fibrin and Gingivitis

Topics: Alveolar Bone Loss; Amino Acid Sequence; Bacteroides; Blood Coagulation Factors; Fibrin; Fibrinogen; Gingival Hemorrhage; Gingivitis; Humans; Molecular Sequence Data; Osteoblasts; Periodontal Diseases; Periodontitis; Thrombin; Tissue Plasminogen Activator

Platelet-rich plasma (PRP) has been promoted as a surgical adjunct to enhance hard and soft tissue wound healing. Although anecdotally reported to be of value, the results of controlled studies examining the added effects of PRP on surgical procedures have been mixed. The purpose of this study was to test the effect of PRP on flap strength at various post-surgical time points in a minipig animal model.. Twelve Yucatan minipigs provided four sites per animal. PRP was prepared from each animal at the time of surgery. Following reflection of a mucoperiosteal flap in each quadrant, subgingival plaque and calculus were removed. Each surgical site was irrigated with sterile saline; prior to suturing, one randomly selected test quadrant in each arch was treated with PRP. Four animals were euthanized at day 14, and two animals were euthanized at 2, 7, 10, and 28 days. The flap strength in each quadrant was tested by attaching to a loop of 3-0 silk suture through the tissue; the force required to separate the flap from the tooth/bone interface was recorded for each site. A separate portion of each flap site was prepared for descriptive histologic examination, including inflammation, hemorrhage, and new bone growth.. Flap strength was significantly less on day 2 compared to later time points, and there were no significant differences between the test and control groups. No histologic differences in healing between test and control sites were seen at any time point.. PRP did not seem to contribute to greater flap strength at any post-surgical time point, nor was it associated with any histologic differences in wound healing in this Yucatan minipig model. The time points chosen for observation post-surgery, as well as the variability in the PRP platelet count, may have contributed to the lack of positive findings in this study.

Topics: Animals; Biomechanical Phenomena; Dental Calculus; Dental Plaque; Disease Models, Animal; Edema; Female; Fibrin; Gingiva; Gingivitis; Necrosis; Osteoblasts; Osteogenesis; Periodontium; Platelet-Rich Plasma; Postoperative Hemorrhage; Random Allocation; Stress, Mechanical; Subgingival Curettage; Surgical Flaps; Suture Techniques; Swine; Swine, Miniature; Tensile Strength; Time Factors; Wound Healing

Twenty-seven patients (19 females and 8 males) with a clinically diagnosed desquamative gingivitis were used in this study. Twenty-seven additional patients with oral and skin diseases and with gingival involvement other than that of the desquamative gingivitis type served as controls. Biopsy gingival specimens were sectioned and stained with H and E. The rest of the tissue specimen was cut with a cryostat and used for immunofluorescent assays of the tissue-bound antibodies (IgG, IgA, IgM, C3 anf fibrin). Circulating antibodies were determined by using the indirect immunofluorescence method in serum samples. Normal human oral mucosa and several animal epithelial tissues were used as substrates. The immunopathologic findings suggest the diagnosis of lichen planus in the presence of linear or granular fibrin deposition at the basement membrane zone/mucosal submucosal interface with or without cytoid bodies and cicatricial pemphigoid, in the presence of circulating and/or tissue-bound immunoglobulins and C3 in a linear continuous pattern along the BMZ. It is suggested that an accurate diagnosis of the underlying disease of the desquamative gingivitis can be made on the bases of the clinical, histopathologic, immunopathologic and follow-up findings.

Topics: Adult; Aged; Complement C3; Female; Fibrin; Fluorescent Antibody Technique; Gingival Diseases; Gingivitis; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Lichen Planus; Male; Middle Aged; Pemphigoid, Benign Mucous Membrane