Collagenase activity and protein content of sulcular fluid after scaling and occlusal adjustment of teeth with deep periodontal pockets

Three teeth from each of 14 adult patients with advanced periodontitis were included in this study. The Test Tooth was an incisor or canine with increased mobility associated with an occlusal interference and a ≥ 5 mm deep pathologic pocket. The Infected Control Tooth was a non-mobile incisor or canine with a ≥ 5 mm pocket. A non-mobile incisor or canine with pockets ≤3 mm served as the Healthy Control Tooth. At least 7 d prior to Day 0 the patients were taught an effective oral hygiene regimen and received a supragingival prophylaxis. At Day 0, sulcular fluid for assay of protein content and Collagenase activity was collected from each chosen pocket. Immediately thereafter the Test Teeth of 7 subjects were scaled and root planed and the Test Teeth of 7 subjects occlusally adjusted. At Day 14, the treatments were reversed for the two groups. Sulcular fluid for the assays was again collected at Days 14 and 28. The protein content and collagenase activity in deep pockets was elevated during periodontitis in both mobile and immobile teeth. After establishment of a supragingivally clean oral environment, a rapid decrease of the collagenase activity took place following scaling and root planing of the root surfaces within the periodontal pockets (p≤0.05). Also, occlusal adjustment of the hypermobile teeth with deep pathological pockets reduced the protein content and collagenase activity in sulcular fluid (p ≤ 0.02). There was a further reduction of collagenase activity when occlu-sally adjusted teeth were scaled and root planed (p≤0.02). No change in the protein content or collagenase activity was observed in the deep pockets of the untreated Control Teeth in the same patients.