Changes In Gingiva Research Articles

Single-cell transcriptional profiling reveals immunomodulatory properties of stromal and epithelial cells in periodontal immune milieu with diabetes in rats

Periodontitis is the sixth major complication of diabetes. Gingiva, as an important component of periodontal tissues, serves as the first defense barrier against infectious stimuli. However, relatively little is known about cellular heterogeneity and cell-specific changes in gingiva in response to diabetes-associated periodontitis. To characterize molecular changes linking diabetes with periodontitis, we profiled single-cell transcriptome analyses of a total of 45,259 cells from rat gingiva with periodontitis under normoglycemic and diabetic condition. The single-cell profiling revealed that stromal and epithelial cells of gingiva contained inflammation-related subclusters enriched in functions of immune cell recruitment. Compared to normoglycemic condition, diabetes led to a reduction in epithelial basal cells, fibroblasts and smooth muscle cells in gingiva with periodontitis. Analysis of differentially expressed genes indicated that stromal and epithelial populations were reprogrammed towards pro-inflammatory phenotypes promoting immune cell recruitment in diabetes-related periodontitis. In aspect of immune cells, diabetes prominently enhanced neutrophil and M1 macrophage infiltration in periodontitis lesions. Cell-cell communications revealed enhanced crosstalk between stromal/epithelial cells and immune cells mediating by chemokine/chemokine receptor interplay in diabetes-associated periodontitis. Our findings deconvolved cellular heterogeneity of rat gingiva associated with periodontitis and diabetes, uncovered altered immune milieu caused by the disease, and revealed immunomodulatory functions of stromal and epithelial cells in gingival immune niche. The present study improves the understanding of the link between the diabetes and periodontitis and helps in formulating precise therapeutic strategies for diabetes-enhanced periodontitis.

Protective periodontitis: the possibility of prevention

Relevance. The isolation of prosthetic periodontitis among inflammatory periodontal pathology has significantly supplemented the generally accepted notions of dentists concerning the etiology and progression of dental prosthetics complications. Improving the methods of preventing inflammatory periodontal lesions caused by the presence of denture structures in the oral cavity is very relevant nowadays, especially in persons using removable dental prostheses. This applies to older age groups, which for financial reasons are more accessible removable acrylic dentures, which they have the opportunity to get at the expense of the budget of the region.Aim. This applies to those in the older age groups who, for financial reasons, have more access to removable acrylic dentures because of the possibility of obtaining dentures at the expense of the regional budget. Therefore, the aim of the study was to assess the possibility of using a new domestic denture fixation cream for the prevention of prosthetic periodontitis in patients using removable dentures.Materials and methods. 63 (18 male and 45 female) elderly patients (61-74 years old) with partial tooth loss on both jaws were examined. Partial removable acrylic dentures were made for patients 1st group (n = 30) and 2nd group (n = 33). The patients of the second group constantly used the domestic ASEPTA РARODONTAL denture fixation cream with herbal extract for 9 months of the study. Assessment of the impact of dentures on the oral tissues and periodontium was carried out on the basis of clinical examination and by studying the antimicrobial potential of saliva.Results. The use of partial removable acrylic dentures has been found to contribute to the occurrence of prosthetic periodontitis, which is associated with the technology used in their manufacture. It is possible to reduce the incidence of prosthetic periodontitis not only by timely correction of prosthesis but also by using adhesive means for fixation of prosthesis, the application of which permitted to reduce the occurrence of prosthetic periodontitis by 47,58% and to reduce the occurrence of inflammatory changes of gingiva in the restored teeth area by 16,06%. The research of the antimicrobial potential of saliva in persons who constantly used ASEPTA РARODONTAL denture fixation cream with herbal extract showed that the immune balance achieved before dental prosthetics can be maintained in the oral cavity.Conclusion. The results of the clinical and laboratory study allow us to recommend more widely the use of adhesive means for fixation of removable dentures, including the ASEPTA PARODONTAL cream with herbal extracts.

The influence of lead on gingiva and periodontal tissue

Introduction. Exposure to lead (Pb) can have harmful effects on the general state of the body, including oral health. The aim of this study was to examine the prevalence of changes in gingiva and periodontal tissue in adult rats intoxicated with lead acetate by histological analysis. Material and methods. The study was conducted on 42 Wistar rats. Intoxication of rats with lead acetate was carried out through drinking water ad libitum. The first group (A1) consisted of 16 rats that received lead-acetate in water at a concentration (1500 ppm) for 14 days, and the second group (A2) consisted of 16 rats that received lead-acetate in water at the same concentration for 30 days. Results. Gingivitis and periodontitis in the first group of rats (A1) were observed in 41.7% of cases, and in the second group (A2) in 84% of cases. A statistically significant difference was found between the investigated groups (?2 = 6.955; p < 0.018). Conclusion. Since changes in the gingiva and periodontium have been observed in rats intoxicated with lead for a long period of time, it is necessary to propose a preventive program for patients exposed to lead, which includes dental procedures such as oral hygiene training and regular visits to the dentist.

Maxillary anterior gingiva and dentoalveolar changes after en-masse retraction between thick and thin gingival biotypes

This study compared the changes of gingiva and alveolar bone parameters, including cortical and cancellous bones between thick and thin gingival biotypes after en-masse retraction. Thirty-two adult subjects (mean age, 20.6 years) with maxillary anterior teeth protrusion and proclination were studied and divided into 2 equal groups: thick gingival biotype (TKB) and thin gingival biotype (TNB). Maxillary anterior teeth were retracted using nickel-titanium coil springs at 150 g of force bilaterally for 4 months. Lateral cephalograms, study models, and cone-beam computed tomography scans were taken before retraction and 3 months after 4 months of retraction. Nonparametric tests compared the changes within the groups at these periods and between the groups. The gingiva gained thickness and length (P<0.01) on the labial and palatal sides. The gingival thickness gained more on the palatal side (P<0.01), whereas the length gained equally in both groups. Labial alveolar bone showed increased thickness and height (P<0.01) as opposed to the palatal alveolar bone that presented with loss of thickness and height (P<0.01). The height loss occurred more in TNB (P<0.01). Labial cortical bone increased in thickness and height (P<0.01), whereas palatal cortical bone thinned (P<0.01) at levels in which no cancellous bone was present at the crestal level for TKB and the crestal and midroot levels for TNB. TKB showed slower incisor movement and less retroclination than the TNB (P<0.01) with minimal incisor extrusion. Favorable gingiva and labial bone responses after en-masse retraction were found in both gingival biotypes, whereas more palatal alveolar bone height loss was presented in TNB. Cortical bone thickness decreased when cancellous bone was absent.

Gingival Pigmentation among E-cigarette Smokers in Vaping Community in Palembang

Introduction: Gingival pigmentation is a color alteration of gingiva caused by melanin produced by melanocytes. The etiologic factors include genetic, local, and systemic factors. One of the local factors is the smoking habit. The liquid content in e-cigarettes could cause gingival pigmentation. Purpose: To describe gingival pigmentation in electric smokers. Methods: This was a descriptive survey with the cross-sectional approach, involving 35 respondents from the vaping community in Palembang, using consecutive sampling and quota sampling techniques. The research instrument was using a questionnaire on google form to observe the gingival pigmentation. Results: The frequency distribution of gingival pigmentation was 82.9% of respondents experienced gingival pigmentation and 17.1% of respondents did not experience gingival pigmentation. Conclusion: Gingival pigmentation was found in most heavy e-cigarette smokers in the vaping community in Palembang. Visually, the color changes in gingiva were darker in dual-use smokers than the e-cigarette smokers alone. However, the difference was not statistically significant.

Assessment of oral health status during pregnancy

Background: Pregnancy is a unique period of diverse physiological changes which affects different body systems of mother under the influence of a number of hormones; and oral cavity is no exception. Estrogen and progesterone have been detected in human gingiva which are stimulatory to prostaglandin synthesis and thereby contribute to various vascular changes in gingiva during pregnancy. The study was aimed to assess the oral health status during pregnancy and to explore the correlation of the same between pregnant and non-pregnant women. Aims and Objectives: This study aims to assess oral health status during pregnancy and to compare the status among three trimesters and with nonpregnant subjects. Materials and Methods: The study was conducted on 135 women in the age group of 22–30 years from the same socioeconomic strata who visited Bharati Hospital, Katraj, Pune. Approval from the Institutional Ethical Committee was obtained before conducting the study. The oral health status was assessed using three oral health parameters – simplified oral hygiene index (OHI-S), decayed missing filled teeth index (DMFT), and periodontal index (PI). Results: Data were analyzed by Fisher’s exact test. A statistically significant increase in scores of OHI-S, DMFT, and PI was seen in pregnancy. Conclusion: It is important to maintain good oral hygiene before and during pregnancy, so as to prevent the occurrence of periodontal disease and to avert the irreparable damage that may arise during the period of pregnancy.

Periodontal management of changes in gingiva during pregnancy: A nonsurgical approach

Periodontal management of changes in gingiva during pregnancy: A nonsurgical approach

Digital assessment of gingiva morphological changes and related factors after initial periodontal therapy.

To establish a digital assessment method for changes in gingiva morphology following initial periodontal therapy. Ten periodontal-healthy participants were selected, and digital models obtained by intraoral scanning and digitizing conventional impressions. Using dentition as a reference, best fit alignment between digital models was carried out. Root mean square (RMS) was calculated to evaluate differences in models, and gingival volume discrepancy (GVD) was calculated after combining separated models. Trueness of intraoral scanning used on the gingiva was evaluated using RMS and GVD between intraoral and conventional models with conventional models as references; precision was evaluated among different intraoral models of one participant. Twenty-three periodontitis-affected participants underwent intraoral scanning immediately after supragingival scaling and two weeks after initial periodontal therapy. The GVD of gingiva between two digital models was calculated to assess gingival changes and related factors after therapy. Trueness of intraoral scanning used on the entire gingiva was 83.65 ± 14.43 μm; precision was 70.71 ± 25.58 μm; GVD error measured by digital models was 15.28 ± 10.00 mm³. Gingival volume in periodontitis-affected participants decreased 104.04-1155.09 mm³ after therapy. Probing depth, bleeding index, and keratinized gingival width positively correlated with changes in gingival volume. Intraoral scanning can be recommended as a method of evaluating morphological changes in gingiva.

Morphological Changes Caused by Streptozotocin-Induced Diabetes in the Healthy Gingiva of Rats.

Epidemiologic and clinical studies have indicated that diabetes is a risk factor for periodontal disease progression. The aim of the present study was to evaluate the morphological changes of gingiva in streptozotocin diabetic rats. 30 male Wistar rats that weighed 250-300 g were used in this study. The animals were randomly divided into 2 groups, one with streptozotocin-induced diabetes and another one with healthy (non-diabetic) animals. All rats were sacrificed after 21 days, and their maxillary first molars with surrounding tissues were observed morphological analyses. In this study, it was observed that the epithelial thickness was greater in the diabetes group, compared to the control group. The statistical comparison of the diabetes and control groups for the thickness of each of the layers of the epithelium demonstrated that the thickness of the keratinized (corneum), granular and basal layers had significantly increased in the diabetic animals. Furthermore, the diabetes group displayed a decrease in the height of the connective tissue papillae, which was found to be statistically insignificant. Another important finding detected in the diabetes group was the congestion of the gingival capillaries, which showed that blood circulation is impaired in diabetes cases. On the basis of the results obtained in this study, it was concluded that streptozotocin-induced diabetes may increase predisposition to periodontal disease by causing morphological changes in the periodontal tissues.

Perception of Saudi dentists and lay people to altered smile esthetics

To evaluate and compare the perceptions of Saudi dentists and lay people to altered smile features. Thirty-six digital smile photographs with altered features were used. Altered features included the following: crown length, width, gingival level of the lateral incisors, gingival display, midline diastema, and upper midline shift. The photographs were presented to a sample of 30 dentists and 30 lay people with equal gender distribution. Each participant rated each picture with a visual analogue scale, which ranged from 0 (very unattractive) to 100 (very attractive). Dentists were more critical than lay people when evaluating symmetrical crown length discrepancies. Compared to lay people, Saudi dentists gave lower ratings to a crown length discrepancy of >2mm (P<0.001), crown width discrepancy of ⩾2mm (P<0.05), change in gingiva to lip distance of ⩾2mm (P<0.01), and midline deviation of >1mm (P<0.01). There was no significant difference between dentists and lay people towards alterations in the gingival level of the lateral incisors or towards a space between the central incisors. No significant sex difference was seen across the groups. In this sample, Saudi dentists gave significantly lower attractiveness scores to crown length and crown width discrepancies, midline deviations, and changes in gingiva to lip distance compared to Saudi lay people.

Effect of smoking on gingival microvasculature: A histological study.

Background:Smoking has been reported as a major risk factor for periodontal disease. Studies have demonstrated decreased bleeding on probing and reduced inflammatory response among smokers, which has been attributed to the alterations in gingival microvasculature, gingival epithelium. In previous investigations, vascular and epithelial changes have been studied in the gingival tissues of smokers suffering from periodontitis and compared with healthy periodontium of non smokers. Inflammation is known to cause vascular and epithelial changes in the gingiva on its own in the absence of smoking. Hence, in the present investigation, an attempt is made to study and to compare the vascular and epithelial changes in the gingiva of smokers and non smokers suffering from chronic periodontitis.Aim of Study:The purpose of this study was to evaluate the vascular and epithelial changes in gingiva of smokers and non smokers with chronic periodontitis.Study Design:Cross sectional studyMaterials and Methods:Gingival biopsies were obtained from 33 male patients (18 smokers and 15 non smokers) who were undergoing periodontal therapy or extraction. The sections were stained with eosin and hematoxylin. Vascular density, area of the lumen, and epithelial thickness were assessed using histomorphometric image analysis.Statistical Method:Data was analyzed using student unpaired ‘t’ test, Karl Pearsons correlation, and Chi-square test.Results:The mean blood vessel density for smokers was 12.388±6.472 and for non smokers was 14.800±4.91. The mean lumen area of the vessels among smokers and non smokers was 19.290±8.775 μm2 and 20.044±7.896 μm2, respectively. The mean epithelial thickness among smokers was 150.551±32.994 μ and 134.941±30.63 μ for non smokers.Conclusion:Based on the present histomorphometric study, it could be concluded that smokers have less vascular density and reduced lumen area and increased epithelial thickness than non smokers. However, these changes were not statistically significant.

MMP-2, MMP-8 Expression in gingival tissue of Chronic Periodontitis associated to Type 2 Diabetes Mellitus

Diabetes mellitus(DM) in itself does not cause periodontitis. However, there are epidemiologic evidences that diabetes predisposes and accelerates the irreversible periodontal destruction. Severe periodontitis has been associated with an increased risk of poor glycemic control and, in turn, untreated advanced periodontal disease can deteriorate the metabolic control of diabetes 1-4) . Accumulation of plaque is not related directly to the early onset and rapid progression of periodontal tissue destruction in diabetes. Various pathogenic factors have been suggested to explain the increased prevalence and severity of periodontitis in diabetes. An exaggerated inflammatory response to potential periodontopathogenic bacterial virulence factors, such as lipopolysaccharide(LPS), may influence the periodontitis in diabetes. Moreover, an impaired recruitment and cellular function of polymorphonuclear leukocytes(PMNLs) has been linked to extensive periodontal tissue destruction 1-3) .1) Structual studies on diabetic patients have revealed vascular changes in gingiva and other tissues, a thickening of subendotherial basement membrane and, paradoxically, an increased permeability of basement membrane to virulent pathogenic microflora and to its potential vilurent factors 5-7) . Futhermore, a prolonged exposure to hyperglycemia can be primary factor responsible for the formation of non-enzymatic advanced glycosylation end-products(AGEs), demonstrated recently in periodontal tissues of diabetic patients. AGEs are further responsible for

Reproducibility and accuracy of automated probe measurements of gingiva and bone levels on stone casts following guided bone regeneration treatment.

For evidence-based evaluation of guided bone regeneration (GBR), accurate registration of changes in gingiva and bone levels is needed. A new method is introduced and evaluated. In a clinical trial with 30 patients, alginate impressions of the surgical area including the interproximal gingiva and alveolar bone at the adjacent teeth were made in duplicate prior to and during GBR surgery, fixture installation and abutment connection. Poured in hard stone, the casts were used for repeated measurements of the level of the free gingival margin and the alveolar bone with an automated probe (Florida disc-probe(R)), using the incisal edge as a fixed reference point. The reproducibility and accuracy of these measurements were evaluated by means of the Intraclass Correlation Coefficients and Generalizability Theory. The effect of treatment was evaluated by multivariate analysis of variance. Generalizability Theory indicated a high accuracy of the gingiva- and bone-level measurements: the Intraclass Correlation Coefficients for gingiva and bone levels were 0.99 and 0.98, respectively. The intra-cast reproducibility was 0.09+/-0.07 mm (mean+/-SD) and the inter-cast reproducibility was 0.10+/-0.09 and 0.20+/-0.07 mm for gingiva and bone levels, respectively. Clinical applicability is demonstrated by the fact that manova revealed on average a small but highly significant (p=0.001) effect of the staged surgical intervention on the gingiva and bone levels at the adjacent teeth. It is concluded that the presented method makes it possible to evaluate reproducibly and accurately changes in gingiva and bone levels for GBR studies.

Effects of toothbrushing frequency on proliferation of gingival cells and collagen synthesis.

Mechanical stimulation by toothbrushing enhances proliferation of fibroblasts and junctional epithelium (JE). These changes in gingiva may depend on the interval between toothbrushing. The effects of toothbrushing frequency on proliferation of gingival fibroblasts and basal cells of JE were evaluated. Twelve mongrel dogs were used. Each tooth was brushed for 20 s at 1.96 N. The subepithelial connective tissue of JE was examined for proliferating cell nuclear antigen (PCNA)-positive fibroblasts and procollagen type-I C-peptide (PIP)-positive fibroblasts. JE was examined for PCNA-positive basal cells. Gingiva that received brushing twice a day showed increases in the density of fibroblasts and ratio of PCNA-positive fibroblasts to total fibroblasts at 4 weeks. The ratio of PIP-positive fibroblasts increased at 8 weeks in gingiva brushed twice a day and once a day. PCNA-positive basal cell ratio increased at 4 weeks in gingiva brushed twice a day and once a day. A high frequency of brushing was associated with increased numbers of PCNA-positive fibroblasts, PIP-positive fibroblasts and PCNA-positive basal cells. Gingival cell proliferation increased and reached a plateau earlier in gingiva brushed twice a day than in gingiva brushed once a day.

Changes in gingiva with orthodontically banded and bonded teeth

The aim of this study was to evaluate the effect of orthodontic bands and metal brackets on the gingival health. The sample was composed of 15 randomly selected patients (5 males and 10 females) 11 to 17 years old. All patients were treated with edgewise fixed orthodontic appliances. Bands were cemented to upper and lower first molars and rest of teeth were bonded with composite. The teeth included in the study were upper right and lower left central incisors, and upper left and lower right first molars. The plaque index, the gingival index and pocket depths were used to measure the oral hygiene of the patients during six months period of fixed orthodontic treatment. The results indicated that orthodontic bands will provoke more periodontal changes than brackets.

Bruxism に関する研究とくに Grinding の発現頻度について

Prevalence of grinding habit was studied on 539 students of a womens college, aged 18 to 21 years, and 85 dental students, aged 23 to 27 years. On the womens college students, examination of gingiva, eye, ear, nose and throat were also performed to know the relation with grinding habit. The results of this study were as follows: 54 womens college students (9.85%) and 19 dental students (22.35%) had grinding habit, and 71 womens college students (13.20%) and 7 dental students (8.20%) were suspected to have the habit. Any changes of gingiva, eye, ear, nose and throat were not significantly related to the existence of grinding habit.

Serum protein analysis by immuno-electrophoresis in patients with periodontal diseases

THE serum protein levels in patients with periodontal diseases have been described by a number of workers. In the majority of cases, total protein was almost normal. Serum globulin, however, showed higher levels in patients, and albumin was lower (KARSHAN et al., 1952; MATSUMURA et al., 1960; TANIMOTO, 1960). SHANNON and GIBSON (1964) and SHANNON, TERRY and CHAUNCEY (1966) reported that there were no significant changes in serum albumin or globulin level in relation to periodontal status. Those experiments were performed in an attempt to reveal that some systemic or metabolic condition might operate as one of the contributing factors in periodontal diseases. Although they used salt-fractionation or electrophoretical methods to separate the serum protein fractions, they determined only two (albumin and globulin) or four (albumin, a-, /?and y-globulins). In the present investigation, the authors analyzed sera by immuno-electrophoresis on agar gel plates and obtained more detailed information. As controls, eight healthy men and three women aged between 18 and 30 years old were examined. Thirty patients aged between 18 and 60 years old were divided into three groups according to the roentgenographic examination and clinical signs, as follows: (1) Inflammatory type (Periodontitis): Inflammatory changes of gingiva and pocket formation are present. Mobility of teeth increased. Roentgenographically the type of alveolar bone resorption is horizontal. (2) Atrophic type (Periodontosis): Atrophy of the alveolar processes and gingival recession are the chief signs. Vertical bone resorption, pocket formation and increased mobility of teeth are present. (3) Mixed type: Gingiva recession with inflammation. Alveolar bone resorption is irregular. Each type was subdivided into three stages, namely, incipient, moderately advanced and far advanced. Serum GOT and GPT were determined in all subjects to eliminate liver dysfunctions. Patients with severe pus discharge from the gingivae were excluded. Serum protein fractions were separated by electrophoresis on cellulose acetate membrane (Sephadex, Joko Sangyo Co., Tokyo), using Verona1 buffer, pH 8 ‘6, ionic

ORAL HYGIENIC STUDY FOR PIT WORKERS IN A CERTAIN METAL MINE

I examined 272 pit workers in the metal mine for dental diseases, especially for gingiva disea ses, which I investigated thoroughly on changes of gingiva and deposit conditions of each individual person year by year. I also examined external wounds in the oral region arising out of duty and furthermore I researched particularily for the causes of stain in the oral cavity as well as its conditions, and then I worked out the preventive measures oral hygienically for the aboves.I sumarize the results of this study as follows:1. Any occukational differences are not seen on the conditions of pit workers suffered from dental caries.2. Dental attrition is found at 77.5%, that seems due to occlusion pressure continusly owing to muscular labor together with crushing powered dusts unconsciously.3. The cases of gingiva disease are at 72.43%, rather as a high percentage. Observing the above cases year by year, one having healthy gingiva, over 35 years old and working more than 16 years becomes gingivitis at 100% after 5 years, and among which the 50% changes from gingivitis to pyorrhea alveolaris after 5 years.4. Among pit workers of gingiva disease, pyorrhoea alveolaris is exceedingly increased on the cases more or less forty years old and worked more than 16 years.5. Occupational accidents in the oral region among the pit workers are at 1.35-1.68% yearly.6. Resulting from the observation made year by year for the relation between the deposit conditions of dental calculus and gingiva disease in pit workers, one having healthy gingiva suffers from dental calculus comparatively a little, and even though the conditions of gingivitis continue to some degree, the gingivitis shows to change into pyorrhoea alveolaris depended upon an increase of deposited quantity of dental calcus.7. Deposit of melanin pigment of gingiva is compartively less (27.04%). Even the cases of pyrrhoea alveolaris are at 37.05%. Considering from the aboves, the pit workers suffer much from a' malignant type of pyorrhoea alveolaris, which is a rapid progressive and serious case type, and its recovery seems to be very difficult.8. Deposit of dental calculus is found in vitry many pit workers at average 99.25%.9. The deposit cause of dental calculus seems due to powdered dustst and dringking water in, the. pit.The aboves to be proved with the following:i. Resulting from a spectroscopic analysis of dental calculus, Pb. Zn. and other metallic elements as the chief composition of mine are detected, which. are not found in the control.ii. I observed some differences in quantity of Pb. Zn. etc. such as metallic elements in gargled water made at the beginning of work from one made after-finished work.iii. Comparing gargled water made by unhanled dust worker before entering the pit with one made after the spot inspection, some differences in quantity of Pb. Zn. and other metallic elements are found.10. Dental calculus in pit workers has Ca.: 31.43% and P.: 13.21%. The dental calculus seems to be adhered firmly with the teeth. Upon the histological view, it is stratified, and the space of its layers becomes narrower according to come nearer to the teeth. The inside of shows layers a retiicuture.11. An artificial experimental dental calculus made with the mixture of gargled water from a pit worker and granules of powdered dusts has a great difference in metals compared with an experimental dental calculus made with gargled water from an unhandled dust worker, as the latter is not found any Pb. Zn. and other metallic elements. From the above, it can be assumed as powdered dusts get mixed in dental calculus.12. As to a countermeasure for preventing dusts in pit workers, the preventive for dusting at the scene of labor as well as preventive for inhaling dusts on the part of the workers are important.