Correlation of collagenolytic enzymes and inhibitors in gingival crevicular fluid with clinical and microscopic changes in experimental periodontitis in the dog.

The quadrants of the jaw in 2 beagle dogs had various forms of periodontal disease induced by ligatures placed around second, third and fourth premolars in one quadrant and, 2.5 months later, around the same teeth in a second quadrant; gingivitis was allowed to develop in a third quadrant after 4 months; the fourth quadrant served as a healthy control. Crevicular fluid flow, plaque index, gingival index, attachment levels and recession were determined at intervals and collagenolytic activity measured in the fluid. The dogs were killed after 5 months and sections of each site prepared for histomorphometry. Clinically-inflamed and degenerating sites had significantly higher collagenolytic activities (p less than 0.001), lower collagenase inhibitor activities and greater fluid flow than control sites which showed abundant inhibitor activity and minimal active enzyme. Periodontitis sites had higher active enzyme, compared to latent enzyme activities, whereas latent collagenase was predominant in control and gingivitis sites. The collagenolytic activities in periodontitis sites fluctuated with time, suggesting a cyclical pattern. Active enzyme activities correlated strongly with gingival crevicular fluid flow and attachment loss. Periodontitis sites had much more inflammatory-cell infiltration than control and gingivitis sites (p less than 0.001). Thus periodontal disease may be monitored by examination of crevicular fluid collagenolytic enzymes, inhibitors and fluid flow, and these criteria may prove more meaningful than current clinical criteria.