Periodontal Connective Tissue Research Articles

Granulomatous Epulis in Maxillary Anterior Interdental Teeth

Introduction: Epulis is a tumor-like enlargement of the gingiva originating from periodontal connective tissue, which is caused by chronic irritation. Epulis that occurs on the upper anterior teeth will disrupt the aesthetics and function of the lips and reduce self-confidence, so treatment is needed. Case report: The patient came to RSGM complaining that there was a lump on the upper front tooth and it felt painful. The patient had gone to the dentist regarding this case and was given topical medication, but the patient forgot the name of the medication. The patient's pain is aggravated when brushing his teeth and eating hard food or meat, for the taste is relieved when left alone. At the first meeting, patients are given information and education regarding the disease they are suffering from. Case management: The surgical phase by excision of the epulis with gingivectomy and subsequent curettage after surgical treatment of the gingiva. Discussion: Granulomatous epulis is a tissue mass that only exists in the gingiva which is richly vascularized, this lesion can grow to a certain size and stop growing. The etiology of granulomatous epulis lesions is usually caused by chronic irritation. Conclusion: Excision treatment and gingival formation performed with a scalpel can be considered for the treatment of maxillary anterior granulomatous epulis

DEVELOPMENT OF PATHOLOGICAL CHANGES IN THE ORAL CAVITY ORGANS OF ANIMALS UNDER CONDITIONS OF POLYNEUROPATHIES OF DIFFERENT GENESIS

The aim of our research is to study the effect of polyneuropathy of different genesis on the development of pathological changes in the large salivary glands and periodontal tissues of animals. Methods. The study was conducted on 62 laboratory rats of both sexes. Toxic polyneuropathy was induced by paclitaxel injection, experimental type 1 diabetes mellitus was modeled by streptozocin injection, and alcoholic polyneuropathy was induced by chronic administration of increasing concentrations of ethanol. The development of polyneuropathy was confirmed by a change in the the pain sensitivity threshold (PST) using the Randall-Selitto tensoalgometric method. In the homogenate of oral cavity organs, total proteolytic and total antitryptic activity, catalase activity, content of TBARS, average mass molecules, oxidatively modified proteins, fucose and glycosaminoglycans (GAG), and amylase activity were determined. The level of total, protein-bound and non-protein sulfhydryl groups, activity of superoxide dismutase, glutathione peroxidase, glutathione transferase, glutathione reductase; content of reduced and oxidized glutathione, diene conjugates and Schiff bases were determined in blood serum. Results. We established the increasing of PST in animals that were simulated neuropathies of different genesis. All three types of polyneuropathies are accompanied by the development of carbonyl-oxidative stress in the soft tissues of the periodontium and large salivary glands of rats, which is evidenced by a probable increase in the content of oxidatively modified proteins and the content of TBARS, as well as average mass molecules compared to these indicators in intact animals . Under the conditions of modeling all three polyneuropathies, the protein-synthetic activity in the large salivary glands is suppressed, as evidenced by a decrease in the activity of α-amylase. Under conditions of experimental diabetic and toxic neuropathy in the salivary glands of animals, changes in the proteinase-inhibitor balance of the compensatory type are observed. We found that polyneuropathies of different genesis cause increased catabolism of biopolymers of the extracellular matrix of the periodontal connective tissue of rats, which confirms the increase in the content of GAG and fucose compared to these indicators in control animals. Conclusions. Under conditions of diabetic, toxic and alcoholic neuropathy, the amylolytic activity of the large salivary glands of animals is suppressed, the balance of the pro- and antioxidant system changes. When modeling peripheral polyneuropathy in animals by administration of paclitaxel, streptozocin, and ethanol, the development of periodontal syndrome is observed, the leading pathogenetic mechanisms of which are increased catabolism of connective tissue glycoconjugates and the development of oxidative stress and proteinase-inhibitor imbalance.

Local application of gingiva-derived mesenchymal stem cells on experimental periodontitis in rats.

Stem cell-based approaches in regenerative periodontal therapy have been used in different experimental models. In this study, the effect of local application of gingival mesenchymal stem cells (GMSC) in fibroin/chitosan oligosaccharide lactate hydrogel (F/COS) on periodontal regeneration was evaluated using experimental periodontitis model in rats. Mesenchymal stem cells were isolated from the gingiva of rats and characterized. Viability tests and confocal imaging of GMSC in hydrogels were performed. Healthy control without periodontitis (Health; H; n=10), control with periodontitis but no application (Periodontitis; P; n=10), only hydrogel application (F/COS; n=10), and GMSC+F/COS (n=10) four groups were formed for in vivo studies. Experimental periodontitis was created with silk sutures around the maxillary second molars. GMSC labeled with green fluorescent protein (GFP) (250,000 cells/50μL) in F/COS were applied to the defect. Animals were sacrificed at 2nd and 8th weeks and maxillae of the animals were evaluated by micro-computed tomography (micro-CT) and histologically. The presence of GFP-labeled GMSC was confirmed at the end of 8weeks. Micro-CT analysis showed statistically significant new bone formation in the F/COS+GMSC treated group compared with the P group at the end of 8weeks (p<0.05). New bone formation was also observed in the F/COS group, but the statistical analysis revealed that this difference was not significant when compared with the P group (p>0.05). Long junctional epithelium formation was less in the F/COS+GMSC group compared with the P group. Periodontal ligament and connective tissue were well-organized in F/COS+GMSC group. The results showed that local GMSC application in hydrogel contributed to the formation of new periodontal ligament and alveolar bone in rats with experimental periodontitis. Since gingiva is easly accessible tissue, it is promising for autologous cell-based treatments in clinical applications.

Effect Of Topical Application Of Ozonated Olive Oil On The Number Of Lymfocite Cells In Male Wistar Rats With Periodontitis

Periodontitis is an inflammation of the supporting tissues of the teeth caused by specific microorganisms or specific groups of microorganism which results in progressive destruction of the periodontal connective tissue and alveolar bone by forming pockets, recession or both. When there is inflammatory periodontitis, the lymphocyte cells increase. Lymphocytes are specific chronic inflammatory cells that become an immune response to the presence of an injury during inflammation. One of the treatments that support wound healing in periodontitis is Ozonated Olive Oil. Ozonated Olive Oil has a disinfectant ability that can suppress the growth of bacteria such as those contained in periodontitis. This study aims to determine the effect of topical application of Ozonated Olive Oil on the number of lymphocyte cells in male Wistar rats with periodontitis. The number of male wistar rats used was 24. Observation of lymphocyte cells was carried out using a light microscope with a magnification of 200x and counted manually by the observer.The results showed that the mean number of lymphocytes in the experimental group was 24±3.26599 and the negative control group was 48±5.65685. The result of the One-Way ANOVA data analysis is 0.000 (0&lt;0.05). The conclusion of this study was that the use of 0.1 ml of Ozonated Olive Oil had an effect on the number of lymphocyte cells in male Wistar rats who had periodontitis.

N-Acetyl-l-cysteine-Derived Carbonized Polymer Dots with ROS Scavenging via Keap1-Nrf2 Pathway Regulate Alveolar Bone Homeostasis in Periodontitis.

Periodontitis is a type of chronic inflammatory oral disease characterized by the destruction of periodontal connective tissue and progressive alveolar bone resorption. As oxidative stress is the key cause of periodontitis in the early periodontal microenvironment, antioxidative therapy has been considered a viable treatment for periodontitis. However, more stable and effective reactive oxygen species (ROS)-scavenging nanomedicines are still highly needed due to the instability of traditional antioxidants. Herein, a new type of N-acetyl-l-cysteine (NAC)-derived red fluorescent carbonized polymer dots (CPDs) has been synthesized with excellent biocompatibility, which can serve as an extracellular antioxidant to scavenge ROS effectively. Moreover, NAC-CPDs can promote osteogenic differentiation in human periodontal ligament cells (hPDLCs) under H2 O2 stimulation. In addition, NAC-CPDs are capable of targeted accumulation in alveolar bone in vivo, reducing the level of alveolar bone resorption in periodontitis mice, as well as performing fluorescence imaging in vitro and in vivo. In terms of mechanism, NAC-CPDs may regulate redox homeostasis and promote bone formation in the periodontitis microenvironment by modulating the kelch-like ECH-associated protein l (Keap1)/nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. This study provides a new strategy for the application of CPDs theranostic nanoplatform for periodontitis.

MANAGEMENT OF SUSPECT GRANULOMATOUS EPULIS OF ANTERIOR MANDIBULAR TEETH WITH GINGIVECTOMY

ABSTRACT Gingival enlargement is a manifestation of hypertrophy (increase in cell size) and hyperplasia (increase in cell number). Epulis is a gingival hyperplasia (tumor-like) that originates from periodontal connective tissue. One type of epulis that often occurs is granulomatous epulis. Granulomatous epulis is a type of epulis that occurs from a granulomatous tissue reaction due to chronic irritation due to calculus, root residues, or carious edges. This case report discusses the management of suspect epulis granulomatous in mandibular anterior teeth. A 45-year-old female patient complained of swollen lower front gums and frequent bleeding when brushing her teeth. Intraoral examination showed that there was gingival enlargement in the form of papules with a size of 6 mm x 8 mm, reddish in color, smooth surface, soft consistency, well demarcated, painless but bleeding on palpation in the tooth area 41. OHI score 4.9 (moderate), BOP ( Bleeding in probing) was positive, and the probing depth of the mesiolabial, midlabial, and distolabial surfaces i.e. for tooth 41 was 5-5-5. The diagnosis in this case led to suspect epulis granulomatous on tooth 41. The treatment plan was KIE (Communication, Information and Education), initial therapy in the form of scaling and root planing, gingivectomy and then control. The results of the treatment showed that the gingival contour was physiologically formed, there was no swelling, negative palpation, negative BOP, and decreased pocket depth from the mesiolabial, midlabial, and distolabial surfaces of tooth 41 to 2-2-3.Keywords: epulis, granulomatous epulis, gingivectomy, gingival enlargement

CYTOKINE-MEDIATED REACTIONS IN THE PATHOGENESIS OF EXPERIMENTAL PERIODONTITIS

Determining cytokinemia role in the destructive processes of the periodontal complex gives new opportunities to the development and subsequent implementation of practical methods for chronic periodontitis diagnosis, justifies including pathogenetic drugs that inhibit the secretion of pro-inflammatory mediators in treatment regimens.&#x0D; The aim of the study is to evaluate the dynamics of cytokine profile indicators and identify their correlation with the local status of periodontal tissues in animals with experimental periodontitis.&#x0D; Materials and methods. The study enrolled 65 white outbred rats weighing 180±20 g. The authors reproduced the model of experimental periodontitis according to K.D. Shkolnaya, V.G. Atrushkevich method (patent RU No. 2625295, December 07, 2017). The cytokine profile was assessed by pro-inflammatory and anti-inflammatory cytokine levels, determined by enzyme-linked immunosorbent assay, Bender MedSystems reagent kit. Local status of periodontal tissues was assessed according to the degrees of gingival hemorrhage, dental mobility and depth of periodontal pockets with a button-shaped and modified periodontal probes.&#x0D; Results. During the experimental periodontitis modeling, a high level of cytokinemia was determined. It destructively effects the periodontal connective tissue matrix, which was confirmed by an increase in the depth of periodontal pockets, gingival hemorrhage and dental mobility. A strong correlation between a high level of cytokinemia and local destructive changes in periodontal tissues was determined. This fact emphasized the conjugation of these pathophysiological mechanisms.&#x0D; Conclusion. Defined disorders of physiological balance in the cytokine balance necessitate the use of pathogenic drugs, as they have an inhibitory effect on the synthesis of pro-inflammatory cytokines and prevent further destruction of the periodontal complex. Changes in the cytokine profile indicate inflammation process, and a decrease in the level of cytokinemia indicate the resolution of infection and can be considered a criterion for the effective treatment.

Role of biologic modifiers in periodontal regeneration- A review

Regenerative techniques, which aim to replace damaged periodontal ligament, bone, cementum, and connective tissue, are newer approaches to periodontal care. In periodontology and oral implantology, the development of molecular mediators has accelerated substantially over the last decade. At various cellular levels, different growth agents cause distinct reactions in periodontal tissues. The potency of biologics in regenerating the periodontal tissues is the call attention in this review paper, in which it discusses the structure, mechanism of action, indication and FDA (Food and Drug Administration) approval to use in regenerating periodontal tissues. The working activity of biologic agents together with reasons for utilizing them in regenerating tissues of periodontium lost due to disease are discussed, as well as the expected benefits as compared to traditional approaches.

Colitis induced by dextran sulphate sodium causes histopathological and immunological changes in the periodontal tissues of Wistar rats.

This study investigated the impact of colitis induced by dextran sulphate sodium (DSS)-induced colitis (DIC) on histopathological and immunological outcomes in the periodontal tissues of Wistar rats. Inflammatory bowel diseases (IBD) and periodontitis have been reported to present a bidirectional relationship. However, the inflammatory pathway that connects both diseases needs further investigation. Twenty-five male Wistar rats were allocated in four groups: unilateral ligature-induced periodontitis for 14 days: LIP (n=7); dextran sulphate sodium-induced colitis only: DIC (n=6); DIC + LIP (n=6) and controls (n=6). Digital images were obtained from the histological sections. In order to assess the attachment loss (AL), the linear distance between the cementoenamel junction (CEJ) and the alveolar bone crest was measured on the mesial root using histological photomicrography's ImageJ software. Immunological analyses of gingival tissues and plasma were performed by Bio-Plex Th1/Th2 Assay. The DIC group showed inflammatory cells extending to the periodontal connective tissues, which contained significantly elevated expressions of IL-1α, IL-1β, IL-2, IL-6, IL-12, IL-13, GM-CSF, IFN-γ and TNF-α compared to controls. There was no significant difference in bone loss between controls and DIC. There were no significant histopathological differences between DIC + LIP and LIP. However, DIC + LIP presented a significantly lower IL-2 and IL-5 than the LIP group. There was no bone loss difference between LIP+DIC and LIP groups. DIC + LIP group presented significantly higher levels of GM-CSF in plasma. DSS-induced colitis was associated with an overexpression of Th1/Th2- related cytokines in the gingival tissue.

Long-acting PFI-2 small molecule release and multilayer scaffold design achieve extensive new formation of complex periodontal tissues with unprecedented fidelity

The faithful engineering of complex human tissues such as the bone/soft tissue/mineralized tissue interface in periodontal tissues requires innovative molecular cues in conjunction with tailored scaffolds. To address the loss of periodontal bone and connective tissues following periodontal disease, we have generated a polydopamine and collagen coated electrospun PLGA-PCL (PP) scaffold enriched with the small molecule mediator PFI-2 (PP-PFI-pDA-COL-PFI). In vitro 3D studies using PDL progenitors revealed that the PP-PFI-pDA-COL-PFI scaffold substantially enhanced Alizarin Red staining, increased Ca/P ratios 4-fold, and stimulated cell proliferation more than 12-fold compared to PP-controls, suggestive of its potential for mineralized tissue engineering. When applied in our experimental periodontitis model, the PP-PFI-pDA-COL-PFI scaffold resulted in a substantial 34% reduction in alveolar bone defect height, a 25% root-length gain in periodontal attachment, and the formation of highly ordered regenerated acellular cementum twice as thick as in controls. Explaining the mechanism of PFI-2 mineralized tissue regeneration in periodontal tissues, PFI-2 inhibited SETD7-mediated β-Catenin protein methylation and increased β-Catenin nuclear localization. Together, dual-level PFI-2 incorporation into a degradable, dopamine/collagen coated PLGA/PCL scaffold backbone resulted in the regeneration of the tripartite periodontal complex with unprecedented fidelity, including periodontal attachment and new formation of mineralized tissues in inflamed periodontal environments.

Management of Fibrous Epulis of Anterior Maxillary Teeth: A Case Report of a 1.5-Year-Old Lesion

Background: Epulis is a gingival hyperplasia (tumor-like) that originates from periodontal connective tissue. It can be caused by many factors such as a chronic local irritation. Epulis that grows on the anterior maxilla area can be inconvenient because it disrupts the aesthetics and also the function of the teeth. Therefore, it has to be completely removed by surgery.&#x0D; Objective: To correct the condition of epulis by excision and gingival contouring for aesthetic need.&#x0D; Case Report: A 30-year-old female patient presented with a complaint of a mass on the gum of the anterior teeth on her upper jaw that made her unconfident to smile. The mass had been there for 1.5 years.&#x0D; Conclusion: The condition of epulis can be corrected by excision procedure and by removing the cause of the epulis (sub-gingival calculus). The aesthetic result can be obtained by gingival contouring after the excision.&#x0D; Keywords: epulis, fibrous epulis, gingival hyperplasia, excision, gingival contouring, gingival biopsy

IMPACT OF LIPID PEROXIDATION ON COLLAGEN FIBRIL DEGRADATION IN EXPERIMENTAL PERIODONTITIS

Lipid peroxidation analysis and identification of the main damage predictors lead to introduction of new diagnostic and treatment technologies into medical practice.&#x0D; The aim of the study was to evaluate the activity of free radical damage processes and identify their association with collagen metabolism disorders in the disease dynamics in experimental periodontitis.&#x0D; Materials and Methods. An experimental study was carried out on 60 white non-linear rats. A rat model of periodontitis was reproduced according to K.D. Shkolnaya and V.G. Atrushkevich method (Patent RU No. 2625295, December 07, 2017). The overall activity of free radical oxidation and antioxidant potential was assessed according to biochemiluminescence parameters. Lipid peroxidation activity was assessed according to the parameters of primary and secondary peroxidation products. Collagen metabolism was assessed by P.N. Sharaev method.&#x0D; Results. The rat model of periodontitis demonstrated a high level of free radical oxidation parameters. At the same time decrease in the antioxidant potential was observed throughout the experiment. It proved a significant inhibition of the antioxidant system ability to neutralize bioradical oxidation reactions. The resulting free radicals caused the collagen destruction, which formed the frame of the periodontal connective tissue structures. It was confirmed by hydroxyproline increase due to its free and peptide-bound fractions throughout the experiment. Finally, an increase in protein-bound hydroxyproline was determined against the background of high levels of free hydroxyproline, which was explained by the formation of pathological granulations and fibrillar collagen with an inferior short-chain structure.&#x0D; Conclusion. Chronic periodontitis is characterized by disturbances in the bioradical balance followed by the oxidative stress development, which induces the dystrophy of periodontal collagen structures. The data obtained substantiate the use of collagen peroxidation and metabolism markers as diagnostic criteria to predict the course of periodontitis, and also prove the importance of antioxidants.

Chlorogenic Acid as a Positive Regulator in LPS-PG-Induced Inflammation via TLR4/MyD88-Mediated NF-κB and PI3K/MAPK Signaling Cascades in Human Gingival Fibroblasts.

Gingival inflammation is one of the main causes that can be related to various periodontal diseases. Human gingival fibroblast (HGF) is the major constituent in periodontal connective tissue and secretes various inflammatory mediators, such as nitric oxide (NO) and prostaglandin E2 (PGE2), upon lipopolysaccharide stimulation. This study is aimed at investigating the anti-inflammatory mechanism of chlorogenic acid (CGA) on Porphyromonas gingivalis LPS- (LPS-PG-) stimulated HGF-1 cells. The concentration of NO and PGE2, as well as their responsible enzymes, inducible NO synthase (iNOS), and cyclooxygenase-2 (COX-2), was analyzed by Griess reaction, ELISA, and western blot analysis. LPS-PG sharply elevated the production and protein expression of inflammatory mediators, which were significantly attenuated by CGA treatment in a dose-dependent manner. CGA treatment also suppressed activation of Toll-like receptor 4 (TLR4)/myeloid differentiation primary response gene 88 (MyD88) and nuclear factor- (NF-) κB in LPS-PG-stimulated HGF-1 cells. Furthermore, LPS-PG-induced phosphorylation of extracellular regulated kinase (ERK) and Akt was abolished by CGA treatment, while c-Jun N-terminal kinase (JNK) and p38 did not have any effect. Consequently, these results suggest that CGA ameliorates LPS-PG-induced inflammatory responses by attenuating TLR4/MyD88-mediated NF-κB, phosphoinositide-3-kinase (PI3K)/Akt, and MAPK signaling pathways in HGF-1 cells.

Стан тканин пародонта у щурів на тлі їх тривалої алкоголізації

The aim of our research is to study the condition of periodontal tissues of rats against the background of prolonged alcoholism. The studies were performed on 19 white nonlinear rats weighing 180-220 g, which were randomly divided into 2 groups. Rats of the first group served as controls. They were injected intragastrally with saline for 72 days. The rats of the second group for 72 days were intragastrically injected with increasing concentrations of ethanol according to the following scheme: 1-24 days - 11.8%; 25-48 - 23.6%; 49- 72 days - 37%. In rat soft periodontal tissues, free fucose content as a monomer of fucoproteins, glycosaminoglycans as proteoglycan heteropolysaccharides, total proteolytic activity, total antitryptic activity, TBA-active products, oxidatively modified proteins and catalase activity was determined. 72- day alcoholization of rats caused an increase in periodontal tissue content of TBA-active products by 74.7%, the content of oxidatively modified proteins by 28.9% and catalase activity by 33.3%, indicating the activation of free radical processes. At the same time, the total proteolytic activity in periodontal tissues decreased by 20.6% against the background of a decrease in the activity of proteinase inhibitors by 9.6%. Also, under conditions of long-term administration of ethyl alcohol to animals an increased depolymerization of fucoproteins and proteoglycans of periodontal connective tissue was observed, as evidenced by an increase in free fucose content by 37.5% and glycosaminoglycans 175.4%. Under conditions of longterm administration of ethyl alcohol to rats, an increased depolymerization of fucoproteins and proteoglycans of periodontal connective tissue is observed, which plays a leading role in the fixation and stability of teeth.

Molecular aspects of Enterococcus faecalis virulence

The Enterococcus faecalis (E. Faecalis) virulence factor plays an essential role in the persistence of root canal infection. Virulence factors of Enterococcus faecalis such as lipoteichoic acid, extracellular superoxide, gelatinase, hyaluronidase, and cytolysin are known to increase the ability of Enterococcus faecalis to induce inflammatory processes, colonization formation, and increase resistance. The virulence factor of E. faecalis is mediated by LTA, which has pattern recognition receptors for cytokine release, bone resorption and triggers apoptosis of osteoblasts, osteoclasts, periodontal connective tissue, macrophages, and neutrophils, which have implications for the occurrence of periradicular lesions. Lipoteichoic acid is also involved in producing D-alanine, which stimulates signals to other bacteria to form biofilms. The E. faecalis will change the balance of oxygen radical production in the periapical lesion, fragment collagen. The fight host's defense mechanisms that cause periapical damage and worsening bone loss. Furthermore, cytolysin will respond to changes in oxygen conditions in the depleting root canals for the dominance of E. faecalis against other bacteria. The energy needs of E. faecalis that assisted by hyaluronidase, which degrades hyaluronan dentin. İt has to produce disaccharide degradation products that can be transported and metabolized intracellularly. These materials hydrolyzing the substrate to obtain essential carbon for its growth. This article aims to describe the molecular aspect of E. faecalis virulence that is involved in root canal infections.

Differential immune responses of 3D gingival and periodontal connective tissue equivalents to microbial colonization

Gingival and periodontal ligament fibroblasts are functionally distinct cell types within the dento-gingival unit that participate in host immune response. Their microenvironment influences the behavior and immune response to microbial challenge. We developed three-dimensional gingival and periodontal connective tissue equivalents (CTEs) using human fibrin-based matrix. The CTEs were characterized, and the heterogeneity in their innate immune response was investigated. The CTEs demonstrated no to minimal response to planktonic Streptococcus mitis and Streptococcus oralis, while their biofilms elicited a moderate increase in IL-6 and IL-8 production. In contrast, Fusobacterium nucleatum provoked a substantial increase in IL-6 and IL-8 production. Interestingly, the gingival CTEs secreted significantly higher IL-6, while periodontal counterparts produced higher IL-8. In conclusion, the gingival and periodontal CTEs exhibited differential responses to various bacterial challenges. This gives insights into the contribution of tissue topography and fibroblast heterogeneity in rendering protective and specific immune responses toward early biofilm colonizers.

MORPHOLOGICAL CHANGES OF PERIODONTAL COMPONENTS UNDER EXPERIMENTAL LIPOPOLYSACCHARIDE PERIODONTITIS COMBINED WITH HYPERTHYROIDISM.

The aim: Investigate structural changes in the tissues of the periodontal complex under the condition of experimental lipopolysaccharide periodontitis combined with hyper¬thyroidism. Materials and methods: The studies were performed on adult white male rats, which simulated periodontitis combined with hyperthyroidism. Periodontal tissues were subjected to morphological examination on the 22nd day of the experiment. Collection of material for microscopic examinations was performed according to the generally accepted method; histological specimens were studied using a light optical microscope. Results: Morphological studies of the components of the periodontal complex of experimental animals with experimental periodontitis established the reorganization of its structural elements. Damage to the epithelium in the area of attachment of the circular ligament and erosive-ulcerative changes of the gums led to a deepening of the gingival sulcus with the formation of a deep periodontal pocket. Intense hyperkeratosis was observed in the area of the bottom of the periodontal pocket. In the own plate of the mucous membrane of the gums - significant edema, collagen fibers were disorganized, defragmented. There were pronounced destructive-degenerative and inflammatory changes of the epithelial and own plates of all areas of the gums and periodontium, damage to the nuclei and cytoplasm of keratinocytes, fibroblasts, and leukocytes. Conclusions: Experimental periodontitis combined with hyperthyroidism is accompanied by pronounced signs of destructive and inflammatory changes in the soft and dense tissues of the periodontal complex, as well as disruption of stromal-vascular interactions, which progress from reversible to irreversible disruption of periodontal connective tissue.

Surfactin attenuates particulate matter-induced COX-2-dependent PGE2 production in human gingival fibroblasts by inhibiting TLR2 and TLR4/MyD88/NADPH oxidase/ROS/PI3K/Akt/NF-κB signaling pathway.

To evaluate the anti-inflammatory effects of surfactin and underlying mechanisms against particulate matter (PM)-induced inflammatory responses in human gingival fibroblasts (HGFs). PM, a major air pollutant, may associate with certain oral diseases possibly by inducing inflammation and oxidative stress. Surfactin, a potent biosurfactant, possesses various biological properties including anti-inflammatory activity. However, the underlying mechanisms are unclear. Also, there is no study investigating the effects of surfactin on PM-induced oral inflammatory responses. As an essential constituent of human periodontal connective tissues which involves immune-inflammatory responses, HGFs serve as useful study models. HGFs were pretreated with surfactin prior to PM incubation. The PGE2 production was determined by ELISA, while the protein expression and mRNA levels of COX-2 and upstream regulators were measured using Western blot and real-time PCR, respectively. The transcriptional activity of COX-2 and NF-κB were determined using promoter assay. ROS generation and NADPH oxidase activity were identified by specific assays. Co-immunoprecipitation assay, pharmacologic inhibitors, and siRNA transfection were applied to explore the interplay of molecules. Mice were given one dose of surfactin or different pharmacologic inhibitors, then PM was delivered into the gingiva for three consecutive days. Gingival tissues were obtained for analyzing COX-2 expression. PM-treated HGFs released significantly higher COX-2-dependent PGE2 , which were regulated by TLR2 and TLR4/MyD88/NADPH oxidase/ROS/PI3K/Akt/NF-κB pathway. PM-induced COX-2/PGE2 increase was effectively reversed by surfactin through the disruption of regulatory pathway. Similar inhibitory effects of surfactin was observed in mice. Surfactin may elicit anti-inflammatory effects against PM-induced oral inflammatory responses.

Penatalaksanaan Epulis Fibromatosa dengan Electrosurgery (Laporan Kasus)

Background : Epulis is a tumor-like enlargement of the gingiva originating from periodontal connective tissue, which is caused by chronic irritation. Epulis that occurs on the upper anterior teeth will interfere with the aesthetics and function of the lips and reduce self-confidence, thus treatment is deemed necessary. Objective : To evaluate the results of fibromatous epulis treatment using electrosurgery. Case report and management : A 25 year old woman came to the practice with complaints of enlarged gums in the upper front area since 6 months ago. The gum was painful when biting food, and bleed easily during tooth cleaning and brushing. Epulis Fibromatosa treatment was initiated with plaque control, scaling and application metronidazole gel. One week later, the epulis was excised with electrosurgery under local anesthesia. In one week evaluation, the patient had no pain or swelling. Clinical examination showed no residual epulis, marginal gingiva 21 was slightly reddish, and the healing process was going well. The results of the pathology examination showed that the surface covered by stratified squamous epithelium, areas appear erosive and ulcerative, also known as chronic inflammation and no malignancy is found, therefore the diagnosis is Fibromatous Epulis. Patient was instructed to maintain oral health and avoid using toothpicks and are advised for orthodontic treatment. Conclusion : The treatment of Epulis Fibromatosa shows good results with electrosurgery

Hyaluronic acid as an active agent to accelerate bone regeneration aftertooth extraction: a literature review

Tooth extraction is a dental treatment that is performed frequently in dentistry. This procedure will stimulate a sophisticated healing process involving a variety of biological factors although it takes a long time to complete. Three phases occur in this process i.e. the inflammatory phase, the proliferation phase, and the remodeling phase which aim to restore the tissue function. Several interventions can be used to accelerate bone formation after tooth extraction. Recently, hyaluronic acid (HA) has been commonly used in dentistry due to their essential physiological effects for the periodontal connective tissue, gingiva, and alveolar bone. Hyaluronic acidis a natural non-sulfate glycosaminoglycans compound that has high molecular weight consisting of D-glucuronic acid and N-acetylglucosamine. Hyaluronic acidis also a component of the extracellular matrix that plays an important role in morphogenesis and tissue healing. The mechanism of action of HA works in two ways, that is passive and active mechanism. The passive mechanism is depend on physical and chemical properties of HA that can change the molecular weight and concentration properties. The active mechanism of HA works by stimulating signal transduction pathway initiated by ligand binding with its receptors through autocrine or paracrine processes. The administration of HA can accelerate bone formation due to it can enhance bone morphogenetic protein (BMP) which belongs to the TGF- β superfamily that has high osteogenic capacity. The HA works through a passive mechanism that depends on its molecular weight and an active mechanism by increasing BMP activity.