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PubMed1981

Melanin pigmentation and inflammation in human gingiva.

The study was carried out to determine the distribution of melanin granules in different anatomical areas of the gingiva and to relate the density of melanin granules to the degree of gingival inflammation. Specimens including free and part of the attached gingiva were secured from the vestibular surfaces of the six maxillary or mandibular teeth of 21 Caucasian subjects during periodontal surgery. Serial histologic sections 5 to 6 mu thick were prepared and stained with Hematoxylin and Eosin or Masson-Fontana. Evaluation of the H & E stained sections disclosed that the number of melanophores and melanin granules in the epithelium and the inflammatory cells of the subepithelial connective tissue gradually decreased from the free gingival groove area to the free gingival crest and from the free gingival groove to the mucogingival junction. The density of melanophores in the vestibular epithelium showed a significant positive correlation (r = 0.38, P less than 0.00003) with the severity of inflammation (numbers of inflammatory cells) in the attached gingiva but not in the free gingiva (r = -0.033, P less than 0.2643). There was a positive significant correlation between the density of melanin granules of the vestibular epithelium and that of the adjacent connective tissue in both the free (r = 0.57, P less than 0.0003) and attached gingiva (r = 0.46, P less than 0.0003).

Adult↗
PubMed1989

Computer-based thermal imaging of human gingiva: preliminary investigation.

Computer-based thermal imaging techniques were used to compare the rewarming rates of normal and inflamed human gingiva following cooling. A Modified Gingival Index (MGI) score, gingival crevicular fluid (GCF) measurement, and clinical photograph were obtained from a maxillary or mandibular anterior facial region in 20 subjects, aged 25 to 44. Baseline thermograms of the marginal/papillary (M/P) and adjacent attached gingiva (AG) were recorded following an acclimatization period with the patient seated and chin resting on a positioning apparatus. The tissue was then cooled with a gentle stream of air and thermograms were recorded at 10 second intervals for 3 minutes as the tissue rewarmed. Rewarming slopes were calculated based on these thermograms. Correlation coefficients were calculated for MGI with GCF, as well as for both MGI and GCF with AG and M/P rewarming slopes. Mean baseline (SE) temperatures (degrees F) for AG were 75.9 (0.9), 78.0 (0.6), and 80.3 (1.3) for normal, mildly inflamed, and moderately-severely inflamed gingivae, respectively; corresponding mean (SE) temperature differences (degrees F) between AG and M/P were 0.5 (0.2), 0.9 (0.2), and 1.4 (0.3). Intragroup mean M/P temperatures were less than mean AG temperatures, with the mean regional differences increasing with greater severity of inflammation. Rewarming rates also increased as inflammation became more severe, with the rewarming slopes of both the AG and M/P having statistically significant correlations with the MGI and the GCF. The correlation between MGI and GCF was also statistically significant. This study suggests that computer-based thermal imaging techniques can detect both static and dynamic temperature differences between normal gingiva and gingivae with increasing severities of inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Hydroxyproline and total protein levels in gingiva and gingival crevicular fluid in patients with juvenile, rapidly progressive, and adult periodontitis.

The aim of this study was to compare hydroxyproline (Hyp) and total protein levels both in the gingiva and gingival crevicular fluid (GCF) from juvenile (JP), rapidly progressive (RPP), and adult periodontitis (AP) patients and periodontally healthy controls (C). A total of 60 individuals, 15 from each group, were studied. GCF was obtained before gingival sampling. Clinical measurements were recorded. The gingival samples were harvested by full thickness flap operation from patients and immediately after the extraction of the teeth for orthodontic reasons from controls. The samples were analyzed biochemically. GCF Hyp levels were significantly higher in the AP group than those of the RPP and C groups. The strong positive correlations between gingival and GCF Hyp levels were determined in the disease groups. Total protein levels in both the gingiva and GCF were significantly higher in disease groups. However, the differences between the disease groups were not statistically significant. Correlations between the clinical parameters and Hyp levels in gingiva and GCF were determined. The findings indicate the Hyp and total protein levels both in the gingiva and GCF appeared to be increased in the disease groups. These findings suggest that both the synthesis and degradation of collagen and total protein are elevated in periodontal disease. However, our findings do not support the concept that measurement of either Hyp or total protein levels in gingiva or GCF is a suitable or reliable criterion in determination of disease activity.

Adolescent↗
PubMed1999

Increasing the amount of attached gingiva using a modified apically repositioned flap.

The purpose of this study is to describe a modification in the apically repositioned flap technique. Unlike the original technique, this technique preserves the marginal gingiva thus avoiding the risk of recession. It is recommended in cases where an increase in attached gingiva is desired. This study reports on the results of 54 single buccal areas consecutively treated in 38 healthy patients. The increase in the amount of attached gingiva, the impact on marginal tissue recession, and the impact on probing depth were analyzed. All 54 areas were evaluated at 8 weeks; 21 areas were analyzed for 24 weeks; and 19 areas for a period of 72 weeks. The final measurements were compared to baseline values. The analysis of variance of measurement (ANOVA) shows a significant increase of keratinized and attached gingiva (P <0.001). There was no statistical change in marginal tissue recession (P = 0.370) or probing depth. The results of this study demonstrate that this modification of the apically repositioned flap is effective and efficient for increasing the height of attached gingiva. This surgical procedure produces minor surgical trauma and does not require palatal donor tissue or membrane placement. It is simpler since it is less time-consuming, requires no suturing, and results in an ideal color match of tissue.

Adolescent↗
PubMed2005

Upregulation of transforming growth factor-beta1 and vascular endothelial growth factor gene and protein expression in cyclosporin-induced overgrown edentulous gingiva in rats.

BACKGROUND: To examine the effects of cyclosporin A (CsA) on the expression of growth factors in induced gingival overgrowth with limited contributing factors arising from local inflammation caused by bacterial plaque, this study of gingival overgrowth was designed on the edentulous ridge of rats. METHODS: After a 3-week healing period following maxillary molar extractions, 16 five-week-old male Sprague-Dawley rats were assigned to CsA and control groups. Animals in the CsA group were fed 30 mg/kg CsA daily, whereas the control rats received a mineral oil vehicle instead. After 4 weeks, all animals were sacrificed, and the morphology of edentulous ridges was recorded by dental impression. The gingivae on the left-hand side were dissected and stored for mRNA analysis, whereas the gingivae on the right-hand side were fixed in 4% paraformaldehyde for immunohistochemistry (IHC) analysis of transforming growth factor-beta1 (TGF-beta1), platelet-derived growth factor beta (PDGF-beta), insulin-like growth factor-1 (IGF-1), and vascular endothelial growth factor (VEGF). RESULTS: The edentulous gingivae were enlarged and the body weights were reduced in the CsA-treated animals compared to controls. The mRNA expressions of TGF-beta1, IGF-1, and VEGF were higher in the gingivae of the CsA group than in the control group. In addition, a greater mRNA expression (7.21-fold) of VEGF was demonstrated in the CsA group than in the control group by real-time polymerase chain reaction (PCR). The percentages of cells staining positive for TGF-beta1 and VEGF were significantly greater in the CsA rats than in the control rats. CONCLUSIONS: Greater mRNA expression and positive staining for TGF-beta1 and VEGF were observed in the edentulous gingivae of rats that received CsA. Therefore, CsA may upregulate TGF-beta1 and VEGF gene expression and protein secretion in CsA-induced gingival overgrowth.

Animals↗
PubMed1989

[Establishment of clinically healthy gingiva in Macaca irus].

UNLABELLED: The purpose of this study was to assess the methods of establishing of clinically (experimental) healthy gingiva and to evaluate the status of healthy gingiva in Macaca irus. Three monkeys (2 males and 1 female) were used. After preliminary feeding with hard food for 6 months, plaque control procedures (scrubbing method, modified Stillman method, and flossing) were started. Frequency of plaque removal was three times per week under KETALAR (SANKYO, Co. Tokyo), dissociative anesthesia. We also monitored clinical data. RESULTS: 1. Forty-nine days later, clinically healthy gingiva were achieved. During this period, no side effects and no tolerance occurred using 12.5 mg/kg of KETALAR, and effective time to perform the procedure was 21.8 minutes. 2. Depending on the plaque control procedure, plaque index (P11), gingival index (GI), and probing depth (PD) were reduced (especially in the first week). However, the level of marginal gingiva (LMG) did not change. 3. Initially and throughout the experiment, PII, GI, PD were lower value in lower jaws, but by the end of experiment there were no differences between the two jaws in PII and PD. However, GI was still lower in the lower jaw at this time. There were no differences between the data for the right and left sides of the jaws at any time throughout the experiment. 4. At the end of experiment, the clinically (experimental) healthy gingiva yielded the following data: PII, 1.7 +/- 0.61; GI, 0.1 +/- 0.60; PD, 1.3 +/- 0.53. No individual differences were found in any of the monkeys at the end of experiment.

Animals↗
PubMed2000

[Blood flow in marginal gingiva as measured with laser Doppler flowmetry].

The clinical application of laser Doppler flowmetry (LDF) provides data on the blood flow of marginal gingiva (GBF) at different dental regions. The aim of the present investigation was to study the GBF at different teeth. Ten adult subjects with good oral hygiene were involved in this experiment. In a series of experiments GBF was recorded bilaterally positioned the flow probe on three sites 1 mm above the marginal gingiva of the upper and lower central incisors. In another series of investigations the same technique was used for GBF registrations at six permanent teeth on the right side (11-16; according to FDI notation). The mean blood flow values obtained at 3 different places of marginal gingiva of the front teeth were nearly identical, therefore the data were pooled. The GBF values registered at the six upper right teeth also showed close similarity (p > 0.30). No differences were observed between the mean GBF values at the left and right central incisors (p > 0.80). There was a significant gingival blood flow value elevation at lower incisors as compared to that in the upper jaw (p < 0.05). Our results indicate that there is homogeneous marginal blood perfusion both in the maxillary and mandibula healthy gingiva. However, difference exists in blood supply between the upper and lower jaws in favor of mandibular marginal gingiva.

Adult↗
PubMed2000

[Geometric relationship of axial crown contour and gingiva contour of normal second mandibular premolars].

OBJECTIVE: To investigate the relationship of axial crown contour and surrounding healthy gingiva contour. METHODS: Mandibular second premolars were selected as the object of study. Three cross-sections were made through crown and gingiva of the model tooth. Curve functions of axial buccal crown and gingiva contour of each section were acquired by means of curve fitting, and the angle of emergence profile was calculated, which represents the degree of undercut. RESULTS: There is unique relationship between axial crown and gingiva contour individually. This character of tooth is similar to its contralateral tooth. The emergence profile angles are in the range of 40 degrees-110 degrees, 84.1% of the angles are in range of 70 degrees-110 degrees, 15.9% in 40 degrees-70 degrees, that is to say natural teeth are inclined to be of less undercut. CONCLUSION: The geometric relationship between crown contour and gingiva contour is so characteristic that contralateral tooth should be the only guidance to replace lost tooth.

Adult↗
PubMedDate not supplied

The width of clinically-defined keratinized gingiva in the mixed dentition.

Some authors have noticed a clear decrease of the width of keratinized gingiva when they compared the width over deciduous and newly erupted permanent teeth. The aim of this cross-sectional study was to assess the width of keratinized gingiva over permanent and deciduous teeth present in 6 to 11-year old children in an urban environment. The greatest width of keratinized gingiva was found over deciduous canines and permanent incisors. When comparing the width of keratinized gingiva over deciduous canines and molars and permanent first incisors and first molars, statistically significant differences were found only between 6- and 11-year-old groups. The findings do not seem to support previously published data, but do suggest that periodontal mucogingival surgery is not needed before the patient reaches the adult age, since there is a tendency of an increase of the width of keratinized gingiva.

Age Factors↗
PubMed1991

Histometric analysis of infiltrated connective tissue in bleeding and non-bleeding gingivae after probing.

The present study was carried out to evaluate and compare the volumetric densities of subepithelial infiltrated connective tissue (ICT) geographically in bleeding and non-bleeding gingivae with special reference to comparisons of the relationships with their corresponding stereomicroscopic findings. A total of 51 biopsies (25 bleeding and 26 non-bleeding gingival specimens) was obtained from 33 patients. After stereomicroscopic examinations, tissue sections were obtained with H&E stain. On each section, the density of ICT was calculated by volumetric analysis. The results showed that the volume of ICT in bleeding-gingiva was significantly greater than that in non-bleeding gingiva. However, there was no specific relationship between the ICT of gingiva and the visibility of vasculature by stereomicroscopy. These results suggest that increased infiltrated inflammatory volumes of gingiva may play a role in the presenting of bleeding on clinical probing, but appear not to be related to the visibility of vasculature by stereomicroscopy.

Adult↗
PubMedDate not supplied

A study of discoloration of the gingiva by artificial crowns.

In this study, soft tissue discoloration including the marginal gingiva, gingival papilla, and attached gingiva were evaluated in subjects with artificial crowns and compared to the soft tissue of natural teeth using a spectrophotometer. Gingivae around artificial crowns had a lower value (L*) and chroma (C*ab) than the gingivae surrounding natural teeth. Hue (Hab o) shifts toward red-purple were frequently noted. There was generally a more noticeable color difference (E*ab) in the marginal gingiva and gingival papilla of teeth with crowns than was found in the attached tissue.

Adult↗
PubMed1995

Squamous cell carcinoma of the gingiva. A case series analysis.

Recent studies suggest that patients with carcinoma of the gingiva exhibit demographic features that differ from those of persons with squamous carcinoma at other intraoral sites. In this study, we sought to explore this hypothesis in greater detail. Records from the University of Connecticut Oral Biopsy Service from 1975 through 1992 inclusive were surveyed for cases of oral carcinoma. A total of 577 cases were retrieved and analyzed with respect to prevalence, gender distribution, and age at diagnosis. We found that the gingiva (alveolar ridge included) was the third most common site for oral squamous carcinoma after carcinoma of the floor of the mouth and tongue. Further, the relative proportion of gingival cancer versus carcinoma at other intraoral subsites remained essentially constant throughout the study period. Male-to-female ratios were significantly greater for cancer of the floor of the mouth as compared with both cancer of the tongue and cancer of the gingiva (ridge included). Age was not a significant predictor of oral cancer subsite, and there were no apparent differences between carcinoma of the dentate gingiva and that of the edentulous ridge. Results of this study indicate that gender-specific predilections exist for squamous cell carcinoma at different intraoral subsites. These differences suggest the possibility of different etiologic factors and pathogenetic mechanisms involved in carcinoma of the gingiva compared with surface carcinoma at other intraoral sites.

Age of Onset↗
PubMed2006

Bilateral symmetrical lymphangiomas of the gingiva: case report.

BACKGROUND: Lymphangioma is a benign lesion that is related to proliferation of lymphatic vessels. Lymphangioma of the gingiva is a rare lesion that manifest as a pebbly hyperplasia on gingiva. The purpose of this study is to report a case of bilateral symmetrical lymphangioma of the gingiva. CASE PRESENTATION: A 32-year-old man was presented with bilateral hyperplasia of gingiva in upper canine regions. The lesions were resected completely and evaluated histologically. The microscopic evaluation revealed lymphangioma. CONCLUSION: Bilateral lymphangioma of the gingiva is a very rare lesion which its origin is controversial.

Journal Article↗
PubMed1989

[Role of attached gingiva in the extension of gingival inflammation. An experimental study in monkeys].

The purpose of this study was to evaluate the inflammatory response in dento-gingival units with or without attached gingiva in monkeys. Two different types of dento-gingival units with or without attached gingiva were established in premolar and first molar areas of three monkeys. In the experimental group, a part of the keratinized gingiva was removed with periodontal scissors following mucoperiosteal flap procedure, while in the control group, sham surgery was performed. After the surgery, plaque control was performed by mechanical tooth cleaning procedures three times a week for 3 months. As baseline examinations, width of the keratinized gingiva, probing pocket depth, position of the gingival margin, and the clinical attachment level were recorded and oral photographs were taken. Following these examinations silk ligatures were placed around the neck of the teeth to induce gingival inflammation in both the experimental and control groups. A soft diet which allowed plaque accumulation on the teeth was given during the experimental periods. The clinical examinations were carried out at 0, 1, 2, 3, 5 and 12 weeks and all monkeys were sacrificed for histological examination. The results obtained were as follows: 1. The use of silk ligature and a soft diet produced moderate to severe gingival inflammation in the monkeys. 2. The degree of gingival inflammation was greater in the experimental group which was characterized by the absence of the attached gingiva. 3. Marked marginal tissue recession with an apical shift of the attachment level was found in the gingival units of the experimental group at 12 weeks. 4. Histologically, a distance between the level of notch on the root surface and the most apical position of epithelial cell was greater in the experimental groups at 5 and 12 weeks, compared with the pre-experimental level. 5. The degree of alveolar bone resorption was higher in the experimental group at 5 and 12 weeks. These results suggest that an attached gingival tissue plays a certain role as a barrier against the extension of gingival inflammation.

Animals↗
PubMed1977

Trigeminal nerve endings in gingiva, junctional epithelium and periodontal ligament of rat molars as demonstrated by autoradiography.

Tritiated-L-proline was injected into the right Gasserian ganglion of mature rats for incorporation into proteins being carried by rapid axonal transport to nerve endings. The distribution of the nerve endings in molar gingivae and periodontium was subsequently mapped in serial sections by autoradiography. We found that sensory nerve terminals are most prominent in two regions of the free gingiva: (1) In the junctional epithelium there is a rich innervation of the basal epithelial layer with many endings penetrating several cell layers. (2) In the crestal epithelium arborized endings are present, especially on the marginal side of the crest. In the attached gingiva a few terminals are found in the epithelium with more in the lamina propria; the latter appear to be encapsulated. The periodontal ligament is only moderately labeled with silver grains located over nerve bundles, over nerves associated with blood vessels, and over a few apparent endings in the apical region. In the cementum no labeled endings are seen. Labeling of Gasserian cell bodies primarily reveals specific intra-epithelial nerve endings in gingiva crest and junctional epithelium. The absence of major labeling of the periodontal ligament supports the view that many nerves in that region are derived from cell bodies in the mesencephalic nucleus.

Animals↗
PubMed1980

Demonstration and preliminary characterization of bone resorbing activity in freeze-dried gingiva of dogs.

The bone resorbing activity of suspensions or supernatants of freeze-dried powdered gingiva was studied by measuring the release of 45Ca from prelabeled fetal rat long bones in organ culture. Two preparations of noninflamed attached gingiva showed no bone resorbing activity, whereas all six preparations of inflamed marginal gingiva tested showed a dose-related stimulation of 45Ca release. Evidence of an osteoclastic mechanism was provided by the inhibition of the bone resorbing activity by calcitonin and cortisol and the minimal activity observed on dead bones. The activity was heat stable and not blocked by human serum. Three different prostaglandin synthetase inhibitors did not inhibit the activity. Immunoassay showed that PGE was present in gingival powder preparations at concentrations in the range 229-2438 pg/mg dry weight. This was insufficient to account for the observed bone resorbing activity by a factor of 50-350. It was concluded that in addition to PGE, inflamed gingiva contains other heat-stable bone resorbing factor(s).

Animals↗
PubMed1989

Extensive changes in cytokeratin expression patterns in pathologically affected human gingiva.

The stratified squamous epithelium of the oral gingiva and the hard palate is characterized by a tissue architecture and a cytoskeletal composition similar to, although not identical with, that of the epidermis and fundamentally different from that of the adjacent non-masticatory oral mucosa. Using immunocytochemistry with antibodies specific for individual cytokeratins, in situ hybridization and Northern blots of RNA with riboprobes specific for individual cytokeratin mRNAs, and gel electrophoresis of cytoskeletal proteins of microdissected biopsy tissue samples, we show changes in the pattern of expression of cytokeratins and their corresponding mRNAs in pathologically altered oral gingiva. Besides a frequently, although not consistently, observed increase in the number of cells producing cytokeratins 4 and 13 (which are normally found as abundant components in the sulcular epithelium and the alveolar mucosa but not in the oral gingiva) and a reduction in the number of cells producing cytokeratins 1, 10 and 11, the most extensive change was noted for cytokeratin 19, a frequent cytokeratin in diverse one-layered and complex epithelia. While in normal oral gingiva cytokeratin 19 is restricted to certain, sparsely scattered cells of --or near--the basal cell layer, probably neuroendocrine (Merkel) cells, in altered tissue of inflamed samples it can appear in larger regions of the basal cell layer(s) and, in apparently more advanced stages, also in a variable number of suprabasal cells. Specifically, our in situ hybridization experiments show that this altered suprabasal cytokeratin 19 expression is more extended at the mRNA than at the protein level, indicating that cytokeratin 19 mRNA synthesis may be a relatively early event during the alteration. These changes in cytokeratin expression under an external pathological influence are discussed in relation to other factors known to contribute to the expression of certain cytokeratins and with respect to changes occurring during dysplasia and malignant transformation of oral epithelia.

Blotting, Northern↗
PubMed1992

Origins of parasympathetic postganglionic vasodilator fibers supplying the lips and gingivae; an WGA-HRP study in the cat.

Application of WGA-HRP to the mandibular lip and buccal gingiva of the cat resulted in retrograde labeling in the ipsilateral otic ganglion (OG), whereas labeled neurons appeared in the pterygopalatine ganglion (PPG) as well as in the OG when the tracer was injected into the maxillary lip and buccal gingiva. The results suggest that both the facial and the glossopharyngeal preganglionic vasodilator fibers supplying the mandibular lip and buccal gingiva mediated in the OG, and those innervating the maxillary lip and buccal gingiva are mediated in the PPG and the OG.

Animals↗