Gingival cervical fluid.pdf.pdf Anatomy of the gingival crevice • The gingival sulcus is the shallow crevice or space around the tooth, bound by surface of the tooth on one side and the epithelial lining the free gingival margin on the other

Anatomy of the gingival crevice
• The gingival sulcus is the shallow
crevice or space around the tooth,
bound by surface of the tooth on
one side and the epithelial lining
the free gingival margin on the
other

1. GINGIVAL
CERVICAL FLUID
Created by: NAWAR HASSAN
MARIAM HAIDER
NOOR ABASS
NOOR AYAD
Astabraq basher

2. INTRODUCTIN
Anatomy of the gingival crevice
• The gingival sulcus is the shallow
crevice or space around the tooth,
bound by surface of the tooth on
one side and the epithelial lining
the free gingival margin on the
other.

3. INTRODUCTIN
• V-shaped; depth as
determined
via histological sections
is 2.1 -0.2mm.

4. INTRODUCTIN
Sections show presence of 3 types
of epithelium,
1. The oral or keratinized epitheliumcovering the gingival tissue in
continuation with
2. The sulcular epithelium, which is
not keratinized. It forms the soft
tissue wall of the gingival sulcus and the

5. INTRODUCTIN

3. Junctional epithelium is in continuation with the oral and
sulcular epithelium. It is formed by few strata of cells, with long flat
basal layer and a very
small desquamating surface
that forms thebase of the gingival sulcus.

6. DEFINITION
• It is composed of serum and locally generated
materials such as tissue breakdown products,
inflammatory mediators, and antibodies
directed against dental plaque bacteria.

7. COMPOSITION OF GCF
Cells: White blood cells, predominantly neutrophils, as well
as some lymphocytes and macrophages.
Proteins and Enzymes: Contains various enzymes (e.g.,
collagenases, alkaline phosphatase) that can break down
proteins, and immunoglobulins (antibodies) that help
defend against pathogens.
Electrolytes and Organic Molecules: Includes calcium,
potassium, and glucose.
Cytokines: Molecules like IL-1, IL-6, and TNF-alpha, which are
markers of inflammation and immune response.

8. IMPORTANCE
Gingival crevicular fluid-composition and clinical
importance in gingivitis and periodontitis:
diagnosis, such as peripheral blood, gum
homogenate, saliva and gingival pocket
fluid, it is the latter that seems to bean
extremely valuable diagnostic and
research material.

9. Identification of mediators in gingival crevicular fluid,
both in the healthy gingival fissure, as well as in
pathological periodontal pockets can be a valuable
supplement to the initial diagnosis and describe the
mechanism of gumorperiodontal diseases.
Changes in the concentration of
individual components in the
gingival crevicular
fluid may be used to a
IMPORTANCE

10. FUNCTION
1. Host Defense: GCF contains immune cells, antibodies,
and enzymes that help fight bacterial infections and
protect the periodontal (gum) tissues.
2. Waste Removal: It removes metabolic by-products,
bacteria, and cellular debris from the gingival sulcus,
helping to maintain a healthy environment around the
teeth.

11. FUNCTION
3. Lubrication: GCF keeps the gingival tissues
moist, protecting them from trauma and irritation.
4. Diagnostic Potential: The composition of GCF
changes in response to inflammation, making it
useful for detecting early signs of periodontal
disease.

12. Gingival Crevicular Fluid (GCF) can be collected and
analyzed using several methods, primarily to assess
periodontal health and detect inflammation or disease. Here
are the main methods used to detect and collect GCF:
1. Absorbent Paper Strips
2. Micropipettes or Capillary Tubes
3. Electronic Devices (Periotron)
4. Filter Paper Discs
5. Spectrophotometry and Other
Biochemical Analysis

13. • Process: Small, sterile paper strips are placed in the gingival
sulcus (the space between the tooth and gum) to absorb GCF for a
specified time.
• Advantages: Simple, non-invasive, widely used in clinical settings.
• Measurement: The volume of GCF absorbed
can be measured by weighing
the strip before and after collection
or by using devices that read
moisture levels.
1. Absorbent Paper Strips

14. 2. Micropipettes or Capillary Tubes
Process: Small glass micropipettes are inserted into the gingival
sulcus to collect GCF directly.
• Advantages: Allows precise volume collection, especially for
biochemical analysis.
• Challenges: More technically challenging than using paper
strips; requires a skilled operator.

15. • Process: Electronic , such as the
Periotron, are used to measure the
moisture level on the absorbent
paper strips.
• Advantages: Provides accurate and
quantitative readings of GCF volume.
• Application: Often used in research
settings where precise volume
measurements are needed.
3. Electronic Devices (Periotron)

16. 4. Filter Paper Discs
Process: Small discs made of
absorbent material are used to
collect GCF by placing them in the
gingival sulcus.
• Advantages: Simple and non-
invasive; suitable for larger surface
areas.
• Challenges: Less precise than
micropipette collection.

17. Process: After collecting GCF with one of the
above methods, the sample can be analyzed
using spectrophotometry, ELISA (enzyme-
linked immunosorbent assay), or PCR
(polymerase chain reaction) to detect
specific biomarkers like cytokines, enzymes,
or bacteria.
• Advantages: Provides detailed information
about inflammation, infection, and
periodontal disease biomarkers.
• Application: Often used in research and
advanced diagnostics.
5. Spectrophotometry and Other
Biochemical Analysis

18. Each method has its own
advantages depending on the
level of accuracy needed and
the specific goals of the
analysis, from simple volume
measurement to detailed
biochemical profiling.

19. 1- Contamination: Usually sample is
contaminated with blood, saliva or
plaque. Contaminated samples must be
discarded
2- Small sample size
3- Sampling time: Prolonged sampling at
the site resulted in protein
concentrations that may
affect the results
PROBLEMS ASSOCIATED
WITH GCF COLLECTION

20. 4- Volume determination: Evaporation is a
significant problem in accurate volume
determination of GCF samples
5- Difference in quality of paper strips used from
different manufacturers
PROBLEMS ASSOCIATED
WITH GCF COLLECTION

21. Medications that are excreted through the GCF may
be used
advantageously in periodontal therapy.
DRUGS AND GCF

22. Tetracyclines are one of
these medications & are effective in treating
refractory
periodontitis because of their concentration in
the gingival
crevice is 2-10 times than that in serum. This
allows a high drug
concentration to be delivered into periodontal
pockets & inhibit
the growth of Aggregatibacter actinomycetem
comitans and
other anaerobic bacteria.

23. Metronidazole is another antibiotic
that has been detected in human GCF. Ampicilin,
cephalexin,
rifampicin was also detected.

24. Collection Techniques: Typically collected using
absorbent paper strips, capillary tubes, or
micropipettes placed in the gingival sulcus.
Laboratory Analysis: Once collected, GCF can be
analyzed using methods like enzyme-linked
immunosorbent assay (ELISA), polymerase chain
reaction (PCR), or mass spectrometry to identify
and quantify its components.
GCF COLLECTION AND
ANALYSIS

25. THANK YOU