1. GINGIVAL FLUID

2. GINGIVAL FLUID
Permeability of JE & SE
Role of GCF, Leucocyte & Saliva

3. GCF Sulcular fluid /Gingival Crevicular Fluid 19th Century
Waerhaug and Brill and Krasse 1950
Transudate(Brill)
Inflammatory Exudate(Others)

4. METHODS OF COLLECTION Absorbing paper strips Twisted threads
Micropipettes
Intracrevicular washings

5. PERMEABILITY OF JE&SE Fluorescein initially(Brill&Krasse)
Confirmed with India ink&saccharated iron
Albumin,endotoxin,thymidine,histamine,phenytoin &Horseradish peroxidase
Mol wt 1000kD

6. AMOUNT OF GCF
Wetted Paper strip(ninhydrin stain) evaluated with Microscope
Periotron(Electronic Methods)
1.5mm wide &1mm within GS =0.1mg GCF(3min)
Molar m L

7. COMPOSITION
Cellular Elements
Electrolytes
Organic Compounds

8. CELLULAR ELEMENT Bacteria Desquamated epithelial cells
Leukocytes(PMNs,Lymphocytes,Monocytes/Macrophages)

9. ELECTROLYTES
Potassium
Sodium
Calcium

10. ORGANIC COMPOUNDS Carbohydrates & Proteins
Glucose hexosamine & hexuronic acid
Glucose conc(GCF) 3-4times>>Serum
Total Protein(GCF) much less than Serum
Metabolic&Bacterial Products

11. Enzymes&Other Compounds
Acid phosphatase,Alkaline phosphatase,α1 Antitrypsin,Arylsulfatase,Aspartate aminotransferase,
Cathelicidin LL-37,Alanine
aminotransferase,Chondroitin sulfatas,Citric acid,Cystatins,
Cytokines (interleukins), IL-1α  IL-1β  IL-4, IL-6, and IL-8  IL-11, IL-12  IF-gamma.

12. Enzymes&Other Compounds contd..
Endopeptidases:  Cathepsin D, Cathepsin B/L, Cathepsin G,  Cathepsin K,  Elastase,Plasminogen activator
Collagenase,Tryptase-like enzyme,Trypsin-like enzyme,Dipeptidylpeptidase IV–like enzyme,Elastase–α1-proteinase inhibitor

13. Enzymes&Other Compounds contd..
Exopeptidases,Fibrin,Fibronectin,β-glucuronidase,Glycosidases, α1-Fucosidase  Sialidase 
 β-N-acetylglucosaminidase  β-Galactosidase  β-MannosidaseHyaluronidase
Immunoglobulins (IgG, IgA, IgG4, IgM),

14. Enzymes&Other Compounds contd..
Lactate dehydrogenase,Lactoferrin,Lactic acid,Lysozyme,α2-Macroglobulins
Medullasin,Metalloproteinases,Myeloperoxidase,Prostaglandin E2 (PGE2),Transferrin,Thromboxane.

15. Compounds&Enzymes of Bacterial Origin
  Acidphosphatase, Alkalinephosphatase,  
Aminopeptidases,  Chondroitin sulfatase,
 Chymotrypsin-like product, Collagenase,
 Deoxyribonuclease, DNase,
 Dipeptidylaminopeptidase IV–like enzyme, 

16. Compounds&Enzymes of Bacterial Origin contd…
Fibrinolysin, Glucosidases,  Hemolysin, Hyaluronidase,  Iminopeptidases,   Immunoglobulinases, β-Lactamase,
Lysophospholipase,   Phospholipase A,   Phospholipase C,  Prostaglandin-like product,   Trypsin-like enzyme

17. Cellular & Humoral Activity
Non invasive methods
Identify cell&humoral responses in Health/Disease
IL-1alpha&IL-1Beta increase the binding of PMNs&monocyte/macrophages
Interferon-alpha may have protective role
Analysis of specificity of antibodies

18. Clinical Significance
Amount of GCF directly proportional to the severity of inflammation
GCF production increase by mastication,toothbrushing,gingival massage,ovulation,oral contraceptive&smoking.
Circadian Periodicity- 6am-10pm

19. Clinical Significance contd…
Sex Hormone: female sex hormone increase GCF
Mechanical stimulation: chewing &vigorous Tooth brushing
Smoking: transient marked increase GCF
Periodontal therapy

20. Drugs in GCF Drugs that are excreted in GCF
Bader&Goldhaber : Dogs GCF (Tetracyclin)
Metronidazole

21. Leuckocytes in the Dentogingival Area
Predominantly PMNs
Clinically healthy sulci 91.2%-91.5%PMNs& %mononuclear cells
Mononuclear cells 58%B-lymphocyte,24%T-lymphocyte&18%mononuclear phagocyte
Peripheral blood T/B lymphocyte 3:1
GCF T/B lymphocyte 1:3

22. MCQ -1
Which of the following cytokines in Gingival crevicular fluid may have protective role in periodontal diseases
a-Interleukin 1-alpha
b-Interleukin 1-beeta
c-Interferon-alpha
d-Prostaglandin-E2

23. MCQ-2 Most common antibiotic that is excreted
through the gingival crevicular fluid may be
used advantageously in periodontal therapy
a-Amoxicillin
b-Doxycyclin
c-Cefalosporin
d-Erythromycin

24. MCQ-3 The following factors are responsible for
enhancement of production of gingival
crevicular fluid EXCEPT
a-smoking
b-trauma from occlusion
c-vigorous brushing
d-healing period after curettage

25. MCQ-4 Which is the correct statement of glucose
and protein content in gingival crevicular
fluid(GCF)
a-glucose conc.3-4times greater than serum
b-glucose conc. 3-4times lesser than serum
c-total protein is more than that of serum
d-total protein is equal to that of serum

26. MCQ-5 What are the ratio of T-lymphocytes to B
lymphocytes in Gingival crevicular fluid
a-1:2
b-2:1
c-1:3
d-3:1