Effects of treatment on gingival crevicular collagenase, stromelysin and tissue inhibitor of metalloproteinases and their ability to predict response to treatment.

Fibroblast collagenase (FIB-CL) and stromelysin (SL) are members of a family of enzymes which are capable of degrading most of the extracellular matrix macromolecules. Extracellular control of these enzymes is performed by tissue inhibitor of metalloproteinases (TIMP). During healing, inflammation and normal tissue turnover, levels of MMPs and TIMP will change. The effect of treatment on the levels of FIB-CL, SL and TIMP as well as their ability, at baseline, to predict the outcome of therapy was investigated. 21 patients each provided 8 gingival crevicular fluid (GCF) samples from sites with probing depths > or = 4 mm. Clinical recordings and GCF sampling were performed at 3 time points. Assays for SL, FIB-CL and TIMP were performed by a sandwich ELISA. Attachment level changes were detected by the "tolerance method". The ability of the GCF constituents to predict the response to treatment was assessed by comparing pre-treatment levels between sites which did or did not show attachment gain after therapy. Although no GCF constituents could reliably predict the response to treatment, SL reduced significantly (p = 0.029) after the hygiene phase of therapy. In addition, both SL and TIMP levels showed a highly significant reduction at follow-up visit (p = 0.003 and p = 0.005 respectively). Thus, SL and TIMP levels are reduced by treatment, but these GCF proteins do not appear to have an ability to predict treatment outcome from baseline.