gingival fluid. permeability of je & se permeability of je & se role of gcf, leucocyte &...
TRANSCRIPT
GINGIVAL FLUIDGINGIVAL FLUID
GINGIVAL FLUIDGINGIVAL FLUID
Permeability of JE & SEPermeability of JE & SE
Role of GCF, Leucocyte & SalivaRole of GCF, Leucocyte & Saliva
GCFGCF
Sulcular fluid /Gingival Crevicular Sulcular fluid /Gingival Crevicular FluidFluid
1919thth Century Century Waerhaug and Brill and Krasse 1950Waerhaug and Brill and Krasse 1950 Transudate(Brill)Transudate(Brill) Inflammatory Exudate(Others)Inflammatory Exudate(Others)
METHODS OF COLLECTIONMETHODS OF COLLECTION
Absorbing paper stripsAbsorbing paper strips Twisted threadsTwisted threads MicropipettesMicropipettes Intracrevicular washingsIntracrevicular washings
PERMEABILITY OF JE&SEPERMEABILITY OF JE&SE
Fluorescein initially(Brill&Krasse)Fluorescein initially(Brill&Krasse) Confirmed with India Confirmed with India
ink&saccharated ironink&saccharated iron Albumin,endotoxin,thymidine,histamiAlbumin,endotoxin,thymidine,histami
ne,phenytoin &Horseradish ne,phenytoin &Horseradish peroxidaseperoxidase
Mol wt 1000kDMol wt 1000kD
AMOUNT OF GCFAMOUNT OF GCF
Wetted Paper strip(ninhydrin stain) Wetted Paper strip(ninhydrin stain) evaluated with Microscopeevaluated with Microscope
Periotron(Electronic Methods)Periotron(Electronic Methods) 1.5mm wide &1mm within GS 1.5mm wide &1mm within GS
=0.1mg GCF(3min)=0.1mg GCF(3min) Molar 0.43-1.56m LMolar 0.43-1.56m L
COMPOSITIONCOMPOSITION
Cellular Elements Cellular Elements
ElectrolytesElectrolytes
Organic CompoundsOrganic Compounds
CELLULAR ELEMENTCELLULAR ELEMENT
BacteriaBacteria
Desquamated epithelial cellsDesquamated epithelial cells
Leukocytes(PMNs,Lymphocytes,MonoLeukocytes(PMNs,Lymphocytes,Monocytes/Macrophages)cytes/Macrophages)
ELECTROLYTESELECTROLYTES
PotassiumPotassium
SodiumSodium
CalciumCalcium
ORGANIC COMPOUNDSORGANIC COMPOUNDS
Carbohydrates & ProteinsCarbohydrates & Proteins Glucose hexosamine & hexuronic Glucose hexosamine & hexuronic
acidacid Glucose conc(GCF) 3-Glucose conc(GCF) 3-
4times>>Serum4times>>Serum Total Protein(GCF) much less than Total Protein(GCF) much less than
SerumSerum Metabolic&Bacterial ProductsMetabolic&Bacterial Products
Enzymes&Other Enzymes&Other CompoundsCompounds
Acid phosphatase,Alkaline Acid phosphatase,Alkaline phosphatase,α1 phosphatase,α1 Antitrypsin,Arylsulfatase,Aspartate Antitrypsin,Arylsulfatase,Aspartate aminotransferase,aminotransferase,
Cathelicidin LL-37,AlanineCathelicidin LL-37,Alanine
aminotransferase,Chondroitin aminotransferase,Chondroitin sulfatas,Citric acid,Cystatins,sulfatas,Citric acid,Cystatins,
Cytokines (interleukins), IL-1α IL-1β IL-Cytokines (interleukins), IL-1α IL-1β IL-4, IL-6, and IL-8 IL-11, IL-12 IF-gamma.4, IL-6, and IL-8 IL-11, IL-12 IF-gamma.
Enzymes&Other Compounds Enzymes&Other Compounds contd..contd..
Endopeptidases: Cathepsin Endopeptidases: Cathepsin D, Cathepsin B/L, Cathepsin D, Cathepsin B/L, Cathepsin G, Cathepsin K, Elastase,Plasminogen G, Cathepsin K, Elastase,Plasminogen activatoractivator
Collagenase,Tryptase-like Collagenase,Tryptase-like enzyme,Trypsin-like enzyme,Trypsin-like enzyme,Dipeptidylpeptidase IV–like enzyme,Dipeptidylpeptidase IV–like enzyme,Elastase–α1-proteinase inhibitorenzyme,Elastase–α1-proteinase inhibitor
Enzymes&Other Compounds Enzymes&Other Compounds contd..contd..
Exopeptidases,Fibrin,Fibronectin,β-Exopeptidases,Fibrin,Fibronectin,β-glucuronidase,Glycosidases, α1-glucuronidase,Glycosidases, α1-Fucosidase Sialidase Fucosidase Sialidase
β-β-NN-acetylglucosaminidase β--acetylglucosaminidase β-Galactosidase β-Galactosidase β-MannosidaseHyaluronidaseMannosidaseHyaluronidase
Immunoglobulins (IgG, IgA, IgG4, Immunoglobulins (IgG, IgA, IgG4, IgM),IgM),
Enzymes&Other Compounds Enzymes&Other Compounds contd..contd..
Lactate Lactate dehydrogenase,Lactoferrin,Lactic dehydrogenase,Lactoferrin,Lactic acid,Lysozyme,α2-Macroglobulinsacid,Lysozyme,α2-Macroglobulins
Medullasin,Metalloproteinases,MyeloMedullasin,Metalloproteinases,Myeloperoxidase,Prostaglandin E2 peroxidase,Prostaglandin E2 (PGE2),Transferrin,Thromboxane.(PGE2),Transferrin,Thromboxane.
Compounds&Enzymes of Compounds&Enzymes of Bacterial OriginBacterial Origin
Acidphosphatase, Alkalinephosphatase, Acidphosphatase, Alkalinephosphatase,
Aminopeptidases, Chondroitin sulfatase, Aminopeptidases, Chondroitin sulfatase,
Chymotrypsin-like product, Collagenase,Chymotrypsin-like product, Collagenase,
Deoxyribonuclease, DNase,Deoxyribonuclease, DNase,
Dipeptidylaminopeptidase IV–like Dipeptidylaminopeptidase IV–like enzyme, enzyme,
Compounds&Enzymes of Compounds&Enzymes of Bacterial Origin contd…Bacterial Origin contd…
Fibrinolysin, Glucosidases, HemolysiFibrinolysin, Glucosidases, Hemolysin, Hyaluronidase, Iminopeptidases, n, Hyaluronidase, Iminopeptidases, Immunoglobulinases, β-Lactamase,Immunoglobulinases, β-Lactamase,
Lysophospholipase, Phospholipase Lysophospholipase, Phospholipase A, Phospholipase C, Prostaglandin-A, Phospholipase C, Prostaglandin-like product, Trypsin-like enzymelike product, Trypsin-like enzyme
Cellular & Humoral ActivityCellular & Humoral Activity
Non invasive methodsNon invasive methods Identify cell&humoral responses in Identify cell&humoral responses in
Health/DiseaseHealth/Disease IL-1alpha&IL-1Beta increase the IL-1alpha&IL-1Beta increase the
binding of binding of PMNs&monocyte/macrophages PMNs&monocyte/macrophages
Interferon-alpha may have protective Interferon-alpha may have protective rolerole
Analysis of specificity of antibodiesAnalysis of specificity of antibodies
Clinical SignificanceClinical Significance
Amount of GCF directly proportional Amount of GCF directly proportional to the severity of inflammationto the severity of inflammation
GCF production increase by GCF production increase by mastication,toothbrushing,gingival mastication,toothbrushing,gingival massage,ovulation,oral massage,ovulation,oral contraceptive&smoking.contraceptive&smoking.
Circadian Periodicity- 6am-10pmCircadian Periodicity- 6am-10pm
Clinical Significance contd…Clinical Significance contd…
Sex Hormone: female sex hormone Sex Hormone: female sex hormone increase GCFincrease GCF
Mechanical stimulation: chewing Mechanical stimulation: chewing &vigorous Tooth brushing&vigorous Tooth brushing
Smoking: transient marked increase Smoking: transient marked increase GCFGCF
Periodontal therapyPeriodontal therapy
Drugs in GCFDrugs in GCF
Drugs that are excreted in GCFDrugs that are excreted in GCF
Bader&Goldhaber : Dogs GCF Bader&Goldhaber : Dogs GCF (Tetracyclin)(Tetracyclin)
Metronidazole Metronidazole
Leuckocytes in the Leuckocytes in the Dentogingival AreaDentogingival Area
Predominantly PMNsPredominantly PMNs Clinically healthy sulci 91.2%-Clinically healthy sulci 91.2%-
91.5%PMNs&8.5-8.8%mononuclear cells91.5%PMNs&8.5-8.8%mononuclear cells Mononuclear cells 58%B-Mononuclear cells 58%B-
lymphocyte,24%T-lymphocyte,24%T-lymphocyte&18%mononuclear lymphocyte&18%mononuclear phagocytephagocyte
Peripheral blood T/B lymphocyte 3:1Peripheral blood T/B lymphocyte 3:1 GCF T/B lymphocyte 1:3GCF T/B lymphocyte 1:3
MCQ -1MCQ -1
Which of the following cytokines in Which of the following cytokines in Gingival crevicular fluid may have Gingival crevicular fluid may have protective role in periodontal protective role in periodontal diseasesdiseases
a-Interleukin 1-alphaa-Interleukin 1-alpha
b-Interleukin 1-beetab-Interleukin 1-beeta
c-Interferon-alphac-Interferon-alpha
d-Prostaglandin-E2 d-Prostaglandin-E2
MCQ-2MCQ-2
Most common antibiotic that is excretedMost common antibiotic that is excreted
through the gingival crevicular fluid may through the gingival crevicular fluid may bebe
used advantageously in periodontal used advantageously in periodontal therapytherapy
a-Amoxicillina-Amoxicillin
b-Doxycyclinb-Doxycyclin
c-Cefalosporinc-Cefalosporin
d-Erythromycind-Erythromycin
MCQ-3MCQ-3
The following factors are responsible forThe following factors are responsible for
enhancement of production of gingivalenhancement of production of gingival
crevicular fluid crevicular fluid EXCEPTEXCEPT
a-smokinga-smoking
b-trauma from occlusionb-trauma from occlusion
c-vigorous brushingc-vigorous brushing
d-healing period after d-healing period after curettagecurettage
MCQ-4MCQ-4
Which is the correct statement of glucoseWhich is the correct statement of glucose
and protein content in gingival crevicularand protein content in gingival crevicular
fluid(GCF) fluid(GCF)
a-glucose conc.3-4times greater than a-glucose conc.3-4times greater than serumserum
b-glucose conc. 3-4times lesser than b-glucose conc. 3-4times lesser than serumserum
c-total protein is more than that of serumc-total protein is more than that of serum
d-total protein is equal to that of serumd-total protein is equal to that of serum
MCQ-5MCQ-5
What are the ratio of T-lymphocytes to What are the ratio of T-lymphocytes to BB
lymphocytes in Gingival crevicular fluidlymphocytes in Gingival crevicular fluid
a-1:2a-1:2
b-2:1b-2:1
c-1:3c-1:3
d-3:1d-3:1