Effect of Porous Titanium Granules on Bone Regeneration and Primary Stability in Maxillary Sinus: A Human Clinical, Histomorphometric, and Microcomputed Tomography Analyses.

The aim of this randomized controlled study was to comparatively analyze the new bone (NB), residual bone, and graft-bone association in bone biopsies retrieved from augmented maxillary sinus sites by histomorphometry and microcomputed tomography (MicroCT) in a split-mouth model to test the efficacy of porous titanium granules (PTG) in maxillary sinus augmentation. Fifteen patients were included in the study and each patient was treated with bilateral sinus augmentation procedure using xenograft (equine origine, granule size 1000-2000 µm) and xenograft (1 g) + PTG (granule size 700-1000 µm, pore size >50 µm) (1 g), respectively. After a mean of 8.4 months, 30 bone biopsies were retrieved from the implant sites for three-dimensional MicroCT and two-dimensional histomorphometric analyses. Bone volume and vital NB percentages were calculated. Immediate after core biopsy, implants having standard dimensions were placed and implant stability quotient values were recorded at baseline and 3 months follow-up. There were no significant differences between groups according to residual bone height, residual bone width, implant dimensions, and implant stability quotient values (baseline and 3 months). According to MicroCT and two-dimensional histomorphometric analyses, the volume of newly formed bone was 57.05% and 52.67%, and 56.5% and 55.08% for xenograft + PTG and xenograft groups, respectively. No statistically significant differences found between groups according to NB percentages and higher Hounsfield unit values were found for xenograft + PTG group. The findings of the current study supports that PTG, which is a porous, permanent nonresorbable bone substitute, may have a beneficial osteoconductive effect on mechanical strength of NB in augmented maxillary sinus.

Do Porous Titanium Granule Grafts Affect Bone Microarchitecture at Augmented Maxillary Sinus Sites? A Pilot Split-Mouth Human Study.

BACKGROUND: The aim of this randomized controlled clinical study was to analyze the bone microarchitecture at augmented maxillary sinus sites by using different materials in patients to compare the effect of porous titanium granules as a sinus augmentation material with bone microstructural features. MATERIALS AND METHODS: Eight subjects with bilateral atrophic posterior maxilla of residual bone height <4 mm included in this study and each patient was treated with bilateral sinus augmentation procedure using xenograft with equine origin (Apatos, Osteobiol; Tecnoss Dental) and xenograft (1 g) + porous titanium (1 g) granules (Natix; Tigran Technologies AB). Sixteen human bone biopsy samples were taken from patients receiving two-stage sinus augmentation therapy during implant installation and analyzed using microcomputerized tomography. Three-dimensional bone structural parameters were analyzed in details: tissue volume, bone volume, percentage of bone volume, bone surface and bone surface density, bone specific surface, trabecular thickness trabecular separation, trabecular number, trabecular pattern factor, structural model index, fractal dimension, and bone mineral density. RESULTS: No statistically significant differences were found between groups according to bone structural parameters. CONCLUSIONS: Porous titanium grafts may ensure a space for new bone formation in the granules, which may be a clinical advantage for long-term success.

Analysis of TNF-α (-308) polymorphism and gingival crevicular fluid TNF-α levels in aggressive and chronic periodontitis: A preliminary report.

OBJECTIVES: The purpose of this study was to determine the differences in the distribution of TNF-α (-308) gene polymorphism among aggressive periodontitis, chronic periodontitis and periodontally healthy individuals and also to investigate whether this polymorphism is associated with gingival crevicular fluid TNF-α levels and periodontal disease severity. MATERIAL AND METHODS: A total of 93 individuals were enrolled in the study including 38 aggressive periodontitis, 29 chronic periodontitis patients, and 26 healthy controls. Single nucleotide polymorphism at TNF-α (-308) is analyzed by PCR-RFLP method. Gingival crevicular fluid samples were analyzed for TNF-α, using ELISA. RESULTS: The distribution of genotypes and allele frequencies for TNF-α (-308) were similar among the groups. After stratification of patients with respect to attachment level, aggressive periodontitis patients with clinical attachment level ⩾4mm was observed to have a higher frequency of TNF-α (-308) allele 2 compared to the chronic periodontitis patients with clinical attachment level ⩾4mm. No significant differences were found between the TNF-α levels of the different genotypes in spite of an insignificant increase in patient groups carrying TNF-α (-308) allele 2. CONCLUSION: The results of this study revealed an association between TNF-α (-308) allele 2 frequency and aggressive periodontitis patients with clinical attachment level ⩾4mm in the population studied.

Evaluation of periodontal pathogens in amniotic fluid and the role of periodontal disease in pre-term birth and low birth weight.

BACKGROUND: Pre-term birth and/or low birth weight (PTLBW) is a serious problem in developing countries. The absence of known risk factors in ≈ 50% of PTLBW cases has resulted in a continued search for other causes. The aim of this study was to examine the effect of periodontitis on pregnancy outcomes. METHODS: Samples were taken from 50 pregnant women who underwent amniocentesis. Polymerase chain reaction was performed on amniotic fluid samples obtained during amniocentesis and on subgingival plaque samples to determine the presence of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola, Tannerella forsythia, Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus and Eikenella corrodens. Plaque index, gingival index, bleeding on probing, probing depth and clinical attachment level were evaluated. Medical records were obtained after birth. RESULTS: Social and demographic variables were similar among the Gingivitis (G), Localized Periodontitis (LP) and Generalized Periodontitis (GP) groups. Four subjects gave birth to PTLBW neonates. Campylobacter rectus, T. forsythia, P. gingivalis and F. nucleatum were detected in the amniotic fluid and subgingival plaque samples of three patients who gave birth to PTLBW neonates. The amniotic fluid sample from the fourth patient was not positive for any of the tested pathogens. CONCLUSION: These findings suggest that the transmission of some periodontal pathogens from the oral cavity of the mother may cause adverse pregnancy outcomes. The results contribute to an understanding of the association between periodontal disease and PTLBW, but further studies are required to better clarify the possible relationship.

Effects of platelet-rich plasma and chitosan combination on bone regeneration in experimental rabbit cranial defects.

This study aimed to investigate and compare the effect of chitosan sponge and platelet-rich plasma (PRP) gel alone as well as their combination on bone regeneration in rabbit cranial defects. Four cranial defects with a 4.5-mm diameter were created in rabbit cranium and grafted with PRP, chitosan sponge alone, and chitosan sponge incorporated with PRP. The rabbits were killed by the fourth and eighth weeks, and the defects were analyzed histologically. Higher bone formation was observed in the PRP group when compared with the other groups at weeks 4 and 8. All parts of the defects were filled with thick trabecular new bone in the PRP group. The amount of new bone formation in the control groups was found to be less when compared with the PRP group and the least in the chitosan group. The defects that were filled with chitosan sponge showed a limited amount of new bone formation and an obvious fibrous demarcation line between chitosan particles and bone. Application of PRP showed a histological tendency toward increased bone formation. Other forms or derivatives of chitosan may have beneficial effects to achieve new bone regeneration.

The possible association among bone density values, resonance frequency measurements, tactile sense, and histomorphometric evaluations of dental implant osteotomy sites: a preliminary study.

PURPOSE: The aim of the clinical preliminary trial was to determine the possible relationship among radiologic bone density, primary implant stability, and tactile sense measurements, and to clarify their possible association with histological measurements at endosseous implant osteotomy sites. MATERIALS: Eleven mandibular and 12 maxillary sites of 10 patients were included. Computerized tomography was used for preoperative evaluation of the jaw-bone for each dental implant site, and bone densities were recorded in Hounsfield units (HU). Implant stability quotients (ISQ) were determined with the Osstell Mentor device. Bone core biopsies were taken from the implant osteotomy sites, where the tactile sense of the practitioner while placing the implants was also recorded. RESULTS: The average radiologic bone density, primary implant stability, and trabecular bone volume (TBV) values were 554.87 HU, 72 ISQ, and 41% for 23 dental implants, respectively. Maxillary sites presented a statistically significant decrease HU values compared with sites in the mandible. The mean TBV in mandibles presented a trend of increase compared to maxillary sites. A significant correlation was noted between ISQ values and tactile sense for male patients, where HU values demonstrated significant correlations among ISQ values, TBV measurements, and tactile sense evaluations in women. CONCLUSIONS: The results of this study demonstrated that computerized tomography measurements in terms of HU evaluations may be a helpful technique for predicting primary stability of the implant and bone quality. Further studies should be performed to understand the relationship between clinical assessments and histological evaluations in implant osteotomy sites in humans.

Analysis of the potential association of implant stability, laboratory, and image-based measures used to assess osteotomy sites: early versus delayed loading.

BACKGROUND: During the assessments made at presurgical, surgical, and follow-up phases, the clinician may benefit from a wide array of clinical and/or image-based measures. Because analysis of the potential associations among the various measures could improve the evaluation process for dental implants, this study attempted to determine the potential correlations among peri-implant sulcus fluid (PISF) volume, implant stability, nitric oxide content of PISF, and marginal bone loss. METHODS: Seventeen completely edentulous patients seeking prosthetic rehabilitation were included. Two ball attachment mandibular overdentures were given to all patients, and early- (N = 18) and delayed-loaded (N = 16) dental implants were compared during 24-weeks of follow-up. Resonance frequency analysis (RFA), marginal bone level, and PISF samples were taken for all dental implants. RESULTS: A consistent and negative correlation was observed between RFA measurements and marginal bone level, whereas some correlations also existed between RFA and PISF volume. The pattern of loading seemed to affect the relationship between RFA measurements and marginal bone level and, to a limited extent, the association between PISF volume and nitrite levels. CONCLUSIONS: Where the potential associations among various implant-related measures are concerned, the factors that may affect such associations (e.g., healing and loading) need to be considered. Data arising from the analysis of the associations between the wide arrays of available implant-related measures may improve dental practitioners' assessment concerning endosseous dental implants.

Multidisciplinary approach for the treatment of an oblique root fracture: a case report.

This clinical case study describes a multidisciplinary modified technique for the treatment of an oblique root fracture. A-38-year old woman with a history of trauma and a broken tooth was referred to our clinic. There was an oblique crown fracture extending the coronal third of the root just underneath the cingulum of the crown. The patient was willing to keep her tooth in function by any means. Two weeks after root canal therapy the flap was raised. The coronal two third of the root canal was enlarged. An impression of the enlarged root canal and tooth surface with surrounding bone was taken. The flap was sutured and the impression was sent to the laboratory for the post-casting preparation. After 7 days, the flap was opened again and casting was cemented. The flap was sutured. Ten days after the second surgery, three anterior teeth were prepared and a final impression was taken for the preparation of porcelain crowns. Restoration was finished 15 days after the second operation. The patient is still under maintenance therapy and the 12 month results are presented in this report. Extraction may not be the only alternative for the root fractures. Even for fractures under the alveolar margin, alternative multidisciplinary approaches can be used to restore and allow the tooth to survive.

Impact of the distinct sampling area on volumetric features of gingival crevicular fluid.

BACKGROUND: Volumetric features of gingival crevicular fluid (GCF) are under the influence of many factors, including sampling variables. Standardizing such factors may enable a more precise methodology. Thus, analysis of the possible impact of the clinical periodontal status and the distinct location of sampling sites on fluid volume was performed. METHODS: Clinical parameters were recorded, and fluid samples were obtained from 931 maxillary sites. The potential site-specific volumetric differences among healthy, gingivitis, and periodontitis sites; between multirooted or single-rooted teeth and mesio-buccal or disto-buccal sampling sites; and the correlations between volume and clinical measures were statistically analyzed. RESULTS: Although volume increased in a disease-related pattern (healthy < gingivitis < periodontitis; P <0.05), the distribution range of volume was widespread, with prominent overlaps between the different clinical periodontal conditions. Multirooted teeth presented more fluid volume, and even mesio-buccal or disto-buccal sites exhibited some volumetric differences (P <0.05). Constant correlations between volume and clinical parameters could be observed only at gingivitis sites (P <0.05). CONCLUSIONS: The spectrum of fluid volume is disease related in general. However, the wide range of volumetric distribution, the site-specific nature, and the clear impact of the distinct sampling site on volume are important volumetric features of this biologic fluid. Whenever possible, standardization of the extent of probing depth, degree of gingival inflammation, and distinct sampling area is likely to improve the reliability of GCF methodology.

The effect of delayed versus early loading on nitric oxide metabolism around dental implants: an 18-month comparative follow-up study.

PURPOSE: Nitrite is a stable end-product of nitric oxide oxidation. The aim of the present study was to quantitatively analyze peri-implant sulcular fluid (PISF) nitrite levels in a longitudinal study design to evaluate the potential changes in nitric oxide metabolism in relation to the clinical status of the peri-implant site and the loading style of the dental implants. MATERIALS AND METHODS: A total of 34 implants, either early loaded (EL) or delayed loaded (DL), in 17 patients were followed up for a period of 18 months. Clinical parameters were recorded, PISF samples were obtained, and PISF nitrite levels were spectrophotometrically determined. Clinical measurements and nitrite analysis were repeated at 1, 3, 6, 9, 12, and 18 months. RESULTS: Despite the gradual decrease in clinical parameters, fluctuations in PISF total nitrite levels were observed during follow-up. The pattern of nitric oxide metabolism, as reflected by PISF nitrite levels, also demonstrated differences between EL and DL implants that diminished toward the end of the experimental period. DISCUSSION: Although the presence of clinical and subclinical gingival inflammation contributes to the PISF total nitrite levels, nitric oxide metabolism is also associated with healing and bone remodeling, and the pattern of loading seemed to have an impact on nitric oxide production at dental implant sites. CONCLUSION: Nitric oxide production at dental implant sites seems to be tightly regulated to enable the maintenance of peri-implant bone.

Tetraploid/diploid mosaicism with generalized aggressive periodontitis.

BACKGROUND: Changes of chromosome number diploid to triploid or tetraploid states are rare in human pregnancies, where the main clinical features of tetraploidy are delayed growth and/or craniofacial abnormalities. The present report describes the oral features of tetraploid/diploid mosaicism. Although the medical literature described the physical manifestations of this genetic abnormality, the oral features of this disorder were not previously described. METHODS: A 13-year-old patient presented because of his severe periodontal conditions. Clinical, radiological, microbiologic, immunologic, and genetic examinations were conducted. RESULTS: Long eyelashes and mandibular micrognathia were noticeable in his extraoral examination. Intraoral examination revealed significant generalized edema of the gingiva and severe sulcular bleeding on probing. Generalized maxillary and mandibular alveolar destruction was determined with radiographic examination. Actinobacillus actinomycetemcomitans was also detected in his subgingival samples. He was diagnosed as generalized aggressive periodontitis. His medical cytogenetic examination revealed 92,XXYY (25%)/46,XY (75%) karyotype indicating tetraploid/diploid mosaicism. He was given initial and advanced periodontal therapy and he is currently under a routine follow-up period. CONCLUSIONS: This report provides information on the oral characteristics of tetraploid/diploid mosaicism and describes periodontal treatment. Severe periodontal conditions such as aggressive periodontitis may accompany tetraploid/diploid mosaicism subjects and these patients should be frequently seen by their dental practitioners. It is suggested that initial and/or advanced periodontal procedures may be a way of treating tetraploid/diploid mosaicism subjects with aggressive periodontitis. The importance of physical examination and medical consultation is also discussed.

Analysis of thte possible impact of inflammation severity and early and delayed loading on nitric oxide metabolism around dental implants.

PURPOSE: The aim of the present study was to analyze the possible impact of clinical status, presence and severity of inflammation, and loading on nitric oxide (NO) metabolism around mandibular dental implants. MATERIALS AND METHODS: A total of 34 implants in 17 patients, loaded either early (EL) or after a delay (DL), were classified according to the presence and severity of clinical inflammation in the peri-implant sites. Clinical parameters were recorded, peri-implant sulcular fluid (PISF) samples were obtained, and PISF nitrite levels were spectrophotometrically determined. Clinical measurements and nitrite analysis were repeated at 1, 3, 6, and 9 months postloading at available sites. RESULTS: Compared to noninflamed sites, inflamed sites demonstrated higher mean total nitrite levels (P = .032) that tended to increase with the severity of inflammation at both EL and DL implants. At noninflamed sites, EL implants provided significantly higher PISF volume than DL implants (P = .001). At noninflamed sites, EL implants revealed higher total nitrite levels; on the contrary, at inflamed sites, DL implants revealed higher total nitrite levels. In general, nitrite levels demonstrated a pattern of decrease followed by an increase during follow-up. DISCUSSION: Increased NO production with the presence and the severity of inflammation supports the contribution of NO in the peri-implant inflammatory process. Loading is also likely to have an impact on NO metabolism, which suggests a role for NO in remodeling and adaptation of bone around dental implants. CONCLUSION: Besides the presence of inflammation, the severity of inflammation and loading also seem to have an impact on NO metabolism around dental implants.

Treatment of periapical inflammatory lesion with the combination of platelet-rich plasma and tricalcium phosphate: a case report.

Periapical surgery is an important treatment alternative in the presence of a periapical inflammatory lesion. To achieve optimal healing and regeneration of the bone, different bone substitutes or barrier membranes can be used after degranulation of the lesion. Tricalcium phosphate (TCP) graft material is one of these substitutes. Platelet Rich Plasma (PRP) preparation is a new biotechnology and can be used in many different surgical procedures. It consists of thrombocyte concentrates and high amounts of growth factors (GFs), especially platelet derived growth factor (PDGF), insulin-like growth factor (IGF-I) and transforming growth factor (TGF-beta), which are important in wound healing and regeneration. In this case report, use of platelet gel in conjunction with TCP in the treatment of periapical inflammatory lesion and the results of 12 months has been reported.

Localized edentulous ridge augmentation with upside down osteotomy prior to implant placement.

Localized bone defects may be seen following the extraction of teeth with periapical lesion or advanced periodontal disease, or as a result of trauma. When these regions are considered for treatment with implants, localized ridge augmentation will be necessary. Autogenous bone grafts are used exclusively for ridge augmentation. This case report represents the treatment of a localized edentulous ridge with an upside down osteotomy technique at the symphysis region prior to implant placement. Systemically healthy 21-year-old female patient, who was missing a lower right incisor tooth, was scheduled for an implant treatment. However, the crestal width was only 1 mm. The augmentation was planned and the region was treated with an upside down osteotomy technique. Nine months after the augmentation procedure, the computed tomography (CT) examination of the area revealed that the width of the crest was 7 mm, and the height of the crest was in good relation with the cementoenamel junction of the adjacent teeth. Flipping a bone block graft, which was harvested from the edentulous area, upside down may provide a successful result in partially edentulous ridges, in both maxilla and mandible.

Critical steps in electronic volume quantification of gingival crevicular fluid: the potential impact of evaporation, fluid retention, local conditions and repeated measurements.

BACKGROUND AND OBJECTIVES: Various methodological factors may operate during clinical gingival crevicular fluid (GCF) sampling, volume quantification or subsequent laboratory analysis. For precise volume quantification, specific concern for generation and maintenance of a reliable calibration curve, the potential risk of GCF loss as a result of evaporation or fluid retention on actual volume and the impact of local conditions is needed because each of these factors may act as a source of subsequent volumetric distortions. Thus, the present study aimed to analyse the impact of sample transfer time on the rate of evaporation and the possibility of fluid retention, and the impact of local conditions and number of replicated measurements on the reliability of calibration data. MATERIALS AND METHODS: To analyse evaporative errors, standardized Periopaper strips provided with known test volumes (0.1 microl, 0.2 microl, 0.5 microl and 0.6 microl) were transferred to Periotron 8000 with different time intervals (immediately, 5 s, 30 s and 60 s). For fluid retention, after quantifying the actual volume of the strips provided with known volumes (0.1 microl and 0.6 microl) of two test fluids, a second set of measurements was performed using dry strips. To determine the impact of local conditions (temperature and humidity) and the validity of 3, 5 and 20 replications (0.0-0.6 microl with 0.1- microl increments) on device calibration for 20 degrees C and 25 degrees C, electronic readings were obtained from three devices at three different locations. Differences in volumetric data in each experimental design were statistically analysed. RESULTS: No significant fluid loss was observed within 5 s, but evaporation clearly led to volumetric distortions with extending transfer times (30 s or 60 s) (p < 0.05). Measurable amounts of fluid retention were found for both volumes and both test fluids, but not with identical patterns. Local conditions resulted in unique calibration data for each test volume and for each device. Although a 5 degrees C increase generally provided higher readings, this was not observed for all devices at all volumes. Additional replicates (n = 5 or n = 20) did not seem to add any further reliability to the triplicate scores for the given test volumes. CONCLUSION: The findings of the present study confirm the reliability of triplicate readings, and uniqueness of each device and electronic data and the distinct impact of local environmental conditions on the generation/maintenance of calibration scores for each particular device. Furthermore, they underline time-dependent evaporation and fluid retention as additional technical concerns and once again highlight the importance of methodological standardization of the electronic volume quantification process.

Intentional replantation for periodontally involved hopeless teeth.

The aim of this study was to evaluate the clinical and radiographic results of intentional replantation of periodontally involved teeth after conditioning of root surfaces with tetracycline-HCl. Thirteen patients (seven female, six male; age range: 35-52 years) with 15 periodontally involved hopeless teeth were included in this study. During the replantation procedure, the affected teeth were gently extracted, then the granulation tissues, calculus, remaining periodontal ligament and necrotic cementum on the root surfaces were removed. Tetracycline-HCl, at a concentration of 100 mg ml(-1), was applied for 5 min to the root surfaces. The teeth were then replaced into the socket and splinted. Patients were clinically and radiographically evaluated at baseline (time of surgery) and 6 months after the surgery. The following measurements were recorded: probing depth (PD), gingival recession (R), the amount of bone loss (BL) and bone gain (BG). Results indicated a reduction in PD and in the amount of bone loss and healthy gingiva. Mean PD was decreased from 5.25 to 2.36 mm, gingival recession was increased from 3.73 to 4.0 mm, and BL was reduced from 73.20 to 56.86%. At the end of 6 months, no root resorption or ankylosis was observed radiographically. Even during the short period of evaluation, it may be suggested that intentional replantation can be an alternative approach to extraction in cases where advanced periodontal destruction is present and no other treatments could be considered.

Analysis of the relationship between the severity of periodontal destruction and proteoglycan metabolism of gingiva and gingival crevicular flu.

BACKGROUND: Although it is well-described that proteoglycans (PGs) are among the major non-collagenous components of the matrix which are degraded during periodontal diseases, the relationship between PG metabolism and seventy of periodontal breakdown, the extent of degradation of PGs together with the resulting end-products, and the elimination pathways of these catabolic end-products is likely to need further clarification. OBJECTIVE: The main aim of the present study was to analyze the possible impact of severity of periodontal destruction on PG metabolism of gingiva and gingival crevicular fluid (GCF). MATERIAL AND METHODS: For this purpose, gingiva and GCF samples obtained from patients (n = 45) exhibiting sites (n = 57) with moderate periodontal breakdown (MP) or severe periodontal breakdown (SP) were analyzed for PG metabolism via spectrophotometric determination of uronic acid levels. Gingiva and GCF samples were obtained from the same sites in every patient to analyze the possible relationship between uronic acid content of gingival tissue and GCF. RESULTS: No significant differences were found in uronic acid levels between sites with MP and SP (p > 0.05). The uronic acid content of GCF and gingiva showed significant overlaps between MP and SP sites and uronic acid levels did not present any constant correlation with the clinical parameters (p > 0.05). In a similar manner, uronic acid content of GCF and gingival tissue was not correlated (p > 0.05). CONCLUSION: The lack of a significant correlation between the uronic acid content of gingival tissue and GCF may suggest that the passage of PG metabolites from gingiva to GCF is likely to be under the influence of multifactorial interactions rather than being linear. As a general measure of PG metabolism, uronic acid levels do not seem to be related with the severity of periodontal destruction and tend to act as different measures when compared to traditional clinical parameters.

Analysis of Human Gingival Tissue and Gingival Crevicular Fluid ß-Glucuronidase Activity in Specific Periodontal Diseases.

BACKGROUND: ß-glucuronidase (ßG) is one of the enzymes involved in the destruction of non-collagenous components of the extracellular matrix. It is also considered an indicator or predictor of periodontal disease activity. The present study was conducted to determine the presence and the levels of ßG activity in gingival tissue and gingival crevicular fluid (GCF) in periodontal disease and health status. The validity of 2 expressions of data, total ßG activity versus ßG concentration, and the correlations between clinical periodontal status and ßG profile was also evaluated. METHODS: ßG activities in gingival tissues and GCF samples from 57 individuals, divided into 3 equal groups of adult periodontitis (AP), early-onset periodontitis (EOP), and periodontally healthy subjects were spectrophotometrically examined. RESULTS: Both patient groups had higher ßG levels in both gingiva and GCF than controls. Significant differences were observed among all groups when total GCF ßG activities were examined (P <0.05). However, the difference between AP and controls was not significant when concentration values were compared (P >0.05). The highest GCF ßG activity, with both expressions, was detected in EOP group. No absolute correlations between clinical parameters and ßG activity were observed, except for random correlations in the patient groups with mean total ßG activities. Also GCF/gingiva ßG levels and the 2 expressions did not show absolute correlations. CONCLUSIONS: The findings of the present study confirm the relationship between ßG activity and periodontal diseases. The differences in data concerning GCF total ßG activity and ßG concentration may suggest that they are not matching measures. Data presentation seems to be an important factor in GCF/enzyme profile studies. J Periodontol 2000;71:618-624.