Repeatability of the gingival crevicular fluid collection and measurement, as determined through alkaline phosphatase activity: Implications for diagnostic uses.
BACKGROUND AND OBJECTIVE: In spite of four decades of studies on gingival
crevicular fluid, no data have been reported on the repeatability of gingival
crevicular fluid collection and the subsequent quantification procedures. The
present study reports, for the first time, on the repeatability and method error
of gingival crevicular fluid collection and quantification, as determined through
its alkaline phosphatase (ALP) activity. Diagnostic considerations are then
explored.
MATERIAL AND METHODS: Twenty-seven healthy subjects (17 women and 10 men; mean
age ± SD, 21.2 ± 4.8 years) with optimal periodontal status were enrolled
according to a blind prospective design. The gingival crevicular fluid was
collected at baseline, and after 1 d, 1 wk and 3 mo. At each clinical session,
two consecutive rounds of gingival crevicular fluid collection were made from
each of the four maxillary incisors, allowing the recovery of resting and flow
gingival crevicular fluid. The total ALP activities were determined
spectrophotometrically, and repeatability and method errors for the resting, flow
and overall (resting + flow) gingival crevicular fluid ALP activities were
calculated, relative to the corresponding baseline levels.
RESULTS: No significant differences were seen over time, although the flow
gingival crevicular fluid ALP activity was generally lower than that for the
resting gingival crevicular fluid. The method errors ranged from 40 to 58%, with
the flow and overall gingival crevicular fluid activities showing the highest and
lowest errors, respectively.
CONCLUSION: Reliable use of the gingival crevicular fluid ALP collection and
quantification, both in research and diagnosis on an individual basis, should
take into account relevant errors, and variations are to be considered as true
only above relevant thresholds.