Abstract
Objective: The present study aimed to assess of four liver enzymes, Alanine Aminotransferase (ALT), Aspartate Transaminase (AST), Alkaline Phosphatase (ALP) and Gamma-Glutamyl Transpeptidase (GGT). 
 Material and Methods: Based on periodontal clinical parameters, sixty four patients with chronic periodontitis (CP) and twenty four controls were enrolled in the study. Saliva and serum samples were collected and Automated Chemistry Analyzer AU 480 was employed to assess levels of enzymes. Results: Compared to healthy controls, the levels of the four enzymes were significant increased in serum of patients, especially in the severe group while in the saliva a significant increase observed only in the level of AST. Moreover, Alanine Aminotransferase (ALT), Aspartate Transaminase (AST), Alkaline Phosphatase (ALP) and Gamma-Glutamyl Transpeptidase (GGT) the levels of these enzymes in serum were significantly higher than those in saliva. 
 Conclusion: ALT, AST, ALP and GGT serum levels are suggested to be important indicators for disease progression as well as predict the liver health.
Highlights
Chronic Periodontitis Disease (CPD) is a chronic multi-factorial inflammation disease because contribution of genetic and environmental factors as well as age, living standards and systemic diseases to initiation and progression of disease [1,2,3], which occurs in the supporting tissues of the tooth, that include gingiva, periodontal ligament, cementum and alveolar bone this is caused by the accumulation of bacterial groups on the surfaces of the teeth as well as between the teeth and will lead to side effects on the health gingiva due to the stimulation of the immune response against these bacterial assemblies that lead to damage and destroyed of gingival tissues and observed that the sensitivity of the host plays an important role in the initiation and development of chronic periodontitis [4,5]
In CPD the inflammation begins by releasing many of these biomarkers in responses to bacterial antigens such as chemical mediators and enzymes from infected gingival tissues and activation immune cells [7], in addition the level of periodontal destruction depends on the balance between destructive and protective mediators [8], and the most periodontal related inflammatory mediators are IL-8, IL-1, TNF-α, IP-10, MIP-1, MCP-1 and CTGF [9,10,11], activation of different enzymes reflected metabolic changes of the gingiva and teeth periodontium in inflammation such as Alanine Aminotransferase, Aspartate Transaminase, Alkaline Phosphatase, Gamma-Glutamyl Transpeptidase, acidic phosphatase, creatine kinase, lactate dehydrogenase and adenosine deaminase [12,13,14]
The patients were classified according to the clinical examination : probing pocket depth (PPD), clinical attachment level (CAL) and plaque index (PLI) into three clinical groups 30 mild their age mean ± S.E. was (40.53±2.33), 26 moderate their age mean ± S.E. was (39.30±2.03) and 8 severe their age mean ± S.E. was (40.50±2.87) cases [17]
Summary
Chronic Periodontitis Disease (CPD) is a chronic multi-factorial inflammation disease because contribution of genetic and environmental factors as well as age, living standards and systemic diseases to initiation and progression of disease [1,2,3], which occurs in the supporting tissues of the tooth, that include gingiva , periodontal ligament , cementum and alveolar bone this is caused by the accumulation of bacterial groups on the surfaces of the teeth as well as between the teeth and will lead to side effects on the health gingiva due to the stimulation of the immune response against these bacterial assemblies that lead to damage and destroyed of gingival tissues and observed that the sensitivity of the host plays an important role in the initiation and development of chronic periodontitis [4,5]. The present study was planned to evaluation of liver enzymes in saliva and serum in a sample of Iraqi patients and to compare if enzymes present in saliva could be a viable alternative biomarker for knowing the progress of the periodontal diseases
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