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The presence and levels of complement factors C3, C4, C5, and C3 proactivator, were determined by electroimmuno assay in gingival cervice material from five individuals with healthy gingiva and from six patients with chronically inflamed gingiva. Higher concentrations of C3 and C4 were found in samples from chronically inflamed gingiva when compared to those healthy gingiva. The amount of C3 in material from healthy as well as from inflamed gingiva was related to that in plasma, when the albumin in plasma and gingival crevice material was used as a reference. The same was found for C4 in samples from healthy gingiva but in those from inflamed gingiva, the values were significantly lower when related to plasma levels. C5 could not be found in material from healthy gingiva but was present in material from inflamed gingiva. C3 proactivator was present in material from inflamed gingiva in the converted form. No C3 proactivator was found in material from healthy gingiva with the methods used. Analysis of C3 in samples from inflamed gingiva, using crossed immunoelectrophoresis, showed that C3 was converted in these samples. The results indicate that the complement system may be activated in gingival crevice material from inflamed gingiva.
One hundred and twenty individuals in good oral health were divided into six groups according to age. Measurements were made on the depth of the gingival sulcus, and the distance from the margin of the free gingiva to the mucogingival junction on the lingual mandibular teeth. The mean, extreme, standard deviation and analysis of variance were computed. A distinct pattern of the width of healthy lingual attached gingiva was found. The largest width was found lingual to the first and second molars with a mean height of 4.7 mm. This was followed by the third molar [3mm] second bicuspid [2.5 mm] first bicuspid [2 mm], and cuspid, lateral and central [1.9mm]. Lingual attached gingiva showed that there was a variation in width with each tooth and between individuals. There was no variation in width of lingual attached gingiva between sexes. The extreme measuremtns ranged from less than 1 mm to 8 mm. The data from the study gives the dentist some indication of the mean and extreme ranges of lingual attached gingiva. This data can serve as a guide in diagnoiss and treatment planning and in selecting procedures to reestablish these zones of attached gingiva.
Sixteen dental, dental hygiene, and dental assisting students and dental faculty members who had contralateral or unilateral areas of minimal (less than or equal to 1.0 mm) and appreciable (greater than or equal to 2.0 mm) widths of keratinized gingiva on mid-buccal plaque-free surfaces of mandibular bicuspids were examined. Gingival exudate amounts and clinical inflammation based on color change and/or swelling and bleeding on probing were evaluated. The results showed that gingiva with "appreciable" width as well as gingiva with "minimal" width of keratinized tissue exhibited only minute amounts of gingival exudate. Also, there were generally no clinical signs of inflammation for both types of tissue. From the groups of 16, six subjects were selected who had contralateral pairs of minimal and appreciable keratinized gingiva. They were instructed to cease oral hygiene in the lower bicuspid area for 25 days. At day 0, 4, 7, 11, 14, 18, 21, and 25, plaque, gingival exudate, and clinical gingival inflammation were evaluated. Results revealed increases in plaque, gingival exudate scores and clinical gingival inflammation over the 25-day period with no apparent difference between the areas with minimal and appreciable width of keratinized gingiva.
The objective of this study was to determine if the regular vascular network previously reported as occurring in noninflamed marginal gingiva would become re-established following plaque control and treatment of gingiva by gingivectomy and scaling. Gingivectomies were performed on dogs with and without pre-experimental gingivitis in order to obtain gingival specimens healed for 4, 8 and 12 weeks. Plaque was controlled using toothbrushing and topical applications of 0.2% chlorhexidine gluconate. After 12 weeks, the animals were perfused via the carotid arteries with glutaraldehyde and Microfil latex compound. Specimens were processed for either routine histology or examination of vascular morphology in methyl salicylate cleared tissues. The absence of inflammation in healed gingiva was evaluated clinically, using the Gingival and Plaque Indices, and histologically. Results showed that in healed clinically and histologically noninflamed gingiva, the vascular morphology was established as a series of looped vessels which could readily be distinguished from the regular network of vessels described by Hock (1975) in marginal gingiva that had neither been inflamed nor resected.
Gingival thickness was measured in 10 subjects with healthy gingiva on the facial aspect of selected maxillary and mandibular teeth at the depth of the gingival sulcus and midway between the sulcus depth and mucogingival line. Measurement instrumentation, consisting of a differential transformer coupled to an oscillator and digital voltmeter was sensitive to the travel of a probe from the gingival surface to tooth surface or alveolar bone. The probe assembly was accurate to 0.01 mm and the average range of differences in replicate measurements under a variety of conditions never exceeded 0.15 mm. 1. Free gingival thickness averaged 1.56 mm + 0.39, attached gingival thickness averaged 1.25 mm + 0.42 and the total mean thickness for all areas measured was 1.41 mm. 2. Thickness in mandibular free and attached gingiva and maxillary free gingiva increased from anterior to posterior. Thickness in maxillary attached gingiva remained fairly constant. 3. Thickness measured at the depth of the sulcus was directly proportional to the free gingival width. 4. Thickness measured midway between sulcus depth and mucogingival junction was inversely proportional to attached gingival width.
The present study evaluates the relationship between periodontal status, concentration of circulating hormones and metabolism of androgens by human male and female gingiva in vitro. In both male and female patients with healthy gingiva the plasma concentration of gonadotropins (LH and FSH) and steroid hormones (testosterone, androstenedione, estradiol-17 beta, progesterone and cortisol) were in a normal range. However, an alteration in the plasma concentration of progesterone was found in both male and female patients with periodontal pathosis. Both androgens (testosterone and androstenedione) were readily metabolized by human gingiva tissue in vitro. The major pathway of the metabolism of testosterone was via the formation of 17 beta-hydroxy-5 alpha-A-ring reduced androgens (5 alpha-dihydrotestosterone and 3 alpha-, 3 beta-androstanediol). In contrast, androstenedione was metabolized mainly to 17-keto-5 alpha-A-ring reduced (5 alpha-androstanedione, androsterone and epiandrosterone) and 17 beta-oxidoreduced (testosterone) compounds. In addition both substrates were metabolized to 5 beta-A-ring reduced androgens (5 beta-dihydrotestosterone, 5 beta-androstanediol and 5 beta-androstanedione). A significant feature of the metabolism of testosterone and androstenedione by inflamed gingiva was an increase of 5 alpha-A-ring reductase activity (mainly the formation of 5 alpha-dihydrotestosterone and 5 alpha-androstanedione) and 17 beta-oxidoreductase activity (mainly the formation of testosterone from androstenedione). The increase in 5 alpha-reductase activity also showed a significant correlation with the plasma progesterone concentration.
The fibrinolytic activity originated by activation of plasminogen was found to be greater in the inflamed gingiva than in the normal gingiva. The activator of plasminogen present in the normal and inflamed gingiva of the beagle dog was demonstrated histochemically. Plasminogen activator was found adjacent to the crevicular epithelium and blood vessels.
A photographic method was described with which changes in the swelling of the gingiva can be objectively determined. During exposure of the film, the flash device projects vertical lines on the teeth and gingiva. These lines are photographed with a compact camera which the subject holds with his teeth over a separate occlusion template. Increased swelling of the gingiva was demonstrated in eight subjects during an observation period of 21 days in which no oral hygiene was carried out.
Collagens, solubilized by pepsin-digestion of diphenylhydantoin-induced overgrown gingiva, appeared similar to collagens solubilized from inflamed gingiva with regard to: ratio of type I to type III collagen, ratio of alpha1 to alpha2 of type I collagen, and degree of hydroxylation of type I collagen.
Gingiva from alloxan and streptozotocin-diabetic rats exhibited markedly enhanced collagenolytic activity in tissue culture. This effect was eliminated by puromycin or by repeated freeze-thawing of the tissue prior to incubation. Soluble extracts of the diabetic gingiva in situ were found to contain breakdown products of collagen similar in size to the reaction products generated by tissue collagenase. These fragments were not detected in the control tissue. This study indicates that experimental diabetes stimulates the synthesis of gingival collagenase in culture and that a similar effect occurs in vivo.
The cytoplasm of normal human male and female gingiva contains a receptor capable of specifically binding 5 alpha-dihydrotestosterone (DHT). This binding has a high affinity for DHT (Kd, approximately 2.2 x 10-9 M) and a low capacity (approximately 190 fmol/mg protein). The binding is extremely heat sensitive and exhibits a pattern of competition similar to that obtained with DHT receptors from other target tissues. The demonstration of a specific DHT receptor in human gingiva provides the first direct biochemical evidence that this tissue may function as a target organ for androgens. There was no correlation between the Kd in normal tissue and gingival hyperplasia or between the Kd or number of binding sites and the age or sex of the patient. However, there sites and the age or sex of the patient. However, there was a significant difference (P less than 0.0005) between the amount of DHT-binding sites per mg protein in normal tissue as compared to gingival hyperplasia (drugs or pregnancy).
An apparatus was developed that was found suitable for measuring gingival color in terms of reflectance at 6328 A. A total of 445 readings were taken on 95 Caucasian subjects in order to determine certain properties of healthy gingival color. It was determined that: 1. Healthy adult gingival color ranged in reflectance from 17% to 45% of the magnesium oxide standard, with a mean of 32%. 2. Gingival color of children was lighter than that of adults. The reflectance of children's gingiva ranged from 31% to 43%, with a mean of 35%. 3. Gingival color did not vary with the sex of the individual. 4. Gingival color was lighter in individuals with blonde hair than in individuals with brown hair. 5. Gingival color was darker in individuals with darker eye color. 6. Gingival color was lighter in individuals with geographic origins that are commonly related to lighter complexions. 7. Gingival color did not vary with age, within the adult range covered in this study. 8. Gingival color did not vary with the following physiological and physical factors: menstrual period, use of oral contraceptives, smoking habits, moistness or dryness of the gingiva, which side was measured, time of day, or time after toothbrushing, smoking a cigarette, eating an apple, or drinking a hot beverage.
A study was made of a series of 302 consecutive cases of localized hyperplastic lesions of the gingiva (epulides). The lesions were classified into five groups: pyogenic granuloma, calcifying fibroblastic granuloma, fibrous hyperplasia, peripheral giant cell granuloma and denture hyperplasia. The study indicates that there are some differences in age and sex distribution as well as in location between the different histological groups. Pyogenic granuloma was found to be the most common lesion on the gingiva. Pyogenic granuloma and calcifying fibroblastic granuloma occur in younger patients more often than fibrous hyperplasia, and thus may represent a stage in the development of fibrous hyperplasia. Denture hyperplasia occurs predominantly in females and it is suggested that its formation may be affected by hormonal alterations in the menopause.
Pressure in selected microvessels was measured directly on the exposed coronal or apical pulp in one of the upper canine teeth or on the gingiva in a total of 36 cats. The vessels were punctured with glass micropipettes, diameter 1-4 micrometer, and the pressure measured with a modified Wiederhielm servocontrolled counter-pressure technique. Pressures in corresponding vessels in coronal and apical pulp were similar. The pressure in pulpal arterioles, diameter 10-70 micrometer averaged 43 mm Hg, or 36% of mean systemic arterial pressure (PA), while pressure in the pulpal venules, diameter 10-80 micrometer, was on an average 19 mm Hg or 16% of PA. Capillary pressure measured in the coronal pulp averaged 35 mm Hg. Mean arterial systemic pressure was 124 mm Hg. The total vascular pressure drop within the pulp was only 20% of the total systemic arteriovenous pressure difference. Accordingly, only one fifth of the vascular resistance governing pulpal blood flow is situated within the pulp itself. This means that blood flow in the dental pulp in cats may be influenced by mechanisms located extrapulpally. In gingiva only venular pressure was measured, which averaged 19 mm Hg.
The activity of cathepsin D has been determined, as a function of gingival inflammation, in biopsies of human gingivae from 10 patients. The determinations have been performed both in the connective tissue and epithelium after their mechanical separation in cryostat sections. A positive and statistically significant correlation was found between the cathepsin D specific activity (as a function of either dry weight or DNA) and the degree of gingiva inflammation. These results support the hypothesis of a possible participation of lysosomal enzymes in the destruction of periodontal tissues during gingivitis and periodontitis.
A rare case of metastasis to the gingiva from carcinoma of the lung has been presented. From the review of the literature, only ten other cases have met the criteria to be considered as metastatic malignancy to the gingiva.