GINGIVAL FLUID GINGIVAL FLUID n Permeability of JE

GINGIVAL FLUID

GINGIVAL FLUID n Permeability of JE & SE n Role of GCF, Leucocyte & Saliva

GCF n Sulcular fluid /Gingival Crevicular Fluid n 19 th Century n Waerhaug and Brill and Krasse 1950 n Transudate(Brill) n Inflammatory Exudate(Others)

METHODS OF COLLECTION n Absorbing paper strips n Twisted threads n Micropipettes n Intracrevicular washings

PERMEABILITY OF JE&SE n Fluorescein initially(Brill&Krasse) n Confirmed with India ink&saccharated iron n Albumin, endotoxin, thymidine, histamine, ph enytoin &Horseradish peroxidase n Mol wt 1000 k. D

AMOUNT OF GCF n Wetted Paper strip(ninhydrin stain) evaluated with Microscope n Periotron(Electronic Methods) n 1. 5 mm wide &1 mm within GS =0. 1 mg GCF(3 min) n Molar 0. 43 -1. 56 m L

COMPOSITION n Cellular Elements n Electrolytes n Organic Compounds

CELLULAR ELEMENT n Bacteria n Desquamated epithelial cells n Leukocytes(PMNs, Lymphocytes, Monocytes /Macrophages)

ELECTROLYTES n Potassium n Sodium n Calcium

ORGANIC COMPOUNDS n Carbohydrates & Proteins n Glucose hexosamine & hexuronic acid n Glucose conc(GCF) 3 -4 times>>Serum n Total Protein(GCF) much less than Serum n Metabolic&Bacterial Products

Enzymes&Other Compounds n Acid phosphatase, Alkaline phosphatase, α 1 Antitrypsin, Arylsulfatase, Aspartate aminotransferase, n Cathelicidin LL-37, Alanine aminotransferase, Chondroitin sulfatas, Citric acid, Cystatins, n Cytokines (interleukins), IL-1α IL-1β IL-4, IL-6, and IL-8 IL-11, IL-12 IF-gamma.

Enzymes&Other Compounds contd. . n Endopeptidases: Cathepsin D, Cathepsin B/L, Cathepsin G, Cathepsin K, Elastase, Plasminogen activator n Collagenase, Tryptase-like enzyme, Trypsin- like enzyme, Dipeptidylpeptidase IV–like enzyme, Elastase–α 1 -proteinase inhibitor

Enzymes&Other Compounds contd. . n Exopeptidases, Fibrin, Fibronectin, β- glucuronidase, Glycosidases, α 1 Fucosidase Sialidase n β-N-acetylglucosaminidase βGalactosidase βMannosidase. Hyaluronidase n Immunoglobulins (Ig. G, Ig. A, Ig. G 4, Ig. M),

Enzymes&Other Compounds contd. . n Lactate dehydrogenase, Lactoferrin, Lactic acid, Lysozyme, α 2 -Macroglobulins n Medullasin, Metalloproteinases, Myeloperoxi dase, Prostaglandin E 2 (PGE 2), Transferrin, Thromboxane.

Compounds&Enzymes of Bacterial Origin Acidphosphatase, Alkalinephosphatase, Aminopeptidases, Chondroitin sulfatase, Chymotrypsin-like product, Collagenase, Deoxyribonuclease, DNase, Dipeptidylaminopeptidase IV–like enzyme,

Compounds&Enzymes of Bacterial Origin contd… n Fibrinolysin, Glucosidases, Hemolysin, Hy aluronidase, Iminopeptidases, Immunogl obulinases, β-Lactamase, n Lysophospholipase, Phospholipase A, Phospholipase C, Prostaglandin-like product, Trypsin-like enzyme

Cellular & Humoral Activity n Non invasive methods n Identify cell&humoral responses in Health/Disease n IL-1 alpha&IL-1 Beta increase the binding of PMNs&monocyte/macrophages n Interferon-alpha may have protective role n Analysis of specificity of antibodies

Clinical Significance n Amount of GCF directly proportional to the severity of inflammation n GCF production increase by mastication, toothbrushing, gingival massage, ovulation, oral contraceptive&smoking. n Circadian Periodicity- 6 am-10 pm

Clinical Significance contd… n Sex Hormone: female sex hormone increase GCF n Mechanical stimulation: chewing &vigorous Tooth brushing n Smoking: transient marked increase GCF n Periodontal therapy

Drugs in GCF n Drugs that are excreted in GCF n Bader&Goldhaber : Dogs GCF (Tetracyclin) n Metronidazole

Leuckocytes in the Dentogingival Area n Predominantly PMNs n Clinically healthy sulci 91. 2%- 91. 5%PMNs&8. 5 -8. 8%mononuclear cells n Mononuclear cells 58%Blymphocyte, 24%Tlymphocyte&18%mononuclear phagocyte n Peripheral blood T/B lymphocyte 3: 1 n GCF T/B lymphocyte 1: 3

MCQ -1 Which of the following cytokines in Gingival crevicular fluid may have protective role in periodontal diseases a-Interleukin 1 -alpha b-Interleukin 1 -beeta c-Interferon-alpha d-Prostaglandin-E 2

MCQ-2 Most common antibiotic that is excreted through the gingival crevicular fluid may be used advantageously in periodontal therapy a-Amoxicillin b-Doxycyclin c-Cefalosporin d-Erythromycin

MCQ-3 The following factors are responsible for enhancement of production of gingival crevicular fluid EXCEPT a-smoking b-trauma from occlusion c-vigorous brushing d-healing period after curettage

MCQ-4 Which is the correct statement of glucose and protein content in gingival crevicular fluid(GCF) a-glucose conc. 3 -4 times greater than serum b-glucose conc. 3 -4 times lesser than serum c-total protein is more than that of serum d-total protein is equal to that of serum

MCQ-5 What are the ratio of T-lymphocytes to B lymphocytes in Gingival crevicular fluid a-1: 2 b-2: 1 c-1: 3 d-3: 1