RELATIONSHIP BETWEEN GINGIVAL CREVICULAR FLUID AND GINGIVAL INFLAMMATION - CLINICAL AND HISTOLOGIC STUDY

This study evaluated the relationships between the gingival status, the Gingival Index, the amount of gingival crevicular fluid flow, and the histologic and histometric status of the gingiva in 60 patients beginning dental treatment. Gingival fluid was collected by placing filter paper strips at the opening of the gingival crevice of the midlabial surface for 3 minutes. The filter paper was removed, heat dried, and stained with 0.2% alcoholic ninhydrin. The stained area was measured to the nearest 0.5 mm under the dissecting microscope. The inflammatory status of the area was assessed using criteria based on bleeding tendency and tissue consistency; a second assessment was then made using the criteria of the Gingival Index. A gingival strip biopsy, 2 mm wide and 1 mm beyond the depth of the pocket, was obtained. Labio-lingual serial sections were prepared and the microscopic level of inflammation was graded by two examiners. There were strong correlations between clinical and histologic scores while the correlations between clinical and histologic scores with Gingival Crevicular Fluid Flow were relatively weak. Although GCF flow tended to increase as the diagnosis of inflammation became more severe, the quantity of gingival crevicular fluid, by itself, was a poor indicator of the severity of gingival inflammation. The recovery of GCF, however, was indicative of the presence of both clinical and histologic gingival inflammation. Gingival crevicular fluid is an exudate and but one of several clinical signs of inflammation which together give a reasonably accurate estimate of the histologic severity of established gingival inflammation.