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ABSTRACT
Objective and methods: The authors have experimented for gingival crevicular fluid measurement by use of
Periotron 8000, at the gingival sulcus on 6 teeth as such tooth as upper and lower, right and left first Molar
and upper and lower central Incisor, to calculate the co-relation co-efficient, in order to find the proper and
simple way to measure the Gingival crevicular Fluid Measurement on the simple tooth , instead of checking
at all 6 teeth portions, 30 volunteers who were out-patients, visited at the dental clinic were participated for
the study in the period of December of 2008 to February in 2009 at one of the dental hospital in Hwaseong
district. Corelation coefficient on the Gingival crevicular Fluid Measurement were calculated both in between
at each tooth and at all 6 teeth include at the associated tooth and at each tooth and at all 5 teeth exclude at
the associated tooth.
Results: Co-relation co-efficient was the most in amount of the gingival crevicular between at the upper right
first Molar portion(r=0.821, p<0.001) and the other 6 portions include the indicated tooth portion, and the next
between at the lower right first Molar portion(r=0.6655, p<0.001) and at the other 6 portions. Co-relation
co-efficient was the most in amount of the gingival crevicular between at the upper right first Molar
portion(r=0.6327, p<0.001) and the other 5 portions exclude the indicated tooth portion, and the next between
at the lower right first Molar portion(r=0.4213, p<0.05) and at the other 5 portions.
Conclusion: It was recommended that the gingiva crevicular fluid would be checked with Periotron 8000 at the
upper right 1st Molar area, in consideration of the simplification and the reliability of the technique, instead
of the checking at all portions in clinical.
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International Journal of Clinical Preventive Dentistry. 2009, Volume 5, Number 1
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Gingival crevicular fluid measure on individual tooth by use of Periotron 8000
Figure 1. Periotron 8000 (Harco. Electronics, Figure 2. GCF checking by using Periotron
Winnipeg, Manitiba, Canada)
3) Hold the one of Periotron strip with the cotton 3) Dry the indicated tooth and surrounding gingiva by
pliers and lay it on the sensor of the Periotron use of the air syringe.
meter. 4) Using cotton piers, grasp the orange plastic handle
4) Adjust the 0 point with the frontal control wheel of a Periopaper strip and pull a fresh strip from its
of Periotron. clean plastic support mounted on the Periopaper strip
5) Acting for 16 seconds in order to control for 0 holder.
point. 5) Insert the white portion of the strip into the
6) Discard used strip after controlling for 0 point. gingival crevice carefully, for applying the
7) Preparation for measuring the gingival crevicular intra-sulcular method, and remove out the pliers
fluid. holding on the strip and waiting for 5 seconds in
order to absorb the gingival crevicular fluid to the
strip.
2.3.2. Interview for subjects 6) Remove out the strip from the gingival crevice by
holding the orange colored handle of the strip with
1) Collect the volunteers for the study and let them the cotton pliers.
sign on the agreement sheet. 7) Move the strip to Periotron meter for checking the
2) Prohibit tooth-brushing or flossing in 2 hours measure.
before measuring. 8) Lay the white portion of the strip on the lower
3) Explain the procedure to subjects as safe and sensor of Periotron and full the movable upper
simple. sensor arm to frontal direction, to close or to
4) Check the menstruations period for woman because contact for both sides of the sensors to the strip.
of the higher value in the period of ovulation 9) Read the digital number of the amounts for the
5) Check the medical history, hormonal contraception gingival crevicular fluid at the reading panel in
agent, or smoking. front.
10) Measure it repeatedly at all subjected teeth, and it
2.3.3. Procedure for checking will takes about 1 minute for a measurement.
11) If the remnant cervical fluid or debris are on the
1) Select 6 portions of the teeth as 4 first Molars sensor, it should be cleaned with the paper tissue
and upper and lower Incisors, to measure the with 70% alcohol and dried paper. And then, 0-point
amount of the gingival crevicular fluid. re adjustment should be done again.
2) Isolate the indicated tooth by use of the cotton 12) 0-point readjustment should be done if needed.
roll. 13) The criteria of the result for Periotron meter
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International Journal of Clinical Preventive Dentistry. 2009, Volume 5, Number 1
Table 2. Co-relation co-efficient on the Gingival Crevicular Fluid Measurement between at each tooth and at all 6 teeth include at the
associated tooth
Associated tooth Number n r p App
16 30 0.8278 0 **
11 30 0.352 0.0564 -
26 30 0.4461 0.0135 *
36 30 0.6211 0.0002 **
31 30 0.4572 0.0111 *
46 30 0.6655 0.0001 **
Table 3. Co-relation co-efficient on the Gingival Crevicular Fluid Measurement between at each tooth and at all 5 teeth exclude at the
associated tooth
Associated tooth Number n r p App
16 30 0.6327 0.0002 **
11 30 0.1163 0.5406 -
26 30 0.2457 0.1905 -
36 30 0.3064 0.0996 -
31 30 0.3238 0.0809 -
46 30 0.4213 0.0204 *
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Gingival crevicular fluid measure on individual tooth by use of Periotron 8000
pocket is important. On Brill method, the absorption paper Climason(18) has reported that about 0.1mg of the
should be inserted until be felt for resistance, in order to gingival crevicular fluid could be absorbed by use of the
stimulate to gingival epithelium to induce the fluid from absorption paper of 1.5mm width and 1mm inserting into
there. the gingival sulcus for 3 minutes, in mild gingivitis area.
Le and Holm-Pedersen(2) have suggested the inserting Challacombe(25) has tried to measure the gingival
technique of the absorption paper on the entrance of the crevicular fluid by use of the injecting the dilution of the
gingival pocket, in order to minimize the gingival irritation. radioactive materials(isotope) into the body.
The gingival crevicular fluid might be absorbed in the paper Through this method, he has got average 0.45 to 1.5ml
without contact with the gingival epithelium by this of the gingival crevicular fluid at the inter proximal area of
technique. the molar tooth from the volunteers who were below the
Weinsteim et al.(3) have estimated the amount of the degree 1 of average gingival index.
gingival crevicular fluid through inserting the twisted silk Gingival fluid is known as the inflammatory exudate(2).
into the gingival sulcus and measuring the weight after full Gingival crevicular fluid can be found an inflammatory
it out. Osmotic pressure was applied by use of the micro tissue in microscopic findings even though on healthy
tube to measure the gingival fluid with inserting the gingiva in clinical.
standard size and length micro tube into the gingival sulcus The amount of the fluid is increased proportion to the
and then analyze the contents by use of the centrifuge(8-10). severity of the gingival inflammation (20,21).
Gingival sulcus cleaning technique is used for analysis on It can be increased on such situations as chewing the
normal gingiva in clinical. Among the various types of the rough foods, tooth-brushing, gingival massage, ovulation(24),
methods, absorption paper strip technique is the most in take the hormonal contraceptives(25) and smoking, even
frequently used because of it's convenience, and the fluid though not influenced by the trauma from occlusion(22).
with the wet absorption paper would be used to be Also, it can be increased in the day time and decreased in
measured. The wet portion on the absorption paper can be naught time or sleeping time(2).
shown distinctly through the dying with Ninhydrin. Periodontal treatment can be one of the causing factors to
Two methods can be introduced for analyzing the fluid as influence the amount of the gingival crevicular fluid(28).
Ninhydrin staining method as observing the stained area on Estrogen as a female hormone can influence to increase the
the paper with the microscope or magnifying glass, and the gingival crevicular fluid by increasing the permeability of
electronic method as changing the wet amount with the the blood vessel(29). So in case of the ovulation(30),
gingival crevicular fluid on the paper strip into the pregnancy and the using the oral pill(31),it can be increased.
electronic current by use of the electronic transducer, such Mastication(8) or hard brushing also influence the flow of
as Periotron device. There was no difference the value of the gingival fluid by stimulation of the gingival tissue with
the measure for gingival crevicular fluid, between these two mild degrees, like as inserting the absorption paper into the
methods1(7). gingival sulcus.
It was known that the value of measured score would be In spite of the effectiveness of the measuring the gingival
various according to gingival inflammatory state. Under the crevicular fluid for checking the presence or the prediction
score 60, it might be judged as normal or mild of early stage of the gingivitis or the periodontitis, it might
inflammation. In case of over score 60, it would be be inconvenient for checking at all portions of the gingival
estimated as active bacterial activities and high risk for sulcus for each patient in clinical. So, 6 portions checking
process on periodontitis, with showing the epithelial method, like examining the simplified oral hygiene index or
attachment loss and periodontal pocket formation with modified patient hygiene performance index, would be
probing in clinical, so it can be imagined more severe in suggest by clinicians. More over 1 portion checking method
periodontitis according to increase the value for measuring, at the most representative portion would be needed for
in over score 60. checking with convenient in clinical.
The amount of the gingival crevicular fluid collected According to the results of this study, the most
might be very few. representative portion was estimated at upper right
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International Journal of Clinical Preventive Dentistry. 2009, Volume 5, Number 1
molar(r=0.8278, p<0.01) and lower right molar gingival crevicular between at the upper right first Molar
portion(r=0.6655, p<0.01) in next, calculated with the portion(r=0.821, p<0.001) and the other 6 portions include
co-relation co-efficient. the indicated tooth portion, and the next between at the
It was the same result in significant test both in lower right first Molar portion(r=0.6655, p<0.001) and at the
calculating the co-relation co-efficient between at the other 6 portions.
indicated tooth and the other 6 portions include the
indicated portion(table 2), and between the indicated tooth 2. Co-relation co-efficient was the most in amount of the
portion and the other 5 portion excluded the indicated gingival crevicular between at the upper right first Molar
portion.(table 3) portion(r=0.6327, p<0.001) and the other 5 portions exclude
Even though it was not clear for the evidence why it the indicated tooth portion, and the next between at the
revealed the high relationship on right side portion of molar lower right first Molar portion(r=0.4213, p<0.05) and at the
tooth, the measurement of the gingival crevicular fluid at other 5 portions.
upper/lower right molar portion could be a representative
value for ones mean value for the amount of the gingival It was recommended that the gingiva crevialar fluid
crevicular fluid. would be checked with Periotron 8000 at the upper right 1st
It should be needed for further studies to find the reasons Molar area, in consideration of the simplification and the
to be more related at the upper and right portion than at reliability of the technique, instead of the checking at all
the lower, left or anterior portion. portions in clinical.
According the clinical experiment, the measurement of the
gingival crevicular fluid at the upper right molar portion Reference
would be recommended, instead of checking at whole teeth
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Gingival crevicular fluid measure on individual tooth by use of Periotron 8000
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