Increased early inflammatory response and osteoclastic activity in gingival tissues following conventional osseous resective surgery compared with the fibre retention technique: a pilot study.

BACKGROUND AND OBJECTIVE: The retention of suprabony connective fibres attached into the root cementum during fibre retention osseous resective surgery (FibReORS) results in a more conservative intrasurgical removal of bone, and limits further bone loss and patient morbidity during healing, compared with conventional osseous resective surgery (ORS). This may be a result of the protective effect of preserved connective tissue over the interproximal sites and the lower activation of the inflammatory mechanisms. Thus, the aim of this pilot study was to compare the expression of inflammatory and osteoclastic activity markers in gingival tissues following FibReORS and ORS in the early postsurgical phase. MATERIAL AND METHODS: Twenty-six posterior sextants requiring osseous resective surgery were selected in 13 patients with chronic periodontitis: 13 sextants were randomly assigned to ORS and 13 to FibReORS in a split-mouth design. Gingival biospies were collected during the surgical sessions and at suture removal. Tissue samples were analysed to evaluate the expression of proinflammatory and immunity regulatory mediators (interleukin-1α, C-X-C motif chemokine ligand 5, interferon-γ and tumour necrosis factor-α), cluster of differentiation 14 (CD14; a monocyte/macrophage marker) and TRAP (an osteoclast marker) using immunohistochemical, immunofluorescence and cytofluorimetric analyses, respectively. RESULTS: Postsurgery, a higher number of inflammatory cells and stronger expression of proinflammatory cytokines were observed in the epithelium and connective tissue of ORS gingival samples compared with FibReORS gingival samples (p < 0.001). This was accompanied by increased numbers of CD14-positive and TRAP-positive cells. CONCLUSION: Retention of the supracrestal connective fibres appears to reduce the postsurgical intensity of the host-mediated inflammatory response.

Bone production by human maxillary sinus mucosa cells.

The Schneider membrane is the mucosa that covers the inner part of the maxillary sinus cavities. The free surface is a ciliated pseudostratified epithelium, while the deeper portion is a highly vascularized connective tissue. The stromal fraction, bordering the bony wall of the sinus, after tooth loss can exhibit increased osteoclastic activity resulting in resorption of the bone in the posterior maxilla. Goal of our study was to isolate and characterize mesenchymal progenitors in the Schneider's membrane connective net and to evaluate their self ability to differentiate toward osteoblastic lineage, in absence of osteoinductive factors and osteoconductive biomaterials of support. This should indicate that maxillary sinus membrane represents an useful an approachable source of MSCs for bone tissue engineering and cell therapy and owns the intrinsic capacity to restore maxillary bone after tooth loss without the needing of biomaterials.