title: Comparison of gingival crevicular fluid sampling methods in patients with severe chronic periodontitis.
abstract: BACKGROUND
  The analysis of samplings from periodontal pockets is important in the diagnosis and therapy of periodontitis. In this study, three different sampling techniques were compared to determine whether one method yielded samples suitable for the reproducible and simultaneous determination of bacterial load, cytokines, neutrophil elastase, and arginine-specific gingipains (Rgps). Rgps are an important virulence factor of Porphyromonas gingivalis, the exact concentration of which in gingival crevicular fluid (GCF) has not been quantified.
  
  
  METHODS
  GCF was sampled from four sites per patient (one sample per quadrant using two samples per method) in 36 patients with chronic periodontitis. One week later, the procedure was repeated with alternative methods. Variables determined were loads of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans) and P. gingivalis, levels of interleukin-6 and -8, activity of neutrophil elastase, and level of Rgps.
  
  
  RESULTS
  The detected cytokine levels were higher using paper strips compared to paper points. Bacteria were found in similar loads from paper strips and paper points. Rgps were only detectable in high quantities by washing the periodontal pocket. The level of Rgps correlated with the load of P. gingivalis.
  
  
  CONCLUSIONS
  The use of paper strips was suitable for the simultaneous determination of microbial and immunologic parameters. Obtaining GCF by washing can be useful for special purposes. The gingipain concentration in periodontal pockets was directly determined to be ≤1.5 μM. This value indicated that most of the substrates of these proteases by in vitro assays identified until now can be easily degraded in P. gingivalis-infected sites.
authors.affiliation: Department of Conservative Dentistry, University Hospital, Jena, Germany.
authors.forename: Arndt
authors.initials: A
authors.lastname: Guentsch
authors.forename: Martin
authors.initials: M
authors.lastname: Kramesberger
authors.forename: Aneta
authors.initials: A
authors.lastname: Sroka
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Pfister
authors.forename: Jan
authors.initials: J
authors.lastname: Potempa
authors.forename: Sigrun
authors.initials: S
authors.lastname: Eick
mesh_terms: D018829:Adhesins, Bacterial / Q000032:analysis; D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D058491:Bacterial Load; D055113:Chronic Periodontitis / Q000378:metabolism*; D003546:Cysteine Endopeptidases / Q000032:analysis; D005260:Female; D000080867:Gingipain Cysteine Endopeptidases; D005883:Gingival Crevicular Fluid / Q000737:chemistry*; D005884:Gingival Hemorrhage / Q000378:metabolism; D006388:Hemagglutinins / Q000032:analysis; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis; D016209:Interleukin-8 / Q000032:analysis; D019272:Leukocyte Elastase / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010209:Paper; D017622:Periodontal Attachment Loss / Q000378:metabolism; D010514:Periodontal Pocket / Q000378:metabolism; D016966:Porphyromonas gingivalis / Q000302:isolation & purification / Q000472:pathogenicity; D013048:Specimen Handling / Q000295:instrumentation / Q000379:methods*; D007507:Therapeutic Irrigation / Q000379:methods; D037521:Virulence Factors / Q000032:analysis
chemical_list: D018829:Adhesins, Bacterial; D000080867:Gingipain Cysteine Endopeptidases; D006388:Hemagglutinins; D015850:Interleukin-6; D016209:Interleukin-8; D037521:Virulence Factors; D019272:Leukocyte Elastase; D003546:Cysteine Endopeptidases