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Kayar NA, Oduncuoğlu BF, Haliloğlu S, Serpek B, Ataoğlu T, Alptekin NÖ. Methodological evaluation of gingival crevicular fluid volume and neutrophil elastase levels: sequential sampling, length of sampling time and two different sampling methods. Acta Odontol Scand 2020; 78:290-296. [PMID: 31852321 DOI: 10.1080/00016357.2019.1703141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives: The mechanisms underlying the formation and composition of gingival crevicular fluid (GCF) and its flow into and from periodontal pockets are not understood very well. The aim of this study was to evaluate the length of sampling time and sequential sampling of GCF neutrophil elastase (NE) enzyme levels by using intracrevicular and orifice methods.Material and methods: Twenty adults (mean age of 41.8 years, ranged 31-60 years, 18 males and 2 females) with chronic periodontitis were enrolled and all completed the 3-d study. GCF was collected by both intracrevicular and intrasulcular methods, 720 samples of GCF were collected. In first, second and third day, the length of sampling time in seconds (s) and order were '5- 10-30-s'; '10- 30- 5-s' and '30- 5- 10-s,' respectively. GCF elastase levels were determined by hydrolysis of neutrophil specific substrate N-methoxysuccinyl-Ala-Ala-Pro-Val-p-nitroanilide.Results: NE activity (µU) and NE activity/volume (µU/µl) were significantly different for order of sampling (p < .05), but not for the length of sampling time (p>.05).Conclusions: Within the limits of this study, the choice of sampling technique in GCF-profile studies seems to be a critical decision as it has the potential to affect the GCF volume and NE activity.
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Affiliation(s)
- Nezahat Arzu Kayar
- Department of Periodontology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | | | - Seyfullah Haliloğlu
- Department of Biochemistry, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Behiç Serpek
- Department of Biochemistry, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Tamer Ataoğlu
- Department of Periodontology, Faculty of Dentistry, Medipol University, İstanbul, Turkey
| | - Nilgün Özlem Alptekin
- Department of Periodontology, Faculty of Dentistry, Başkent University, Ankara, Turkey
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Tatsi C, Toumba KJ. Effect of fluoride slow-release glass devices on salivary and gingival crevicular fluid levels of fluoride: A pilot study. Clin Exp Dent Res 2019; 5:620-626. [PMID: 31890298 PMCID: PMC6934337 DOI: 10.1002/cre2.227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/11/2019] [Accepted: 07/11/2019] [Indexed: 11/15/2022] Open
Abstract
Objectives To estimate the effect of fluoride slow-release glass devices on the levels of fluoride in a pooled sample of human gingival crevicular fluid and in human saliva. Materials and Methods Ten healthy adult volunteers wore fluoride slow-release glass devices for 3 months in a longitudinal experimental clinical pilot study. Whole unstimulated human saliva and gingival crevicular fluid were collected using paper points at baseline, after 2 weeks and at 3 months and analysed for their fluoride levels using ion chromatography and fluoride electrode. Results No adverse effects were reported, and the Löe Plaque and Gingival Index remained low (0.22). The saliva determination of fluoride using the fluoride electrode showed an increase after 3 months from 0.02 ± 0.04 ppm to 0.06 ± 0.12 ppm, whereas the ion chromatography showed an increase from 0.15 ± 0.10 ppm to 0.44 ± 0.36 ppm. The fluoride levels in a pooled sample of gingival crevicular fluid from four intraoral sites were determined using the ion chromatography, and the results showed that after 3 months, the fluoride levels were still low (0.71 ± 0.34 ppb) similar to those at baseline (0.74 ± 0.31 ppb). Conclusions The fluoride concentration in a pooled sample of gingival crevicular fluid was reported to be low with a range from 0.46 to 0.75 ppb and was not changed by placement of fluoride slow-release glass devices. The fluoride concentration in unstimulated human saliva showed an increase after 3 months when the fluoride slow-release glass devices were attached when determined with both the fluoride electrode (from .02 ± 0.04 ppm to 0.06 ± 0.12 ppm) and ion chromatography (from 0.15 ± 0.10 ppm to 0.44 ± 0.36 ppm).
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Affiliation(s)
- Chrysoula Tatsi
- Department of Paediatric Dentistry, Leeds School of DentistryUniversity of LeedsLeedsLUUK
| | - Kyriacos Jack Toumba
- Department of Paediatric Dentistry, Leeds School of DentistryUniversity of LeedsLeedsLUUK
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Chatzopoulos GS, Mansky KC, Lunos S, Costalonga M, Wolff LF. Sclerostin and WNT‐5a gingival protein levels in chronic periodontitis and health. J Periodontal Res 2019; 54:555-565. [DOI: 10.1111/jre.12659] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/18/2019] [Accepted: 03/09/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Georgios S. Chatzopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry University of Minnesota Minneapolis Minnesota
| | - Kim C. Mansky
- Division of Orthodontics, Department of Developmental and Surgical Sciences, School of Dentistry University of Minnesota Minneapolis Minnesota
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute University of Minnesota Minneapolis Minnesota
| | - Massimo Costalonga
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry University of Minnesota Minneapolis Minnesota
| | - Larry F. Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry University of Minnesota Minneapolis Minnesota
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Lu R, Meng H, Gao X, Xu L, Feng X. Effect of non-surgical periodontal treatment on short chain fatty acid levels in gingival crevicular fluid of patients with generalized aggressive periodontitis. J Periodontal Res 2013; 49:574-83. [PMID: 25340203 DOI: 10.1111/jre.12137] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- R. Lu
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - H. Meng
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - X. Gao
- Department of Cariology and Endodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - L. Xu
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
| | - X. Feng
- Department of Periodontology; Peking University School and Hospital of Stomatology; Beijing China
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Gupta M, Chaturvedi R, Jain A. Role of monocyte chemoattractant protein-1 (MCP-1) as an immune-diagnostic biomarker in the pathogenesis of chronic periodontal disease. Cytokine 2013; 61:892-7. [PMID: 23375122 DOI: 10.1016/j.cyto.2012.12.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 12/06/2012] [Accepted: 12/19/2012] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Monocyte chemoattractant protein-1 (MCP-1) is an important chemokine responsible for the initiation, regulation and mobilization of monocytes to the active sites of severe periodontal inflammation. The present study aims at evaluating the levels of MCP-1 in GCF, saliva and serum and to analyze the changes following phase I periodontal therapy. Assessment of possible correlations between levels of MCP-1 in the three biological fluids was also done. METHODS Fifteen healthy and 30 patients of severe chronic periodontitis (diseased) participated in the study. Patients of the diseased group underwent scaling/root planing. Evaluation of PI, GI, PD, CAL and collection of samples of GCF, serum and saliva was done at baseline and 6 weeks following periodontal therapy. MCP-1 levels were quantified in all samples using ELISA. RESULTS Compared to healthy controls, MCP-1 levels were statistically significantly higher in GCF (p<0.001), saliva (p=0.002) and serum (p<0.001) in subjects with chronic periodontitis. Levels of MCP-1 in all the three fluids decreased significantly in patients after periodontal therapy (p<0.001). There was a significant positive correlation between MCP-1 levels in GCF, saliva and serum in patients of chronic periodontitis both pre (r>0.9) and post-treatment (r>0.6). CONCLUSIONS The results suggest that levels of MCP-1 in GCF and saliva can be reliable indicators of severity of periodontal destruction and their serum levels reflect the systemic impact of this local inflammatory disease thereby strengthening the reciprocal oro-systemic association.
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Affiliation(s)
- Mili Gupta
- Department of Biochemistry, Dr. Harvansh Singh Judge, Institute of Dental Sciences & Hospital, Panjab University, Chandigarh, India.
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Perinetti G, Di Leonardo B, Di Lenarda R, Contardo L. Repeatability of gingival crevicular fluid collection and quantification, as determined through its alkaline phosphatase activity: implications for diagnostic use. J Periodontal Res 2012; 48:98-104. [PMID: 22817691 DOI: 10.1111/j.1600-0765.2012.01508.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE In spite of four decades of studies on gingival crevicular fluid, no data have been reported on the repeatability of gingival crevicular fluid collection and the subsequent quantification procedures. The present study reports, for the first time, on the repeatability and method error of gingival crevicular fluid collection and quantification, as determined through its alkaline phosphatase (ALP) activity. Diagnostic considerations are then explored. MATERIAL AND METHODS Twenty-seven healthy subjects (17 women and 10 men; mean age ± SD, 21.2 ± 4.8 years) with optimal periodontal status were enrolled according to a blind prospective design. The gingival crevicular fluid was collected at baseline, and after 1 d, 1 wk and 3 mo. At each clinical session, two consecutive rounds of gingival crevicular fluid collection were made from each of the four maxillary incisors, allowing the recovery of resting and flow gingival crevicular fluid. The total ALP activities were determined spectrophotometrically, and repeatability and method errors for the resting, flow and overall (resting + flow) gingival crevicular fluid ALP activities were calculated, relative to the corresponding baseline levels. RESULTS No significant differences were seen over time, although the flow gingival crevicular fluid ALP activity was generally lower than that for the resting gingival crevicular fluid. The method errors ranged from 40 to 58%, with the flow and overall gingival crevicular fluid activities showing the highest and lowest errors, respectively. CONCLUSION Reliable use of the gingival crevicular fluid ALP collection and quantification, both in research and diagnosis on an individual basis, should take into account relevant errors, and variations are to be considered as true only above relevant thresholds.
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Affiliation(s)
- G Perinetti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
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Castro CE, Koss MA, López ME. Intracytoplasmic enzymes in gingival crevicular fluid of patients with aggressive periodontitis. J Periodontal Res 2011; 46:522-7. [PMID: 21488876 DOI: 10.1111/j.1600-0765.2011.01367.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Biochemical parameters of crevicular fluid could provide evidence of periodontal tissue disease. The aim of this study was to analyze enzymes in crevicular fluid in aggressive localized and generalized periodontitis. MATERIAL AND METHODS One hundred and twenty-four subjects were classified as having localized (n = 36) or generalized aggressive periodontitis (n = 38) and subclassified into moderate and severe groups. Controls were 50 periodontitis-free subjects. Activities of the enzymes lactate dehydrogenase, neutrophil elastase, alkaline phosphatase and aspartate aminotransferase were determined. Data were analyzed using one-way ANOVA and Tukey's test. RESULTS Among the subjects with localized aggressive periodontitis, values of lactate dehydrogenase and alkaline phosphatase increased notably in moderate and severe periodontitis compared with control subjects. Values for aspartate aminotransferase increased with the severity of the disease, and neutrophil elastase was increased in the moderate and severe states. In generalized aggressive periodontitis, lactate dehydrogenase showed higher values than in control subjects in both periodontal subgroups. Alkaline phosphatase and neutrophil elastase showed higher significant differences between moderate and severe periodontitis compared with the control group. Aspartate aminotransferase showed differences between the severe and moderate periodontitis groups compared with the control group. Of all the enzymes analyzed, only lactate dehydrogenase showed higher values in localized than in generalized aggressive periodontitis. CONCLUSION Lactate dehydrogenase may distinguish localized and generalized aggressive periodontitis. Alkaline phosphatase increases from moderate to severe states in both types of periodontitis. Aspartate aminotransferase and neutrophil elastase only increase with strong evidence of periodontal destruction.
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Affiliation(s)
- C E Castro
- Department of Periodontology, Faculty of Dentistry, National University of Tucumán, San Miguel de Tucumán, Argentina
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Drummond S, Canavarro C, Perinetti G, Teles R, Capelli J. The monitoring of gingival crevicular fluid volume during orthodontic treatment: a longitudinal randomized split-mouth study. Eur J Orthod 2011; 34:109-13. [PMID: 21273285 DOI: 10.1093/ejo/cjq172] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
UNLABELLED This randomized split-mouth study was aimed at evaluating whether an orthodontic appliance per se or orthodontic tooth movement can induce detectable changes in gingival crevicular fluid (GCF) volume, and thus whether GCF volume is a predictable biomarker for tissue remodelling incident to orthodontic tooth movement. MATERIALS AND METHODS Sixteen healthy orthodontic patients (7 females and 9 males; mean age, 17.7 years; range, 13-27 years) with the need for extraction of the first upper premolars were enrolled. One randomly chosen maxillary canine was subjected to a distalizing force by a 0.017 × 0.025 inch titanium-molybdenum alloy archwire and considered as the test tooth (TT). The contralateral canine, which was not subjected to any force but was included in an orthodontic appliance, was used as a control (CT). GCF sampling was performed at both mesial and distal sites of the CTs and TTs at baseline, immediately before applying the orthodontic appliance, and after 1 hour, 24 hours, and 7, 14, and 21 days. A Periotron was used to measure the GCF volume. A modest but significant increase in the GCF volume over time was seen in both the CTs (mesial sites) and the TTs (both mesial and distal sites) with no differences between the experimental teeth. Subclinical tissue inflammation consequent to the placement of the orthodontic appliance might be responsible for these GCF volume changes. The GCF volume does not appear to be a reliable biomarker for tissue remodelling during orthodontic treatment.
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Affiliation(s)
- S Drummond
- Department of Orthodontics, School of Dentistry, Rio de Janeiro State University, Bl. 28 de Setembro 157, Rio de Janeiro, Brazil.
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Guentsch A, Kramesberger M, Sroka A, Pfister W, Potempa J, Eick S. Comparison of gingival crevicular fluid sampling methods in patients with severe chronic periodontitis. J Periodontol 2011; 82:1051-60. [PMID: 21235330 DOI: 10.1902/jop.2011.100565] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The analysis of samplings from periodontal pockets is important in the diagnosis and therapy of periodontitis. In this study, three different sampling techniques were compared to determine whether one method yielded samples suitable for the reproducible and simultaneous determination of bacterial load, cytokines, neutrophil elastase, and arginine-specific gingipains (Rgps). Rgps are an important virulence factor of Porphyromonas gingivalis, the exact concentration of which in gingival crevicular fluid (GCF) has not been quantified. METHODS GCF was sampled from four sites per patient (one sample per quadrant using two samples per method) in 36 patients with chronic periodontitis. One week later, the procedure was repeated with alternative methods. Variables determined were loads of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) and P. gingivalis, levels of interleukin-6 and -8, activity of neutrophil elastase, and level of Rgps. RESULTS The detected cytokine levels were higher using paper strips compared to paper points. Bacteria were found in similar loads from paper strips and paper points. Rgps were only detectable in high quantities by washing the periodontal pocket. The level of Rgps correlated with the load of P. gingivalis. CONCLUSIONS The use of paper strips was suitable for the simultaneous determination of microbial and immunologic parameters. Obtaining GCF by washing can be useful for special purposes. The gingipain concentration in periodontal pockets was directly determined to be ≤1.5 μM. This value indicated that most of the substrates of these proteases by in vitro assays identified until now can be easily degraded in P. gingivalis-infected sites.
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Affiliation(s)
- Arndt Guentsch
- Department of Conservative Dentistry, University Hospital, Jena, Germany
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Koss MA, Castro CE, Salúm KM, López ME. Enzymatic Profile of Gingival Crevicular Fluid in Association With Periodontal Status. Lab Med 2009. [DOI: 10.1309/lmcnuqi8ulcuk2bk] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Khoury SB, Thomas L, Walters JD, Sheridan JF, Leblebicioglu B. Early wound healing following one-stage dental implant placement with and without antibiotic prophylaxis: a pilot study. J Periodontol 2009; 79:1904-12. [PMID: 18834245 DOI: 10.1902/jop.2008.070670] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND One-stage implant placement has clinically acceptable treatment outcomes. Among other advantages, it may allow investigation of early wound healing. The purpose of this pilot study was to determine whether peri-implant crevicular fluid (PICF) can be used to detect early changes around implants placed with one-stage surgical protocol following 1 week of healing. METHODS Twenty subjects (11 males and nine females; aged 22 to 72 years; two smokers) were included. Exclusion criteria were allergies to amoxicillin and systemic conditions that may affect healing. Subjects had a healthy periodontium and needed a single implant; eight received antibiotic prophylaxis, and 12 served as controls. Clinical healing was evaluated with plaque and gingival indices (PI and GI, respectively). Gingival crevicular fluid (GCF) from the surgical site was obtained prior to the surgery, whereas PICF was collected at the 1-week visit. Enzyme-linked immunosorbent assay was used to determine GCF/PICF interleukin (IL)-1beta and -8 concentrations. Peripheral blood and GCF antibiotic levels were measured by high-performance liquid chromatography. RESULTS Postoperative PI and GI were slightly increased. Total GCF and PICF volumes did not show a significant difference between appointments. There was an increase in PICF IL-1beta and -8 levels at 1 week postoperatively. Mean amoxicillin serum concentration was 5.1 +/- 2 microg/ml at 1 to 4 hours following the initial dose, whereas GCF amoxicillin levels were below the limit of detection. Antibiotic prophylaxis had a modest effect on clinical indices (PI and GI) and no appreciable effect on biomarkers. CONCLUSIONS PICF content can be studied as early as 1 week following one-stage implant placement. The results raise doubts regarding the clinical usefulness of amoxicillin prophylaxis.
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Hatipoğlu H, Yamalik N, Berberoğlu A, Eratalay K. Impact of the Distinct Sampling Area on Volumetric Features of Gingival Crevicular Fluid. J Periodontol 2007; 78:705-15. [PMID: 17397319 DOI: 10.1902/jop.2007.060331] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Volumetric features of gingival crevicular fluid (GCF) are under the influence of many factors, including sampling variables. Standardizing such factors may enable a more precise methodology. Thus, analysis of the possible impact of the clinical periodontal status and the distinct location of sampling sites on fluid volume was performed. METHODS Clinical parameters were recorded, and fluid samples were obtained from 931 maxillary sites. The potential site-specific volumetric differences among healthy, gingivitis, and periodontitis sites; between multirooted or single-rooted teeth and mesio-buccal or disto-buccal sampling sites; and the correlations between volume and clinical measures were statistically analyzed. RESULTS Although volume increased in a disease-related pattern (healthy < gingivitis < periodontitis; P <0.05), the distribution range of volume was widespread, with prominent overlaps between the different clinical periodontal conditions. Multirooted teeth presented more fluid volume, and even mesio-buccal or disto-buccal sites exhibited some volumetric differences (P <0.05). Constant correlations between volume and clinical parameters could be observed only at gingivitis sites (P <0.05). CONCLUSIONS The spectrum of fluid volume is disease related in general. However, the wide range of volumetric distribution, the site-specific nature, and the clear impact of the distinct sampling site on volume are important volumetric features of this biologic fluid. Whenever possible, standardization of the extent of probing depth, degree of gingival inflammation, and distinct sampling area is likely to improve the reliability of GCF methodology.
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Affiliation(s)
- Hasan Hatipoğlu
- Department of Periodontology, Faculty of Dentistry, University of Hacettepe, Ankara, Turkey
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Hanioka T, Matsuse R, Shigemoto Y, Ojima M, Shizukuishi S. Relationship between periodontal disease status and combination of biochemical assays of gingival crevicular fluid. J Periodontal Res 2005; 40:331-8. [PMID: 15966911 DOI: 10.1111/j.1600-0765.2005.00807.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Currently, no biochemical assay involving gingival crevicular fluid is utilized routinely as a screening test for periodontal disease. OBJECTIVE The objective of the present study was to evaluate the potential of gingival crevicular fluid assay as a screening methodology. METHODS The subject population was comprised of 27 volunteers. Nine participants were classified as 'subject with periodontal destruction' (SPD) exhibiting at least one site with pocket depth and attachment loss>3.5 mm, whereas the remaining individuals were categorized as 'subject with minimal periodontal destruction' (SMD). Gingival crevicular fluid was collected from fixed sites via a standardized method. Biochemical assays of 12 substances (hemoglobin, albumin, transferrin, alpha(1)-antitrypsin, fibronectin, IgA, IgG, IgM, lactoferrin, myeloperoxidase and neutrophil elastase) were conducted at a commercial laboratory. Power transformation of total quantities in gingival crevicular fluid was performed for statistical analysis. RESULTS Relationships between total quantity of each substance and periodontal disease status were unclear. Logistic regression analysis yielded six predictive models, which consisted of substance pairs: neutrophil elastase/IgA, neutrophil elastase/hemoglobin, neutrophil elastase/alpha(1)-antitrypsin and neutrophil elastase/IgG, and IgA/albumin and IgA/transferrin (p<0.05). Regression lines for SPD and SMD on a scattergram of IgA and neutrophil elastase were nearly parallel within the range of amounts in gingival crevicular fluid. The predictive model derived from both substances afforded sensitivity and specificity of 88% and 94%, respectively. CONCLUSIONS These results indicated that the combination of IgA and neutrophil elastase in gingival crevicular fluid may be crucial for prediction of periodontal disease status. Furthermore, these data suggested that biochemical assays employing both substances in gingival crevicular fluid may provide a satisfactory screening test for periodontal disease.
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Affiliation(s)
- Takashi Hanioka
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan.
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Tsalikis LE, Kaklamanos EG, Kavadia-Tsatala S, Chasapopoulou E, Pidonia-Manika I. Association of gingival crevicular fluid and serum intracytoplasmic enzyme levels in periodontally healthy homozygous (major) beta-thalassemia patients. J Clin Periodontol 2004; 31:356-63. [PMID: 15086617 DOI: 10.1111/j.1600-051x.2004.00485.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess tissue necrosis in beta-thalassemia major patients, as in other areas of medicine, lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) have been widely used. These markers of tissue degradation have also been studied in the gingival crevicular fluid (GCF) in relation to periodontal disease status. The purpose of this study was to investigate whether periodontal diagnostic tests based on these markers of tissue degradation are influenced from the enzymes' levels in serum and, therefore, could be used in the assessment of the patient's periodontal status. MATERIAL AND METHODS Forty-four periodontally healthy, homozygous beta-thalassemia patients were enrolled in the study. GCF and serum samples were obtained and the levels of AST, ALT and LDH were determined; the measurements took place in an automated analyzer (Hitachi 777) using the kits of Roche Company. RESULTS Lack of correlations between serum and GCF enzyme levels was demonstrated. Serum LDH and serum AST, serum AST and serum ALT are significantly positively correlated. Concerning the GCF, AST and ALT were proved to be significantly positively correlated. CONCLUSIONS Elevated values of LDH, ALT and AST in serum do not constitute a confounding factor in GCF measurements of the respective enzymes.
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Affiliation(s)
- Lazaros E Tsalikis
- Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Greece.
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Yucekal-Tuncer B, Uygur C, Firatli E. Gingival crevicular fluid levels of aspartate amino transferase, sulfide ions and N-benzoyl-DL-arginine-2-naphthylamide in diabetic patients with chronic periodontitis. J Clin Periodontol 2004; 30:1053-60. [PMID: 15002891 DOI: 10.1046/j.0303-6979.2003.00426.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The aim of this study is to analyze the correlations between plaque index (PlI), gingival index (GI), probable pocket depth (PPD), clinical attachment level (CAL), aspartate aminotransferase (AST), N-benzoyl-DL-arginine-2-naphthylamide (BANA) and sulfide ion activity (SIA) of diabetic patients with chronic periodontitis with regard to disease activity detected by AST levels. MATERIAL AND METHODS A total of 95 sites from eight diabetic patients with chronic periodontitis and 74 sites from eight systemically healthy patients with chronic periodontitis were enrolled in the study. The patients had no history of periodontal treatment or any antibiotic therapy during the last 6 months and were nonsmokers. All the sites selected for the study had a CAL of at least 2 mm. Gingival crevicular fluid volumes (GCFV) were measured in all sites. RESULTS According to the result of AST analysis, 45 sites were AST positive and 50 were AST negative in the diabetic group and 36 sites were AST positive and 38 were AST negative in the control group. There was a significant correlation between BANA hydrolysis and PPD in both diabetic and control groups, but no correlation between PPD and AST levels. A significant correlation was observed between AST-positive sites and GI, but not between GI and BANA hydrolysis. In both groups, the correlation between SIA and BANA hydrolysis was significant, but no correlation was revealed between SIA and AST levels in either diabetic or control groups. CONCLUSION The GCF metabolites had significant correlations with periodontally diseased sites in patients with chronic periodontitis, whether diabetic or systemically healthy, and may help to confirm clinical findings.
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Affiliation(s)
- B Yucekal-Tuncer
- Department of Periodontology, School of Dentistry, Istanbul University, Isthanbul, Turkey
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Jin L, Yu C, Corbet EF. Granulocyte elastase activity in static and flow gingival crevicular fluid. J Periodontal Res 2003; 38:303-10. [PMID: 12753369 DOI: 10.1034/j.1600-0765.2003.00606.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study aimed to evaluate the volume of gingival crevicular fluid (GCF) and granulocyte elastase activity in static GCF (sGCF) and flow GCF (fGCF) from subjects with various periodontal conditions. METHODS Eleven periodontally healthy, 10 gingivitis and 12 periodontitis subjects were recruited and the sites investigated consisted of healthy sites from healthy subjects (HH); healthy (HG) and gingivitis sites (GG) from gingivitis subjects; and healthy (HP), gingivitis (GP) and periodontitis sites (PP) from periodontitis subjects. fGCF samples were collected either 1 min or 5 min following sGCF collection by paper strip technique. GCF volume was determined by Periotron 6000 and granulocyte elastase activity was assayed with a specific substrate [l-pyroglutamyl-l-prolyl-l-valine-p-nitroanilide(pGluProVal-pNA)]. RESULTS At baseline, no significant differences existed in clinical and GCF parameters between the two matched sites for subsequent collection of fGCF samples either 1 min or 5 min after sGCF sampling in all subjects. The flow exudate in HG and HP sites quickly replenished to sGCF levels, while a delayed replenishment was found in HH sites, despite the similar sGCF volumes of these sites. The GCF volume and elastase levels in the fGCF at 1 min were higher in GP sites than in GG sites (P < 0.05). Overall, depletion of elastase levels in the fGCF at 1 min was observed in all subjects, whereas elastase levels in the fGCF at 5 min had replenished to sGCF levels in HP, GP, PP sites and GG sites, but had remained at a lower level in HH and HG sites. An overall positive correlation was found between sGCF and fGCF for GCF volume and elastase activity (P < 0.001); however, this correlation varied with GCF parameters and with site conditions of the subjects concerned. CONCLUSIONS This study shows that patterns of dynamic changes in GCF flow and elastase activity varied under different periodontal conditions. Assessment of both sGCF and fGCF may allow better insight into the dynamic change of the target components in GCF.
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Affiliation(s)
- Lijian Jin
- Faculty of Dentistry, Periodontology, The University of Hong Kong, Hong Kong SAR, China.
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Lamster IB. Evaluation of components of gingival crevicular fluid as diagnostic tests. ANNALS OF PERIODONTOLOGY 1997; 2:123-37. [PMID: 9151549 DOI: 10.1902/annals.1997.2.1.123] [Citation(s) in RCA: 125] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Gingival crevicular fluid (GCF) is an inflammatory exudate that can be collected at the gingival margin or within the gingival crevice. The biochemical analysis of the fluid offers a noninvasive means of assessing the host response in periodontal disease. In recent years, the relationship of measures of the inflammatory response in GCF to risk for development of active periodontal disease (defined as clinical attachment loss or radiographic bone loss) has been studied in longitudinal trials. The greatest interest has focused on prostaglandin E2, an arachidonic acid metabolite; beta-glucuronidase and neutrophil elastase, markers of lysosomal enzyme release from neutrophils; and aspartate aminotransferase, a cytoplasmic enzyme indicative of cellular necrosis. Analysis of the data allows a number of conclusions to be drawn concerning the potential diagnostic significance of GCF: 1) an exuberant host inflammatory response is associated with progressive disease in patients with periodontitis; 2) collection of GCF using small precut strips is a reproducible and reliable collection technique; 3) the total amount of the mediator and not concentration of the mediator in the GCF sample can be reported when timed samples are collected; and 4) technology exists for GCF-based diagnostic tests to be performed in the dental office. Nevertheless, many questions remain. Still to be determined are: 1) the relationship of test results to the development of periodontitis in patients with gingivitis; 2) the level of test accuracy needed to justify use of these tests; 3) the unit of observation (patient, site) that is being evaluated by the test; and 4) the need for such tests as perceived by clinicians. While these questions are formidable, introduction of GCF-based diagnostic tests will provide clinicians with an improved, quantitative means of evaluating patients and offer specific criteria to assess the effectiveness of treatment.
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Affiliation(s)
- I B Lamster
- Division of Periodontics, Columbia University School of Dental and Oral Surgery, New York, New York, USA
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Affiliation(s)
- H E Schroeder
- Institute of Oral Structural Biology, University of Zurich, Switzerland
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Affiliation(s)
- G C Armitage
- Division of Periodontology, School of Dentistry, University of California, San Francisco, USA
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Uitto VJ, Nieminen A, Coil J, Hurttia H, Larjava H. Oral fluid elastase as an indicator of periodontal health. J Clin Periodontol 1996; 23:30-7. [PMID: 8636454 DOI: 10.1111/j.1600-051x.1996.tb00501.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The study was designed to find out whether oral elastase activity could be used as a simple biochemical indicator of periodontal health. Both stimulated whole saliva and water rinse samples were collected from subjects with different degrees of adult periodontitis, gingivitis or healthy periodontium. In both sample types, elastase was mostly bound to insoluble fraction and preferred valine containing synthetic substrate, similar to neutrophil elastase. The elastase measurement required very little manipulation or time and its reproducibility was found to be good. The elastase levels were found to be negligible in edentulous subjects and usually very low in subjects with healthy periodontium. In about 85% of periodontitis cases having at least 1 deep periodontal pocket ( > or = 6 mm), clearly elevated elastases levels were detected in both the saliva and r rinse samples. In advanced periodontitis cases, the colour reaction took place in 0.5 to 2 h. In localized periodontitis cases, 2- to 18-h incubations were required for positive reaction. There was a good correlation between the elastase activity and the number of deep periodontal pockets and the average community periodontal index of the subjects. Elastase activity was not a good indicator of gingivitis. About 45% of gingivitis cases were positive with the elastase test, and the enzyme values were not significantly increased in experimental gingivitis. In a longitudinal study on advanced periodontitis cases, elastase levels dropped dramatically as a result of clinically successful therapy, close to the values of healthy subjects. The oral elastase test could serve as a valuable adjunct in periodontal screening and assessment of treatment efficacy.
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Affiliation(s)
- V J Uitto
- Department of Oral Biology, University of British Columbia, Vancouver, Canada
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Jin LJ, Söder PO, Asman B, Bergström K. Granulocyte elastase in gingival crevicular fluid: improved monitoring of the site-specific response to treatment in patients with destructive periodontitis. J Clin Periodontol 1995; 22:240-6. [PMID: 7790531 DOI: 10.1111/j.1600-051x.1995.tb00141.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In 13 patients with severe destructive periodontitis, the response to periodontal therapy was estimated by granulocyte elastase level in gingival crevicular fluid (GCF). 62 sites were classified according to changes of probing depths (PD) and quantitative bone height (BH%) before and after 5-year regular maintenance treatment: (i) 17 consistently healthy sites with no changes of PD and BH%; (ii) 6 initially healthy sites with deterioration in PD and BH%; (iii) 14 diseased sites with improvement in PD and BH%; (iv) 25 diseased sites with no improvement in PD and BH%. GCF was collected by an intracrevicular washing system. The released elastase in the supernatants (EA-S) and the cell-bound elastase in the pellets (EA-P) were determined with a low molecular weight substrate specific for granulocyte elastase. The ratio of EA-S and EA-P (S/P-ratio) was used as a relative measure of elastase released by the granulocytes present. The sites classified as diseased with no improvement or initially healthy but deteriorating, had significantly higher EA-S, EA-P and S/P-ratios than the consistently healthy sites or diseased but improving sites (p < 0.01). Both EA-S and S/P-ratio showed strongly positive correlations with the current levels of gingival inflammation and periodontal destruction (p < 0.001). The present study suggests that increased elastase level is associated with disease progression, and may be used to monitor the response to longitudinal maintenance therapy.
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Affiliation(s)
- L J Jin
- Department of Periodontology, School of Dentistry, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden
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Abstract
Host responses to periodontal infections include the production of several families of enzymes that are released by stromal, epithelial or inflammatory cells. Study of these enzymes in gingival crevicular fluid may lead to insights into pathogenesis and may provide a rational basis for the development of novel diagnostic tests. However, analogous to other diagnostic interventions in dentistry and medicine, validation of host enzymes as diagnostic indicators is dependent on clear-cut demonstrations of the identity of the enzyme, reproducibility, diagnostic accuracy and clinical utility. The enzyme of interest should be readily measured over a broad range of disease severity and in varied clinical settings. Ideally, the enzyme should also be an essential component of proposed pathogenic mechanisms. In this context, the connective tissue matrix degrading enzymes elastase, collagenase and gelatinase are promising because of their apparently central role in periodontal attachment loss and disease progression. Sensitive and specific assays are also available to quantify these enzymes. Other work on enzymes associated with cell death (aspartate aminotransferase, lactate dehydrogenase) and several neutrophil lysosomal enzymes (beta glucuronidase, arylsulphatase, cathepsins) has demonstrated positive associations between enzyme levels and attachment loss and inflammation. While numerous cross-sectional studies have indicated that the levels of hydrolytic enzymes in gingival crevicular fluid parallel the severity of periodontal lesions, there are much less data on reproducibility, diagnostic accuracy and clinical utility in longitudinal studies. As appropriate study design is an essential prerequisite for establishing the efficacy of host enzymes as diagnostic tests, future clinical investigations should include: (1) individuals who would most likely benefit by early diagnosis, i.e., rapidly progressive and recurrent periodontitis cases; (2) longitudinal, cohort study designs to show that attachment loss is temporally linked with large increases in enzyme activity; (3) the use of a battery of tests to overcome intrinsic problems of low predictive values when prevalence of active disease is low. In the final analysis, the utility of host enzymes as diagnostic indicators will need to be examined in randomized controlled trials in which the question is asked: are patients better off as a result of testing?
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Affiliation(s)
- C A McCulloch
- Faculty of Dentistry, University of Toronto, Ontario, Canada
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