Free haem levels in gingival crevicular fluid and their relationship to periodontal clinical parameters, smoking and subgingival microbial composition

BACKGROUND AND OBJECTIVES: Periodontitis caused by multifactorial polymicrobial infection results in a destructive inflammatory process and loss of tooth supporting tissues. Many putative bacterial virulence factors that cause host destruction are regulated by iron and haem. Therefore, this study investigated the free haem levels in the gingival crevicular fluid (GCF) at periodontitis sites in smokers and nonsmokers and their relationship to subgingival microbial composition. MATERIALS AND METHODS: A cross-sectional study was carried out on 78 patients with a split-mouth design who were divided into Group I A – periodontally healthy sites and Group I B – periodontally diseased sites in nonsmokers with chronic periodontitis and Group II A – periodontally healthy sites and Group II B – periodontally diseased sites in smokers. Clinical parameters recorded included a plaque and gingival index, papillary bleeding index, pocket probing depth, and clinical attachment level. The collected GCF samples were subjected to Biovision™ Hemin Colorimetric Assay Kit and subgingival plaque samples to BANA™ test. RESULTS: Increased GCF free haem concentration and positive BANA sites were seen at periodontitis sites compared to healthy sites, in both smokers and nonsmokers group. However, no difference was found in GCF free haem levels between smokers and nonsmokers, but it was statistically significant with respect to BANA-positive sites. CONCLUSION: Thus, this study concludes that the higher concentration of GCF free haem at diseased sites indicates that it could be used as a potential biomarker to determine active periodontal sites, also smoking and BANA results did not influence the biomarker levels.