Menstrual Cycle-Associated Gingivitis Clinical Trial
Official title:
The Effect of Menstrual Cycle on Periodontium
Aim: Women's menstrual cycle is controlled by the secretion of sex hormones. Sex steroid
hormones are thought to be affect to periodontal tissues, wound healing, periodontal disease
progression and bone turn over. The aim the study is to evaluate clinical periodontal
parameters and interleukin- 6 (IL-6) and tumor necrosis factor alpha (TNF-α) levels in
gingival crevicular fluid (GCF) in menstrual cycle.
Material and methods: Twenty-five patients were included in this study clinical periodontal
parameters and levels of IL-6 and TNF α in gingival crevicular fluid were evaluated at three
periods of menstrual cycle (menstruation day (MD)-ovulation day(OD)-premenstruation day
(PmD)). Levels of IL-6 and TNF α in gingival crevicular fluid were determined by ELISA.
Study Population
Sixty women were initially included in this longitudinal, prospective study in Yuzuncu Yil
University, Faculty of Dentistry, Department of Periodontology.
The procedure was accepted and informed consent was signed by all participants. The material
and method used in the trial were accepted by the Yuzuncu Yil University Ethics Committee and
were found to conform to the guidelines issued in the Declaration of Helsinki. To standardize
the effect of plaque accumulation on the tested parameters, subjects were given oral hygiene
instructions before the study.
Clinical Procedures, and Measurements
All subjects were scheduled for periodontal measurements and GCF sampling on the specific
days determined as follows: 1) menstruation day (MD); on days 2-3 of menstruation 2)
ovulation day (OD); detected by saliva fertility microscope 12-14 days of menstrual cycle and
3) premenstruation day (PmD); 22-24 days of menstruation cycle.
The subjects evaluated the study criteria in terms of the duration of a regular menstrual
cycle (28 ± 3 d) and were followed up for three menstrual cycles. Five participants were
excluded from the study if their menstrual cycles were longer or shorter than 28 ± 3 d for
the last 12 months.
Donna ® Saliva Fertility Tester was used to detect the ovulation day. Patients also made
their own fever measurement and confirmed the ovulation day. A small amount of saliva was
placed onto microscope and after 5 minutes results were evaluated according to manufacturer's
instructions. The outside of microscope lens cleaned with alcohol and a cotton swab after
each use.
Periodontal measurements were performed for all patients at each of the three time points
from index teeth. Periodontal measurements were: 1) plaque index (PI) (according to Silness
and Löe index) 9: measured at six sites around each tooth; the highest score per tooth was
recorded; 2) gingival index (GI) (according to Löe and Silness index) 10: measured at six
sites around each tooth; the highest score per tooth was recorded; 3) probing depth (PD):
measured at six sites around each tooth.
The GCF samples were obtained for 30 seconds from the mesiobuccal gingival sulcus of teeth
using periodontal paper strips . The samples were taken 3 hours after the patients brush
their teeth in the morning.
To avoid irritation of the periodontal pocket epithelium, the clinical measurements were
obtained after the GCF samples collecting. The area was isolated with cotton rolls. All paper
strips were stored in phosphate buffered solution. Paper points contaminated with blood and
saliva were not used for study. GCF samples were stored at -80 °C for laboratory analyses.
GCF samples were analyzed for IL-6 and TNF-α using commercially available sandwich
enzyme-linked immunosorbent assay according to the manufacturer's instructions. Results were
reported as concentrations of IL-6 and TNF-α in GCF.
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