With the increasing number of the orthodontic patients, the relationship between periodontal and orthodontic becomes increasingly close. Orthodontic treatment can improve periodontal status, but the adverse clinical problems of periodontal tissue during orthodontic treatment are relatively common. In this paper, we discuss the problems of soft tissue, including causes, prevention, and treatment of gingivitis, gingival enlargement, gingival recession, and gingival invagination in orthodontic treatment.
Gingiva ; Gingival Overgrowth ; therapy ; Gingival Recession ; therapy ; Gingivitis ; therapy ; Humans ; Tooth Movement Techniques

Previous studies to elucidate the etiology of cyclosporine(Cs)-induced gingival overgrowth in children have not completely excluded all factors that may cause differences among individuals. This study examined the effect of cyclosporine on the metabolism of type 1 collagen(CoL-I) in experimental models that controlled the effects of biological variations on individuals. Five 5-week-old male Sprague-Dawley rats were administered Cs by gastric feeding for 6 weeks. Gingival specimens were harvested from the mandibular posterior area before beginning Cs administration and at 2, 4, and 6 weeks thereafter. Gingival fibroblasts were cultured from all the 20 biopsies collected from the gingiva. Half of the fibroblasts collected prior to the Cs administration were designated as Control. The other half of the fibroblasts were treated with Cs in vitro and called in vitro test group(Tt). The fibroblasts collected 2, 4, and 6 weeks after the Cs administration were called in vivo test groups : T2, T4, T6, respectively. Immunofluorescence microscopy was used to detect CoL-I in all the fibroblasts. CoL-I was analyzed at both the gene and protein expression levels by real-time polymerase chain reaction and western blotting. Changes in CoL-I before and after Cs treatment were evaluated from the gingiva of each rat. There was no significant difference in gene expression of CoL-I in the control and test groups. CoL-I protein expression levels of fibroblasts increased in in vitro Cs treatment for each individual, and also increased in in vivo Cs treatment. In this study, the experimental method that control biological variations that can occur due to differences among individuals was useful. Subsequent studies on other factors besides CoL-I and in-depth studies in humans are needed.
Animals ; Biopsy ; Blotting, Western ; Child ; Collagen Type I ; Cyclosporine ; Fibroblasts ; Gene Expression ; Gingiva ; Gingival Overgrowth ; Humans ; In Vitro Techniques ; Male ; Metabolism ; Methods ; Microscopy, Fluorescence ; Models, Theoretical ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction

Drug-induced gingival overgrowth (DIGO) is characterized by fibrous gingival hyperplasia and increased gingival volume. DIGO is histologically associated with proliferation of cells and deposition of extracellular matrices, particularly collagen. Integrin α2β1 is related to collagen phagocytosis and involved in the occurrence and progression of DIGO. This paper reviews the progress of research on the relationship between integrin α2β1 and DIGO.
Collagen ; Gingiva ; Gingival Overgrowth ; Humans ; Integrin alpha2beta1 ; Phagocytosis

Anticonvulsants, calcium channel blockers and immunosuppressants are representative drugs related with gingival enlargement. Clinical signs and symptoms caused by drug-induced gingival enlargment frequently appear within 1 to 3 months after medication. At initial stage, it is limited to attached gingiva but may extend coronally and interfere with esthetics, mastication and speech. Interproximal spaces are common beginning area and pathologic teeth migration could be occurred by the lesion. Withdrawal or substitution of medication would be the most effective treatment of drug-induced gingival enlargement. However, periodontal treatment and further supportive periodontal therapy should be provided where change in medication is impossible. The present study reports the cases which show the resolution of inflammation with spontaneous teeth migration without change in medication. In all cases discussed in this report could be efficiently managed with proper periodontal treatment and further supportive periodontal therapy.
Anticonvulsants ; Calcium Channel Blockers ; Esthetics ; Gingiva ; Gingival Overgrowth ; Humans ; Immunosuppressive Agents ; Inflammation ; Mastication ; Periodontal Diseases ; Tooth*

Unusual presentation of localized gingival enlargement associated with a subjacent tumoural pathology is reported. The patient was a 55-year-old black male, whose chief complaint was a progressive gingival overgrowth for more than ten years, in the buccal area of the anterior left mandible. According to the clinical features and the radiological diagnosis of odontogenic keratocyst, a conservative surgery with enucleation and curettage was performed. Tissue submitted for histopathological analysis rendered the diagnosis of odontogenic myxoma. After 12-month of follow-up, no evidence of recurrence was found. Clinicians should be cautious when facing any gingival enlargement to avoid diagnostic pitfalls and to indicate the appropriate treatment.
Diagnosis, Differential ; Gingival Overgrowth ; etiology ; pathology ; Humans ; Male ; Mandibular Neoplasms ; complications ; pathology ; surgery ; Middle Aged ; Myxoma ; complications ; pathology ; surgery ; Odontogenic Tumors ; complications ; pathology ; surgery

OBJECTIVETo investigate the effect of cyclosporin A (CsA) and tumor necrosis factor-α (TNF-α) on cell proliferation of cultured human gingival fibroblasts (GF), and the relationship between gingival inflammation and drug-induced gingival overgrowth.

METHODSHuman GF were cultured in vitro using tissue culture method. then cells from the 4 - 8 th passage were used in the experiment. The cells were cultured and incubated with various concentrations of CsA and TNF-α (A: blank group, B1: 10 µg/L CsA, B2: 50 µg/L CsA, B3: 250 µg/L CsA, B4: 1250 µg/L CsA, C: 5 µg/L TNF-α, D1: 10 µg/L CsA + 5 µg/L TNF-α, D2: 50 µg/L CsA + 5 µg/L TNF-α, D3: 250 µg/L CsA + 5 µg/L TNF-α, D4: 1250 µg/L CsA + 5 µg/L TNF-α) solution for 3, 5 and 7 days. Methyl thiazolyl tetrazolium assay was used to evaluate the cell proliferation in the culture meidiun.

RESULTSThe proliferation of fibroblasts was inhibited when exposed to different concentration of CsA and A value decreased. There was no significant difference between group B1, B2, B3 and the control group, while the A value of group B4 was significantly higher than that of control group (P < 0.01). Fibroblast proliferation was significantly increased while cultured with 5 µg/L TNF-α. A value increased (P < 0.01). When exposed to CsA + TNF-α, A value of group D1, D2, D3 was much higher than that of group A, but was lower than that of group C (P < 0.05). Cell proliferation in group D4 was significantly increased, and significantly different with that in group C (P < 0.01).

CONCLUSIONSCsA did not stimulate the cell proliferation, and high concentration of CsA inhibited cell proliferation. TNF-α can stimulate the cell proliferation. High-concentration CsA + TNF-α can enhance the fibroblast proliferation, which suggests that CsA in certain concentration have amplification effect on TNF-α to stimulate fibroblast proliferation.

Adult ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cyclosporine ; adverse effects ; pharmacology ; Dose-Response Relationship, Drug ; Fibroblasts ; cytology ; Gingiva ; cytology ; Gingival Overgrowth ; chemically induced ; Humans ; Immunosuppressive Agents ; adverse effects ; pharmacology ; Tumor Necrosis Factor-alpha ; adverse effects ; pharmacology

Amlodipine is one of the most commonly used calcium-channel blockers for the management of hypertension in Korea. Gingival overgrowth is an infrequent complication in patients receiving amlodipine treatment. A 52-year-old man on an amlodipine regimen of 10 mg/day for 25 months sought medical attention because of gradually progressive gingival enlargement. Examination of the oral cavity revealed severe gingival overgrowth. We stopped the amlodipine treatment and recommended the maintenance of good oral hygiene and a gingivectomy. Histological findings of the gingivectomy were typical of drug-induced gingival overgrowth, including epithelial thickening with proliferation, acanthosis with elongated rete ridges, and focal parakeratosis. A marked reduction in gingival overgrowth was evident 1 month after the gingivectomy and cessation of amlodipine. This report describes the case of a 52-year-old man who developed severe and histologically confirmed amlodipine-induced gingival overgrowth.
Amlodipine ; Gingival Overgrowth ; Gingivectomy ; Humans ; Hypertension ; Korea ; Middle Aged ; Mouth ; Oral Hygiene ; Parakeratosis

Gingival fibromatosis is a rare disease, especially its syndromic form. Here, we review the literatures on gingival fibromatosis and briefly summarize some characters on clinical, etiological, genetic and histopathological aspects. We also present a rare case of gingival fibromatosis with multiple unusual findings in a 21-year-old man. And we differentiate it from some well-known syndromes including gingival fibromatosis. Maybe it implies a new syndrome within the spectrum of those including gingival fibromatosis.
Atrophy ; Bone Diseases, Developmental ; diagnosis ; Cataract ; congenital ; Cerebellum ; pathology ; Deafness ; diagnosis ; Diagnosis, Differential ; Fibromatosis, Gingival ; diagnosis ; Frontal Lobe ; pathology ; Gingival Overgrowth ; diagnosis ; Humans ; Male ; Maxillary Diseases ; diagnosis ; Young Adult

Amlodipine is one of the most commonly used calcium-channel blockers for the management of hypertension in Korea. Gingival overgrowth is an infrequent complication in patients receiving amlodipine treatment. A 52-year-old man on an amlodipine regimen of 10 mg/day for 25 months sought medical attention because of gradually progressive gingival enlargement. Examination of the oral cavity revealed severe gingival overgrowth. We stopped the amlodipine treatment and recommended the maintenance of good oral hygiene and a gingivectomy. Histological findings of the gingivectomy were typical of drug-induced gingival overgrowth, including epithelial thickening with proliferation, acanthosis with elongated rete ridges, and focal parakeratosis. A marked reduction in gingival overgrowth was evident 1 month after the gingivectomy and cessation of amlodipine. This report describes the case of a 52-year-old man who developed severe and histologically confirmed amlodipine-induced gingival overgrowth.
Amlodipine ; Gingival Overgrowth ; Gingivectomy ; Humans ; Hypertension ; Korea ; Middle Aged ; Mouth ; Oral Hygiene ; Parakeratosis

OBJECTIVETo observe the effect of Ciclosporin (CsP) on apoptosis and expression of the associated protein Bcl-2, Caspase-3 in gingival epithelium of rats in order to approach the mechanism of CsP-induced gingival epithelium overgrowth.

METHODSEighty SPF grade male 7-week-old Wistar rats were randomly divided into experimental group and control group, and each group was divided into 4 subgroups according to the duration of treatment (10, 20, 30 and 40 days). The experimental objects were given fresh milk including CsP intragastrically and the control ones were given only fresh milk. After perfusion of 4% paraform for internal fixation, the specimens' bucco-lingual paraffin sections at lower first molar were made. Apoptosis was detected using TdT-mediated dUT nick end labeling (TUNEL) and the expression of Bcl-2 and Caspase-3 using immunohistochemisty of PV. The apoptotic index, positive cell rate of Caspase-3 and average gray scale of Bcl-2 was measured with an image analysis system. Data were analyzed by two-way analysis of variance of factorial design.

RESULTSThe apoptosis index and positive cell rate of Caspase-3 were down-regulated in the experimental group, and were significant difference from the control group (P < 0.05). The average gray scale of Bcl-2 was up-regulated in the experimental group, and was significant difference from the control group (P < 0.05).

CONCLUSIONCsP-induced gingival epithelial overgrowth is likely to associated with interference to the path of mitochondrial apoptosis and inhibition apoptosis.

Animals ; Apoptosis ; Caspase 3 ; Cyclosporine ; Gingival Overgrowth ; In Situ Nick-End Labeling ; Male ; Proto-Oncogene Proteins c-bcl-2 ; Rats ; Rats, Wistar