Ib. Lamster et al., THE RELATIONSHIP OF BETA-GLUCURONIDASE ACTIVITY IN CREVICULAR FLUID TO CLINICAL-PARAMETERS OF PERIODONTAL-DISEASE - FINDINGS FROM A MULTICENTER STUDY, Journal of clinical periodontology, 21(2), 1994, pp. 118-127
Previous reports have suggested that persistently elevated levels of t
he acidic glycohydrolase beta-glucuronidase (beta G) in gingival crevi
cular fluid (GCF) can identify patients with chronic adult periodontit
is who are at risk for future probing attachment loss (PAL). To compre
hensively study beta G activity in GCF, a multicenter trial examining
the relationship of the enzyme in GCF to traditional clinical paramete
rs of periodontal disease and PAL was conducted. In this report, the b
aseline data was used to evaluate the relationship of beta G activity
in GCF to traditional parameters of periodontal disease. The study gro
up included 130 patients who had been treated for periodontal disease
and were on a regular recall schedule, and 10 patients with chronic ad
ult periodontitis who had never received treatment. Upon entering the
longitudinal trial, the patients were examined, and a standardized 30-
s GCF sample was collected from the mesiobuccal crevice of all study t
eeth. As a control, GCF samples and clinical data were collected from
62 patients with a healthy periodontium or mild inflammatory gingiviti
s without loss of probing attachment. At baseline, beta G activity for
the periodontitis patients ranged from 0 to 1704 Units (U), with a me
dian of 32 U. beta G could not be detected in 0.2% of samples (activit
y less than or equal to 2.0 U). The 90% cumulative relative frequency
was 139 U. For the healthy/gingivitis subjects beta G activity ranged
from 0 to 504 U, with a median of 22 U. Enzyme was not detectable in 0
.4% of samples. Only 0.9% of samples contained greater than 139 U. bet
a G activity in GCF was not related to gender or age. For the periodon
titis patients, elevated enzyme activity(greater than or equal to 140
U) was most often associated with molar teeth, followed by maxillary b
icuspids. Maxillary central incisors, and mandibular central and later
al incisors displayed the lowest frequency of elevated enzyme activity
. The relationship of beta G activity to the traditional parameters of
probing depth and bleeding on probing was assessed. For shallow sites
(1.0-1.5 mm, 2.0-2.5 mm probing depth), the large majority of GCF sam
ples contained low enzyme activity (90% of samples < 50 U). Descriptiv
e indicators demonstrated a trend of increased beta G activity with in
creased probing depth. The median beta G activity shifted from 15 U fo
r the shallowest sites (1.0-1.5 mm) to 127 U for the deepest sites (5-
8 mm). However, this was due to a broadening of the distribution rathe
r than representing a shift in the distribution profile. The relations
hip of bleeding on probing to beta G activity was assessed on a tooth
basis (bleeding at 0 to 6 sites). Teeth with no bleeding sites demonst
rated a median beta G activity of 22 U, while teeth with 5-6 bleeding
sites had a median beta G activity of 86 U. Again, this was the result
of a broadening and flattening of the distribution observed with incr
eased occurrence of bleeding on probing. These data suggest that while
sites and teeth with increased severity of periodontal disease demons
trate greater beta G activity, quantitative assessment of this enzyme
in GCF provides a different measure of periodontal pathology than trad
itional clinical parameters of disease.