The Study Of ALP Level In Gingival Crevicular Fulid Of Occlusal Trauma Teeth With Chronic Periodontitis Before And After SRP And Occlusal Adjustment

Objective: Trauma from occlusion was considered to be a codestructive factor in the progression of periodontal disease.It is suggested that occlusal trauma could cause periodontal destruction,gingival recession,increased probing depth,radiographic widened periodontal ligament spaces,the change of bone white line and vertical bone loss.Recently,the studies of occlusal trauma mainly focus on the influence of occlusal trauma and occlusal therapy to clinical parameters and the mechanism of bone loss caused by occlusal trauma.However,there is little information concerning the relation between occlusal theropy and inflammation control of periodontal disease.The purpose of this study was to compare the changes of subjective biting evaluation,periodontal clinical parameters including clinical attachment levels(CAL),pocket depth(PD),bleeding index(BI)and tooth mobility(TM)and the level of alkaline phosphatase(ALP)in sulcular fluid before and after scaling and root planning(SRP)and occlusal therapy,and to evaluate the association of occlusal theropy with the health of periodontal tissues.Methods : A total 23 patients(30 teeth)were collected from department of periodontitis,School of Stomatology,China Medical University,from May 2016 to August 2017,which were diagnosed as chronic periodontitis combined with occlusal trauma.This analysis used a self-control trial comparing on the teeth with occlusal trauma.All patients underwent periodontal initial therapy and radiographs were taken at baseline.Plaque indication was performed in the 4th week,and the teeth with occlusal trauma were under occlusal therapy in the 6th week and the examination was repeated in the 10 th week.At baseline,in the 6th week and the 10 th week,the subjective biting evaluation was collected.Clinical parameters were scored and the gingival crevicular fluid(GCF)was collected for each tooth.The GCF ALP levels were detected by enzyme-linked immunosorbent assays.Chi-square test was used to compare the differences of subjective biting stabilization,pain,and biting force at baseline,in the 6th week and the 10 th week.The paired sample t-test was used to test the variation of PD,CAL,BI and ALP concentration and the wilcoxon rank sum test was used to test TM variation of teeth with occlusal trauma at baseline,in the 6th week and the 10 th week.The Spearman analysis was performed to determine the correlation between ALP level and periodontal clinical parameters and the test level was bilateral ? = 0.05.Results: 1.The patients' subjective biting stability,biting ability of hard food increased and biting pain reducted after SRP and occlusal adjustment(P <0.05).2.The PD,CAL,BI,and TM of the teeth with chronic periodontitis combined with occlusal trauma decreased in the sixth week and the tenth week,compared with those at baseline.The PD,CAL and BI decreased furtherly in the tenth week compared with those in the sixth week.There was no significant difference of TM between the sixth and the tenth week.3.The ALP level of the teeth with chronic periodontitis combined with occlusal trauma decreased in the sixth week and the tenth week,compared with it at baseline.The ALP level decreased furtherly in the tenth week compared with it in the sixth week.4.Variations in the PD,BI,CAL,and TM had significant positive effects on variation in the gingival ALP level.Conclusions: 1.The patients' subjective biting stability,biting ability of hard food increased and biting pain reducted after SRP and occlusal adjustment.2.Occlusal adjustment can reduce PD,CAL and BI and the level of ALP in gingival crevicular fluid of the teeth with chronic periodontitis combined with occlusal trauma.