Clinical and Biochemical Evaluation of Lozenges Containing Lactobacillus reuteri as an Adjunct to Non‐Surgical Periodontal Therapy in Chronic Periodontitis

Background: This study evaluates the effects on clinical and biochemical parameters of Lactobacillus reuteri–containing probiotic supplementation adjunctive to initial periodontal therapy in patients with chronic periodontitis (CP). Methods: Thirty patients with CP were included and divided into two groups. Every patient had, in each quadrant, ≥2 teeth each with approximal sites with a probing depth (PD) of 5 to 7 mm and gingival index (GI) of ≥2. The test group received scaling and root planing (SRP) and probiotic‐containing lozenges. The control group received SRP and placebo lozenges. Plaque index (PI), GI, bleeding on probing (BOP), PD, and attachment gain were measured. Gingival crevicular fluid (GCF) was sampled for the analysis of matrix metalloproteinase (MMP)‐8 and tissue inhibitor of metalloproteinase (TIMP)‐1 by enzyme‐linked immunosorbent assay. All evaluations were performed at baseline and on days 21, 90, 180, and 360. Results: Differences in intergroup comparisons of PI, GI, BOP, and PD were found to be significant (P <0.05) in favor of the test group at all time points. Decreased GCF MMP‐8 levels and increased TIMP‐1 levels were found to be significant up to day 180 (P <0.05). Mean values of attachment gain were significantly higher in the test group compared with the control group on days 90, 180, and 360. Conclusions: Lozenges containing L. reuteri may be a useful supplement in moderately deep pockets of patients with CP. Low MMP‐8 and high TIMP‐1 levels may indicate the role of the lozenges in reduction of inflammation‐associated markers up to day 180.     

Gingival Crevicular Fluid Matrix Metalloproteinase‐8 Levels Predict Treatment Outcome Among Smokers With Chronic Periodontitis

Background: Molecular biomarkers are needed for diagnostic use in periodontal diseases. The aim of this study is to explore different gingival crevicular fluid (GCF) matrix metalloproteinase‐8 (MMP‐8) patterns in smokers and non‐smokers with chronic periodontitis (CP) and test the utility of baseline GCF MMP‐8 levels in predicting categorically assessed treatment outcomes. Methods: The study population comprised 15 patients with CP (five non‐smokers and 10 smokers). GCF sampling of five to seven periodontal sites per patient was done at baseline, post‐treatment, and bimonthly during the maintenance period from 8 to 12 months. GCF MMP‐8 levels were measured with an immunofluorometric assay. MMP‐8 response patterns were explored by cluster analysis. The ability of baseline MMP‐8 levels to predict categorical treatment outcomes was analyzed with receiver operating characteristic curves. Results: GCF MMP‐8 response patterns could be clustered into two different site profiles among both smokers and non‐smokers. Smoker site profiles 1 and 2 had significantly different clinical attachment level and gingival recession changes by the end of the maintenance period. In smoker sites, baseline MMP‐8 levels significantly predicted the categorical treatment outcome. Conclusions: Baseline GCF MMP‐8 levels strongly predict how MMP‐8 levels behave during the maintenance period. In smoker sites, high baseline MMP‐8 levels indicate weak treatment response.     

The Utility of Gingival Crevicular Fluid Matrix Metalloproteinase‐8 Response Patterns in Prediction of Site‐Level Clinical Treatment Outcome

Background: Different gingival crevicular fluid (GCF) matrix metalloproteinase (MMP)‐8 response patterns were studied among non‐smoking and smoking patients with chronic periodontitis (CP) and generalized aggressive periodontitis (GAgP) to test the utility of GCF MMP‐8 levels predicting the site‐level treatment outcome. Methods: Data from four independent longitudinal studies were combined. Altogether, the studies included 158 periodontal sites from 67 patients with CP and 32 patients with GAgP, and GCF samples were collected at baseline, after the treatment, and during the 6‐month maintenance period. All GCF samples were analyzed by immunofluorometric assay for MMP‐8. Different site‐level MMP‐8 response patterns were explored by the cluster analysis. Most optimal MMP‐8 cutoff levels were searched with receiver operating characteristic analyses, and the predictive utility of defined levels was tested. Results: Distinct types of MMP‐8 response patterns were found in both smokers and non‐smokers. MMP‐8 levels exceeding the optimal cutoff levels separately defined for smokers and non‐smokers indicated increased risk for compromised treatment outcome at baseline and during the maintenance period. Seventy‐one percent of non‐smokers (positive likelihood ratio of 4.22) and 88% of smokers (positive likelihood ratio of 5.00) with positive test results at both baseline and the maintenance period had compromised treatment outcome. The double‐positive result indicated 46% and 39% point risk increase for the compromised outcome, respectively. Conclusion: GCF MMP‐8 analysis with defined cutoff levels could be used to predict the site‐level treatment outcome and for longitudinal monitoring of the disease status during the maintenance period.     

Clinical and Microbiologic Effects of Adjunctive Metronidazole Plus Amoxicillin in the Treatment of Generalized Chronic Periodontitis: Smokers Versus Non‐Smokers

Background: The aim of the present study is to evaluate the clinical and microbiologic effects of the adjunctive use of metronidazole (MTZ) and amoxicillin (AMX) in the treatment of smokers and non‐smokers with generalized chronic periodontitis (CP). Methods: Thirty‐two smokers and 32 non‐smokers were selected and received scaling and root planing (SRP) combined with MTZ (400 mg three times daily) and AMX (500 mg three times daily) for 14 days. Clinical and microbiologic examinations were performed at baseline and 3 months after SRP. Nine subgingival plaque samples per patient were analyzed using checkerboard DNA–DNA hybridization. Results: Both groups presented a significant improvement in all clinical parameters at 3 months after therapy (P <0.05). Non‐smokers showed lower mean number of sites with probing depth (PD) ≥5 mm after therapy. Fewer non‐smokers exhibited at least nine of these sites at 3 months after treatment. Non‐smokers also presented the greatest reductions in mean PD and gain in clinical attachment between baseline and 3 months after therapy at initially deep (PD ≥7 mm) sites (P <0.01). The most beneficial changes in the microbial profile were also observed in the non‐smoker group, which showed the lowest proportions of the orange complex at 3 months, as well as a significant increase in the proportions of Actinomyces species after treatment. Conclusion: Smokers with CP benefit less than non‐smokers from treatment by the combination of SRP, MTZ, and AMX.     

Shh蛋白与慢性牙周炎炎症程度的相关性研究

目的:探讨Sonic Hedgehog(Shh)信号通路中Shh蛋白与慢性牙周炎炎症程度的相关性。方法:选择健康对照20例(健康对照组),轻度牙周炎患者20例(轻度牙周炎组),中重度牙周炎患者20例(中重度牙周炎组),收集其龈沟液样本。采用ELISA法检测龈沟液中Shh蛋白、白细胞介素-6(IL-6)及白细胞介素-10(IL-10)的水平。结果:Shh蛋白、IL-6在慢性牙周炎组的水平均高于健康对照组(P<0.05),且中重度慢性牙周炎组高于轻度慢性牙周炎组(P<0.05);IL-10在轻度慢性牙周炎组的水平高于健康对照组及中重度慢性牙周炎组(P<0.05),且健康对照组高于中重度慢性牙周炎组(P<0.05);Shh蛋白、IL-6水平与出血指数(BI)、探诊深度(PD)均呈正相关(P<0.05)。结论:Shh信号通路可能参与了慢性牙周炎的炎症反应过程。     

Matrix Metalloproteinase (MMP)‐8 and Tissue Inhibitor of MMP‐1 (TIMP‐1) Gene Polymorphisms in Generalized Aggressive Periodontitis: Gingival Crevicular Fluid MMP‐8 and TIMP‐1 Levels and Outcome of Periodontal Therapy

Background: The aim of the present study is to investigate matrix metalloproteinase (MMP)‐8 and tissue inhibitor of MMP‐1 (TIMP‐1) gene polymorphisms in generalized aggressive periodontitis (GAgP) and to assess the effects of MMP‐8 and TIMP‐1 genotypes on the outcomes of non‐surgical periodontal therapy. Methods: Genomic DNA was obtained from peripheral blood of 100 patients with GAgP and 167 periodontally healthy controls. MMP‐8 +17 C/G, ?799 C/T, ?381 A/G and TIMP‐1 372 T/C, *429 T/G polymorphisms were determined by polymerase chain reaction‐restriction fragment length polymorphism. Patients with GAgP received non‐surgical periodontal therapy and were followed for 6 months. Clinical periodontal parameters and gingival crevicular fluid (GCF) samples were collected at baseline and at follow‐up visits. GCF biomarkers were analyzed by immunofluorescence assay and enzyme‐linked immunosorbent assay. Results: Distribution of the MMP‐8 ?799 C/T genotypes was significantly different between the GAgP and control groups (P <0.005). TIMP‐1 372 T/C and *429 T/G genotypes in males were also significantly different between study groups (P <0.004). GCF MMP‐8 levels decreased until 3 months after non‐surgical therapy compared with baseline in T and G alleles, as well as G and C allele carriers (P <0.0125), whereas no significant decreased was observed in non‐carriers (P >0.0125). Conclusion: On the basis of the present findings, it can be suggested that MMP‐8 ?799 C/T and TIMP‐1 372 T/C, *429 T/G gene polymorphisms in males may be associated with the susceptibility to GAgP in the Turkish population.     

Effects of Photodynamic Therapy on Clinical and Gingival Crevicular Fluid Inflammatory Biomarkers in Chronic Periodontitis: A Split‐Mouth Randomized Clinical Trial

Background: There are limited clinical experiments addressing the effects of photodynamic therapy (PDT) as an adjunct to conventional scaling and root planing (SRP) on clinical and biologic features of periodontitis. This trial compares the clinical parameters and cytokine profiles in gingival crevicular fluid of patients with moderate‐to‐severe chronic periodontitis (CP) who have been treated using SRP alone or SRP + PDT. Methods: Twenty‐two patients with two contralateral teeth affected with moderate‐to‐severe CP were selected. After SRP, the participants’ teeth were randomized to receive either no further treatment or a single application of PDT using a 638‐nm laser and toluidine blue. Although the change in probing depth was the primary outcome, bleeding on probing, clinical attachment level, gingival recession, interleukin‐1β, tumor necrosis factor (TNF)‐α, and matrix metalloproteinase 8 and 9 were also evaluated at baseline and 3 months postintervention. An oral rinse assay was also performed to determine the total levels of oral polymorphonuclear cells (PMNs) before and 3 months after the treatments. Results: Within each group, significant improvements (P <0.001) were found for all variables in 3‐month follow‐up compared with baseline. Only TNF‐α was significantly improved in the PDT + SRP versus SRP group. Total levels of PMNs were reduced for all patients compared with baseline levels (P <0.001). Conclusion: In patients with CP, a single application of PDT (using a 638‐nm laser and toluidine blue) did not provide any additional benefit to SRP in terms of clinical parameters or inflammatory markers 3 months following the intervention.     

Correlation Between Gingival Crevicular Fluid Hemoglobin Content and Periodontal Clinical Parameters

Background: Probing depth (PD) and bleeding on probing (BOP) are essential clinical parameters used for periodontal diagnosis. This study investigated whether detection of hemoglobin (Hb) in gingival crevicular fluid (GCF), along with PD and BOP, would improve diagnostic accuracy. Methods: After plaque index (PI) was measured, GCF was collected from the gingival sulci of 401 anterior teeth in the maxilla and mandible from 184 patients who had entered periodontal maintenance therapy. Clinical parameters (gingival index [GI], PD, clinical attachment level [CAL], and BOP) were recorded. Hb values in GCF were assessed by immunochromatography. Moreover, cutoff values for PI, GI, and CAL based on the degree of PD and amount of GCF were created and analyzed. Results: Hb was detected in 64.8% of GCF samples in 105 BOP‐negative (–) sites in the periodontally stable group out of 107 sites that were less than all cutoff values. There were 71 BOP(–) sites in the periodontal‐management‐required group out of 122 sites that were more than all cutoff values, although no improvement in periodontal disease was observed. Hb was detected in 88.7% of GCF samples from these 71 BOP(–) sites. Conclusions: Hb was observed in more than 60% of GCF samples in BOP(–) gingival sulci in both periodontally stable and periodontal‐management‐required groups. These results suggest inspection of Hb derived from microbleeding in gingival sulci may serve as an index for preclinical diagnosis.     

Effect of azithromycin, as an adjunct to nonsurgical periodontal treatment, on microbiological parameters and gingival crevicular fluid biomarkers in generalized aggressive periodontitis

Emingil G, Han B, Özdemir G, Tervahartiala T, Vural C, Atilla G, Baylas H, Sorsa T. The effect of azithromycin, as an adjunct to nonsurgical periodontal treatment, on microbiological parameters and gingival crevicular fluid biomarkers in generalized aggressive periodontitis. J Periodont Res 2012; 47: 729–739. © 2012 John Wiley & Sons A/S Background and Objective: To study the effectiveness of azithromycin in combination with nonsurgical periodontal therapy on clinical and microbiological parameters, and on the MMP‐8 and TIMP‐1 levels in gingival crevicular fluid, over a 6‐mo time‐period in patients with generalized aggressive periodontitis. Material and Methods: Thirty‐two patients with generalized aggressive periodontitis were included in this randomized, double‐blind, placebo‐controlled, parallel‐arm study. They were randomly assigned to azithromycin or placebo groups (500 mg once daily for 3 d). Probing depth, clinical attachment levels, presence of bleeding on probing and plaque were recorded. Gingival crevicular fluid samples were obtained from one single‐rooted tooth, while microbiological samples were obtained from two single‐rooted teeth, all with a probing depth of ≥ 6 mm. Microbiological parameters were analyzed by quantitative real‐time PCR for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia and total bacteria. Gingival crevicular fluid biomarkers were determined by immunofluorometric assay and ELISA. Results: All clinical parameters improved, and microbiological parameters and gingival crevicular fluid MMP‐8 levels significantly decreased, over the 6‐mo period (p < 0.05); both groups demonstrated similar improvements. The azithromycin group presented a higher percentage of deep pockets resolved (probing depth reduction of ≥ 3 mm from baseline) compared with the placebo group at 1 mo (p < 0.05). Conclusion: Adjunctive azithromycin therapy provides no additional benefit over nonsurgical periodontal treatment on clinical parameters, microbiological parameters and gingival crevicular fluid biochemical markers investigated in patients with generalized aggressive periodontitis.     

慢性牙周炎龈沟液中白细胞介素-8与硫化物的相关关系

目的：探讨慢性牙周炎龈沟液（gingival crevicular fluid，GCF）中白细胞介素-8（interleukin-8，IL-8）与硫化物（suleus sulphide level，SUL）的关系。方法：采用双抗体夹心ELISA法、金刚牙周诊断仪对龈沟液中IL-8和硫化物的含量和临床指标进行测定。23个牙周健康牙作正常对照组（C），12个慢性牙周炎健康牙作实验组1（T1），30个慢性牙周炎患牙作实验组2（T2）。用标准化滤纸条采集观察牙位GCF样本，记录相应位点30’硫化物浓度，同时记录龈沟出血指数（SBI）、牙周袋探诊深度（PPD）、牙周附着丧失水平（CAL）。结果：①受检位点龈沟液中IL-8总量存在显著性差别，其中慢性牙周炎炎症牙位组IL-8总量高于健康牙位组、正常对照组（p〈0.05），但龈沟液中IL-8浓度无显著性差别。龈沟液中IL-8总量与SBI、PPD、CAL之间有明显相关关系（P〈0.05），但IL-8的浓度与临床指标间相关关系不明显。②慢性牙周炎炎症牙位组的硫化物浓度与健康牙位组、正常牙位组之间均有显著性差别（P〈0.05），慢性牙周炎健康牙位组与正常牙位组之间无显著性差别。③慢性牙周炎炎症牙位组硫化物浓度与临床指标间具正相关关系（P〈0.05），而健康牙位组和正常对照组硫化物浓度与临床指标间无相关关系。GCF中慢性牙周炎炎症牙位组的硫化物浓度与IL-8总量具负相关关系（P〈0．05），而慢性牙周炎健康牙位组和正常对照组的硫化物浓度与IL-8总量之间无相关关系。结论：慢性牙周炎患牙龈沟液中IL-8和硫化物的含量与临床指标之间有相关性。龈沟液中细菌代谢产物所产生的硫化物对IL-8的含量存在一定抑制作用。     

慢性牙周炎龈沟液中硫离子水平与临床相关性研究

目的:分析慢性牙周炎(CP)患者龈沟液中硫离子(su lfides)水平的变化与临床牙周指数的相关关系及其对诊断预后的意义。方法:采用金刚牙周诊断仪进行龈沟液硫离子和牙周临床指标测定。选定实验组(T):36例慢性牙周炎患者,57颗牙位,共342个位点。其中健康牙位(T1)21颗,位点126个;炎症牙位(T2)36颗,位点216。对照组(C):全身及牙周健康者8例,16颗牙位,共96个位点。测定所选位点龈沟液(GCF)中硫化物水平(su lcussu lph ide level,SUL),牙周袋探诊深度(prob ing depth,PD),牙周临床附着丧失水平(c lin ical attachm ent level,CAL),龈沟出血指数(su lcus b leed ing index,SB I)。所有统计结果均采用SPSS11.0进行统计学分析。结果:1)牙周健康对照组(C)GCF中硫离子SUL的浓度均值为(0.0648±0.0169)pg/mL,明显低于慢性牙周炎炎症牙位组(T2)(0.3249±0.0489)pg/mL及慢性牙周炎健康牙位组(T1)(0.1160±0.0271)pg/mL;慢性牙周炎炎症牙位组(T2)GCF中硫离子(SUL)的浓度均值均高于正常对照组及慢性牙周炎健康牙位组(T1)。2)经相关性分析,慢性牙周炎炎症牙位组(T1)GCF中SUL的浓度均值与PD、SB I和CAL均呈正相关关系。而慢性牙周炎健康牙位组(T1)及正常对照组(C)GCF中SUL的浓度均值与PD、SB I及CAL间无相关性。结论:慢性牙周炎(CP)炎症牙位组龈沟液中硫离子(SUL)的浓度均值与牙周临床指标之间具有相关关系,其水平的高低变化可客观反映牙周组织的炎症状态。     

Salivary and Serum Leptin Concentrations in Patients With Chronic Periodontitis

Background: The discovery of leptin has led to the elucidation of a robust physiologic system that not only maintains fat stores but is also an integral part of the host defense mechanism. However, leptin concentrations in the saliva of patients with chronic periodontitis (CP) has not been explored despite the potential role of salivary biomarkers in determining the presence, risk, and progression of periodontal disease. Methods: Eighty‐four participants (44 with generalized severe CP and 40 without periodontitis) were enrolled. For each patient, the values of periodontal parameters were recorded, such as plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (AL), and percentage of sites with bleeding on probing (BOP) and clinical AL ≥5 mm. Saliva and serum samples were collected to estimate the leptin concentrations using enzyme‐linked immunosorbent assay kits. Statistical analysis was performed using software. Results: Participants with CP demonstrated significantly higher BOP, PI, GI, and percentage of sites with clinical AL >5 mm (P <0.05). Leptin was detectable in all the clinical samples. Salivary leptin concentrations in patients with CP were significantly lower than in healthy volunteers (6,200.61 ± 2,322.11 versus 8,799.60 ± 901.70 pg/mL), whereas serum leptin concentrations were significantly higher in patients with CP than in healthy volunteers (11,600.00 ± 1,705.01 versus 7,616.62 ± 1,169.83 pg/mL). In addition, the results reflected a significant negative correlation of salivary leptin and a positive correlation of serum leptin with PD (P <0.05). Conclusion: The results suggest that leptin concentrations in saliva and serum are significantly altered in CP and relate closely to current disease activity; however, further studies are needed to confirm the findings.     

8‐Hydroxy‐Deoxyguanosine Levels in Gingival Crevicular Fluid and Saliva in Patients With Chronic Periodontitis After Initial Periodontal Treatment

Background: This study evaluates the effects of initial periodontal treatment on the gingival crevicular fluid (GCF) and salivary levels of 8‐hydroxy‐deoxyguanosine (8‐OHdG) as a marker of oxidative deoxyribonucleic acid (DNA) damage in patients with chronic periodontitis (CP). Methods: At baseline, clinical parameters were determined and GCF and saliva samples were obtained from 24 patients with CP and 24 individuals with clinically healthy periodontium. GCF, saliva samples, and clinical periodontal measurements were repeated at day 10, 1 month, and 3 months following initial periodontal therapy in patients with CP. 8‐OHdG levels of GCF and saliva samples were investigated by using an enzyme‐linked immunosorbent assay. Results: Statistically significant higher 8‐OHdG levels of GCF and a significant decrease after initial periodontal therapy were determined in the CP group (P <0.001). A significant positive correlation was found between 8‐OHdG levels of GCF and clinical periodontal measurements (P <0.001). However, salivary levels of 8‐OHdG did not differ between groups or during initial periodontal therapy (P >0.05). Conclusions: This study reveals that DNA injury and oxidative stress increase in tissue cells and especially in periodontal pockets in patients with CP, and the periodontal treatment results in a significant decrease of 8‐OHdG levels in the GCF samples. To the best of our knowledge, this study evaluates for the first time, 8‐OHdG levels in GCF, which is shown to be more useful as a biomarker than saliva. 8‐OHdG was found to be important and may reveal the severity of periodontal disease and the effect of periodontal therapy.     

Soluble Triggering Receptor Expressed on Myeloid Cells 1 (sTREM‐1) in Gingival Crevicular Fluid: Association With Clinical and Microbiologic Parameters

Background: Soluble triggering receptor expressed on myeloid cells 1 (sTREM‐1) belongs to the immunoglobulin superfamily and is involved in amplification of the inflammatory response to bacterial infection. This cross‐sectional study aims to investigate the levels of sTREM‐1 in gingival crevicular fluid (GCF) of individuals without periodontitis and with chronic periodontitis (CP) or generalized aggressive periodontitis (GAgP) and their association with the levels of key periodontal pathogens in subgingival plaque. Methods: GCF and subgingival plaque samples were obtained from healthy sites of participants without periodontitis (n = 20) and periodontitis sites of patients with CP (n = 22) and GAgP (n = 20). sTREM‐1 levels in GCF were measured by enzyme‐linked immunosorbent assay. Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Aggregatibacter actinomycetemcomitans levels in subgingival plaque were analyzed by quantitative real‐time polymerase chain reaction. Results: sTREM‐1 levels in GCF were higher in CP and GAgP than healthy sites by 3.6‐ and 4.4‐fold, respectively, with no significant differences between the two forms of periodontitis. Moreover, sTREM‐1 levels in GCF were positively correlated with site‐specific clinical periodontal parameters and levels of P. gingivalis, T. denticola, and T. forsythia, but not A. actinomycetemcomitans, in subgingival plaque. Conclusion: Increased GCF levels of sTREM‐1 at diseased sites and their positive correlation with clinical and microbiologic parameters strengthen the association of this inflammatory marker with periodontitis.     

Effect of Non‐Surgical Periodontal Treatment on Visfatin Concentrations in Serum and Gingival Crevicular Fluid of Patients With Chronic Periodontitis and Type 2 Diabetes Mellitus

Background : This study aims to assess visfatin concentrations in serum and gingival crevicular fluid (GCF) and investigate this relationship in patients with type 2 diabetes mellitus (T2DM) and chronic periodontitis (CP) before and after non‐surgical periodontal treatment. Methods: Fifty‐four patients with T2DM and CP were recruited. The patients were randomly divided into two groups: treatment and control. Serum and GCF visfatin concentrations and glycated hemoglobin (HbA1c) levels were measured by enzyme‐linked immunosorbent assay at different time points (at baseline and 3 and 6 months after non‐surgical periodontal treatment). Results: Serum and GCF visfatin concentrations showed no significant differences between the groups at baseline (t test, P >0.05). A significant decline of visfatin in the treatment group was found in serum and GCF 3 months after non‐surgical periodontal treatment (t test, P <0.01). Baseline and 3‐month HbA1c levels were not significantly different, but at 6 months, a statistically significant difference was detected (t test, P >0.05). Conclusions: The data suggest that non‐surgical periodontal treatment is helpful for glucose control, an effect that may be associated with reduced visfatin in patients with T2DM and periodontitis. Furthermore, the data suggest that visfatin may be considered an inflammatory marker for periodontal diseases.     

成人牙周炎患者治疗前后龈沟液中谷胱甘肽过氧化物酶水平的变化

目的：了解谷胱甘肽过氧化物酶（ＧＰｘ）在牙周病变过程中的变化及其临床意义。方法：选择２３例成人牙周炎（ＡＰ）患者的４４颗患牙,记录临床指标ＧＩ、ＰＤ、ＡＬ,并测定治疗前后ＧＣＦ－ＧＰｘ水平。结果：ＧＣＦ－ＧＰｘ与ＰＤ、ＡＬ负相关（Ｐ〈０．０５,Ｐ,０．００５）,与ＧＩ无明显相关性。牙周治疗后临床指标均明显下降（Ｐ〈０．００１）,ＧＣＦ－ＧＰｘ水平明显上升（Ｐ〈０．００１）,但ＧＣＦ－ＧＰＸ水平的上     

The effect of topical doxycycline usage on gingival crevicular fluid MMP-8 levels of chronic and aggressive periodontitis patients: a pilot study

Abstract:  The aim of this study was to evaluate the efficacy of topical subgingival application of doxycycline hyclate (DH) gel adjunctive to non-surgical periodontal therapy on gingival crevicular fluid (GCF) matrix metalloproteinase (MMP)-8 levels in chronic and aggressive periodontitis patients. Forty teeth of 10 chronic periodontitis patients and 32 teeth of eight aggressive periodontitis patients were screened for 6 months. Scaling and root planing (SRP) was applied to the control sites and DH gel adjunctive to SRP was applied to the test sites of each patient simultaneously. GCF MMP-8 levels were analysed at baseline, 7 days; and at 1, 3 and 6 months by Sandwich Elisa Method. At 1, 3 and 6 months, probing depth ( P  < 0.0051) and plaque scores and bleeding on probing values ( P  = 0.000) significantly decreased in each group when compared with the baseline, but there was no statistically significant difference between the test and control sites. GCF MMP-8 levels reduced presenting statistically significant differences on 7 days, 1, 3 and 6 months in four of the groups ( P  < 0.05); however, intergroup differences were not statistically significant. Developing functional and immunological-based chair-side MMP tests might serve as useful adjunctive diagnostic tools when monitoring the effects of DH gel application.