Healthy Gingiva Research Articles

MRNA Expression of Ezrin in Gingival Crevicular Fluid and Whole Blood of Gingivitis and Chronic Periodontitis Patients - A Polymerase Chain Reaction Study.

Background:A comparative analysis of protein expression of gingival crevicular fluid (GCF) obtained from healthy individuals and individuals with periodontal diseases would help to identify proteins involved in periodontal disease progression. Among the identified proteins, Moesin which is a disease-associated protein belongs to the ezrin-radixin-moesin protein family and was proved to play an important role in the recognition of oral bacteria contributing to the consequent development of inflammatory immune responses involved in periodontal disease development.Aim:The aim of the study is to quantify and compare mRNA expression levels of ezrin in GCF and whole blood of gingivitis and chronic periodontitis patients.Materials and Methods:A total of 60 patients were selected for the study and were divided into three groups as follows: Group 1 (20 participants with healthy gingiva), Group 2 (20 participants with gingivitis), and Group 3 (20 participants with chronic periodontitis). Clinical parameters such as gingival index, periodontal index, probing pocket depth, and clinical attachment level were assessed. GCF and blood samples were taken from these patients and assessed for the mRNA expression of ezrin using real-time polymerase chain reaction.Results:The expression and mean relative quantification of mRNA expression of ezrin in GCF and blood were higher for periodontitis (18.32 ± 8.398, 19.34 ± 9.487) when compared to that of gingivitis (5.34 ± 3.609, 5.48 ± 4.428) and healthy individuals (2.33 ± 0.643, 3.47 ± 1.923) and they positively correlated with the clinical parameters.Conclusion:The increased expression of ezrin can be considered as a good indicator to assess the inflammatory activity in periodontitis and gingivitis.

Quantitative proteomic analysis of gingival crevicular fluids to identify novel biomarkers of gingival recession in orthodontic patients

ObjectiveTo identify gingival recession-related biomarkers in orthodontic patients, we compared the proteome of gingival crevicular fluids (GCF) from healthy gingiva without orthodontic treatment (GH), healthy gingiva undergoing orthodontic treatment (OGH), and recessed gingiva undergoing orthodontic treatment (OGR). MethodsGCF samples were obtained from the anterior teeth of 15 volunteers (n = 5/group). Quantitative proteomic analysis was performed using DIA-based liquid chromatography-tandem mass spectrometry (LC-MS/MS). Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were used to annotate differentially expressed proteins (DEPs). Receiver-operating characteristic (ROC) analysis was performed to detect and filter biomarker candidates, while Protein-Protein Interaction (PPI) Networks were utilized to determine the interactions between these DEPs. ResultsA total of 253, 238, and 101 DEPs were found in OGR vs. OGH, OGR vs. GH, and OGH vs. GH groups, respectively. Based on the Venn diagram of three groups, 128 DEPs in OGR vs. OGH group were identified as specific proteins associated with progressive gingival recession (GR) during orthodontic treatment. Molecular function analysis showed that 128 DEPs were enriched in “molecular binding”, including antigen binding, RNA binding, double-stranded RNA binding, cadherin binding involved in cell-cell adhesion, vinculin binding, S100 protein binding, and Ral GTPase binding. The majority of these DEPs were also involved in cytoskeletal regulation. In addition, biological process analysis showed an enrichment in translation, while cellular component analysis indicated that 128 DEPs were related to extracellular exosome. Furthermore, Ribosome and Phagosome were the top two terms in KEGG analysis. The results of ROC analysis demonstrated that 26 proteins could be potential biomarker candidates for GR. PPI networks analysis predicted that IQGAP1, ACTN1, TLN1, VASP, FN1, FERMT3, MYO1C, RALA, RPL35, SEC61G, KPNB1, and NPM1 could be involved in the development of GR via cytoskeletal regulation. ConclusionsIn summary, we identified several GCF proteins associated with GR after orthodontic treatment. These findings could contribute to the prevention of GR in susceptible patients before the initiation of orthodontic treatment. SignificanceOrthodontic patients with GR often report esthetic defects or root hypersensitivity during orthodontic treatment, especially at the anterior teeth site. GCF, rich in protein, is an easily accessible source of potential biomarkers for the diagnosis of periodontal diseases; however, little is known about the changes in GCF proteome associated with GR in orthodontic patients. In this study we firstly used DIA-based LC-MS/MS to evaluate the proteome and to identify the biomarker candidates for GR in orthodontic patients. These findings will improve our understanding of GR during orthodontic treatment, and could contribute to an earlier diagnosis, or even prevention, of GR in susceptible populations before orthodontic treatment.

An Evaluation of a Supervised School Tooth Brushing Program on Plaque and Gingival Scores of a Group of Rural Nigerian Primary School Children

Aim: The study assessed the Plaque and Gingival scores of rural Nigerian school children before and after supervised school brushing program.
 Methods: This was an interventional study of 96 children aged 6 to 12 years in selected rural primary schools in Enugu, Nigeria. Data on sex, age, type of school, Plaque score and Gingival score were collected. Data was analyzed using SPSS version 20 and student's t- test was used to compare means. P<0.05 was considered significant.
 Results: There were 45(46.9%) male and 51(53.1%) female participants and their mean age was 8.45±1.83years. Forty nine(51.0%) children attended private school while 47(49.0%) attended public school. Only 10(10.4%) had good Plaque score while 8(8.3%) had healthy gingiva. Before intervention, 83(86.5%) children used tooth brush as cleansing tool, 7(7.3%) children brushed twice a day while after the intervention, 96(100.0%) children used toothbrush and 39(40.6%) children brushed twice a day. Also, before intervention, there was significant association between Plaque scores (p=0.012), Gingival scores (p<0.001) and type of school attended. The mean plaque score for the school children before and after intervention was 2.17±0.57, and 1.28±0.49 respectively and the change was statistically significant (p=0.01). The mean gingival score before and after intervention was 1.23±0.67 and 0.31±0.49 respectively and the change was also statistically significant (p<0.001).
 Conclusion: Children who attended private schools had better Plaque and Gingival scores than those who attended public schools. Supervised school tooth brushing program improved the plaque and gingival scores of rural primary school children in the study population.
 Authors
 S P Ozoemena 1, N K Onyejaka 2, E F Ani 1, O F Eboh 3, E O Odo 4

Characteristics Salivaricins producing Streptococcus salivarius isolated from gingiva

The bacteriocins study (Salivaricins) produced by Streptococcus salivarius. S. salivarius strains were isolated from healthy gingiva , The bacteriocin production under anaerobic conditions at 37°C for 24 hrs and inoculum (1.5 ˟ 109 CFU/ml) and Salivaricins was purified by precipitation ammonium sulphate, (75)% chromatofocusing by using column Sephadex G-50 the antibacterial activity against streptococci oral and other bacterial oral species was detection positive and ngative strain showed a different activity. The molecular weight of Salivaricins to be 8 kDa. The cells viability was decreased with increasing the concentration of Bacteriocin and the IC50 values of the HdFn cells (2.5 µg/mL).In conclusion, S. salivarius bacteriocin could be a good antibacteral agent and acivity against other types of species isolation gingiva.

Efficacy of Curcumin Mouth Wash on Gingival Inflammation in Patients with Chronic Gingivitis

Objective: For gingival disease, various modalities of treatment are available. Turmeric is a novel product obtained from plants that plays a vital role in treating gingival and periodontal diseases. This study aims to evaluate the anti-plaque and anti-inflammatory property effects of curcumin mouthwash (0.1%) on participants with plaque-induced gingivitis. 
 Methods: From eighty subjects, sixty participants with generalized gingivitis received meticulous scaling and polishing (S&P) and were divided randomly into 3 groups: Curcumin (CU), Chlorhexidine (CHX), and control (S&P) groups. Clinical parameters: PI, GI, BOP, and salivary IL-1β were assessed at baseline and after 4 weeks of therapy. The rest of the twenty patients with clinically healthy gingiva. 
 Results: The results showed a significant reduction in the mean values of PI, GI, BOP, and Il-1β levels after 4 weeks of therapy as compared to baseline in all 3 groups (p≤0.05), with the highest mean reduction of GI, BOP, and IL-1 β scores detected in the CU when compared to the CHX and S&P groups, and the highest mean reduction of PI scores detected in the CHX group in comparison to the CU and S&P groups (p≤0.05), with significant differences, existed between the 3 groups (p≤0.05). 
 Conclusions: CU was more effective than CHX when anti-inflammatory property effects were considered, while CHX was more effective than CU when anti-plaque property effects were considered. Therefore, CU mouthwash can be considered an effective alternative antigingivitis agent to CHX due to its anti-plaque and anti-inflammatory property effects.

Expression of human caspase-4 in the gingival epithelium affected with periodontitis: Its involvement in Porphyromonas gingivalis-challenged gingival epithelial cells

ObjectiveImplication of human caspase-4 in periodontitis and in sensing periodontal pathogens by gingival epithelial cells (GECs) is unclear. This study aimed to determine caspase-4 and interleukin (IL)-18 expressions in gingival tissues affected with periodontitis and to investigate caspase-4 involvement in mediating innate immune responses in GECs. DesignEx vivo, caspase-4 and IL-18 expressions in gingival biopsies, obtained from healthy participants with periodontitis or clinically healthy gingiva (N = 20 each), were determined by immunohistochemistry. In vitro, caspase-4 activation in cultured GECs stimulated with Porphyromonas gingivalis or Fusobacterium nucleatum was analyzed by immunoblotting. mRNA expressions of human β-defensin-2 (hBD-2), IL-8, and IL-18 in stimulated GECs in the presence or absence of a caspase-4 inhibitor were assayed by RT-qPCR. ResultsEx vivo, compared with healthy gingival epithelium, the epithelium affected with periodontitis displayed a significant decrease in caspase-4 expression (P = 0.015), whereas IL-18 expression was significantly increased (P = 0.012). Moreover, the expression of caspase-4, but not IL-18, was found to be a predictor of periodontitis (P = 0.007). In vitro, caspase-4 was activated in cultured GECs challenged with P. gingivalis, but not F. nucleatum. mRNA upregulations of hBD-2, IL-8, and IL-18 upon P. gingivalis stimulation were significantly reduced when caspase-4 was inhibited (P < 0.05), whereas the inhibitor failed to suppress those inductions by F. nucleatum. ConclusionsCaspase-4 expression is diminished in the epithelium affected with periodontitis while that of IL-18 is enhanced. Caspase-4 activation in P. gingivalis-infected GECs upregulates the three innate immune effector molecules, suggesting a possible sensing mechanism of caspase-4 in GECs in periodontal disease pathogenesis.

Sex-related differences in endothelium-dependent vasodilation of human gingiva

BackgroundSex hormones influence circulation, periodontitis, and wound healing. The aim of the study was to compare the endothelium-dependent and independent vasodilation in human gingiva in men and women.MethodsGingival blood flow was evaluated in twelve male and twelve female subjects with healthy gingiva and no systemic conditions after acetylcholine or nitric oxide donor (NitroPOHL). Agonists were administered into the gingival sulcus at the right secondary incisor (test site). Regional gingival blood flow (GBF) was imaged by Laser Speckle Contrast Imager from the marginal gingiva to the mucogingival junction in four consecutive regions (coronal, midway1, midway2 and apical). Blood flow was expressed in Laser Speckle Perfusion Unit (LSPU). The absolute maximal blood flow change (Dmax), the area under the blood flow curve (AUC), and the time to peak (TTP) were calculated.ResultsMales had higher baseline GBF than females (257 ± 18.2 vs. 225 ± 18.8 LSPU, p < 0.001). Acetylcholine and NitroPOHL significantly increased the GBF in all test regions. The Dmax after the acetylcholine was reduced apically compared to the coronal (90 ± 13 LSPU vs. 117 ± 7 LSPU, p < 0.01), but it was similar after NitroPOHL (78 ± 9 LSPU vs. 86 ± 6 LSPU, p = 0.398) in both sexes. The Dmax and AUC were higher, and the TTP was smaller in men in most regions after acetylcholine but not after NitroPOHL.ConclusionIn the human gingiva, the endothelium-independent vasodilation propagates without attenuation in the line of the vascular supply in both sexes. At the same time, the endothelium-dependent ascending vasodilation attenuates similarly in men and women. However, men had more pronounced endothelium-dependent vasodilation than women. Therefore, it might contribute to the increased severity of periodontal disease in men.Trial registrationThe study was registered with ClinicalTrials.gov on 09.06.2021 (NCT04918563).

Esthetic evaluation of conventional and socket shield technique immediate implant restoration

Objective: To evaluate the pink and white esthetics of conventional and socket shield technique (SST) immediate implant restoration. Methods: Thirty volunteers were recruited according to preset criteria, and were assigned to 3 groups. Natural teeth group (ten undergraduates or postgraduates from Peking University School and Hospital of Stomatology in January 2020, n=10): all volunteers' maxillary anterior teeth were natural teeth with healthy gingiva, and none of the teeth were restored by crowns or composite. Conventional group and SST group (patients had a maxillary central incisor immediate implant placed in Department of Prosthodontics, Peking University School and Hospital of Stomatology during October 2016 to January 2021, n=10 for each group): the volunteer had an unrestored natural maxillary central incisor, and the contralateral maxillary central incisor was restored by conventional or SST immediate implant placement, temporization and all ceramic final restoration, photos were taken 12 months post-surgery. Three groups of evaluators namely layperson (staff from Second Clinical Division of Peking University School and Hospital of Stomatology and 2 family members, n=10), dental students (class 2015 undergraduates from Peking University School and Hospital of Stomatology, n=10) and prosthodontists (from Department of Prosthodontics, Peking University School and Hospital of Stomatology, n=10) were invited to assess the esthetics using pink esthetic score (PES) and white esthetic score (WES). The results were statistically analyzed. Results: PES and WES of natural teeth group [9(8, 10) and 8(7, 10)] were significantly higher than conventional group [7(6,8) and 7(6,9)] (H=287.08, 132.79,P<0.01) and SST group [7(6, 9) and 8(7, 9)] (H=216.01, 101.21, P<0.01). SST group yielded higher PES than the conventional group (H=-71.06, P<0.01), yet had similar WES (H=-31.57, P>0.05). Dental students had significant lower PES and WES than prosthodontists (H=-120.90, -218.86, P<0.01) and layperson (H=-109.55, 134.97, P<0.01). Prosthodontists and layperson got similar PES (H=-11.36, P>0.05), however yielded different WES (H=-83.89, P<0.01). Conclusions: SST immediate implant placement obtained better pink esthetics than conventional protocol 12-month after implant surgery, profession may have significant impact on evaluators during pink and white esthetic evaluation.

Management of External Cervical Resorption in Mandibular Molar Furcation Area - A Case Series

&lt;p&gt;External cervical resorption (ECR) is an aggressive form of root resorption causing loss of tooth structure and sometimes leading to destruction of adjacent alveolar bone. In the advanced extent of ECR lesion, surgical intervention is inevitable. Several studies presented favorable treatment outcomes on advanced ECR lesions at single teeth. In the light of these studies, this article reports on surgical management of two ECR cases. Materials and Methods: Two cases had ECR combined with bony defect in left mandibular first molar. Case 1 had ECR lesion over buccal furcation area combined with buccal bone plate loss. Following root canal treatment, the resorptive defect was restored by mineral trioxide aggregate and the bony defect was treated with guided tissue regeneration (GTR). Case 2 had class II furcation defect with ECR over furcal surfaces of mesial and distal roots. The resorptive defect was restored with bioceramic putty and class II furcation bony defect was treated by GTR. Root canal treatment of tooth 36 was done later after case 2 suffered from symptomatic irreversible pulpitis of tooth 36. Result: At one-year follow-up of case 1, no inflammatory signs with probing pocket depth (PPD) less than 3mm clinically and regeneration of buccal bone plate radiographically were found of tooth 36. At half year follow-up of case 2, there was a healthy gingiva with PPD less than 3mm clinically and the furcation area has been partially filled with regenerated bone radiographically of tooth 36. Conclusion: These case series presented an interdisciplinary surgical management of two cases with external cervical resorption combined with bony defect over lower molar furcation area which were successfully treated with biocompatible restorative material in combination with GTR technique in short-term follow-up.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Comparison of culture and polymerase chain reaction-restriction fragment length polymorphism for identification of various Capnocytophaga species from subgingival plaque samples of healthy and periodontally diseased individuals.

Introduction:Capnocytophaga are facultative anaerobic Gram-negative bacilli and recognized as opportunistic pathogens of various extraoral infections. Only a few studies attempted to identify all the seven species of Capnocytophaga phenotypically and genotypically in healthy individuals and patients with chronic periodontitis. Studies to determine the prevalence of Capnocytophaga in subgingival plaque samples from healthy individuals, chronic gingivitis and periodontitis among Indian population are lacking.Aim:The aim of this study was to identify and compare the presence of Capnocytophaga species phenotypically through microbial culture and biochemical tests and genotypically through polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) in subgingival plaque of healthy individuals and patients with chronic gingivitis and chronic periodontitis.Materials and Methods:A total of 300 subjects, 100 each with gingivitis, periodontitis and periodontally healthy gingiva subjected, were included. Subgingival plaque was collected and was cultured for phenotypic identification (microbial culture and biochemical test), and for genotypic identification, DNA extraction was done and PCR-RFLP analysis was performed to identify the genus Capnocytophaga and also to identify different species of Capnocytophaga.Results:Of 300 individuals, Capnocytophaga species were identified from 237 (79%) individuals by PCR and 82 (27.33%) by culture. The prevalence of Capnocytophaga ochracea was found to be higher with both the methods followed by Capnocytophaga gingivalis and Capnocytophaga granulosa. Capnocytophaga genospecies, Capnocytophaga leadbetteri and Capnocytophaga Sputigena were isolated only by culture with very low prevalence that is 1.33%, 1.33% and 0.66%, respectively. We could not get any isolate of Capnocytophaga haemolytica by any of the two methods.Conclusion:Capnocytophaga species could be found in gingival sulci as well as periodontal pockets and can be detected by culture and PCR-RFLP. However, higher prevalence of these species in healthy compared to disease requires further analysis to determine their role in healthy and diseased periodontium.

Quantity (Number) and Quality (Morphology) Comparison of Mast Cells in Healthy and Diseased Gingiva

Introduction: Comprehending the pathogenesis of chronic periodontitis is helpful in the prevention of this disease. Since there are conflicting results regarding the role of mast cells in periodontitis, the aim of this study was to compare mast cell counts and morphology in periodontitis with clinically healthy gingiva.&#x0D; Materials and Methods: This cross sectional case-control study was performed on 36 gingival samples (obtained from 14 patients with chronic periodontitis and 22 cases with clinically healthy gingiva among those referred to a specialized medical center in 2013. Toluidine blue and hematoxylin -eosin staining was used to identify mast cells. The total number of mast cells (intact and degranulated) was counted under the light microscope in 5 consecutive high power fields (10×40) with no overlap. Data were recorded and analyzed statistically by SPSS 22 and Independent T-test. All of the data with a statistical significance (p value &lt; 0.05) were analyzed.&#x0D; Results: According to Independent t-test, mean number of degranulated mast cells in periodontitis group was 17.78 and in healthy gingiva group was 29.72 which was not statistically significant(p value = 0.071). Mean number of mast cells in periodontitis group was 20.57 and in healthy gingiva was 36.54 and was statistically significant (p value = 0.042). Mast cell degranulation proportion in periodontitis group was 0.857 and in healthy gingiva group was 0.866, not statistically significant (p value = 0.891).&#x0D; Conclusion: According to results of present study it can be concluded that total number of mast cells and proportion of degranulated mast cell to the total number showed no significant relationship but the total number of mast cell was significantly increased in healthy group.

PERIODONTAL APPROACH TO GINGIVITIS IN PATIENTS’ FIXED ORTHODONTICS APPLIANCES (PENDEKATAN PERIODONTAL UNTUK GINGIVITIS PADA PASIEN DENGAN PESAWAT ORTODONTI CEKAT)

Comprehensive care of a patient from multidisciplinary periodontics and orthodontic is found in gingivitis cases with patients that use fixed orthodontics appliances. Periodontal pathogenic bacteria were initiated to dental plaque formation, followed by predisposing factors such as fixed orthodontic appliance, orthodontic movement, and bad oral hygiene. This case report describes a female patient (23 years old) who needs treatment at the anterior mandibular region. Clinical examination explained crowding anterior 32, 31, 41, 42 and applied bracket on each tooth. Pocket depth on the facial side was average 6-5 mm, accompanied by bleeding on probing. Periodontal approach for gingivitis used gingivectomy and gingivoplasty with blade number 15c to eliminate gingival pocket on crowding teeth at anterior mandibular region. Evaluation results in one week and one month after surgery showed healthy gingiva with an average probing depth of 3mm. Gingivectomy is a periodontal approach for gingivitis in patients with fixed orthodontics appliances that could create healthy gingiva and follow excellent oral hygiene instructions.

Gingival bleeding and pocket depth among smokers and the related changes after short-term smoking cessation

Background Smoking is associated with the deteriorating health of the gingiva and periodontium. The long-term beneficial effects of smoking cessation on oral health are well known. However, the effects of short-term smoking cessation on gingival bleeding and periodontal pocket depth are unknown. The purpose of the present study was to determine the effects of short-term smoking cessation on gingival bleeding and periodontal pocket depth. Methods Dentate smokers with a mean age of 56.9 ± 14.4 years at an outpatient smoking cessation clinic participated in this study. A professional dentist checked the periodontal pocket depth and gingival bleeding. Patients visited the smoking cessation clinic on their first visit and 2, 4, 8, and 12 weeks (three months). The gingival assessment was re-performed in those who succeeded in smoking cessation 3 months after the baseline. Results The baseline data of 83 patients showed that an increase in pocket depth was associated with increasing age and the amount of smoking. A significant increase in gingival bleeding (p = .031) and increase in pocket depth (p = .046) were observed 3 months after the baseline in patients who successfully quit smoking (n = 14). Conclusion Short-term smoking cessation increased periodontal pocket depth and gingival bleeding. These findings may reflect healing processes that occur in the healthy gingiva. Implications Study findings will be useful to advise patients during smoking cessation programs. Dentists can inform patients that an initial increase in gingival bleeding and pocket depth could be associated with smoking cessation. Such advice will prevent patients from any apprehension that may cause them to recommence smoking.

Effect of Nonsurgical Periodontal Therapy On IL-36 Levels in Serum, Gingival Crevicular Fluid of Type 2 Diabetic and Non-Diabetic Patients with Chronic Periodontitis

Objective: The aim of this study was to compare the level of inflammatory marker IL-36β in serum and gingival crevicular fluid in type 2 diabetic and non-diabetic patients with chronic periodontitis, before and after phase I therapy. Methods: A total of fifty subjects was included in this study; 20 Type 2 diabetic subjects with chronic periodontitis (group I) and 20 systemically healthy subjects with chronic periodontitis (group II) in addition to 10 systemically healthy subjects with clinically healthy gingiva as a control group (group III). The nonsurgical periodontal therapy was done to both group I and group II. Periodontal parameters, including plaque index, gingival index, bleeding on probing, probing depth and the clinical attachment level, in all the sites were recorded. GCF and serum were collected from all individuals included in the study; the first sample was collected from all groups (study and control) before phase I therapy. The second sample was collected 6 weeks after phase I therapy from group I&amp; group II. Levels of IL-36β in GCF and serum were quantified using ELISA. Results. The current results showed statistically significant reduction in total level of IL-36β in serum and GCF in both groups; Type 2 diabetes with chronic periodontitis group (I) and systemically healthy with periodontitis group (II) after phase I therapy. Results also showed all clinical parameters were significantly improved after the phase I periodontal therapy in both groups I &amp;II (p&lt;0.001). Conclusions. Scaling and root planning (SRP) is the mainstay of treatment of periodontal diseases as SRP was effective in improving clinical parameters in diabetic and non-diabetic patients with chronic periodontitis. IL-36β could be used as a potential diagnostic marker for periodontal disease activity in both serum and gingival crevicular fluid.

Interleukin-17 levels in gingival crevicular fluid of aggressive periodontitis and chronic periodontitis patients.

Interleukin-17 (IL-17) plays an important function in initiation, progression of any inflammatory condition. It is a pro-inflammatory cytokine and considered to be founding member. Periodontitis being an inflammatory condition of periodontium, IL-17 does have a potential role in periodontitis. The current research has shown positive correlation between the IL-17 and severity of periodontitis. Therefore, this research study aimed to evaluate the levels of IL-17 in aggressive periodontitis (AgP), chronic periodontitis (CP), and "healthy gingival sites." A total of 45 selected subjects (90 samples) were equally divided into three different groups. Group 1 (Healthy gingiva on clinical examination): Subjects with healthy gingiva and no evidence of periodontal attachment level (PAL), probing pocket depth (PPD) <3 mm papillary bleeding index (PBI) <1. Group 2 (AgP): Subjects having age <35 years with at least six permanent teeth apart from the incisors and first molars with PPD and PAL ≥5 mm. Group 3 (CP): It consist of subjects with clinical features of inflammation of gingiva with minimum six teeth in each jaw, with PPD ≥4 mm, PAL ≥4 mm. IL-17 levels were analyzed by using Gingival crevicular fluid (GCF). It was collected from the sulcus of first maxillary molar sites for quantitative analysis. GCF IL-17 levels in AgP were found to be 1.12 ± 0.29, 1.96 ± 1.71 in CP and 0.64 ± 0.23 in healthy gingival sites. Clinical parameters such as (1) plaque index (Turesky et al., modification of Quigley-Hein), (2) PPD, (3) PBI were higher (significantly) in periodontitis group as compared to healthy gingiva. Positive correlation was found to be significant between levels of IL-17 with PAL and PPD in AgP however in cases of CP, positive correlation of IL-17 levels was found only with PAL but not PPD. Our study shows that the IL-17 levels were comparatively higher in GCF of AgP, CP in comparison to healthy gingiva, but the GCF IL-17 levels were higher in CP as compared to AgP.

Comparative assessment of exfoliated gingival cells in healthy individuals and chronic periodontitis patients with and without tobacco chewing habit: A cytomorphometric study.

Background:Cytomorphometry is the analysis of the morphometry of exfoliated cells. Studies on exfoliated gingival epithelial cells in chronic periodontitis were not evident on the literature search. In the backdrop of this information, we were inspired to conduct a cytomorphometric study.Aim:The aim of the study is to correlate the nuclear area (NA), cytoplasm area (CA), and the nuclear: cytoplasm ratio (N/C) in the gingival cells of healthy individuals, patients with chronic periodontitis, and chronic periodontitis patients who are tobacco chewers.Materials and Methods:Ninety subjects, aged 35–45 years, were categorized into three equal groups of 30 each. Group I had individuals with healthy gingiva, Group II patients with chronic periodontitis without any deleterious habits, while Group III patients with chronic periodontitis and tobacco chewing habit. Exfoliated gingival cells were stained with Papanicolaou stain. Analysis of cells was done using binocular light microscope under ×40 and i-progress® image analyzer software.Results:There was statistically significant increase in CA in all the groups, but NA and N/C ratio did not show any statistical significant difference. When Group II was compared with Group III, we found significant correlation of CA with pocket probing depth and clinical attachment loss (CAL) in Group II. Similarly, we also found a correlation of CA and N/C with pocket depth and CA with CAL in Group III.Conclusion:The results suggest that molecular level changes occur in the cells. Cytomorphometry can be used to analyze the cellular changes in chronic periodontitis patients even before clinical signs manifest. Hence, it can be used as an investigative tool.

Gingival Biotype Variations with Gender in Indian Population Using Direct Visual Inspection, Probe Transparency and Transgingival Probing Technique: A Cross -Sectional Study

Background Gingival biotype is the thickness of gingiva in the labiopalatal or labiolingual aspect. It is directly related to periodontal health and disease. It also describes the prognosis and outcome of periodontal treatment. It differs from person to person and with gender. Hence one should have a better understanding of the gingival biotype in the population.Aim The aim of the study was to assess the variations in gingival biotype with gender in Indian population males and females.Methodology A total of 200 subjects 100 males and 100 females were included in the study. Subjects with healthy gingiva were considered. Gingival biotype was measured in the esthetic region ndash anteriors. The methods used for the measurement of gingival biotype were direct visual inspection probe transparency and transgingival probing methods.Results It was observed that males showed thicker gingival biotype whereas females showed thinner type. Statistical significance was established with p lt0.05.Conclusion A definitive clear thick gingival biotype was observed in males as compared to females who presented thin gingiva.

Assesment of radiotherapy effects on the blood flow in gingiva and dental pulp - a laser Doppler flowmetry study

This study aims to determine and compare the dental pulp and gingival blood flow in patients referred for oropharyngeal radiotherapy (RT) at three different time points: before the start, immediately after, and six months following the completion of RT. The aim is also to evaluate the dependence of the pulp and gingival blood flow on the radiation dose. A prospective study included 10 patients referred for intensity-modulated RT (IMRT) in the oropharyngeal region, with at least one intact tooth surrounded by a healthy gingiva. The dose received by each selected tooth and adjacent gingiva was determined according to the map of treatment planning and computer systems. The blood flow measurements were performed using the laser Doppler flowmetry (LDF) method. Comparing vascular flows at three different time points, the median blood flow in the dental pulp showed no statistically significant difference (p=0.325), contrary to gingiva (p=0.011). Immediately after RT completion, the gingival flow significantly increased compared to its starting point (p=0.012). The pulp flow correlated negatively with the radiation dose, whereas a strong correlation was noted 6 months following the RT completion. RT caused a significant acute gingival blood flow increase, followed by a long-term (over six months) tendency to return to the starting levels. The dental pulp blood flow is differently affected by higher radiation doses (over 50Gy) in comparison to lower doses (below 50Gy). During RT planning, considering the possibility of protecting the teeth localized near the Gross Tumor Volume as a sensitive organ is recommended.

Comparative evaluation of subgingival microbiome in healthy periodontium and gingivitis using next-generation sequencing technology: A case-control study.

Background:Human dental plaque is a complex microbial community containing millions of species. Gingivitis is a dysregulated immune-inflammatory response induced by dysbiotic plaque biofilm that interrupts symbiosis. The emergence of next-generation sequencing with 16S rRNA gene has greatly contributed in understanding the complexity of microbiota. However, studies focusing on microbiome in gingivitis are limited. The whole bacterial community is important in causing periodontal disease than a small number of periodontal pathogens. In this study, we attempted to profile the subgingival microbiome from individuals with healthy gingiva and in patients with gingivitis using next-generation sequencing technology.Materials and Methods:Subgingival plaque samples from 15 healthy periodontium (Group I) and 15 gingivitis (Group II) were collected and 16s rRNA sequencing was done in Illumina Solexa Sequencer. Data analysis using 16s metagenomics tool from BaseSpace onsite operational taxonomic units was assigned to each sequence using HOMD database. Individual variation in the microbiome of the subgingival samples between the two groups was also evaluated.Results:The comparison of top 20 species between Group I and Group II revealed no significant species group between them. Synergistetes was absent in Group I samples but found in Group II. At the genus level, HACEK group species were found in both the groups, while Dialister and Aneroglobus were found abundantly in the Group II.Conclusion:The presence of unique genera and species seen in Group II samples could point toward a dysbiotic shift that could be taking place in the subgingival environment leading to gingivitis.

Prevalence of Gingivitis and Correlation between Frequency of Brushing and Gingivitis in 3- to 15-Year-Old School Children in Rural Parts of Barabanki District, Uttar Pradesh, India

Background: In India, the majority population lives in rural areas where there is less awareness on the maintenance of oral health. At the rural level, less work has been done among children to determine the incidence of gingival disease and its relation to the cleaning rate. Hence, it is necessary to evaluate the prevalence of gingivitis among these masses. Aims and Objectives: The goal of the study was to determine the prevalence of gingivitis and its relation to the frequency of tooth brushing among school-going children between 3 and 15 years of age group in rural areas of Barabanki district, India. Materials and Methods: The study was done on a sample size of 1200 school-going children, in which 611 boys and 589 girls are there, from rural schools of Barabanki. The sample consisted of four age groups of children from 3 to 5 years, 6–9 years, 10–12 years, and 13–15 years of age. Gingival Index given by Loe and Silness was used to determine the severity of gingivitis. The data were evaluated using the Chi-square test. Results: The overall prevalence of gingivitis obtained was 86.17% and it was highly significant in relation to age groups. On comparing the frequency of brushing and gingivitis in all age groups it was revealed that twice daily brushing was significantly related to healthy gingiva. Conclusions: The study revealed a high prevalence rate of gingivitis among children in these age groups indicating oral health program is highly recommended for both parents and school children in rural areas to maintain oral hygiene.