Peripheral giant cell granulomas: a series of 279 cases.

OBJECTIVE: This study investigated the demographic, clinicopathologic, and histopathologic findings of lesions diagnosed as peripheral giant cell granuloma (PGCG) by the Louisiana State University Oral Pathology Biopsy Service from 1974 to 2011. STUDY DESIGN: Clinical, demographic, and histopathologic evaluation was completed for 279 cases. A follow-up questionnaire was mailed to all surgeons who performed these biopsies from 1990 to 2011. RESULTS: Of the 279 lesions, 58% occurred in the mandible, 44% occurred in the anterior portion of the arches, 83% were adjacent to teeth, 14% occurred in edentulous areas, and 2% were adjacent to implants. Average duration was 10.5 months, and the average size was 12.7 mm. The recurrence rate was 17.5%. Histopathologically, 78% of lesions extended to the base of the specimen, 50% exhibited ulceration, 41% contained calcifications, and 6% exhibited features overlapping with another pathologic entity. CONCLUSIONS: PGCG is a well-defined pathologic entity among reactive gingival lesions. Recurrent lesions were more likely to contain calcifications.

Use of saliva for assessment of stress and its effect on the immune system prior to gross anatomy practical examinations.

The objective of this study was to determine the longitudinal effects of a series of stressful gross anatomy tests on the immune system. Thirty-six freshman occupational therapy students completed a written stress evaluation survey, and saliva samples were obtained at baseline and prior to each of three timed-practical gross anatomy tests. Cortisol, secretory IgA (sIgA), and IL-12 concentrations were measured within the salivary samples by enzyme-linked immunosorbent assay. The total scores from the stress surveys were used as markers for environmental stress. Data were compiled for each student at baseline and prior to each examination and were compared by repeated-measures MANOVA and Pearson's correlation test. Following normalization for protein concentration and flow rate, the concentrations of IL-2, IL-6, IL-12, and sIgA progressively increased from baseline to the third test. Cortisol concentrations, following normalization for flow rate, were highest prior to the first test and became significantly reduced prior to second and third test. Prior to second and third test, salivary concentrations of IL-6, IL-2, IL-12, and sIgA were significantly correlated (P < 0.05). In contrast, prior to third test, there was a negative correlation between salivary concentrations of cortisol and IL-12 (P < 0.05). Progressive increases in salivary sIgA, IL-6, IL-2, and IL-12 concentrations from the first to the third test coincident to decreased salivary cortisol suggest that the initial examination stressors precede significant effects on the immune system. These data suggest that there may be latent effects of examination stress on the immune system and that saliva can be used to predict these effects.

Relationship between gingival angiopoietin-1 concentrations and depth of the adjacent gingival sulcus.

BACKGROUND: The purpose of this study was to assess concentrations of angiopoietin (Ang)-1 at various stages of gingival inflammation. Ang-1 is an anti-inflammatory mediator present in various inflammatory diseases. However, its presence during the pathogenesis of gingival inflammation has not been established in vivo. METHODS: Gingiva was obtained from 110 human donors before extraction of the adjacent teeth. The tissue was grouped based on adjacent probing depth and bleeding on probing (BOP). Gingiva adjacent to a 6-mm sulci was classified as "diseased, severe" (DSev). Tissues were solublized, and concentrations of interleukin (IL)-1beta and -6, tumor necrosis factor (TNF)-alpha, endothelin (ET)-1, Ang-1, vascular cell adhesion molecule (VCAM)-1, and vascular endothelial growth factor (VEGF) were assessed by enzyme-linked immunosorbent assay. Data were compared by factorial analysis of variance, the post hoc Tukey test, and the Pearson correlation test. Groups were defined as significantly different when P <0.05. RESULTS: Gingival concentrations of IL-1beta and -6, TNF-alpha, VEGF, and ET-1 were significantly greater, and VCAM-1 and Ang-1 were significantly lower, in DSev and DM than in N and DS tissues (P <0.05). In addition, gingival concentrations of IL-6, VEGF, and ET-1 were significantly greater, and VCAM-1 and Ang-1 were significantly lower, in DSev than in DM tissues (P <0.05). There were significant positive correlations among sulcular depth, IL-1beta and -6, TNF-alpha, VEGF, and ET-1 and negative correlations among VCAM-1, Ang-1, sulcular depth, and the other biomarkers (P <0.001). CONCLUSIONS: Depleted tissue concentrations of Ang-1 may allow gingival inflammation to become more severe because VEGF and ET-1 secretion become less inhibited. Thus, the tissues become edematous and more likely to develop BOP.

Gingival concentrations of interleukin-23 and -17 at healthy sites and at sites of clinical attachment loss.

BACKGROUND: The presence of interleukin (IL)-23 has not been reported within inflamed gingiva, so we evaluated its concentration within gingiva from normal sites and sites of chronic periodontal disease. METHODS: Gingiva was obtained prior to extraction of teeth. It was grouped based on clinical attachment loss (CAL): 0 to 2 mm (normal-slight), 3 to 4 mm (moderate), and >5 mm (severe). Tissues were solubilized, and IL-12, -23, -6, -17, and -1beta; interferon-gamma (IFN-gamma); and tumor necrosis factor-alpha (TNF-alpha) concentrations were assessed by enzyme-linked immunosorbent assay. Data were compared by factorial analysis of variance, post hoc Tukey test, and Pearson correlation test. Groups were defined as significantly different when P <0.05. RESULTS: The gingival concentrations of IL-23, -17, -1beta, and -6 and IFN-gamma were significantly greater at moderate CAL sites than at normal-slight CAL sites. Gingival concentrations of IL-23, -1beta, -17, and -6 and TNF-alpha were significantly greater at severe CAL sites than at normal-slight CAL sites. In addition, the gingival concentrations of IL-23, -17, and -6 and TNF-alpha were significantly greater and the gingival concentrations of IL-12 and IFN-gamma were significantly lower at severe CAL sites than at moderate CAL sites. Gingival concentrations of IL-23, -17, -6, and -1beta and TNF-alpha correlated positively with CAL. The IL-23 gingival concentration correlated significantly with IL-17, -1beta, and -6 and TNF-alpha concentrations and correlated negatively with IL-12 and IFN-gamma concentrations. CONCLUSIONS: Our results suggested the possibility that the IL-23/IL-17 immune response was present within chronically inflamed gingiva. This is a host response that had not been reported previously in periodontal disease and may be an important factor in the chronic nature of the disease.