Interleukin 1ß and Prostaglandin E2 affect expression of DNA methylating and demethylating enzymes in human gingival fibroblasts.

Periodontitis is a common chronic inflammatory condition that results in increased levels of inflammatory cytokines and inflammatory mediators. In addition to oral disease and tooth loss, it also causes low-grade systemic inflammation that contributes to development of systemic conditions including cardiovascular disease, pre-term birth, diabetes and cancer. Chronic inflammation is associated with epigenetic change, and it has been suggested that such changes can alter cell phenotypes in ways that contribute to both ongoing inflammation and development of associated pathologies. Here we show that exposure of human gingival fibroblasts to IL-1ß increases expression of maintenance methyltransferase DNMT1 but decreases expression of de novo methyltransferase DNMT3a and the demethylating enzyme TET1, while exposure to PGE2 decreases expression of all three enzymes. IL-1ß and PGE2 both affect global levels of DNA methylation and hydroxymethylation, as well as methylation of some specific CpG in inflammation-associated genes. The effects of IL-1ß are independent of its ability to induce production of PGE2, and the effects of PGE2 on DNMT3a expression are mediated by the EP4 receptor. The finding that exposure of fibroblasts to IL-1ß and PGE2 can result in altered expression of DNA methylating/demethylating enzymes and in changing patterns of DNA methylation suggests a mechanism through which inflammatory mediators might contribute to the increased risk of carcinogenesis associated with inflammation.

Redesigning Existing Provisional Restorations While Maintaining Established Transmucosal Anatomy in a Multi-Implant System/Natural Tooth, Full-Arch Case.

Redesigning existing provisional restorations when a combination of two different implant systems and natural teeth exist in the same arch can be challenging. Problems such as acrylic locking into undercuts and loss of spatial landmarks both subgingivally and supragingivally are common concerns for the practitioner. Two techniques, presented herein, offer treatment options to retain the previously developed transmucosal anatomies of implant-level provisional abutments while allowing for redesign of the clinical crown component of the same long-term provisional restorations. By modifying only the supragingival aspect of the provisional prosthesis, the previously developed transmucosal areas remain intact. Use of a segmented matrix from an approved wax-up offers greater control versus a single matrix of the entire arch.