Evaluation of bleeding on probing and gingival crevicular fluid enzyme activity for detection of periodontally active sites during supportive periodontal therapy
Evaluation of bleeding on probing and gingival crevicular fluid enzyme activity for detection of periodontally active sites during supportive periodontal therapy
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DOI：
10.1007/s10266-012-0090-1
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发表时间：
2014-01-01
期刊：
影响因子：
2.5
通讯作者：
Nagata, Toshihiko
中科院分区：
文献类型：
--
作者：
Ito, Hiroshi;Numabe, Yukihiro;Nagata, Toshihiko
本研究旨在分析龈沟液（GCF）中酶活性及其与临床参数，尤其是探诊出血（BOP）的关系，从而重新考虑BOP记录的意义和准确性。共选择184名接受牙周支持治疗的患者，从401个位点收集GCF，然后记录临床参数，探测袋深度（PPD），BOP，临床附着水平，牙龈指数和菌斑指数。同时检测GCF中中性粒细胞弹性蛋白酶、天门冬氨酸氨基转移酶活性及蛋白质含量。在临床生化指标中，龈沟液量的相关性最强。根据ROC曲线和Youden指数确定BOP和PPD的临界值。对所有临床参数和生化数据进行分析。在401个地点中，有51个低于临界值，为BOP阴性。另一方面，29个位点的值超过临界值，其中14个BOP阴性位点和15个BOP阳性位点。结论如下：29个高于临界值的位点被诊断为需要牙周治疗的位点，然而，其中14个是BOP阴性的。结果提示，BOP、PPD联合其他生化检查可提高牙周病诊断的准确性。在未来的研究中，必须找到一种可以精确检测牙周病活动的标记物，并开发一种用于椅旁使用的诊断工具。
This study aimed to analyze the enzyme activity in gingival crevicular fluid (GCF) and its association with clinical parameters, especially bleeding on probing (BOP), and thus reconsider the significance and accuracy of recording BOP. A total of 184 patients who had entered supportive periodontal therapy were selected and GCF was collected from 401 sites before recording the clinical parameters, probing pocket depth (PPD), BOP, clinical attachment level, gingival index and plaque index. The enzyme activity of neutrophil elastase and aspartate aminotransferase and amount of protein in GCF were also analyzed. In the clinical parameters for biochemical data, amount of GCF showed the most correlation. A cut-off value for BOP and PPD were determined by the ROC curve and Youden index. Analysis was performed with all clinical parameters and biochemical data. Of the 401 sites, 51 were less than the cut-off value and were BOP-negative. On the other hand, 29 sites had values more than the cut-off value, with 14 BOP-negative sites and 15 BOP-positive sites. A conclusion is as follows: twenty-nine sites with values more than the cut-off value were diagnosed as sites requiring periodontal management, however, 14 of these were BOP-negative. These results suggest that combining other biochemical tests with examination of BOP and PPD may improve the validity of periodontal disease diagnosis. In future studies, it will be essential to find a marker that can precisely detect periodontal disease activity, and to develop a diagnostic tool for chair-side use.