2. INTRODUCTION:
Serum exudate that appears in the gingival sulcus and that contains
molecular elements and cellular elements of the immune response
Actually, gcf is both transudate and exudate ;but transudate is
negligible (so it is only considered as inflammatory exudate)
Warhaung and brill and crasse elucidated its role in the oral defence
Alfano called it inflammatory exudate
Brill proposed it to be a transudate
3. Formation of GCF:Theories
This is based on theories:
1. ACCORDING TO BRILL AND EGLEBERG:
• According to him Gcf is a transudate
• What is transudate= whenever there is a inflammation there is a
increase in the permeability of capillaries there will be a leakage of
the fluid from the capillaries i.e
LEAKAGE OF THE FLUID FROM THE CAPILLARIES IS CALLED
TRANSUDATE
4. According to Alfano and pashley:
Initially;according to Alfano:
oThe fluid which is formed in the capillaries due to the inflammation is
a transudate.
According to pashley: he created a model :
i.e., the fluid goes to firstly---capillariestissueslymphatic drainage.
Later on;
oAs the inflammation progress, due to the change in the osmotic
concentration the amount of capillary infiltrate increases and leads to
uneven lymphatic drainage which leads to the formation of either
TISSUE OEDEMA OR IN THE FORM OF GCF THROUGH THE GINGIVAL
SULCUS i.e. exudate
5. Basic difference between the transudate and
exudate;
•A fluid substance that
comes out due to
increase in permeability
of capillaries.
Protein content of the
transudate is less.
it is a clear substance
Specific gravity is less
Due to increase in
inflammation, there to gap
in epithelial cells of
capillaries leads to increase
in fluid and the other
components from the
capillaries which causes
the formation of
inflammatory exudate
Protein content of the
transudate is more.
it is a cloudy substance
Specific gravity is more
TRANSUDATE
EXUDATE
6. Composition of GCF: which acts as prognostic and
diagnostic marker for the progression of periodontal disease
ELECTROLYTES
1. Sodium
2. Potassium
3. calcium
ENZYMES
1. Beta-glucuronidase
2. Lactic acid and
dehydrogenase
3. Collagenase
4. Phospholipase
5. Alkaline phosphatase
6. Acid phosphatase
7. Pyrophosphatase
(increase in the collagenase,
alkaline ,acid &
pyrophosphatases indicate
the active periodontal
disease i.e. increased bone
resorption)
CELLULAR ELEMENTS
1. Pmn’s
2. Bacteria's
3. Desquamated epithelial
cells
4. Mononuclear cells
5. Beta lymphocytes(58%)
6. T-lymphocytes(24%)
7. Mononuclear(18%)
phagocytes
• Pmns are found in initial
stages of the disease
• 3,4,5,6,7 are mostly
found in the later stages
of the disease
ORGANIC
1. Carbohydrates
2. Glucose hexosamine
3. Hyaluronic acid
4. Protein
5. Metabolic and bacterial
products such as urea
,hydroxy proline, lactic
acid, formic acid and
ammonia
7. IMPORTANT FOR MCQ’S:
the ratio of t-lymphocytes and b-lymphocytes in peripheral blood
smear is 3:1
Where as in GCF it is 1:3 (reversed to peripheral blood smear)
Gingival sulcus is the main portal entry into the oral cavity
Protein content of gingival fluid is less than that of the serum
Glucose content of the GCF is 3-4 times higher than the serum
8. Clinical significance of GCF:
• Circadian rhythm: GCF increases from 6 am to 10 am and decreases
afterwards.
• Hormonal effects: increased GCF seen in female sex hormones i.e.
oestrogen and progesterone [pregnancy]
• Inflammation: increased GCF
• Vigorous gingival brushing and chewing stimulates the oozing of gingival
fluid
• GCF is not increased by TFO but it is increased by mastication of of coarse
food
• Smoking causes transient increase of GCF
• Tetracycline is the drug that attains maximum concentration in gcf
9. Function of GCF:
Gcf cleans materials from gingival sulcus
It contains plasma proteins that helps in the adhesion of the
epithelium to the tooth
It posses the antimicrobial property
It exerts antibody activity in defence of the gingiva
IgG is more prevalent in GCF
