Melatonin levels in periodontal health and disease.

BACKGROUND AND OBJECTIVE: The aim of this study was to measure melatonin levels in the gingival crevicular fluid and saliva of subjects with healthy periodontal tissues, plaque-induced gingival inflammation, chronic periodontitis and aggressive periodontitis. MATERIAL AND METHODS: A total of 70 subjects were examined and assigned to four groups: healthy periodontium (10 subjects); plaque-induced gingival inflammation (20 subjects); chronic periodontitis (20 subjects); and aggressive periodontitis (20 subjects). Gingival crevicular fluid and saliva samples were collected from each subject and analyzed using ELISAs. RESULTS: The melatonin levels in both gingival crevicular fluid and saliva were lower in patients with chronic periodontitis (10.4 and 12.8 pg/mL, respectively) and aggressive periodontitis (8.4 and 8.8 pg/mL, respectively) than in patients with gingivitis (13.9 and 17.6 pg/mL, respectively) and in healthy subjects (16.6 and 22.9 pg/mL, respectively). The mean melatonin levels in both gingival crevicular fluid and saliva were statistically significantly higher in healthy patients compared with patients with chronic periodontitis and aggressive periodontitis; however, there was no significant difference in the plaque-induced gingival inflammation between the study groups. CONCLUSIONS: The melatonin levels in gingival crevicular fluid and saliva are decreased in diseased periodontal tissues, especially periodontitis. The melatonin level was lowest in the aggressive periodontitis group.

Inflammatory cells and pocket epithelium in periodontitis cases. Transmission and scanning electron microscopic study.

Epithelial pocket walls of 10 hopeless teeth were separated from root surfaces after extraction. The tissues were prepared for examination by transmission (TEM) and scanning electron microscopies (SEM). The study focuses on inflammatory cells and their possible pathologic effects on gingival tissues. TEM observations showed widening of intercellular spaces and interruption or even complete deterioration of basal lamina when macrophages and lymphocytes were recognized between epithelial cells. SEM findings showed scattered lymphocytes and polymorphonuclear leukocytes (PMNs) on the pocket wall surfaces with several perforations that corresponded to their size. These observations led to the conclusion that separation between epithelial cells and perforations on pocket wall surfaces by inflammatory cells may promote periodontal tissue destruction by passage of irritant and destructive substances into the underlying connective tissue.

Comparison of scanning and transmission electron microscopy of the epithelial pocket wall in juvenile and adult periodontitis.

Using scanning (SEM) and transmission (TEM) electron microscopy, this study compared fine structural features of the pocket walls in both juvenile and adult periodontitis (JP and AP, respectively) in 40 cases. Gingiva was also obtained from a control group consisting of periodontally noninvolved teeth. Clinical parameters were assessed in both JP and AP patients as well as in controls. Clinical findings showed low plaque accumulation, marked periodontal tissue destruction and less gingival inflammation in JP. Bone destruction and attachment loss were more marked in JP than in AP. AP had a higher plaque index and more evident gingival inflammation. SEM observations of JP as compared to AP showed gross distortions in pocket walls, an increased beaded appearance of microridges, and separation between pocket epithelial cells. TEM showed partially desquamated and separated superficial epithelial cells, but only in JP were fine granular precipitates observed in the intercellular spaces. The observations demonstrated structural features indicative of more prominent degenerative changes in JP than in AP. Also, these features were coincidental with a higher plaque index in AP than in JP, where clinical features (including a low plaque index) were not proportional to the epithelial destructive changes present.