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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 3  |  Issue : 2  |  Page : 51-53

Evaluation of gingival crevicular fluid volume by (Periotron 8000)® in Yemeni qat chewing samples


Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia

Date of Web Publication16-Jun-2016

Correspondence Address:
Mohammed M. A. Abdullah Al-Abdaly
Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2348-2915.184212

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  Abstract 

Background: A high rate of periodontal disease has been observed among Yemeni male qat chewers. This study was performed to evaluate clinically the effect of qat chewing habit on the volume of gingival crevicular fluid (GCF) by (Periotron 8000)®. Subjects and Methods: A total of 120 subjects (80 males) and (40 females) qat chewers patients were involved. They were divided into three groups according to the duration of qat chewing habits (5 years, 6–10 years and >10 years). The plaque index (PLI) and gingival index (GI) were recorded at baseline, 10 days, 15 days, and 20 days intervals. The GCF samples were collected by insertion of absorbent strips subgingivally without contact with gingival tissues 1 mm for 30 s. Periotron 8000® was used for the evaluation of the volume of GCF at baseline, for 1 h, 24 h, 5 days, 10 days, 15 days, and 20 days intervals. The data were collected and analyzed by NOVA test. Results: There were significant differences in the mean of (PLI), GI and the volume of GCF in all patients groups at all intervals of this study. Conclusion: The GI and GCF were increased with duration of qat chewing habit due to increased severity of gingival inflammation whereas the PLI was decreased due to the effect of self-cleansing during qat chewing habit.

Keywords: Gingival crevicular fluid, Periotron 800®, qat chewing habits


How to cite this article:
Abdullah Al-Abdaly MM. Evaluation of gingival crevicular fluid volume by (Periotron 8000)® in Yemeni qat chewing samples. J Dent Res Rev 2016;3:51-3

How to cite this URL:
Abdullah Al-Abdaly MM. Evaluation of gingival crevicular fluid volume by (Periotron 8000)® in Yemeni qat chewing samples. J Dent Res Rev [serial online] 2016 [cited 2022 Nov 27];3:51-3. Available from: https://www.jdrr.org/text.asp?2016/3/2/51/184212


  Introduction Top


Qat is a plant that grows in Yemen and some eastern regions in Africa. Qat chewing habit is commonly known as a popular habit in Yemen especially among males, recently it spread among females as a social habit, and there were many studies about its negative effect on gingival and periodontal tissues.[1] Chemically, there are three alkaloid compounds in qat: Cathedulins, phenylethylamine, and phenylalkylamine.[2] It has been found that the cause of psychostimulant effect of qat is active ingredients known as cathinone and cathine. Cathinone is similar to amphetamine in its chemical structure, and it is a powerful stimulant to the central nervous system as amphetamine. The effect of cathine is less than cathinone. These active ingredients in fresh qat leaves lose their effectiveness after 48 h.[3]

The leaves of qat are usually placed in the lower of distal mucosal fold and chewed 6 h during social meetings.[4] Chewing of qat causes oral mucosa dryness; therefore, the qat chewers drink liquids during the qat chewing session [5] and some of them smoke during qat chewing habit.[6] Oral keratosis were found in 50% of qat chewers in oral mucosa without cancerous changes at the site of qat chewing [7] but there were cancer cases in a study was performed 2 years back in Aseer region of Saudi Arabia [8] and there were gingival and oral mucosa white lesions in 100% and 90% respectively, in a cross-sectional study of 431 subjects (325 chewers for not <3 years and 106 non-chewers)[9] and deeper periodontal pocket formation were found on non qat chewing side compared to qat chewing side due to the self-cleansing effect of qat chewing.[7]

The study depends on the community index of treatment needs on 1001 Yemeni qat chewers. There were significant differences in clinical attachment loss and calculus index in the 12–24 years age group while there were no significant differences in the 35–44 years age group.[10] The present study was designed to evaluate the gingival crevicular fluid (GCF) volume by (Periotron 8000)® in Yemeni qat chewing samples.


  Subjects and Methods Top


Patients samples

Total 120 qat chewers patients (80 males and 40 females) were the subjects in the present study. Only individuals who provided a history of chewing qat for >5 years, not <4 days per week, and not <4 h per day were considered. In addition, only individuals who used to chew qat on one side of their mouth were selected. They were divided into three main groups:

  • Group I: 40 patients who provided a history of chewing qat 5 years
  • Group II: 40 patients who provided a history of chewing qat 6–10 years
  • Group II: 40 patients who provided a history of chewing >10 years.


Clinical examination

Prior to crevicular fluid collection, supragingival plaque was scored using plaque index (PLI).[11] Gingival inflammation was scored using gingival index (GI).[12] All clinical data were recorded at baseline, 10 days, 15 days, and 20 days intervals.

Crevicular fluid sampling

The GCF was collected by inserting the paper strips into the teeth services without saliva and blood contamination. The strips were left in situ 30 s and then transferred for volume determination with an electronic device (Periotron 8000). The readings were converted to actual volume (μl) by reference to the standard curve.

Statistical analysis

All results were collected tabulated and statistically analyzed. The mean and standard deviation (SD) were calculated for each parameter at different test periods and statistically analyzed using ANOVA test.


  Results Top


The mean and ± SD of males and females patients age in the present study was 35 ± 2.4 and 27 ± 1.8, respectively. [Table 1] and [Figure 1] show the mean and ± SD of gingival status of each group, including PLI and GI. There were differences in plaque index in the present study intervals (P< 0.05). In the same table, there were significant differences in GI in Group I compared to Group II and Group III in the present study intervals (P< 0.05).
Table 1: Mean±standard deviation of clinical parameters

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Figure 1: Mean of clinical parameters

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[Table 2] and [Figure 2] summarize the mean and ± SD of GCF volume in the present study. There were significant differences in GCF in the comparison between Group I, II, and III in present study intervals (P< 0.05).
Table 2: The mean±standard deviation of gingival crevicular fluid volume

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Figure 2: The mean of gingival crevicular fluid volume

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  Discussion Top


Qat chewing habit for long time has caused stomatitis, and secondary infection due to the mechanical and chemical effect of qat [13] and there were adverse effects of qat chewing habit on gingival and periodontal tissues reported in earlier studies on Yemeni Jews who migrated to Israel.[14] In the present study, increased severity gingival inflammation appeared among the patients who provided a history of chewing >10 years compared to among the patients who provided a history of chewing <10 years.

In the study that was carried out in Kenya on 131 mirra chewers (Qat in Kenya) and 199 non mirra chewers, there were no significant differences in periodontal health between mirra chewers and non mirra chewers group but PLI and GI was lower in mirra chewers than non mirra chewers group [15] and the calculus index and clinical attachment loss were more in 1001 Yemeni qat chewers than non qat chewers especially in 12–24 years age group while no significance differences in the 35–44 years age group [10] so qat chewing habit was considered as a risk factor for a number of periodontal lesions.[9]

In the present study, there was increased GI in the intervals after qat chewing habit compared to the intervals of qat chewing habit; while in the study of Hill and Gibson the gingival bleeding was more in qat chewers than non qat chewers.[7] These side effects of qat chewing on mucosal and periodontal tissues are due to hardness and friction mechanism of qat chewing.[5] The present study indicated a decrease of PLI in chewing habit intervals compared to the intervals after qat chewing due to the self-cleansing effect of qat chewing habit. The components of gingival crvicular fluid have protective mechanisms of gingival crvicular area.[16] It also has flushing effect against bacteria and carbon particles which had been forcefully inserted into the givgival sulcus [17] and it has a role in carrying antimicrobial agents to the crevicular area.[18]

The GCF volume increases with the increase of gingival inflammation severity.[19] The present study reported the GCF volume is higher in the intervals after qat chewing habit compared to the intervals of qat chewing habit. I believe this is caused by the increase of PLI and GI in the intervals after qat chewing habit.


  Conclusion Top


There were significant differences in PLI and GI in the present study. There was an increase in PLI in all intervals compared to baseline interval in all patient groups whereas no significant difference at 15 days compared to baseline in Group I of the present study. There was a decrease in GI in all intervals compared to baseline in all patients of the present study. The volume of GCF increased after qat chewing habit. In this study, there was an increase in PLI, GI, and GCF volume after qat chewing habit due to disappearance of the effect of qat chewing self-cleansing.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Kennedy G. The flower of paradise. The institutionalized use of the drug qat in North Yemen. Dordrecht: D Reidel Publishing Company, 1987. p. 176-7.  Back to cited text no. 1
    
2.
Al-Motarreb A, Baker K, Broadley KJ. Khat: Pharmacological and medical aspects and its social use in Yemen. Phytother Res 2002;16:403-13.  Back to cited text no. 2
    
3.
Kalix P. Leaf of Allah: Qat and agricultural transformation in Harerge. In: Gebissa E, editor. The Pharmacology of Qat. Ohio: Ohio State University Press; 2004. p. 69-73.  Back to cited text no. 3
    
4.
Elmi AS. The chewing of khat in Somalia. J Ethnopharmacol 1983;8:163-76.  Back to cited text no. 4
    
5.
Al-Bekairi AM, Abulaban FS, Qureshi S, Shah AH. The toxicity of Catha edulis (Qat). A review. Fitoterapia 1991;62:291-300.  Back to cited text no. 5
    
6.
Giannini AJ, Miller NS, Turner CE. Treatment of khat addiction. J Subst Abuse Treat 1992;9:379-82.  Back to cited text no. 6
    
7.
Hill CM, Gibson A. The oral and dental effects of q'at chewing. Oral Surg Oral Med Oral Pathol 1987;63:433-6.  Back to cited text no. 7
    
8.
Soufi HE, Kameswaran M, Malatani T. Khat and oral cancer. J Laryngol Otol 1991;105:643-5.  Back to cited text no. 8
    
9.
AL-Sharabi A. Oral and Para-oral Lesions Caused by Takhzeen Al Qat (chewing). PhD Thesis. Al-Khartoum, Sudan: University of Khartoum; 2002.  Back to cited text no. 9
    
10.
Mengel R, Eigenbrodt M, Schünemann T, Florès-de-Jacoby L. Periodontal status of a subject sample of Yemen. J Clin Periodontol 1996;23:437-43.  Back to cited text no. 10
    
11.
Loe H, Theilade E, Jensen SB. Experimental gingivitis in man. J Periodontol 1965;36:177-87.  Back to cited text no. 11
    
12.
Silness J, Loe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand 1964;22:121-35.  Back to cited text no. 12
    
13.
Halbach H. Medical aspects of the chewing of khat leaves. Bull World Health Organ 1972;47:21-9.  Back to cited text no. 13
    
14.
Rosenzweig KA, Smith P. Periodontal health in various ethnic groups in Israel. J Periodontal Res 1966;1:250-9.  Back to cited text no. 14
    
15.
Jorgensen E, Kaimenyi JT. The status of periodontal health and oral hygiene of miraa (Catha edulis ) chewers. East Afr Med J 1990;67:585-90.  Back to cited text no. 15
    
16.
Brill N. Influence of capillary permeability on flow of tissue fluid into gingival pockets. Acta Odontol Scand 1959;17:23-33.  Back to cited text no. 16
    
17.
Brill N. Removal of particles and bacteria from gingival pockets by tissue fluid. Acta Odontol Scand 1959;17:431-40.  Back to cited text no. 17
    
18.
Brill N. Effect of chewing on flow of tissue fluid into human gingival pockets. Acta Odontol Scand 1959;17:277-84.  Back to cited text no. 18
    
19.
Rüdin HJ, Overdiek HF, Rateitschak KH. Correlation between sulcus fluid rate and clinical and histological inflammation of the marginal gingiva. Helv Odontol Acta 1970;14:21-6.  Back to cited text no. 19
    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2]


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[Pubmed] | [DOI]



 

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Abstract
Introduction
Subjects and Methods
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