Estimation of Calcium and Iron Levels in Gingival Crevicular Fluid and Serum in Periodontal Health and Disease

Abstract
Introduction: Gingival Crevicular Fluid (GCF) has been referred to as a promising medium for detection of markers for periodontal disease activity. Analysis of GCF shows minute changes in biomarker levels well before the onset of clinical signs and symptoms; which helps to even predict a person’s predisposition towards periodontal disease occurrence. The elemental analysis of human blood serum is noteworthy in routine clinical practice as well as in medical research. Aim: This study was done to determine the changes in calcium and iron levels in GCF and serum in human subjects with normal periodontal health and those with disease. Materials and Methods: This was a cross-sectional study conducted from March 2019 to December 2019. Eight study subjects (4 healthy subjects and 4 periodontitis cases) were selected from the patients reporting to the Department of Periodontics at Tagore Dental College and Hospital, Chennai. The subjects were chosen based on inclusion and exclusion criteria and all patients were subjected to a clinical examination wherein the Probing Depth (PD) and Clinical Attachment Level (CAL) were recorded by a single examiner using William’s Periodontal probe. The GCF samples were collected by Capillary Tubing method. Blood was collected by venipuncture and centrifuged to provide serum samples. Dual viewing Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) was used to estimate Calcium and Iron in GCF and serum. SPSS version 21.0 was used for statistical analysis. Mann Whitney U test was used for comparing the groups. p-value less than 0.05 was considered statistically significant. Results: Serum iron levels were significantly less in periodontitis patients than healthy subjects (p-value 0.043). GCF iron level (p-value 0.386), GCF calcium level (p-value 0.149) and serum calcium level (p-value 0.564) did not show any major variation among subjects with normal periodontal health and those with disease. Conclusion: The findings of this study showed that iron and calcium are present in GCF and serum samples of healthy persons and patients with chronic periodontitis which can be detected using ICP-OES. A significant difference in serum iron levels between health and disease could indicate a patient’s predisposition towards developing periodontitis. Calcium levels in GCF and serum do not point towards periodontal disease activity.