The effect of Swedish and American smokeless tobacco extract on periodontal ligament fibroblasts in vitro

Use of moist snuff is widespread in Sweden. In 2004 approximately 8oo,ooo Swedes were daily users which corresponds to 22% of the male population and 3% of the female population. The aim of the present study was to evaluate the effect of Swedish moist snuff extract on PDLfibroblast growth and hard tissue production and compare with moist snuff extract from USA. Periodontal ligament cells (PDL-cells) were obtained from 3 healthy subjects (1 female 14 years, 2 males 14 and 17 years) from the root surface of premolars extracted for orthodontic reasons. The cells were isolated from explants and grown in Dulbecco's Modified Eagle's Medium (DMEM) supplemented with 10% fetal calf serum (FBS) and cultivated in 37 degrees C with 5% CO2 in air. Snuff extract in concentrations 0.3%, 1% and 3% (in DMEM with 1% FBS) was tested. Cells from each individual were tested three times, each time in triplicate. Photographs were taken at o and 24 hours with a digital camera and analysed in terms of growth and morphology. Then the cell suspension was frozen and later thawed for examination of the production of alkaline phosphatase after exposure to different snuff concentrations. This in vitro study has shown that PDL cells from 3 different subjects demonstrated a reduced number of cells at exposure to 3% of both Swedish and American snuff extract.The production of alkaline phosphatase after 2 hours was similarly reduced from cells exposed to 3% snuff extract. Further studies have to be made to understand the effect of smokeless tobacco on periodontal tissues. However, from this study can be concluded that smokeless tobacco has biological effects in terms of reduced PDL cell growth and production of alkaline phosphatas

Klinisk utvärdering av lokal antibiotikabehandling hos rökare i ett parodontalt stödbehandlingsprogram

KLINISK UTVÄRDERING AV LOKAL ANTIBIOTIKABEHANDLING HOS RÖKARE I ETT PARODONTALT STÖDBEHANDLINGSPROGRAM. Författare Kerstin Stagnér. Medförfattare Gunilla Bratthall, Avdelning för Parodontologi, Odontologiska Fakulteten, Malmö Högskola. Syfte - Syftet med den här studien var att undersöka om lokal antibiotika gel, 8,8 % Doxycyklin (Atridox®), kan förbättra läkningen av inflammerade tandköttsfickor hos vuxna rökande patienter under stödbehandling. Material och Metod. I den här experimentellt blinda randomiserade studien valdes 20 rökande patienter (≥ 10 cigaretter/dag) med diagnos kronisk parodontit ut från ett parodontalt stödbehandlingsprogram. Varje patient hade ≥ 5 tänder, och ≥ 5 tandköttsfickor med fickdjup ≥ 5 millimeter. Patienterna indelades i två grupper, 10 i testgruppen (Doxycyklingel 8,8 %, Atridox®) och 10 i kontrollgruppen (Placebogel). Vid baseline och 3 månader efter behandling utfördes följande kliniska registreringar: fickdjup (PPD), klinisk fästenivå (CAL), blödning vid sondering (BOP), och plackindex (PLI) vid 4 ytor på alla indextänder. Mätning av mängden gingivalexudat (GI) utfördes vid 2 ytor på indextänder. Tandhygienist (KS) utförde scaling och debridering i hela bettet, även molarer (full-mouth). Tandläkare behandlade omgående patienterna i testgruppen med applicering av antibiotikagel Atridox® i minst 5 tandköttsfickor med primärt fickdjup ≥ 5 millimeter och blödning vid sondering. Patienterna i kontrollgruppen fick placebogel applicerad på motsvarande sätt. Efter applikationen av gel sköljde patienterna med 0,1 % klorhexidin i 7-10 dagar då mekanisk munhygien inte fick utföras under den perioden. Statistiska analyser. Statistikprogram som användes var StatXact och Excel. Statistiska metoder Wilcoxon rank och Wilcoxon tecken rank test. P-värden ≤ 0.05 har bedömts som statistiskt signifikanta. Medelvärden över alla tänder/ytor har använts för varje patient och med patienten som statistisk enhet. Resultat. När studien avslutades var det 16 patienter kvar. 4 patienter exkluderades ur studien på grund av sjukdom. Dessvärre visade det sig att bortfallet endast var i testgruppen som då bestod av 4 kvinnor och 2 män med genomsnittsålder 56,3 år. I kontrollgruppen ingick 5 kvinnor och 5 män med genomsnittsålder 59,4 år. Tre månader efter behandling noterades signifikant förbättring för testgruppen avseende PPD -1.36 mm (p=0.0313), signifikant förbättring för kontrollgruppen avseende PPD -1.07 mm (p=0.0020), CAL -0.65 mm (p=0.0200) och BoP (p=0.0078). Efter 3 månader fanns det ingen signifikant skillnad mellan test- och kontrollgrupp avseende samtliga parametrar. När resultaten av samtliga tänder (inklusive indextänder) analyserades noterades signifikant förbättring av PPD för både test- (p=0.0313) och kontrollgrupp (p=0.0039). Signifikant förbättring noterades även för kontrollgruppen av BOP, CAL och GI. Ingen signifikant skillnad mellan doxycyklin- respektive placebobehandlade bett avseende samtliga parametrar. Slutsats. Resultatet av den här randomiserade kontrollerade studien kunde inte visa statistisk signifikant skillnad mellan test- och kontrollgrupp i det här begränsade materialet. Lokal antibiotikabehandling med 8,8 % Doxycyklingel (Atridox®) hade inte någon tilläggseffekt till scaling och debridering hos vuxna rökare med diagnos kronisk parodontit i ett stödbehandlingsprogram. Resultatet visade god läkning och signifikant förbättring av inflammerade tandköttsfickor efter subgingival scaling och debridering i både test- och kontrollgrupp utan någon skillnad mellan antibiotika- och placebogel.Clinical evaluation of local antibiotic treatment in smokers with chronic periodontitis in a maintenance care program. Authors: Kerstin Stagnér, Gunilla Bratthall. Institution Department of Periodontology, Faculty of Odontology, Malmö University. Aim. To evaluate if local antibiotics, 8.8 % doxycycline gel, can improve periodontal healing in smoking adults in a maintenance care program. Material and Methods. In a double-blind randomized controlled study 20 smoking patients were selected from a maintenance care program. Each subject demonstrated at least 5 probing pocket depths (PPD) ≥ 5mm with bleeding on probing (BOP) in a minimum of 5 teeth. The patients were divided into 2 groups, the test group (8.8 % doxycycline gel, Atridox®) and the control group (placebo gel). At baseline and 3 months after treatment a clinical registration was performed, including PPD, clinical attachment level (CAL), BOP, and plaque index (PlI) at 4 sites of test- and control teeth. Gingival index (GI) was performed using Periotron® at 2 sites of all index-teeth. At baseline all subjects received full-mouth scaling followed with application of test or placebo gel in all index pockets. After gel application 0.1 % chlorhexidine was used for mouth rinsing during 7-10 days, since no mechanical oral hygiene was allowed during that period. Results. There were 16 patients left in the end of the study. Four subjects in the test group had to be excluded because of disease. Three months after treatment significant improvement for PPD was shown both in the test (p=0.0313) and the control group (p=0.0020). Significant improvement for the control group was also demonstrated for CAL and BoP. There were no significant differences in any parameter in the change after 3 months between test - and control groups. When the results from all teeth (including index teeth) were analyzed significant improvement was shown in PPD both in the test (p=0.0313) and the control group (p=0.0039). Significant improvement for the control group was also demonstrated for CAL, BOP and GI. There were no significant differences between test and placebo treated dentitions. Conclusion. This study could not show any statistically significant clinical differences between the test - and control groups based on results of index teeth as well as all teeth. This means that local antibiotic treatment with 8.8 % doxycycline gel (Atridox®) did not show any additional effects to scaling. The results, however, showed significant improvement of periodontal pockets after subgingival scaling in both test- and control groups

Klinisk utvärdering av lokal antibiotikabehandling hos rökare i ett parodontalt stödbehandlingsprogram

KLINISK UTVÄRDERING AV LOKAL ANTIBIOTIKABEHANDLING HOS RÖKARE I ETT PARODONTALT STÖDBEHANDLINGSPROGRAM. Författare Kerstin Stagnér. Medförfattare Gunilla Bratthall, Avdelning för Parodontologi, Odontologiska Fakulteten, Malmö Högskola. Syfte - Syftet med den här studien var att undersöka om lokal antibiotika gel, 8,8 % Doxycyklin (Atridox®), kan förbättra läkningen av inflammerade tandköttsfickor hos vuxna rökande patienter under stödbehandling. Material och Metod. I den här experimentellt blinda randomiserade studien valdes 20 rökande patienter (≥ 10 cigaretter/dag) med diagnos kronisk parodontit ut från ett parodontalt stödbehandlingsprogram. Varje patient hade ≥ 5 tänder, och ≥ 5 tandköttsfickor med fickdjup ≥ 5 millimeter. Patienterna indelades i två grupper, 10 i testgruppen (Doxycyklingel 8,8 %, Atridox®) och 10 i kontrollgruppen (Placebogel). Vid baseline och 3 månader efter behandling utfördes följande kliniska registreringar: fickdjup (PPD), klinisk fästenivå (CAL), blödning vid sondering (BOP), och plackindex (PLI) vid 4 ytor på alla indextänder. Mätning av mängden gingivalexudat (GI) utfördes vid 2 ytor på indextänder. Tandhygienist (KS) utförde scaling och debridering i hela bettet, även molarer (full-mouth). Tandläkare behandlade omgående patienterna i testgruppen med applicering av antibiotikagel Atridox® i minst 5 tandköttsfickor med primärt fickdjup ≥ 5 millimeter och blödning vid sondering. Patienterna i kontrollgruppen fick placebogel applicerad på motsvarande sätt. Efter applikationen av gel sköljde patienterna med 0,1 % klorhexidin i 7-10 dagar då mekanisk munhygien inte fick utföras under den perioden. Statistiska analyser. Statistikprogram som användes var StatXact och Excel. Statistiska metoder Wilcoxon rank och Wilcoxon tecken rank test. P-värden ≤ 0.05 har bedömts som statistiskt signifikanta. Medelvärden över alla tänder/ytor har använts för varje patient och med patienten som statistisk enhet. Resultat. När studien avslutades var det 16 patienter kvar. 4 patienter exkluderades ur studien på grund av sjukdom. Dessvärre visade det sig att bortfallet endast var i testgruppen som då bestod av 4 kvinnor och 2 män med genomsnittsålder 56,3 år. I kontrollgruppen ingick 5 kvinnor och 5 män med genomsnittsålder 59,4 år. Tre månader efter behandling noterades signifikant förbättring för testgruppen avseende PPD -1.36 mm (p=0.0313), signifikant förbättring för kontrollgruppen avseende PPD -1.07 mm (p=0.0020), CAL -0.65 mm (p=0.0200) och BoP (p=0.0078). Efter 3 månader fanns det ingen signifikant skillnad mellan test- och kontrollgrupp avseende samtliga parametrar. När resultaten av samtliga tänder (inklusive indextänder) analyserades noterades signifikant förbättring av PPD för både test- (p=0.0313) och kontrollgrupp (p=0.0039). Signifikant förbättring noterades även för kontrollgruppen av BOP, CAL och GI. Ingen signifikant skillnad mellan doxycyklin- respektive placebobehandlade bett avseende samtliga parametrar. Slutsats. Resultatet av den här randomiserade kontrollerade studien kunde inte visa statistisk signifikant skillnad mellan test- och kontrollgrupp i det här begränsade materialet. Lokal antibiotikabehandling med 8,8 % Doxycyklingel (Atridox®) hade inte någon tilläggseffekt till scaling och debridering hos vuxna rökare med diagnos kronisk parodontit i ett stödbehandlingsprogram. Resultatet visade god läkning och signifikant förbättring av inflammerade tandköttsfickor efter subgingival scaling och debridering i både test- och kontrollgrupp utan någon skillnad mellan antibiotika- och placebogel.Clinical evaluation of local antibiotic treatment in smokers with chronic periodontitis in a maintenance care program. Authors: Kerstin Stagnér, Gunilla Bratthall. Institution Department of Periodontology, Faculty of Odontology, Malmö University. Aim. To evaluate if local antibiotics, 8.8 % doxycycline gel, can improve periodontal healing in smoking adults in a maintenance care program. Material and Methods. In a double-blind randomized controlled study 20 smoking patients were selected from a maintenance care program. Each subject demonstrated at least 5 probing pocket depths (PPD) ≥ 5mm with bleeding on probing (BOP) in a minimum of 5 teeth. The patients were divided into 2 groups, the test group (8.8 % doxycycline gel, Atridox®) and the control group (placebo gel). At baseline and 3 months after treatment a clinical registration was performed, including PPD, clinical attachment level (CAL), BOP, and plaque index (PlI) at 4 sites of test- and control teeth. Gingival index (GI) was performed using Periotron® at 2 sites of all index-teeth. At baseline all subjects received full-mouth scaling followed with application of test or placebo gel in all index pockets. After gel application 0.1 % chlorhexidine was used for mouth rinsing during 7-10 days, since no mechanical oral hygiene was allowed during that period. Results. There were 16 patients left in the end of the study. Four subjects in the test group had to be excluded because of disease. Three months after treatment significant improvement for PPD was shown both in the test (p=0.0313) and the control group (p=0.0020). Significant improvement for the control group was also demonstrated for CAL and BoP. There were no significant differences in any parameter in the change after 3 months between test - and control groups. When the results from all teeth (including index teeth) were analyzed significant improvement was shown in PPD both in the test (p=0.0313) and the control group (p=0.0039). Significant improvement for the control group was also demonstrated for CAL, BOP and GI. There were no significant differences between test and placebo treated dentitions. Conclusion. This study could not show any statistically significant clinical differences between the test - and control groups based on results of index teeth as well as all teeth. This means that local antibiotic treatment with 8.8 % doxycycline gel (Atridox®) did not show any additional effects to scaling. The results, however, showed significant improvement of periodontal pockets after subgingival scaling in both test- and control groups

Clinical evaluation of local antibiotic treatment in smokers with chronic periodontitis in a maintenance care program

Syftet med den här studien var att undersöka om lokal antibiotika gel, 8,8 % Doxycyklin (Atridox®), kan förbättra läkningen av inflammerade tandköttsfickor hos vuxna rökande patienter under stödbehandling. Material och Metod I den här experimentellt blinda randomiserade studien valdes 20 rökande patienter (≥ 10 cigaretter/dag) med diagnos kronisk parodontit ut från ett parodontalt stödbehandlingsprogram. Varje patient hade ≥ 5 tänder, och ≥ 5 tandköttsfickor med fickdjup ≥ 5 millimeter. Patienterna indelades i två grupper, 10 i testgruppen (Doxycyklingel 8,8 %, Atridox®) och 10 i kontrollgruppen (Placebogel). Vid baseline och 3 månader efter behandling utfördes följande kliniska registreringar: fickdjup (PPD), klinisk fästenivå (CAL), blödning vid sondering (BOP), och plackindex (PLI) vid 4 ytor på alla indextänder. Mätning av mängden gingivalexudat (GI) utfördes vid 2 ytor på indextänder. Tandhygienist (KS) utförde scaling och debridering i hela bettet, även molarer (full-mouth). Tandläkare behandlade omgående patienterna i testgruppen med applicering av antibiotikagel Atridox® i minst 5 tandköttsfickor med primärt fickdjup ≥ 5 millimeter och blödning vid sondering. Patienterna i kontrollgruppen fick placebogel applicerad på motsvarande sätt. Efter applikationen av gel sköljde patienterna med 0,1 % klorhexidin i 7-10 dagar då mekanisk munhygien inte fick utföras under den perioden. Statistiska analyser Statistikprogram som användes var StatXact och Excel. Statistiska metoder Wilcoxon rank och Wilcoxon tecken rank test. P-värden ≤ 0.05 har bedömts som statistiskt signifikanta. Medelvärden över alla tänder/ytor har använts för varje patient och med patienten som statistisk enhet. Resultat När studien avslutades var det 16 patienter kvar. 4 patienter exkluderades ur studien på grund av sjukdom. Dessvärre visade det sig att bortfallet endast var i testgruppen som då bestod av 4 kvinnor och 2 män med genomsnittsålder 56,3 år. I kontrollgruppen ingick 5 kvinnor och 5 män med genomsnittsålder 59,4 år. Tre månader efter behandling noterades signifikant förbättring för testgruppen avseende PPD -1.36 mm (p=0.0313), signifikant förbättring för kontrollgruppen avseende PPD -1.07 mm (p=0.0020), CAL -0.65 mm (p=0.0200) och BoP (p=0.0078). Efter 3 månader fanns det ingen signifikant skillnad mellan test- och kontrollgrupp avseende samtliga parametrar. När resultaten av samtliga tänder (inklusive indextänder) analyserades noterades signifikant förbättring av PPD för både test- (p=0.0313) och kontrollgrupp (p=0.0039). Signifikant förbättring noterades även för kontrollgruppen av BOP, CAL och GI. Ingen signifikant skillnad mellan doxycyklin- respektive placebobehandlade bett avseende samtliga parametrar. Slutsats Resultatet av den här randomiserade kontrollerade studien kunde inte visa statistisk signifikant skillnad mellan test- och kontrollgrupp i det här begränsade materialet. Lokal antibiotikabehandling med 8,8 % Doxycyklingel (Atridox®) hade inte någon tilläggseffekt till scaling och debridering hos vuxna rökare med diagnos kronisk parodontit i ett stödbehandlingsprogram. Resultatet visade god läkning och signifikant förbättring av inflammerade tandköttsfickor efter subgingival scaling och debridering i både test- och kontrollgrupp utan någon skillnad mellan antibiotika- och placebogel.Title Clinical evaluation of local antibiotic treatment in smokers with chronic periodontitis in a maintenance care program. Authors Kerstin Stagnér, Gunilla Bratthall Institution Department of Periodontology, Faculty of Odontology, Malmö University Aim To evaluate if local antibiotics, 8.8 % doxycycline gel, can improve periodontal healing in smoking adults in a maintenance care program. Material and Methods In a double-blind randomized controlled study 20 smoking patients were selected from a maintenance care program. Each subject demonstrated at least 5 probing pocket depths (PPD) ≥ 5mm with bleeding on probing (BOP) in a minimum of 5 teeth. The patients were divided into 2 groups, the test group (8.8 % doxycycline gel, Atridox®) and the control group (placebo gel). At baseline and 3 months after treatment a clinical registration was performed, including PPD, clinical attachment level (CAL), BOP, and plaque index (PlI) at 4 sites of test- and control teeth. Gingival index (GI) was performed using Periotron® at 2 sites of all index-teeth. At baseline all subjects received full-mouth scaling followed with application of test or placebo gel in all index pockets. After gel application 0.1 % chlorhexidine was used for mouth rinsing during 7-10 days, since no mechanical oral hygiene was allowed during that period. Results There were 16 patients left in the end of the study. Four subjects in the test group had to be excluded because of disease. Three months after treatment significant improvement for PPD was shown both in the test (p=0.0313) and the control group (p=0.0020). Significant improvement for the control group was also demonstrated for CAL and BoP. There were no significant differences in any parameter in the change after 3 months between test - and control groups. When the results from all teeth (including index teeth) were analyzed significant improvement was shown in PPD both in the test (p=0.0313) and the control group (p=0.0039). Significant improvement for the control group was also demonstrated for CAL, BOP and GI.. There were no significant differences between test and placebo treated dentitions. Conclusion This study could not show any statistically significant clinical differences between the test - and control groups based on results of index teeth as well as all teeth. This means that local antibiotic treatment with 8.8 % doxycycline gel (Atridox®) did not show any additional effects to scaling. The results, however, showed significant improvement of periodontal pockets after subgingival scaling in both test- and control groups

Prevalence of cervical enamel projection and its correlation with furcation involvement in eskimos dry skulls

The objectives of this study were to investigate the prevalence of cervi-cal enamel projection (CEP) in molars of Eskimo dry skulls and to study the correlation of CEP with furcation involvement (FI). The ma-terial consisted of 834 upper and lower first and second permanent molars from 133 Eskimo dry skulls. CEPs were investigated from the buccal aspect of the tooth and classified according to a system modi-fied from Masters & Hoskins (12). FI was measured horizontally from the buccal aspect into the furcation with a graduated probe to the nearest mm. Any measurement > or = 2 mm was considered to have positive FI. The result showed a presence of 72% of CEPs among the examined molars. Grade III was found in 53%, Grade II in 9% and Grade I in 11% of the 834 molars. Lower molars had a higher preva-lence of CEPs (78%) than upper molars (67%). With the individual skull used as the unit for analysis, a statistically significant correlation of CEP with FI was found in upper right 2nd molar, upper left 1st mo-lar, lower left 1st and 2nd molars and lower right 1st molar. These re-sults may be of clinical importance since the impact of CEPs to perio-dontal treatment of FIs has been discussed

Functional effects of LPS and estrogen in the periodontium

Objectives: Several studies have addressed the association between changes in the female sex hormones estrogen levels and changes in parameters of periodontitis. Estrogen affects inflammatory conditions in different parts of the body, such as brain, cardiovascular system and in colon. The effects of LPS in PDL cell inflammatory versus normal physiological conditions are poorly mapped. The aim of the present study was to investigate how LPS affects PDL cell inflammatory versus normal physiological characteristics, and if the effect of LPS was reversed by estrogen. Methods: Human PDL cells were obtained from teeth extracted for orthodontic reasons. The cells were cultured from periodontal tissue explants and used in passages 3-5. The cells were treated with different concentrations of Escherichia coli LPS in the absence or presence of estrogen. Cytokine (IL-6 and CRP) and chemokine (MCP-1) production was measured using ELISA. DNA and collagen synthesis was determined by measuring the incorporation of [3H]thymidine and [3H]proline, respectively. ALP activity was determined colorimetrically. All measurements were normalized to total amount of protein. Results and Conclusions: LPS enhanced the inflammatory characteristics of PDL cells, reflected by enhanced production of IL-6 and MCP-1 but did not effect CRP production. LPS had no effect on collagen and DNA synthesis and alkaline phosphatase activity, however, which suggests that LPS does not affect the physiological properties of PDL cells. Estrogen did not reverse LPS-induced IL-6 and MCP-1 production. The present study suggests that PDL cells in response to LPS via enhanced MCP-1 production contribute to the recruitment of leucocytes to the area of inflammation in periodontitis

Implication of cervical enamel projection to furcation involvement in molars. A pilot clinical study

The aim of this study was to investigate the correlation of cervical enamel projection (CEP) with furcation involvement (FI) and compare the healing response of molars with or without CEP after surgery. A total of 30 patients contributing 78 maxillary and mandibular first or second molars were included. Plaque Index (PII), Gingival Index (GI), probing pocket depth (PPD) and probing attachment level (PAL) were measured before surgery and 1 and 3 or 6 months postoperatively. During surgery, CEPs were identified and classified with a modified grading system from Masters & Hoskins (24). FI was measured hori-zontally from the buccal aspect into the furcation with a graduated probe to the nearest mm. Any measurement > or = 1 mm was consid-ered as FI. CEPs were found in 33 molars (42%). Grade III CEPs were found in 14 teeth, Grade IIIb in 4 teeth, Grade II in 1 tooth and Grade I in 14 teeth. The results showed no significant correlation of CEP with FI. Nor was CEP significantly affecting the PPD and PAL 3 or 6 months after surgery. However, FI was a significant factor in the fur-ther loss of PAL after surgery. Further studies, involving larger sample size may be necessary in order to give more conclusive results

Implications of cervical enamel projection to furcation involvement in molars. A pilot clinical study

The aim of this study was to investigate the correlation of cervical enamel projection (CEP) with furcation involvement (FI) and compare the healing response of molars with or without CEP after surgery. A total of 30 patients contributing 78 maxillary and mandibular first or second molars were included. Plaque Index (PlI), Gingival Index (GI), probing pocket depth (PPD) and probing attachment level (PAL) were measured before surgery and 1 and 3 or 6 months postoperatively. During surgery, CEPs were identified and classified with a modified grading system from Masters & Hoskins (1964). FI was measured horizontally from the buccal aspect into the furcation with a graduated probe to the nearest mm. Any measurement ³ 1mm was considered as FI. CEPs were found in 33 molars (42%). Grade III CEPs were found in 14 teeth, Grade IIIb in 4 teeth, Grade II in 1 tooth and Grade I in 14 teeth. The results showed no significant correlation of CEP with FI. Nor was CEP significantly affecting the PPD and PAL 3 or 6 months after surgery. However, FI was a significant factor in the further loss of PAL after surgery. Further studies, involving larger sample size may be necessary in order to give more conclusive results

Alpha-1-antitrypsin deficiency and periodontitis, a pilot study

Proteases are capable of tissue breakdown. Plasma and gingival crevicular fluid (GCF) contain antiproteases, such as alfa-1-antitirypsin (AAT). Lack of AAT may lead to periodontal destruction. The aim was to study if periodontal parameters and elastase in GCF and plasma are different in AAT deficient subjects compared to subjects without AAT deficiency. Material & methods: 30 subjects were included, 20 of whom with severe AAT deficiency. Ten of them suffered from chronic obstructive pulmonary disease (group 1) and 10 were asymptomatic (group 2). Ten control subjects (group 3) were recruited from a public dental clinic. The examination comprised GCF, Gingival index (GI), Plaque Index (PlI), probing pocket depth (PPD) and radiography. GCF was collected with paper strips (Periopaper®). Plasma AAT concentration was measured by nephelometry and AAT in GCF with ELISA. Elastase activity and protein in plasma and GCF were determined by spectrophotometry. Results: The mean values for GI, PlI, PPD and the radiological measurements did not show any statistically significant differences between the groups. AAT in GCF and plasma did not show any significant difference between group 1 and 2 but a statistical difference in comparison with group 3. Elastase in GCF and plasma did not show any difference between the three groups. In conclusion no differences were found between AAT deficient subjects and healthy controls in this limited material