Usefulness of hemoglobin examination in gingival crevicular fluid during supportive periodontal therapy to diagnose the pre-symptomatic state in periodontal disease

Hiroshi Ito,Yukihiro Numabe,Tomohisa Ogawa,Shuichi Hashimoto,Sunao Uehara,Ya-Hsin Wu

doi:10.1007/s00784-020-03396-0

Hiroshi Ito, Yukihiro Numabe + Show 4 more

Open Access

https://doi.org/10.1007/s00784-020-03396-0

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Abstract

ObjectivesThe absence of bleeding on probing (BOP) is a good predictor of disease stability. This study investigated whether detection of hemoglobin (Hb) in gingival crevicular fluid (GCF) indicates minute signs of periodontal disease, even in BOP (−) cases.Materials and methodsGCF was collected from gingival sulci of 152 sound maxillary and mandibular teeth from 76 patients who had entered supportive periodontal therapy (SPT) using the split-mouth design. As clinical parameters, plaque index, GCF amount, gingival index, probing depth (PD), clinical attachment level, BOP, and alveolar bone resorption ratio were then recorded. As biochemical parameters, Hb amount, alkaline phosphatase (ALP) activity, and protein amount in GCF were measured. Periodontal conditions of diseased sites (PD ≥ 4 mm, BOP (+)) and healthy sites (PD ≤ 4 mm, BOP (−)) were further classified into two groups using the Hb cutoff value determined by PD and BOP and analyzed.ResultsDespite being healthy, ALP activity and protein amount in sulci of the group with Hb level greater than the cutoff value were significantly higher than those in the group with Hb level less than the cutoff value (P < 0.01).ConclusionsThis study indicates that Hb examination is a promising candidate marker of pre-symptomatic periodontal disease because Hb presence in GCF suggests slight tissue damage, even in healthy sites defined as BOP (−).Clinical relevanceHb examination of GCF is a powerful diagnostic tool for pre-symptomatic diagnosis of periodontal disease.

Highlights

Important items during the period of supportive periodontal therapy (SPT) are the accurate diagnosis of periodontitis and prompt response corresponding to symptoms in order to prevent the recurrence of periodontal disease [1, 2]
We reported that Hb amount in gingival crevicular fluid (GCF) collected from 401 pockets in 184 SPT patients correlates well with assessments of clinical parameters (e.g., plaque index (PlI), GCF amount, probing depth (PD), clinical attachment level (CAL), gingival index (GI), and bleeding on probing (BOP)) for periodontal condition [10]
A significant correlation was observed between every parameter (PlI, GCF amount, GI, PD, CAL, BOP, ABR ratio, alkaline phosphatase (ALP) activity, and protein amount) at 152 sites and Hb amount in GCF of the same site (P < 0.05) (Table 3)

Summary

Introduction

Important items during the period of supportive periodontal therapy (SPT) are the accurate diagnosis of periodontitis and prompt response corresponding to symptoms in order to prevent the recurrence of periodontal disease [1, 2]. Both probing depth (PD) measurement and bleeding on probing (BOP) examination are presently recognized worldwide as extremely effective parameters for assessing. Japan periodontal disease and recurrence [3,4,5] These measurements and examinations are inspections requiring delicate skills, and tests in which the burden on the patient increases due to pain associated with the examination according to the condition of deteriorated periodontal disease [6].

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