Short-term effects of phase I therapy on crevicular cell populations

The purpose of the present study was to use a novel intracrevicular lavage technique to evaluate short-term effects of phase I therapy on crevicular cell populations. Nineteen patients with untreated advanced adult periodontitis were selected for phase I therapy. One side of the dentition was treated with ultrasonic curets (U), the other side with manual curets (M). Nine months before (-9), immediately prior to (0), and 1 month after treatment (+1) gingival index (GI), plaque index (PI), bleeding index (BI), bleeding on probing (BOP), probing depth (PD), and probing attachment levels (PAL) were measured at all sites in the dentition. Crevicular lavages were obtained from 3 to 4 selected sites per patient at the same time points. Crevicular leukocytes were vital stained with ethydium bromide-fluorescein-diacetate (EB-FDA). The total number of cells and the percentage of vital cells (%) were calculated for each sample. Clinical and lavage parameters obtained from the selected sites were compared between U and M sites, and between pre- and post-treatment values. The results showed that without treatment PAL remained at the same level at both pretreatment time points -9 and -0 (control). At 1 month after treatment there were statistically significant reductions in GI, PI, BOP, and PD (P < 0.001 for each comparison), and a statistically significant gain in PAL from 4.9 to 4.1 mm (P = 0.014). The total number of leukocytes per sample was similar at both pretreatment time points, but numerically reduced at 1 month after treatment. The percent of vital leukocytes was above 74% at both pretreatment time points (control). After treatment these values were below 70%. This reduction was statistically significant (P < 0.002). These results suggest that periodontal phase I therapy leads to shifts in crevicular cell populations.