Background: This study assesses the long-term cost-effectiveness of this screening protocol from ... more Background: This study assesses the long-term cost-effectiveness of this screening protocol from a healthcare system perspective. Methods: Australians presenting to private oral healthcare practices recruited to the iDENTify study were included as the study population. A Markov model preceded by a decision tree was developed to assess the intervention’s long-term cost-effectiveness when rolled out to all eligible Australians, and measured against ‘no-intervention’ current practice. The model consisted of four health states: normoglycaemia; pre-diabetes; type 2 diabetes and death. Intervention reach of various levels (10%, 20%, 30%, and 40%) were assessed. The model adopted a 30-year lifetime horizon and a 2020 reference year. Costs and benefits were discounted at 5% per annum. Results: If the intervention reached a minimum of 10% of the target population, over the lifetime time horizon, each screened participant would incur a cost of $38,462 and a gain of 10.564 QALYs, compared to $...
The reasons for attendance, presenting health problems, functional status, pain and severity, and... more The reasons for attendance, presenting health problems, functional status, pain and severity, and satisfaction with emergency and primary care were examined using routinely collected data and an interviewer-assisted survey of patients. Patients attended, mostly after hours, because they believed their health problems required hospital-based management. GPs referred for admission and further evaluation. Ethnicity, employment status, gender and age contributed to differences in access, morbidity and pain scores. Pain scores, functional status and English language skills influenced satisfaction. Culturally sensitive hospital- and community-based clinicians are important to promote better services, after-hours care, referral and triage. It is essential to have appropriate policy and legislation, adequate infrastructure and resources, good communication strategies, telecommunication technology, explicit evidence-based protocols for shared care, referral and triage and ongoing training and support for clinicians and consumers.
The aim of this study was to compare the proteome composition of gingival crevicular fluid obtain... more The aim of this study was to compare the proteome composition of gingival crevicular fluid obtained from healthy periodontium, gingivitis and chronic periodontitis affected sites. Owing to its site-specific nature, gingival crevicular fluid is ideal for studying biological processes that occur during periodontal health and disease progression. However, few studies have been conducted into the gingival crevicular fluid proteome due to the small volumes obtained. Fifteen males were chosen for each of three different groups, healthy periodontium, gingivitis and chronic periodontitis. They were categorized based on clinical measurements including probing depth, bleeding on probing, plaque index, radiographic bone level, modified gingival index and smoking status. Gingival crevicular fluid was collected from each patient, pooled into healthy, gingivitis and chronic periodontitis groups and their proteome analyzed by gel electrophoresis and liquid chromatography electrospray ionization ion trap tandem mass spectrometry. One hundred and twenty-one proteins in total were identified, and two-thirds of these were identified in all three conditions. Forty-two proteins were considered to have changed in abundance. Of note, cystatin B and cystatin S decreased in abundance from health to gingivitis and further in chronic periodontitis. Complement proteins demonstrated an increase from health to gingivitis followed by a decrease in chronic periodontitis. Immunoglobulins, keratin proteins, fibronectin, lactotransferrin precursor, 14-3-3 protein zeta/delta, neutrophil defensin 3 and alpha-actinin exhibited fluctuations in levels. The gingival crevicular fluid proteome in each clinical condition was different and its analysis may assist us in understanding periodontal pathogenesis.
To investigate differences in the characteristics of general practitioners (GPs) and patients, re... more To investigate differences in the characteristics of general practitioners (GPs) and patients, referral rates, rates of prescribing and ordering of tests and x-rays, and types of counselling and consultation, between private and community health centre (CHC) GPs in Victoria. All 51 full-time Victorian CHC GPs were invited to enrol in the Australian Morbidity and Treatment Survey (AMTS) developed by the Family Medicine Research Unit at the University of Sydney in 1992. The control group comprised the 114 Victorian GPs involved in this survey in 1991. Thirty-nine CHC GPs (76%) provided complete data. CHC GPs were more likely to be younger, female, and to have less experience in general practice. Patient age and gender distributions were similar. CHC GPs had higher rates of offering counselling and advice and of referral to allied health professionals, but similar rates of referral to medical specialists to those of private GPs. We found no differences in prescribing after multivariate...
A nested case-control study was undertaken to investigate whether an excess of lympho-haematopoie... more A nested case-control study was undertaken to investigate whether an excess of lympho-haematopoietic cancers in the Australian petroleum industry was associated with benzene exposure. The benzene exposures of the cases and controls were estimated using a quantitative algorithm based largely on exposures measured in the Australian petroleum industry. The algorithm was used to estimate, for each subject, the benzene exposure in parts per million (ppm) for each job held in the industry, and the cumulative exposure in ppm years. Because of the critical importance of the exposure assessment in this design of epidemiological study, particular attention was paid to the reliability of the inputs to the algorithm. The inputs [base estimates (BEs) of exposure and technology-specific exposure modifiers (EMs)] were compared to data from other sources including the occupational hygiene literature. Where such comparison data were available, they were generally found to confirm the values used in the algorithm, although four input values were changed as a result of the validation exercise. The integrity of the task-based algorithm was validated by employing it to calculate the exposures of the tanker drivers in the study and comparing these with measured daily exposure for tanker drivers in the Australian petroleum industry and exposure values found in the occupational hygiene literature. After adjustment for the mix of products carried by the Australian tanker drivers, the estimates from the algorithm were found to be comparable to the measured and literature values. This exercise provided evidence that the exposure assessment for the epidemiological study was reliable and that the results of the study can be used as the basis for evaluating the relationship between exposure to benzene and the risk of lympho-haematopoietic cancer.
The reasons for attendance, presenting health problems, functional status, pain and severity, and... more The reasons for attendance, presenting health problems, functional status, pain and severity, and satisfaction with emergency and primary care were examined using routinely collected data and an interviewer-assisted survey of patients. Patients attended, mostly after hours, because they believed their health problems required hospital-based management. GPs referred for admission and further evaluation. Ethnicity, employment status, gender and age contributed to differences in access, morbidity and pain scores. Pain scores, functional status and English language skills influenced satisfaction. Culturally sensitive hospital- and community-based clinicians are important to promote better services, after-hours care, referral and triage. It is essential to have appropriate policy and legislation, adequate infrastructure and resources, good communication strategies, telecommunication technology, explicit evidence-based protocols for shared care, referral and triage and ongoing training and support for clinicians and consumers.
A total of 1666 patients undergoing isolated coronary artery bypass were studied for the occurren... more A total of 1666 patients undergoing isolated coronary artery bypass were studied for the occurrence of postoperative atrial fibrillation. Possible associations of this arrhythmia with various preoperative, intraoperative, and postoperative factors were studied by univariate (chi 2 and t tests) and multivariate (logistic regression) analyses. The overall incidence of postoperative atrial fibrillation was 28.4%, with the major occurrence 2 days after the operation. Both univariate and multivariate studies indicated the patient's age to be the dominant factor promoting postoperative atrial fibrillation, with an increasing prevalence in older patients (p = 0.0001). Multivariate analysis showed that postoperative beta-blocker therapy conveyed considerable protection against postoperative atrial fibrillation (p = 0.001) but was less effective in the older patients. Men were more prone to this arrhythmia (p = 0.02). Although these associations appeared significant, the logistic model p...
This paper utilises a Poisson frailty regression model with clustering to report on the failure r... more This paper utilises a Poisson frailty regression model with clustering to report on the failure rates of sealants placed and repaired during a three-year follow-up school-based comprehensive preventive programme. The programme included annual application/reapplication of light-cured fissure sealants in 210 12-year-old subjects over three years. Sealants placed at the commencement of each year of the programme were assessed for retention 12 months later and repair/reapplication was undertaken at that time for those surfaces judged to require it. An application of a Poisson regression model with random effects ("frailties") and clustering was used in this paper to allow for heterogeneity between subjects. Whilst it appears that the direct utilization of frailty models in determining fissure sealant failure rates has not been reported, it is clearly an appropriate use of this statistical method. A total of 1,544 sealants were placed during the study period. Of these, 1,038 (6...
Objective: This pilot study was conducted to test the impact on the caries-risk status of impleme... more Objective: This pilot study was conducted to test the impact on the caries-risk status of implementing a Minimal Intervention Dentistry protocol to a group of adolescent public dental patients (13-18 years) at high risk to dental caries. Method: 112 adolescents were recruited through a community dental clinic. Following baseline examinations the participants were randomized to either the Control group (n=56) or Intervention group (n=56). Semi-structured interviews were conducted at baseline, 6- and 12-month visits to obtain information on participants’ dietary and oral health behaviors. For Intervention group +participants, this information was used during the motivational interviews at their 3- and 6-month visits to ascertain what behaviors they were willing to change to improve their oral health status. Agreed changes were documented on an MI Agreement Form, which was then used in the discussion at later visits of whether the agreed self-management behavioral changes had been achi...
ABSTRACT Interest in the association between oral cancer risk and Candida-associated promotion of... more ABSTRACT Interest in the association between oral cancer risk and Candida-associated promotion of mucosal dysplasia continues. However, little is known of the presence and amount of oral yeast in the mouths of healthy patients without mucosal lesions. The purpose of this prospective cross-sectional clinical study was to ascertain the prevalence and degree of carriage of Candida in the oral cavities of a non-cancer population, with reference to a range of parameters affecting the oral environment. Oral rinse samples were collected from a sample of 203 patients attending the Royal Dental Hospital of Melbourne and analysed for the presence and degree of colonisation of yeast species that were phenotypically identified as albicans and non-albicans species. Oral yeast carriage was found in 98/203 patients (48.3%), and of these, 83 (84.7%) patients carried C. albicans. There was no statistical difference in carriage when comparing gender, age, or presence of a removable prosthesis. Both smoking and the presence of active carious lesions were found to be positively correlated with the carriage of oral Candida. Individuals who are current smokers are nearly seven times more likely to have oral Candida, and participants with high candidal colonisation are more likely to be current smokers. Participants with active carious lesions were also more likely to carry oral Candida. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
International journal of oral and maxillofacial surgery, 2005
Little is known regarding disease-specific cumulative survival and factors affecting survival in ... more Little is known regarding disease-specific cumulative survival and factors affecting survival in Australian populations with oral squamous cell carcinoma. Kaplan Meier and Cox proportional hazards models were used to determine survival factors in 116 consecutive patients treated surgically at a single institution. Overall 5-year disease-specific survival rate was 83.3%. Five-year disease-specific survival probability was 88.7%, 83.8%, 83.3% and 76.5% for stage I, II, III and IV, respectively. Univariate analysis revealed that local and regional recurrence, distant metastases, N stage, margin status, radiotherapy, perivascular spread and extra-capsular spread (ECS) significantly influenced survival. Significant multivariate factors included local and regional recurrence, positive margins, and ECS. Better survival rates were found than in previous, older Australian reports. Close observation for early recurrence and aggressive management of patients with recurrence, positive margins a...
To determine the efficacy and effectiveness of a primary preventive dental programme. A field tri... more To determine the efficacy and effectiveness of a primary preventive dental programme. A field trial comparing an intervention and control group over three years. The intervention group received a preventive programme which consisted of a weekly fluoride mouthrinse (0.2% neutral NaF), an annual application, replacement or repair of pit and fissure sealants, and an annual oral hygiene education programme. The control group received the oral hygiene education programme only. Examinations to record dental caries status were conducted annually for both study groups. Five secondary colleges in two non-fluoridated regions of Victoria, Australia. 522 subjects aged 12-13 years and considered at high risk of developing dental caries were recruited for the study; 256 received the preventive programme and 266 acted as controls. Dental caries was diagnosed according to World Health Organization criteria. Subjects in the intervention group who completed the three-year preventive programme (effica...
The aim of this study was to compare the proteome composition of gingival crevicular fluid obtain... more The aim of this study was to compare the proteome composition of gingival crevicular fluid obtained from healthy periodontium, gingivitis and chronic periodontitis affected sites. Owing to its site-specific nature, gingival crevicular fluid is ideal for studying biological processes that occur during periodontal health and disease progression. However, few studies have been conducted into the gingival crevicular fluid proteome due to the small volumes obtained. Fifteen males were chosen for each of three different groups, healthy periodontium, gingivitis and chronic periodontitis. They were categorized based on clinical measurements including probing depth, bleeding on probing, plaque index, radiographic bone level, modified gingival index and smoking status. Gingival crevicular fluid was collected from each patient, pooled into healthy, gingivitis and chronic periodontitis groups and their proteome analyzed by gel electrophoresis and liquid chromatography electrospray ionization ion trap tandem mass spectrometry. One hundred and twenty-one proteins in total were identified, and two-thirds of these were identified in all three conditions. Forty-two proteins were considered to have changed in abundance. Of note, cystatin B and cystatin S decreased in abundance from health to gingivitis and further in chronic periodontitis. Complement proteins demonstrated an increase from health to gingivitis followed by a decrease in chronic periodontitis. Immunoglobulins, keratin proteins, fibronectin, lactotransferrin precursor, 14-3-3 protein zeta/delta, neutrophil defensin 3 and alpha-actinin exhibited fluctuations in levels. The gingival crevicular fluid proteome in each clinical condition was different and its analysis may assist us in understanding periodontal pathogenesis.
Background: This study assesses the long-term cost-effectiveness of this screening protocol from ... more Background: This study assesses the long-term cost-effectiveness of this screening protocol from a healthcare system perspective. Methods: Australians presenting to private oral healthcare practices recruited to the iDENTify study were included as the study population. A Markov model preceded by a decision tree was developed to assess the intervention’s long-term cost-effectiveness when rolled out to all eligible Australians, and measured against ‘no-intervention’ current practice. The model consisted of four health states: normoglycaemia; pre-diabetes; type 2 diabetes and death. Intervention reach of various levels (10%, 20%, 30%, and 40%) were assessed. The model adopted a 30-year lifetime horizon and a 2020 reference year. Costs and benefits were discounted at 5% per annum. Results: If the intervention reached a minimum of 10% of the target population, over the lifetime time horizon, each screened participant would incur a cost of $38,462 and a gain of 10.564 QALYs, compared to $...
The reasons for attendance, presenting health problems, functional status, pain and severity, and... more The reasons for attendance, presenting health problems, functional status, pain and severity, and satisfaction with emergency and primary care were examined using routinely collected data and an interviewer-assisted survey of patients. Patients attended, mostly after hours, because they believed their health problems required hospital-based management. GPs referred for admission and further evaluation. Ethnicity, employment status, gender and age contributed to differences in access, morbidity and pain scores. Pain scores, functional status and English language skills influenced satisfaction. Culturally sensitive hospital- and community-based clinicians are important to promote better services, after-hours care, referral and triage. It is essential to have appropriate policy and legislation, adequate infrastructure and resources, good communication strategies, telecommunication technology, explicit evidence-based protocols for shared care, referral and triage and ongoing training and support for clinicians and consumers.
The aim of this study was to compare the proteome composition of gingival crevicular fluid obtain... more The aim of this study was to compare the proteome composition of gingival crevicular fluid obtained from healthy periodontium, gingivitis and chronic periodontitis affected sites. Owing to its site-specific nature, gingival crevicular fluid is ideal for studying biological processes that occur during periodontal health and disease progression. However, few studies have been conducted into the gingival crevicular fluid proteome due to the small volumes obtained. Fifteen males were chosen for each of three different groups, healthy periodontium, gingivitis and chronic periodontitis. They were categorized based on clinical measurements including probing depth, bleeding on probing, plaque index, radiographic bone level, modified gingival index and smoking status. Gingival crevicular fluid was collected from each patient, pooled into healthy, gingivitis and chronic periodontitis groups and their proteome analyzed by gel electrophoresis and liquid chromatography electrospray ionization ion trap tandem mass spectrometry. One hundred and twenty-one proteins in total were identified, and two-thirds of these were identified in all three conditions. Forty-two proteins were considered to have changed in abundance. Of note, cystatin B and cystatin S decreased in abundance from health to gingivitis and further in chronic periodontitis. Complement proteins demonstrated an increase from health to gingivitis followed by a decrease in chronic periodontitis. Immunoglobulins, keratin proteins, fibronectin, lactotransferrin precursor, 14-3-3 protein zeta/delta, neutrophil defensin 3 and alpha-actinin exhibited fluctuations in levels. The gingival crevicular fluid proteome in each clinical condition was different and its analysis may assist us in understanding periodontal pathogenesis.
To investigate differences in the characteristics of general practitioners (GPs) and patients, re... more To investigate differences in the characteristics of general practitioners (GPs) and patients, referral rates, rates of prescribing and ordering of tests and x-rays, and types of counselling and consultation, between private and community health centre (CHC) GPs in Victoria. All 51 full-time Victorian CHC GPs were invited to enrol in the Australian Morbidity and Treatment Survey (AMTS) developed by the Family Medicine Research Unit at the University of Sydney in 1992. The control group comprised the 114 Victorian GPs involved in this survey in 1991. Thirty-nine CHC GPs (76%) provided complete data. CHC GPs were more likely to be younger, female, and to have less experience in general practice. Patient age and gender distributions were similar. CHC GPs had higher rates of offering counselling and advice and of referral to allied health professionals, but similar rates of referral to medical specialists to those of private GPs. We found no differences in prescribing after multivariate...
A nested case-control study was undertaken to investigate whether an excess of lympho-haematopoie... more A nested case-control study was undertaken to investigate whether an excess of lympho-haematopoietic cancers in the Australian petroleum industry was associated with benzene exposure. The benzene exposures of the cases and controls were estimated using a quantitative algorithm based largely on exposures measured in the Australian petroleum industry. The algorithm was used to estimate, for each subject, the benzene exposure in parts per million (ppm) for each job held in the industry, and the cumulative exposure in ppm years. Because of the critical importance of the exposure assessment in this design of epidemiological study, particular attention was paid to the reliability of the inputs to the algorithm. The inputs [base estimates (BEs) of exposure and technology-specific exposure modifiers (EMs)] were compared to data from other sources including the occupational hygiene literature. Where such comparison data were available, they were generally found to confirm the values used in the algorithm, although four input values were changed as a result of the validation exercise. The integrity of the task-based algorithm was validated by employing it to calculate the exposures of the tanker drivers in the study and comparing these with measured daily exposure for tanker drivers in the Australian petroleum industry and exposure values found in the occupational hygiene literature. After adjustment for the mix of products carried by the Australian tanker drivers, the estimates from the algorithm were found to be comparable to the measured and literature values. This exercise provided evidence that the exposure assessment for the epidemiological study was reliable and that the results of the study can be used as the basis for evaluating the relationship between exposure to benzene and the risk of lympho-haematopoietic cancer.
The reasons for attendance, presenting health problems, functional status, pain and severity, and... more The reasons for attendance, presenting health problems, functional status, pain and severity, and satisfaction with emergency and primary care were examined using routinely collected data and an interviewer-assisted survey of patients. Patients attended, mostly after hours, because they believed their health problems required hospital-based management. GPs referred for admission and further evaluation. Ethnicity, employment status, gender and age contributed to differences in access, morbidity and pain scores. Pain scores, functional status and English language skills influenced satisfaction. Culturally sensitive hospital- and community-based clinicians are important to promote better services, after-hours care, referral and triage. It is essential to have appropriate policy and legislation, adequate infrastructure and resources, good communication strategies, telecommunication technology, explicit evidence-based protocols for shared care, referral and triage and ongoing training and support for clinicians and consumers.
A total of 1666 patients undergoing isolated coronary artery bypass were studied for the occurren... more A total of 1666 patients undergoing isolated coronary artery bypass were studied for the occurrence of postoperative atrial fibrillation. Possible associations of this arrhythmia with various preoperative, intraoperative, and postoperative factors were studied by univariate (chi 2 and t tests) and multivariate (logistic regression) analyses. The overall incidence of postoperative atrial fibrillation was 28.4%, with the major occurrence 2 days after the operation. Both univariate and multivariate studies indicated the patient's age to be the dominant factor promoting postoperative atrial fibrillation, with an increasing prevalence in older patients (p = 0.0001). Multivariate analysis showed that postoperative beta-blocker therapy conveyed considerable protection against postoperative atrial fibrillation (p = 0.001) but was less effective in the older patients. Men were more prone to this arrhythmia (p = 0.02). Although these associations appeared significant, the logistic model p...
This paper utilises a Poisson frailty regression model with clustering to report on the failure r... more This paper utilises a Poisson frailty regression model with clustering to report on the failure rates of sealants placed and repaired during a three-year follow-up school-based comprehensive preventive programme. The programme included annual application/reapplication of light-cured fissure sealants in 210 12-year-old subjects over three years. Sealants placed at the commencement of each year of the programme were assessed for retention 12 months later and repair/reapplication was undertaken at that time for those surfaces judged to require it. An application of a Poisson regression model with random effects ("frailties") and clustering was used in this paper to allow for heterogeneity between subjects. Whilst it appears that the direct utilization of frailty models in determining fissure sealant failure rates has not been reported, it is clearly an appropriate use of this statistical method. A total of 1,544 sealants were placed during the study period. Of these, 1,038 (6...
Objective: This pilot study was conducted to test the impact on the caries-risk status of impleme... more Objective: This pilot study was conducted to test the impact on the caries-risk status of implementing a Minimal Intervention Dentistry protocol to a group of adolescent public dental patients (13-18 years) at high risk to dental caries. Method: 112 adolescents were recruited through a community dental clinic. Following baseline examinations the participants were randomized to either the Control group (n=56) or Intervention group (n=56). Semi-structured interviews were conducted at baseline, 6- and 12-month visits to obtain information on participants’ dietary and oral health behaviors. For Intervention group +participants, this information was used during the motivational interviews at their 3- and 6-month visits to ascertain what behaviors they were willing to change to improve their oral health status. Agreed changes were documented on an MI Agreement Form, which was then used in the discussion at later visits of whether the agreed self-management behavioral changes had been achi...
ABSTRACT Interest in the association between oral cancer risk and Candida-associated promotion of... more ABSTRACT Interest in the association between oral cancer risk and Candida-associated promotion of mucosal dysplasia continues. However, little is known of the presence and amount of oral yeast in the mouths of healthy patients without mucosal lesions. The purpose of this prospective cross-sectional clinical study was to ascertain the prevalence and degree of carriage of Candida in the oral cavities of a non-cancer population, with reference to a range of parameters affecting the oral environment. Oral rinse samples were collected from a sample of 203 patients attending the Royal Dental Hospital of Melbourne and analysed for the presence and degree of colonisation of yeast species that were phenotypically identified as albicans and non-albicans species. Oral yeast carriage was found in 98/203 patients (48.3%), and of these, 83 (84.7%) patients carried C. albicans. There was no statistical difference in carriage when comparing gender, age, or presence of a removable prosthesis. Both smoking and the presence of active carious lesions were found to be positively correlated with the carriage of oral Candida. Individuals who are current smokers are nearly seven times more likely to have oral Candida, and participants with high candidal colonisation are more likely to be current smokers. Participants with active carious lesions were also more likely to carry oral Candida. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
International journal of oral and maxillofacial surgery, 2005
Little is known regarding disease-specific cumulative survival and factors affecting survival in ... more Little is known regarding disease-specific cumulative survival and factors affecting survival in Australian populations with oral squamous cell carcinoma. Kaplan Meier and Cox proportional hazards models were used to determine survival factors in 116 consecutive patients treated surgically at a single institution. Overall 5-year disease-specific survival rate was 83.3%. Five-year disease-specific survival probability was 88.7%, 83.8%, 83.3% and 76.5% for stage I, II, III and IV, respectively. Univariate analysis revealed that local and regional recurrence, distant metastases, N stage, margin status, radiotherapy, perivascular spread and extra-capsular spread (ECS) significantly influenced survival. Significant multivariate factors included local and regional recurrence, positive margins, and ECS. Better survival rates were found than in previous, older Australian reports. Close observation for early recurrence and aggressive management of patients with recurrence, positive margins a...
To determine the efficacy and effectiveness of a primary preventive dental programme. A field tri... more To determine the efficacy and effectiveness of a primary preventive dental programme. A field trial comparing an intervention and control group over three years. The intervention group received a preventive programme which consisted of a weekly fluoride mouthrinse (0.2% neutral NaF), an annual application, replacement or repair of pit and fissure sealants, and an annual oral hygiene education programme. The control group received the oral hygiene education programme only. Examinations to record dental caries status were conducted annually for both study groups. Five secondary colleges in two non-fluoridated regions of Victoria, Australia. 522 subjects aged 12-13 years and considered at high risk of developing dental caries were recruited for the study; 256 received the preventive programme and 266 acted as controls. Dental caries was diagnosed according to World Health Organization criteria. Subjects in the intervention group who completed the three-year preventive programme (effica...
The aim of this study was to compare the proteome composition of gingival crevicular fluid obtain... more The aim of this study was to compare the proteome composition of gingival crevicular fluid obtained from healthy periodontium, gingivitis and chronic periodontitis affected sites. Owing to its site-specific nature, gingival crevicular fluid is ideal for studying biological processes that occur during periodontal health and disease progression. However, few studies have been conducted into the gingival crevicular fluid proteome due to the small volumes obtained. Fifteen males were chosen for each of three different groups, healthy periodontium, gingivitis and chronic periodontitis. They were categorized based on clinical measurements including probing depth, bleeding on probing, plaque index, radiographic bone level, modified gingival index and smoking status. Gingival crevicular fluid was collected from each patient, pooled into healthy, gingivitis and chronic periodontitis groups and their proteome analyzed by gel electrophoresis and liquid chromatography electrospray ionization ion trap tandem mass spectrometry. One hundred and twenty-one proteins in total were identified, and two-thirds of these were identified in all three conditions. Forty-two proteins were considered to have changed in abundance. Of note, cystatin B and cystatin S decreased in abundance from health to gingivitis and further in chronic periodontitis. Complement proteins demonstrated an increase from health to gingivitis followed by a decrease in chronic periodontitis. Immunoglobulins, keratin proteins, fibronectin, lactotransferrin precursor, 14-3-3 protein zeta/delta, neutrophil defensin 3 and alpha-actinin exhibited fluctuations in levels. The gingival crevicular fluid proteome in each clinical condition was different and its analysis may assist us in understanding periodontal pathogenesis.
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Papers by Geoffrey Adams