Gingivitis resolution followed by optical coherence tomography and fluorescence imaging: A case study.

Gingivitis is highly prevalent in adults, and if left untreated, can progress to periodontitis. In this article, we present an interesting case study where the resolution of gingivitis was followed over a period of 10 days using optical coherence tomography (OCT) and light-induced autofluorescence (LIAF). We demonstrate that OCT and its functional angiography can distinctively capture the changes during the resolution of gingivitis; while LIAF can detect red-fluorescent signals associated with mature plaque present at the inflamed site. The acute inflammatory region showed evidence of angiogenesis based on the quantification of vessel density and number; while no angiogenesis was detected within the less inflamed region. Gingival thickness showed a reduction of 140 ± 26 µm on average, measured between the peak gingivitis event and the period wherein the inflammation was resolved. Vessels in the angiogenesis site was found to reduce exponentially. The mildly inflamed site showed a decreasing trend in the vessel size, which however was within the error of the measurement.

A proof of concept study to confirm the suitability of an intra oral scanner to record oral images for the non-invasive assessment of gingival inflammation.

OBJECTIVES: To compare gingival inflammation scores obtained chairside using the non-invasive modified gingival index (MGI) with MGI scores from an intraoral scan (IOS) captured at the clinical visit but viewed 10 days later. METHODS: Single visit, anterior teeth, observational, proof of concept study in healthy adult participants with a spectrum of gingival inflammation. One investigator performed both clinical and intraoral scan MGI assessments, a second repeated the MGI evaluation from the IOS. RESULTS: 23 participants aged 18-72 yielded data for 552 gingival sites. There was agreement at 90 % of sites comparing clinical with IOS MGI scores. The commonest disagreements were MGI grade 0 read as 1 and 2 read as 3, the highest single probability of error occurring where a clinical score of 0 was scored 1 from the IOS: 0.118 and 0.129 for examiners 1 and 2 respectively. The second most common probability of error occurred where an IOS score of 3 was scored clinically as 2: 0.089 and 0.097 for examiners 1 and 2 respectively. MGI scores from the scans were similar for both examiners (91 % agreement), with no discrepancies of greater than 1 scale point. There was very close agreement between clinical MGI and IOS colour/texture scores. CONCLUSION: This study conclusively demonstrated that the MGI score from the scanned image was very similar to the MGI scored clinically. This study confirms that a digital IOS accurately captures gingival contour images allowing a clinician to determine health or degree of gingival inflammation from it using MGI scores. CLINICAL SIGNIFICANCE STATEMENT: This study confirms that IOS images of teeth and soft tissues are sufficiently accurate to allow the clinical evaluation of health or inflammatory gingival status using non-invasive indices. IOS has great potential for efficient and accurate data capture, for general practice and research facilitating remote evaluation and data verification.

Handheld optical coherence tomography for clinical assessment of dental plaque and gingiva.

SIGNIFICANCE: Optical coherence tomography (OCT) offers high spatial resolution and contrast for imaging intraoral structures, yet few studies have investigated its clinical feasibility for dental plaque and gingiva imaging in vivo. Furthermore, the accessibility is often limited to anterior teeth due to bulky imaging systems and probes. AIM: A custom-designed, handheld probe-based, spectral-domain OCT system with an interchangeable attachment was developed to assess dental plaque and gingival health in a clinical setting. APPROACH: Healthy volunteers and subjects with gingivitis and sufficient plaque were recruited. The handheld OCT system was operated by trained dental hygienists to acquire images of dental plaque and gingiva at various locations and after one-week use of oral hygiene products. RESULTS: The handheld OCT can access premolars, first molars, and lingual sides of teeth to visualize the plaque distribution. OCT intensity-based texture analysis revealed lower intensity from selected sites in subjects with gingivitis. The distribution of the dental plaque after one-week use of the oral hygiene products was compared, showing the capability of OCT as a longitudinal tracking tool. CONCLUSIONS: OCT has a strong potential to display and assess dental plaque and gingiva in a clinical setting. Meanwhile, technological challenges remain to perform systematic longitudinal tracking and comparative analyses.

Red fluorescence of Interdental plaque for screening of gingival health.

BACKGROUND: Pathogenic dental plaque with deteriorated bacterial homeostasis around the gingival margin induces gingivitis. This study evaluated the applicability of red fluorescence (RF) properties of interdental plaque in screening for gingival health status. METHODS: This cross-sectional study examined 178 teeth of 40 healthy subjects who had not lost both their first and second molars in at least one quadrant. Three groups (healthy, gingivitis, and periodontitis) were identified based on the periodontal health status (bleeding on probing, probing depth, clinical attachment loss) and plaque accumulation level (plaque index) in the interdental site between the first and second molars was evaluated. This interdental plaque between the first (distal surface) and the second molar (mesial surface) was collected using dental floss. A quantitative light-induced fluorescence (QLF) technology was used to assess RF emitted from the interdental plaque. The RF properties of the interdental plaque were quantified by fluorescence intensity (R/G value) and area (%). The RF variables were compared between the groups. RESULTS: The RF variables of the interdental plaque (R/G value and area) were significantly higher in the gingivitis and periodontitis group compared to the healthy group (p<0.0001, p=0.001), but there was no significant difference between the gingivitis and periodontitis groups. Significant correlations were identified between R/G value and bleeding on probing (r = 0.49, P < 0.01) and between R/G value and visual plaque index (r = 0.59, P < 0.01) for each tooth. CONCLUSION: Interdental plaque obtained by flossing and its red fluorescence quantified by QLF technology could be used as a potential indicator of gingivitis.

Further opportunities for digital imaging in dental epidemiology.

Dental epidemiological research permits accurate tracking of the prevalence and distribution of oral disease across population groups, enabling planning and evaluation of public health interventions and healthcare service provision. This first section of this paper aimed to review traditional assessment methods in dental epidemiology and to consider the methodological and logistical benefits provided by digital imaging, both generally and specifically in relation to an established dual-camera system. The remainder of this paper describes the results of a semi-structured examination of an image archive from previous research utilising a dual-camera system, exploring whether the diagnostic yield of the images might be increased. Common oral conditions are presented alongside suggestions of the diagnostically useful data displayed in example images. Possible scoring mechanisms are discussed with consideration of the limitations that might be encountered for each condition. The retrospective examination suggests further data is obtainable from images acquired using the dual-camera system, however, consideration should be given to how best to validate this clinically. Additionally, other imaging modalities are discussed whilst taking into account the potential limitations of the dual-camera system.

Optical coherence tomography assessment of gingival epithelium inflammatory status in periodontal - Systemic affected patients.

INTRODUCTION: Optical coherence tomography (OCT) is an imaging tool used in various medical fields (ophthalmology, dermatology), which allows the observation of morphological particularities on the surface of tissues or internal constructive details of about 2-3mms in depth. In periodontology, it has been used as an experimental tool for periodontal pocket analysis (depth, calculus deposits) but not for the assessment of periodontal inflammation in the gingival tissues, which has been the subject of our in-vitro study. MATERIAL AND METHOD: Gingival samples were collected from three types of patients: patients with periodontal disease; patients with periodontal disease and a systemic comorbidity; periodontal and systemic healthy patients. The samples were scanned with an OCT light beam, resulting two-dimensional images of the gingival tissue (full thickness epithelium and partial connective tissue). The images were assessed using dedicated software, which allowed the quantification of pixels on a given segment in the epithelium. The average pixel densities were then calculated for each patient group and statistically analyzed. RESULTS: The resulted pixel densities were highest for the control group samples, while the lowest pixel densities were found in samples originating from periodontal patients with diabetes mellitus. For the other possible periodontal comorbidity, chronic hepatitis C, image assessment also exhibited lower pixel densities than those of the periodontal group, suggesting that this condition could also have an added effect on the tissular changes induced by periodontal disease. CONCLUSION: OCT has proven that in an in-vitro environment it can be a useful tool for the assessment of periodontal inflammation in gingival samples of periodontal patients. In terms of inflammatory tissular changes observed by OCT analysis, chronic hepatitis C could be regarded as possible periodontal disease's comorbidity.

A relação entre ciclo menstrual e gengivite / The relationship between the menstrual cycle and gingivitis

A gengivite é uma doença inflamatória que interfere nos tecidos de suporte dos dentes. Inicia-se pelo acúmulo da placa bacteriana sobre as faces dentárias e a margem gengival, promovendo a liberação de produtos tóxicos que são efeitos da combinação da bactéria e do hospedeiro. Há indícios de que os hormônios sexuais, principalmente os esteroidais, que estão presentes no ciclo menstrual, apresentem efeitos sobre a saúde periodontal, causando impactos diretos na inflamação gengival e em possíveis alterações de substâncias no fluido gengival. Para tanto, realizou-se uma pesquisa de campo com o intuito de validar a relação entre o ciclo menstrual e a gengivite e seus possíveis diagnósticos frente aos hormônios sexuais que se apresentam de forma tão relevante. OBJETIVO: O objetivo do presente trabalho é verificar através de uma pesquisa de campo, se durante o ciclo menstrual, as alterações hormonais causadas neste período têm capacidade de gerar alterações nos tecidos gengivais. METODOLOGIA: Trata-se de uma pesquisa de campo, realizada por meio de artigos indexados na base científica SciELO e avaliação clínica e sondagem da gengiva de 20 voluntárias durante o período pré-mentrual, menstrual e período pós-mentrual de cada uma.(AU)

Gingivitis is an inflammatory disease that affects the supporting tissues of the teeth. It begins by the accumulation of bacterial plaque on the dental faces and the gingival margin, promoting the release of toxic products that are effects of the combination of bacteria and the host. There are indications that the sex hormones, especially the steroidal ones, that are present in the menstrual cycle, have effects on the periodontal health, causing direct impacts on gingival inflammation and possible alterations of substances in the gingival fluid. Therefore, a field research was carried out with the purpose of validating the relationship between the menstrual cycle and gingivitis and its possible diagnoses against the sex hormones that present themselves in such a relevant way. OBJECTIVE: The objective of the present study is to verify through a field survey whether, during the menstrual cycle, the hormonal changes caused in this period have the capacity to generate alterations in the gingival tissues. METHODOLOGY: This is a field study, carried out by means of articles indexed in SciELO scientific basis and clinical evaluation and gingival probing of 20 volunteers during the pre-mentual period, menstrual period and post-mentual period of each.(AU)

[Modern approaches to periodontal microcirculatory parameters assessment]. / Sovremennye podkhody k otsenke pokazatelei mikrogemodinamiki v tkanyakh parodonta.

The article presents comprehensive functional study of periodontal tissues in 62 patients aged 20-45 with periodontal disease by laser Doppler flowmetry, Doppler ultrasound and computer capillaroscopy. All patients were divided into 5 groups depending on the severity of inflammation in the periodontium (chronic gingivitis, light, moderate and severe chronic periodontal disease). The relationship between microcirculatory indexes was evaluated by Pearson Product Moment Correlation or PPMC. The study shows high correlation between blood flow velocity measurement, diameter of microvessels and oxygen saturation in periodontal tissues that establish a direct relationship between studied parameters.

T2 relaxation mapping MRI of healthy and inflamed gingival tissue.

OBJECTIVES: To investigate the use and reproducibility of MRI transverse relaxation time (T2) mapping in healthy and inflamed gingivae. METHODS: 21 subjects were recruited into 2 groups: those without evidence of gingivitis ("healthy"; n = 11, age 24.0 ± 3.66 years) by visual assessment and those with moderate to severe gingivitis ("gingivitis"; n = 10, age 28.9 ± 6.03 years) exhibited across the second mandibular premolar and first mandibular molar buccal gingivae. Subjects were imaged by MRI twice in a single day. Three T2 weighted turbo spin-echo volumes with 0.25 × 0.25 × 0.8-mm3 resolution were acquired at echo times of 16, 32 and 48 ms for T2 decay fitting. Image analysis was fully blinded; the two imaging sessions were not identifiable as coming from the same subject. Each imaging session had independent regions of interest drawn on the first echo image and applied to the calculated T2 decay maps. RESULTS: The coefficient of variation was low and similar in healthy and gingivitis populations: 6.10 and 5.25% populations, respectively, with 5.65% populations across both groups. Bland-Altman analysis revealed no bias (mean -2.93%; 95% confidence intervals -22.20 to 16.34%) between sessions. The intersession agreement was good (r = 0.744, ρ = 0.568, intraclass correlation coefficient = 0.68). T2 mapping did not differentiate healthy from gingivitis groups. The mean T2 value in the healthy group (63.7 ms) was similar to that of the gingivitis group (65.23 ms) (p = 0.30). CONCLUSIONS: Mapping of the T2 decay in the gingivae was a repeatable process; however, T2 value alone did not differentiate those with clinical examination-determined gingivitis from those without signs of gingivitis.

Design and evaluation of a miniature laser speckle imaging device to assess gingival health.

Current methods used to assess gingivitis are qualitative and subjective. We hypothesized that gingival perfusion measurements could provide a quantitative metric of disease severity. We constructed a compact laser speckle imaging (LSI) system that could be mounted in custom-made oral molds. Rigid fixation of the LSI system in the oral cavity enabled measurement of blood flow in the gingiva. In vitro validation performed in controlled flow phantoms demonstrated that the compact LSI system had comparable accuracy and linearity compared to a conventional bench-top LSI setup. In vivo validation demonstrated that the compact LSI system was capable of measuring expected blood flow dynamics during a standard postocclusive reactive hyperemia and that the compact LSI system could be used to measure gingival blood flow repeatedly without significant variation in measured blood flow values (p<0.05). Finally, compact LSI system measurements were collected from the interdental papilla of nine subjects and compared to a clinical assessment of gingival bleeding on probing. A statistically significant correlation (?=0.53; p<0.005) was found between these variables, indicating that quantitative gingival perfusion measurements performed using our system may aid in the diagnosis and prognosis of periodontal disease.

Dynamics of red fluorescent dental plaque during experimental gingivitis--A cohort study.

OBJECTIVES: The dynamics of red fluorescent plaque (RFP) in comparison to clinical plaque and bleeding scores were studied during an experimental gingivitis protocol in a cohort of healthy participants. METHODS: Forty-one participants were monitored for RFP before (24h plaque), during 14 days plaque accumulation (days 2, 5, 9, 14) and after 7 days recovery (24h plaque). RFP was assessed on fluorescence photographs of the vestibular aspect of the anterior teeth (cuspid to cuspid) in the upper and lower jaw. Clinical plaque and bleeding were assessed at days -14, 0, 14 and 21. RESULTS: RFP of 24h plaque was reproducible (days -14, 0), then increased during 14 days plaque accumulation and returned to baseline after 7 days recovery. Groups of low, moderate and high RFP formers were statistically significantly different at all times even already at baseline. The individual RFP response during 14 days plaque accumulation correlated well with RFP of 24h plaque (days -14, 0). RFP correlated moderate to well with clinical plaque at days -14, 0, 14 and 21. From day 2 of the gingivitis challenge RFP correlated with bleeding at day 14. CONCLUSIONS: RFP provided an objective measure of oral hygiene status. Given the correlation with clinical parameters found, the amount of RFP after 24h plaque accumulation was indicatory for the inflammatory response during a prolonged period of no oral hygiene. This trial was registered at the public trial register ​of the Central Committee on Research Involving Human Subjects (CCMO) under number NL51111.029.14 CLINICAL SIGNIFICANCE: This paper shows the association between RFP after 24h plaque accumulation and inflammatory response after a prolonged period of no oral hygiene. Red plaque fluorescence can be used to identify subjects at risk for developing gingival inflammation.

Oral health of individuals aged 3-80 years in Jönköping, Sweden during 40 years (1973-2013). II. Review of clinical and radiographic findings.

The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973-2003. In 1973, 1983, 1993, 2003, and 2013 random samples of 1,000; 1,104; 1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, 70, and 80o years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jönköping, Sweden. The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment. The frequency of edentulous individuals aged 40-70 years was 16, 12, 8, 1, and 0.3% in 1973, 1983, 1993, 2003, and 2013, respectively. No complete denture weareryounger than 80-years old was found in 2013. During the 40-year period, the mean number of teeth in the age groups 30-80 years increased. In 2013, the 60-year-olds had nearly complete dentitions. Implants were found in all age groups from 30 years of age. The total number of individuals with implants was 36 in 2013. This was higher than earlier surveys, 4 in 1993, and 18 in 2003. The percentage of children and adults without caries and restorations increased during the 40-year period. It was found that the percentage of caries-free 3- and 5-year-olds were 79% and 69%, respectively, of the individuals in 2013. In the age groups 10-20 years, the percentage of caries-free individuals increased between 2003 and 2013. In 2013, 43% of the 15-year-olds were completely free from caries and restorations compared to 20% in 2003. In all age groups 5-60 years, DFS was lower in 2013 compared to the earlier examinations.There was no major change in DFS between 2003 and 2013 in the age groups 70 and 80 years. The most obvious change was the decrease in number of FS over the 40-year period of time. Regarding crowned teeth the most clear changes between 1973 to 2013 were the decrease in percentage of crowned teeth in the age groups 40 and 50-year-olds. The percentage of endodontically treated teeth decreased between 1973 and 2013 in all age groups. In age groups 10-30-year-olds a major reduction from about 30% to 15% in mean plaque score was seen between 1973-2003. Only a minor change in plaque score was seen during the last decade. For the age groups 40 years and older, a decrease in the percentage of surfaces with plaque was observed between 2003-2013. The percentage of tooth sites with gingivitis was for 20 years and older about 40% in 1973. In 2013, the percentage was about 15%. The frequency of sites with gingivitis was generally lower in 2013 compared with the otheryears,1973-1993. The percentage of individuals with probing pocket depths > 4mm increased with age. Between 2003-2013 a clear reduction was seen in all age groups in frequency of individuals with probing pocket depth > 4mm. Over the 40-year period an increase in the number of individuals with no marginal bone loss and a decrease in the number of subjects with moderate alveolar bone loss were seen. The continuous improvement in oral health and the reduced need of restorative treatment will seriously affect the provision of dental helath care and dental delivery system in the near future.

Clinical and Radiographic Evaluation of the Periodontium with Biologic Width Invasion by Overextending Restoration Margins - A Pilot Study.

AIM: 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. MATERIALS AND METHODS: 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). RESULTS: 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. CONCLUSIONS: 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.

Dental radiographic findings in cats with chronic gingivostomatitis (2002-2012).

OBJECTIVE: To compare dental radiographic findings in cats with and without feline chronic gingivostomatitis (FCGS). DESIGN: Retrospective case-control study. ANIMALS: 101 cats with FCGS (cases) and 101 cats with other oral diseases (controls). PROCEDURES: Controls were age- and treatment date-matched with cases. Conventional full-mouth dental radiographic views were evaluated for distribution, pattern, and severity of alveolar bone loss (periodontitis), tooth resorption, buccal bone expansion, tooth fractures, and retained roots. RESULTS: All cases and 77 (76%) controls had periodontitis; differences in extent and severity of periodontitis were significant, with semigeneralized or generalized and moderate or severe periodontitis in 78 (77%) and 93 (92%) cases, respectively, and 28 (28%) and 38 (38%) controls, respectively. The pattern of alveolar bone loss in cases was dominated by horizontal bone loss, with a nonsignificant increase in vertical bone loss, compared with that of controls. Cases were more likely than controls to have external inflammatory root resorption (49 [49%] vs 25 [25%]) and retained roots (57 [56%] vs 28 [28%]). Fewer dental fractures occurred in cases (14 [14%]) than in controls (35 [35%]). There were no differences between cases and controls in breed, sex, or presence of feline resorptive lesions or buccal bone expansion. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that FCGS was associated with more widely distributed and severe periodontitis, with a higher prevalence of external inflammatory root resorption and retained roots than other oral diseases. Full-mouth radiographic views are indicated for cats with FCGS to diagnose the extent of associated periodontitis, reveal external inflammatory root resorption, and identify retained roots.

Subgingival microbiota from Cebus apella (capuchin monkey) with different periodontal conditions.

This present study evaluated the subgingival microbiota of the Cebus apella with different periodontal conditions kept by the Tufted Capuchin Monkey Procreation Center (São Paulo State University - UNESP) or free-ranging monkeys. For this purpose, clinical specimens of subgingival biofilm were collected from 52 monkeys, of both genders, 40 kept in captivity and 12 free-ranging monkeys. The primates were submitted to periodontal evaluation and biofilm samples were transferred to VMGA III transport medium and ultrapure water. The microbiota was cultivated in selective and non-selective culture media and microbial DNA was extracted and the presence of periodontal pathogens was evaluated using PCR and real-time PCR. The actinomycetes, fusobacteria, Campylobacter rectus, Eikenella corrodens, black-pigmented Gram-negative anaerobic rods, Tannerella forsythia, staphylococci and streptococci represent the predominantly detected microorganisms. Aggregatibacter actinomycetemcomitans, Dialister pneumosintes and Prevotella nigrescens were rarely observed, whereas Treponema denticola was not found. Populations of C. rectus, E. corrodens, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, T. forsythia and the total microbial load were significantly higher in animals with bone loss and, in smaller extension, in animals with gingival bleeding.

Periodontal disease in relation to smoking and the use of Swedish snus: epidemiological studies covering 20 years (1983-2003).

AIM: The aim of the present study was to examine how deleterious current smoking and the use of Swedish moist snuff (snus) is for periodontal health compared with non-tobacco users. MATERIALS AND METHODS: The studies comprised three epidemiological cross-sectional studies, in 1983, 1993 and 2003, of stratified random samples aged 20, 30, 40, 50, 60 and 70 years. The numbers of dentate participants were 550, 552 and 523, respectively. The participants were examined clinically and radiographically. Diagnostic criteria were the number of teeth, plaque, gingival status, probing pocket depth (PPD) ≥ 4 mm, height of the alveolar bone level and classification by periodontal disease experience. In addition, participants were asked about their tobacco habits. RESULTS: Multiple logistic regression shows, after adjusting for age, gender and sociodemographic variables, that relative to non-tobacco users, cigarette smokers had statistically significant less gingivitis, a higher frequency of PPD ≥ 4 mm and a higher incidence of severe periodontitis. There was no significant association between gingivitis, frequency of PPD ≥ 4 mm and periodontal disease experience and snus use. CONCLUSIONS: Cigarette smokers were found to have a statistically significant higher risk of severe periodontitis than non-tobacco users and users of snus. Using snus did not seem to be a risk factor for periodontitis.

Oral cavity evaluation and dental chart registration of coati (Nasua nasua) in captivity.

The aims of this study were to develop a dental evaluate any oral cavity disease, develop gypsum models of the dental arches, and to register the occlusions found in coatis (Nasua nasua) in captivity Formulation of the dental chart was assisted by intraoral radiographs from the head of an adult coati cadaver of the same species with the following dental formula.: I 3/3, C 1/1, P 4/3, M 2/2. Seven live coatis of the Nasua nasua species were evaluated. Five of the seven coatis presented with various dental abnormalities as follows: dental plaque (71.4 0%), gingivitis (71.4 %), periodontitis (57.1 %), dental stain (42.9 %), dental abrasion (57.1 %), dental fracture (57.1 %), pulp exposure (42.9 %), malocclusion (57.1 %) and supernumerary teeth (14.2 %).

Gingival crevicular fluid and serum matrix metalloproteinase-8 and tissue inhibitor of matrix metalloproteinase-1 levels in renal transplant patients undergoing different immunosuppressive therapy.

AIM: We investigated gingival crevicular fluid (GCF) and serum matrix metalloproteinase-8 (MMP-8) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) levels from renal transplant patients receiving cyclosporine-A (CsA) and having gingival overgrowth (GO), from patients receiving CsA therapy and having no GO and patients receiving tacrolimus therapy. MATERIAL AND METHODS: GCF samples were collected from sites with GO (GO+) and without GO (GO-) in CsA patients having GO; and GO- sites in CsA patients having no GO; sites from tacrolimus, gingivitis and healthy subjects. GCF and serum MMP-8 and TIMP-1 levels were determined by a time-resolved immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay. RESULTS: GO+ sites in CsA patients having GO had elevated GCF MMP-8 levels compared with those of CsA patients having no GO, tacrolimus and healthy subjects (p<0.005), but these levels were similar to those of gingivitis. The GCF MMP-8 level was higher in GO+ compared with GO- sites in CsA patients having GO (p<0.05). GCF TIMP-1 levels were similar between groups. Tacrolimus patients had lower GCF MMP-8 levels than gingivitis (p<0.005), but levels similar to the healthy group. CONCLUSION: These results show that CsA and tacrolimus therapy has no significant effect on GCF MMP-8 levels, and gingival inflammation seems to be the main reason for their elevations.

Repeatability of ultrasonic determination of gingival thickness.

The aim of the present study was to assess the degree of disagreement of ultrasonic measurements of gingival thickness at different teeth. Gingival thickness was determined in 33 volunteers with plaque-induced gingivitis. Facial/buccal gingiva was measured at the level of the gingival sulcus depth. Measurements were repeated after 2 and 4 weeks. A repeated measures, two-level (occasion, subject), variance components model revealed a within-subject variance of 0.187 mm(2) resulting in a repeatability coefficient of 1.20 mm. When modeling level 1 (occasion) variance as a function of tooth type, respective error terms were used for calculating 95% repeatability coefficients for different teeth. Unreliable measurements were largely confined to upper and lower second and third molars. Error terms were lowest (0.03-0.05) at upper canines and first premolars as well as lower anterior teeth and premolars, where repeatability coefficients of 0.5 to 0.6 mm could be estimated. It was concluded that performance of the device was best at certain tooth types with rather thin gingiva. The present resolution and rather high degree of disagreement may preclude, however, detection of minute increases in thickness in the micrometer range, which seem to occur during gingivitis.