Browsing by Subject "Gingiva"
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- PublicationRestrictedA surgical approach to root coverage and correction of mucogingival conditions and deformities in mandibular incisors with isolated gingival recession: free mucogingival graft. A pilot prospective cohort study(Quintessence Publishing Co Inc, 2024-03-20) Moreno Rodríguez, José Antonio; Ortiz Ruiz, Antonio José; Dermatología, Estomatología, Radiología y Medicina FísicaThe aim of this study was to present a periodontal plastic surgery approach to treat gingival recessions (GRs) and correct mandibular incisor mucogingival conditions and deformities. Isolated deep GRs (≥ 3 mm) in the mandibular incisors (n = 24 teeth) were treated: 66.6% of sites were recession types 2 or 3, and 58.3% of teeth were malpositioned. Recessions were treated using free mucogingival grafts (FMGs) harvested from the buccal aspect of donor teeth with altered passive eruption or healthy periodontal support, with < 3 mm between the cementoenamel junction and the buccal alveolar crest. Clinical parameters (GR, clinical attachment level, interproximal papilla tip location, keratinized tissue, vestibule depth) and root coverage esthetic score were evaluated at 9 months. FMG significantly reduced GR (P < .001) and increased keratinized tissue (P < .001) without loss of vestibule depth (P > .05). Mean root coverage was 94.37% ± 10.60%, mean residual GR was 0.08 ± 0.65 mm, and the mean root coverage esthetic score was 8.9 ± 1.24. Recession types 2/3 showed significant interproximal clinical attachment gain (P < .05). The interproximal papilla was significantly augmented at sites with papilla loss (P < .001). No clinical attachment loss (P = .346) was detected at donor sites. These results suggest that FMG is a promising root coverage approach for recession types 1, 2, and 3, correcting mucogingival conditions and deformities and reconstructing the interproximal papilla.
- PublicationOpen AccessChanges in the number and distribution of Langerhans cells in the hydantoin hyperplasic gingiva as compared with the clinically normal one(Murcia : F. Hernández, 1990) Ibañez, P.; Sagredo, E.; Pino, A.A study was made of the number of Langerhan's cells (LCs) per mm2 of section which express the antigens T, and/or HLA-DR in seriated gingival sections of diphenylhydantoine-induced hyperplasia (HG) and clinically normal gingivae (NG). NG showed histological correlation with its macroscopic appearance. In HG the classical histopathological findings were verified, as well as the epithelial maturation irregularities, conducive to the development of epithelial gaps. In the immunostained samples, LCs appear amply distributed in the epithelium in greater numbers than in NG and more branched except in the immature areas, where they mostly express HLA-DR. In HG keratinocytes, HLA-DR' are observed in the basal layer, except in developing epithelial gap zones. The Wilcoxon test for the NG-T6lNG-DR and HG-T,/HGDR was not significant; but the Mann Whitney test for NG-TdHG-T, and NG-DWHG-DR was significant to p < 0.05. It is understood that the increase in LC numbers in HG is a manifestation of their active participation in local immune reactions. The presence of DR+/T,- LCs in the less keratinized areas seems to indicate the relationship of LCs with epithelial proliferation and/or differentiation.
- PublicationOpen AccessPhenytoin activates SMAD3 phosphorylation and periostin expression in drug-induced gingival enlargement(Universidad de Murcia. Departamento de Biología Celular e Histología, 2018) Kim, Shawna S.; Nikoloudaki, Georgia; Darling, Mark; Rieder, Michael J.; Hamilton, Douglas W.Drug-induced gingival enlargement (DIGE) is a fibrotic condition associated with systemic administration of the anti-epileptic drug, phenytoin. We have previously demonstrated that periostin, which is transforming growth factor-beta (TGF-β) inducible gene, is upregulated in various fibrotic conditions including gingival enlargement associated with nifedipine. The objective of this study was to assess periostin expression in phenytoin-induced gingival enlargement (PIGE) tissues and to investigate the mechanisms underlying periostin expression. Human PIGE tissues were assessed using Masson’s trichrome, with cell infiltration and changes in extracellular matrix composition characterized through labeling with antibodies to periostin, phospho-SMAD 3, TGF-β, as well as the macrophage markers CD68 and RM3/1. Using human gingival fibroblasts (HGFs) in vitro, we examined the pathways through which phenytoin acts on fibroblasts. In PIGE tissues, which demonstrate altered collagen organization and increased inflammatory cell infiltration, periostin protein was increased compared with healthy tissues. p-SMAD2/3, the transcription factor associated with canonical TGF-β signaling, is localized to the nuclei in both gingival fibroblasts and oral epithelial cells in PIGE tissues, but not in healthy tissue. In vitro culture of HGFs with 15 and 30 μg/ml of phenytoin increased periostin protein levels, which correlated with p-SMAD3 phosphorylation. Inhibition of canonical TGF-β signaling with SB431542 significantly reduced phenytoin induction of SMAD3 phosphorylation and periostin expression in HGFs. Analysis of PIGE tissues showed a subset of CD68 stained macrophages were TGF-β positive and that RM1/3 regenerative macrophages were present in the tissues. Our results demonstrate that phenytoin up-regulates periostin in HGFs in a TGF-β-dependent manner.
- PublicationOpen AccessSystematic review and meta-analysis of the use of hyaluronic acid injections to restore interproximal papillae(MDPI, 2021-11-10) Sánchez Pérez, Arturo Joaquín; Vela-García, Tania Rosa; Mateos Moreno, Bibiana; Jornet García, Alfonso Felipe; Navarro-Cuellar, Carlos; Dermatología, Estomatología, Radiología y Medicina Física; Facultad de MedicinaThe absence of interdental papillae leads to the appearance of black triangles. For most patients, the appearance of these triangles is an important reason for concern and affects their social relationships. Multiple reconstruction techniques have been developed with different degrees of success and predictability. The main aim of this study was to evaluate the efficiency of hyaluronic acid (HA) injected into interproximal papillae 6 months after injection and to perform a systematic review and meta-analysis. After a systematic review, seven articles were selected: two clinical randomised controlled trials and five clinical trials. In total, 127 patients with a deficiency in upper papillae in the front of the maxilla and jaw were included in the study. The height variable was evaluated (mm) 6 months after HA injection. In total, 166 interproximal papillae were studied. Four articles showed an important difference in favour of intervention. The total result regarding in the injection of HA was favourable with an approximate average filling of 0.47 mm in the height of the interdental papilla. The injection of HA for the reconstruction of deficient papillae in the region of the upper and lower maxilla was a possible option treatment strategy in mild black triangles.