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While gingival crevicular fluid provides for the cellular defence and humoral factors to combat against the microbial insult, the gingival crevicular fluid also deliver novel substrates, in the form of proteins and glycoproteins, for bacterial metabolism. These include haeme containing molecules and iron, such as haemoglobin and transferrin.
It is caused by precipitation of minerals from saliva and gingival crevicular fluid (GCF) in plaque on the teeth. This process of precipitation kills the bacterial cells within dental plaque, but the rough and hardened surface that is formed provides an ideal surface for further plaque formation.
The early lesion displays acute exudative inflammation; exudative components and crevicular lymphocytes reach their maximum levels between days 6–12 after plaque accumulates and gingival inflammation commences [21] with the quantity of crevicular fluid being proportional to the size of the reaction site within the underlying connective tissue.
They migrate from the tissues in a specialized exudate called gingival crevicular fluid also known as GCF. Neutrophils are recruited to the gingival crevice area as they are signalled to by molecules released by plaque microorganisms. Damage to epithelial cells releases cytokines which attract leukocytes to assist with the inflammatory response.
In addition to acting as a buffer, saliva and gingival crevicular fluid contain primary nutrients including amino acids, proteins and glycoproteins. This feeds the bacteria involved in plaque formation. The host diet plays only a minor role in providing nutrients for the resident microflora. [20]
The plasma cells produce specific antibodies in response to the periodontal pathogens, which diffuse into the gingival crevicular fluid. They produce mainly IgG, with some IgA. [13] It has been suggested that these gingival crevicular fluid antibody levels could be potentially useful in the development of a vaccine. [14]
The gingival crevice area (supporting structures of the teeth) provides a habitat for a variety of anaerobic species. Bacteroides and spirochetes colonize the mouth around puberty. [ 7 ] Of particular interest is the role of oral microorganisms in the two major dental diseases: dental caries and periodontal disease .
The gingival tissue forms a crevice surrounding the tooth, similar to a miniature, fluid-filled moat, wherein food debris, endogenous and exogenous cells, and chemicals float. The depth of this crevice, known as a sulcus , is in a constant state of flux due to microbial invasion and subsequent immune response.
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