Site‐specific alkaline phosphatase levels in gingival crevicular fluid in health and gingivitis: cross‐sectional studies

Abstract

Using a recently developed chemiluminescent assay enabling alkaline phosphatase (ALP) quantification in nanolitre volumes of gingival crevicular fluid (GCF), we have investigated GCF ALP levels in health and in the presence of gingivitis. In gingival health, there was a site-specific pattern of ALP concentration with higher enzyme concentrations around the upper and lower anterior teeth. Furthermore, clinically normal sites that had been subjected to different levels of plaque control produced significantly different ALP levels, (p < 0.03). This indicates that biochemical components of GCF may be used to measure subclinical inflammatory status. The ratio of GCF to serum ALP varied from 6:1 to 11:1, suggesting that a major source of the enzyme is through local production. The main cross-sectional study of 30 patients with gingivitis (276 sites) demonstrated that total GCF ALP levels, collected over a 30-s sampling time were higher for a gingival index of 1 than of 0 (p < 0.014). There was no significant relationship between total GCF ALP and plaque levels of the enzyme, and analysis of plaque within the study group demonstrated very low levels of ALP, indicating that the enzyme is likely to be largely derived from the periodontal tissues. The ratio of GCF ALP levels to those of saliva within individuals was 530:1, thereby eliminating saliva contamination as a risk, when total GCF ALP is being measured.

Assessment of the alkaline phosphatase level in gingival crevicular fluid, as a biomarker to evaluate the effect of scaling and root planing on chronic periodontitis: An in vivostudy

“…[132930] The decrease in the inflammation as a result of the mechanical plaque control methods such as scaling and root planing has resulted in the statistically significant decrease of GCF AL P values in the study. This is also reflected in the decreased pocket depth as seen by the positive correlation to probing depth.…”

“…[29] This suggests that the total ALP level reflects the state of the periodontium more accurately in disease and healing and is not significantly affected by the external bacterial factors in plaque. [17252930]…”

Clinical Relevance of the Advanced Microbiologic and Biochemical Investigations in Periodontal Diagnosis: A Critical Analysis

“…In particular, Loos and Tjoa [47] undertook a critical review of biomarkers in gingival crevicular fluid and found that only eight of 94 in the literature of the time fulfilled any of the criteria for biomarker status. These eight biomarkers were alkaline phosphatase [48][49][50][51][52][53][54] A number of diagnostic kits emerged based upon individual biomarkers within gingival crevicular fluid, but market research had not been performed that actively and the tests did not popularize much among practicing dentists due to several reasons: (1) time-consuming and laborious to perform; (2) difficult to interpret and understand; (3) site specific and the choice of site being problematic; (4) the results not materializing to alterations in therapeutic intervention; (5) expensive for routine use. As compared to GCF, collection of salivary and mouth-rinse samples was considered more convenient, practical, rapid, and noninvasive and requires neither professional stuff nor specific materials.…”

Comparison Of Bone Turnover Markers In Gingival Crevicular Fluid Of Elderly Individuals With Different Periodontal Diseases

“…15 GCF ALP is correlated with increased gingival index. 16 Daltaban et al reported higher GCF ALP levels in post-menopausal women with periodontitis than in the clinically healthy control group. 17 A recent study, demonstrated low levels of GCF ALP in non-destructive and slightly destructive periodontitis sites, whereas significantly high levels of ALP were observed in moderately and severely destructive sites.…”

“…15 It is present as a glycosyl-phosphatidyl-inositol-anchored ectoenzyme on the membranes of osteoblastic cells. 16 Although its exact function is not fully understood, ALP is required on the cell membrane for bone mineralization. 17 Ishikawa et al showed that GCF ALP levels were significantly higher in both chronic and aggressive periodontitis patients than healthy subjects.…”