title: Evidence for the early onset of gingival inflammation following short-term plaque accumulation.
abstract: OBJECTIVE
  A study was undertaken to examine cytokine markers in gingival crevicular fluid (GCF) during the early stages of plaque accumulation.
  
  
  METHODS
  A panel of five subjects with good oral hygiene went without brushing for 1 or 3 days, after which GCF samples were taken by placing paper strips into the gingival margins of the maxillary premolars and first molar for 30 s. GCF flow rates were determined with a Periotron instrument (Oraflow, Inc., Plainview, New York), and neutrophils (polymorphonuclear leukocytes) were determined as myeloperoxidase activity. Interleukin-1b (IL-1b) and IL-8 were eluted from the paper strips and assayed with enzyme-linked immunosorbent assay (ELISA) systems.
  
  
  RESULTS
  The plaque index rose to 2.7 +/- 0.2 (mean +/- SE) after 3 days without brushing, and the GCF flow rate increased to 146.8% of baseline. PMN and IL-8 concentrations fell but, when corrected for dilution as a result of increased GCF flow, were not statistically different from baseline. IL-1b was slightly elevated after 1 day, and increased to 223.8 +/- 54.3% (from 6.8 +/- 1.7 to 13.8 +/- 3.6 pg/30 s; p = 0.04) after 3 days of plaque accumulation. Resumption of tooth brushing led to a return of IL-1b to baseline (109.1% after 2 days of brushing). When subjects rinsed with 0.12% chlorhexidine during the 3-day no-brushing period, the increases in plaque index, GCF flow rates and IL-1b release rates did not occur.
  
  
  CONCLUSIONS
  The results indicate that IL-1b release rates increase in the GCF after 3 days of plaque accumulation, before any clinical signs of inflammation appear.
authors.affiliation: Nutrition Section, The Forsyth Institute, Boston, Massachusetts, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Shelby
authors.initials: S
authors.lastname: Kashket
authors.forename: Peter
authors.initials: P
authors.lastname: Lingström
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000890:Anti-Infective Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D002710:Chlorhexidine / Q000627:therapeutic use; D003773:Dental Plaque / Q000150:complications* / Q000517:prevention & control; D003774:Dental Plaque Index; D004797:Enzyme-Linked Immunosorbent Assay; D005883:Gingival Crevicular Fluid / Q000737:chemistry / Q000378:metabolism; D005891:Gingivitis / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis / Q000096:biosynthesis; D016209:Interleukin-8 / Q000032:analysis / Q000096:biosynthesis; D009067:Mouthwashes / Q000627:therapeutic use; D009504:Neutrophils / Q000201:enzymology; D009195:Peroxidase / Q000032:analysis
chemical_list: D000890:Anti-Infective Agents; D015415:Biomarkers; D007375:Interleukin-1; D016209:Interleukin-8; D009067:Mouthwashes; D009195:Peroxidase; D002710:Chlorhexidine