Effect of nicotine-treated epithelial cells on the proliferation and collagen production of gingival fibroblasts.

BACKGROUND, AIMS: Several in vitro and in vivo studies have indicated that tobacco smoking may be an important risk factor for the development and severity of inflammatory periodontal disease. METHOD: In the present study, we developed an in vitro model to study the interactions between nicotine-treated epithelial cells (EC) and gingival fibroblasts (GF) derived from the same patient. EC were treated with nicotine concentrations varying from 1 microg/ml to 500 microg/ml and their effect on different functions of GF was studied. The proliferation of GF was evaluated by the incorporation of 3H-thymidine. A dose-dependent inhibition was observed with nicotine concentrations > or =100 microg/ml. Similar results were observed when studying the total protein synthesis of GF by incorporation of 3H-proline into non-dialyzable material. RESULTS: When collagen production was evaluated by 3H-proline incorporation into collagenase-sensitive protein, a dose-dependent reduction was observed: the degree of inhibition varied from 25% with 50 microg/ml nicotine, to almost 60% with 500 microg/ml. Interestingly, the production of non-collagenous proteins decreased by almost 50% only when EC were treated with the highest concentration of nicotine. CONCLUSIONS: The results suggest that epithelial cells, acting as mechanical barrier, can reduce but not completely eliminate the deleterious effect of nicotine on gingival fibroblasts.

Muco-gingival and periodontal health recovery following reimplantation of teeth.

Reimplantation of avulsed permanent teeth following traumatic injuries is a widely accepted therapeutic measure; however, though periodontal healing is considered to be the major determinant of long-term survival of reimplanted teeth, the mucogingival reaction to reimplantation has never been assessed. In the present study, hygiene level and gingival inflammation of 13 reimplanted teeth were assessed according to the plaque index (PI) and the gingival index (GI) around both reimplanted and control teeth. The periodontal condition was evaluated by measuring probing depth and probing attachment level at the same location. The clinical parameters of the reimplanted teeth were compared with those of contralateral teeth with the help of the non-parametric Wilcoxon signed ranks test. There were no statistically significant differences in PI and GI scores at any points of measurements around both reimplanted and control teeth; neither did probing depths and probing attachment levels differ between reimplanted and contralateral teeth. The results of the present study indicated that the muco-gingival reaction following traumatic avulsion did not affect the long-term prognosis of the reimplanted teeth.

A longitudinal study of various crevicular fluid components as markers of periodontal disease activity.

In order to examine the relationship of possible crevicular biochemical parameters to attachment loss (ALOSS), 330 sites from 8 untreated adult patients were monitored longitudinally at 3-month intervals, for up to 1 year. Attachment levels were measured with a force-sensing probe and an acrylic stent in duplicates at each study point. Crevicular samples were collected and used for the determination of the following 11 markers: number of polymorphonuclear leukocytes (PMNs), prostaglandin E2 (PGE2), osteocalcin (OC), alkaline phosphatase (ALP), collagenase (COL), beta-glucuronidase (BG), antigenic and functional elastase (AEL and FEL), alpha-1 antitrypsin (a1AT), alpha-2 macroglobulin (a2M) and aspartate aminotransferase (AST). 10 sites with ALOSS of > or = 1.5 mm per 3 months (active sites) and 43 sites with negligible changes (inactive sites) were identified. Total amounts of ALP, BG and COL were found to be significantly higher in active as compared to inactive sites, prior to significant ALOSS, without any significant differences in crevicular fluid volume and clinical indices. When biochemical parameters were expressed as ratios to the number of PMNs, PGE2/ PMNs was significantly elevated in active sites. The capacity of such individual parameters to distinguish between active and inactive sites was limited. However, linear discriminant analysis using total amounts of PGE2, COL, ALP, a2M, OC and AEL showed more significant diagnostic values (sensitivity: 80%, specificity: 91%). These findings suggest that the combination of several biochemical parameters in crevicular fluid could give more information to predict future clinical ALOSS.

Caries prevalence and associated predisposing conditions in recently hospitalized elderly persons.

The prevalence of caries and caries risk factors was studied among 120 consecutively hospitalized elderly persons. Coronal caries was recorded using the WHO criteria, and active and inactive root caries in accordance with Fejerskov et al. The CPITN was used to evaluate the periodontal state and plaque accumulation in accordance with Löe & Silness. Of the 1212 teeth examined 5% had active coronal caries (2% inactive), 14% active root caries (2% inactive), and 10% fillings with recurrent caries. No relationship was found between caries prevalence, degree of dependence, number of medicaments, age, and gender. Patients with psychiatric diseases had increased caries prevalence (P < 0.01), and lower caries prevalence was associated with frequent tooth brushing (P < 0.05). At the tooth level root caries was associated with high plaque scores (P < 0.001), degree of gingival recession (P < 0.001), presence of coronal caries (P < 0.001), and increased pocket depth (P < 0.01). The results strongly indicate that oral hygiene measures should be introduced immediately after hospitalization of these patients.

[The orodental situation of aged patients hospitalized at the Hôpital de Gériatrie of Geneva]. / Situation bucco-dentaire chez les patients âgés hospitalisés à l'Hôpital de Gériatrie de Genève.

The purpose of the present study was to identify the major oral and dental problems and treatment needs among 216 patients who had been consecutively hospitalized at Hôpital de Gériatrie de Genéve. The patients were interviewed and examined during the week following their hospitalization. There were 150 women (73.6%) and 57 men with a mean age of 84 years. Of these 44.4% were completely edentulous. The patients with remaining teeth had on average 11 teeth, of which 24.1% showed active caries. Active root caries was observed in 54.2% of the patients with natural teeth. Of the remaining teeth 27.4% were crowned and three quarters of these had poorly adapted margins. Removable dentures were observed in 81% of the patients. Of the complete dentures 18.5% were poorly adapted and 30.3% of the removable partial dentures were unstable. Denture stomatitis was observed among 20.5% of the denture wearers. It appears from this study that elderly patients have many oral, dental and prosthetic problems and that their treatment needs are generally important. In order to improve the situation it seems necessary to introduce dental care programs for homebound and institutionalized elderly patients.

Osteocalcin, prostaglandin E2 and alkaline phosphatase in gingival crevicular fluid: their relations to periodontal status.

Prostaglandin E2 (PGE2) and alkaline phosphatase (ALP) have often been measured in gingival crevicular fluid (GCF) as possible indicators of gingival inflammation and bone metabolism. Osteocalcin (OC), a major component of bone matrix, is mainly produced by osteoblasts, and could also be considered as a marker of bone turnover. The aims of this preliminary study were to examine if OC was present in GCF and to assess the relationships of OC, PGE2 and ALP in GCF to periodontal conditions. GCF samples were collected with durapore strips from 34 healthy, 72 gingivitis and 118 periodontitis sites in 17 subjects. ELISA techniques were used for the determinations of OC and PGE2. ALP was measured spectrophotometrically by using p-nitrophenyl phosphate as substrate. Total amounts and concentrations of PGE2 and ALP were significantly higher in periodontitis as compared to healthy and gingivitis sites, and were significantly and positively correlated with probing depth (PD) and gingival index (GI). OC was present in GCF from both healthy and diseased sites with mean concentrations more than ten times greater than normal serum levels. Total OC amounts from strips soaked with GCF from periodontitis sites were significantly higher than those found in healthy and gingivitis sites. When the data were expressed as concentrations, OC showed significantly positive correlations with GI, but not with PD. However, total amounts of OC significantly correlated with both clinical parameters. OC, PGE2 and ALP were found to have significantly positive correlations with each other, both when expressed as total amounts and concentrations. These data suggest that a significant amount of OC present in GCF is produced locally by periodontal tissues.(ABSTRACT TRUNCATED AT 250 WORDS)

[Gingival hyperplasia of drug origin. A review of the literature]. / Les hyperplasies gingivales d'origine médicamenteuse. Une revue de la littérature.

The frequency of gingival overgrowth is increasing, due to the more and more frequent use of cyclosporin and calcium antagonists. Such lesions are the same as those known to occur in patients treated with phenytoin. They appear after a few months of treatment and are favoured by inflammation. Marginal gingiva starts to grow in excess, especially in the anterior region, and might end up covering the teeth entirely, with major occlusal problems. The hyperplasia occurs in about 50% of the phenytoin treated patients and in about 20% of those treated with cyclosporin or calcium antagonists. A genetic predisposition has been thought to be present in such susceptible people. However, no precise pathogenic pathway, possibly common for the three types of drugs, has been clearly proposed. As for therapy, the most severe lesions are treated by surgery but, in general, the dentist can be very helpful by simply stressing gingival hygiene.