New classification of periodontal diseases (NCPD): an application in a sub-Saharan country

Abstract Purpose To determine the clinical and radiological profile of periodontitis according to the 2018 NCPD, in a Dakar (Senegal) based periodontal clinic. Methods This is a descriptive study based on patient’s records in the periodontology clinic. The study was conducted between November 2018 and February 2020 (15 months). All periodontitis cases were included in the study. Incomplete records (due to lack of radiographic workup or unusable periodontal charting) were excluded. Periodontitis diagnosis was established based on criteria used in the 2018 NCPD. Statistical analysis was carried out using SPSS version 20.0, with the significance threshold set at 0.05. Results A total number of 517 patient records were collected during the study period but only 127 periodontitis records were complete. The mean age of participants was 46.8 ± 13.8 years and 63.8% of participants were males. The mean plaque index and bleeding on probing (BOP) were 74% ± 21.3 and 58.1% ± 25.1, respectively. The mean maximum clinical attachment loss was 8.7 mm ±2.7, with a probing depth greater than 6 mm present in 50.4% of the sample. The median number of missing teeth was 3 (interquartile range 5–1). Pathological mobility was present in 60.6% of the patients and 78.0% had occlusion problems. Bone crest defect at the most affected site was moderate in 52.8% of cases. The ratio of bone loss to age greater than one concerned 66.1% of the sample. Generalised (81.9%), Stage IV (70.1%) and grade C (69.3%) were the most encountered diagnosis. The disease severity was associated with age (r = 0.241; P < 0.001), BOP (r = 0.230; P = 0.013) and the number of teeth with pathological mobility (r = 0.318; P < 0.001). Conclusion Patients with periodontitis in this study had advanced forms of the disease and required multidisciplinary care. Clinical hindsight is necessary to improve this classification.

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Reduced Bone Stiffness in Women Is Associated with Clinical Attachment and Tooth Loss

Journal of Dental Research ◽

10.1177/0022034516666491 ◽

2016 ◽

Vol 95 (13) ◽

pp. 1464-1471 ◽

Cited By ~ 5

Author(s):

J.L. Silveira ◽

M. Albers ◽

D.M. Vargas ◽

E.T. Santa Helena ◽

C.M. Cordova ◽

...

Keyword(s):

Postmenopausal Women ◽

Tooth Loss ◽

Premenopausal Women ◽

Median Number ◽

Population Based ◽

Stiffness Index ◽

Clinical Attachment Loss ◽

Bone Stiffness ◽

Number Of Teeth ◽

The Mean

The authors evaluated the association of reduced bone stiffness of the calcaneus with clinical attachment loss (CAL) and tooth loss. The authors analyzed data from 4,678 subjects (2,384 women), aged 20 to 88 y, from the second follow-up of the population-based Study of Health in Pomerania (SHIP-2) and the baseline examination of the SHIP-Trend cohort. Bone stiffness, characterized by the stiffness index (SI) and the osteoporotic fracture risk (OFR), was assessed by quantitative ultrasound of the heel. SI and OFR were significantly associated with the mean CAL in women. While 1) the SI showed a significant association with the mean CAL and 2) the OFR with the median number of teeth in just the postmenopausal women, the OFR showed a significant association with mean CAL for both pre- and postmenopausal women. In postmenopausal women, a 10-unit increase in the SI was associated with a decrease in the mean CAL of 0.05 mm (95% confidence interval [CI]: –0.10 to 0.00; P = 0.046). Moreover, the adjusted median number of teeth was 21.4 (95% CI: 20.9 to 21.9) among the postmenopausal women with a low OFR, while it was 19.1 (95% CI: 17.8 to 20.3; P = 0.001) among the postmenopausal women with a high OFR. For the premenopausal women with a low OFR, the mean CAL was 1.60 mm (95% CI: 1.53 to 1.66), while for the premenopausal women with a high OFR, it was 2.24 mm (95% CI: 1.78 to 2.69; P = 0.006). Reduced bone stiffness was associated with clinical attachment and tooth loss in women but not in men.

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Periodontal Conditions and Whole Salivary IL-17A and -23 Levels among Young Adult Cannabis sativa (Marijuana)-Smokers, Heavy Cigarette-Smokers and Non-Smokers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207435 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7435

Author(s):

Fawad Javed ◽

Abeer S. Al-Zawawi ◽

Khaled S. Allemailem ◽

Ahmad Almatroudi ◽

Abid Mehmood ◽

...

Keyword(s):

Young Adult ◽

Cannabis Sativa ◽

Demographic Data ◽

Stage Iv ◽

The United States ◽

Marginal Bone Loss ◽

Clinical Attachment Loss ◽

Cigarette Smokers ◽

Probing Depth ◽

Whole Saliva

In the United States, prevalence of marijuana-use has doubled in the past 2 decades. The aim was to compare the periodontal conditions and whole-salivary IL-17A and IL-23 levels among young adult marijuana-smokers, heavy cigarette-smokers and non-smokers. Self-reported marijuana-smokers, heavy-cigarette-smokers, non-smokers with periodontitis and periodontally-healthy non-smokers were included. Demographic data was recorded and full-mouth plaque index (PI), bleeding on probing (BoP), probing depth (PD) and clinical attachment loss (AL), marginal bone loss (MBL) and missing teeth were recorded. Levels of IL-17A and IL-23 levels were measured in the whole saliva. p < 0.01 was considered statistically significant. Fifteen-marijuana-smokers, 15 heavy-cigarette-smokers, 16 non-smokers-with-periodontitis and 15 periodontally-healthy-non-smokers) were included. The clinicoradiographic parameters were worse among marijuana-smokers (p < 0.01), cigarette-smokers (p < 0.01) and non-smokers-with-periodontitis (p < 0.01) than periodontally-healthy-non-smokers. Marijuana- and cigarette-smokers had Stage-IV/Grade C and non-smokers with periodontitis had Stage-III/Grade-C. Salivary IL-17A and IL-23 levels were higher in marijuana-smokers than cigarette-smokers (p < 0.01) and non-smokers-with-periodontitis (p < 0.01). Whole salivary IL-17A and IL-23 levels were higher among cigarette-smokers than non-smokers with periodontitis (p < 0.01) and periodontally-healthy-individuals (p < 0.01). Marijuana- and heavy cigarette-smokers have comparable clinicoradiographic periodontal statuses. This rejects hypothesis-1. However, whole salivary immunoinflammatory response may be moderately worse in marijuana-smokers compared with heavy cigarette-smokers and non-smoker with periodontitis thereby supporting hypothesis-2.

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Serum Inflammatory and Prooxidant Marker Levels in Different Periodontal Disease Stages

Healthcare ◽

10.3390/healthcare9081070 ◽

2021 ◽

Vol 9 (8) ◽

pp. 1070

Author(s):

Ricardo Andreu ◽

Sergio Santos-del-Riego ◽

Francisco Payri

Keyword(s):

Periodontal Disease ◽

Inflammatory Diseases ◽

Stage Iv ◽

High Sensitivity ◽

Cross Sectional Study ◽

Oxidative Stress Biomarkers ◽

Clinical Attachment Loss ◽

Cross Sectional ◽

Reactive Protein ◽

Probing Depth

Background: Periodontitis has been associated to systemic diseases and this association could be due to an increase in circulating inflammatory and oxidative stress biomarkers in the periodontal disease. This study aimed to evaluate the relationship between inflammatory and pro-oxidant markers according to different stages of periodontitis. Methods: This cross-sectional study included 70 subjects who were divided into three groups according to periodontitis stage: stage II (n = 22), stage III (n = 30), and stage IV (n = 18). We evaluated periodontal parameters and levels of high-sensitivity C-reactive protein (hsCRP), fibrinogen, and malondialdehyde (MDA) in serum, and 8-hydroxy-2′-deoxyguanosine (8-OHdG) in urine. Results: Serum hsCRP and fibrinogen levels were associated with periodontitis severity, which were higher in stage IV than in stages III and II of periodontitis (p = 0.003 and p = 0.025, respectively). We observed a slight yet insignificant increase in MDA levels related to periodontitis severity. Probing depth and clinical attachment loss were associated with serum fibrinogen and hsCRP levels. However, there were no significant associations between periodontal variables and MDA and 8-OHdG levels. Conclusion: Our data support an association between periodontitis and systemic inflammation, which increases with periodontal disease severity. This indicates the importance of the early diagnosis and treatment of periodontal disease to avoid the development or worsening of systemic inflammatory diseases.

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Association between Hemoglobin Level and Severity of Chronic Periodontitis

Journal of King Abdulaziz University-Medical Sciences ◽

10.4197/med.17-1.6 ◽

2010 ◽

Vol 17 (1) ◽

pp. 53-64 ◽

Cited By ~ 1

Author(s):

Hind A. Aljohani

Keyword(s):

Chronic Periodontitis ◽

Hemoglobin Level ◽

Missing Teeth ◽

Clinical Attachment Loss ◽

Bleeding On Probing ◽

Attachment Loss ◽

Probing Depth ◽

Significant Difference ◽

King Abdulaziz University ◽

The Mean

The aim of this study is to investigate the association between hemoglobin level and the severity of chronic periodontitis. Data were collected from 124 systemically healthy chronic periodontitis patients, referred to the Division of Periodontology, Faculty of Dentistry, King Abdulaziz University. Medical history, dental history, and periodontal parameters such as bleeding on probing. Plus probing depth, clinical attachment loss and distance from cement-enamel junction to gingival margin, furcations, mobility and number of missing teeth] were recorded. Blood samples were collected to measure the hemoglobin level. The correlation between hemoglobin and the means of clinical attachment loss and bleeding on probing was insignificant. There was no significant difference in the mean hemoglobin level for individuals with different severity of periodontitis among male and females. The mean hemoglobin found to be insignificantly correlated with the number of missing teeth. No association between hemoglobin levels and periodontal status was found. Further longitudinal studies with larger sample size are needed to investigate this association, and the effect of periodontal treatment on hemoglobin level.

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Prognostic factors affecting the short-term efficacy of non-surgical treatment of chronic periodontitis: a multilevel modeling analysis

European Journal of Medical Research ◽

10.1186/s40001-021-00520-y ◽

2021 ◽

Vol 26 (1) ◽

Author(s):

Hui-Jie Liu ◽

Bo Wang ◽

Ao-Chen Wang ◽

Dan-Hong Zhang ◽

Cui Mao ◽

...

Keyword(s):

Surgical Treatment ◽

Multilevel Modeling ◽

Stage Iv ◽

Short Term ◽

Clinical Attachment Loss ◽

Factors Affecting ◽

Term Efficacy ◽

Modeling Analysis ◽

Probing Depth ◽

Non Surgical Treatment

Abstract Background This study is aimed to analyze the prognostic factors affecting the short-term efficacy of non-surgical treatment of patients in periodontitis from stage II to stage IV by the multilevel modeling analysis. Materials and methods A total of 58 patients with chronic periodontitis were included in this study. Patients were clinically explored before and 3 months after the treatment and the difference in probing depth was determined [Reduction of probing depth (Δ PD) = baseline PD – finial probing depth (FPD)] which is considered as the therapeutic evaluation. Three different levels were analyzed: patients, teeth and sites to construct a multi-layer linear model. Results Probing depth (PD) improved significantly compared with that before treatment (p < 0.05), in which FPD was (3.90 ± 1.39) mm, and the ΔPD was (1.79 ± 0.97) mm. Compared with the mesial sites and distal sites of the multi-rooted teeth, the number of PD ≥ 5 mm or PD < 5 mm after the treatment was significantly different (P < 0.05), and the proportion of PD < 5 mm was higher in mesial sites. The null model showed that Δ PD varied greatly between groups at various levels (P < 0.001), with prediction variable of site level, tooth level, and patient level accounted for 66%, 18%, and 16% of the overall difference, respectively. The complete model showed that the Δ PD of smokers was significantly lower than that of non-smokers (P < 0.001). The Δ PD of the mesial and distal sites was larger than that of the buccolingual central site (P < 0.001). The Δ PD of single-rooted teeth was larger than that of multi-rooted teeth (P < 0.001). The baseline PD, tooth mobility (TM), bleeding index (BI), clinical attachment loss (CAL) were significantly negatively correlated with Δ PD (P < 0.001). Conclusions Patients with periodontitis from stage II to stage IV, who were non-smoking, have good compliance, good awareness of oral health, and low percentage sites with PD ≥ 5 mm at baseline, single-rooted teeth with hypomobility, less clinical attachment loss and lower bleeding index and sites of mesial or distal can obtain an ideal short-term efficacy of non-surgical treatment.

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The influence of removable partial dentures on the periodontal health of abutment and non-abutment teeth

European Journal of Dentistry ◽

10.4103/1305-7456.163234 ◽

2015 ◽

Vol 09 (03) ◽

pp. 382-386 ◽

Cited By ~ 1

Author(s):

Linda J. Dula ◽

Kujtim Sh. Shala ◽

Teuta Pustina-Krasniqi ◽

Teuta Bicaj ◽

Enis F. Ahmedi

Keyword(s):

Periodontal Diseases ◽

Mean Difference ◽

Plaque Index ◽

Periodontal Health ◽

Bleeding On Probing ◽

Probing Depth ◽

Abutment Teeth ◽

The Mean ◽

Clinical Measurements ◽

Level Of Significance

ABSTRACT Objective: The aim of this study was to evaluate the influence of removable partial dentures (RPD) on the periodontal health of abutment and non-abutment teeth. Materials and Methods: A total 107 patients with RPD participated in this study. It was examined 138 RPD, they were 87 with clasp-retained and 51 were RPD with attachments. The following periodontal parameters were evaluated for abutment and non-abutment teeth, plaque index (PLI), calculus index (CI), bleeding on probing (BOP), probing depth (PD) (mm) and tooth mobility (TM) index. These clinical measurements were taken immediately before insertion the RPD, then one and 3 months after insertion. The level of significance was set at (P < 0.05). Results: The mean scores for PLI, CI, BOP, PD, and TM index, of the abutment teeth and non-abutment teeth were no statistically significant at the time of insertion of RPD. After 1-month, PLI was statistically significant (0.57 ± 0.55 for abutment and 0.30 ± 0.46 for non-abutment teeth). After 3 months, there were significant differences between abutment and non-abutment teeth with regard to the BOP (1.53 ± 0.50 and 1.76 ± 0.43 respectively), PD (0.28 ± 0.45 and 0.12 ± 0.33 respectively) and PLI (1.20 ± 0.46 and 0.75 ± 0.64 respectively). No significant mean difference in TM and CI was found between the abutment and non-abutment teeth (P > 0.05). Conclusions: With carefully planned prosthetic treatment and adequate maintenance of the oral and denture hygiene, we can prevent the periodontal diseases.

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LL-37 and hBD-2 in the gingival crevicular fluid of smokers and nonsmokers with periodontitis

Revista de Odontologia da UNESP ◽

10.1590/1807-2577.05621 ◽

2021 ◽

Vol 50 ◽

Author(s):

Alessandra Barreto LOPES ◽

Natália Helena COLOMBO ◽

Naida Zanini ASSEM ◽

Marta Aparecida Alberton NUERNBERG ◽

Valdir Gouveia GARCIA ◽

...

Keyword(s):

Gingival Crevicular Fluid ◽

Periodontal Diseases ◽

Epidemiological Studies ◽

Clinical Parameters ◽

Clinical Attachment Loss ◽

Probing Depth ◽

Significant Difference ◽

Level Of Significance ◽

Crevicular Fluid ◽

Attachment Level

Abstract Introduction The association between smoking and periodontal diseases has been described in clinical and epidemiological studies. Objective The aim of this study was to compare the LL-37 and human β-defensin-2 (hBD-2) levels in crevicular fluid of patients with generalized periodontitis in smokers (S) and nonsmokers (NS). Material and method A total of 35 patients with generalized periodontitis stages III and IV, 15 NS (11 female, 4 male) and 20 S (7 female and 13 male), were included in the study. The evaluated clinical parameters were bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL). Enzyme-linked immunosorbent assays were performed to quantify the LL-37 and hBD-2 levels in the gingival crevicular fluid of these patients. The results were analyzed statistically with the level of significance set at 5%. Result In relation to periodontal clinical parameters, no statistically significant difference was observed for BOP and PD between groups S and NS. There was a higher CAL in the S group than in the NS group (p = 0.0095). There was no statistically significant difference between the levels of LL-37 and hBD-2 when comparing groups S and NS (p>0.05). Conclusion It was concluded that smokers have a higher clinical attachment loss than nonsmokers, but that smoking did not influence the levels of LL-37 and hBD-2 in the gingival crevicular fluid in periodontitis.

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THU0517 THE ROLE OF ULTRASOUND-DEFINED SYNOVITIS GRADE I IN PATIENTS PRESENTING WITH INFLAMMATORY ARTHRALGIA, A RETROSPECTIVE STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4886 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 497.2-497

Author(s):

J. Arroyo Palomo ◽

M. Arce Benavente ◽

C. Pijoan Moratalla ◽

B. A. Blanco Cáceres ◽

A. Rodriguez

Keyword(s):

Rheumatoid Arthritis ◽

Inflammatory Arthritis ◽

Statistical Tests ◽

Median Number ◽

Painful Joint ◽

Significant Difference ◽

The Mean ◽

Specialized Unit

Background:Musculoeskeletal ultrasound (MSUS) is frequently used in several rheumatology units to detect subclinical inflammation in patients with joint symptoms suspected for progression to inflammatory arthritis (IA). Synovitis grade I (EULAR-OMERACT combined score) is known to be a casual finding in healthy individuals, but studies headed to unravel its possible role on rheumatic diseases are sparse.Objectives:To investigate the correlation between synovitis grade I, and the diagnosis of IA made after a year follow-up period since MSUS findings, in patients of an MSUS-specialized unit of a Rheumatology Department.Methods:We conducted a descriptive, retrospective and unicentric study. 30 patients were selected from the MSUS-specialized unit of our Rheumatology Department from July-18 to January-19. Patients presenting synovitis grade 0 (exclusively), 2 and/or 3 on combined score were excluded. Data collection at baseline included age, sex, immunological profile and previous physical examination to the MSUS findings, as well as the diagnosis made by the rheumatologist in 1-year visit follow-up: dividing the patient sample into two groups: those who were diagnosed with IA and those not. Non-parametric statistical tests for comparing means were used.Results:The mean age was 51,6 years and 70% were females. 6 (20%) patients were diagnosed with inflammatory arthritis after a year follow-up: 2 (4,8%) psoriatic arthritis, 1 (3,3%) undifferentiated arthritis, 1 (3,3%) rheumatoid arthritis, 1 (3,3%) Sjögren’s syndrome. Non-inflammatory arthropathies were also found 24 (80%), of which, 12 (40%) were non-specific arthralgias and 8 (19%) osteoarthritis.In the group of patients who did not developed an IA the mean C-reactive protein (CPR) value was 3,12 mg/L and erythrocyte sedimentation rate (ESR) was 8,2 mm; all of them were rheumatoid factor (RF) positive and ACPA-negative except one patient. 5 (31,3%) patients presented low antinuclear antibodies (ANAs) levels. In those who HLA B-27 and Cw6 were tested (4,25%); both were negative except for one that was HLA B-27 positive. The median number of swollen and painful joint count was 0, and the mean of joints with MSUS involvement was 3,5; the mean involved metacarpophalangeal (MCP) joints was 1,83; proximal interphalangeal (PIP) joints was 1,48 and distal interphalangeal (DIP) joints 0,21.Among the group of patients that developed an IA the mean of CPR and ESR was 9,27 mg/L and 14,17 mm respectively; 2 (33%) patients were RF- positive, and 1 ACPA-positive. ANAs were positive in 3 cases (50%). The median of swollen joint count was 2 and for painful joint count was 0, the median of joints with MSUS involvement was 4,5. The mean of MSUS involvement was for MCP, PIP and DIP joints: 1,67, 2 and 0. Comparing the means of CPR values in the two groups with Student’s t-test we obtained a statistically significant difference (p=0,023). No other significant differences were found.Conclusion:Despite the limitations and possible statistical bias, the presence of MSUS-defined synovitis grade I and elevated CRP levels could be related to further diagnoses of inflammatory arthropathy. Besides, the absence of synovitis in DIP joints might have a diagnostic role. Normal physical exploration and normal levels of CRP might suggest low MSUS value. However, further research is needed to clarify the role of MSUS-defined synovitis grade I.References:[1]D’Agostino MA et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardized, consensus-based scoring system. RMD Open. 2017;3(1):e000428.[2]Van den Berg R et al. What is the value of musculoskeletal ultrasound in patients presenting with arthralgia to predict inflammatory arthritis development? A systematic literature review. Arthritis Research & Therapy (2018) 20:228.Disclosure of Interests:None declared

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Patterns of Periodontal Destruction among Smokeless Tobacco Users in a Central Indian Population

Healthcare ◽

10.3390/healthcare9060744 ◽

2021 ◽

Vol 9 (6) ◽

pp. 744

Author(s):

Pradeep S. Anand ◽

Supriya Mishra ◽

Deepti Nagle ◽

Namitha P. Kamath ◽

Kavitha P. Kamath ◽

...

Keyword(s):

Smokeless Tobacco ◽

Tobacco Consumption ◽

Periodontal Health ◽

Clinical Attachment Loss ◽

Periodontal Tissues ◽

Probing Depth ◽

High Prevalence ◽

Periodontal Destruction ◽

Different Populations ◽

Oral Hygiene Habits

Background: Findings of studies testing the association between smokeless tobacco (SLT) use and periodontal health have shown varying results in different populations. Considering the high prevalence of SLT use in India, the present study was conducted to understand the pattern of periodontal destruction within different areas of the dentition among SLT users. Methods: Age, gender, oral hygiene habits, the frequency and duration of SLT consumption, the type of SLT product used, and the site of retention of the SLT product in the oral cavity were recorded among 90 SLT users. Probing depth (PD), recession (REC), and clinical attachment loss (CAL) at SLT-associated and non SLT-associated teeth of the mandibular arch were compared based on the site of retention of the SLT product, the type of product used, and the duration of the habit. Results: REC and CAL were significantly higher at the SLT-associated zones compared to non SLT-associated zones and at both interproximal and mid-buccal sites of SLT-associated teeth. Among individuals who had the habit for more than 5 years and also among those who had the habit for 5–10 years, PD, REC, and CAL were significantly higher at SLT-associated teeth than at non SLT-associated teeth. Significantly greater periodontal destruction was observed at SLT-associated teeth among khaini users and gutkha users. Conclusions: Smokeless tobacco consumption resulted in greater destruction of periodontal tissues. The severity of periodontal destruction at SLT-associated sites differed depending on the type of smokeless tobacco used, the site of retention of the SLT, and the duration of the habit.

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Are Proteinase 3 and Cathepsin C Enzymes Related to Pathogenesis of Periodontitis?

BioMed Research International ◽

10.1155/2014/420830 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Oya Türkoğlu ◽

Elif Azarsız ◽

Gülnur Emingil ◽

Necil Kütükçüler ◽

Gül Atilla

Keyword(s):

Gingival Crevicular Fluid ◽

Periodontal Diseases ◽

Study Groups ◽

Aggressive Periodontitis ◽

Control Group ◽

Proteinase 3 ◽

Cathepsin C ◽

Probing Depth ◽

Inflammatory Processes ◽

Crevicular Fluid

Aim. Cathepsin C is the activator of the polymorphonuclear leukocyte-derived proteinase 3, which contributes to inflammatory processes. The aim of the present study was to investigate gingival crevicular fluid (GCF) proteinase 3 and cathepsin C levels in periodontal diseases.Design. Eighteen patients with chronic periodontitis (CP), 20 patients with generalized aggressive periodontitis (G-AgP), 20 patients with gingivitis, and 18 healthy subjects were included in the study. Periodontal parameters including probing depth, clinical attachment level, papilla bleeding index, and plaque index were assessed in all study subjects. GCF proteinase 3 and cathepsin C levels were analyzed by ELISA.Results. GCF proteinase 3 total amount was significantly higher in diseased groups compared to control group, after adjusting ageP<0.05. No differences were found in GCF cathepsin C levels among the study groupsP>0.05. Periodontal parameters of sampling sites were positively correlated with GCF proteinase 3 total amountsP<0.01but not with cathepsin C total amountsP>0.05.Conclusions. Elevated levels of GCF proteinase 3 in CP, G-AgP, and gingivitis might suggest that proteinase 3 plays a role during inflammatory periodontal events in host response. However, cathepsin C in GCF does not seem to have an effect on the pathogenesis of periodontal diseases.

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