bromochloroacetic-acid and Gingivitis

Topics: Animals; Gingiva; Gingivitis; Gingivoplasty; Humans; Keratins; Macaca mulatta; Surgical Flaps; Tooth Movement Techniques

The health of peri-implant soft tissues is important for the long-term success rate of dental implants and the surface topography is pivotal in influencing it. Thus, the aim of this study was to evaluate, in human patients, the inflammatory mucosal microenvironment in the tissue surrounding a new, nanoscale, laser-treated healing abutment characterized by engineered nanopores versus a standard machined-surface. Analyses of anti- and pro-inflammatory markers, cytokeratins, desmosomal proteins and scanning electron microscopy were performed in 30 soft-tissue biopsies retrieved during second-stage surgery. The results demonstrate that the soft tissue surrounding the laser-treated surface was characterized by a lower grade of inflammation than the one facing the machined-surface, which, in turn, showed a disrupted epithelium and altered desmosomes. Moreover, higher adhesion of the epithelial cells on the laser-treated surface was detected compared to the machined one. In conclusion, the laser-treated surface topography seems to play an important role not only in cell adhesion, but also on the inflammatory makers' expression of the soft tissue microenvironment. Thus, from a clinical point of view, the use of this kind of topography may be of crucial importance not only on healing abutments but also on prosthetic ones

Topics: Aged; Cell Adhesion; Dental Abutments; Dental Implants; Female; Gingiva; Gingivitis; Humans; Intercellular Adhesion Molecule-1; Keratins; Laser Therapy; Male; Matrix Metalloproteinase 9; Microscopy, Electron, Scanning; Middle Aged; Nanopores; Tissue Inhibitor of Metalloproteinase-1; Tumor Necrosis Factor-alpha

Topics: Adult; Aged; Analysis of Variance; Dental Implantation, Endosseous; Dental Implants; Dental Plaque Index; Female; Gingivitis; Humans; Keratins; Linear Models; Longitudinal Studies; Male; Middle Aged; Mouth Mucosa; Osseointegration; Periodontal Index; Prospective Studies; Treatment Outcome

Topics: Adhesiveness; Chitosan; Gelatin; Gingivitis; Hydrocortisone; Keratins; Succinates

The aim of this study was to correlate radiographic examination with the clinical periodontal condition in cases of biologic width invasion by overextending restoration margins in restored premolars and molars.. The present pilot study involved nine people (mean age 32 years) with biologic width invasion by 21 surfaces overextending restoration margins in restored premolars and molars. Radiographs were made in a standardized unit using the interproximal technique and were evaluated by a single calibrated investigator. The clinical periodontal parameters were analyzed with the use of a computerized periodontal probe. Exploratory analysis and Spearman's correlation were used to perform statistical analyses (SPSS, p < 0.05).. The most prevalent teeth with biologic width invasion were second premolars and first molars. Mean plaque index was 30.76%, and bleeding on probing was 27.0%. The mesial surface was invaded in 47.6% of cases and the distal surface in 52.4%. The 21 sites with biologic width invasion were found in patients with the following periodontal status: periodontal health (11 sites), gingivitis (2 sites), mild periodontitis (7 sites) and moderate periodontitis (1 site). There was a correlation between plaque index and bleeding on probing with the horizontal component of the bone level.. There was correlation between the radiographic parameters of biologic width invasion and clinical conditions. The measure of the bone crest level correlated with the gingival recession. The horizontal component of bone defect correlated with plaque index and bleeding on probing.

Topics: Adult; Alveolar Bone Loss; Alveolar Process; Bicuspid; Dental Plaque Index; Dental Restoration, Permanent; Female; Gingiva; Gingival Recession; Gingivitis; Humans; Keratins; Male; Molar; Periodontal Attachment Loss; Periodontal Diseases; Periodontal Index; Periodontitis; Periodontium; Pilot Projects; Radiography; Surface Properties

Nifedipine, a calcium channel-blocking agent, has been associated with gingival enlargement in humans. This enlargement has also been successfully established in animal models. Previous investigators have administered nifedipine through a systemic route, most commonly by oral intake. The aim of the present study was to measure the effects of nifedipine administered directly into rat gingival interproximal papillae.. Twenty-four adult female rats were assigned to three groups. Each animal received a series of three injections, one week apart; each injection was placed directly into the interdental papilla of the maxillary and mandibular central incisors. Group 1 (control) received only saline. Group 2 received a low (10 microg/ml) concentration of nifedipine, while Group 3 received a higher concentration (500 microg/ml). One week after the last series of injections, gingival specimens were harvested from the injection site and prepared for histological and immunocytochemical analyses.. Specimens from Group 3 displayed a significantly greater number of ED2-positive cells compared to the other two groups. Specimens from Group 2 showed a significantly higher mean count of positive cells compared to Group 1. Collectively, our data suggest that repeated local injections of 10 microg/ml and 500 microg/ml nifedipine each elicit an inflammatory response in the gingival connective tissue.. Immunocytochemical analysis revealed dose-dependent increases of resident tissue macrophages in rats receiving nifedipine (p<0.005). An increased inflammatory infiltrate also was observed via routine histology. Gross macroscopic changes consistent with gingival enlargement were not observed.

Topics: Animals; Calcium Channel Blockers; Cell Count; Connective Tissue; Dose-Response Relationship, Drug; Epithelial Attachment; Extracellular Matrix; Female; Fibroblasts; Gingiva; Gingivitis; Granulocytes; Immunohistochemistry; Incisor; Injections; Keratins; Lymphocytes; Macrophages; Nifedipine; Phagocytes; Rats; Sodium Chloride; Time Factors

The purpose of this study was to evaluate the responses of peri-implant tissue in the presence of keratinized mucosa.. A total of 276 implants were placed in 100 patients. From the time of implant placement, the average follow-up observation period was 13 months. The width of keratinized mucosa was compared and evaluated through the gingival inflammation index (GI), plaque index (PI), the pocket depth, mucosal recession, and marginal bone resorption.. The GI, PI, and pocket depth in the presence or absence of the keratinized gingiva did not show statistically significant differences. However, mucosal recession and marginal bone resorption experienced statistically significant increases in the group of deficient keratinized mucosa. Based on implant surface treatments, the width of keratinized gingiva and crestal bone loss did not show a significant difference.. In cases with insufficient keratinized gingiva in the vicinity of implants, the insufficiency does not necessarily mediate adverse effects on the hygiene management and soft tissue health condition. Nonetheless, the risk of the increase of gingival recession and the crestal bone loss is present. Therefore, it is thought that from the aspect of long-term maintenance and management, as well as for the area requiring esthetics, the presence of an appropriate amount of keratinized gingiva is required.

Topics: Alveolar Bone Loss; Dental Implantation, Endosseous; Dental Implants; Dental Plaque Index; Female; Gingival Recession; Gingivitis; Humans; Keratins; Male; Middle Aged; Mouth Mucosa; Periodontal Index; Retrospective Studies; Surface Properties

The need for keratinized mucosa (KM) or immobile keratinized mucosa (i.e., attached mucosa [AM]) for the maintenance of osseointegrated endosseous dental implants has been controversial. The purpose of this study was to investigate the significance of KM in the maintenance of root-form dental implants with different surfaces.. A total of 339 endosseous dental implants in place for at least 3 years in 69 patients were evaluated. The width of KM and AM, modified plaque index (mPI), gingival index (GI), modified bleeding index (mBI), probing depth (PD), and average annual bone loss (ABL) were measured clinically and radiographically by a masked examiner. Based on the amounts of KM or AM, implants were categorized as follows: 1) KM <2 mm (KL); 2) KM > or =2 mm (KU); 3) AM <1 mm (AL); and 4) AM > or =1 mm (AU). Implants were further subdivided into the following four subgroups based on their surface configurations: 1) smooth surface implants (SI) with KM <2 mm (SKL); 2) SI with KM > or =2 mm (SKM); 3) rough surface implants (RI) with KM <2 mm (RKL); or 4) RI with KM > or =2 mm (RKM); or 1) SI with AM <1 mm (SAL); 2) SI with AM > or =1 mm (SAM); 3) RI with AM <1 mm (RAL); or 4) RI with AM > or =1 mm (RAM). The effect of KM or AM on clinical parameters was evaluated by comparing the different KM/AM groups. In addition, the significance of the presence of KM on implant prostheses types (i.e., fixed versus removable) and on implant locations (i.e., anterior versus posterior) was evaluated.. Comparison of ABL among the four subgroups in KM or AM failed to reveal statistically significant differences (P >0.05); however, statistically significantly higher GI and mPI were present in SKL or SAL compared to the other three subgroups (P <0.05). GI and mPI were significantly higher in KL (0.94 and 1.51) than KU (0.76 and 1.26) and higher in AL (0.95 and 1.50) than AU (0.70 and 1.19) (P <0.05), respectively. The difference in GI between posterior implants with or without an adequate amount of KM was also significant (P <0.05).. The absence of adequate KM or AM in endosseous dental implants, especially in posterior implants, was associated with higher plaque accumulation and gingival inflammation but not with more ABL, regardless of their surface configurations. Randomized controlled clinical trials are needed to confirm the results obtained in this retrospective clinical study.

Topics: Adult; Aged; Aged, 80 and over; Alveolar Bone Loss; Analysis of Variance; Cross-Sectional Studies; Dental Implantation, Endosseous; Dental Implants; Dental Plaque; Dental Plaque Index; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Female; Gingivitis; Humans; Keratins; Male; Middle Aged; Mouth Mucosa; Periodontal Index; Radiography; Retrospective Studies; Surface Properties

The aim of this study was to evaluate the predictability of the free connective tissue graft in prosthetically treated patients needing gingival augmentation. The following outcome variables were studied 1) dimensional changes of free connective gingival grafts; 2) color blending with adjacent tissues; and 3) periodontal and marginal health status, when compared to a non-surgical control group.. Two groups of patients without periodontitis were investigated. The test group (group A) consisted of 16 patients. The inclusion criteria for surgical correction were: 1) at least 1 site lacking (<1 mm) keratinized tissue and/or lacking vestibular depth; 2) insufficient plaque control; and 3) the selected site was scheduled to undergo or had already received a fixed prosthetic restoration. The control group (group B) included 14 patients with the same inclusion criteria, but declining to undergo surgery. Group A patients were treated with a free connective tissue graft to augment the keratinized tissue at the selected sites. The size of the graft was recorded at baseline (surgical intervention) and the width of keratinized tissue was measured at 1, 4, 26, and 52 weeks. Gingival inflammation and plaque accumulation were assessed at baseline and 52 weeks in both groups. Probing depth and clinical attachment levels were recorded at baseline and 26 and 52 weeks in both groups. Evaluation of the esthetic results was carried out at the end of the study. All patients in both groups received oral hygiene instructions and supragingival plaque and calculus removal before and at the end of the investigation.. In group A, the results showed a mean amount of keratinized tissue of 5.81 +/- 1.42 mm at 26 weeks and 5.25 +/- 1.34 mm at 52 weeks. Mean shrinkage of the graft was 10.2% (P = 0.001) at 1 week, 28.4% (P = 0.0004) at 4 weeks, 37.2% (P = 0.0004) at 26 weeks, and 43.25% (P = 0.0004) at 52 weeks. All the dimensional changes were statistically significant, when compared to baseline. Evaluation of color blending with the surrounding gingiva demonstrated an "excellent result" at 52 weeks with an 87.5% agreement among the three masked examiners. In the test group, the periodontal indices improved or remained stable; in the control group, there was a minor improvement of the indices, with three patients showing a worse gingival inflammation score and two a worse plaque score.. Although these results are not conclusive, mostly due to a lack of a large enough sample population, the statistically significant results shown in this investigation tend to support the use of gingival augmentation procedures in prosthetic patients with insufficient keratinized gingiva and/or shallow or absent vestibules, when they cannot demonstrate adequate plaque control.

Topics: Adult; Aged; Color; Connective Tissue; Dental Plaque Index; Denture, Partial, Fixed; Esthetics, Dental; Female; Follow-Up Studies; Gingiva; Gingival Recession; Gingivitis; Graft Survival; Humans; Keratins; Male; Middle Aged; Periodontal Attachment Loss; Periodontal Pocket; Statistics, Nonparametric; Treatment Outcome

The purpose of this study was to analyze the expression of adhesion molecules on endothelial cells in the alveolar ridge mucosa, the gingiva and the periimplant mucosa in humans.. Twelve partially edentulous subjects were included in the study. In each subject, one soft tissue biopsy was harvested from the edentulous alveolar ridge mucosa, one from a tooth site and one from an implant site. After 3 weeks of undisturbed plaque accumulation, an additional biopsy was obtained from one tooth and one implant site in each subject. The tissue samples were snap frozen and prepared for immunohistochemical analysis.. In the alveolar ridge mucosa, smaller proportions of endothelial cells expressing ICAM-1, ELAM-1 and VCAM-1 were observed than in the gingiva. ELAM-1-positive cells occurred in lower numbers than in periimplant mucosa. After 21 days of plaque accumulation, ELAM-1 was increased in tooth sites, but decreased in periimplant mucosa.. The results of the present study indicated that the proportions of activated endothelial cells and the extravasation of leukocytes is larger in gingiva and periimplant mucosa than in alveolar ridge mucosa. This might be due to the less permeable keratinized epithelial layer in the edentulous ridge mucosa, which offers proper protection against microbial pathogens. The greater expression of endothelial cell adhesion molecules during experimental gingivitis, compared to periimplant mucositis, may reflect its longer history of repeated antigenic assaults.

Topics: Aged; Alveolar Process; Antibodies, Monoclonal; Connective Tissue; Dental Implants; Dental Plaque; E-Selectin; Endothelium, Vascular; Epithelial Attachment; Epithelial Cells; Female; Gingiva; Gingivitis; Humans; Immunohistochemistry; Intercellular Adhesion Molecule-1; Jaw, Edentulous, Partially; Keratins; Leukocytes; Male; Matched-Pair Analysis; Middle Aged; Mouth Mucosa; Statistics as Topic; Vascular Cell Adhesion Molecule-1

The cells of the junctional epithelium (JE) provide and maintain the epithelial attachment, and remain morphologically and phenotypically distinct from oral sulcular (OSE) and external oral epithelia (EOE), from which they may be regenerated de novo. Expression of cytokeratins (CK) in human epithelia has been shown to be highly site-specific, implying a functional role. The aims of this study were to differentiate between the cytokeratin profiles of JE, OSE, EOE and pocket epithelia (PE) in health and disease, in smokers and non-smokers.. The cytokeratin profiles of 40 samples of healthy and clinically inflamed human gingival tissue taken from 15 smokers and 25 non-smokers were studied by immunocytochemistry. Cryostat sections of fresh frozen gingival tissues were stained with a panel of monoclonal antibodies (mAb) and visualised by a biotin-Streptavidin-peroxidase complex technique.. JE and PE expressed an identical range of cytokeratins irrespective of the inflammatory or smoking status, with the exception of CK4 expression, which tended to be increased in smokers. The OSE and EOE expressed non-cornifying and cornifying differentiation cytokeratins respectively, but in the presence of inflammation, both these epithelia showed increased expression of CK19 at a basal level in association with expression of one or more of the simple cytokeratins. JE/PE expressed CK17 in external layers only, approximating the tooth surface. All epithelia expressed CK6, 16 the markers of high cell turnover.. CK 19 was a consistent differentiation marker for JE and PE. Expression of CK8, 18 was enhanced by inflammation. CK4 expression increased in association with smoking. Markers of differentiation were not always co-expressed equally within a pair. Pairs were not always completely mutually exclusive with frequent co-localisation.

Topics: Adolescent; Adult; Biomarkers; Cell Differentiation; Child; Connective Tissue; Epithelial Attachment; Epithelium; Female; Gingiva; Gingivitis; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Periodontal Pocket; Phenotype; Smoking

The present study was designed to determine, in a cross-sectional study, whether there was any relationship between the keratin-positive material in gingival crevicular fluid and the clinical periodontal status. Keratins were selected as putative indicators of degradation of epithelial cells cytoskeletal proteins. Keratin positive material was determined by enzyme-linked immunosorbent assay in 42 subjects exhibiting clinical sites of health, chronic gingivitis and chronic periodontitis. The concentration of keratin in parotid saliva was also measured for each subject. Keratin concentration in gingival crevicular fluid samples was significantly greater at sites exhibiting signs of gingivitis and periodontitis compared with healthy sites. No differences were detected between sites exhibiting gingivitis and periodontitis. No differences were found between the 3 groups for the saliva keratin-positive material which was significantly less than that detected in gingival crevicular fluid. These results suggest that gingival crevicular fluid keratin concentration may serve as a marker of gingival damage.

Topics: Adult; Biomarkers; Chronic Disease; Cross-Sectional Studies; Enzyme-Linked Immunosorbent Assay; Gingival Crevicular Fluid; Gingivitis; Humans; Keratins; Middle Aged; Peritonitis; Saliva; Statistics, Nonparametric

The keratin pattern in oral epithelia is related to the type of terminal differentiation observed morphologically (keratinization/nonkeratinization) and to the presence or absence of epithelial dysplasia. Furthermore, it has been suggested recently that inflammatory phenomena influence the keratin expression in human gingiva. The aim of the present study was to describe the keratin pattern in oral lichen planus (OLP) lesions, which are well known to be characterized by hyperkeratinization and severe inflammatory changes, in order to elucidate the role of inflammation in keratin expression of oral epithelia. Tissue sections were stained with antikeratin antibodies directed to groups of keratins (AE1 and AE2) and to single keratin proteins (Nos. 5, 8, 13, and 19). The keratin pattern in OLP lesions differed in some respects from that of leukoplakias and frictional keratoses as characterized in previous studies. No consistent patterns for use in a diagnostic context were found. However, the changes in OLP lesions did not mimic those previously described in inflamed gingival specimens and in oral epithelial dysplasias. Thus, the results encourage further studies on the potential diagnostic use of keratin expression in premalignant oral lesions. Furthermore, the study suggests that the inflammatory reaction seen in OLP lesions does not influence keratin expression in a way comparable with the suggested influence of inflammation in gingival specimens.

Topics: Antibodies, Monoclonal; Atrophy; Connective Tissue; Epithelium; Gingivitis; Humans; Keratins; Lichen Planus, Oral; Mouth Mucosa; Staining and Labeling

Fourteen specimens of periodontal pockets and the associated marginal gingiva were collected and either frozen for examination using antibodies against various defined cytokeratin specificities or processed for 2-dimensional gel electrophoresis. The epithelium forming the pocket lining typically extended into the connective tissue of the pocket wall in the form of a network of finger-like strips. Immunocytological staining indicated that keratins (K) 5, 6, 14 and 19 were expressed by almost all cells of the pocket lining and K13 and K16 by the suprabasal cells. The coronal region of the pocket lining showed some cells staining for K4. Staining for K8 and K18 was seen in the apical region of the pocket lining and in the finger-like extensions of epithelium into the connective tissue. Compared with normal gingiva, the sulcular and the oral gingival epithelia showed a marked increase in staining for K19. Surprisingly, the pattern of keratin expression of the epithelium of the pocket lining was found to be essentially similar to that of normal junctional epithelium and the anatomical position of the boundaries between each epithelial phenotype were not significantly altered. These patterns of keratin expression were confirmed by the 2D electrophoretic analyses of microdissected regions of epithelium. The potential significance of inflammation to the epithelial changes associated with pocket formation is discussed.

Topics: Adult; Antibodies, Monoclonal; Electrophoresis, Gel, Two-Dimensional; Epithelial Attachment; Epithelium; Gingivitis; Humans; Immunoenzyme Techniques; Keratins; Middle Aged; Periodontal Pocket

The purpose of the present study was to examine the relationship between the form of the crowns in the maxillary front tooth segment and (1) a group of morphological characteristics and (2) the thickness of the gingiva. 108 subjects devoid of symptoms of destructive periodontal disease were examined regarding, e.g., probing depth, thickness of the free gingiva, width of the keratinized gingiva and the contour of the marginal gingiva. From clinical photographs of the maxillary front tooth region, the width (at the apical third--CW) and the length (CL) of the crowns of the 6 front teeth were determined. A CW/CL-ratio was calculated for each tooth and averaged for each tooth region. The individual mean CW/CL-ratio values for the central incisors were ranked. After correction for incisal attrition, the 10 subjects ranked highest and the 10 ranked lowest were selected as having either a long-narrow (group N) or a short-wide (group W) form of the crown of the tooth. The data for each of the examined parameters were averaged for each tooth region in each subject and mean values for subjects in groups W and N were compared using the Student t-test. Stepwise multiple regression analysis, including data from the whole sample, was performed for each tooth region with the thickness of the free gingiva as the dependent variable.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Cuspid; Dental Arch; Dental Cementum; Dental Enamel; Epithelial Attachment; Gingiva; Gingival Pocket; Gingivitis; Humans; Incisor; Keratins; Maxilla; Models, Dental; Odontometry; Tooth Abrasion

Miniature swine exhibit naturally-occurring, progressive recession on facial surfaces of the permanent mandibular incisors. The purpose of this study was to determine whether placing a free gingival graft to augment the width of keratinized gingiva of mandibular incisors in miniature swine would prevent or retard recession at the grafted site compared to an untreated contralateral control site. In 8 litter-mate miniature swine, free gingival grafts were placed on the facial surface of the permanent central and lateral incisors on one side of the mandible. The contralateral mandibular incisors did not receive any treatment and served as controls. Clinical measurements, including eruption, recession, pocket depth, attachment level, and keratinized gingival width were obtained preoperatively, 2 to 3 weeks after surgery to assess the success of gingival augmentation, and 3, 6, and 9 months postoperatively. Eight grafted sites were successful and showed significant augmentation of the keratinized gingival width, with a mean increase of 5.8 +/- 0.7 mm, while 6 grafts failed and showed a slight decrease in the mean width of -0.4 +/- 0.5 from the preoperative to postoperative examination. All sites showed significant recession during the experimental period. Successful sites showed no statistically significant or clinically major difference in the rate or amount of recession than contralateral control sites. By 9 months, the average increase in recession from the baseline examination was 2.8 +/- 1.5 mm for successfully grafted sites and 2.6 +/- 1.3 mm for contralateral controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Gingiva; Gingival Pocket; Gingival Recession; Gingivitis; Keratins; Swine; Swine, Miniature; Time Factors; Wound Healing

By the indirect immunoperoxidase labelling procedure the expressions of type I and III collagens, laminin and fibronectin and of KL1 cytokeratin and vimentin were examined in the first stages and repair of experimental gingivitis in young subjects. A two month longitudinal study was performed using the tissue from buccal marginal gingival biopsies of four subjects taken sequentially at five specific times: before and during plaque accumulation, and during plaque elimination. The sites examined microscopically were the coronal half of the junctional epithelium and the underlining infiltrated connective tissue fraction. No clinical change could be observed during the study period. Histological examination showed reversible cellular changes during the accumulation of plaque. There were increases in vascularization and cellularity and loss of collagen. They recovered 56 days after plaque elimination their baseline level. Electron microscopic examination showed myofibroblastic aspects in some fibroblasts. The changes in the expression of laminin, fibronectin and KL1 in the J.E. might be due to a proliferation rate enhancement, and suggest an adaptation to the alterations brought about by the inflammatory process. They also reinforce the hypothesis that this epithelium resembles a developmental tissue. Type I collagen demonstrated the "collagen loss-repair" cycle shown in connective tissue by the histological study. The rise in type III collagen and the vimentin fall, both at the initial stage, suggest that these protein profiles may yield information for clinical research purposes during the very early inflammatory process. The variations in fibronectin indicate its key role in the early inflammatory and repair processes. Finally, the variations in matrix and cytoskeletal proteins variations, as well as the morphological modifications observed, were nearly all reversible.

Topics: Adolescent; Adult; Collagen; Extracellular Matrix; Female; Fibroblasts; Fibronectins; Gingiva; Gingivitis; Humans; Intermediate Filaments; Keratins; Laminin; Male; Vimentin; Wound Healing

Cytokeratins represent specific markers of certain pathways of epithelial differentiation. The purpose of this study was to describe the alterations of cytokeratin pattern and topographical distribution of individual cytokeratins in inflamed gingiva. Five healthy and 15 inflammatory samples of human gingiva were studied. From each biopsy, cryostat sections allowed histological staining, immunofluorescence microscopy using a battery of monoclonal antibodies to cytokeratins, and gel electrophoresis. The results show marked differences in cytokeratin expression by healthy epithelia as compared with inflamed gingiva: in suprabasal cell layers there were reductions or disappearance of cytokeratins 1, 2 and 10, 11--specific for terminal differentiation--and increased expression of cytokeratins 4 and 13, as well as--in basal and parabasal cell layers--expression of cytokeratin 19. These alterations might represent an adaptation of involved epithelia to the alterations brought about by the inflammatory process.

Topics: Adult; Antibodies, Monoclonal; Cell Differentiation; Electrophoresis, Polyacrylamide Gel; Epithelium; Gingivitis; Humans; Keratins; Microscopy, Fluorescence

In clinically healthy/subclinically inflamed biopsies of marginal gingiva, the immunohistochemical distribution of keratin proteins was studied in junctional (JE), sulcular (SE), oral gingival (OGE) and in a few samples of alveolar mucosal epithelium (AE) by means of various mouse monoclonal anti-keratin antibodies in an indirect fluorescence technique. All regions stained in a nearly similar way with AE3 (keratins 1-8, all cells) and BE14 (keratin 5, basal and supra/parabasal cells). AE8-staining (keratin 13, supra/parabasal and spinous cells) was primarily confined to the stratified, nonkeratinized epithelia SE and AE, but also a variable part of JE and less frequently OGE were positive. The parakeratinized OGE was distinct in showing a homogeneous staining with AE2 (keratins 1/2, 10) and AE5 (keratin 3) throughout spinous cell layers. These antibodies did not stain JE and AE whereas SE stained in a scattered way with AE5 and sometimes also with AE2. The latter finding might indicate initial keratinization at molecular level. The JE was distinct in retaining basal characteristics throughout the epithelium with PKK2 (keratin 7, 16, 17, 19) and BE14 (keratin 5) although some initial suprabasal maturation, as observed with AE8, cannot be excluded. Differences in keratin staining of gingival epithelia and the AE was found with respect to AE1-reactivity (keratins 10, 14-16, 19) which was suprabasal in JE, SE and OGE but basal in AE.

Topics: Adolescent; Antibodies, Monoclonal; Child; Epithelial Cells; Epithelium; Fluorescent Antibody Technique; Gingiva; Gingivitis; Humans; Immunohistochemistry; Keratins; Staining and Labeling

The stratified squamous epithelium of the oral gingiva and the hard palate is characterized by a tissue architecture and a cytoskeletal composition similar to, although not identical with, that of the epidermis and fundamentally different from that of the adjacent non-masticatory oral mucosa. Using immunocytochemistry with antibodies specific for individual cytokeratins, in situ hybridization and Northern blots of RNA with riboprobes specific for individual cytokeratin mRNAs, and gel electrophoresis of cytoskeletal proteins of microdissected biopsy tissue samples, we show changes in the pattern of expression of cytokeratins and their corresponding mRNAs in pathologically altered oral gingiva. Besides a frequently, although not consistently, observed increase in the number of cells producing cytokeratins 4 and 13 (which are normally found as abundant components in the sulcular epithelium and the alveolar mucosa but not in the oral gingiva) and a reduction in the number of cells producing cytokeratins 1, 10 and 11, the most extensive change was noted for cytokeratin 19, a frequent cytokeratin in diverse one-layered and complex epithelia. While in normal oral gingiva cytokeratin 19 is restricted to certain, sparsely scattered cells of --or near--the basal cell layer, probably neuroendocrine (Merkel) cells, in altered tissue of inflamed samples it can appear in larger regions of the basal cell layer(s) and, in apparently more advanced stages, also in a variable number of suprabasal cells. Specifically, our in situ hybridization experiments show that this altered suprabasal cytokeratin 19 expression is more extended at the mRNA than at the protein level, indicating that cytokeratin 19 mRNA synthesis may be a relatively early event during the alteration. These changes in cytokeratin expression under an external pathological influence are discussed in relation to other factors known to contribute to the expression of certain cytokeratins and with respect to changes occurring during dysplasia and malignant transformation of oral epithelia.

Topics: Blotting, Northern; Cytoskeletal Proteins; Gingiva; Gingivitis; Humans; Immunohistochemistry; Keratins; Nucleic Acid Hybridization; RNA Probes; RNA, Messenger

The expression of the Class II products DR and DQ on human gingival epithelium was examined using immunofluorescence and immunoperoxidase staining. Differential expression of Class II antigens was seen in chronic gingivitis in adults, with T6(+) DR(+) cells being more numerous than T6(+) DQ(+) cells. The periodontopathic organism Fusobacterium nucleatum (FN) induced DQ expression on Langerhans' cells (LC) during in vitro explant culture of gingival tissue. This effect was mimicked by endotoxin (LPS) from F. nucleatum and by E. coli LPS. These results indicate that differential expression of Class II products, a feature of chronic gingival inflammation, may result from the action of LPS on gingival LC.

Topics: Culture Techniques; Fusobacterium; Gingivitis; HLA-D Antigens; HLA-DQ Antigens; HLA-DR Antigens; Humans; Keratins; Langerhans Cells; Lipopolysaccharides; Time Factors

Topics: Animals; Gingiva; Gingival Recession; Gingivectomy; Gingivitis; Haplorhini; Humans; Keratins; Periodontal Index; Regeneration; Vestibuloplasty

Topics: Binding, Competitive; Carbohydrate Metabolism; Epithelium; Gingivitis; Histocytochemistry; Humans; Keratins; Lectins; Receptors, Mitogen

This study was undertaken in order to: evaluate the cell population in carrageenan-induced inflammation and investigate the extent to which this inflammation modified mitotic activity, and keratinization of the sulcular epithelium induced by daily prophylaxes in monkeys. Normal-keratinized oral gingival epithelium was also evaluated for these processes in the same gingival specimens. Each of three adult Rhesus monkeys received a thorough prophylaxis 1 week prior to the experiment. Over the 10-week experimental period, each monkey received daily rubber cup prophylaxes. In addition, during the last 10 days, daily gingival injections of a 1% carrageenan saline solution and normal saline solution were given. One hour prior to sacrifice, each monkey received an intravenous injection of tritiated thymidine, 1 microCi/gram of body weight. After sacrifice and tissue processing, the histologic sections were evaluated. It was found that the carrageenan solution injected into gingival tissues produced an acute inflammatory response consisting of polymorphonuclear leukocytes PMNs (61.3%), lymphocytes (5.2%), monocytes/macrophages (23.5%), plasma cells (2.0%) and unidentified cells (3.8%). An Inflammatory Index and a Mitotic Activity Index were determined, and keratin length and widths were measured. Data were analyzed statistically using analysis of variance. Pairwise comparisons were also made using Scheffe's method of multiple comparisons. The study showed that: carrageenan solutions injected into gingival tissues elicited an acute inflammation; acute inflammation present in gingival connective tissue stimulated an increase in mitotic activity in subjacent gingival epithelium; acute inflammation within gingival tissues did not modify the induced-keratinized sulcular epithelium, or the normally-keratinized oral gingival epithelium; and acute inflammation may not necessarily affect tissue keratinization, if bacterial plaque is removed daily.

Topics: Animals; Autoradiography; Carrageenan; Collagen; Connective Tissue; Connective Tissue Cells; Dental Prophylaxis; Epithelial Cells; Epithelium; Gingiva; Gingivitis; Keratins; Macaca mulatta; Male; Mitosis; Neutrophils

The expression of the histocompatibility antigens HLA-DR and HLA-A, B, C within periodontally diseased tissue was investigated using immunohistological and histochemical techniques. Tissue was obtained from 18 patients with periodontal disease and from 2 healthy volunteers. HLA-DR antigen was expressed by the keratinocytes of the oral epithelium in all inflamed samples but was not a feature of normal tissue where HLA-DR reactivity was confined to Langerhans cells. These results are consistent with an underlying cellular immune process. Using a variety of phenotypic markers it was possible to characterize the macrophage population within the connective tissue into 2 distinct types: an antigen-presenting cell type located subjacent to the oral epithelium and a phagocytic cell type situated deep within the connective tissue.

Topics: Chronic Disease; Fluorescent Antibody Technique; Gingiva; Gingivitis; Histocompatibility Antigens Class II; Histocytochemistry; HLA-DR Antigens; Humans; Keratins

The present investigation was performed to assess the inflammatory response in gingival units subsequent to the placement of restorations with subgingivally located margins. 3 beagle dogs were used. Cotton floss ligatures were placed around the neck of the mandibular third and fourth premolars of all dogs. The ligatures were exchanged once a month during the first 6 months of experiment. When 40-50% of the height of the supporting tissues had been lost in an experimental periodontitis the ligatures were removed but the animals allowed to accumulate deposits for another 60 days. The inflamed periodontal tissues were subsequently excised using either an "apically placed flap" procedure or a "gingivectomy" procedure. In the flap procedure the main part of the keratinized gingiva was preserved while in the gingivectomy procedure the keratinized part of the gingiva was removed in toto. Following scaling and root planing the animals were during a maintenance period of 4 months placed on a program involving chlorhexidine application and mechanical tooth cleaning twice daily. On Day 0 a notch was prepared in the buccal surface of each root at the level of the gingival margin. Furthermore, steel bands were placed along the buccal surface of each root of the third and fourth premolars and secured with an apical margin at the level of 1 mm apical to the notch. The bands were cemented to the root surfaces by a cement. The dogs were allowed to accumulate plaque and calculus for 6 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Bicuspid; Dental Restoration, Permanent; Dogs; Gingiva; Gingival Diseases; Gingivitis; Keratins; Ligation; Periodontium; Time Factors

Topics: Gingiva; Gingivitis; Humans; Keratins; Malocclusion; Periodontal Pocket; Periodontics; Wound Healing

The cell population present during dextran-induced inflammation and its effect upon induced keratinization of the sulcular epithelium was investigated in two young adult male Rhesus monkeys. Keratinization of the sulcus epithelium was induced by a combined regimen of scaling, an intravenous injection of achromycin and daily rubber cup prophylaxes. After keratinization was confirmed by means of biopsies, inflammation was induced either by injecting 200 microliters of a 5% dextran saline solution or by applying the solution topically on the marginal gingiva for 2 weeks. Clinical grade dextran, molecular weight 70,000, was used. Physiologic saline solution, either injected or topical, was also used. At the same time, the daily prophylaxes were continued. After the 2 weeks, gingival biopsies were taken from each tooth treated with the different regimens. One-half of each biopsy was routinely processed and stained with hematoxylin and eosin or Rhodamine B, while the other half was processed for and stained with alcoholic and aqueous PAS to detect dextran in tissues. Histologic evaluation was carried out in three areas: a crestal zone, a cervical zone and an oral gingival zone. An Inflammatory Index (II) was determined and the width and length of keratin were measured. Dextran, either topical or injected, produced mainly a chronic inflammatory response characterized by lymphocytes (30-35%), monocytes-macrophages (5-10%), plasma cells (10%), polymorphonuclear leukocytes (PMNs) (15%) and unidentified cells (35%). Conversely, the physiologic saline-induced inflammation showed PMNs (75%), lymphocytes (5%) and unidentified cells (20%). The II for injected areas was significantly higher than for those topically treated or for nontreated controls. However, the increased II did not affect the degree of keratinization achieved.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Animals; Cell Count; Dental Prophylaxis; Dextrans; Epithelial Cells; Epithelium; Gingiva; Gingivitis; Keratins; Macaca mulatta; Male

The use of smokeless tobacco appears to be finding its way onto middle school, high school and college campuses as a socially acceptable and popular habit. Numerous reports in the literature have described the oral changes that appear to be associated with the use of smokeless tobacco in adults. Such information is unavailable for the lower age groups. A study was therefore undertaken to determine the prevalence and frequency of oral hard- and soft-tissue alterations associated with the use of smokeless tobacco in a teen-age population. High school students in grades 9 to 12 were evaluated on a random basis. From a total sample of 1,119 students, 117 users of smokeless tobacco were identified. Four distinct lesions associated with smokeless tobacco use were identified clinically: (1) hyperkeratotic or erythroplakic lesions of the oral mucosa, (2) gingival or periodontal inflammation, (3) a combination of oral mucosal lesions and periodontal inflammation, and (4) cervical erosion of the teeth. Among the smokeless tobacco users, 113 were boys and 4 were girls. Fifty-seven (48.7 percent) of the users had soft-tissue lesions and/or periodontal inflammation or erosion of dental hard tissues. Ninety-nine of the 117 users were Caucasian, 6 were Hispanic, 1 was black, 1 was Asian, 1 was an American Indian, and 6 failed to identify an ethnic origin. Use ranged from one to twenty "dips" per day, with an average time per dip of 30 minutes. Most users had been dipping for an average of 2 years, and twelve different tobacco brands were identified.

Topics: Adolescent; Adult; Female; Gingivitis; Humans; Keratins; Male; Mouth Mucosa; Nicotiana; Periodontitis; Plants, Toxic; Time Factors; Tooth Erosion

Topics: Animals; Dental Plaque; Dogs; Gingiva; Gingival Crevicular Fluid; Gingivitis; Keratins; Periodontal Index

Topics: Adolescent; Adult; Cell Count; Cell Differentiation; Epithelium; Female; Gingivitis; Humans; Keratins; Male; Mitosis

The purpose of the present study was to determine the effect of intrasulcular toothbrushing on permeability of the sulcular epithelium. Twenty-four dental students were divided into two groups of 12 each. On day 0, subjects in Group I began having the buccal aspects of the maxillary right first and second molars brushed for 30 seconds daily for 49 days by an examiner using an intrasulcular technique while subjects in Group II had the same teeth brushed with an extrasulcular technique. On day 49, clinical evaluation of inflammation was performed and biopsies were taken to evaluate gingival inflammation, sulcular epithelial keratinization and permeability of the sulcular epithelium in vitro using a microperfusion technique. Results indicate that subjects in both groups had attained equally high levels of gingival health. The intrasulcular group demonstrated a significantly higher degree of sulcular epithelial keratinization. However, no relationship was found between the degree of sulcular epithelial keratinization and sulcular epithelial permeability. Thus, the benefits derived from intrasulcular brushing and increasing sulcular epithelial keratinization are questionable.

Topics: Epithelium; Gingiva; Gingivitis; Humans; Keratins; Permeability; Toothbrushing

Topics: Animals; Dental Plaque; Dogs; Gingiva; Gingivitis; Keratins; Time Factors; Wound Healing

Topics: Animals; Anti-Infective Agents, Local; Bacteria; Chlorhexidine; Gingiva; Gingivitis; Haplorhini; Keratins; Macaca mulatta; Male; Mitosis; Tetracycline

Free grafts, consisting of nonkeratinized crevicular epithelium and supporting connective tissue, were placed into recipient beds prepared in nonkeratinized alveolar mucosa of the rhesus monkey. Four weeks later these grafts clinically resembled keratinized gingiva and this was confirmed by biopsy and histological examination. Electron microscopy indicated that the connective tissue supporting the crevicular epithelium changed to resemble that supporting keratinized gingiva in the 4-week graft. These findings were interpreted to indicate that crevicular epithelium has the potential to keratinize and that this potential is only realized when the inflammation is resolved in its supporting connective tissue.

Topics: Animals; Collagen; Connective Tissue; Epithelium; Fibroblasts; Gingiva; Gingivitis; Haplorhini; Keratins; Macaca mulatta; Male; Transplantation, Autologous

Topics: Adult; Connective Tissue; Epithelium; Female; Gingiva; Gingivectomy; Gingivitis; Humans; Keratins; Male; Middle Aged; Periodontal Diseases; Time Factors; Wound Healing

Sixteen dental, dental hygiene, and dental assisting students and dental faculty members who had contralateral or unilateral areas of minimal (less than or equal to 1.0 mm) and appreciable (greater than or equal to 2.0 mm) widths of keratinized gingiva on mid-buccal plaque-free surfaces of mandibular bicuspids were examined. Gingival exudate amounts and clinical inflammation based on color change and/or swelling and bleeding on probing were evaluated. The results showed that gingiva with "appreciable" width as well as gingiva with "minimal" width of keratinized tissue exhibited only minute amounts of gingival exudate. Also, there were generally no clinical signs of inflammation for both types of tissue. From the groups of 16, six subjects were selected who had contralateral pairs of minimal and appreciable keratinized gingiva. They were instructed to cease oral hygiene in the lower bicuspid area for 25 days. At day 0, 4, 7, 11, 14, 18, 21, and 25, plaque, gingival exudate, and clinical gingival inflammation were evaluated. Results revealed increases in plaque, gingival exudate scores and clinical gingival inflammation over the 25-day period with no apparent difference between the areas with minimal and appreciable width of keratinized gingiva.

Topics: Dental Plaque; Gingiva; Gingival Crevicular Fluid; Gingivitis; Humans; Keratins; Oral Hygiene

Filter imprint cytologic specimens were obtained from the gingiva of 41 male dental students following clinical assessment of gingival health using a modification of the Loe gingival index. Nineteen of the specimens were from inflamed, and 22 from uninflamed gingiva. The imprints were fixed and stained by a modification of the Papanicolaou method and macroscopic and microscopic examinations showed that: 1. With increasing severity of clinically detectable gingival inflammation,, there appears to be an increase in the width of the bands of inflammatory cells and epithelial cells adjacent to the gingival margin. 2. An inverse relationship is found between keratinization and inflammation in that the percentages of anucleated epithelial cells was reduced at the gingival margin and significantly reduced midway in the attached gingiva of the inflamed groups. 3. No changes associated with inflammation were noted in cell cytology at the mucogingival junction.

Topics: Cytodiagnosis; Gingiva; Gingivitis; Humans; Keratins; Micropore Filters

Cytochemical studies of glycogen of oral mucosa cells have been made on the smears by freeze-drying and PAS staining. The specimens were obtained from different areas of oral cavity of 77 human subjects and an attempt was made to find some interrelation amoung glycogen deposition, keratinization and inflammation. The largest glycogen deposition was found in the mucosa cells from mouth floor and cheek, a little in those from gingiva and quite a small or no glycogen in those from mucosa of hard palate and tongue. In gingiva the cells showing much more keratinization were less in glycogen contents, and vice versa. In inflammation some increase in glycogen contents were found in the gingivitis and the highest glycogen content in the cases of denture irritation of the palate as far as the present observation is concerned.

Topics: Adolescent; Adult; Aged; Cheek; Denture, Complete; Female; Gingiva; Gingivitis; Glycogen; Humans; Inflammation; Keratins; Male; Middle Aged; Mouth Diseases; Mouth Floor; Mouth Mucosa; Palate; Stomatitis, Aphthous; Tongue

Topics: Adult; Cytodiagnosis; Epithelial Cells; Gingiva; Gingivitis; Humans; Keratins; Male; Mouth Mucosa; Palate; Specimen Handling

Topics: Adolescent; Adult; Blood Vessels; Chromium Alloys; Collagen; Denture Bases; Denture, Partial, Removable; Female; Gingiva; Gingival Diseases; Gingival Pocket; Gingivitis; Humans; Keratins; Lymphocytes; Male; Methylmethacrylates; Middle Aged; Plasma Cells; Stomatitis; Stomatitis, Denture

Topics: Cytodiagnosis; Cytological Techniques; Dentifrices; Epithelial Cells; Gingiva; Gingivectomy; Gingivitis; Humans; Keratins; Microscopy, Electron; Mouth Mucosa; Oral Hygiene; Toothbrushing; Wound Healing

Topics: Alveolar Process; Animals; Blood Cell Count; Bone Marrow Cells; Chronic Disease; Gingivitis; Keratins; Periodontal Diseases; Periodontium; Phagocytosis; Rabbits

Topics: Acid Phosphatase; Carbohydrates; Cell Membrane; Cytoplasmic Granules; Diabetes Complications; Epithelial Cells; Gingiva; Gingivitis; Glycogen; Histocytochemistry; Humans; Keratins; Lysosomes; Microscopy, Electron

Topics: Animals; Autoradiography; Connective Tissue; Gingiva; Gingivitis; Haplorhini; Keratins; Macaca; Mitosis; Mouth Mucosa; Periodontium; Thymidine; Tritium

Topics: Alveolar Process; Animals; Autoradiography; Gingiva; Gingivitis; Haplorhini; Keratins; Keratosis; Mitosis; Mouth Diseases; Mouth Mucosa; Thymidine; Tritium

Topics: Animals; Gingivitis; Keratins; Rats; Vitamin A; Vitamin A Deficiency

Topics: Adult; Age Factors; Female; Gingiva; Gingivitis; Humans; Keratins; Male; Middle Aged; Periodontitis; Sex Factors