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Host response tests for diagnosing periodontal diseases.
1Department of Periodontics, School of Dentistry, University of Washington, Seattle.
Journal of Periodontology
|April 1, 1992
Summary
New diagnostic tests for periodontal disease are emerging, focusing on host response factors in gingival crevicular fluid (GCF). These tests aim to identify susceptible individuals and active disease sites, improving upon traditional diagnostic methods for better periodontitis management.
Area of Science:
- Periodontology and diagnostics
- Host response in periodontal disease
- Biomarker discovery for periodontitis
Background:
- Periodontal disease progression is episodic and occurs in susceptible individuals.
- Current diagnostic methods fail to identify susceptible patients or active disease sites.
- Need for new diagnostic tests based on host response factors.
Purpose of the Study:
- To explore the potential of host response factors as diagnostic markers for periodontal disease.
- To evaluate different biological sources for these diagnostic markers, including gingival crevicular fluid (GCF), blood cells, and serum.
- To identify specific biomarkers associated with active periodontal disease and susceptibility.
Main Methods:
- Analysis of various components in gingival crevicular fluid (GCF).
- Evaluation of blood cell abnormalities in early-onset periodontitis.
- Assessment of monocyte release of prostaglandin E2 (PGE2) and Interleukin-1.
- Measurement of serum antibodies to periodontopathic bacteria and IgG2 subclass response.
Main Results:
- GCF components like alkaline phosphatase, beta-glucuronidase, prostaglandin-E2, aspartate aminotransferase, and IgG4 antibody subclass show association with active disease (attachment loss ≥ 2 mm).
- Commercialized tests for beta-glucuronidase, neutral proteases, and aspartate aminotransferase are available; one has FDA approval.
- Leukocyte adherence molecule abnormalities diagnose generalized prepubertal periodontitis; chemotactic receptor defects and GP110 abnormalities are noted in localized juvenile periodontitis.
- Enhanced PGE2 and Interleukin-1 release by monocytes may indicate susceptibility to severe periodontitis.
- Serum antibodies show limited diagnostic value for site-specific disease activity, but IgG2 response may indicate susceptibility.
Conclusions:
- Gingival crevicular fluid components show promise for diagnosing active periodontal disease.
- Blood cell analysis is valuable for specific early-onset periodontitis forms.
- Further clinical studies are needed to validate GCF biomarkers and susceptibility indicators.