Ⅱ°根分叉病变患者引导组织再生治疗术前术后龈沟液中糖氨多糖水平的变化

目的　观察Ⅱ°根分叉病变患者引导组织再生治疗术 (guidedtissueregeneration ,GTR)前后龈沟液(gingivalcrevicularfluid ,GCF)中糖氨多糖 (glycosaminoglycans ,GAG)水平变化的同时 ,探讨GCF中GAG能否作为判断GTR术后组织成熟的指标。方法　对 6例Ⅱ°根分叉病变的患牙采用GTR治疗 ,并于手术前 ,手术后 1、2、3、4、5、6周收集GCF。用 0 .1%阿尔辛兰 (Alcianblue)染色 ,分光光度法测定GCF中总的硫酸化GAG及硫酸软骨素 (chondroitinsulfate ,CS)的水平。结果　GTR术后 1～ 2周 ,GCF中CS明显降低 (P <0 .0 5 ) ,然后逐渐升高 ,第 6周恢复到基线水平。而GCF中总的硫酸化GAG则在术后 1周明显升高 (P <0 .0 5 ) ,然后下降 ,到第 6周升高并超过基线水平。结论　GCF中总的硫酸化GAG ,尤其是CS可用作监测牙周伤口愈合和组织再生的一个潜在指标 ,但是否可以用作GTR术后组织成熟的指标 ,还需加大样本并结合病理进行进一步的纵向观察

Levels of glycosaminoglycans in gingival crevicular fluid of patients with periodontal degree II furcation involvement before and after guided tissue regeneration.

Objective To monitor glycosaminoglycans in gingival crevicular fluid and to investigate whether the levels of glycosaminoglycans in gingival crevicular fluid of patients with periodontal degree II furcation involvement before and after GTR can be used as indicators of tissue maturation under guided tissue membranes used to treat periodontal furcation defects.Methods Six patients were selected on the basis of having at least one degree II buccal furcation involvement on a molar tooth. Each molar furcation was treated with the standard GTR surgical protocol using a non-resorbable expanded polytetrafluoroethylene membrane. Gingival crevicular fluid samples were taken at baseline (immediately prior to insertion of the membrane) and at 1, 2, 3, 4, 5 and 6 weeks (immediately prior to remove of the membrane). Glycosaminoglycan levels were determined using an Alcian blue dye detection system. Results The mean levels ofchondroitin sulfate in the gingival crevicular fluid significantly decreased during the first 2weeks after GTR surgery. By week 3 the levels began to rise and by week 6 the levels had returned to baseline levels. At week 1 the amount of total sulfated glycosaminoglycans in the gingival crevicular fluid showed a tendency to increase and, thereafter, it rapidly fell to below baseline values and then increase to above the baseline levels by week 6.Conclusion Sulfated glycosaminoglycans, especially chondroitin sulfate in the gingival crevicular fluid may be a useful potential indicator of monitoring the status of the regenerating tissues. However, further longitudinal studies are required to assess if the sulfated glycosaminoglycans can be used as indicator of tissue maturation under guided tissue membrane used to treat periodontal defects.