Topic 14 (Gingival Crevicular Fluid & Structure & Composition Flashcards
Shallow crevice/ space around the teeth, bounded by the surface of tooth on one side and epithelium lining the free margin of gingiva on the other side
Gingival Sulcus
V-shaped, barely permits the penetration of probe.
Gingival Sulcus
The clinical evaluation used to determine the depth of the sulcus involves the introduction of a metallic instrument, the periodontal probe, and the
estimation of the distance it penetrates.
Gingival Sulcus
It is the V shaped. The depth as determined with histological sections is 1.8mm
Gingival Sulcus
Gingival sulcus is the V shaped. The depth as determined with
histological sections is ____.
1.8mm
The so-called probing depth of a clinically normal ____ is 2-3mm
Gingival Sulcus
The so-called probing depth of a clinically normal gingival sulcus is ____.
2 - 3mm
Sections show presence of 3 types of epithelium.
Gingival Sulcus
Section show presence of 3 types of epithelium, what are those:
- The oral/keratinized epithelium
- The Sulcular Epithelium
- Junctional Epithelium
An epithelium covering the gingival connective tissue in continuation with the sulcular epithelium.
The oral or keratinized Epithelium
An epithelium which is not keratinized. it forms the soft tissue wall of the gingival sulcus and the Junction Epithelium.
The Sulcular Epithelium
It is in continuation with the oral & sulcular epithelium.
Junctional Epithelium
It is formed by few starts of cells, with long flat basal layer and very small desquamating surface that forms of the gingival sulcus.
Junctional Epithelium
Complex mixture of substances.
Gingival Crevicular Fluid
Who confirmed the presence of GCF in humans and considered it to be a ‘transudate’.
Brill (1959)
Brill (1959) confirmed the presence of GCF in humans and considered it to be a ____.
Transudate
However, others demonstrated that GCF is an inflammatory exudate, not a continuous transudate. In strictly normal gingiva, little or no fluid can be collected.
TRUE OR FALSE
TRUE
Who suggested that the initial fluid is the interstitial fluid which appears in the crevice as a resuit of osmotic gradient.
Alfano (1974) and Pashley (1976)
This initial, proinflammatory: fluid was earlier considered to be ____, and on stimulation it changes to an exudate.
transudate
Collection of gingival crevicular fluid is ____ and therefore this approach has been extensively explored in the search for potential diagnostic biomarkers of periodontal disease .
noninvasive
As a result of interaction between the bacterial biofilm and the cells of the periodontal tissues, gingival crevicular fluid appears as an attractive oral diagnostic fluid due to its ease of collection and allowing for sampling of multiple sites within the oral cavity simultaneously.
TRUE OR FALSE
TRUE
What are the functions of GCF:
- Cleans material from the sulcus
- Contain plasma protein
- Possess antimicrobial properties
- Exert antibody activity in defense of the gingival
What are the factors affecting flow of GCF:
● Histamine
● Pre-inflammatory GCF
● Concentration of protein
● Mechanical stimuli
● Passage of fluid & PMN
● Morphology of JE
● Inflammatory changes of BM
Increased vascular permeability
Gingival Vasculature & Crevicular Fluid
What are the 3 different method that increases the vascular permeability of the Gingival vasculature & Crevicular Fluid:
- Topical application of histamine
- Gentle massage of the gingiva by means
of ball-ended amalgam plugger - Scraping of the gingival crevice by means
of blunted dental explorer
Degree of permeability of the oral mucosa is not equal to the degree of keratinization.
Squire (1973)
Degree of permeability of the oral mucosa is not equal to the degree of keratinization.
Permeability of Junctional & Sulcular Epithelium
(Permeability of Junctional & Sulcular Epithelium) Give the 3 routes have been described:
- Passage form CT into the sulcus.
- Passage from the sulcus into the CT.
- Passage of substances through pathological or
experimentally modified gingival sulcus.
Give the methods of collecting of GCF:
- Absorbent filter paper strips
- Preweighed twisted threads
- Sampling by means of micropipettes
- Gingival washings
- Other strips
Give the 2 examples for absorbing paper strip:
- Intracrevicular
- Extracrevicular
Give 2 other strips:
- Plastic strips
- Platinum loops
In this technique the gingival crevice is perfused with an isotonic solution of fixed volume.
Gingival Washing Methods
The fluid collected then represents a dilution of crevicular fluid and contains both cells and soluble constituents such as plasma proteins.
Gingival Washing Methods
In Gingival Washing method technique the gingival crevice is perfused with an ____.
Isotonic solution of fixed volume
What are the composition of GCF:
- Cellular Components
- Organic Ions
- Inorganic Ions
- Enzymes
- Bacterial Products
PMNL (Neutrophils), Lymphocytes, Monocytes, Epithelial Cells
- Cellular Components
- Organic Ions
- Inorganic Ions
- Enzymes
- Bacterial Products
Cellular Components
Protein 70g/g, Albumins 35 g/l, Gammaglobulin 7.5 g/l, Immunoglobins
- Cellular Components
- Organic Ions
- Inorganic Ions
- Enzymes
- Bacterial Products
Organic Ions
Sodium, Potassium, Calcium, Magnesium, Phosphate
- Cellular Components
- Organic Ions
- Inorganic Ions
- Enzymes
- Bacterial Products
Inorganic Ions
Acid Phosphate, Alkaline Phosphate, Cathepsin B & D, Collagenase, Elastase, Beta-glucuronidase, Lactate, Dehydrogenase, Lactoferrin, Lysozyme, Plasminogen Activator, Myeloperoxidases, Asparate Aminotransferase, Arylsufatase, Gelatinases
- Cellular Components
- Organic Ions
- Inorganic Ions
- Enzymes
- Bacterial Products
Enzymes
Endotoxins, Trypsin ike enzymes, Acid phosphatase, Alkaline Phosphate, Prostaglandin like products
- Cellular Components
- Organic Ions
- Inorganic Ions
- Enzymes
- Bacterial Products
Bacterial Products
Give the Clinical Significance of GCF:
● Circadian periodicity
● Smoking
● Sex hormones
● Periodontal therapy
● Drugs
● Mechanical stimulation
● Diabetes
Give the Problems Associated with GCF Collection:
● Sampling time
● Contamination
● Recover from strips
● Volume determination
● Data reporting
What are the Enzymes & Enzyme Inhibitors:
● Lysozyme
● B Glucoronidase
● Hyaluronidase
● Acid phosphatase
● Pyrophosphotase
● Lactate dehydrogenase
● Proteolytic enzymes
Give the Host-Derived Enzymes:
● Aspratate aminotransferase
● Alkaline phosphatase
● Cathepsin B
● Neutrophil elastase
● Prostaglandin E2
● Cytokines
Give the diagnosis of GCF biomarkers:
- GCF sample harvest
- Volume measurement
- Biomaker elutiom
- Sample and Micro Analyser
- Biomaker Report
