Western Society of Periodontics

Laboratory Studies

Volume Number 3, 1995

Granulocyte elastase in gingival crevicular fluid: improved monitoring of the site-specific response to treatment in patients with destructive periodontitis

In this study, the site-specific response to periodontal therapy in a group of patients with severe destructive periodontitis was monitored. Granulocyte elastase has been measured in GCF from four types of sites: with (1) consistent health, (2) deteriorating health, (3) remission, and (4) continuous destruction. The participants were 13 subjects selected from a group of patients with severe destructive periodontitis on the basis of persisting deep pockets and continuing loss of alveolar bone on radiographs, after completion of five-year regular maintenance therapy. Elastase (EA) was assessed both from supernatants (EA-S) and the palates (EA-P).The ratio of EA-S and EA-P (S/P-ratio) was used as a relative measure of elastase released by the granulocytes present. The sites classified as diseased with no improvement, or initially healthy but deteriorating had significantly higher EA-S, EA-P, and S/P-ratios than the consistently healthy sites or diseased but improving sites. Both EA-S and S/P-ratio showed strongly positive correlations with the current levels of gingival inflammation and periodontal destruction. [E.L.H.]