High-resolution ultrasonography of gingival biomarkers for periodontal diagnosis in healthy and diseased subjects.

OBJECTIVE: To determine the capacity of ultrasonographic image-based measurements of gingival height and alveolar bone level for monitoring periodontal health and disease. METHODS: Sixteen subjects were recruited from patients scheduled to receive dental care and classified as periodontally healthy (n = 10) or diseased (n = 6) according to clinical guidelines. A 40-MHz ultrasound system was used to measure gingival recession, gingival height, alveolar bone level, and gingival thickness from 66 teeth for comparison to probing measurements of pocket depth and clinical attachment level. Interexaminer variability and comparison between ultrasound measurements and probing measurements was performed via Bland-Altman analysis. RESULTS: Gingival recession and its risk in non-recessed patients could be determined via measurement of the supra- and subgingival cementoenamel junction relative to the gingival margin. Interexaminer bias for ultrasound image analysis was negligible (<0.10 mm) for imaged gingival height (iGH) and 0.45 mm for imaged alveolar bone level (iABL). Diseased subjects had significantly higher imaging measurements (iGH, iABL) and clinical measurements (probing pocket depth, clinical attachment level) than healthy subjects (p < 0.05). Subtraction of the average biologic width from iGH resulted in 83% agreement (≤1 mm difference) between iGH and probing pocket depth measurements. CONCLUSIONS: Ultrasonography has an equivalent diagnostic capacity as gold-standard physical probing for periodontal metrics while offering more detailed anatomical information.

Interleukins in gingival crevicular fluid in patients with definitive full-coverage restorations.

The objective of this study was to determine interleukin (IL)-1α and IL-8 levels in the gingival crevicular fluid (GCF) of patients with different levels of crown margin placements. Samples of GCF were obtained from 12 study participants with definitive full-coverage restorations with supragingival or equigingival crown margin placements. The periodontal status of the volunteers ranged from healthy to generalized severe periodontitis. Pocket depth and bleeding on probing were assessed at the clinical examination, and interleukin concentrations were determined by enzyme-linked immunosorbent assay (ELISA). Analysis of variance (ANOVA) was used to statistically compare interleukin concentrations between the control, supragingival, and equigingival GCF samples. Compared to controls (60.4 ± 8.9 pg/mL), the average IL-1α concentration in the GCF samples surrounding the supragingival margins was 53.8 ± 9.7 pg/mL and was 110.5 ± 23.3 pg/mL in the equigingival margins. Compared to controls (59.0 ± 14.1 pg/mL), the average IL-8 concentration in the supragingival margins was 46.9 ± 9.7 pg/mL and was 131.4 ± 27.5 pg/mL in the equigingival margins. The trend of higher levels of interleukins in GCF corresponding to equigingival margins was consistent, as was the trend of lower concentrations in supragingival margins compared to the controls; however, statistical significance was not achieved because of the wide biological variation within and between patients. In conclusion, differences in GCF IL-1α and IL-8 concentrations were observed when comparing fixed crown restorations with equigingival and supragingival margins. Gingival inflammation may be dependent on the periodontal condition in addition to restoration or margin placement.