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PubMed1992

Gingival crevicular fluid of patients with gingivitis or periodontal disease: evaluation of elastase-alpha 1 proteinase inhibitor complex.

Elastase-alpha 1 proteinase inhibitor (E alpha 1PI) concentrations were assessed in gingival crevicular fluids and evaluated in relation to the clinical signs of periodontal disease. 7 gingivitis patients (group G), 38 patients with adult periodontitis and clinically stable lesions (group AP), 21 patients with rapidly progressive periodontitis and clinically stable lesions (group RPP) and 11 patients with either adult periodontitis or rapidly progressive periodontitis and clinically progressive lesions (group Pr) were studied. 6 healthy subjects served as the control group (group H). Significantly differences were observed in the E alpha 1PI concentration between the healthy, gingivitis, clinically stable periodontitis and clinically progressive periodontitis group. In the control group, no E alpha 1PI was detected. Groups G, AP and RPP showed mean E alpha 1PI concentrations of 10.95 +/- 4.96 micrograms/ml, 35.55 +/- 18.64 micrograms/ml and 38.56 +/- 20.89 micrograms/ml, respectively. In these groups, high enzyme levels were correlated with clinical signs of inflammation. The highest E alpha 1PI levels were observed in the clinically progressive lesions. However, they were not necessarily associated with bleeding on probing or clinical evidence of inflammation. These data suggest that a significant increase in crevicular E alpha 1PI levels may be an early manifestation of a progressive or potentially progressive periodontal lesion.

Adult↗
PubMed1993

Relationship of "bleeding on probing" and "gingival index bleeding" as clinical parameters of gingival inflammation.

Bleeding on probing (BOP) and the gingival index have been used to clinically characterize the degree of gingival inflammation. It is, however, unclear to what extent these parameters correlate to each other and to probing pocket depth (PD). The purpose of this clinical study was to evaluate the association between BOP and GI bleeding (scores of 2 and 3), as well as the relationship of these variables to PD, in a group of patients presenting with naturally-occurring gingivitis. Based on screening examinations of 125 subjects with at least 20 teeth, no more than 4 sites with PD over 6 mm, a BOP frequency of 30% or greater, and no systemic condition that would influence the inflammatory response, were selected. 2 weeks after screening they were examined at 6 sites per tooth for plaque index, GI, PD and BOP. A standardized pressure sensitive probe (Florida Probe) with 20 g probing force was used for BOP and PD measurements. In this population, means of 40.9% (S.E. = 1.36) BOP sites and 35.3% (S.E. = 1.81) GI bleeding sites per patient were found. A total of 20,008 sites ranging in PD up to 5.9 mm were evaluated; however, the majority of sites (19,723, 98.6%) presented with < 4 mm PD. When sites were evaluated, BOP demonstrated a positive correlation with PD, whereas GI bleeding correlated with PD. For sites characterized by the absence of BOP as well as the absence of GI bleeding (scores 0 and 1), the highest % of agreement between the 2 indices (77.7%) was found in shallow sites (0.1-2 mm).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1981

The relationship between gingival tissue temperatures and various indicators of gingival inflammation.

IN PERIODONTICS there is a need for objective measurements in monitoring disease processes and in assessing the effectiveness of treatment. The purpose of this study was to compare gingival temperatures with indicators of gingival inflammation in order to examine the application of temperature as a diagnostic aid. In six patients the temperature of interproximal sulcular tissue was measured and compared with bleeding upon probing, crevicular fluid flow, pocket depth, plaque accumulation and calculus formation. The results show significantly higher temperatures with bleeding upon probing and with the presence of dental plaque and calculus. Temperature increase correlated with increase in crevicular fluid flow, but a relationship to pocket depth is not clear. The thermocouple microprobe is a very sensitive instrument. The method used is noninvasive, safe and efficient. It can be concluded from our data that differences in gingival temperature reflect not only a regional tissue variability but also can indicate an inflammatory state.

Adult↗
PubMed1993

Effects of two toothbrushes on plaque, gingivitis, gingival abrasion, and recession: a 1-year longitudinal study.

Plaque removal is an important part of good oral hygiene. Many short-term studies have compared the effectiveness of an electric toothbrush in plaque removal to that of a conventional, manual toothbrush. Previous studies proved the electric toothbrush to be more effective on a short-term basis; however, little is known about its long-term effects. In a study that examined 32 patients over a 12-month period, the authors found electric toothbrushing to be more effective in plaque removal. The study measured the differences in abrasion, gingival recession, gingival bleeding, and plaque scores. The study also concluded that no significant gingival abrasion was caused by electric toothbrushing.

Adult↗
PubMed1996

Establishing the gingival emergence profile of restorations by using a resilient gingival replica.

All references to gingival morphology are destroyed once the die is trimmed during construction of crowns, onlays, or veneers. The need for reconstruction of a gingival replica to assist in the reproduction of a restoration's gingival contour and emergence profile is discussed. A simple, practical approach to duplicate the natural sulcus and free gingival morphology with currently available materials is presented. The advantages and limitations of implementing this technique and its multiple uses in prosthodontic and implant reconstructions and implant cases are presented.

Crowns↗
PubMed2000

Nitric oxide synthase type-II is synthesized by human gingival tissue and cultured human gingival fibroblasts.

Nitric oxide is known to be an important inflammatory mediator, and is implicated in the pathophysiology of a range of inflammatory disorders. The aim of this study was to determine the localization and distribution of endothelial NOS (NOS-II) in human gingival tissue, and to ascertain if human gingival fibroblasts express NOS-II when stimulated with interferon gamma (IFN-gamma) and bacterial lipopolysaccharide (LPS). The distribution of NOS-II in inflamed and non-inflamed specimens of human gingivae was studied using a monoclonal antibody against nitric oxide synthase II. Cultures of fibroblasts derived from healthy human gingivae were used for the cell culture experiments. The results from immunohistochemical staining of the tissues indicated an upregulation of NOS-II expression in inflamed compared to non-inflamed gingival tissue. Fibroblasts and inflammatory cells within the inflamed connective tissue were positively stained for NOS-II. In addition, basal keratinocytes also stained strongly for NOS-II, in both healthy and inflamed tissue sections. When cultured human gingival fibroblasts were stimulated by INF-gamma and Porphyromonas gingivalis LPS, NOS-II was more strongly expressed than when the cells were exposed to LPS or IFN-gamma alone. These data suggest that, as for other inflammatory diseases, NO plays a role in the pathophysiology of periodontitis.

Cells, Cultured↗
PubMed2006

Organotypic co-cultures allow for immortalized human gingival keratinocytes to reconstitute a gingival epithelial phenotype in vitro.

We report here that the organotypic co-culture (OCC) system allows for significant preservation of the tissue-specific phenotype of human gingival keratinocytes (IHGK) immortalized with the E6/E7 gene of the human papillomavirus type 16 (HPV16). The approach adopted is based on the OCC system facilitating spatially separated cell growth and cell-to-cell interactions via diffusible growth factors. Generally, IHGK reveal transcription of the HPV16 E6/E7 gene at rising passages. Fluorescence in situ hybridization performed for chromosomes 1, 8, 10, and 18 demonstrates that disomic fractions differ between the tested chromosomes but otherwise remain fairly constant. Monosomies of chromosome 18 are more prominent in late passages 81 and 83, while polysomies of chromosome 10 and 18 are detected in early passages 25 and 27. In comparison with corresponding monolayer cultures (MCs), IHGK in OCCs form stratified epithelia, proliferate, and express gingival-specific gene products in vitro. Moreover, mRNA gene transcription for growth factors interleukin 1beta, granulocyte-macrophage colony stimulating factor, fibroblast growth factor 7, and EGF in OCCs is different from that in MCs. When grafted onto nude mice, IHGK develop hyperplastic, differentiated surface epithelia devoid of malignant growth. We are not aware of any other OCC system comprising of IHGK, which allows for site-specific expression of gingival epithelial markers. This substantiates reconstitution of a gingival epithelial phenotype in vitro.

Animals↗
PubMed2005

Effect of smoking on the gingival capillary density: assessment of gingival capillary density with orthogonal polarization spectral imaging.

OBJECTIVES: Microvascular changes because of smoking are frequently presumed in models because of the negative effect of smoking portrayed on the microcirculation. We hypothesized that cigarette smoke might lead to a decrease in gingival capillary density. MATERIALS AND METHODS: Capillary density was assessed with orthogonal polarization spectral (OPS) imaging, a technique using special optics by which a virtual light source is created at a depth of 1 mm within the mucosa. The light is absorbed by haemoglobin, resulting in an image of the capillaries in negative contrast. The gingival capillary density was measured in 20 healthy male dental students with a mean age of 25. Ten of the students were smokers and 10 were non-smokers. In each subject six images of the right maxillary pre-molar region were obtained, and the mean gingival capillary density was determined through the use of K&K software technology. RESULTS: The mean capillary density in smokers was 69.3 +/- 8.9 capillaries per visual field compared with a mean capillary density in non-smokers of 60.6 +/- 5.4 (p=0.33). CONCLUSION: No significant differences were found between the gingival capillary density of smokers and non-smokers.

Adult↗
PubMed1999

Direct interaction between gingival fibroblasts and lymphoid cells induces inflammatory cytokine mRNA expression in gingival fibroblasts.

In inflamed periodontal lesions, dense infiltration of lymphocytes is usually observed in the extravascular periodontal connective tissue, adjacent to gingival fibroblasts. Our previous study revealed that activated lymphocytes can adhesively interact with gingival fibroblasts in vitro. In the present study, we investigated whether gingival fibroblasts are activated through direct interaction with lymphoid cells by monitoring the expression of inflammatory cytokine mRNA in human gingival fibroblasts (HGF). Co-culture with various human lymphoid cells in vitro resulted in a marked increase in the expression of IL-1alpha, IL-1beta, and IL-6 mRNA by the HGF. In addition, expression of the mRNA of the IL-1beta-converting enzyme (ICE), which is essential to produce the mature form of IL-1beta, was constitutively observed in the HGF, suggesting that mature IL-1beta is produced by these cells. When HGF were cultured with the culture supernatant of the lymphoid cells, the increase in the inflammatory cytokine mRNA expression was not observed. Similarly, when HGF and lymphoid cells were cultured in the same well but separated by a membrane which prevented direct contact between the cells, no increase in inflammatory cytokine mRNA expression was observed. These results strongly indicate that direct interaction between these heterotypic cell types transduces activation signals into HGF that induce an increase in inflammatory cytokine mRNA expression. Furthermore, IL-1beta mRNA expression in the HGF was synergistically increased when HGF directly interacted with lymphoid cells in the presence of exogeneous IL-1beta. The present study demonstrates that direct interaction between HGF and lymphoid cells stimulates HGF to increase inflammatory cytokine mRNA expression, and raises the possibility that heterotypic cell-cell interaction may facilitate local inflammatory reactions.

Caspase 1↗
PubMed2005

Gingival bleeding on repeat probing after different time intervals in plaque-induced gingivitis.

The aim of this study was to assess agreement and association of gingival bleeding after repeated probing at different time intervals in subjects with gingivitis. Twenty adults participated. Periodontal probing (P approximately 1.27 MPa) was conducted at six sites of every tooth present. Probing was repeated in different quadrants immediately after the first probing (T0), after 1 h (T1), 4 h (T4), and 24 h (T24). A total of 3,459 sites were probed twice. The mean proportion of sites bleeding on probing (BOP) was 0.23 (standard deviation 0.08, range 0.10-0.41). Probing itself had a significant effect on the results of repeated probing. For T0 through T24, respective mean differences of proportions were 0.04, 0.04, 0.01, and -0.03. Ninety-five percent repeatability coefficients of proportions were 0.17-0.18. Estimates of overall kappa were 0.390, 0.234, 0.233, and 0.046 for T0 through T4, respectively. Adjusted two-level binary response models revealed odds ratios (95% confidence interval) for BOP at T0 through T4 of 6.52 (4.34, 9.80), 3.23 (2.19, 4.76), 3.80 (2.63, 5.50), and 2.68 (1.85, 3.89). It was concluded that a certain degree of agreement of site-specific bleeding scores in subjects with plaque-induced gingivitis could be observed only if probing was repeated at once. Adjusted associations between repeat BOP were weak in general, but strongest immediately after first probing. There appears to be a significant effect of probing itself, which may last for more than 1 h, whereas 24-h results are obtained under different conditions.

Adult↗
PubMed1990

Protease activity in gingival crevicular fluid from discrete periodontal sites in humans with periodontitis or gingivitis.

Sensitive fluorogenic assays were used to compare the protease activities of fluid collected from eight such sites in each of 21 adult patients with gingivitis and 22 with periodontitis. The degradation of N-carbobenzoxy-gly-gly-arginine-AMC, L-arginine-AMC, glyproline-AMC, L-leucine-AMC, N-alpha-benzoyl-L-arginine-AMC, N-[p-toluenesulphonyl]-gly-pro-arginine-AMC, N-tert-butoxycarbonyl-leu-ser-thr-arginine-AMC, N-tert-butoxycarbonyl-ileu-glut-gly-arginine-AMC and N-tert-butoxycarbonyl-val-leu-lysine-AMC was significantly greater by fluid from the periodontitis group. The specific rates of degradation of L-arginine-AMC, gly-proline-AMC, N-alpha-benzoyl-L-arginine-AMC and N-[p-toluene-sulphonyl]gly-pro-arginine-AMC were significantly greater in that group, indicating that the composition of their gingival crevicular fluid was different from that of the gingivitis group. Discriminant analysis of the substrate hydrolysis data alone correctly identified 77.6% of sites with sensitivity and specificity values of 73.3 and 82.1%, respectively. The predictive value of these assays requires further investigation, but it is possible that they will prove useful for monitoring the success of periodontal treatment.

Adult↗
PubMed1995

Clinical evaluation of the effect of an ultrasonic toothbrush on plaque, gingivitis, and gingival bleeding: a six-month study.

This study evaluated the long-term effect of an ultrasonic toothbrush used as part of a daily oral hygiene regimen on supragingival plaque, gingivitis, and gingival bleeding. Compared with a conventional toothbrush, the ultrasonic toothbrush was significantly more effective in reducing plaque formation (p < 0.05), removing plaque (p < 0.05), and reducing gingivitis (p < 0.05) during the 6-month study period.

Adult↗
PubMed2006

Platelet-derived growth factor (PDGF) isoform and PDGF receptor expression in drug-induced gingival overgrowth and hereditary gingival fibrosis.

OBJECTIVE: To investigate possible associations between platelet-derived growth factor (PDGF), PDGF receptor expression and macrophages in drug-induced and hereditary gingival overgrowth. MATERIALS AND METHODS: Tissues from patients with drug-induced gingival overgrowth (DIGO) (n = 10) and hereditary gingival fibrosis (n = 10) were studied and compared with 'control' gingiva (n = 10). Expression of PDGF and its alpha and beta receptors was investigated immunohistochemically and by RT-PCR. Macrophages were identified by immunostaining for CD68. RESULTS: PDGF isoforms and receptors were detected in most cells within all specimens. There were no differences in the numbers of macrophages, or fibroblasts expressing PDGF or receptors, between groups. The level of PDGF expression by fibroblasts, determined by absorbance measurements, was similar between groups for PDGF A. Significantly lower levels of total PDGF and the receptors were detected in drug-induced overgrowth compared to those in hereditary fibrosis (P < 0.004) and control specimens (P < 0.034). All specimens expressed mRNA for PDGF A, PDGF B and alpha and beta receptors. CONCLUSIONS: These data do not support a pivotal role for macrophage-derived PDGF B in the pathogenesis of DIGO. They suggest that fibroblasts in drug-induced lesions have a lowered capacity to produce, and respond to, PDGF, a property not shared by fibroblasts associated with hereditary fibrosis.

Adolescent↗
PubMed1985

Development of a biochemical profile for gingival crevicular fluid. Methodological considerations and evaluation of collagen-degrading and ground substance-degrading enzyme activity during experimental gingivitis.

The potential application of gingival crevicular fluid (GCF) analysis to periodontal diagnosis has been examined for more than 25 years. Unfortunately, the information available has not provided the clinician with a more sensitive means of diagnosing periodontal disease or an effective means of monitoring periodontal therapy. A careful review of the literature on GCF, however, suggests that discrepancies occur in the method of GCF collection, the use of GCF for analysis from pooled or isolated crevicular locations, the method of analyzing the samples and the way in which the data is reported. Studies in our laboratory have suggested a technique for GCF analysis that collects GCF from individual crevices with a filter paper strip inserted for a standard time, determines the volume of GCF collected with a calibrated electronic meter and elutes the material into a larger volume of diluent. This approach allows for detection of site-to-site and patient-to-patient differences in GCF volume while providing sufficient samples to analyze GCF for multiple constituents. We have used this approach to evaluate GCF for vertebrate forms of the enzymes collagenase (latent and active forms), beta-glucuronidase and arylsulfatase during the development of experimental gingivitis in man. Interproximal and midradicular areas were studied. Our results indicate that during the 4 weeks of the gingivitis, the absolute amount of active collagenase in GCF increased 550% at the interproximal sites and 190% in the midradicular sites, and the per cent of active collagenase increased from 15 to 71% at the interproximal sites, and from 16 to 36% at the midradicular sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2000

Analysis of human gingival tissue and gingival crevicular fluid beta-glucuronidase activity in specific periodontal diseases.

BACKGROUND: Beta-glucuronidase (betaG) is one of the enzymes involved in the destruction of non-collagenous components of the extracellular matrix. It is also considered an indicator or predictor of periodontal disease activity. The present study was conducted to determine the presence and the levels of betaG activity in gingival tissue and gingival crevicular fluid (GCF) in periodontal disease and health status. The validity of 2 expressions of data, total betaG activity versus betaG concentration, and the correlations between clinical periodontal status and betaG profile was also evaluated. METHODS: betaG activities in gingival tissues and GCF samples from 57 individuals, divided into 3 equal groups of adult periodontitis (AP), early-onset periodontitis (EOP), and periodontally healthy subjects were spectrophotometrically examined. RESULTS: Both patient groups had higher betaG levels in both gingiva and GCF than controls. Significant differences were observed among all groups when total GCF betaG activities were examined (P <0.05). However, the difference between AP and controls was not significant when concentration values were compared (P >0.05). The highest GCF betaG activity, with both expressions, was detected in EOP group. No absolute correlations between clinical parameters and betaG activity were observed, except for random correlations in the patient groups with mean total betaG activities. Also GCF/gingiva betaG levels and the 2 expressions did not show absolute correlations. CONCLUSIONS: The findings of the present study confirm the relationship between betaG activity and periodontal diseases. The differences in data concerning GCF total betaG activity and betaG concentration may suggest that they are not matching measures. Data presentation seems to be an important factor in GCF/enzyme profile studies.

Adolescent↗
PubMedDate not supplied

[The collagenolytic activity in the mixed saliva, gingival fluid and gingival tissues of patients with periodontal inflammation].

Collagenolytic activity of mixed saliva, gingival fluid and tissue was radioimmunoassayed in 39 patients with periodontal inflammations. The findings evidence a significant elevation of this activity, correlating with the inflammation severity. Gingival fluid was found the most informative of the three studied biologic media for the assessment of the inflammatory destructive changes in periodontal tissues. Therefore it is preferred to use the gingival fluid in the biochemical studies for the early diagnosis of periodontal diseases.

Adolescent↗
PubMed1981

Gingivitis induced by gingival impaction in monkeys.

Impaction of the gingival sulcus with elastic bands deforms the gingival sulcus, forming a surface for growth of bacterial plaque, compresses and causes necrosis of surface epithelium and the subjacent lamina propria. The teeth become extruded and make premature contact with their apposing teeth. During mastication, forces applied to extruded teeth probably contribute to their displacement, resulting in their mobility. An inflammatory process commences within 3 days and becomes clinically evident by 7 days. The gingival becomes red-magenta in color and is slightly hemorrhagic. Pockets 4 to 6 min. in depth form within 1 week and remain as long as the impacted substance occupies the space between the tooth and the sulcus epithelium. Removal of the impacted substance results in prompt repair, with complete restoration within 3 weeks. Such repair may be by an epithelial attachment rather than by a fibrous periodontal ligament.

Animals↗
PubMed1992

Gingival sequestration of nifedipine in nifedipine-induced gingival overgrowth.

The mechanism of gingival overgrowth associated with long-term use of nifedipine and of other drugs that affect calcium homoeostasis, such as cyclosporin and phenytoin, is unknown. With an ultrasensitive assay, we measured the pharmacokinetics of nifedipine in plasma and gingival crevicular fluid (GCF) of nine patients receiving this drug for angina and hypertension. In seven patients, the maximum nifedipine concentration was in the range 15-316 (mean 84 [SD 105]) times greater in GCF than in plasma. The two patients with low (undetectable) GCF nifedipine did not have overgrowth. We propose that gingival tissues sequester nifedipine and that the very high nifedipine concentrations predispose the tissues to overgrowth.

Gingiva↗