VARIATIONS IN CREVICULAR FLUID ELASTASE LEVELS IN PERIODONTITIS PATIENTS ON LONG-TERM MAINTENANCE

Granulocyte elastase was determined in the gingival crevicular fluid ( GCF) of 18 periodontitis patients. They initially had similar severity of disease but had responded differently to 5-yr maintenance, 13 resp onders and 5 non-responders. A total of 102 sites were investigated an d categorized as: i) consistently healthy, ii) healthy after treatment , iii) gingivitis, and iiii) periodontitis, according to clinical crit eria. GCF elastase activity was determined with a granulocyte-specific substrate. The sites from non-responders had consistently higher elas tase levels than the corresponding category of sites from responders, despite similar gingival inflammation and periodontal destruction, wit h the exception of consistently healthy sites. Within the non-responde rs, the periodontitis sites had higher elastase levels than the gingiv itis sites commensurate with probing depth, while no difference existe d between gingivitis sites and sites healthy after treatment, despite a difference in probing depth. In contrast, in the responders similar elastase levels were found at the periodontitis sites and gingivitis s ites despite difference in probing depth, while both diseased sites ha d higher elastase levels than the sites healthy after treatment, comme nsurate with probing depth, This study suggests that increased granulo cyte-specific elastase levels in GCF may serve as a diagnostic marker for refractory periodontitis patients.