吸烟对牙龈炎治疗前后龈沟液中弹性蛋白酶水平的影响

目的:研究吸烟和不吸烟牙龈炎患者治疗前后龈沟液中细胞外弹性蛋白酶EA-s和细胞内弹性蛋白酶EA-p水平的变化.方法:慢性龈缘炎患者37例,共119个探诊出血位点,GI≥2,PD≤3 mm,AL≤1 mm的牙龈炎位点,吸烟组17例59个位点,非吸烟组20例60个位点.观察牙周治疗前后PLI,GI,BOP和龈沟液中EA-s,EA-p水平的变化.结果:治疗前,吸烟组GI低于非吸烟组(P＜0.05),两组间EA-s,EA-p水平无显著性差异(p＞0.05).治疗后,两组各临床指标和EA-s水平均有不同程度下降.两组间各临床指标和EA-s,EA-p水平无显著性差异(p＞0.05).结论:吸烟对牙龈炎患者治疗前后龈沟液中EA-s,EA-p水平无显著影响.     

吸烟对牙周炎患者龈沟液中弹性蛋白酶水平的影响

目的比较吸烟与非吸烟牙周炎患者和健康人龈沟液中细胞外弹性蛋白酶EA-s和细胞内弹性蛋白酶(EA-p)水平的变化。方法选择慢性牙周炎患者41例,共146个探诊出血(BOP)、牙周袋探诊深度(PD)≥4mm、附着丧失(AL)≥2mm的牙周炎位点,将其分为吸烟组79个,非吸烟组67个。同时选择牙周健康者31人作为对照,共85个探诊不出血,牙龈指数(GI)≤1,PD≤3mm,AL≤1mm的位点,同样分为2组,吸烟组45个,非吸烟组40个。观察牙周治疗前、后牙周临床指标菌斑指数(PLI),GI,PD,AL,BOP和龈沟液中EA-s、EA-p水平的变化。结果牙周炎患者中,吸烟组的GI,AL和EA-s水平低于非吸烟组(P<0.05),其余指标差异无显著性(P>0.05),健康者的各项指标差异均无显著性(P>0.05)。无论是吸烟组还是不吸烟组,牙周炎患者的EA-s,EA-p水平均高于健康者(P<0.05)。结论吸烟会降低牙周炎患者龈沟液中EA-s水平,但对EA-p水平影响不大。吸烟对健康人EA水平无显著影响。     

吸烟对牙周炎治疗前后龈沟液中弹性蛋白酶水平变化的影响

目的:比较吸烟和不吸烟的牙周炎患者治疗前后龈沟液中细胞外弹性蛋白酶EA-s和细胞内弹性蛋白酶EA-p水平的变化。方法:选取慢性牙周炎患者41人,共146个探诊出血,PD≥4 mm,CAL≥2 mm的牙周炎位点,将其分为吸烟组79个,非吸烟组67个。观察牙周治疗前后牙周临床指标PLI、G I、PD、CAL、BOP和龈沟液EA-s、EA-p水平的变化。结果:治疗前,吸烟组的G I和EA-s水平低于非吸烟组(P<0.05)。治疗后,两组各临床指标,EA-s、EA-p水平均有不同程度下降。两组间,PLI、G I、BOP等临床指标无显著差异(P>0.05),非吸烟组EA-s、EA-p水平均较低(P<0.05)。结论:吸烟的牙周炎患者龈沟液中EA-s水平较低,但EA-p水平与非吸烟者差别不大。治疗后,非吸烟者龈沟液EA-s,EA-p水平更低,可能与吸烟者牙周治疗效果不佳有关。     

吸烟对牙周基础治疗前后龈沟液量和弹性蛋白酶水平的影响

目的　评价吸烟是否影响牙周炎基础治疗前、后龈沟液 (gingivalcrevicularfluid ,GCF)量和龈沟液中弹性蛋白酶 (elastase ,EA)的水平。方法　将 37例男性慢性牙周炎患者分为吸烟组 (2 2例 ,12 2个牙位点 ,每日吸烟≥ 2 0支 )和非吸烟组 (15例 ,90个牙位点 )。牙周炎基础治疗前、后用滤纸条法收集GCF ,用Periotron 6 0 0 0龈沟液测量仪测定GCF量。对吸烟组 92个位点和非吸烟组 6 0个位点GCF样本 ,用底物分解法检测EA水平。结果　治疗前吸烟组GCF量 (139 2± 33 4 )U和EA水平(0 6 34± 0 5 87)明显低于非吸烟组 [GCF量 :(15 5 4± 39 7)U ,EA水平 :0 835± 0 5 72 ],P <0 0 1。治疗后 ,两组GCF量和EA水平均显著降低 (P <0 0 0 1)。但吸烟组 91个位点 (74 6 % )GCF和 70个位点(76 1% )的EA水平治疗后有改善 ;而非吸烟组高达 88个位点 (97 8% )GCF和 5 6个位点 (93 3% )的EA水平有改善 (P <0 0 1)。结论　治疗前探诊深度相同的情况下 ,吸烟组GCF量和EA水平均低于非吸烟组 ,治疗后吸烟组的GCF和EA的减少程度不如非吸烟组明显。     

妊娠期牙龈炎龈沟液中免疫球蛋白测定

妇女在怀孕期，由于体内性激素含量变化常会出现牙龈肿胀、充血、出血等现象。本文对妊娠12周以内与28周以后，并患有不同程度牙龈炎孕妇的龈沟液进行IgA、IgG、IgM含量测定（共31份），另以16份同样患有不同程度的牙龈炎非妊娠妇女的龈沟液作对照，目的在于了解妊娠期内龈沟液中免疫球蛋白的含量有无特殊性。1材料与方法1．1对象及分组在上海石化疾病防治所与金山医院作产前检查的孕妇，随机抽样患有牙龈炎的妊娠12周以内的16人（下称初孕组），妊娠28周之后的15人（下称晚孕组），同时设相同年龄段并患有类似程度牙龈炎的非妊娠妇女16…     

快速进展性牙周炎患者龈沟液中的弹性蛋白酶活性

目的探讨中性多形核白细胞与快速进展性牙周炎的关系。方法检测２例快速进展性牙周炎患者共１０２个位点（其中２８个位点进行治疗前后的对比）的龈沟液弹性蛋白酶活性,将人多形核白细胞弹性蛋白酶特异底物———Ｓ２４８４与龈沟液反应,测吸光度值,以反映龈沟液弹性蛋白酶活性。结果快速进展性牙周炎龈沟液中的弹性蛋白酶活性［（０．６３±０．３８）Ａｂｓ／位点］明显高于健康对照组［（０．０７±０．０５）Ａｂｓ／位点］,差异有显著性;弹性蛋白酶活性的高低与龈沟液体积、探诊深度、附着丧失和出血指数呈正相关关系;治疗后龈沟液体积和各临床指数显著降低,弹性蛋白酶活性也从治疗前的（０．７３±０．３６）Ａｂｓ／位点下降为（０．１±０．１７）Ａｂｓ／位点,差异有显著性。结论快速进展性牙周炎患者的中性多形核白细胞并不是趋化反应不足,而是过度浸润与释放溶酶体酶,起协同致炎作用。     

生物活性玻璃植入前后龈沟液量及弹性蛋白酶水平的研究

目的　观察生物活性玻璃 (bioactiveglass,BAG)植入后龈沟液量和弹性蛋白酶水平的变化情况 ,以判断牙周组织的炎症反应。方法　用翻瓣术加BAG移植治疗 13处牙周骨下袋 ,用单纯翻瓣术治疗 7处骨下袋。测定术前及术后 1、2、3、4、6、8、10、12周的龈沟液 (gingivalcrevicularfluid ,GCF)量及GCF中弹性蛋白酶 (elastase ,EA)水平。结果　两组GCF量的变化相似 ,术后 1周GCF量明显升高 ,术后 3周至术前水平 ,6周左右达最低值。BAG组的BCF -EA水平在术后各时间点均较术前明显降低 ;翻瓣组GCF -EA水平在术后 1个月内明显低于术前 ,随后有逐渐回升趋势。术后 12周时 ,BAG组的GCF -EA水平明显低于翻瓣组 (P <0 .0 5 )。结论　BAG可能有助于减轻牙周组织的炎症。     

吸烟对全瓷冠修复后菌斑指数和龈沟液的影响

目的：探讨不同吸烟剂量对全瓷冠修复后基牙菌斑指数和龈沟液的影响。方法：选取近两年在我院口腔修复科就诊的35-40岁,需进行全瓷单冠修复的患者60例为受试对象,均为男性,根据吸烟情况分成不吸烟组,少量吸烟组(≤10支/d)和大量吸烟组(＞10支/d)。全瓷冠修复前1周常规牙周洁治,分别在修复前以及修复后1个月,2个月检测基牙菌斑指数,龈沟液的分泌量以及碱性磷酸酶和肿瘤坏死因子α水平。结果：与修复前相比,不吸烟组修复后1个月,2个月多数指标无显著变化,少量吸烟组和大量吸烟组修复后1个月,2个月多数指标都有所上升。与不吸烟组相比,少量吸烟组和大量吸烟组修复后1个月,2个月多数指标也有所上升,并且与吸烟剂量正相关。结论：吸烟可使全瓷冠修复后基牙菌斑指数升高,龈沟液分泌量增加,相关炎性因子表达增高。     

吸烟与糖尿病对龈沟液中天冬氨酸转氨酶活性水平的影响

目的 :研究吸烟、糖尿病对牙周龈沟液中天冬氨酸转氨酶 (GCF AST)水平的影响。方法 :选择 10 5例吸烟者、86例糖尿病患者及 90例对照者 ,测定牙周病指数 (PDI)、GCF AST水平并比较。结果 :吸烟组和糖尿病组PDI值均明显高于对照组 ,牙周健康区数低于对照组 ;牙龈炎区数 3组相近 ;牙周炎区数高于对照组。在PDI相同的情况下 3组GCF AST水平无显著性差异。结论 :吸烟、糖尿病是牙周病流行的高危因素 ,而对GCF AST水平无直接影响     

吸烟和非吸烟慢性牙周炎患者基础治疗后龈沟液肝细胞生长因子水平的变化

目的研究吸烟和非吸烟的慢性牙周炎患者牙周基础治疗前后龈沟液（GCF）中肝细胞生长因子（HGF）的水平变化。了解吸烟和基础治疗对GCF中HGF的水平的影响。方法将研究对象分为吸烟慢性牙周炎组和非吸烟慢性牙周炎组,每组患者各15例,实验牙各30颗,用滤纸条法在龈沟袋内获取牙周基础治疗前后的GCF样本．采用酶联免疫吸附试验（ELISA）测定其中的HGF水平。结果基础治疗后慢性牙周炎患者非吸烟组与吸烟组相比,GCF中HGF水平降低更明显（P〈0．01）。结论吸烟和GCF中HGF水平变化有关系。     

Granulocyte elastase activity in static and flow gingival crevicular fluid

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.     

Effect of smoking on gingival crevicular fluid cytokine profile during experimental gingivitis

BACKGROUND: Cigarette smoking is a significant risk factor in the pathogenesis of periodontal disease, able to influence both the subgingival microbiota and host responses. AIM: The aim of the present study was to determine the influence of smoking on the amount of IL-1beta, IL-4 and IL-8 in gingival crevicular fluid (GCF) during experimental gingivitis in humans. MATERIAL AND METHODS: Twenty-two healthy subjects, 10 smokers and 12 non-smokers, participated in the study. After professional cleaning, they performed optimal hygiene to reach perfect clinical gingival health. Oral hygiene measures were ceased for a period of 10 days. Clinical indices, including plaque index (PI), gingival index (GI), probing pocket depth (PPD) and bleeding on probing (BOP), were assessed 2 days before (day -2), at the beginning (day 0) and at the end of the experimental gingivitis period (day 10). At the same time, GCF was collected from 12 sites in each patient, by means of durapore filter membranes. Total amounts of IL-1beta, IL-4 and IL-8 were determined by enzyme-linked immunoadsorbent assay. RESULTS: Clinical data revealed that both smokers and non-smokers showed an increase in PI, GI and BOP scores during the experiment. Although no differences were noted with regard to PI at day 10, the GI and BOP were significantly less pronounced in smokers than non-smokers (p < 0.005). Non-smokers showed higher total amounts of IL-4 but lower amounts of IL-8 than smokers, throughout the experiment. Total amounts of IL-1beta and IL-8 increased significantly during plaque accumulation in both groups. IL-4 remained stable for the smoker group and decreased for the non-smoker group. CONCLUSIONS: The present results indicate that smoking interferes with cytokine production. When performing studies regarding the pathogenesis of periodontitis, the smoking status of the participants needs to be taken into consideration.     

龈沟液弹性蛋白酶洗提和保存方法的初步研究

目的 :观察不同保存温度、时间和不同缓冲液以及不同洗提方法对龈沟液弹性蛋白酶 (GCF-EA)活性的影响。方法 :采用底物反应法分别于取样即刻和 1、2、3、4周时检测 - 2 0℃和 - 70℃保存的PBS组和Tris-HCl组以震荡法和震荡 +离心法洗提的GCF样本中EA的活性。结果 :不同洗提方法间洗提效果的差异具有显著性 (0 .0 1

0 .5 )。在相同时间内 ,PBS组或Tris -HCl组 - 2 0℃保存的GCF样本EA活性与- 70℃者间的差异无显著性 (P >0 .0 5 ) ,但 - 2 0℃保存者有略高于 - 70℃者的倾向 ,且 - 2 0℃比 - 70℃条件下保持EA活性的时间略长。结论 :将滤纸条上的GCF样本进行洗提时 ,采用“震荡 +离心法”优于“震荡法”。GCF样本的保存过程中 ,缓冲液的种类以及保存温度可影响GCF -EA的活性。以PBS作为缓冲液、- 2 0℃保存可能更利于其中EA活性的稳定。     

Granulocyte elastase in gingival crevicular fluid

The granulocyte elastase activity and the immuno-reactive (antigenic) granulocyte elastase of gingival crevicular fluid (GCF) were studied in 16 periodontitis patients and in 10 gingivitis patients. The elastase activity was measured with a low molecular weight substrate specific for granulocyte elastase. The antigenic elastase was determined with specific antibodies against granulocyte elastase. Intracrevicular sampling of GCF with paper strips for 30 s seemed to provide representative values of elastase. The elastase activity correlated with probing depth and attachment loss and appeared to be a measure of the degree of tissue destruction. Antigenic elastase represents the number of granulocytes in GCF and should thus be related to the degree of inflammation. The periodontitis patients and the gingivitis patients both had a similar degree of inflammation as measured by antigenic elastase per microliter GCF and gingival index. The elastase activity per microliter GCF, however, was higher in the periodontitis group. Elevated granulocyte elastase activity in GCF seems to be independent of inflammation and could thus be an indicator of patients at risk for periodontitis.     

The gingival crevicular fluid ciprofloxacin level in subjects with gingivitis and periodontitis, and its effects on clinical parameters

OBJECTIVES: The purpose of this study, conducted on patients with gingivitis and periodontitis, was twofold: to find out the serum and gingival crevicular fluid concentration of ciprofloxacin, which is a common drug used effectively against Actinobacillus actinomycetemcomitans and to determine the effects of ciprofloxacin administration on clinical parameters. METHOD: A total of 32 adult patients, consisting of 16 subjects with gingivitis and 16 subjects with untreated chronic periodontitis, were included in the study. The subjects were divided into four groups: group I included eight subjects with chronic gingivitis who had not previously received any ciprofloxacin; group II included eight subjects with chronic gingivitis to whom three doses of ciprofloxacin were administered (Siprosan 500 mg) to establish adequate gingival crevicular fluid and serum concentrations of the agent; group III consisted of eight subjects with chronic periodontitis who had not received any ciprofloxacin; group IV included eight subjects with chronic periodontitis to whom three doses of ciprofloxacin were administered to establish adequate gingival crevicular fluid and serum concentrations of the agent. All patients were systemically healthy, free of pain and reported no current medication usage. Each patient was treated with scaling and/or root planing using specific hand instruments under local anesthesia. Gingival index, plaque index and clinical attachment levels of the teeth were used to determine the clinical condition of the subjects and findings were recorded at the beginning, seventh day, 21st day and third month of the study. Serum ciprofloxacin level was measured in venous blood. Approximately 5 ml of venous blood was drawn from subjects in groups II and IV using a standard venipuncture technique. Gingival crevicular fluid samples were sampled from six interproximal sites with six paper strips in the posterior region of upper jaw (excluding third molar) and all gingival crevicular fluid and serum samples were evaluated by high-performance liquid chromatography. RESULTS: The serum concentrations of ciprofloxacin at the first and 72nd hour were not significantly different in subjects with periodontitis compared to subjects with gingivitis. But the gingival crevicular fluid concentrations of ciprofloxacin at the same hours were significantly high in subjects with periodontitis compared to subjects with gingivitis. Both subjects with gingivitis and periodontitis had significantly higher ciprofloxacin levels in the gingival crevicular fluid than in serum. The application of ciprofloxacin did not have any positive or statistically significant effect upon the clinical parameters of the subjects with gingivitis. On the other hand, a significant decrease in the clinical attachment level scores of the subjects with periodontitis (group IV) was observed compared to group III in the 21st day and third month. CONCLUSION: According to these results, the use of ciprofloxacin as an alternative drug in subjects with periodontitis but not gingivitis can be recommended. However, long-term studies are also needed to assess the effects of ciprofloxacin on clinical parameters.     

Influence of oral hygiene on elastase concentration of gingival crevicular fluid

PMN elastase concentration of gingival crevicular fluid (GCF) was investigated in 11 healthy volunteers before professional tooth cleaning and after a 5-week period of intensive oral hygiene. GCF was collected using filter paper strips and the enzyme concentration was evaluated by the ELISA-technique. Intensive daily oral hygiene led to a considerable improvement in the clinical indices and to a reduction in the concentration of elastase in GCF. Despite the changes in the oral hygiene status, functional elastase was still present in the samples at the end of the experiment. This could mean that even at clinically healthy sites there is a lack of alpha-1-proteinase inhibitor, the major serum protein inactivating PMN elastase.     

A 2-year longitudinal study of elastase in human gingival crevicular fluid and periodontal attachment loss

Abstract The purpose of this study is to determine whether gingival crevicular fluid (GCF) elastase total activity (TA) and concentration (EC) correlate with and predict progressive attachment loss (AL). 75 previously untreated patients with moderate periodontitis were recruited. GCF was collected from 16 molar and pre-molar mesiobuccal sites and probing attachment loss (PAL), probing depth (PPD), gingival index (GI), gingival bleeding index (GBI) and plaque index (PLI) were measured, PAL and PPD were measured with an electronic, constant pressure probe. Patients were given basic periodontal treatment prior to baseline when the above procedures were repeated. In addition, carefully localised radiographs were taken of the test teeth and repeated annually. Patients were seen at 3 months intervals to 2 years and the procedures were repeated. 119 AL sites were detected and 89 of these were rapid AL sites (RAL) and 30 were gradual AL sites (GAL). Elastase levels (TA & EC) at RAL sites were significantly higher (p≤0.0001) than paired control sites in the same patient at both the attachment loss time (ALT) and the prediction time (PT). The mean levels (TA & EC) over the study period at GAL sites were significantly higher (p≤0.0001) than paired control sites in the same patient. Using a critical value (CV) of 125 μU/30 s (TA) and 400 μU/μL (EC) in 2×2 contingency tables showed a sensitivity of 100% and specificity of 99.95% (TA) and a sensitivity of 100% and specificity of 99.91% (EC) at the PT with very similar values at the ALT. Patient level comparisons showed that the mean elastase levels (TA & EC) were significantly higher (p≤0.0001) at RAL and GAL sites than non-attachment loss (NAD sites in AL patients and that the mean levels were significantly higher (p≤0.0001) in AL patients than NAL patients. All these results indicate that these CVs for GCF elastase activity may serve as a predictors of future attachment loss.     

Smoking cessation increases gingival blood flow and gingival crevicular fluid

OBJECTIVES: The purpose of the present study was to determine the effect of smoking cessation on gingival blood flow (GBF) and gingival crevicular fluid (GCF). MATERIAL AND METHODS: Sixteen male smokers (aged 22-39 (25.3+/-4.0) years), with no clinical signs of periodontal and systemic diseases, were recruited. The experiment was performed before (baseline) and at 1, 3 and 5 days, and at 1, 2, 4 and 8 weeks after smoking cessation. The status of smoking and smoking cessation was verified by exhaled carbon monoxide (CO) concentration, and by serum nicotine and cotinine concentrations. A laser Doppler flowmeter was used to record relative blood flow continuously, on three gingival sites of the left maxillary central incisor (mid-labial aspect of the gingival margin and bilateral interdental papillae). The GCF was collected at the mesio- and disto-labial aspects of the left maxillary central incisor and the volume was calculated by the Periotron 6000(R) system. The same measurements except for the GBF were performed on 11 non-smoking controls (four females and seven males), aged 23-27 (24.4+/-1.2) years. RESULTS: Eleven of 16 smokers successfully completed smoking cessation for 8 weeks. At 1 day after smoking cessation, there was a significantly lower CO concentration than at baseline (p<0.01). Also, nicotine and cotinine concentrations markedly decreased at the second measurement. The GBF rate of smokers was significantly higher at 3 days after smoking cessation compared to the baseline (p<0.01). While the GCF volume was significantly increased at 5 days after smoking cessation compared to the baseline (p<0.01), it was significantly lower than that of non-smokers until 2 weeks after smoking cessation (p<0.01). CONCLUSION: The results show that the gingival microcirculation recovers to normal in the early stages of smoking cessation, which could activate the gingival tissues metabolism/remodeling, and contribute to periodontal health.