title: Relationship between periodontal disease status and combination of biochemical assays of gingival crevicular fluid.
abstract: BACKGROUND
  Currently, no biochemical assay involving gingival crevicular fluid is utilized routinely as a screening test for periodontal disease.
  
  
  OBJECTIVE
  The objective of the present study was to evaluate the potential of gingival crevicular fluid assay as a screening methodology.
  
  
  METHODS
  The subject population was comprised of 27 volunteers. Nine participants were classified as 'subject with periodontal destruction' (SPD) exhibiting at least one site with pocket depth and attachment loss>3.5 mm, whereas the remaining individuals were categorized as 'subject with minimal periodontal destruction' (SMD). Gingival crevicular fluid was collected from fixed sites via a standardized method. Biochemical assays of 12 substances (hemoglobin, albumin, transferrin, alpha(1)-antitrypsin, fibronectin, IgA, IgG, IgM, lactoferrin, myeloperoxidase and neutrophil elastase) were conducted at a commercial laboratory. Power transformation of total quantities in gingival crevicular fluid was performed for statistical analysis.
  
  
  RESULTS
  Relationships between total quantity of each substance and periodontal disease status were unclear. Logistic regression analysis yielded six predictive models, which consisted of substance pairs: neutrophil elastase/IgA, neutrophil elastase/hemoglobin, neutrophil elastase/alpha(1)-antitrypsin and neutrophil elastase/IgG, and IgA/albumin and IgA/transferrin (p<0.05). Regression lines for SPD and SMD on a scattergram of IgA and neutrophil elastase were nearly parallel within the range of amounts in gingival crevicular fluid. The predictive model derived from both substances afforded sensitivity and specificity of 88% and 94%, respectively.
  
  
  CONCLUSIONS
  These results indicated that the combination of IgA and neutrophil elastase in gingival crevicular fluid may be crucial for prediction of periodontal disease status. Furthermore, these data suggested that biochemical assays employing both substances in gingival crevicular fluid may provide a satisfactory screening test for periodontal disease.
authors.affiliation: Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan. haniokat@college.fdcnet.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Hanioka
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Matsuse
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Shigemoto
authors.forename: Miki
authors.initials: M
authors.lastname: Ojima
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shizukuishi
mesh_terms: D000328:Adult; D005260:Female; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis / Q000378:metabolism; D019272:Leukocyte Elastase / Q000032:analysis / Q000378:metabolism; D016015:Logistic Models; D008297:Male; D010510:Periodontal Diseases / Q000175:diagnosis* / Q000378:metabolism*; D011237:Predictive Value of Tests
chemical_list: D007070:Immunoglobulin A; D019272:Leukocyte Elastase