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Cephalexin concentrations in human serum, gingiva, and mandibular bone following a single oral administration.

1. Cephalexin concentrations in human serum, gingiva, and mandibular bone after a single oral administration of cephalexin (500 mg) were measured by the paper disc method. 2. The peak times of serum, gingiva, and mandibular bone were approximately 90, 120 and 120 min, respectively. 3. The peak concentrations of serum, gingiva, and mandibular bone were 10.58 micrograms/ml, 5.57 micrograms/g and 2.12 micrograms/g, respectively. 4. The concentration ratio of gingiva/serum and mandibular bone/serum peak time of serum were 0.47 and 0.18, respectively. 5. Cephalexin concentrations in gingiva and mandibular bond did not exceed the MIC80s for clinically isolated strains of Staphylococcus aureus spp., alpha-Streptococci and Peptostreptococcus spp.

Adolescent↗

Cefaclor concentrations in human serum, gingiva, mandibular bone, and dental follicle following a single oral administration.

1. Cefaclor concentrations in human serum (n = 59), gingiva (n = 46), mandibular bone (n = 39), and dental follicle (n = 42) following a single oral administration of cefaclor (500 mg) were measured by the paper disk method. 2. The peak times of serum, gingiva, mandibular bone, and dental follicle were 1.5, 2, 2, and 1.5 hr, respectively. 3. The mean peak concentrations of serum, gingiva, mandibular bone, and dental follicle were 7.58 micrograms/ml, 3.71, 1.59 and 2.42 micrograms/g, respectively. 4. The concentration ratios of gingiva/serum, mandibular bone/serum, and dental follicle/serum at peak times of the tissues were 0.49, 0.18, and 0.32, respectively. 5. Mean cefaclor concentrations in gingiva, mandibular bone, and dental follicle at peak times exceeded MIC for 90% for clinically isolated strains of alpha-hemolytic Streptococci.

Administration, Oral↗

Lipopolysaccharide stimulates histamine-forming enzyme (histidine decarboxylase) activity in murine dental pulp and gingiva.

To examine the potential role of the histamine-forming enzyme, histidine decarboxylase (HDC), in oral inflammation and disease, we studied HDC activity in oral tissue after induction by bacterial agents. Following injection of E. coli-derived lipopolysaccharide (LPS) into mice, we measured the quantitative changes in HDC activity over time in dental pulp and gingiva. Oral tissue taken from individual mice was insufficient for detecting precise HDC activity, thus, we combined dental pulp or gingival tissues from four mice and assayed them over the course of 24 h. Our results indicate that LPS stimulated marked elevations of HDC activity in dental pulp and gingiva. This increase reached a maximum at 6 h after LPS injection and remained detectable at for least 24 h. Since mast cells are known to produce histamine through a difference mechanism than HDC induction, we compared LPS-induced HDC activity in dental pulp and gingiva to that in ear skin (a tissue rich in mast cells) and liver (a tissues lacking in mast cells). LPS also induced a marked increase in the HDC activity in liver and ear skin at 6 h after LPS injection. By contrast, saline injection had no effect on the HDC activity in any of the four tissues, although basal levels of HDC activity in ear skin was markedly higher than basal HDC activity in the other three kinds of tissues. Still, the relative increase in LPS-induced HDC activity in dental pulp and gingiva were much greater than that in ear skin. Since liver are devoid of mast cells and ear skin is considered the tissue richest in mast cells, the differences in HDC activity between tissues indicates that histamine induced by LPS may be produced by cells other than mast cells through another mechanism of action. These results also suggest that histamine produced in oral tissues in response to bacterial agents such as LPS could be involved in development of pulpitis or gingivitis (periodontitis), the most common diseases in the dental clinic, and that efforts to inhibit HDC activity, which elevates histamine levels in oral tissues, might offer the basis for novel treatment strategies.

Animals↗

Localization of the neuropeptide galanin in nerve fibers and epithelial keratinocytes of the rat molar gingiva.

Knowledge of the histochemical substrates of cellular and neurovascular connections in the gingiva is essential in order to understand the initial mechanisms of inflammation in the periodontium. Since the localization of the neuroendocrine peptide galanin in the gingiva is still unclear, we used immunohistochemical, in situ hybridization and immunoblot techniques to assess the localization of galanin in the gingiva of rat molars. Galanin-immunoreactive nerve fibers were located around blood vessels in the lamina propria, beneath the epithelium, in the epithelial-proprial junction and in the basal layer of the epithelium. Galanin was highly expressed in the suprabasal keratinocytes of the gingival epithelium. The localization of galanin in gingival nerve fibers and the expression of galanin in keratinocytes of the gingival epithelium indicate that galanin may be a possible regulator of different cellular functions in the gingiva.

Animals↗

Distribution and synthesis of elastin in porcine gingiva and alveolar mucosa.

Histologically, there are variations in the distribution of the types of elastic fibers within the tissues of the masticatory mucosa. For example, the alveolar mucosa has heavy deposits of elastin which decrease in quantity and size as it merges with the attached gingiva. These differences in elastin content may result from the tissues' different physiological workload modulating the expression of tropoelastin mRNA. Alternatively, these differences could be due to the presence of phenotypically different fibroblasts that have different basal levels of tropoelastin mRNA expression. The aim of this study was to determine whether the differences in the distribution of elastin between alveolar mucosa and attached gingiva could be due to phenotypic differences between fibroblasts derived from these tissues. Histochemical (Miller's elastin stain) and immunohistochemical staining were used to localize elastin within these tissues. Elastin production by cultured fibroblasts derived from alveolar mucosa and attached gingiva was assessed by Western blot analyses, and Northern blot analyses were used to detect levels of elastin mRNA by these cells. The results from this study have confirmed that elastin is richly expressed in oral mucosa and poorly expressed in attached gingiva. In vitro, the cells demonstrated a capacity to synthesize and secrete tropoelastin, however this was not found to differ between cells from the two different sources. These findings indicate that while some heterogeneity in fibroblast populations may exist within various tissues of the periodontium, other factors, such as functional requirements of the tissues in which they reside, may also play an important role in the phenotypic expression of these cells.

Analysis of Variance↗

S100A8 and S100A9 calcium-binding proteins: localization within normal and cyclosporin A-induced overgrowth gingiva.

S100A8 and S100A9, also called myeloid related protein (MRP) 8 and 14, are calcium-binding proteins highly expressed in neutrophils, in which they play a key role in the inflammatory progression. In this study, we looked at the expression of S100A8/A9 within gingiva from normal and Cyclosporin A (CsA)-induced overgrowth gingiva. In gingiva from the CsA group, several positive S100A8/A9 cells were seen within the connective tissue, whereas in normal gingiva very few positive S100A8/A9 cells were detected. These cells correspond either to activated macrophages or to neutrophils, reflecting the well-known gingival inflammatory status associated with the CsA-treated group. In addition, in both the normal and drug-treated group, the gingival epithelia appeared S100A8/A9 immunopositive. More specifically, S100A8/A9 appeared in the majority within the spino-cellular layer and located extracellularly within the desmosomes. In addition, S100A8/A9 also appeared sporadically intracellularly, located within the cytoplasm and the nuclei, reflecting S100A8/A9 translocations.

Adult↗

Correlation between clinical and histological evaluations of the peri-implant gingiva around the single-crystal sapphire endosseous implant.

The correlation between clinical periodontal parameters and histological structure of the gingiva around a single-crystal sapphire implant has been evaluated in two volunteer subjects. The implants had functioned after 6 years as the distal abutment of implant bridges in the Kennedy class II mandible. First, clinical evaluation was performed (gingival bleeding index, crevicular fluid volume, plaque index and probing depth) of the gingiva around the implant and natural teeth abutments and then a small piece of peri-implant gingiva was excised from the lingual site of the implant of each subject for histological evaluation. The clinical evaluation using the periodontal parameter indices corresponded with the histological evaluation of the peri-implant gingiva. The result suggests that it is possible for such parameters to be used in practice for judging the success of an implant.

Adult↗

A clinical study comparing the width of attached gingiva and the prevalence of gingival recessions.

One hundred preclinical year dental students were examined. Oral hygiene status and gingival condition were determined using the Plaque Index score (Silness & Löe 1964) and the Gingival Index score systems (Löe & Silness 1963). The width of the attached gingiva and the depth of the gingival pockets were evaluated. The gingival recessions were recorded and their heights measured from the CEJ to the gingival margin. No significant correlation was found between oral hygiene and gingival recession, oral hygiene and width of attached gingival conditions and width of attached gingiva. Only a negative correlation (P less than 0.05) was found between the width of attached gingiva and the number of gingival recessions. No statistically significant differences were observed in oral hygiene status and gingival conditions among three groups of students (without, with one and with two or more recessions, respectively). The roles of toothbrushing trauma and "adequate" width of attached gingiva in the etiology of gingival recessions are questioned.

Adult↗

Alkaline phosphatase activity in the periodontal ligament and gingiva of the rat molar: its relation to cementum formation.

Alkaline phosphatase (ALP) is a glycoprotein thought to be involved in processes leading to mineral formation in tissues like bone and cementum. In the rat molar periodontium, several regions are associated with the formation of cementum (periodontal ligament, inner part of the gingiva), whereas other areas are not (e.g., the outer part of the gingiva just beneath the outer oral epithelium). In an attempt to establish how the spatial distribution of ALP activity relates to cementum formation, we assessed the activity of the enzyme quantitatively in the periodontium of the rat maxillary molars, by using the indoxyl-tetrazolium salt method. It appeared that the distribution of enzyme activity in the ligament was heterogeneous, indicating local variations in the phosphate household. Highest activity was found in areas related to mineralization, adjacent to the alveolar bone and cementum. Enzyme activity was higher adjacent to cellular cementum than to acellular cementum. With respect to acellular cementum, a highly significant positive correlation was found between ALP activity and cementum thickness, which indicates a close relationship between local phosphate production and cementum formation rate. An interesting observation in the connective tissue of the gingiva mesial to the first molar was a sharp demarcation between an ALP-positive inner part, adjacent to the tooth, and an ALP-negative outer part, underneath the outer oral epithelium. In the interdental gingiva, the entire connective tissue proved positive for the enzyme, suggesting that this region consists of the combined inner gingival parts of two adjacent teeth.

Alkaline Phosphatase↗

Thickness of facial gingiva.

Gingival thickness was measured in 10 subjects with healthy gingiva on the facial aspect of selected maxillary and mandibular teeth at the depth of the gingival sulcus and midway between the sulcus depth and mucogingival line. Measurement instrumentation, consisting of a differential transformer coupled to an oscillator and digital voltmeter was sensitive to the travel of a probe from the gingival surface to tooth surface or alveolar bone. The probe assembly was accurate to 0.01 mm and the average range of differences in replicate measurements under a variety of conditions never exceeded 0.15 mm. 1. Free gingival thickness averaged 1.56 mm + 0.39, attached gingival thickness averaged 1.25 mm + 0.42 and the total mean thickness for all areas measured was 1.41 mm. 2. Thickness in mandibular free and attached gingiva and maxillary free gingiva increased from anterior to posterior. Thickness in maxillary attached gingiva remained fairly constant. 3. Thickness measured at the depth of the sulcus was directly proportional to the free gingival width. 4. Thickness measured midway between sulcus depth and mucogingival junction was inversely proportional to attached gingival width.

Adult↗

Concentration of circulating hormones and metabolism of androgens by human gingiva.

The present study evaluates the relationship between periodontal status, concentration of circulating hormones and metabolism of androgens by human male and female gingiva in vitro. In both male and female patients with healthy gingiva the plasma concentration of gonadotropins (LH and FSH) and steroid hormones (testosterone, androstenedione, estradiol-17 beta, progesterone and cortisol) were in a normal range. However, an alteration in the plasma concentration of progesterone was found in both male and female patients with periodontal pathosis. Both androgens (testosterone and androstenedione) were readily metabolized by human gingiva tissue in vitro. The major pathway of the metabolism of testosterone was via the formation of 17 beta-hydroxy-5 alpha-A-ring reduced androgens (5 alpha-dihydrotestosterone and 3 alpha-, 3 beta-androstanediol). In contrast, androstenedione was metabolized mainly to 17-keto-5 alpha-A-ring reduced (5 alpha-androstanedione, androsterone and epiandrosterone) and 17 beta-oxidoreduced (testosterone) compounds. In addition both substrates were metabolized to 5 beta-A-ring reduced androgens (5 beta-dihydrotestosterone, 5 beta-androstanediol and 5 beta-androstanedione). A significant feature of the metabolism of testosterone and androstenedione by inflamed gingiva was an increase of 5 alpha-A-ring reductase activity (mainly the formation of 5 alpha-dihydrotestosterone and 5 alpha-androstanedione) and 17 beta-oxidoreductase activity (mainly the formation of testosterone from androstenedione). The increase in 5 alpha-reductase activity also showed a significant correlation with the plasma progesterone concentration.

Adolescent↗

Comparative analysis of biopsy specimens from gingiva and alveolar mucosa.

A total of 834 consecutive biopsy specimens from the gingiva and 448 from the alveolar mucosa were examined to see if differences in structure and function are reflected in categories and frequency of diagnoses. In both regions, inflammatory/reactive hyperplasia accounted for about 85% of the lesions and neoplasia for most of the remainder. Pyogenic granuloma was the most common lesion in the gingiva (23.6%) and fibrous hyperplasia in the alveolar mucosa (23.2%). The ratio of benign to malignant neoplasms was greater in the gingiva (10:1) than in the alveolar mucosa (almost 1:1). Benign tumors of the gingiva and malignant tumors of the alveolar mucosa occurred more often in males than one would expect from their proportion in the survey (keeping in mind that the numbers in alveolar mucosa were small). Lesions in these two regions were similar, but differed greatly in their frequency and in sex and age distribution.

Adolescent↗

A clinical comparison of the effect on the gingiva of the Prophy-Jet and the rubber cup and paste techniques.

This clinical trial compared the effect on the gingiva of the Prophy-Jet and the rubber cup and paste techniques of stain and supragingival plaque removal. Twenty-one human subjects with healthy gingiva or slight gingivitis participated. A split mouth design was used. The Prophy-Jet caused a statistically significant increase (P less than 0.05) in gingival irritation immediately posttreatment, but the differences were not deemed clinically significant. There were no statistically significant (P less than 0.05) or clinically significant differences in the effect on the gingiva between the two techniques at 7 and 21 days posttreatment. There was no lasting difference in gingival trauma between the two methods of stain and supragingival plaque removal in subjects with healthy gingiva or slight gingivitis.

Dental Plaque↗

Lipid composition and biosynthesis in the gingiva of the domestic cat.

Periodontal disease in the domestic cat may assume debilitating and serious consequences; however, little is known of the biochemical composition or metabolism of feline gingiva in health or disease. In this report the chemical composition and metabolism of gingival lipids from inflamed an non-inflamed sites is presented and compared to other species with naturally occurring periodontitis. The neutral and phospholipid composition of feline gingiva was found to be distinct from that of porcine and human. As a measure of de novo lipid synthesis, the total incorporation of 14C-acetate into fractionated lipid components was determined and revealed an approximate 2 to 3 fold decrease in inflamed versus non-inflamed gingiva. The decrease in 14C-acetate incorporation appeared to result from a 2-fold increase in free acetate pools in inflamed compared to non-inflamed gingival samples, since total lipase and phospholipase activity were comparable in inflamed and non-inflamed gingiva and total lipid composition was not changed between inflamed and non-inflamed sites. These data are similar to those reported for periodontally involved human gingival tissue and suggest a common effect of periodontal inflammation on lipid metabolism in both species.

Acetates↗

Axonal transport of fluorescent carbocyanine dyes allows mapping of peripheral nerve territories in gingiva.

Sensory innervation of gingival tissue can cause neurogenic inflammation that depends on the extent of the branching area of the peripheral nerve fibers. We designed the present study to determine whether single trigeminal axons branch to both the buccal and palatal gingiva of maxillary molars of adult rats. Accumulation via retrograde transport of DiI (red) or DiA (green) fluorescent carbocyanine dyes in neurons of trigeminal ganglia was evaluated 7 days after applying one dye to the buccal sulcus and the other to the palatal sulcus. Both dyes were absorbed through the junctional epithelium, and the two sites each labeled similar numbers and sizes of neurons in the lateral zone of the maxillary division (44% from buccal and 46% from palatal gingiva). Double-labeled neurons had the same size (32.5 +/- 6.70 microns, mean circumference +/- S.D.) and location as single-labeled neurons, and they were 9% of the total. This study shows that exogenous dyes can diffuse into mucosa and thereby allow in vivo mapping of sensory nerve branching patterns to several intact tissues per animal. We found that 9% of the labeled cells extended to both the buccal and palatal gingiva. Thus, inflammation that spreads from one gingival region to the other could have a neurogenic mechanism involving trigeminal sensory neurons that extend their peripheral branches to innervate both buccal and palatal gingiva of adult rat molars.

Absorption↗

Cells with osteoblastic phenotypes can be explanted from human gingiva and periodontal ligament.

Considerable phenotypic heterogeneity has been reported in gingival fibroblasts. Similarly, cells from the periodontal ligament (PDL) can be isolated with different phenotypes. Although it has been suggested that cells from the gingiva do not contribute to the formation of hard tissue, it is theoretically possible that under appropriate stimuli, immature mesenchymal cells in gingiva could differentiate along an osteoblastic pathway. Differentiation of immature mesenchymal cells into osteoblasts following stimulation with osteoinductive factors has been demonstrated in muscle. We undertook experiments to establish whether cells with osteoblastic characteristics could be identified from human gingiva as well as from human periodontal ligament. Some cell populations from each of these tissues were found to have high basal alkaline phosphatase activity, to release osteocalcin in response to 1,25(OH)2 VitD3, and to form a mineralized matrix. Thus, cells can be isolated from the gingiva and PDL that exhibit phenotypic markers, which taken together are characteristic of osteoblastic cells. Other cell populations derived from the PDL and gingival connective tissue were isolated that had fibroblastic characteristics. These studies support the concept that gingival tissue can give rise to cells which may differentiate along either a fibroblastic or an osteoblastic pathway.

Adult↗

The influence of restorative materials on marginal gingiva.

BACKGROUND: A great variety of dental materials are now available for use in restorative treatments. Much attention has been devoted to physical and chemical properties, but the biological effects of these materials have been less frequently studied. AIM: The aim of this study is to test the influence of resin based restorations, amalgams and gold alloys, as restorative materials in immediate contact with the gingival tissues. METHODS: In 103 patients (54 male and 49 female, 39 smokers and 64 non-smokers, mean age: 34 +/- 13 years) with 255 restored teeth (101 resin-based materials, 98 amalgams, and 56 gold inlays), the marginal gingiva was examined. The restorations selected had to be in place more than 6 months. The patients participating in the study had no systemic diseases and pregnant patients were excluded, as were those under long-term medication and those with severe periodontal disease. The filling materials were examined for surface roughness, secondary carious lesions and gaps. The marginal gingiva in contact with the restorative materials was tested by reference to Bleeding Index (BI), Gingiva Index (GI), probing depth and degree of tooth mobility. As controls 255 teeth without fillings, of the same type, in the opposite jaw were used. RESULTS: The 101 resin-based restorations had a mean age of 3.1 (+/- 2.0) years, the amalgam fillings were in place 6.6 (+/- 4.1) years and the gold inlays had an average age of 4.7 (+/- 4.6) years. Surface roughness was observed in 66.3% of the resin-based restorations, in 47.9% of the amalgams and in 10.7% of the gold inlays. Absence of bleeding after probing was observed for 25.7% of the resin-based restorations, for 55.1% of the amalgam fillings, and for 58.9% of the gold inlays. All classes of restored teeth showed significant differences from the controls without fillings. The mean probing depth for the resin-based fillings was 3.6 mm (control 2.4 mm), for teeth with amalgams 3mm (control: 2.4 mm) and for teeth with gold inlays 2.5 mm (control 2.1 mm). A significant difference between smokers and non-smokers was only found in the group of resin-based restorations. The Bleeding Index was significantly higher in the group of smokers (p = 0.0005) in comparison to the non-smokers, as was the Gingiva Index (p=0.0106). CONCLUSION: The marginal adaptation of the restored teeth examined showed materially specific differences. The handling of resin-based materials, in comparison to amalgam or gold remains very sensitive and consequently there is prevalent error of technique. The high prevalence of gingival irritation in association with resin based materials may be caused by non-indicated applications, failures of technique, or simply the chemical properties of the materials.

Adolescent↗

Surgical thickening of the existing gingiva and reconstruction of interdental papillae around implant-supported restorations.

With the present knowledge of osseointegration and implants, it seems reasonable to hope that implants will be placed in a way that provides optimal function, esthetics, and phonetics. The esthetic objectives of implant dentistry should be similar to those of conventional prosthodontics, and the esthetics for implants begins with implant placement. Often, because of limitations in position and/or quality of bone, implants may have to be placed in locations that are not ideal in the axial position. Preangulated and customized abutments have been used in some situations primarily to salvage poorly placed implants. An adequate zone of attached gingiva is also necessary around these restorations to hide the periimplant restoration boundary and provide for a good soft tissue profile, which is the essence of esthetics. There are numerous situations where implants have been placed in areas of minimal keratinized gingiva. The crown margin around these areas of thin gingiva is usually supragingival; therefore, the esthetic appearance is poor Three case reports, which are part of a preliminary study, outline a plastic surgical technique of tunneling/pouching and the use of submerged connective tissue grafts. This technique allows the thickening of the existing gingiva but is also useful for reconstructing interdental papillae around implant-supported restorations.

Adult↗