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Open access

Mansur Rahnama, Łukasz Czupkałło, Maryla Kozicka-Czupkałło and Michał Łobacz


Among many substances used in clinical diagnosis, such as peripheral blood, gum homogenate, saliva and gingival pocket fluid, it is the latter that seems to bean extremely valuable diagnostic and research material. Identification of mediators in gingival crevicular fluid, both in the healthy gingival fissure, as well as in pathological periodontal pockets can be a valuable supplement to the initial diagnosis and describe the mechanism of gumorperiodontal diseases.

Changes in the concentration of individual components in the gingival crevicular fluid may be used to assess the severity of periodontal disease.

There are numerous methods for collecting fluid from the sulcus described: Micro-capillary drainage, micropipette drainage, rinsing pocket or drainage with the use of methylcellulose strips and then reading with Periotron.

Gingival fluid is composed mainly of blood electrolytes and organic molecules, i.e. albumins, globulins, lipoproteins or fibrinogen and cellular components as well as peptides, bacteria and enzymes.

Therefore gingival crevicular fluid (GCF) is treated as a window for noninvasive analysis of periodontitis, taking into account indicators and markers of connective tissue and bone destruction.

Open access

Lukasz Czupkallo, Mansur Rahnama, Dominik Kielbowicz, Michal Lobacz and Maryla Kozicka-Czupkallo


Periodontal disease is an inflammatory disease of multifactorial etiology. In order for it to appear there must come to an imbalance between the effects of pathogens and host defense mechanisms. As a result of its course the destruction of structures supporting the teeth appears (periodontium, cement, bone), and consequently leads to teeth loosening and loss. In recent years, the participation of RANKL/RANK/OPG in bone remodeling process was highligted.

At the molecular level the bone resorption is regulated through the interaction of the ligand receptor activator of nuclear NF-kappa B (RANKL) and osteoprotegerin (OPG), which is a system of two proteins belonging to the protein tumor necrosis factor (TNF). Recent findings about the RANKL protein and OPG have shed new light on the previously unexplained phenomenon of the basis of bone resorption.

Research has shown that both protein OPG and RANKL can be detected in gingival crevicular fluid, which has become a window of opportunity in the analysis of non-invasive markers of periodontal tissues, confirming elevated levels of RANKL protein in periodontal disease, and decreased levels of OPG protein. Bone resorption is initiated by the binding of the RANKL protein to receptors RANK present on the surface of mature osteoclasts, and their precursors, which leads to the differentiation and activation of osteoclasts. OPG, being RANKL’s inhibitor, has, in turn, opposite characteristics to RANKL, resulting in the reduction of osteoclastogenesis process. Despite all this, the exact mechanism of bone resorption has not yet been elucidated.

Open access

Mansur Rahnama, Michal Lobacz, Anna Szyszkowska, Grzegorz Trybek and Maryla Kozicka-Czupkallo


In adult life, proper bone metabolism requires efficient regulation of bone formation and resorption processes. Bone turnover markers allow for assessing the rate of bone formation and resorption processes. In menopausal period, female patients experience gradual reduction in blood estradiol levels. The deficit of estrogens leads to enhanced osteoclastogenesis and bone resorption. Alkaline phosphatase (ALP) is a membranebound enzyme that stimulates the osteoblast activity and bone mineralization. It is synthesized by osteoblasts and incorporated into the newly formed bone tissue. The produced enzyme stimulates the osteoblast activity and bone mineralization. The goal of this study is to determine the effect of hormone replacement therapy in postmenopausal women on the expression of alkaline phosphatase gene (ALPL) within the mucosal epithelium of the cheek and in peripheral blood lymphocytes. The studies show that hormone replacement therapy has no significant effect on the increase in ALPL expression within the mucosal epithelium of the cheek. Only in women having undergone ovarectomy (OV), the epithelial ALPL expression level was higher than in the remaining groups.