Topic 14 (Gingival Crevicular Fluid & Structure & Composition

Question 1

Shallow crevice/ space around the teeth, bounded by the surface of tooth on one side and epithelium lining the free margin of gingiva on the other side

Answer 1

Gingival Sulcus

Question 2

V-shaped, barely permits the penetration of probe.

Answer 2

Gingival Sulcus

Question 3

The clinical evaluation used to determine the depth of the sulcus involves the introduction of a metallic instrument, the periodontal probe, and the
estimation of the distance it penetrates.

Answer 3

Gingival Sulcus

Question 4

It is the V shaped. The depth as determined with histological sections is 1.8mm

Answer 4

Gingival Sulcus

Question 5

Gingival sulcus is the V shaped. The depth as determined with
histological sections is ____.

Answer 5

1.8mm

Question 6

The so-called probing depth of a clinically normal ____ is 2-3mm

Answer 6

Gingival Sulcus

Question 7

The so-called probing depth of a clinically normal gingival sulcus is ____.

Answer 7

2 - 3mm

Question 8

Sections show presence of 3 types of epithelium.

Answer 8

Gingival Sulcus

Question 9

Section show presence of 3 types of epithelium, what are those:

Answer 9

• The oral/keratinized epithelium
• The Sulcular Epithelium
• Junctional Epithelium

Question 10

An epithelium covering the gingival connective tissue in continuation with the sulcular epithelium.

Answer 10

The oral or keratinized Epithelium

Question 11

An epithelium which is not keratinized. it forms the soft tissue wall of the gingival sulcus and the Junction Epithelium.

Answer 11

The Sulcular Epithelium

Question 12

It is in continuation with the oral & sulcular epithelium.

Answer 12

Junctional Epithelium

Question 13

It is formed by few starts of cells, with long flat basal layer and very small desquamating surface that forms of the gingival sulcus.

Answer 13

Junctional Epithelium

Question 14

Complex mixture of substances.

Answer 14

Gingival Crevicular Fluid

Question 15

Who confirmed the presence of GCF in humans and considered it to be a ‘transudate’.

Answer 15

Brill (1959)

Question 16

Brill (1959) confirmed the presence of GCF in humans and considered it to be a ____.

Answer 16

Transudate

Question 17

However, others demonstrated that GCF is an inflammatory exudate, not a continuous transudate. In strictly normal gingiva, little or no fluid can be collected.

TRUE OR FALSE

Answer 17

TRUE

Question 18

Who suggested that the initial fluid is the interstitial fluid which appears in the crevice as a resuit of osmotic gradient.

Answer 18

Alfano (1974) and Pashley (1976)

Question 19

This initial, proinflammatory: fluid was earlier considered to be ____, and on stimulation it changes to an exudate.

Answer 19

transudate

Question 20

Collection of gingival crevicular fluid is ____ and therefore this approach has been extensively explored in the search for potential diagnostic biomarkers of periodontal disease .

Answer 20

noninvasive

Question 21

As a result of interaction between the bacterial biofilm and the cells of the periodontal tissues, gingival crevicular fluid appears as an attractive oral diagnostic fluid due to its ease of collection and allowing for sampling of multiple sites within the oral cavity simultaneously.

TRUE OR FALSE

Answer 21

TRUE

Question 22

What are the functions of GCF:

Answer 22

• Cleans material from the sulcus
• Contain plasma protein
• Possess antimicrobial properties
• Exert antibody activity in defense of the gingival

Question 23

What are the factors affecting flow of GCF:

Answer 23

● Histamine
● Pre-inflammatory GCF
● Concentration of protein
● Mechanical stimuli
● Passage of fluid & PMN
● Morphology of JE
● Inflammatory changes of BM

Question 23

Increased vascular permeability

Answer 23

Gingival Vasculature & Crevicular Fluid

Question 24

What are the 3 different method that increases the vascular permeability of the Gingival vasculature & Crevicular Fluid:

Answer 24

1. Topical application of histamine 2. Gentle massage of the gingiva by means of ball-ended amalgam plugger 3. Scraping of the gingival crevice by means of blunted dental explorer

Question 25

Degree of permeability of the oral mucosa is not equal to the degree of keratinization.

Answer 25

Squire (1973)

Question 26

Degree of permeability of the oral mucosa is not equal to the degree of keratinization.

Answer 26

Permeability of Junctional & Sulcular Epithelium

Question 27

(Permeability of Junctional & Sulcular Epithelium) Give the 3 routes have been described:

Answer 27

1. Passage form CT into the sulcus. 2. Passage from the sulcus into the CT. 3. Passage of substances through pathological or experimentally modified gingival sulcus.

Question 28

Give the methods of collecting of GCF:

Answer 28

1. Absorbent filter paper strips 2. Preweighed twisted threads 3. Sampling by means of micropipettes 4. Gingival washings 5. Other strips

Question 29

Give the 2 examples for absorbing paper strip:

Answer 29

- Intracrevicular - Extracrevicular

Question 30

Give 2 other strips:

Answer 30

- Plastic strips - Platinum loops

Question 31

In this technique the gingival crevice is perfused with an isotonic solution of fixed volume.

Answer 31

Gingival Washing Methods

Question 32

The fluid collected then represents a dilution of crevicular fluid and contains both cells and soluble constituents such as plasma proteins.

Answer 32

Gingival Washing Methods

Question 33

In Gingival Washing method technique the gingival crevice is perfused with an ____.

Answer 33

Isotonic solution of fixed volume

Question 34

What are the composition of GCF:

Answer 34

- Cellular Components - Organic Ions - Inorganic Ions - Enzymes - Bacterial Products

Question 35

PMNL (Neutrophils), Lymphocytes, Monocytes, Epithelial Cells - Cellular Components - Organic Ions - Inorganic Ions - Enzymes - Bacterial Products

Answer 35

Cellular Components

Question 36

Protein 70g/g, Albumins 35 g/l, Gammaglobulin 7.5 g/l, Immunoglobins - Cellular Components - Organic Ions - Inorganic Ions - Enzymes - Bacterial Products

Answer 36

Organic Ions

Question 37

Sodium, Potassium, Calcium, Magnesium, Phosphate - Cellular Components - Organic Ions - Inorganic Ions - Enzymes - Bacterial Products

Answer 37

Inorganic Ions

Question 38

Acid Phosphate, Alkaline Phosphate, Cathepsin B & D, Collagenase, Elastase, Beta-glucuronidase, Lactate, Dehydrogenase, Lactoferrin, Lysozyme, Plasminogen Activator, Myeloperoxidases, Asparate Aminotransferase, Arylsufatase, Gelatinases - Cellular Components - Organic Ions - Inorganic Ions - Enzymes - Bacterial Products

Answer 38

Enzymes

Question 39

Endotoxins, Trypsin ike enzymes, Acid phosphatase, Alkaline Phosphate, Prostaglandin like products - Cellular Components - Organic Ions - Inorganic Ions - Enzymes - Bacterial Products

Answer 39

Bacterial Products

Question 40

Give the Clinical Significance of GCF:

Answer 40

● Circadian periodicity ● Smoking ● Sex hormones ● Periodontal therapy ● Drugs ● Mechanical stimulation ● Diabetes

Question 41

Give the Problems Associated with GCF Collection:

Answer 41

● Sampling time ● Contamination ● Recover from strips ● Volume determination ● Data reporting

Question 42

What are the Enzymes & Enzyme Inhibitors:

Answer 42

● Lysozyme ● B Glucoronidase ● Hyaluronidase ● Acid phosphatase ● Pyrophosphotase ● Lactate dehydrogenase ● Proteolytic enzymes

Question 43

Give the Host-Derived Enzymes:

Answer 43

● Aspratate aminotransferase ● Alkaline phosphatase ● Cathepsin B ● Neutrophil elastase ● Prostaglandin E2 ● Cytokines

Question 44

Give the diagnosis of GCF biomarkers:

Answer 44

- GCF sample harvest - Volume measurement - Biomaker elutiom - Sample and Micro Analyser - Biomaker Report