Armitage G C, Jeffcoat M K, Chadwick D E, Taggart E J, Numabe Y, Landis J R, Weaver S L, Sharp T J
Department of Stomatology, University of California, School of Dentistry, San Francisco.
J Periodontol. 1994 Feb;65(2):120-8. doi: 10.1902/jop.1994.65.2.120.
To determine whether elastase levels in gingival crevicular fluid (GCF) could serve as a marker for the progression of periodontitis, we monitored GCF elastase and periodontal status in selected sites in 32 periodontally healthy volunteers and 31 periodontitis patients at intervals over a 6-month period. Clinical measurements included plaque index, gingival index, bleeding on probing, suppuration, probing depth, clinical attachment level, and relative attachment level measured with an automated disk probe. GCF elastase, detected by reaction with a fluorescent substrate, was assessed visually against fluorescence standards and quantitatively with a fluorometer. Bone loss was detected by subtraction radiography of standardized vertical bite-wing radiographs at baseline and 6 months. Mean visual elastase scores (VES) and quantitative elastase measurements were significantly higher (P < 0.001) in sites from periodontitis patients than in sites from healthy volunteers. When bone loss was used as the criterion for disease progression, significantly higher (P < 0.001) visual and quantitative GCF elastase levels were found at progressing sites than in nonprogressing sites in the periodontitis patients. The odds ratios (OR) for the event of developing bone loss with positive 4-minute and 8-minute VES tests were 4.2 (P < 0.001) and 7.4 (P < 0.001), respectively. When corrected for the tendency of progressing sites to be clustered within a subpopulation of patients, the OR for developing bone loss with the 4-minute and 8-minute VES tests were 3.1 (P < 0.007) and 4.9 (P < 0.001), respectively. These data indicate that sites with high levels of elastase are at significantly greater risk for progressive bone loss as assessed by digital subtraction radiography.
为了确定龈沟液（GCF）中的弹性蛋白酶水平是否可作为牙周炎进展的标志物，我们在6个月的时间内，对32名牙周健康志愿者和31名牙周炎患者的选定部位，定期监测其GCF弹性蛋白酶和牙周状况。临床测量包括菌斑指数、牙龈指数、探诊出血、化脓、探诊深度、临床附着水平以及使用自动盘式探针测量的相对附着水平。通过与荧光底物反应检测到的GCF弹性蛋白酶，通过与荧光标准进行视觉对照评估，并使用荧光计进行定量测定。通过对基线和6个月时标准化垂直咬合翼片进行数字减影放射照相来检测骨吸收。牙周炎患者部位的平均视觉弹性蛋白酶评分（VES）和弹性蛋白酶定量测量值显著高于（P < 0.001）健康志愿者部位。当以骨吸收作为疾病进展的标准时，在牙周炎患者的进展部位发现的视觉和定量GCF弹性蛋白酶水平显著高于（P < 0.001）非进展部位。4分钟和8分钟VES测试阳性时发生骨吸收事件的优势比（OR）分别为4.2（P < 0.001）和7.4（P < 0.001）。当校正进展部位在患者亚群中聚集的趋势时，4分钟和8分钟VES测试发生骨吸收的OR分别为3.1（P < 0.007）和4.9（P < 0.001）。这些数据表明，通过数字减影放射照相评估，弹性蛋白酶水平高的部位发生进行性骨吸收的风险显著更高。
