Analysis of factors that may affect the enzymatic profile of gingival crevicular fluid: Sampling technique, sequential sampling and mode of data presentation.

Abstract

To evaluate the possible effect of sampling technique and sequential sampling on gingival crevicular fluid (GCF) volume and myeloperoxidase (MPO) activity, 14 patients presenting at least two symmetrical maxillary sites with mild/moderate periodontitis were selected. Two sites in each individual were sequentially sampled using either the deepintracrevicular or orifice technique. Spectrophotometrically determined MPO levels were presented either as total MPO activity or MPO concentration. Although the clinical periodontal status of the 20 sampling sites were similar, the deep-intracrevicular technique regularly provided larger GCF volumes. With both techniques, the last samples contained the highest GCF volume. During sequential orifice sampling, GCF volume was relatively more stable. In general, a depletion of MPO activity was observed with sequential sampling performed with either of the techniques. Depletion of MPO did not replenish to baseline levels at the end of the 10-min sequential sampling. Although MPO activity showed a general reduction during sequential orifice sampling with both modes of data presentation, total MPO activity and MPO concentration did not match with the deepintracrevicular technique. Due to the potential of affecting GCF volume/composition, the selection of sampling technique seems to be a critical methodological decision in GCF-profile studies, primarily during sequential sampling. In GCF-profile studies, mode of data presentation should also be considered.

Impact of the Distinct Sampling Area on Volumetric Features of Gingival Crevicular Fluid

“…Clinical periodontal status is among the major determinants of the volumetric features of GCF 1,3,4,6‐8,17,18,21,24,25 . Studies have shown that probing depth (PD), 3,12,17 presence/severity of gingival inflammation, 1,6,17,18 and periodontitis 1,6‐8,13,21,25 affect the biodynamics of GCF.…”

“…Studies have shown that probing depth (PD), 3,12,17 presence/severity of gingival inflammation, 1,6,17,18 and periodontitis 1,6‐8,13,21,25 affect the biodynamics of GCF. Volumetric measures are also highly sensitive to sampling techniques 7,14,16,17,24 . It has been well shown that mechanical injury during sampling can increase vascular and sulcular epithelium permeability and the flow rate of the fluid, thus diluting the actual GCF 7,9,14,16,24,26,27 .…”

“…Volumetric measures are also highly sensitive to sampling techniques 7,14,16,17,24 . It has been well shown that mechanical injury during sampling can increase vascular and sulcular epithelium permeability and the flow rate of the fluid, thus diluting the actual GCF 7,9,14,16,24,26,27 . It is clear that the diagnostic potential of GCF depends on the appropriateness of the GCF samples 25 and the sampling strategy 1,7,14,17,24 .…”

“…It has been well shown that mechanical injury during sampling can increase vascular and sulcular epithelium permeability and the flow rate of the fluid, thus diluting the actual GCF 7,9,14,16,24,26,27 . It is clear that the diagnostic potential of GCF depends on the appropriateness of the GCF samples 25 and the sampling strategy 1,7,14,17,24 . Therefore, a better understanding of the GCF flow system 4,20,25 and sampling variables 4,7,8,14,16,25,28 is essential for GCF to continue to serve as a reliable diagnostic tool 14,25 …”

“…Some specific recommendations such as the preference of the shortest sampling time and the procedure to cause the least interference with the site and dilution effect and to allow comparison between samples are frequently made 7,16 . However, a general consensus on the “ideal” clinical sampling protocol does not yet exist 7,14,16,24,25 . The need for standardization of the factors with the potential for altering the actual V r /flow rate is frequently underlined 1,4,7,9,10,14‐16,23‐25,27‐29 .…”