- Volume 43 Issue 5
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Comparative volumetric and clinical evaluation of peri-implant sulcular fluid and gingival crevicular fluid
- Bhardwaj, Smiti (Department of Periodontology, Krishnadevaraya College of Dental Sciences and Hospital) ;
- Prabhuji, Munivenkatappa Lakshmaiah Venkatesh (Department of Periodontology, Krishnadevaraya College of Dental Sciences and Hospital)
- Received : 2013.07.19
- Accepted : 2013.09.27
- Published : 2013.10.31
Purpose: Peri-implant sulcular fluid (PISF) has a production mechanism similar to gingival crevicular fluid (GCF). However, limited research has been performed comparing their behavior in response to inflammation. Hence, the aim of the present study was to comparatively evaluate PISF and GCF volume with varying degrees of clinical inflammatory parameters. Methods: Screening of patients was conducted. Based on the perimucosal inflammatory status, 39 loaded implant sites were selected from 24 patients, with equal numbers of sites in healthy, peri-implant mucositis, and peri-implantitis subgroups. GCF collection was done from age- and sex-matched dentate patients, selected with gingival inflammatory status corresponding to the implant sites. Assessment of the inflammatory status for dental/implant sites was performed using probing depth (PD), plaque index/modified plaque index (PI/mPI), gingival index/simplified gingival index (GI/sGI), and modified sulcular bleeding index (BI). Sample collection was done using standardized absorbent paper strips with volumetric evaluation performed via an electronic volume quantification device. Results: Positive correlation of the PISF and GCF volume was seen with increasing PD and clinical inflammatory parameters. A higher correlation of GCF with PD (0.843) was found when compared to PISF (0.771). PISF expressed a higher covariation with increasing grades of sGI (0.885), BI (0.841), and mPI (0.734), while GCF established a moderately positive correlation with GI (0.694), BI (0.696), and PI (0.729). Conclusions: Within the limitations of this study, except for minor fluctuations, GCF and PISF volumes demonstrated a similar nature and volumetric pattern through increasing grades of inflammation, with PISF showing better correlation with the clinical parameters.
- American Academy of Periodontology. Glossary of periodontal terms. Chicago: American Academy of Periodontology; 2001.
- Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963;21:533-51. https://doi.org/10.3109/00016356309011240
- Loe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38(6):Suppl:610-6. https://doi.org/10.1902/jop.19188.8.131.520
- Mombelli A, van Oosten MA, Schurch E Jr, Land NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol 1987;2:145-51. https://doi.org/10.1111/j.1399-302X.1987.tb00298.x
- Lindquist LW, Rockler B, Carlsson GE. Bone resorption around fixtures in edentulous patients treated with mandibular fixed tissue-integrated prostheses. J Prosthet Dent 1988;59:59-63. https://doi.org/10.1016/0022-3913(88)90109-6
- Apse P, Zarb GA, Schmitt A, Lewis DW. The longitudinal effectiveness of osseointegrated dental implants. The Toronto Study: peri-implant mucosal response. Int J Periodontics Restorative Dent 1991;11:94-111.
- Gargiulo AW, Wentz FM, Orban B. Dimensions and relations of dentogingival junctions in humans. J Periodontol 1961;32:261-7. https://doi.org/10.1902/jop.19184.108.40.2061
- Karbach J, Callaway A, Kwon YD, d'Hoedt B, Al-Nawas B. Comparison of five parameters as risk factors for peri-mucositis. Int J Oral Maxillofac Implants 2009;24:491-6.
- Black GV. The fibers and glands of the peridental membrane. Dent Cosmos 1899;41:101-22.
- Brill N. Influence of capillary permeability on flow of tissue fluid into gingival pockets. Acta Odontol Scand 1959;17:23-33. https://doi.org/10.3109/00016355909011230
- Egelberg J. Permeability of the dento-gingival blood vessels. 1. Application of the vascular labelling method and gingival fluid measurements. J Periodontal Res 1966;1:180-91. https://doi.org/10.1111/j.1600-0765.1966.tb01858.x
- Egelberg J. Permeability of the dento-gingival blood vessels. III. Chronically inflamed gingivae. J Periodontal Res 1966;1:287-96. https://doi.org/10.1111/j.1600-0765.1966.tb01873.x
- Alfano MC. The origin of gingival fluid. J Theor Biol 1974;47:127-36. https://doi.org/10.1016/0022-5193(74)90103-9
- Pashley DH. A mechanistic analysis of gingival fluid production. J Periodontal Res 1976;11:121-34. https://doi.org/10.1111/j.1600-0765.1976.tb00060.x
- Griffiths GS, Sterne JA, Wilton JM, Eaton KA, Johnson NW. Associations between volume and flow rate of gingival crevicular fluid and clinical assessments of gingival inflammation in a population of British male adolescents. J Clin Periodontol 1992;19:464-70. https://doi.org/10.1111/j.1600-051X.1992.tb01158.x
- Ozkavaf A, Aras H, Huri CB, Mottaghian-Dini F, Tozum TF, Etikan I, et al. Relationship between the quantity of gingival crevicular fluid and clinical periodontal status. J Oral Sci 2000;42:231-8. https://doi.org/10.2334/josnusd.42.231
- Lindhe J, Hamp SE, Loe H. Experimental periodontitis in the beagle dog. Int Dent J 1973;23:432-7.
- Stewart JE, Christenson PD, Maeder LA, Palmer MA. Reliability of filter-strip sampling of gingival crevicular fluid for volume determination using the Periotron. J Periodontal Res 1993;28:227-30. https://doi.org/10.1111/j.1600-0765.1993.tb01073.x
- Apse P, Ellen RP, Overall CM, Zarb GA. Microbiota and crevicular fluid collagenase activity in the osseointegrated dental implant sulcus: a comparison of sites in edentulous and partially edentulous patients. J Periodontal Res 1989;24:96-105. https://doi.org/10.1111/j.1600-0765.1989.tb00863.x
- Lang NP, Berglundh T; Working Group 4 of Seventh European Workshop on Periodontology. Periimplant diseases: where are we now? Consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol 2011;38 Suppl 11:178-81. https://doi.org/10.1111/j.1600-051X.2010.01674.x
- Hatipoglu H, Yamalik N, Berberoglu A, Eratalay K. Impact of the distinct sampling area on volumetric features of gingival crevicular fluid. J Periodontol 2007;78:705-15. https://doi.org/10.1902/jop.2007.060331
- Tozum TF, Hatipoglu H, Yamalik N, Gursel M, Alptekin NO, Ataoglu T, et al. Critical steps in electronic volume quantification of gingival crevicular fluid: the potential impact of evaporation, fluid retention, local conditions and repeated measurements. J Periodontal Res 2004;39:344-57. https://doi.org/10.1111/j.1600-0765.2004.00758.x
- Ciantar M, Caruana DJ. Periotron 8000: calibration characteristics and reliability. J Periodontal Res 1998;33:259-64. https://doi.org/10.1111/j.1600-0765.1998.tb02198.x
- Lindhe J, Meyle J; Group D of European Workshop on Periodontology. Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodontol 2008;35(8 Suppl):282-5. https://doi.org/10.1111/j.1600-051X.2008.01283.x
- Lang NP, Bosshardt DD, Lulic M. Do mucositis lesions around implants differ from gingivitis lesions around teeth? J Clin Periodontol 2011;38 Suppl 11:182-7. https://doi.org/10.1111/j.1600-051X.2010.01667.x
- Froum SJ, Rosen PS. A proposed classification for peri-implantitis. Int J Periodontics Restorative Dent 2012;32:533-40.
- Mombelli A, Graf H. Depth-force-patterns in periodontal probing. J Clin Periodontol 1986;13:126-30. https://doi.org/10.1111/j.1600-051X.1986.tb01444.x
- Strbac GD, Monov G, Cei S, Kandler B, Watzek G, Gruber R. Cathepsin K levels in the crevicular fluid of dental implants: a pilot study. J Clin Periodontol 2006;33:302-8. https://doi.org/10.1111/j.1600-051X.2006.00904.x
- Salvi GE, Lang NP. Diagnostic parameters for monitoring peri-implant conditions. Int J Oral Maxillofac Implants 2004;19 Suppl:116-27.
- Luterbacher S, Mayfield L, Bragger U, Lang NP. Diagnostic characteristics of clinical and microbiological tests for monitoring periodontal and peri-implant mucosal tissue conditions during supportive periodontal therapy (SPT). Clin Oral Implants Res 2000;11:521-9. https://doi.org/10.1034/j.1600-0501.2000.011006521.x
- Listgarten MA, Lang NP, Schroeder HE, Schroeder A. Periodontal tissues and their counterparts around endosseous implants. Clin Oral Implants Res 1991;2:1-19. https://doi.org/10.1034/j.1600-0501.1991.020309.x
- Chaytor DV, Zarb GA, Schmitt A, Lewis DW. The longitudinal effectiveness of osseointegrated dental implants. The Toronto Study: bone level changes. Int J Periodontics Restorative Dent 1991;11:112-25.
- Schierano G, Pejrone G, Brusco P, Trombetta A, Martinasso G, Preti G, et al. TNF-alpha TGF-beta2 and IL-1beta levels in gingival and peri-implant crevicular fluid before and after de novo plaque accumulation. J Clin Periodontol 2008;35:532-8. https://doi.org/10.1111/j.1600-051X.2008.01224.x
- Gunday S, Topcu AO, Guncu GN, Akman CS, Karabulut E, Yamalik N. Analysis of potential factors affecting peri implant sulcus fluid volume. Clinical Dent Res 2011;35:12-24.
- Tozum TF, Turkyilmaz I, Yamalik N, Tumer C, Kilinc A, Kilinc K, et al. Analysis of thte possible impact of inflammation severity and early and delayed loading on nitric oxide metabolism around dental implants. Int J Oral Maxillofac Implants 2005;20:547-56.
- Guncu GN, Tozum TF, Guncu MB, Yamalik N, Tümer C, Karabulut E, et al. Myeloperoxidase as a measure of polymorphonuclear leukocyte response in inflammatory status around immediately and delayed loaded dental implants: a randomized controlled clinical trial. Clin Implant Dent Relat Res 2008;10:30-9. https://doi.org/10.1111/j.1708-8208.2007.00058.x
- Tozum TF, Guncu GN, Yamalik N, Turkyilmaz I, Guncu MB. The impact of prosthetic design on the stability, marginal bone loss, peri-implant sulcus fluid volume, and nitric oxide metabolism of conventionally loaded endosseous dental implants: a 12-month clinical study. J Periodontol 2008;79:55-63. https://doi.org/10.1902/jop.2008.070351
- Mann WV. The correlation of gingivitis pocket depth and exudate from the gingival crevice. J Periodontol 1963;34:379-87. https://doi.org/10.1902/jop.19220.127.116.119
- Oliver RC, Holm-Pederen P, Loe H. The correlation between clinical scoring, exudate measurements and microscopic evaluation of inflammation in the gingiva. J Periodontol 1969;40:201-9. https://doi.org/10.1902/jop.1918.104.22.168
- Niimi A, Ueda M. Crevicular fluid in the osseointegrated implant sulcus: a pilot study. Int J Oral Maxillofac Implants 1995;10:434-6.