Longitudinal evaluation of GCF MMP-3 and TIMP-1 levels as prognostic factors for progression of periodontitis.

BACKGROUND: To determine whether matrix metalloproteinase-3 (MMP-3) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in gingival crevicular fluid (GCF) could serve as prognostic factors for the progression of periodontitis, we monitored GCF MMP-3 and TIMP-1 and periodontal status of selected sites in 40 medically healthy subjects over a 6-month period. METHOD: Clinical measurements including gingival index (GI), plaque index, bleeding on probing, suppuration, probing depth (PD), attachment loss (AL), and GCF samples were taken from 2 healthy sites (including sites with gingival recession, GI=0 PD < or =3 mm; AL < or =2 mm) and 2 periodontitis sites (GI > or =1; PD > or =5 mm; AL > or =3 mm) of each patient at baseline, 3-month and 6-month visits by means of sterile paper strips. GCF levels of MMP-3 and TIMP-1 were determined by sandwich ELISA assays. RESULTS: The mean amounts of MMP-3 and TIMP-1 in diseased sites were significantly higher than in healthy sites (p<0.0001). Significantly higher GCF levels of MMP-3 and TIMP-1 were found at progressing sites than in nonprogressing periodontitis sites (0.001 or =2 mm loss of attachment during 6- month study period. GCF levels of MMP-3 were highly correlated with clinical measurements taken at baseline, 3-month and 6-month visits (p<0.001). TIMP-1 levels were only moderately correlated with probing depth and attachment level (p<0.01). Step-wise multiple regression analysis was performed to construct models for the prediction of probing depth and attachment loss increases. The most parsimonious regression models which had the best R2 values included the following variables and accounted for the indicated % of variability. The regression model for the prediction of probing depth increase included MMP-3, smoking pack-years, TIMP-1 and accounted for 53% of the variability. The best model for the prediction of attachment loss increase included MMP-3, smoking pack-years, age, TIMP-1 and explained 59% of the variability. CONCLUSION: These data indicate that sites with high GCF levels of MMP-3 and TIMP-1 are at significantly greater risk for progression of periodontitis.

Otitis media and the mastoid cell system. A study of men born in 1913 and 1923.

Within the framework of the Study of Men Born in 1913 and 1923, which is a prospective population study in Gothenburg, Sweden, a subsample consisting of 128 men 20, 30, 50, and 60 years old was investigated in order to elicit information on factors influencing the size of the mastoid cell systems, measured planimetrically from X-ray films. The mastoid cell area (MCA) closely correlated with body size, height being the best measure. Young men had larger relative MCAs (adjusted for height) than old men. Within each age group, men with small relative MCA were characterized by a lower social class, a longer history of otitis media, more tympanic membrane pathology, and more hearing loss than men with large MCA. These results support the view that in addition to genetic factors, environmental factors may exert a strong influence on the development and ultimate size of the mastoid cell systems.

Middle ear disease in samples from the general population. II. History of otitis and otorrhea in relation to tympanic membrane pathology. The study of men born in 1913 and 1923.

A study of 1371 men 20, 30, 50 and 60 years old and living in the city of Göteborg was performed to obtain information on otitis media infections in the general population. In addition to anamnestic data, a thorough examination of the ENT status was made by one observer. In this second report a sizable proportion of the men reported a history of otitis or otorrhea but had normal tympanic membranes. However, overall there was a close correlation between a positive history of otitis and otorrhea, and findings of pathological tympanic membranes in all the age groups, and the longer the duration of the otitis with or without otorrhea, the more frequent were the pathological findings. Men with a history of both otitis and otorrhea of long duration had generally more serious pathological findings than men with otitis but no longterm otorrhea.