The short-term effectiveness of non-surgical treatment in reducing protease activity in gingival crevicular fluid from chronic periodontitis patients

Objective: The aim of this study was to evaluate the short-term effect of non-surgical periodontal treatment on protease activity in gingival crevicular fluid (GCF) of patients with chronic periodontitis. Material and Methods: After clinical examination, in which pocket probing depth, probing attachment level, plaque and bleeding indices were recorded, gingival fluid samples from 21 chronic periodontitis patients were collected from gingivitis (GP) and periodontitis (PP) sites with an intracrevicular washing method. Samples were taken in the same way from a group of patients with gingivitis alone (GG). The periodontitis patients received non-surgical periodontal treatment and were re-evaluated 30 days later. We compared elastase and collagenase activities before and after treatment. The former activity was measured with a low-weight substrate (S-2484) and inhibited by alpha-1-antitrypsin. Matrix-metalloproteinase-8 (MMP-8) was measured with an ELISA and collagenolytic activity with fluorescein-conjugated collagen type I as substrate. Results: All clinical parameters showed a significant improvement after treatment (p<0.05) which was accompanied by a significant reduction in the values of total elastase activity, free elastase, MPP-8 and collagenolytic activity in both GP and PP sites (p<0.05). However, the latter sites continued to have higher levels of MMP-8 and collagenolytic activity than the former ones after treatment. The free elastase activity and the proportion of free elastase in GP and PP samples after treatment remained higher than in untreated GG samples. Conclusion: This study shows that the clinical improvements after non-surgical treatment are accompanied by reductions in protease and neutrophil activities.