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[Determination of the changes in the quantity, pH, protein and erythrocytes of gingival fluid in students with dental-jaw deformities and chronic catarrhal gingivitis after hygienic-therapeutic course with the toothpaste Propodent].

The changes in the quantity, pH, protein and erythrocytes were studied in the gingival fluid of students with chronic catarrhal gingivitis and impaired oral hygiene due to dental-jaw deformities (DJD) after a 5-week hygienic-therapeutic course with the toothpaste "Propodent". The data about the indices studied in the experimental group--24 children and juveniles with DJD and chronica catarrhal gingivitis, aged from 8 to 16, were compared with the values of the indices studied in the control group of 10 children and juveniles without DJD and with clinically health periodontium of the same age. The comparison between the mean values of the quantity gingival fluid, pH, protein and erythrocytes of the experimental group, before and after the treatment, revealed: 78.6% reduction of the quantity of gingival fluid, 3.8% increase of pH, 93.74% reduction of protein and 95.98% reduction of erythrocytes. In this way, the indices studied in the experimental group after the treatment did not differ with statistical significance from those of the healthy children. The methods for determination of the quantity, pH, protein and erythrocytes, proposed by T. Dzemileva and P. Nenov, objectivized the clinically observed favourable changes in gingiva as a result from the hygienic-therapeutic course in the students with DJD and chronic catarrhal gingivitis.

Adolescent↗

The effect of dentifrices containing Triclosan on the development of gingivitis in a 21-day experimental gingivitis study.

The aim of this study was to investigate the ability of Triclosan dentifrices to delay the development of gingivitis during a 21-day period without toothbrushing. Test pastes contained 0.3 per cent Triclosan; seven also contained 0.75 per cent zinc citrate; one other contained 2 per cent Gantrez. Plaque and gingivitis increased significantly (p < 0.001) between day 0 and day 21 in the control group. there was no evidence to reject the assumption of similar efficacy across the seven Triclosan/zinc citrate variants. For the combined Triclosan/zinc citrate groups, statistically significant reductions in plaque formation and in gingivitis relative to the control were recorded. Reductions in plaque and gingival bleeding compared to control for the Triclosan/Gantrez group were not statistically significant, although reductions in gingival indices were. The greater reduction in the Gingival Index of the Triclosan/zinc citrate group was also statistically significantly different from that of the Triclosan/Gantrez group, suggesting that a dentifrice containing the former would have a greater antigingivitis potential than a dentifrice containing the latter.

Adult↗

Associations between volume and flow rate of gingival crevicular fluid and clinical assessments of gingival inflammation in a population of British male adolescents.

Gingival crevicular fluid (GCF) sampling was performed on 2 occasions separated by 1 year, at 2 sites in the mouths of 102 male adolescents, mean age 17.85 years. Samples were collected onto 5 filter paper strips which were sequentially applied to the mouth of the crevice over a 9-min collection period. Volume and flow rates of GCF were determined for each site and were compared with clinical measurements of plaque, gingival colour, bleeding, gingival index (GI) and pocket depth, using a general linear models (GLM) procedure. While the initial volume of GCF showed no association with any clinical measurement, there was an association between flow rate of GCF and gingival colour. The volume of GCF collected in the final, 5th sample was associated with the GI. The sample site strongly influenced all measures of GCF volume. It is proposed that the flow rate of GCF may be a better indicator of gingival inflammation than the more imprecise clinical assessments of inflammation, since GCF flow rates more precisely reflect changes in tissue permeability. The association between the final sample, collected after 9 min, and clinical measurements, was probably a reflection of the association between clinically-detectable inflammation and the susceptibility of the site to mild irritation.

Adolescent↗

A clinical study of plasminogen activator activity in gingival tissue in dogs with gingivitis and periodontitis.

The aim of the present study was to evaluate plasminogen activator activity (PAA), tissue-type plasminogen activator (t-PA) antigen level and plasminogen activator inhibitor-1 (PAI-1) antigen in normal canine gingival tissue samples, gingivitis as well as in different stages of periodontal disease. Gingival tissue from 141 adult dogs were analysed spectrophotometrically in order to determine PAA. The tissues were also examined histopathologically. The Sulcus Bleeding Index was used to evaluate the active and inactive phase of periodontal disease. T-PA antigen as well as PAI-1 antigen level was measured by ELISA. There was a significant increase of PAA and t-PA antigen in samples from inflamed gingival tissue compared with normal gingival tissue, while PAI-1 antigen was not detected in either normal or inflamed gingiva. As the severity of periodontal disease was increasing, PAA and t-PA antigen values were significantly higher in periodontitis tissue sample groups, according to the pattern: gingivitis moderate bleeding>slight bleeding, P<0.001). In conclusion, this study indicates that PAA and t-PA antigen level may be used to evaluate the evolution of periodontal disease in dog.

Animals↗

Smoking cessation increases gingival blood flow and gingival crevicular fluid.

OBJECTIVES: The purpose of the present study was to determine the effect of smoking cessation on gingival blood flow (GBF) and gingival crevicular fluid (GCF). MATERIAL AND METHODS: Sixteen male smokers (aged 22-39 (25.3+/-4.0) years), with no clinical signs of periodontal and systemic diseases, were recruited. The experiment was performed before (baseline) and at 1, 3 and 5 days, and at 1, 2, 4 and 8 weeks after smoking cessation. The status of smoking and smoking cessation was verified by exhaled carbon monoxide (CO) concentration, and by serum nicotine and cotinine concentrations. A laser Doppler flowmeter was used to record relative blood flow continuously, on three gingival sites of the left maxillary central incisor (mid-labial aspect of the gingival margin and bilateral interdental papillae). The GCF was collected at the mesio- and disto-labial aspects of the left maxillary central incisor and the volume was calculated by the Periotron 6000(R) system. The same measurements except for the GBF were performed on 11 non-smoking controls (four females and seven males), aged 23-27 (24.4+/-1.2) years. RESULTS: Eleven of 16 smokers successfully completed smoking cessation for 8 weeks. At 1 day after smoking cessation, there was a significantly lower CO concentration than at baseline (p<0.01). Also, nicotine and cotinine concentrations markedly decreased at the second measurement. The GBF rate of smokers was significantly higher at 3 days after smoking cessation compared to the baseline (p<0.01). While the GCF volume was significantly increased at 5 days after smoking cessation compared to the baseline (p<0.01), it was significantly lower than that of non-smokers until 2 weeks after smoking cessation (p<0.01). CONCLUSION: The results show that the gingival microcirculation recovers to normal in the early stages of smoking cessation, which could activate the gingival tissues metabolism/remodeling, and contribute to periodontal health.

Adult↗

Analysis of proliferative activity in oral gingival epithelium in immunosuppressive medication induced gingival overgrowth.

BACKGROUND: Drug-induced gingival overgrowth is a frequent adverse effect associated principally with administration of the immunosuppressive drug cyclosporin A and also certain antiepileptic and antihypertensive drugs. It is characterized by a marked increase in the thickness of the epithelial layer and accumulation of excessive amounts of connective tissue. The mechanism by which the drugs cause gingival overgrowth is not yet understood. The purpose of this study was to compare proliferative activity of normal human gingiva and in cyclosporine A-induced gingival overgrowth. METHODS: Gingival samples were collected from 12 generally healthy individuals and 22 Cyclosporin A-medicated renal transplant recipients. Expression of proliferating cell nuclear antigen was evaluated in formalin-fixed, paraffin-embedded gingival samples using an immunoperoxidase technique and a monoclonal antibody for this antigen. RESULTS: There were differences between the Cyclosporin A group and control group in regard to proliferating cell nuclear antigen and epithelial thickness. In addition, the degree of stromal inflammation was higher in the Cyclosporin A group when compared with the control group. CONCLUSION: The results suggest that the increased epithelial thickness observed in Cyclosporin A-induced gingival overgrowth is associated with increased proliferative activity in keratinocytes.

Adult↗

Application of BANA during experimental gingivitis. Application of N-alpha-benzoyl-DL-arginine 2 naphtilamide (BANA) hydrolysis to identify periodontopathic environments during experimental gingivitis in man.

This study evaluates the accuracy of the PerioScan reagent card kit which uses BANA hydrolization to detect the presence of P. gingivalis, T. denticola, and B. forsythus in dental plaque during an experimental gingivitis in man. 32 healthy subjects underwent a phase of optimal oral hygiene before they abolished all oral hygiene practices for 21 days, but rinsed twice daily with a slurry of three different toothpastes. On days 0, 7, 14, and 21, full mouth Plaque and Gingival Index scores were assessed and, in addition, on days 0 and 21, sulcular plaque samples were obtained from the mesiobuccal aspects of the second premolars. The samples were placed on BANA reagent cards (PerioScan), and the result of the trypsin-like activity read after 15 minutes. Subsequently, the samples were processed for the detection of P. gingivalis, T. denticola and B. forsythus using ELISA. The Gingival Indices on day 21 indicated a development towards gingival inflammation. The frequencies of detection of the three periodontopathogens revealed by ELISA showed increased presence of P. gingivalis, B. forsythus and T. denticola on day 21. Changes in the composition of the microbiota were also indicated by the higher rate of positive BANA results at the end of the experimental gingivitis. Without considering further clinical diagnostic tests such as "bleeding on probing", this clinically simple test does not provide a prognostic indicator for the eventual onset of disease in cases with gingival inflammation. However, specificity was only 61% and the sensitivity was 41.7%.

Adult↗

Streptococcal gingivitis: a report of case with a description of a unique gingival prosthesis.

Acute streptococcal gingivitis is an acute inflammation of the oral mucosa. Specific bacterial infections of the gingiva may be due to neisseria gonorrhea, treponema pallidum, streptococci, and other organisms. Streptococcal infections are seen rarely. This case report describes a patient who presented with severe gingival inflammation and pain that was diagnosed as an acute streptococcal infection. Bacterial cultures were obtained from the lesion, and biopsies were obtained from the gingiva of lower incisors for histopathologic evaluation. The patient was successfully treated using conventional periodontal therapy (scaling, root planning, curettage) and antibacterial agents. The reconstructive phase for this patient consisted of the fabrication of a heat-cured acrylic gingival facade to mask the gingival recession. The treatment of acute gingivostomatitis is of importance because of the possibility of systemic secondary infections. When esthetics is important, a gingival prostheses can be considered. The differential diagnosis, etiology, and treatment of acute streptococcal gingivitis are discussed and the literature is reviewed in this report.

Gingivitis↗

The ability of gingival crevicular fluid acute phase proteins to distinguish healthy, gingivitis and periodontitis sites.

3 acute phase proteins, from the local gingival inflammatory response, were examined for their ability to distinguish healthy, gingivitis and periodontitis sites. Indirect competitive immunoassays were developed for the quantification of alpha 2-macroglobulin (alpha 2-M) and transferrin (TF), and for alpha 1-antitrypsin (alpha 1-AT), a double antibody sandwich assay was produced. Healthy (25), gingivitis (31) and periodontitis (28) sites were sampled with filter paper strips (2 x 13 mm) and the volume assessed with the Periotron 6000. The samples were eluted in phosphate-buffered saline and analyzed for alpha 2-M, alpha 1-AT and TF. The results were expressed as absolute amounts per sample (ng/30 s) and on a concentration basis (ng/microliter of GCF). Higher GCF absolute amounts of alpha 2-M, alpha 1-AT and TF were consistently obtained from diseased (gingivitis and periodontitis) sites than healthy sites (p less than 0.005). Absolute amounts of GCF alpha 2-M, alpha 1-AT and TF were increased in periodontitis sites over gingivitis sites, although these differences were not statistically significant (p greater than 0.1). When the results were expressed on a concentration basis, alpha 2-M levels from diseased sites were significantly higher than healthy sites (p less than 0.01). In addition, GCF TF concentration was increased in periodontitis compared to healthy sites (p = 0.03).

Enzyme-Linked Immunosorbent Assay↗

Comparison of gingival and peripheral blood T cells among patients with periodontitis suggests skewing of the gingival T cell antigen receptor V beta repertoire.

The present study investigated the expression of different variable regions of T cell receptor beta-chain (V beta) among functional subsets of T cells, i.e. CD45RO+ (activated/memory), CD4+ and CD8+ in gingiva and peripheral blood of patients with periodontitis. Gingival tissue specimens (n = 25) and peripheral blood were procured from 18 patients with periodontitis during periodontal surgery or extraction. Single-cell suspensions of gingival tissues were made by enzymatic digestion. These cells were immunofluorescently labeled with a panel of monoclonal antibodies specific for 18 TCR V beta regions, in concert with markers for various T cell subsets. The cells were then analyzed with 3-color multivariate flow cytometry. Results demonstrated that a significantly higher proportion of T cells in gingiva expressed V beta 5.2 (0.0005), V beta 6 (0.0007) and V beta 9 (0.003) regions compared to those in peripheral blood. Comparison of CD45RO+ (activated/memory) and CD45RO- (naïve) subsets of gingival T cells revealed differences in the expression of TCR V beta regions. V beta 5.2 expression was significantly higher among CD45RO+ gingival T cells (p = 0.004), whereas V beta 14 expression was elevated among the CD45RO- subset relative to peripheral blood (p = 0.008). Analysis of TCR V beta region expression among CD4+ and CD8+ subsets did not reveal any statistically significant differences between gingiva and peripheral blood, although some V beta regions approached significance. Collectively, these results demonstrate that the T cell repertoire in the gingival compartment differs significantly from that in the peripheral blood. Furthermore, since the skewing of TCR V beta was observed among naïve, as well as activated/memory T cells, it is likely that both developmental and environmental factors are influential in shaping the gingival TCR repertoire in patients with periodontitis. Elucidation of the cause of the skewed expression of T cell receptors in gingiva can provide insights into the specificity of T cells in periodontitis.

Adult↗

Bioassay of interleukin 1 (IL-1) in human gingival crevicular fluid during experimental gingivitis.

The cytokine IL-1 was demonstrated in crevicular fluid during a 14- and 21-day experimental gingivitis in healthy human volunteers. A sensitive and specific bioassay allowed detection of biologically active IL-1 at levels ranging from 0.18 ng/microliters at baseline to 1.70 ng/microliters in inflamed gingiva. Levels of IL-1 increased rapidly with plaque accumulation and in advance of the subsequent gingival inflammation, peaking within 7 days of the start of gingivitis. As changes in IL-1 were detected before clinically recognizable gingival changes, IL-1 may have potential as an early marker of gingival inflammatory changes.

Adult↗

Cyclosporin-induced gingival overgrowth: correlation with dental plaque scores, gingivitis scores, and cyclosporin levels in serum and saliva.

Gingival overgrowth, dental plaque, and gingivitis were assessed by means of standardized semiquantitative indices in thirty renal transplant patients undergoing immunosuppression with cyclosporin-A (Cy-A). Radioimmunoassay techniques were used to determine Cy-A in serum samples and in parotid, submandibular, and whole saliva samples from each patient. A significant positive correlation was found between gingival overgrowth scores and both dental plaque and gingivitis scores. A significant positive correlation was found between whole-saliva Cy-A and both plaque and gingival overgrowth scores. No such correlation was found when parotid Cy-A or submandibular Cy-A was considered. This was attributed to differences in saliva-collection methods, and a possible role of dental plaque as a local reservoir of Cy-A is proposed.

Adult↗

Expression of growth factors in the gingival crevice fluid of patients with phenytoin-induced gingival enlargement.

The mechanism underlying phenytoin (PHT)-induced gingival enlargement (GE) is not yet known. The aim of the present study was to investigate transforming growth factor-beta1 (TGF-beta1), platelet-derived growth factor-BB (PDGF-BB) and basic fibroblast growth factor (bFGF) profiles in the gingival crevice fluid (GCF) of patients with PHT-induced GE and to compare the results with healthy controls. Five PHT-treated patients and five healthy subjects with normal periodontal tissue were included in this study. GCF samples were collected from (i) enlarged gingival sites in patients receiving PHT (GE+); (ii) non-enlarged gingival sites in the same patients (GE-); (iii) normal gingival sites of healthy subjects (control). The levels of TGF-beta1, PDGF-BB and bFGF in the GCF samples were analysed by ELISA. The results showed that the total amounts of TGF-beta1 and PDGF-BB in the GE+ group were higher than in the GE- group and significantly higher than in the control group (P < 0.05). However, no significant differences were found between the groups when the concentrations of these growth factors were compared. bFGF levels were not compared as this growth factor could be detected in only 33, 41 and 44% of the GE+, GE- and control GCF samples, respectively. These results show that TGF-beta1 and PDGF-BB are readily detectable in GCF obtained from enlarged and non-enlarged sites of PHT recipients and suggest that since the amounts were markedly higher at the GE+ than the GE- sites, the systemic administration of PHT has a pronounced localised effect on the levels of these growth factors. Moreover, our findings provide evidence that both TGF-beta1 and PDGF-BB are closely associated with the clinical manifestation of PHT-induced GE.

Adolescent↗

Effect of smoking on gingival crevicular fluid cytokine profile during experimental gingivitis.

BACKGROUND: Cigarette smoking is a significant risk factor in the pathogenesis of periodontal disease, able to influence both the subgingival microbiota and host responses. AIM: The aim of the present study was to determine the influence of smoking on the amount of IL-1beta, IL-4 and IL-8 in gingival crevicular fluid (GCF) during experimental gingivitis in humans. MATERIAL AND METHODS: Twenty-two healthy subjects, 10 smokers and 12 non-smokers, participated in the study. After professional cleaning, they performed optimal hygiene to reach perfect clinical gingival health. Oral hygiene measures were ceased for a period of 10 days. Clinical indices, including plaque index (PI), gingival index (GI), probing pocket depth (PPD) and bleeding on probing (BOP), were assessed 2 days before (day -2), at the beginning (day 0) and at the end of the experimental gingivitis period (day 10). At the same time, GCF was collected from 12 sites in each patient, by means of durapore filter membranes. Total amounts of IL-1beta, IL-4 and IL-8 were determined by enzyme-linked immunoadsorbent assay. RESULTS: Clinical data revealed that both smokers and non-smokers showed an increase in PI, GI and BOP scores during the experiment. Although no differences were noted with regard to PI at day 10, the GI and BOP were significantly less pronounced in smokers than non-smokers (p < 0.005). Non-smokers showed higher total amounts of IL-4 but lower amounts of IL-8 than smokers, throughout the experiment. Total amounts of IL-1beta and IL-8 increased significantly during plaque accumulation in both groups. IL-4 remained stable for the smoker group and decreased for the non-smoker group. CONCLUSIONS: The present results indicate that smoking interferes with cytokine production. When performing studies regarding the pathogenesis of periodontitis, the smoking status of the participants needs to be taken into consideration.

Adult↗

Correlation analysis for clinical and gingival crevicular fluid parameters at anatomically related gingival sites.

This study was designed to evaluate the relationship of certain clinical and biochemical measures of periodontal pathology at anatomically related gingival sites. The maxillary first molar--second bicuspid region was studied in patients with gingivitis and periodontitis. The mesiobuccal site on the first molar was compared to the mesiopalatal and direct buccal sites on the molar and the distobuccal site on the second bicuspid. Probing depth, attachment level, gingival index, gingival crevicular fluid (GCF) volume, and GCF levels of the lysosomal enzyme B-glucuronidase (BG), the cytoplasmic enzyme lactate dehydrogenase, IgG and the protease-inhibitor alpha-2-macroglobulin were studied. For the 3 anatomical pairs that were analyzed, the correlation coefficients for the GCF constituents were generally higher than the correlations for the clinical parameters. The mean correlations for the GCF constituents were higher for the periodontitis patients as compared to the gingivitis patients. For the periodontitis patients, BG activity was correlated at adjacent proximal sites, approached significance at adjacent papillary sites, but was not significantly correlated at adjacent facial-proximal sites. This data suggests that sampling of BG activity from a mesiobuccal site provides information about the anterior papillary unit. In contrast, IgG in GCF collected from the mesiobuccal site on the first molar was significantly correlated with the total IgG in the 3 other sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Site-specific alkaline phosphatase levels in gingival crevicular fluid in health and gingivitis: cross-sectional studies.

Using a recently developed chemiluminescent assay enabling alkaline phosphatase (ALP) quantification in nanolitre volumes of gingival crevicular fluid (GCF), we have investigated GCF ALP levels in health and in the presence of gingivitis. In gingival health, there was a site-specific pattern of ALP concentration with higher enzyme concentrations around the upper and lower anterior teeth. Furthermore, clinically normal sites that had been subjected to different levels of plaque control produced significantly different ALP levels, (p < 0.03). This indicates that biochemical components of GCF may be used to measure subclinical inflammatory status. The ratio of GCF to serum ALP varied from 6:1 to 11:1, suggesting that a major source of the enzyme is through local production. The main cross-sectional study of 30 patients with gingivitis (276 sites) demonstrated that total GCF ALP levels, collected over a 30-s sampling time were higher for a gingival index of 1 than of 0 (p < 0.014). There was no significant relationship between total GCF ALP and plaque levels of the enzyme, and analysis of plaque within the study group demonstrated very low levels of ALP, indicating that the enzyme is likely to be largely derived from the periodontal tissues. The ratio of GCF ALP levels to those of saliva within individuals was 530:1, thereby eliminating saliva contamination as a risk, when total GCF ALP is being measured.

Adult↗

Cathepsins B, H and L activities in gingival crevicular fluid from chronic adult periodontitis patients and experimental gingivitis subjects.

To clarify roles of lysosomal cysteine proteinases cathepsins B, H and L in pathological destructive process of periodontal tissues, levels of their enzymatic activities were determined in gingival crevicular fluid (GCF) from chronic adult periodontitis patients and from experimental gingivitis subjects. In periodontitis patients, higher levels of cathepsins B, H and L activities were found at sites with more serious signs of the disease activity. The total activity of each enzyme (per unit time) was positively correlated with the GCF volume. However, it had little or no correlation with the probing depth (PD). In contrast, the specific activity of each enzyme in GCF (activity units per mg protein), which reflects the selectivity of enzyme exudation, was negatively correlated with the GCF volume. These results suggest that the cysteine proteinases are selectively released into gingival crevices at a relatively mild stage of periodontitis. In experimental gingivitis subjects, no significant activity of each enzyme was detected in GCF, even when the quantity of GCF was comparable to that from periodontitis patients. These data suggest that no significant amounts of these enzymes are released at experimental gingivitis sites or that a homeostatic mechanism, including regulation by protease inhibitors, may control activities of these enzymes in GCF with acute inflammation.

Adult↗