Healthy Gingiva Research Articles

Fibrin-assisted soft tissue promotion (FASTP) as a simple root coverage technique: A case report

Objective: The objective of this article is to present fibrin-assisted soft tissue promotion (FASTP), a simple root coverage surgical procedure associated with the use of A-PRF as a source of autogenous growth factors that allow the recipient soft tissue to promote the fabrication of new keratinized and attached tissue without a donor site.
 Methods: The case of a 20-year-old non-smoker female patient was reported to the Universitas Airlangga Dental Hospital with a chief complaint of tooth hypersensitivity to cold stimuli at the posterior right maxilla and mandibular. A 1–1,5 mm gingival recession was found on the buccal aspect of 14, 15, 44, and 46. A final diagnosis of clinically healthy gingiva on reduced periodontium in a non-periodontitis patient was made. The treatment plan included dental health education with a focus on brushing methods and scaling procedures that were performed as non-surgical therapy. A FASTP procedure was planned for root coverage treatment on the buccal aspect of 14, 15, 44, and 46.
 Results: A 1-year evaluation was done and showed complete root coverage with an acceptable gingival phenotype.
 Conclusion: FASTP is a simple root coverage surgical technique without the need to harvest tissue from a donor site, thereby decreasing procedure-related morbidity. Case selection plays an important role in proper surgical technique consideration.

Efficacy of curcumin gel as an adjunct to scaling and root planing on salivary procalcitonin level in the treatment of patients with chronic periodontitis: a randomized controlled clinical trial

The aim of the studyTo evaluate the effect of curcumin gel combined with scaling and root planing (SRP) on salivary procalcitonin in periodontitis treatment.Materials and methodsseventy patients were selected from the Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, and sixteen patients were excluded. Patients in groups II and III included stage II grade A periodontitis. The participants were classified into three groups: group I as a negative control group (individuals with healthy gingiva), group II (SRP) were treated with SRP, and group III (curcumin gel) which was applied weekly for four weeks after SRP. Clinical indices (plaque index (PI), gingival index (GI), clinical attachment level (CAL), and probing depth (PD)) and saliva samples for procalcitonin (PCT) assessment using an enzyme-linked immunosorbent assay (ELISA) test were collected and measured at both baselines and after six weeks.ResultsThis randomized controlled clinical trial registered on ClinicalTrials.gov (NCT05667376) and first posted at 28/12/2022 included Fifty-four patients (20 male; 34 female). Regarding the age and sex distribution, there was no statistically significant difference between the three studied groups (p > 0.05). There was no significant statistical difference regarding PI, GI, PPD, and CAL between group II and group III at baseline p (> 0.05). However, there was a significant statistical difference regarding the clinical parameters at baseline of both group II and group III as compared to group I (p ≤ 0.05). At six weeks after treatment, group III showed greater improvement in the PI, PD, and CAL as opposed to group II (p ≤ 0.05). Regarding PCT values, at baseline, there wasn’t a statistically significant difference between group II and group III (p > 0.05). However, there was a significant statistical difference between group II, group III, and group I (p ≤ 0.05). At six weeks after treatment, there was a statistically significant decrease in PCT levels of both group II and III (p ≤ 0.05).ConclusionThe application of curcumin gel was found to have a significant effect on all clinical indices as opposed to SRP.

Clinical Evaluation of Correlation between Periodontal Diseases and ABO Blood Grouping

Periodontal disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. Several studies have focused on the relationship between ABO blood and RH factor groups and periodontal diseases. However, the results showed a lot of discrepancies Aim of the study: to evaluate the relationship between ABO, Rh blood groups and distribution of periodontal diseases. Material And Method: This study involved 560 subjects aged between 20 to 55 years; selected on random basis from the outpatient department of Periodontology at AL -mammon specialized dental center in Baghdad. The patients sample have been classified in a 3 groups in relation to their clinical presentation and the periodontal scores on a basis of Ramfjord’s Periodontal index. Result: out of 560 patients there were 312 male, 248 female patients. According to sample classification in relation to clinical condition and periodontal score, Group I 115 patients with healthy gingiva; group II 225 patients with gingivitis; and group III 220 patients with periodontitis ,the highest prevalence of periodontitis are among blood group O(34.1%), while higher gingivitis percentage are associated with blood group A (34.2%). The prevalence of gingivitis was higher in Rh positive group 43.1%, while periodontitis show higher prevalence in Rh negative group 40%. Discussion and conclusion: We concluded that there was significant relationship between ABO, Rh blood group system and periodontal disease. Blood group ‘A’ could be a factor of risk for gingivitis and blood group ‘O’ could be a factor of risk for the developing of periodontitis. Similarly Rh positive group considered a risk factor for gingivitis, while Rh negative group is a risk factor for periodontitis.

Pomegranate Peel Extract Differently Modulates Gene Expression in Gingiva-Derived Mesenchymal Stromal Cells under Physiological and Inflammatory Conditions.

Pomegranate has shown a favorable effect on gingivitis/periodontitis, but the mechanisms involved are poorly understood. The aim of this study was to test the effect of pomegranate peel extract (PoPEx) on gingiva-derived mesenchymal stromal cells (GMSCs) under physiological and inflammatory conditions. GMSC lines from healthy (H) and periodontitis (P) gingiva (n = 3 of each) were established. The lines were treated with two non-toxic concentrations of PoPEX (low-10; high-40 µg/mL), with or without additional lipopolysaccharide (LPS) stimulation. Twenty-four genes in GMSCs involved in different functions were examined using real-time polymerase chain reaction (RT-PCR). PoPEx (mostly at higher concentrations) inhibited the basal expression of IL-6, MCP-1, GRO-α, RANTES, IP-10, HIF-1α, SDF-1, and HGF but increased the expression of IL-8, TLR3, TGF-β, TGF-β/LAP ratio, IDO-1, and IGFB4 genes in H-GMSCs. PoPEx increased IL-6, RANTES, MMP3, and BMP2 but inhibited TLR2 and GRO-α gene expression in P-GMSCs. LPS upregulated genes for proinflammatory cytokines and chemokines, tissue regeneration/repair (MMP3, IGFBP4, HGF), and immunomodulation (IP-10, RANTES, IDO-1, TLR3, COX-2), more strongly in P-GMSCs. PoPEx also potentiated most genes' expression in LPS-stimulated P-GMSCs, including upregulation of osteoblastic genes (RUNX2, BMP2, COL1A1, and OPG), simultaneously inhibiting cell proliferation. In conclusion, the modulatory effects of PoPEx on gene expression in GMSCs are complex and dependent on applied concentrations, GMSC type, and LPS stimulation. Generally, the effect is more pronounced in inflammation-simulating conditions.

Comparing gingivitis diagnoses by bleeding on probing (BOP) exclusively versus BOP combined with visual signs using large electronic dental records

The major significance of the 2018 gingivitis classification criteria is utilizing a simple, objective, and reliable clinical sign, bleeding on probing score (BOP%), to diagnose gingivitis. However, studies report variations in gingivitis diagnoses with the potential to under- or over-estimating disease occurrence. This study determined the agreement between gingivitis diagnoses generated using the 2018 criteria (BOP%) versus diagnoses using BOP% and other gingival visual assessments. We conducted a retrospective study of 28,908 patients' electronic dental records (EDR) from January-2009 to December-2014, at the Indiana University School of Dentistry. Computational and natural language processing (NLP) approaches were developed to diagnose gingivitis cases from BOP% and retrieve diagnoses from clinical notes. Subsequently, we determined the agreement between BOP%-generated diagnoses and clinician-recorded diagnoses. A thirty-four percent agreement was present between BOP%-generated diagnoses and clinician-recorded diagnoses for disease status (no gingivitis/gingivitis) and a 9% agreement for the disease extent (localized/generalized gingivitis). The computational program and NLP performed excellently with 99.5% and 98% f-1 measures, respectively. Sixty-six percent of patients diagnosed with gingivitis were reclassified as having healthy gingiva based on the 2018 diagnostic classification. The results indicate potential challenges with clinicians adopting the new diagnostic criterion as they transition to using the BOP% alone and not considering the visual signs of inflammation. Periodic training and calibration could facilitate clinicians' and researchers' adoption of the 2018 diagnostic system. The informatics approaches developed could be utilized to automate diagnostic findings from EDR charting and clinical notes.

Hyperbaric oxygen therapy restores wound healing in irradiated gingiva to a similar level to that in healthy gingiva.

This study aimed to investigate the involvement of mitochondrial biogenesis, and determine the extent of fibroblast proliferation and cellular apoptosis, in the gingiva of patients who had undergone head and neck radiation, after receiving hyperbaric oxygen therapy (HBOT), in comparison with normal gingiva. A total of 16 patients who had undergone head and neck radiation with HBOT and six healthy subjects were included in the study. After the completion of radiation therapy, patients received HBOT at 2 ATA for 90 minutes per session, and for 20 sessions per patient. Samples of gingival tissues were then taken. The levels of: transforming growth factor beta (TGF-β); phospho-nuclear factor kappa-light-chain-enhancer of activated B cells (p-NFϰB); nuclear factor kappa-light-chain-enhancer of activated B cells (NFϰB); proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α); phospho-dynamin-related protein 1 at ser616 (p-Drp1ser616); dynamin-related protein 1 (Drp1); Bcl-2-associated X-protein (Bax); and B-cell lymphoma 2 (Bcl-2) were determined using a Western blot. Independent t-test and Chi-squared tests were used in the study. There were no differences in the levels of TGF-β, p-NFϰB, NFϰB, p-Drp1ser616, Drp1, Bax and Bcl-2 between the two groups. However, the level of PGC-1α was greater in irradiated gingival tissues with HBOT than in the healthy gingiva. Radiation-induced impaired wound healing can be improved by HBOT as indicated by levels of apoptosis, mitochondrial dynamics, cell proliferation and inflammation in irradiated gingiva with HBOT to a similar level to normal healthy gingiva. These findings may occur through an increase in mitochondrial biogenesis following HBOT.

Comparison between HSV-1 Ag detection techniques by ELISA and real-time PCR in breast cancer patients suffering from periodontitis

J Fac Med Baghdad 2023; Vol.65, No. 3 Received:March., 2023 Accepted: June. 2023 Published: Oct. 2023 Background: Periodontitis is a long-standing infection that destroys the gums, periodontal ligaments, and the alveolar bone that supports the teeth. Inflammation of the gums and chronic periodontitis are both caused by the bacteria in the dental plaque and the herpes viruses, especially types 1 and 2 of the herpes simplex virus. Objectives: To compare the ELISA and real-time PCR as ways to detect the herpes simplex virus in breast cancer patients with periodontitis who are receiving chemotherapy. Cases and methods: In this case-control study, a total of 90 subjects (30 with periodontitis with breast cancer after receiving chemotherapy, 30 with periodontitis (without chemotherapy treatment), and 30 cases which do not have periodontitis (healthy gingiva) and without breast cancer as a healthy control group. The mean ±SD age was (51.06±8.521). Enzyme-linked immunosorbent assay (ELISA) kits were used for the analysis and Real-Time PCR to detection of Herpes simplex virus-1 in saliva samples. Results: In the present study, the incidence of HSV-1 Ag in patients having periodontitis and receiving chemotherapy was high but not significantly so compared with those having periodontitis but without chemotherapy and the healthy control group. In contrast, the result of Real-time PCR was positive (13.3%) and (10.0%), which proves the presence of HSV in most patients with periodontitis without chemotherapy and with periodontitis receiving chemotherapy but was not significant (p>0.05). Conclusion: Real-time PCR was able to back up ELISA's findings in this study. Since ELISA is more cost-effective than real-time PCR, it is advised that the first screening may be performed using ELISA, and then positive samples might be investigated with real-time PCR to confirm the presence of HSV-DNA Received:March., 2023 Accepted: June. 2023 Published: Oct. 2023

Gingival displacement before impression making: A prospective, comparative randomized clinical trial

Gingival displacement is used in prosthodontics to obtain an accurate impression. However, randomized clinical trials to analyze the performance of different gingival displacement products are lacking. The purpose of this prospective, comparative randomized clinical trial was to evaluate the clinical effectiveness of 3 gingival displacement techniques: Racegel cordless, Racegel with a cord, and Racestyptine with a cord. A prospective, multicenter randomized, open label, 3-arm parallel group study was carried out in private dental practices. Patients with prepared teeth with healthy gingiva were recruited to make impressions before and after gingival displacement, which were digitized. Lateral and vertical gingival displacements were measured with computer-aided 3-dimensional analysis performed by a single operator who was blinded to the technique and the patient. For mean lateral gingival displacement, each gingival displacement method was compared with a required clinical value of 200µm with the Student t test. The comparison of means among the 3 groups was performed using an ANOVA. Periodontal indices were recorded immediately and 7 to 14days after gingival displacement. The percentages were compared with the chi-squared test or the Fisher exact test (α=.05 for all tests). Eighty-eight participants were enrolled. The mean lateral gingival displacement obtained by Racestyptine with a cord (253 ±59µm, P<.001) and by Racegel with a cord (247 ±61µm, P<.001) were significantly higher than 200µm. Lateral displacement observed with Racegel cordless was 207 ±57µm (P=.53). For vertical gingival displacement, no difference among the 3 techniques was found. The astringent effect of these products was confirmed by the absence of crevicular fluid or bleeding. No periodontal damage was observed immediately or 7-14days after displacement. The study showed that cord impregnated with Racestyptine and Racegel with or without a cord provided a sufficient sulcus opening before impression making in prosthodontics, consistent with the clinical requirements for lateral displacement.

Fifteen ceramic gingival samples: A proposed gingival shade guide

Objective(1) To put forward a set of valid pink ceramic samples for subjective gingival colour selection in the Caucasian population, and (2) to assess the quality of the shade matches provided by the selected pink samples. MethodsThe ceramic gingival shade samples (n = 133) were obtained by mixing pairs of basic colours from a single system. In each mixture, the proportions of the colours were altered in 10% increments, following the numerical order used by the manufacturers of the three colour systems under study (Heraceram, Vita VM9 and IPS Style). The CIELAB colour coordinates were recorded using spectrophotometry in three zones of healthy anterior gingiva (n = 360). The sample was randomly divided into two subsamples, each of which contained 180 participants. Subsample 1 was used to select the ceramic gingival samples that provided the best shade matches, using the k-means clustering method. Subsample 2 was used to assess the chromatic validity of the selected gingival samples, according to the coverage error. ResultsTo identify the ceramic gingival samples that best represented participants’ gingival colour, the minimum colour differences (ΔEab∗, ΔE00) between the cluster centroids and the 133 gingival samples were calculated. Fifteen gingival samples were selected: 8 from the Heraceram system, 4 from the VM9 system, and 3 from the IPS Style system. Coverage errors for the 15 gingival samples fell below the gingival clinical acceptability thresholds in the three gingival zones examined. ConclusionsThe 15 ceramic gingival colour samples provide satisfactory coverage of the gingival colour space, with coverage errors below the ΔE00 clinical acceptability threshold of 2.9 units. These pink colour samples have the potential to provide good gingival shade matches in subjective colour selection. Clinical SignificanceMixing basic ceramic colours is a viable method for generating a series of pink shades that can be used as a physical gingival shade guide. The resulting guide provides valid results (under the acceptability thresholds) for subjective selection gingival colour selection in clinical practice.

Heterogeneity of T-cells in periapical lesions and in vitro validation of the proangiogenic effect of GZMA on HUVECs.

T-cells are key immunomodulatory cells in periapical lesions. This study aimed to explore the roles of T-cells in chronic apical periodontitis (CAP) using single-cell RNA sequencing and to further investigate Granzyme A (GZMA) in angiogenesis regulation. A total of five CAP samples were collected for single-cell RNA sequencing. We performed sub-cluster and lineage-tracing analyses for T-cells. According to differential gene expression, distinct biological functions enriched in T-cells of CAP were presented by Gene Set Enrichment Analysis (GSEA) and compared with healthy gingiva (data obtained from the GEO database). CellChat was used to explore potential ligand-receptor interactions between T-cells and endothelial cells in CAP. The coculture of primary human umbilical vein endothelial cells (HUVECs) and Jurkat T-cells, as well as the addition of GZMA recombinant protein, was used to validate the predicted pair of GZMA and_Coagulation Factor II Thrombin Receptor (F2R) by RT-PCR, angiogenesis, and migration assays. A transcriptomic atlas of 44,746 individual cells was constructed from the periapical lesions of five patients with CAP by single-cell RNA-seq, and eight cell types were identified. We identified nine subsets of T cells and deciphered the cellular heterogeneity of T-cells in CAP at the functional level by sub-clustering and GSEA. Lineage-tracing revealed a distinct lineage of T-cells in CAP and predicted the transition of the T cellular state upon CAP. GSEA revealed multiple biological processes and relevant angiogenesis genes upregulated in CAP T-cells. GZMA-F2R pairs were predicted by cell-cell interactions in CAP. High expression of GZMA and F2R was observed in the coculture of HUVECs and Jurkat T-cells, and the proangiogenic capacity of the GZMA recombinant protein was emphasized by in vitro experiments. Our study provides novel insights into the heterogeneity of T-cells in periapical lesions and reveals the potential role of GZMA in T-cells in regulating angiogenesis in HUVECs.

The effects of maternal environmental tobacco smoke exposure on periodontal health and mother-infant bonding in relation to salivary cotinine level

Background: Environmental tobacco smoking is produced by active smokers burning the tip of a cigarette and breathed by nonsmokers and measured by cotinine level. It has the potential to raise the risk of periodontal disease. One of the most frequent chronic diseases in adults is periodontal disease. The lower maternal-fetal attachment has been found to predict smoking status in previous studies, but no research has examined whether maternal-fetal attachment predicts environmental tobacco smoking. This study assessed the effects of maternal environmental tobacco smoke exposure on periodontal health and mother-infant bonding concerning salivary cotinine levels. Materials and methods: This is a comparative cross-sectional study comparing environmental tobacco smoke on exposed and non-exposed mothers aged between 20-35 years with their infants aged up to one year who attended primary health care centers in rural areas of AL-Karkh sector/Baghdad. Along with the essential socio-demographic data, a secondhand smoke exposure scale and postpartum bonding questionnaire were employed. Collection of unstimulated saliva from mothers was done according to Navazesh and Kumer in 2008. After that, the clinical Assessment of gingival bleeding and periodontal pockets was performed by using Community Periodontal Index according to the world health organization in 1997. Results: Out of 150 subjects,67(44.66%) were exposed to environmental tobacco whereas the non-exposed mothers were composed of 83 (55.33%). The highest mean number of CPI0(healthy gingiva) and CPI1(gingival bleeding) were among the non-exposed mothers while the highest mean number of CPI2(dental calculus), CPI3 (shallow pocket 4-5mm) and CPI4(deep pocket 6mm or more) were among the exposed mothers. The mean value of cotinine level among the non-exposed mothers was lower than exposed mothers with significant results. A higher salivary cotinine level was linked to a lower maternal-fetal bonding score. Conclusions: Mother’s exposure to environmental tobacco smoke significantly negatively impacts periodontal disease. Furthermore, mothers who have a stronger sense of attachment and affiliation to their fetus have lower salivary cotinine concentrations than mothers who have a less sense of fetal attachment.

Effects of orthodontic treatment on porphyromonas gingivalis, gingipains and gingival inflammation

Purpose: To assess the effects of orthodontic treatment on the changes of Porphyromonas gingivalis ( P.g) and gingipains as well as gingival inflammation. Materials and methods: A total of 105 patients who had healthy gingivae and were treated as research subjects, the gingival crevicular fluid of whom was all collected before treatment and in the 1st, 2nd, 3rd, and 6th months after wearing an appliance. Then, the 16S ribosomal deoxyribonucleic acid (rDNA) polymerase chain reaction (PCR) technique was employed to detect the levels of P.g, Lys-gingipain (Kgp) and Arg-gingipain (Rgp) in the specimens. It was followed by a statistical analysis of the data via the SPSS 23.0 software package. Results: In P.g detection, the 16S rDNA PCR technique presented specific advantages and high sensitivity. The positive detection rate of P.g in the 1st, 2nd and 3rd month of treatment ( p &lt; .05), that of Kgp in P.g-positive patients in the 2nd and 3rd months of treatment ( p &lt; .05), and that of Rgp in P.g-positive patients in the 2nd and 3rd months of treatment ( p &lt; .05) were higher than the pre-treatment results. Compared with gingival index (GI)-0 patients, GI-1 patients exhibited higher positive detection rates of P.g and Kgp and Rgp, which were further found to be positively correlated with the treatment duration and GI ( p &lt; .05). Conclusion: In the early stage of orthodontic treatment, the levels of P.g, Kgp and Rgp rise after wearing the appliance, inducing gingival inflammation.

Assessment of salivary Alkaline Phosphatase in patients with healthy gingiva on reduced periodontium versus periodontitis

Assessment of salivary Alkaline Phosphatase in patients with healthy gingiva on reduced periodontium versus periodontitis

Determination of gingival temperatures of dogs with healthy gums by means of a thermal camera

In this study, the gingival inflammation degree of dogs was determined according to the Gingival Index (GI). According to this index, it was aimed to determine the free gingiva (FG), attached gingiva (AG) and alveolar mucosa (AM) temperatures of the gingiva of dogs with healthy gums by means of a thermal camera. The material of the study consisted of the gingiva of 140 dogs aged 2 years and older, who were brought to Burdur Mehmet Akif Ersoy University, Faculty of Veterinary Medicine, Animal Hospital, Surgery Clinic, non-brachiocephalic and without periodontal destruction in their gingiva. Healthy maxillary (n= 427) and mandibular (n= 671) gums in addition maxillary (n=432) and mandibular (n= 463) gums with gingivitis were included in the study. The FG temperature of the buccal surface of the healthy maxillary gingiva was 36.25±1.43°C, the AG temperature was 36.81±1.37°C, and the AM temperature was 37.53±1.30°C. The FG temperature of the buccal surface of the healthy mandibular gingiva was 35.46±1.42°C. In addition the AG temperature was 36.26±1.35°C, and the AM temperature was 37.01±1.22°C. The FG temperature of the maxillary gums with gingivitis was 36,40±1,32°C, the AG temperature was 36,95±1,21°C, and the AM temperature was 37,57±1,21°C. The FG temperature of the mandibular gums with gingivitis was 35,82±1,26°C, the AG temperature was 36,57±1,16°C, and the AM temperature was 37,27±1,10°C. Temperature difference (r) between in maxillary and mandibular FG (r= 0.78°C and p= .000), AG (r= 0.52°C and p= .000) and AM (r= 0.51°C and p= .000) of dogs with healthy gums temperatures were found to be significant. Temperature difference between maxillary and mandibular FG with gingivitis (r= 0.58°C and p= .000), AG (r= 0.38°C and p= .000) and AM (r= 0.29°C and p= .000) were found to be statistically significant. It was concluded that the thermal camera can be an effective diagnostic tool in detecting inflammatory changes in the gingiva.

Assessment of Salivary Levels of the RANKL and RANK in Patients with Healthy Gingiva on Reduced Periodontium Versus Periodontitis

Introduction: We aimed to compare the changes in the two salivary biomarkers, RANKL and RANK, among patients with healthy gingiva on reduced periodontium versus generalized periodontitis stages II and III. Methods: Study subjects were divided into three groups: (1) healthy periodontium (control group) (n = 15), (2) generalized periodontitis stages II and III (n = 30), and (3) healthy gingiva on reduced periodontium (n = 30). Salivary levels of RANKL and RANK were assessed using an enzyme-linked immunosorbent assay. Data analysis was done by the one-way ANOVA and the Tukey post hoc test using R software. Results: There was a statistically significant difference among the three study groups regarding salivary levels of the RANKL (P &lt; 0.001) and RANK (P &lt; 0.001). A Post hoc test showed that the difference between salivary levels of the RANKL (P = 0.50) and RANK (P = 0.86) among periodontitis groups and healthy gingiva in the reduced periodontium group was not statistically significant. Conclusion: High salivary levels of RANKL and RANK in comparison with healthy gingiva are not necessarily associated with the active phase of periodontal disease and progressive bone destruction.

PREVALENCE OF ENTAMOEBA GINGIVALIS IN PATIENTS WITH GINGIVITIS AND PERIODONTITIS AND HEALTHY INDIVIDUALS AND ITS ASSOCIATED FACTORS

The present study was carried out to determine the prevalence of Entamoeba gingivalis among 300 (156 males and 144 females) participants divided into three groups as follows: 100 patients with periodontitis (periodontitis group), 100 patients with gingivitis (gingivitis group), and 100 individuals with healthy gingiva (healthy control group), using wet mount technique with physiological saline and Giemsa stain. The overall prevalence of E. gingivalis was 18.3% and the highest prevalence of E. gingivalis was among periodontitis group (29%) followed by gingivitis group (18%), and healthy group (8%). The highest prevalence (23.7%) of E. gingivalis was found among the age group 40-49 years. Infection was highly significant in males than females (23.7% vs.12.5%). With regard to risk factors, the prevalence of E. gingivalis was common in non-tooth brush users, smokers, qat chewers, and diabetic patients and there were significant differences between tooth-brush users and non-tooth brush users, smokers and non-smokers, qat chewers and non-gat chewers, and between diabetic and non-diabetic patients and occurrence of E. gingivalis. We conclude that the higher prevalence of E. gingivalis in periodontal disease compared to healthy individuals may be an indicator of the potential role E. gingivalis in the pathogenesis of periodontal diseases.

Comparison of Antimicrobial Activity against Porphyromonas gingivalis between Advanced Platelet-Rich Fibrin and Injectable Platelet-Rich Fibrin.

Platelet-rich fibrin (PRF) obtained via low-speed centrifugation has antimicrobial properties. This study was conducted to evaluate the effectiveness of advanced platelet-rich fibrin plus (A-PRF+) and injectable platelet-rich fibrin (I-PRF), obtained from patients with different periodontal states, against Porphyromonas gingivalis. A-PRF+ and I-PRF samples were obtained from venous blood of 60 subjects divided equally into three groups: periodontitis, gingivitis, and healthy gingiva groups. The antibacterial experiments evaluated biofilm inhibition, mature biofilm impact, and time-kill kinetics. The percent reduction in biofilm-growing and mature biofilm bacteria ranged from 39% to 49% and 3% to 7%, respectively. In the time-kill kinetics assay, PRF from the periodontitis group was more effective as an antimicrobial than that from the gingivitis and healthy gingiva group (p < 0.001); I-PRF was more effective than A-PRF+ (p < 0.05) and both of them showed peak antibacterial activity after 12 h of exposure. Both A-PRF+ and I-PRF exhibited antibacterial properties against P. gingivalis, but I-PRF appeared to be more effective. The PRF obtained from the different groups appeared to have different degrees of antimicrobial efficacy.

The expression of cyclic GMP-AMP synthase in human apical periodontitis: A laboratory investigation.

As a key DNA sensor, cyclic GMP-AMP synthase (cGAS) has emerged as a major mediator of innate immunity and inflammation. Human apical periodontitis has yet to be studied for the presence of cGAS. This investigation was conducted to determine if cGAS is involved in the pathological process of human apical periodontitis. Sixty four human periapical lesions, comprising 20 periapical granulomas and 44 radicular cysts, were employed in this investigation. Healthy gingiva (n=6), dental pulp (n=3), and apical papilla (n=3) were used as control samples. The expression of cGAS in the periapical tissues was discovered using immunohistochemical staining. mRNA-Sequencing and qRT-PCR were utilized to determine the differentially expressed genes (DEGs) associated with DNA-sensing signalling in periapical lesions compared to the healthy control. Immunofluorescence labelling was used to identify the co-expression of cGAS, interleukin-1β, and interleukin-18. A significantly greater expression level of cGAS was discovered in the periapical lesions, with no significant difference between radicular cysts and periapical granulomas. mRNA-Sequencing analysis and qRT-PCR identified differentially expressed mRNA, such as cGAS and its downstream DEGs, between periapical lesions and healthy control tissues. Immunofluorescence labelling further revealed that cGAS, interleukin-1, and interleukin-18 were co-localized. These observations imply that along with the synthesis of interleukin-1 and interleukin-18, cGAS may be involved in the aetiology of apical periodontitis.

Breaking the Gingival Barrier in Periodontitis.

The break of the epithelial barrier of gingiva has been a subject of minor interest, albeit playing a key role in periodontal pathology, transitory bacteraemia, and subsequent systemic low-grade inflammation (LGI). The significance of mechanically induced bacterial translocation in gingiva (e.g., via mastication and teeth brushing) has been disregarded despite the accumulated knowledge of mechanical force effects on tight junctions (TJs) and subsequent pathology in other epithelial tissues. Transitory bacteraemia is observed as a rule in gingival inflammation, but is rarely observed in clinically healthy gingiva. This implies that TJs of inflamed gingiva deteriorate, e.g., via a surplus of lipopolysaccharide (LPS), bacterial proteases, toxins, Oncostatin M (OSM), and neutrophil proteases. The inflammation-deteriorated gingival TJs rupture when exposed to physiological mechanical forces. This rupture is characterised by bacteraemia during and briefly after mastication and teeth brushing, i.e., it appears to be a dynamic process of short duration, endowed with quick repair mechanisms. In this review, we consider the bacterial, immune, and mechanical factors responsible for the increased permeability and break of the epithelial barrier of inflamed gingiva and the subsequent translocation of both viable bacteria and bacterial LPS during physiological mechanical forces, such as mastication and teeth brushing.

Simultaneous Esthetic Crown Lengthening and Frenotomy Procedure for Smile Rejuvenation

&#x0D; Introduction: Gingival tissue plays an important role in smile aesthetics, especially in the anterior maxillary region. A gummy smile (GS) is a gingival condition that appears excessive when the patient smiles. The prevalence of gummy smile in individuals aged from 20 to 30 is 10% of population. It is more common in women and can cause aesthetic problems. Gummy smile aetiology is multifactorial. This case report discusses gummy smile case caused by altered passive eruption (APE) and associated with the presence of aberrant frenum. Case Report: A 19-year-old female patient with chief complaints of the excessive gingival display. The diagnosis of the case was confirmed by clinically healthy gingiva in an intact periodontium with gummy smile due to the presence of altered passive eruption type I-B accompanied by an aberrant frenum. The final surgical plan was aesthetic crown lengthening (CL) with flap surgery and osteotomy simultaneous with a frenotomy. Conclusion: The aesthetic crown lengthening surgery and frenotomy can be performed simultaneously to correct the gummy condition and improve the patient’s smile profile. Appropriate examination, diagnosis, and treatment planning help achieve optimal patient outcomes.