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Previous reports have described a method by which multiple constituents can be analyzed from a sample of gingival crevicular fluid (GCF) collected with a precut filter paper strip. In this study the relationship of changes in GCF levels of the vertebrate (lysosomal) enzymes beta-glucuronidase (BG) and arylsulfatase (AS) and the cytoplasmic enzyme lactate dehydrogenase (LDH) was evaluated longitudinally in reference to loss of clinical attachment in patients with existing chronic adult periodontitis. Thirty-six patients were followed for six months. Clinical attachment loss was recorded as the change between the baseline and three month examinations, and the three- and six-month examinations. GCF analysis was performed at baseline and three months. Three groups of patients were identified based on disease progression. Group I patients (N = 5) displayed a generalized form of disease activity. In these patients we observed clinical attachment loss of at least 2.0 mm at a minimum of three unrelated sites. Group II patients (N = 4) displayed a localized form of disease activity. In these patients clinical attachment loss of at least 2.5 mm occurred at one site, or two anatomically related sites. Group III patients (N = 27) did not display clinical attachment loss as defined here. Enzyme analysis was evaluated as a whole mouth score (the per cent of samples from a patient in which enzyme activity was at least twice the population mean) and at individual samples. Group I patients could be identified by elevated whole mouth scores for BG, while Group II patients could not be identified by whole mouth scores for any of the enzymes.(ABSTRACT TRUNCATED AT 250 WORDS)

It is generally accepted that normal prepubertal children do not develop periodontitis, and that the severity of gingivitis in prepubertal children is usually less than that observed in children after puberty. One possible explanation is that the bacteria associated with periodontal diseases cannot become established in great numbers prior to puberty. Studies by Kornman and Loesche and others suggest that levels of black pigmented Bacteroides, especially B. intermedius, increase with increased levels of gonadotrophic hormones in pregnant women. Delaney and Kornman have found that there is a similar increase in levels of black pigmented Bacteroides with puberty. The present study involved cultural and microscopic characterization of the subgingival plaque flora of prepubertal, circumpubertal and postpubertal children with similar Silness and Löe plaque index scores. Puberty was confirmed through examination of wrist radiographs. Populations of black pigmented Bacteroides were very low in prepubescent children and were much higher in circumpubertal and postpubertal children. However, B. intermedius predominated only in circumpubertal plaques. Levels of total motile bacteria increased at each age level, but levels of spirochetes above 2% were observed only in the postpubertal group. These results support those of previous investigators who postulated a relationship between hormone levels and black pigmented Bacteroides levels in subgingival plaque and suggest that differences in the subgingival environment profoundly influence the proportions of suspected periodontopathic species in plaque.