:0-alkyl-PAF). Initial salivary PAF levels (12.1 +/- 2.8 pmole equivalents of 16:0-alkyl-PAF/ml saliva; mean +/- SE) decreased following supragingival plaque control (9.6 +/- 2.4) and were further reduced following scaling and
root planing (5.7 +/- 1.4). In parallel, salivary PMN levels were significantly reduced and clinical estimates of
periodontal disease were significantly improved; i.e., there was a decrease in the percentage of sites with both
bleeding on probing (from 46.1 +/- 4.6% of sites at pretreatment to 25.9 +/- 2.6% after scaling and
root planing) and probing depths > or = 4 mm (from 16.7 +/- 1.9% of sites to 10.3 +/- 1.2%). Thus, initial periodontal
therapy reduced salivary PAF levels in concert with improvements in clinical estimates of marginal and submarginal periodontal
inflammation suggesting that PAF may participate in inflammatory events during periodontal tissue injury and disease.