THE RELATIONSHIP BETWEEN GINGIVAL CREVICULAR FLUID CATHEPSIN-B ACTIVITY AND PERIODONTAL ATTACHMENT LOSS IN CHRONIC PERIODONTITIS PATIENTS -A 2-YEAR LONGITUDINAL-STUDY
Bm. Eley et Sw. Cox, THE RELATIONSHIP BETWEEN GINGIVAL CREVICULAR FLUID CATHEPSIN-B ACTIVITY AND PERIODONTAL ATTACHMENT LOSS IN CHRONIC PERIODONTITIS PATIENTS -A 2-YEAR LONGITUDINAL-STUDY, Journal of Periodontal Research, 31(6), 1996, pp. 381-392
This study aims to determine whether gingival crevicular fluid (GCF) c
athepsin B levels, total activity (TA) and concentration (EC) predict
progressive attachment loss (AL). Seventy-five previously untreated pa
tients with moderate periodontitis were recruited, GCF was collected f
rom 16 molar and premolar mesiobuccal sites and probing attachment lev
el (PAL) and probing depth (PPD) were measured with an electronic prob
e. Gingival, gingival bleeding and plaque indices were then scored. Pr
ior to baseline patients were given basic periodontal treatment after
which the above procedures were repeated. Carefully localized radiogra
phs were taken of the test teeth and repeated annually. Patients were
seen 3-monthly for 2 yr and the procedures were repeated. One hundred
and twenty-one AL sites, 90 rapid AL (RAL) and 31 gradual AL (GAL), in
49 patients were detected. Cathepsin B levels (TA & EC) at RAL sites
were significantly higher (p<0.0001) than paired control sites at the
attachment loss time (ALT) and prediction time (PT). Mean levels (TA &
EC) over the study period at GAL sites were significantly higher (p<0
.0001) than paired control sites. Using a critical value (CV) of 7.5 m
u U/30 s (TA) and 30 mu U/mu L (EC) showed a sensitivity of 100% and s
pecificity of 99.83% (TA) and 100% and 99.75%(EC) at both ALT & PT. Me
an cathepsin B levels (TA & EC) were significantly higher (p<0.0001) a
t RAL and GAL sites than nonattachment loss (NAL) sites in AL patients
in intrapatient comparisons and mean patient levels were significantl
y higher (p<0.0001) in AL patients than NAL patients in interpatient c
omparisons. These results indicate that GCF cathepsin B may serve as a
predictor of attachment loss.