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AnalysisofDaytimeVariationsinGingivalCrevicularFluid:ACircadianPeriodicity?Dialnet

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AnalysisofDaytimeVariationsinGingivalCrevicular
Fluid:ACircadianPeriodicity?
Autores:SevimGnday,AliOrkunTopcu,EsraErcan,NerminYamalik
Localizacin:Journalofperiodontology,ISSN00223492,N.3,2014,pgs.4756
Idioma:ingls
Resumen
Background:Volumetricalterationsingingivalcrevicularfluid(GCF)arewidelyacceptedtobeassociatedwithperiodontal
health/disease.Thevolume/flowofGCFwasshowntobeaffectedbyanarrayofmethodologicalfactors.However,relatively
limitedinformationisavailableonwhetherGCFissubjecttocircadianrhythm.Themainaimofthepresentstudyistoassess
thepossiblepresence/absenceofGCFcircadianrhythm.Theimpactofthesamplingtechniqueondaytimevolumetric
variationsisalsoanalyzed.
Methods:ThepossibledailyvolumetricvariationsofGCFwith2hourintervals(from08:00to18:00hours)wereassessedin100
toothsitesand600GCFsamples.Onlymaxillaryincisorswereincludedtoeliminateanypotentialvolumetricdifferencesdue
totoothdimensions.ToanalyzethepotentialimpactofsamplingtechniqueonGCFvolumeanddaytimevariations,atonesite
modifiedintracrevicularsamplingtechnique(MIST)wasused,whereasthecontralateralsitewassampledwithadeep
intracrevicularsamplingtechnique(DIST).ClinicalperiodontalparametersoftheGCFsiteswerealsorecorded.
Results:NosignificantdailyvariationsinGCFvolumecouldbedetected.Highervolumetricmeasureswereobservedin
inflamedsubgroupscomparedwithhealthysubgroups(P<0.05).MISTwasequivalenttoDISTwithregardtomeanGCF
volumesandthepossibledaytimevolumetricalterations.
Conclusions:Withinthelimitsofthepresentstudy,itcanbesuggestedthatdaytimevariationsdidnothavesignificantimpact
onGCFvolume.ThesamplingmethodologyhadnoapparentimpactonthecircadianperiodicityofGCF.
Gingivalcrevicularfluid(GCF)isdefinedasaspecificserumoriginatingbiologicfluidfoundinperiodontalmicroenvironment
andcanbeharvestedfromthegingivalsulcusofnaturalteeth.1,2TheflowofGCFiswidelyacceptedasoneoftheindicatorsof
periodontalhealth/diseasestatus,asithasthecapacitytoreflectthecellularresponsewithintheperiodontiumcreatedbyboth
serumandgingivalsulcuscomponents.2SuchfeaturesarelikelytomakeGCFareliabletoolforbetterunderstandingthe
pathogenesisofperiodontaldiseasesandalsofordevelopingsusceptible/specifictestsfordefinitiveperiodontaldiagnosis.3
Studiesanalyzingthevolumetricfeatures,enzymaticprofile,orcytokineprofileofGCFhaveemphasizedthediagnostic
potentialofGCFaseitheranearlyindicatorofchangesinperiodontalhealthstatusoranoninvasiveprognostictool.1,4Ithas
beenwelldemonstratedthatGCFvolumeisaffectedbyanarrayoffactors,includingmechanicalstimulation,smoking,sex
hormones,periodontaltherapy,drugs,andcircadianperiodicity.VolumetricpropertiesofGCFareimportantbecausetheycan
affectthefindingsofconcentrationbasedGCFstudiesthereforesuchfactorsareaspecificconcernwhenconsideringthe
improvementofthereliabilityofGCFrelatedresearch.2,57Inanumberofstudies,smokinghasbeendemonstratedtocausea
transientbutremarkableincreaseinGCFflow.5,8,9Duringtheperiodsofpuberty,ovulation,andpregnancy,anincreaseinthe
productionofsexsteroidhormonesandasubsequentincreaseinGCFflowwasobservedinwomen.6Further,GCFproduction
wasshowntoincreaseduringthehealingperiodafterperiodontalsurgery.10SinceEisenbergetal.11detectedmetronidazolein
GCF,BaderandGoldhaber12showedthattetracyclinesareexcretedthroughGCF,andHoetal.7recentlyobservedthat
azithromycindecreasesGCFvolume,drugusagehasbeenacceptedasaffectingtheresultsofstudiesonGCF.
MechanicalstimulationhasbeendemonstratedtoincreasetheflowofGCF.2,13WhileharvestingGCF,collectingthefluid
withouttriggeringtheflowofthisbiologicfluidisacrucialmethodologicalstepbecausethefluidcollectedfromthesulcusis
verylimitedandGCFflowcanbeeasilyaffectedbymechanicalirritation.2,14ManyGCFcollectionmethods(gingival
washing,intracrevicularwashing,micropipettes,twistedthreadsplacedaroundandintothesulcus,absorbentpaperstrips,etc.)
areavailable.2However,collectingGCFusingstandardizedabsorbentpaperstripsisthepreferredmethodologyusingeither
intracrevicularorextracrevicularsamplingmethods.13Inextracrevicularsamplingmethods,thepaperstripisplacedatorover
theentranceofthegingivalsulcustominimizethemechanicalirritationthatmayaltertheactualflowofthefluid.13The
intracrevicularmethodcanbefurthersubdivideddependingonwhetherthestripisinsertedjustattheentranceofthecreviceor
periodontalpocket(orificetechnique),15insertedtothebaseofthepocketoruntilminimumresistanceisfelt(deep
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AnalysisofDaytimeVariationsinGingivalCrevicularFluid:ACircadianPeriodicity?Dialnet

intracreviculartechnique),16orinsertedexactly1mmintothepocket(modifiedintracreviculartechnique).17Different
techniquesofintracrevicularsamplinghavebeenwidelyappliedbyotherinvestigators.1822Circadianperiodicityisanother
factorwiththepotentialtodeterminethevolume/flowofGCF.2However,littleandinconsistentinformationisavailableon
whetherGCFissubjecttocircadianrhythm.23,24Bissadaetal.23suggestedthatGCFactuallyexhibitsaclearcircadian
periodicity.SimilarfindingswereobservedinastudybyBergmannandDeinzer,25whoreporteddaytimevariationsof
interleukin1?levelsinGCF.Inearlierstudies,Suppipatetal.24andDeinzeretal.21demonstratedthatvariationintimeofday
didnotinfluencetheflowrateofthisbiologicfluid.Further,Deinzeretal.21claimedcircadianperiodicitywasassociatedwith
theirritationfromGCFsampling.
ThefirstaimofthepresentstudyistoassessthepossiblecircadianrhythmofGCF,andthesecondaimtocomparatively
analyzethepotentialimpactofmodifiedintracrevicularanddeepintracrevicularmethodologyofGCFsamplingoncircadian
periodicity.

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