Open Access Research article

Comparisons between two biochemical markers in evaluating periodontal disease severity: a cross-sectional study

Sakornrat Khongkhunthian1, Prachya Kongtawelert2, Siriwan Ongchai2, Peraphan Pothacharoen2, Thanapat Sastraruji3, Dhirawat Jotikasthira4 and Suttichai Krisanaprakornkit3*

Author Affiliations

1 Department of Restorative Dentistry and Periodontology, Faculty of Dentistry, Chiang Mai 50200, Thailand

2 Department of Biochemistry, Thailand Excellence Center for Tissue Engineering and Stem Cells and Center of Excellence for Innovation in Chemistry, Faculty of Medicine, Chiang Mai 50200, Thailand

3 Department of Oral Biology and Diagnostic Sciences, Center of Excellence in Oral and Maxillofacial Biology, Faculty of Dentistry, Chiang Mai 50200, Thailand

4 Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand

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BMC Oral Health 2014, 14:107  doi:10.1186/1472-6831-14-107

Published: 30 August 2014



The purpose of this study was to compare two biochemical markers, which have been previously used to determine the degrees of alveolar bone destruction, in evaluating periodontal disease severity.


The WF6 epitope of chondroitin sulfate (CS) and the alkaline phosphatase (ALP) levels were determined in gingival crevicular fluid (GCF) samples collected from patients with various degrees of disease severity, including ten patients with gingivitis (50 gingivitis sites) and 33 patients with chronic periodontitis (including gingivitis, slight, moderate, and severe periodontitis sites; n = 50 each), as well as from ten healthy volunteers (50 healthy sites) by Periopaper strips. The levels of CS and ALP were measured by an ELISA and a fluorometric assay, respectively.


The results demonstrated low levels of CS and ALP in non-destructive and slightly destructive periodontitis sites, whereas significantly high levels of these two biomolecules were shown in moderately and severely destructive sites (p < 0.05). Although a significant difference in CS levels was found between moderate and severe periodontitis sites, no difference in ALP levels was found. Stronger correlations were found between CS levels and periodontal parameters, including probing depth, loss of clinical attachment levels, gingival index and plaque index, than between ALP levels and these parameters.


It is suggested that the CS level is a better diagnostic marker than the ALP level for evaluating distinct severity of chronic periodontitis.

Alkaline phosphatase; Chondroitin sulfate; Chronic periodontitis; Gingival crevicular fluid