Immunohistochemical Analysis of the Role Connective Tissue Growth Factor in Drug-induced Gingival Overgrowth in Response to Phenytoin, Cyclosporine, and Nifedipine.

OBJECTIVE: To evaluate for the presence of connective tissue growth factor (CTGF) in drug (phenytoin, cyclosporine, and nifedipine)-induced gingival overgrowth (DIGO) and to compare it with healthy controls in the absence of overgrowth. MATERIALS AND METHODS: Thirty-five patients were chosen for the study and segregated into study (25) and control groups (10). The study group consisted of phenytoin-induced (10), cyclosporine-induced (10), and nifedipine-induced (5) gingival overgrowth. After completing necessary medical evaluations, biopsy was done. The tissue samples were fixed in 10% formalin and then immunohistochemically evaluated for the presence of CTGF. The statistical analysis of the values was done using statistical package SPSS PC+ (Statistical Package for the Social Sciences, version 4.01). RESULTS: The outcome of immunohistochemistry shows that DIGO samples express more CTGF than control group and phenytoin expresses more CTGF followed by nifedipine and cyclosporine. CONCLUSION: The study shows that there is an increase in the levels of CTGF in patients with DIGO in comparison to the control group without any gingival overgrowth. In the study, we compared the levels of CTGF in DIGO induced by three most commonly used drugs phenytoin, cyclosporine, and nifedipine. By comparing the levels of CTGF, we find that cyclosporine induces the production of least amount of CTGF. Therefore, it might be a more viable drug choice with reduced side effects.

Evaluation of Salivary Levels of Pyridinoline Cross Linked Carboxyterminal Telopeptide of Type I Collagen (ICTP) in Periodontal Health and Disease.

BACKGROUND: Traditional parameters (Pocket depth, bleeding on probing, clinical attachment loss, radiographic findings) have been used for a long time for the assessment of periodontal disease conditions. However, these parameters only indicate towards the periodontal damage that has already taken place but do not give any idea regarding the current status of the periodontal health or disease. Hence, the present study is aimed at evaluating the concentration of the bone biomarker ICTP in saliva, which can give a better real time assessment of periodontal health and disease. MATERIALS AND METHODS: Forty three patients were selected and divided into three groups based on the recorded clinical parameters of probing pocket depth, attachment loss and bleeding on probing. Group I (Healthy, n = 11), Group II (Gingivitis, n = 17), Group III (Periodontitis. n = 15). Salivary samples were collected before scaling and root planning to avoid contamination by blood. ICTP levels were evaluated in the salivary samples by using enzyme linked immunosorbent assay (ELISA). STATISTICAL ANALYSIS USED: Kruskal Wallis test was used to compare the mean ICTP level of the three groups. RESULTS: ICTP was detected in all the samples. Highest mean ICTP concentrations in saliva were obtained for group III (periodontitis group) and the lowest mean ICTP concentrations were seen in group I (healthy group). This suggests that the level of ICTP in saliva increases proportionally from periodontal health to diseased conditions (gingivitis & periodontitis). CONCLUSION: There is a substantial increase in the salivary concentration of ICTP in chronic periodontitis patients than in gingivitis and healthy patients. Salivary ICTP levels were the maximum in chronic periodontitis patients followed by gingivitis patients and the least in healthy individuals. ICTP may be considered as a biomarker in periodontal disease progression.