Cytokine levels in gingival tissues as an indicator to understand periodontal disease severity.

Cytokines regulate periodontal pathogenesis and are relevant estimates of current disease activity. There is sparse information on status of cytokine protein levels in periodontal pocket (gingival) tissues. The current study analysed proteins and transcripts of selected cytokines in varying severity of periodontal disease and elucidated cytokine/cytokine ratios that best indicated periodontal disease severity, in gingival tissues. A total of 92 participants comprising of generalised moderate periodontitis (GMP, n = 18), generalised severe periodontitis (GSP, n = 46) and periodontally healthy controls (PHC, n = 25) were recruited for the study. Interproximal gingival tissue samples were utilised for cytokine protein estimation and mRNA quantification by qRT-PCR and ELISA respectively. Selected key pro and anti-inflammatory cytokines, also representative of various Th subsets were analysed. ROC curve analysis was performed and Youden index was calculated for individual cytokines and pro/anti-inflammatory cytokine ratio to estimate the best indicator of periodontal severity/progression in tissues. IL-1ß, TGF-ß and IFN-γ cytokine protein levels varied significantly (p ≤ 0.05) with severity of periodontal disease between groups. On comparison between deep and shallow sites within same participant, deep sites showed significant elevation of TGF-ß (p ≤ 0.01) and IFN-γ (p ≤ 0.05) and IL-17 cytokines and shallow sites showed elevation of IL-4(p ≤ 0.01) and IL-1ß (p ≤ 0.05) cytokines. Analysis of transcripts showed IFN-γ and IL-1ß transcript predominance in GSP (p = 0.01) compared to PHC. ROC analysis illustrated 97% sensitivity, 93% specificity with Youden index of 90% for IL-1ß cytokine and 81%sensitivity, 79% specificity with a Youden index of 60% for IL-1ß/TGF-ß ratio In periodontal pocket tissue, a lack of distinct predominance of specific cytokines between study groups or between shallow and deep sites affected by periodontal disease was observed. However, ROC analysis of cytokines revealed IL-1ß cytokine and IL-1ß/TGF-ß ratio as promising indicators of periodontal disease severity in gingival tissues.

Calcifying ghost cell odontogenic cyst: A review on terminologies and classifications.

Calcifying ghost cell odontogenic cyst (CGCOC) is a relatively uncommon odontogenic lesion characterized by varied clinical, radiographical features and biological behavior. CGCOC can exhibit either as a cystic or a solid lesion. Since its first description by Gorlin et al, in 1962, it has been known by different names and classified and sub-classified into various types. In this article we present a case of CGCOC and discuss the related literature regarding the terminology, classification and biological behavior of CGCOC.

An unusual presentation of peripheral buttressing bone in anterior maxilla: Case report and management.

The phenomenon of buttressing bone formation is relatively uncommon in the alveolar bone, more so in the anterior maxilla. In our case, peripheral buttressing bone formation presented as an isolated hard gingival swelling with relation to 21 in a 14-year-old girl. Radiographic presentation was normal with no evidence of bone loss or altered bone density. Therefore explorative surgery was planned. Buttressing bone formation could be appreciated, which also was the cause for swelling clinically. Osteoplasty was done and bone graft placed in the defect. On a subsequent recall visit gingivoplasty was done to reduce gingival thickness to improve esthetics. We report the case for its unusual presentation, its management with follow-up.