The reported therapeutic benefits of nonsteroidal anti-inflammatory drugs (NSAIDs) in slowing periodontal disease progression appear intimately linked to the effective inhibition of local prostaglandin synthesis. This randomized, partially double-blind, controlled trial was conducted to evaluate the pharmacodynamic effects of the NSAID, ketoprofen (KTP), on gingival crevicular fluid (GCF) prostanoids. 42 subjects, ages 35-57 years, with moderate to advanced adult periodontitis were recruited and monitored for 22 days. On day 1, subjects were randomized for 1 of 5 treatments: i) 0.5% KTP gel; ii) 1.0% KTP gel; iii) 1.0% KTP alternate gel; iv) 2.0% KTP gel; v) 25 mg KTP capsule (positive control). Subjects applied 1 ml of gel topically to their gingiva or administered one capsule p.o., b.i.d. for 14.5 days. GCF samples were collected from posterior, interproximal sites on days 1 (pre-dosing; 1, 2, 3, 6 h), 8 (pre-dosing; 2 h), 15 (pre-dosing; 2 h) and 22 (post-treatment). GCF levels of prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) were determined using RIA, and expressed in ng/ml and % reduction from baseline (%Effect). Neither a significant difference among groups nor a dose response in % effect for either prostanoid was evident, both overall and among cohorts with elevated baseline mediator levels ([PGE2]>34 ng/ml; [LTB4]>300 ng/ml). When data were combined from all groups, significant (p<0.01) % reductions in GCF PGE2 were noted at 1 and 2 h post-dosing (29% and 24% respectively). In comparing topical versus systemic formulations, all topical formulations were as equipotent as systemic dosing in altering local prostaglandin levels despite lower KTP exposures with gel treatments. These data indicate that both topical and systemic KTP therapies pharmacodynamically reduce GCF PGE2 levels in adult periodontitis subjects, allowing for potential inhibition of disease progression.

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The purpose of this study was to evaluate the relationship between volatile sulphur compounds (VSC) and gingival health status, and to monitor the changes in VSC in early dental plaque-induced gingivitis. Using an experimental gingivitis model, twelve subjects between 19 and 28 years old, with a healthy gingival status, refrained from brushing and flossing one randomly selected half of the mandibular arch for two weeks. At baseline and during six subsequent appointments, gingival inflammation (GI), bleeding on probing (BOP), and sulfide levels (SUL) were measured using the Gingival Index and the Diamond Probe/Perio 2000 System. The Spearman correlation was used to compare the relationships between SUL, GI, and BOP on the brushing (B) and non-brushing (NB) sides. Data on the NB side revealed a stronger correlation than on the B side. Wilcoxon rank sum was used to evaluate the differences between mean SUL, GI, and BOP scores on the B and NB sides over time. Results indicate that SUL were the first periodontal parameter to show a significant difference between sides. SUL were significantly higher on the NB side at 4 of the 6 data collection intervals; therefore, SUL may be associated with the initiation and progression of early plaque-induced gingivitis.

A new ultrasonic periodontal probe has been developed that offers the potential for earlier detection of periodontal disease activity, non-invasive diagnosis, and greater reliability of measurement. A comparison study of the ultrasonic probe to both a manual probe, and a controlled-force probe was conducted to evaluate its clinical effectiveness. Twelve patients enrolled into this study. Two halfmonth examinations were conducted on each patient, scheduled one hour apart. A one-way analysis of variance was performed to compare the results for the three sets of probing depth measurements, followed by a repeated measures analysis to assess the reproducibility of the different probing techniques. These preliminary findings indicate that manual and ultrasonic probing measure different features of the pocket. Therefore, it is not obvious how the two depth measurements correspond to each other. However, both methods exhibited a similar tendency toward increasing pocket depths as Gingival Index scores increased. Based on the small sample size, further studies need to be conducted using a larger population of patients exhibiting a wider range of disease activity. In addition, studies that allow histological examination of the pocket after probing will help further evaluate the clinical effectiveness of the ultrasonic probe. Future studies will also aid in the development of more effective automated feature recognition algorithms that convert the ultrasonic echoes into pocket depth readings.