A RELATIONSHIP BETWEEN PROTEINASE ACTIVITY AND CLINICAL-PARAMETERS INTHE TREATMENT OF PERIODONTAL-DISEASE

The objective of this research was to determine the effectiveness of a biochemical assay which measures proteolytic enzyme activity in gingi val crevicular fluid (GCF) and to relate this enzyme activity to clini cal parameters traditionally utilized for periodontitis detection. A c linical trial was conducted on 8 periodontitis subjects with greater t han or equal to 4 sites exhibiting a loss of attachment of greater tha n or equal to 5 mm and probing depths of greater than or equal to 5 mm with bleeding on probing. On each subject; a plaque index was perform ed, followed by GCF sampling at those sites which exhibited a loss of attachment and probing depths. GCF was analyzed for activity against b enzoyl-L-arginine-p-nitroanilide in the presence (BAPNA w/gly-gly) and the absence (BAPNA w/o gly-gly) of glycyl-glycine and against MeOSuc- Ala-Ala-Pro-Val-pNA and Suc-Ala-Ala-Pro-Phe-pNA for neutrophil serine proteinases activity (elastase and cathepsin G, respectively). Subsequ ently, a gingival index was performed, attachment levels and probing d epths were recorded using a constant force probe with bleeding on prob ing being noted. A split-mouth design was employed and half mouths wer e randomly assigned to the following treatment groups: group A, half o f the mouth received scaling/root planing and polishing: group B, half of the mouth received no treatment (control). Subjects were treated, then instructed on toothbrushing and interdental cleaning. After 4 wee ks, subjects returned to receive a plaque index, GCF sampling, gingiva l index, attachment levels, probing depths and bleeding on probing as described above. Using a paired Student t-test, the findings suggest t hat BAPNA w/gly-gly was significantly less in treatment sites than in non-treated control sites (p=0.05). No such correlation was found for other activities, including neutrophil serine proteinases which were s hown to occur in GCF in free, proteolytically active forms. In additio n, significant treatment effects were detected fur probing depths (p=0 .03) which reduced by 1.3 mm and attachment levels (p=0.02) which gain ed 0.7 mm. The reduction of P. gingivalis From treated periodontitis s ites as detected by a significant decrease in BAPNA w/gly-gly may prov e to be a valuable marker for periodontal disease activity.