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A study of antitrypsin and macroglobulin levels in serum and saliva of patients with gingivitis.

Periodontal diseases are associated with chronic inflammation. The destruction of connective tissue matrix is responsible for the pathogenesis of chronic inflammatory states. The degradation of matrix is initiated extra and pericellularly by proteinases produced locally at the inflammatory site. The regulation of these proteinases are by inhibitors present in serum and extravascular tissues, and it is the proteinase/proteinase inhibitor balance that determines the progression of chronic inflammatory state. Few contradicting studies are available on changes in the levels of proteinase inhibitors in serum in periodontal disease. The occurrence of these inhibitors in saliva has not been studied in detail. The present study was aimed at measuring the Proteinase inhibitors in serum and saliva of patients with periodontal disease.

Adult↗

The gingivae.

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Disease↗

Necrotizing ulcerative gingivitis.

Necrotizing periodontal diseases are unique in their clinical presentation and course. Data suggest that the etiology and pathogenesis of necrotizing periodontal diseases may also be distinctive from other periodontal diseases. Necrotizing ulcerative gingivitis (NUG) is a type of necrotizing periodontal disease in which the necrosis is limited to the gingival tissues. Three specific clinical characteristics must be present to diagnose NUG, pain (usually of rapid onset) interdental necrosis, and bleeding. Epidemiological and prospective clinical studies have found an altered ability to cope with psychological stress, immunosuppression, and tobacco use to be strongly associated with the onset of NUG.

Gingivitis, Necrotizing Ulcerative↗

Role of p38 in nitric oxide synthase and cyclooxygenase expression, and nitric oxide and PGE2 synthesis in human gingival fibroblasts stimulated with lipopolysaccharides.

Periodontal disease, a gingival inflammatory disease caused by gram-negative bacteria, is the main cause of tooth loss. Lipopolysaccharides (LPS) present in bacterial cell walls induce human gingival fibroblasts' production of pro-inflammatory cytotoxins such as IL-1beta and TNFalpha. The goal of this study was to determine p38 role in the expression of inducible nitric oxide synthase enzyme (i-NOS) and cyclooxygenase (COX-2), as well as in PGE(2) and nitric oxide synthesis in human gingival fibroblasts challenged with LPS. We found that lipopolysaccharides induced a rapid and significant increase in p38 phosphorylation. After interruption of p38 transduction pathway by pre-treatment with inhibitor SB203580, no response to stimulation with LPS was observed; i-NOS expression and nitric oxide synthesis was completely blocked. However, p38 inhibition only partially blocked COX-2 expression and PGE2 synthesis. We conclude that p38 is critically involved in i-NOS induction, and that it participates in COX-2 expression and in PGE2 synthesis.

Cells, Cultured↗

Pathogenesis of inflammatory periodontal disease. A summary of current work.

Chronic periodontitis, a common disease of microbial origin, is the major cause of tooth loss in adult humans. The disease serves as a convenient experimental model for analysis of many aspects of chronic inflammation. A consideration of currently available data has permitted the formulation of a new concept of the pathogenesis of this disease. The gingival tissues respond within 2 to 4 days to a beginning accumlation of microbial plaque with a classic acute exudative vasculitis which we have termed the initial lesion. This response, which includes loss of perivascular collagen, is comparable to that elicited in most other tissues subjected to acute injury and may be a consequence of the elaboration and release of chemotactic and antigenic substances by microbial plaque. Within 4 to 10 days, the early lesion develops. It is characterized by a dense infiltrate of lymphocytes and other mononuclear cells, pathologic alteration of fibroblasts, and continuing loss of the connective tissue substance. The structural features of the early lesion are consistent with those expected in some form of cellular hypersensitivity, and a mechanism of this kind may be important in the pathogenesis. The early lesion is followed by the established lesion which develops within 2 to 3 weeks and is distinguished by a predominance of plasma cells in the absence of significant bone loss. The established lesion, which is extremely widespread in humans and in animals, may remain stable for years or decades, or it may become converted into a progressive destructive lesion. Factors causing this conversion are not understood. In the advanced lesion, plasma cells continue to predominate although loss of the alveolar bone and periodontal ligament, and disruption of the tissue architecture with fibrosis are also important characteristics. The initial, early, and established lesions are sequential stages in gingivitis and they, rather than the advanced lesion which is manifest clinically as periodontitis, make up the major portion of inflammatory gingival and periodontal disease in humans.

Adolescent↗

PMN responses in chronic periodontal disease: evaluation by gingival crevicular fluid enzymes and elastase-alpha-1-proteinase inhibitor complex.

OBJECTIVES: In the present trial, the hypothesis was examined that the local PMN responses in untreated and treated chronic periodontitis can be differentiated by gingival crevicular fluid lysosomal enzyme activities and elastase-alpha-1-proteinase inhibitor complex. METHODS: In nine subjects (average age 49.2 +/- 7.1 years) with chronic periodontitis, clinical parameters and markers of the PMN-derived inflammatory tissue response in gingival crevicular fluid (GCF) were assessed before and 6 months after surgical periodontal therapy. Myeloperoxidase (MPO), beta-N-acetyl-hexosaminidase (beta-NAH) and cathepsin D (CD) were analyzed as indicators of the PMN-associated host tissue destruction, and elastase-alpha-1-proteinase inhibitor complex (alpha-1-EPI) as the major serum protein inactivating PMN elastase. The total activities of the lysosomal enzymes MPO and beta-NAH were evaluated spectrophotometrically, the CD levels by liquid scintillation counting with [14C] hemoglobin as substrate, and the total alpha-1-proteinase inhibitor complex using a sandwich-immunoassay. RESULTS: The clinical parameters revealed a statistical significant decrease at the 6-month reexamination. PD levels dropped from 5.40 to 2.88 mm (change 2.52 +/- 1.04 mm), the CAL scores from 6.67 to 4.43 mm (change 2.24 +/- 0.77 mm). The 30 s GCF volumes dropped from 129.8 to 68.6, displaying a change of 61.1 +/- 18.6, p </= 0.05. The decrease in total MPO, beta-NAH and CD levels (medians: 1.7/0.6 micro U MPO, 0.035/0.020 micro U beta-NAH, 1.3/0.5 ng CD) following therapy was associated with a significant drop in total GCF amounts of alpha-1-EPI from 76.3 ng at baseline to 52.4 ng after 6 months. CONCLUSION: The clinical healing in chronic periodontal disease is associated with a downregulation of the local PMN responses following periodontal therapy. The reorganization of periodontal tissues is characterized by a decrease of lysosomal enzyme activities and the alpha-1-proteinase inhibitor complex in gingival crevicular fluid.

Adult↗

Effect of age and removable partial dentures on gingivitis and periodontal disease.

The periodontal disease variables manifested in the individuals with partial dentures were more severe, which suggests that the contribution of denture status is significant. Age, while related to increased bone loss, did not appear to be of significance. Common sense suggests that poor oral hygiene in persons wearing removable partial dentures also is a contributing factor.

Adult↗

[Effectiveness of feeding large kibbles with mechanical cleaning properties in cats with gingivitis].

Periodontal disease is the most common acquired oral disease in cats. It starts with plaque accumulation and gingivitis. The aim of this study was to evaluate the effectiveness of different types of kibble and teeth brushing after professional dental cleaning. To this end, the ratio of facultative anaerobic and obligate anaerobic bacteria was determined, and the amount of plaque and tartar and the severity of gingivitis were measured. Eighty-eight cats with gingivitis and tartar were randomly divided into four groups and given different treatments after professional dental cleaning. The dental treatments were: group 1, cats were fed on small kibbles with mechanical cleaning qualities; group 2, cats were fed on small kibbles without mechanical cleaning qualities, and owners were instructed to brush the cats' teeth; group 3, cats were fed on large kibbles with mechanical cleaning qualities; and group 4, cats were fed on the same kibbles as group 2, but owners were not asked to brush their cats' teeth. A supragingival plaque sample was taken, and used for bacteriological analysis scores for tartar, plaque, and gingivitis were determined at the initial presentation and at 3 and 6 months after professional dental cleaning. Cats fed on the large kibbles with mechanical cleaning qualities (group 3) had significantly less gingivitis and tartar.

Animal Feed↗

Linear IgA disease presenting as desquamative gingivitis: a pattern poorly recognized in medicine.

Linear IgA disease is a subepidermal blistering disorder of unknown cause. Along with dermatologic blistering, other manifestations include oral ulceration and desquamative gingivitis. We present a case of linear IgA disease that manifested simply as oropharyngeal ulceration and desquamative gingivitis, resulting in considerable delay in diagnosis and treatment. This article (1) highlights the difficulties of diagnosing linear IgA disease when the predominant presenting features are mucosal and (2) reviews the current literature regarding linear IgA disease.

Autoimmune Diseases↗

Crohn's disease: early detection by gingival biopsy.

A definitive diagnosis of Crohn's disease was made in a 31-year-old female patient who presented with a chief complaint of red, burning gingiva and an itchy palate. The microscopic identification of multinucleated giant cells in the gingival biopsy was suggestive of Crohn's disease. This led to a complete medical work-up including an upper and lower bowel series, which confirmed the diagnosis of Crohn's disease.

Adult↗

Human gingival collagenase in periodontal disease: the release of collagenase and the breakdown of endogenous collagen in gingival explants.

Collagen degradation in different stages of gingival inflammation was examined. Higher collagenolytic activity and nonspecific protease activity were found in the severely inflamed gingiva, as compared to mildly inflamed or healthy gingiva. This was shown by electrophoretic studies and measurement of peptide-bound hydroxyproline in the culture.

Collagen↗