Gingival crevicular fluid tissue/blood vessel-type plasminogen activator and plasminogen activator inhibitor-2 levels in patients with rheumatoid arthritis: effects of nonsurgical periodontal therapy.

BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the effect of nonsurgical periodontal therapy on clinical parameters and gingival crevicular fluid levels of tissue/blood vessel-type plasminogen activator (t-PA) and plasminogen activator inhibitor-2 (PAI-2) in patients with periodontitis, with or without rheumatoid arthritis (RA). MATERIAL AND METHODS: Fifteen patients with RA and chronic periodontitis (RA-P), 15 systemically healthy patients with chronic periodontitis (H-P) and 15 periodontally and systemically healthy volunteers (C) were included in the study. Plaque index, gingival index, probing pocket depth, clinical attachment level, bleeding on probing, gingival crevicular fluid t-PA and PAI-2 levels, erythrocyte sedimentation rate, serum C-reactive protein and disease activity score were evaluated at baseline and 3 mo after mechanical nonsurgical periodontal therapy. RESULTS: All periodontal clinical parameters were significantly higher in the RA-P and H-P groups compared with the C group (p < 0.001) and decreased significantly after treatment (p < 0.001). Pretreatment t-PA levels were highest in the RA-P group and significantly decreased post-treatment (p = 0.047). Pre- and post-treatment PAI-2 levels were significantly lower in controls compared with both periodontitis groups (p < 0.05). Gingival crevicular fluid volume and the levels of t-PA and PAI-2 were significantly correlated. CONCLUSION: In patients with periodontitis and RA, nonsurgical periodontal therapy reduced the pretreatment gingival crevicular fluid t-PA levels, which were significantly correlated with gingival crevicular fluid PAI-2 levels. The significantly higher t-PA and PAI-2 gingival crevicular fluid levels in periodontal patients, regardless of systemic status, suggest that the plasminogen activating system plays a role in the disease process of periodontitis.

The effects of periodontal therapy on gingival crevicular fluid matrix metalloproteinase-8, interleukin-6 and prostaglandin E2 levels in patients with rheumatoid arthritis.

OBJECTIVE: The aim of this study was to evaluate the effects of non-surgical periodontal therapy on gingival crevicular fluid levels of matrix metalloproteinase-8 (MMP-8), interleukin-6 (IL-6) and prostaglandin E2 (PGE2 ) in patients with rheumatoid arthritis (RA) with periodontal disease. MATERIAL AND METHODS: Twenty-seven patients with gingivitis and periodontitis with RA, 26 patients with gingivitis and periodontitis that were systemically healthy and 13 periodontally and systemically healthy volunteers (control group) were included in this study. RA activity was assessed by disease activity score test. The clinical periodontal parameters, fasting venous blood and gingival crevicular fluid samples were obtained and gingival crevicular fluid MMP-8, IL-6 and PGE2 levels were evaluated at baseline and at 3 mo follow-up after non-surgical periodontal treatment. RESULTS: Gingival crevicular fluid MMP-8, PGE2 and IL-6 levels were higher in all groups than the control group. Following periodontal therapy, there were significant decreases in gingival crevicular fluid MMP-8, PGE2 and IL-6 levels from patients with RA with periodontitis (p < 0.05). Plaque index, gingival index and bleeding on probing were significantly correlated with IL-6 and PGE2 at baseline and at 3 mo follow-up after non-surgical periodontal treatment. CONCLUSION: Non-surgical periodontal therapy of patients with RA with periodontitis may provide beneficial effects on local inflammatory control via decreases in gingival crevicular fluid MMP-8, PGE2 and IL-6 levels.

A histopathological investigation on the effects of the bisphosphonate alendronate on resorptive phase following mucoperiosteal flap surgery in the mandible of rats.

BACKGROUND: The present study was designed to examine histopathologically whether local delivery of aminobisphosphonate (alendronate) could be effective in preventing the alveolar bone resorption associated with mucoperiosteal flaps. METHODS: Following mucoperiosteal flap elevation in the molar region of the rat mandible, a surgical pellet soaked with aminobisphosphonate was locally applied on the exposed bone surface and covered by flap. The determined parameters with a semi-quantitative subjective method for the histopathological evaluation were as follows: existing inflammatory cell infiltration of the related periodontal tissue; fibrotic component content and bundles of collagen fibers; the number and morphology of osteoclasts of the alveolar bone and interdental septum; existing resorption lacunae (osteoclast surfaces); and existing osteoblastic activity (forming surfaces). RESULTS: The results showed that while there were no detectable statistically significant differences between the saline and alendronate-treated groups on the existing inflammatory cell infiltration (ICI), number of osteoclasts, and osteoblastic activity, the results for the fibrotic and collagen component, osteoclast morphologies, and existing resorption lacunae were statistically significant. CONCLUSIONS: These results suggest that local application of the aminobisphosphonate alendronate can be used as an adjunct in therapy for reducing bone resorption following surgery. It can also be suggested for consideration that, even for the surgical approaches in dentistry where bone graft materials and/or dental implants are needed, using bisphosphonate may achieve a new dimension in periodontal therapy in the near future.

Destructive membranous periodontal disease (Ligneous periodontitis).

Generalized membranous gingival enlargement due to accumulation of amyloid or fibrin-like material is a rare, destructive and poorly defined disease entity. Some patients also show extraoral manifestations. The lesion is an involvement of periodontal tissues caused by the same process as ligneous conjunctivitis. In this report, 3 new cases, two of whom are siblings, are presented. Defective fibrinolysis and abnormal wound healing seem to be the main pathogenetic mechanism of this unusual disease, which should be evaluated systemically considering other mucosal involvement.

Gingival Langerhans' cells in type I diabetes mellitus.

Langerhans' cells (LCs) are intraepithelial immunocompetent cells. Changes in the number of LCs occur in inflammatory and autoimmune diseases. In this study, the number of gingival LCs in patients with type I diabetes mellitus was compared with those of normal individuals using immunohistochemical methods. Gingival biopsies were obtained from 20 type I diabetics and 10 healthy individuals. Anti-CD1 positive LCs formed an intraepithelial network and showed a marked increase in type I diabetics. This increase was not related to diabetic age. The number of LCs was proportional to the density of subepithelial inflammatory cells. Our findings suggest that LCs may play a role in the development of diabetic gingivitis.

Familial gingival fibromatosis with unusual histologic findings.

This article describes the occurrence of numerous calcifications, amyloid deposits, and islands of odontogenic epithelium in the gingiva of 3 siblings with familial gingival fibromatosis. These microscopic features have not been reported previously in patients with this condition.

Estrogen and progesterone receptors in the peripheral giant cell granulomas of the oral cavity.

Peripheral giant cell granulomas are common proliferative lesions of the oral cavity with a predilection for females. In this study, the presence of estrogen and progesterone receptors in 26 peripheral giant cell granuloma cases were studied utilizing the immunoperoxidase technique. In fourteen cases, estrogen receptor positivity was found in stromal cells. In ten of these, osteoclast-type giant cells also exhibited estrogen receptor immunostaining. Progesterone receptor expression was not detected. It was concluded that the cells forming peripheral giant cell granuloma are potential targets for estrogens and that these lesions might be conditioned by sex hormones.

Examination of periodontal tissues by a cutting-grinding technique.

The decalcification process removes the mineralized part of the dental hard tissues, making the histologic examination of enamel-associated tissues less than optimal. The cutting-grinding technique allows preparation of histologic slides with well preserved dental hard tissues together with their surrounding soft tissue components. In this paper, the histologic appearances of undecalcified teeth and their associated periodontal tissues prepared using the cutting-grinding technique are described.

Mast cells in periodontal disease.

Since the roles of mast cells in periodontal tissues are not clear, this study aimed to count the number of mast cells in gingival tissues of healthy volunteers and patients with chronic periodontal disease before and three weeks after surgical treatment. The numbers of mast cells were found to be increased on postoperative healed tissues and inflamed tissues respectively, compared to healthy tissues. This increase is closely related to fibrosis in connective tissues.

[Mast cells in gingival inflammations]. / Diseti inflamasyonlarinda mast hücreleri.

Mast cells are the normal components of the connective tissues. They are found in different densities and different regions of the inflamed and healthy gingival tissues. The role of mast cell mediators in periodontal disease progression were not studied in detail. Since the roles of mast cells in periodontal tissues are not clear, this study aimed to count the number of mast cells in gingival tissues of healthy volunteers and patients with gingival inflammation. Numbers of mast cells were found increased on inflamed tissues comparing to healthy tissues. This increase is closely related with the degree of inflammation on the fields which counting made on.

[Mast cell counting in fibrous gingival hyperplasias and giant cell granuloma]. / Fibröz diseti hiperplazileri ve dev hücreli granulomlarda mast hücre sayimi.

Mast cells are the normal components of the connective tissues and they are found particularly in perivascular areas. They have a primary role in hypersensitivity reactions and inflamatuar process. They are found in whole healthy and inflamed periodontal tissues. Number of mast cells increase in some connective tissue tumors. However the roles of mast cells in fibrous gingival hyperplasias and giant cell granulomas of gingiva, is not clear. In this study, the number of mast cells were counted in both lesion groups. Numbers of mast cells were found increased on gingival fibrous hyperplasias, comparing to normal connective tissues and giant cell granulomas.

Congenital gingival granular cell tumor. A case report.

Congenital gingival granular cell tumor is a rare benign lesion of uncertain origin, which has been found only in newborn infants. This article describes one such case. Our immunohistochemical study employing antibodies against S-100 protein, epithelial membrane antigen, carcinoembryonic antigen, wide-spectrum keratin, desmin and vimentin yielded data supporting the theory of a mesenchymal cell origin for this lesion.