Influence of treatment with clindamycin on the amount of gingival crecivular fluid and its immune modulators PMN-Elastase, Prostaglandin E2 and Leukotrien B4

Gingivitis and periodontitis are primarily caused by bacterial plaque. They belong to the most frequent diseases in dogs. The gingival crevicular flui d (GCF), an exudation of the gingival crevice, and some of the biochemical substances contained in it are used as sensible parameters both in periodon tal diagnostics and in checking the success of a treatment. It was the aim of this study to point out the result of a treatment with clindamycin on th e amount of GCF and the concentration of its immunemediators LTB4, PGE2 and PMN-Elastase, in order to get specific information about the effectiveness of clindamycin within the microenvironment of the gingival crevice and the junctional epithelium in dogs. A crossed double-blind test was carried out twice, with an interval of five months, where the treatment group of serie s 1 acted as control group in series 2 and vice versa. The ten patients of the treatment group received clindamycin (Antirobe(R)) in a dose of 11 mg/k g/d perorally. At the beginning and at the end of each series the amount of GCF was assessed by the Periotron(R) 8000 machine in the treatment as well as in the control group. Additionally, plaque- and gingival indices were a ssessed on sir: reference teeth of each patient. The concentration of LTB4, PGE2, and PMN-Elastase in GCF was determined by ELISA. In series 1 the pla que index in the treatment group dropped from 2.83 +/- 0.72 to 0.17 +/- 0.3 8 (p < 0.001), the gingival index from 2.30 +/- 0.65 to 0.27 +/- 0.45 (p < 0.001), the amount of GCF from 92.55 +/- 32.66 to 32.25 +/- 16.5 periotron units (p < 0.001), the amount of LTB4 from 67.33 +/- 7.51 ng/ml to 55.20 +/ - 8.85 ng/ml (p < 0.01) and the amount of PGE2 from 44.60 +/- 10.54 ng/ml t o 29.97 +/- 5.38 ng/ml (p < 0.01). In series 2 the plaque index in the trea tment group dropped from 2.40 +/- 0.59 to 0.37 +/- 0.55 (p < 0.001), the gi ngival index from 2.35 +/- 0.55 to 0.30 +/- 0.46 (p < 0.001). The amount of GCF dropped from 75.65 +/- 24.71 to 20.30 +/- 9.45 periotron units (p < 0. 001), the amount of LTB4 from 65.82 +/- 10.29 ng/ml to 50.12 +/- 8.03 ng/ml (p < 0.01), the amount of PGE2 from 68.62 +/- 31.84 ng/ml to 41.21 +/- 16. 39 ng/ml (p < 0.01), and the amount of PMN-Elastase from 74.76 +/- 32.92 mu g/l to 41.38 +/- 12.42 mug/l (p < 0.001). Good evidence has been presented that the antimicrobial effect of clindamycin is not only due to high blood and salivary levels but also mirrors its effectiveness via the microenviron ment of the gingival crevice.