Thinning of Inner Retinal Layers after Vitrectomy with Silicone Oil versus Gas Endotamponade in Eyes with Macula-Off Retinal Detachment.

PURPOSE: To evaluate retinal layer thickness with optical coherence tomography (OCT) in eyes with macula-off retinal detachment after silicone oil (SiO) or gas endotamponade. PROCEDURES: Cross-sectional study of 40 eyes with macula-off rhegmatogenous retinal detachment that underwent vitrectomy. 20 eyes received SiO tamponade and 20 matched eyes received gas. 33 healthy fellow eyes served as controls. Macular spectral domain OCT was performed with automated layer detection in the 5 inner subfields of the Early Treatment Diabetic Retinopathy Study (ETDRS) map. RESULTS: Comparing the SiO group with the gas group, the ganglion cell layer showed a significant thinning in all fields of the inner ring of the ETDRS map, the inner plexiform layer in the nasal, superior and temporal quadrants, and the outer plexiform layer in the nasal quadrant. CONCLUSIONS: Inner retinal layers in the fovea/parafovea were significantly thinner in the SiO group. Prospective studies are warranted to further elucidate possible retinal adverse effects of SiO tamponade.

An In Vitro Study of Condylar Displacement Caused by Interocclusal Records: Influence of Recording Material, Storage Time, and Recording Technique.

PURPOSE: To evaluate the condylar displacement after mounting working casts using different interocclusal recording materials and to analyze the influence of the storage time and the recording technique on the displacement caused by the interocclusal record. MATERIALS AND METHODS: Eight interocclusal records were made in each of the following groups: G1: Aluwax (aluminum wax), G2: Beauty Pink wax (hydrocarbon wax compound), G3: Futar D Fast, G4: Futar Scan (G3, G4: vinylpolysiloxane), G5: Ramitec (polyether), G6: LuxaBite (composite resin based on bis-acryl), G7: LuxaBite corrected with Aluwax. A condylar-positioning indicator measured the condylar displacement in the three planes after storage of the records for two periods of 1 and 48 hours. Two-way ANOVA was used to determine the influences of recording materials and each of the following factors: (1) region (record and non-record side), (2) storage time, and (3) recording technique. The statistical significance level was set at p < 0.05. RESULTS: The vertical displacement caused by the interocclusal records in the record side after storage time of 1 hour ranged between 0.29 mm (Aluwax) and 0.14 mm (Futar Scan). The lateral displacement ranged between 0.13 mm (Aluwax) and 0.02 mm (Ramitec) while the anteroposterior displacement ranged between 0.15 mm (Ramitec) and 0.04 mm (Futar Scan). The corrected resin record showed generally lower displacement values than other materials tested (0.03, 0.02, and 0.07, respectively). On the non-record side, the values were lower than that on the record side. The condylar displacement increased after a storage time of 48 hours for all materials. Both factors, storage time and recording technique, had statistically significant influence on the condylar displacement. CONCLUSIONS: Based on the results, the vertical displacement of the condyle caused by the interocclusal records was higher than the lateral or the anteroposterior displacement. Elastomers caused statistically significantly less condylar displacement than waxes or uncorrected composite resin. Corrected LuxaBite records with Aluwax showed significantly less condylar displacement than all other materials.

Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico-spongeous bone grafts - a prospective study of two cohorts.

OBJECTIVES: The augmentation of the alveolar ridge using iliac cortico-spongeous bone grafts is routinely used. However, bone grafts show a substantial degree of resorption, which may negatively affect the long-term success of dental implants in the augmented area. The aim of this study was to evaluate the effect of a deproteinized bovine bone matrix coverage on the resorption of iliac bone grafts. MATERIAL AND METHODS: Two cohorts consisting of 40 patients who received a vertical augmentation of the alveolar ridge with onlay grafts from the iliac crest were prospectively investigated over a period of 2 years. In half of the patients (n = 40), the grafts were covered by a thin layer of deproteinized bovine bone matrix (DBBM cohort). The other 40 patients received the identical surgical procedure without a DBBM coverage (non-DBBM cohort). The graft height/resorption was radiographically determined immediately after surgery, 6 months, 1 year, and 2 years postoperatively. RESULTS: The height of the bone graft 6 months after surgery accounted 92.15% of the initial value in the DBBM cohort and 87.76% in the non-DBBM cohort. One year after augmentation, the height reduced to 83.95% in the DBBM cohort and 72.92% in the non-DBBM cohort. Two years after surgery, the resorption slowed down and the height of the grafts accounted 81.27% in the DBBM cohort and 71.43% in the non-DBBM cohort. The difference was statistically significant. CONCLUSION: Deproteinized bovine bone matrix reduces the postoperative resorption of iliac bone block grafts and may therefore enhance the long-term implant prognosis in the augmented area.

Comparison of platelet rich fibrin and collagen as osteoblast-seeded scaffolds for bone tissue engineering applications.

OBJECTIVES: The loss of jaw bone caused by different kinds of pathologies leads to dysfunction and reduced quality of life in affected patients. Thus, the pivotal goal in bone tissue engineering is to reconstruct these defects. The essential precondition for new tissue generation is an extracellular matrix which acts as a scaffold so that cells can migrate, differentiate, and proliferate. Fibrin, a biopolymer responsible for blood clot formation, has been shown to be suitable for tissue engineering applications. The aim of the present study is a comparison of platelet rich fibrin (PRF) with the commonly used collagen membrane BioGide(®) as a scaffold for human osteoblast cell seeding for bone tissue engineering. MATERIAL AND METHODS: Human osteoblasts were cultured with eluates from PRF (n = 7) and BioGide(®) (n = 8) membranes incubated in serum-free cell culture medium. Vitality of these cells was assessed by fluorescein diacetate and propidium iodide staining, biocompatibility with the lactate dehydrogenase test and proliferation levels with the MTT ([3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium-bromide]), and BrdU (5-bromo-2-deoxyuridine) tests. In addition, human osteoblasts were seeded on both membrane systems and cell growth was compared by the water soluble tetrazolium (WST-1) (4-[3-(4-iodophenyl)-2-(4-nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate) test and scanning electron microscopy (SEM). Osteoblastic differentiation was assessed by alkaline phosphatase activity measured by ELISA in the supernatant of osteoblasts cultivated on PRF membranes (n = 10), PRF clots (n = 10), and BioGide(®) membranes (n = 10). RESULTS: Lactate dehydrogenase test values were higher for PRF compared to BioGide(®) . The BrdU test showed superior cell growth after cultivation in eluate from PRF than in eluate from BioGide(®) . The WST-1 assay demonstrated superior cell proliferation on PRF than on BioGide(®) . SEM revealed osteoblast colonization of both membranes. Cultivation of osteoblasts on PRF membranes and PRF clots showed significantly higher alkaline phosphatase activity than on BioGide(®) membranes. CONCLUSION: Metabolic activity and proliferation of human osteoblast cells in vitro were supported to a significant higher extent by eluates from PRF membranes. Both membranes are suitable as scaffolds for cultivation of human osteoblast cells in vitro; proliferation was significant higher on PRF membranes and on PRF clot than on BioGide(®) membranes.

Dimensional changes of periodontal soft tissues after intrasulcular incision.

In maxillofacial surgery, intrasulcular incisions are often used. This prospective case series was established to evaluate the detrimental effects of intrasulcular incisions on periodontal structures. In 35 patients, measurements of probing depth and crown length before and 10 months postoperatively were performed to calculate changes of attachment level and gingival recession. In a subgroup, surgically treated sites were compared with untreated control sites. A nonparametric test was applied for longitudinal and split-mouth comparisons. Overall, intrasulcular incisions did not induce significant attachment loss. The frequency of sites losing > or = 2 mm of attachment was 5.0%, 2.6%, and 4.7% at mesial, buccal, and distal sites, respectively. Intrasulcular incisions caused only a slight increase in gingival recession by 0.4 +/- 0.5, 0.2 +/- 0.3, and 0.3 +/- 0.4 mm at mesial, buccal, and distal sites, respectively. Within the limitations of the study design, it can be concluded that intrasulcular incisions without additional vertical incisions do not impose a serious risk for attachment loss and/or gingival recession.

Wear of feldspathic ceramic, nano-filled composite resin and acrylic resin artificial teeth when opposed to different antagonists.

The aim of this study was to evaluate the wear of denture teeth and their antagonists produced by two-body and three-body wear tests. Three types of denture teeth, namely feldspathic ceramic (FC), nano-filled composite resin (NCR), and experimental acrylic resin teeth (AR), were tested. For each type two groups of eight upper premolars each were prepared. The first group was tested against cusps from the same material and the second group was tested against human enamel cusps. Each group was loaded with a total of 200,000 chewing cycles (two-body wear 100,000 cycles and three-body wear 100,000 cycles). Wear was analyzed by measuring the maximum depth and volume loss of the denture teeth using a laser scanner and by measuring the vertical loss of the antagonists using an optical macroscope. Statistically, there was no significant difference between the following combinations: FC-FC and NCR-NCR regarding the vertical and volume loss; and FC-enamel and NCR-enamel regarding the total vertical substance loss. The combinations AR-AR and AR-enamel showed higher wear values than the other combinations. For complete dentures, composite resin and ceramic teeth showed similar vertical and volume loss, whereas composite resin teeth seemed to be more suitable for partial dentures opposing natural teeth in terms of wear of teeth and antagonists.

Fluorescence-controlled Er:YAG laser for caries removal in permanent teeth: a randomized clinical trial.

The aim of this randomized clinical study was to compare the efficacy of a fluorescence-controlled erbium-loaded yttrium aluminum garnet (Er:YAG) laser with conventional bur treatment for caries therapy in adults. Twenty-six patients with 102 carious lesions were treated using either the Er:YAG laser, at threshold levels of 7, 8, 9, and 10 [U], or rotary burs. Both techniques were applied to each lesion at separate locations. After treatment, dentine samples were obtained using a carbide bur. The viable counts of Streptococcus mutans (SM) and lactobacilli (LB) [expressed as colony-forming units (log10 CFUs)], treatment time, pain, vibration, and sound intensity were determined. The median numbers of CFUs for SM and LB were not statistically different between laser and bur treatment at threshold levels 7 and 8 [U]. At threshold levels 9 and 10 [U], the median number of CFUs for LB [1.11 (range: 0.00-2.04)] were significantly higher following laser treatment than following bur treatment [0.30 (range: 0.00-0.60)]. The results indicate that treatment with a fluorescence-controlled Er:YAG laser at threshold levels of 7 and 8 removed caries to a level similar to that achieved using conventional bur treatment, with clinically irrelevant amounts of remaining bacteria. Although more time consuming, laser treatment provided higher patient comfort than bur treatment.

Self-perception versus professional assessment of functional outcome after ablative surgery in patients with oral cancer.

PURPOSE: The extent of functional impairment after ablative surgery in the orofacial region may be directly reflected in a reduction in Quality of Life. This study intended to compare the patients' perception with an objective functional evaluation of the orofacial system in order to bilaterally distinguish direct influence factors. METHODS: A total of 45 patients were included in this study and were asked to complete the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-30) and the Head and Neck 35 Module (H&N 35). Afterward one independent speech therapist evaluated the patients applying the Frenchay Dysarthria Assessment regarding four main categories: mouth opening, tongue motility, swallowing and intelligibility. Comparisons between groups were performed using Whitney-Mann U-Wilcoxon test and calculating Spearman's rho. RESULTS: Overall the professional assessments by the speech therapists revealed significantly higher scores regarding intelligibility, swallowing and mouth opening when compared to the patients' self-perception. Smaller tumor sizes, no bone resection and local reconstruction techniques led to significantly better functional outcomes, when assessed by speech therapists. Swallowing was perceived significantly better by patients in cases of local reconstruction. CONCLUSIONS: From the professionals' point of view differences were perceived in more items compared to the patients' self-assessments, who widely experienced a more severe functional impairment. Physicians should take this into account when discussing adverse therapy effects with the patients.

The mechanical integrity of in vivo engineered heterotopic bone.

Recent advances in tissue engineering have aroused interest in growth of heterotopic bone for the repair of skeletal defects. This study demonstrates an in vivo method in minipigs of engineering individual human-sized mandible replacements of heterotopic bone with a mechanical integrity similar to natural bone. Ten individualized mandible replacement scaffolds were created using computer-aided design (CAD) techniques. Five had a resorbable external scaffold made of polylactite mesh (test group 1) and five had had a non-resorbable external scaffold of titanium mesh (test group 2). The mesh scaffolds were loaded each with five BioOss blocks serving as internal scaffolds and 3.5 mg recombinant human Bone Morphogenetic Protein-7. The loaded mesh scaffolds were implanted into the latissimus dorsi muscles of five infant minipigs. After 6 weeks the mandible replacements were harvested. Core biopsy cylinders were taken from the replacements of both test groups and from the natural pig mandibles (control 1). Also, core biopsies from plain BioOss Blocks were gained (control 2). The core biopsy cylinders were loaded axially into a compression test device to evaluate the mechanical compression resistance. Additional specimen underwent histological examination. Both test groups resulted in successful bone induction with degrees of compression resistance [Test 1: 1.62 MPa (SD+/-0.73); Test 2: 1.51 MPa (SD+/-0.56)] statistically insignificant when compared to natural porcine mandibular bone [1.75 MPa (SD+/-0.69)]. This differed significantly from the much lower compression resistance seen in the unadulterated BioOss [0.92 MPa (SD+/-0.04)]. Following this, the in vivo engineered bone has a similar mechanical compression stability as natural bone.

Stress-coping and cortisol analysis in patients with non-syndromic cleft lip and palate: an explorative study.

BACKGROUND: Non-syndromic clefts of the orofacial region occur in approximately 1 per 500 to 2,500 live births, depending on geographical area and ethnicity. It can be supposed that the disruption of the normal facial structure and the long-standing pressure of treatment from birth to adulthood bring about a range of life stressors which may lead to a long-lasting impact on affected subjects throughout their lives. Therefore, the present study aimed to assess different aspects of psychosocial stress in affected individuals. METHODS: The study was divided into two parts: first, the Trier Social Stress Test which involves uncontrollability and high levels of social-evaluative stress under real conditions and second, the query of various aspects of coping with psychosocial stress. The test group consisted of 30 affected adult subjects, and an equally sized control group of unaffected volunteers. Cortisol dysregulation was determined by saliva samples before and after stress induction. Meanwhile, participants were asked to complete the SVF 120 stress-coping questionnaire. RESULTS: The analysis of saliva samples showed a similar baseline concentration as well as a similar increase in cortisol levels after stress induction for both groups. Subsequently, the decline in cortisol concentrations was significantly faster in the CLP group (course: p<0.001; groups: p = 0.102; interaction: p = 0.167). The evaluation of the stress-coping questionnaire revealed a significantly shorter rumination about a stressful event in individuals with CLP-related malformations (p = 0.03). CONCLUSION: We conclude that adults with CLP have significantly better stress-coping strategies than their healthy peers. TRIAL REGISTRATION: German Clinical Trials Organization DRKS00003466.

Survival of transplanted rat bone marrow-derived osteogenic stem cells in vivo.

This study was designed to trace bone marrow-derived stromal cells (MSC) after implantation in an ectopic rat model of bone tissue engineering. MSC were isolated from adult donor rats, expanded, seeded on a hydroxyapatite/ß-tricalcium phosphate bone graft substitute (Straumann® BoneCeramic), and cultivated until confluent. Before subcutaneous implantation of seeded constructs and controls (unseeded bone graft substitute) in isogenic rats (n = 32), cells were labeled with the fluorescent dye carboxyfluoresceine-diacetate-succinimidyl-ester. Specimens were harvested at sacrifice on day 1, 3, 7, or 14 after implantation (n = 8 per group) and processed for histology (hematoxylin and eosin, CD68, 4',6-diamidino-2-phenylindol). Carboxyfluoresceine-diacetate-succinimidyl-ester-labeled transplanted cells were quantified in decalcified sections (50 fields of view per specimen) at 488 nm. Over time, transplanted cells decreased in number from 31.3 ± 2.3 (day 1) to 9.2 ± 1.1 (day 3) and 0.3 ± 0.1 (day 7) (p < 0.001). Fourteen days postimplantation MSC could no longer be identified. Additionally, starting on day 3 postimplantation, cellular disintegration was noted. Multinucleated giant cells were present in constructs and controls on day 7 and increased to day 14 postimplantation. These results indicate that ectopically transplanted MSC survive for a rather short time after implantation. Possible reasons for early cell death are discussed.

Prevalence of dental caries and periodontal disease in patients with inflammatory bowel disease: a case-control study.

AIM: Previous reports suggest a higher incidence of dental caries in patients with inflammatory bowel disease (IBD) and similarities in the immunopathogenesis of IBD and periodontitis. This study assessed the prevalence of periodontal disease and caries in patients with IBD. METHODS: In the present case-control study, 62 patients seeking treatment of IBD and 59 matched healthy controls of a dental practice were clinically examined. Oral soft-tissue alterations, the decayed, missing and filled tooth surface (DMF-S) index, dentine caries, plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment loss (CAL) were evaluated in each patient and in the controls. RESULTS: Patients with IBD showed a significantly higher number of oral manifestations compared with controls. The DMF-S index showed no significant differences, but there was a significantly higher number of subjects with dentine caries in patients with IBD. The mean PPD in patients with IBD was 2.08 versus 2.23 mm in controls (p=0.014). Compared with controls, patients with IBD had more sites with CAL of at least 4 mm (81% versus 64% in controls, p=0.07) and 5 mm (63% versus 46%, p=0.07), respectively. CONCLUSIONS: The results of this case-control study demonstrate a higher frequency of dentine caries in patients with IBD but the periodontal findings showed no distinct differences between cases and controls.

Focal adhesion contact formation by fibroblasts cultured on surface-modified dental implants: an in vitro study.

A major consideration in designing dental implants is to create a surface that provides strong attachment of the implant to bone, connective tissue and epithelium. The aim of the present study was to examine the influence of different treatments of titanium (Ti) implant surfaces on focal adhesion contact (FAC) formation in fibroblast cultures. Human gingival fibroblasts were cultured on glass sheets and polished Ti discs with different surface coatings (applied by physical vapor deposition (PVD): Ti, titanium nitride (TiN), zirconium nitride (ZrN)) or on Ti discs with different surface topographies. For characterization of all surfaces, modified estimation of surface roughness and spacing parameter was carried out using a contact stylus profilometer. Contact angle measurements were carried out to calculate surface energy. Fibroblasts were prepared for transmission electron microscopy at day 3 after seeding, and the number of FACs and the ratio FAC/cellular cross-sections was determined at a length of 300 microm in ultrathin sections. To visualize the extracellular fibronectin and vitronectin molecules and the intracellular actin and vinculin in FAC areas, immunogold labeling was performed. The results revealed a strong correlation between the number of FACs and the surface roughness. The highest number of FACs and the majority of the immunogold-labeled intra- and extracellular matrix molecules were counted on surfaces with the lowest surface roughness: glass sheets coated with either Ti, TiN or ZrN (roughness average=0.03-0.1 microm). These surfaces appear to favor cellular attachment of human gingival fibroblasts and moreover in previous studies the hard coatings have been shown to reduce bacterial adhesion.

Significant influence of scaler tip design on root substance loss resulting from ultrasonic scaling: a laserprofilometric in vitro study.

OBJECTIVES: Ultrasonic scalers have become increasingly popular for subgingival debridement. The aim of the present study was to investigate the influence of different working tip designs (narrow versus wide) on root substance loss caused by either magnetostrictive or piezoelectric ultrasonic devices. METHODS: In this in vitro study, a magnetostrictive ultrasonic system with either Slimline or TFI-10 inserts and a piezoelectric ultrasonic system with either Perioprobe or Type-A inserts were compared at different application forces. Loss of root dentin was determined by defect width, defect depth and defect volume resulting from standardized instrumentation using laser profilometry. RESULTS: There were consistent and statistically significant differences between all groups. The mean observed dentin alterations for the magnetostrictive ultrasonic device operating a Slimline insert at a lateral force of 0.3 N were 254.4 microm, 6.3 microm and 22.5 microm3 and for the TFI-10 tip 759.0 microm, 23.5 microm and 160.2 microm3 for the parameters defect width, depth and volume, respectively. For the piezoelectric ultrasonic system operating a Perioprobe insert, the corresponding mean values were 352.0 microm/12.1 microm/56.4 microm3 and for the universal Type-A insert they were 402.4 microm/14.0 microm/133.4 microm3. With application forces of 0.7 N, root substance removal increased up to twofold. CONCLUSION: The present investigation could demonstrate that the aggressiveness of magnetostrictive and piezoelectric ultrasonic devices to root substance was significantly influenced by the scaler tip designs, increasing for wider scaler tips as compared with narrow, probe-shaped inserts.

Interleukin-1 gene polymorphisms and experimental gingivitis.

BACKGROUND: Recently, an association between the severity of periodontitis and specific variations in the interleukin-1 (IL1) alpha and beta genes has been demonstrated. AIM: : The purpose of this study was to evaluate the relationship of the IL1 genotype to the development of experimental gingivitis. MATERIALS AND METHODS: Twenty young adult subjects presenting with healthy gingival conditions participated after giving their informed consent. The group included 10 risk genotype positive (P+) and 10 risk genotype negative (P-) individuals. The IL1 genotypes were determined on DNA samples from peripheral blood using PCR-RFLP analyses for the IL1alpha and IL1beta polymorphisms. Experimental gingivitis was allowed to develop in two posterior sextants per subject. Bleeding on probing (BOP%) and gingival crevicular fluid volume (GCF) were assessed at baseline and days 2, 7, 9, 14, 16 and 21. The day 21 results for BOP and GCF as well as the rate of increase of these parameters - mean area under the curve (AUC) and mean increase per day (slope) - were evaluated using risk analyses for IL1 genotype, smoking status and gender. RESULTS: Experimental gingivitis developed with a gradual increase in BOP scores and GCF values (expressed as Periotron units=PU) from baseline to day 21 (BOP, P+: 0.5 to 26.0%; P-: 1.0 to 28.1%; GCF, P+: 36.8 to 138.5 PU, P-: 43.1 to 143.4 PU). No significant risk was associated with P+ and P- for day 21 results, AUC or slope. CONCLUSION: The results of this study failed to provide evidence that the IL1 risk genotype was associated with higher GCF volume and percentage BOP during the development of experimental gingivitis.

Particulated bone grafts--effectiveness of bone cell supply.

OBJECTIVE: The objective of this study was to measure the amount of viable bone cells present in different types of bone graft. MATERIAL AND METHODS: Bone chips were harvested from the trabecular or cortical bone of the mandible or the iliac crest and either milled or not. The average size of unmilled bone particles was 5 x 5 x 5 mm and that of milled was 2 x 2 x 2 mm. Drill sludge was obtained using either a ball reamer, a diamond ball or an implant drill (the latter from mandibular bone and of average dimension 1 x 1 x 1 mm). A measure of 0.5 g of each category was cultured in Dulbecco's modified Eagle's medium with additives for four weeks. Cell counts were performed. An analysis of the osteocalcin synthesis, the alkaline phosphatase (ALP) activity, the collagen types and the concentration of bone-specific collagen cross-links in medium supernatants was performed. RESULTS: Cells stained positively for osteocalcin and ALP in all groups. Bone-specific collagen cross-links could be quantified and collagen of types I and V was present with no difference in all groups. Unmilled spongy bone chips revealed greater cell counts than milled (P<0.05). Spongy bone chips revealed greater cell counts than cortical bone chips (P<0.05). Drill sludge obtained by hard alloy ball reamer showed the least amount of viable cells (P<0.05). CONCLUSIONS: Bone milling reduces the quantity of osteoblasts. Bone obtained by the ball reamer supplies a smaller number of cells than bone obtained by other methods. Unmilled spongy bone chips appear to offer the greatest amount of viable osteoblasts.

Elevated levels of collagen cross-link residues in gingival tissues and crevicular fluid of teeth with periodontal disease.

Lysylpyridinoline (LP) and hydroxylysylpyridinoline (HP) are collagen cross-link residues. Lysylpyridinoline is present in most tissues, whereas LP is present mainly in mineralized tissue. Both are elevated in tissue with increased collagen resorption. The purpose of this investigation was to assess if the concentrations of LP and HP are elevated in gingiva and gingival crevicular fluid (GCF) of teeth with advanced periodontitis (AP). We investigated human gingival biopsies of healthy teeth (n = 19) and teeth with AP (n = 43) in 49 individuals. Samples of GCF from 54 teeth with AP were collected in seven patients and compared with samples from 11 patients with experimentally induced gingivitis. Levels of LP and HP were measured by HPLC and fluorescence detection. Gingival concentrations of HP but not LP around teeth with advanced periodontitis were significantly elevated compared with teeth with healthy periodontium. While significant amounts of HP and LP were measurable in the GCF of teeth with AP, no HP and LP was identified 3 months following non-surgical periodontal therapy of the teeth or in fluid from teeth subjected to experimentally induced gingivitis. Elevated concentrations of HP and LP in GCF may serve as indicators of ongoing destruction of periodontal tissues and alveolar bone in advanced periodontitis.