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Background Normal or inflamed gingival tissues are regarded as a source of mesenchymal stem cells (MSCs) abundant and easily accessible through minimally invasive dental procedures. Due to the proximity of dental resin composites to gingival tissues and to the possible local cytotoxic effect of the eluted components, gingiva-derived MSCs could be used to investigate the biocompatibility of dental biomaterials. Purpose The present research aimed to isolate (MSCs) from inflamed and normal gingiva, to fully characterize them and to observe their behavior in relation with some commercial resin composite materials and one experimental material. Material and methods Following their isolation, putative MSCs from both gingival sources were grown under the same culture conditions and characterized by immunophenotyping of cell surface antigens by flow-cytometry and transcription factors by immunocytochemical staining. Moreover, stemness gene expression was evaluated by RT-PCR analysis. Multipotent mesenchymal differentiation potential was investigated. Osteogenic and neurogenic differentiated cells were highlighted by immunocytochemical staining, chondrogenic cells by cytochemical staining, and adipocytes by cytochemical staining and spectrophotometry, respectively. Resin composite cytotoxicity was evaluated by cell membrane fluorescent labeling with PKH 26 and MTT assay. The results of PKH labeling were statistically analysed using two-way RM ANOVA with Bonferroni post-tests. For MTT assay, two-way RM ANOVA with Bonferroni post-tests and unpaired t test with Welch’s correction were used. Results A similar expression pattern of surface markers was observed. The cells were positive for CD105, CD73, CD90, CD49e, CD29, CD44 and CD166 and negative for CD45, CD34, CD14, CD79, HLA-DR and CD117 indicating a mesenchymal stem cell phenotype. The qRT-PCR analysis revealed a low gene expression for NOG, BMP4 and Oct3/4 and an increased expression for Nanog in both cells lines. Immunocytochemical analysis highlighted a more intense protein expression for Nanog, Oct3/4 and Sox-2 in MSCs derived from normal gingiva than from inflamed gingiva. Multipotent differentiation capacity of MSCs isolated from both sources was highlighted. The tested materials had no hazardous effect on MSCs as the two cell lines developed well onto resin composite substrates. Cell counting revealed some significant differences in the number of PKH-labeled MSCs at some experimental moments. Also, some differences in cell viability were recorded indicating better developmental conditions offered by some of the tested biomaterials. Conclusions The experimental resin composite behaved like the most biocompatible commercial material. Inflamed gingiva-derived MSCs retain their stem cell properties and could be used as a valuable cell line for testing dental biomaterials.

Background. Wound healing is a tissue repair process after an injury, and two of its main components are inflammation and angiogenesis, in which course a cascade of mediators is involved. The aim of this research was to evaluate the involvement of Pentraxin 3 and Thrombospondin 1 in wound healing after periodontal surgery (gingivectomy) for gingival overgrowth during orthodontic treatment with or without magnification devices, by assessing their levels in GCF.Methods. From 19 patients with gingival overgrowth as a result of fixed orthodontic treatment, the overgrown gingiva was removed by gingivectomy, from one half of the mandibular arch without magnification and from the other under magnification. Pentraxin 3 and Thrombospondin 1 were determined from gingival crevicular fluid by ELISA tests.Results. Statistically significant differences (p<0.05) and correlations between levels of the two biomarkers were analyzed. Statistically significant differences were established between levels of the two biomarkers at different time points, with significant positive correlation at the point of 24 hours.Conclusions. Within the limitations of this study, the results seem to sustain the involvement of Pentraxin 3 and Thrombospondin 1 in the processes of inflammation and angiogenesis in wound healing of patients with postorthodontic gingivectomy. The dynamics of Pentraxin 3 and Thrombospondin 1 levels could suggest a reduced inflammation and a faster angiogenesis using microsurgery.

Aim. Periodontal remodellng produced during dental orthodontic treatment represents a series of biologicallyactive substances, part of them playing some role in the initiation and propagation of inflammatory processes. The present study aims at demonstrating the MMP8, MMP9 and TIMP1 levels intervening in tissular periodontal remodeling produced during orthodontic treatments, accompanied by gingival overgrowth, as a reaction of the marginal periodontium to mechanical stress. Materials and Method. Selected for the study were 21 patients – 13 females and 8 males – with ages between 13 and 32 years (17.6±1.3 years) affected with dento-maxillary anomalies, who received orthodontic treatment with fixed apparatus. Sampling from the gingival fluid was performed 6 times, namely: 1 hour prior to the application of the orthodontic apparatus, 4 hours after its application, again after 8 and 24 hours and then 1 and, respectively, 2 weeks later. If gingival hypertrophy was installed (HTG), the hypertrophic gingiva was removed, and an immuno-histo-chemical examination was made. The patient was weekly monitorized in the first 6 weeks – during the initial orthodontic treatment, then monthly, samples being taken over from the gingival sulcus on each visit made in the first 6 weeks. Results. MMP-9 immuno-marking was positive both at corione level and in the deep structures of the covering epithelium. The positive cells at MMP-9 evidenced different intensities at the level of each structure forming the gingival mucous membrane. In four of the cases under analysis, disorganization of the normal layering/stratification of the epithelium was evidenced, along with the presence of numerous red cells in the chorione of the mucous membrane. In such cases, immuno-marking to MMP8 showed a normal intensity, even if few positive cells, dispersed among the extravasated red cells could be observed. Immunologically, MMP8 and MMP9 obey the same pattern, registering maximum values in the first 8 hours after the application of the orthodontic device, after which they begin to decrease, returning to the baseline in the first 2 weeks, for the cases having not developed HTG, while continuing to increase in those demonstrating HTG. The TIMP1 levels in GCF are more strongly correlated with those of MMP8 and not with those of MMP9. Conclusions. MMP8, MMP9 and TIMP1 evolution in various time moments of the orthodontic treatment evidences their involvement in the occurrence of HTG.

In the recent years, statistically significant associations between rheumatoid arthritis (RA) and periodontal disease have been identified. Emerging as a chronic inflammatory joint disease, RA displays various features and pathogenetic events similar to chronic periodontitis (CP). The purpose of this study was to evaluate the utility of determining systemic and crevicular levels of metalloproteinase-9 (MMP-9) as potential biomarkers for association between RA and CP. A total of fifty-six patients were included in the study. The subjects were categorized into four groups as follows: healthy-control (n=21), active RA (n=16), CP (n=14), and RA-CP association (n=12). Assessment of serum and crevicular concentrations of total MMP-9 (active and pro-MMP-9) was based on ELISA technique. The results of this study showed statistically significant differences of serum MMP-9 between patients groups and control. Serum levels of MMP-9 were similar in RA and RA-CP associated patients. Gingival crevicular fluid (GCF) recorded increased MMP-9 levels in RA-CP association subjects as compared to CP. Considering that RA-CP association is characterized by a disregulation of the inflammatory response, MMP-9 may play a role in the pathogenesis of RA-CP association. MMP-9 is therefore a sensitive tool in the diagnosis and management of patients affected by this binomial association.

The teeth with extensive coronal destructions due to carious process can be saved by using split cast post and core. This technique has been used for a long time and with positive results recognized by many authors. The clinical case presented here describes indirectly the reconstitution technique with split cast post and core with latch of a maxillary molar with divergent roots and extensive coronal destruction both in area and depth.

Purpose. Craniofacial morphology is usualy described by the head (cephalic index) and face form (prosopic index). The aim of this study was to establish the existence of correlations between the cranial and facial types and the dento-maxillary anomalies. Material and Methods. Data were collected from two groups of patients (a control group of 42 patients without dental anomalies and a test group of 76 patients with dento-maxillary anomalies) of both sexes and age range 11-16 years. Results. Both in the control and test groups, 50% of patients were classified in mesocephalic type and mesoprosopic type. Conclusions. Groups studied by us showed correlations between anomalies in the transverse plane and dolichocephalic type and correlations between anomalies in the sagittal plane and leptoprosopic type.

Diabetes mellitus is a systemic disease with several major complications affecting both the quality and length of life. One of these complications is periodontal disease. Periodontal disease (periodontitis) is much more than a localized oral infection, recent data indicating that periodontitis may cause changes in systemic physiology. The interrelationships between periodontitis and diabetes provide an example of systemic disease predisposing to oral infection, and once that infection is established, the oral infection exacerbates systemic disease. The relationship between periodontitis and diabetes has been extensively investigated over the last years, but despite of the numerous scientific studies on the influence of periodontal treatments on glycemic control, there is limited knowledge on the impact of glycemic control upon periodontal status. Moreover, the impact of periodontal treatment on sugar metabolic control in diabetics has not been fully elucidated, the present chapter intending an outlining of the features that governs the interrelationship diabetes mellitus – periodontal disease, a discussion of the present scientific evidences, mainly focusing on clinic-biological research in juvenile groups of population.

OBJECTIVES: To measure the levels of pentraxin-3 (PTX-3) in gingival crevicular fluid (GCF) in orthodontic young and adult patients in the first 2 weeks after the orthodontic appliance to determine whether those changes occur during orthodontic treatment and if those values could be the expression of an inflammatory state. MATERIALS AND METHODS: GCF samples were collected with paper strips from 16 orthodontic young patients and 13 orthodontic adult patients from an upper canine requiring distalization as a test tooth. A contralateral canine was used as a control tooth. The absorbed volume was eluted in 100 µL phosphate-buffered saline (pH = 7.2). PTX-3 levels in GCF were determined using a commercial enzyme-linked immunosorbent assay kit, and the results were expressed in ng/mL. RESULTS: The results showed an increase of GCF levels of PTX-3 from 1 hour before the orthodontic appliance to a maximum at 24 hours, followed by a decrease in both groups of adult and young patients. CONCLUSIONS: The results suggest PTX-3 involvement in periodontal orthodontic remodeling and the aseptic inflammation induced by the orthodontic forces.

Diabetes mellitus and periodontal disease are two pathological entities that destructively emphasize each other. The aim of our study was the histological and immunohistochemical analyze of the inflammatory infiltrate in the gingival tissue at patients with diabetes mellitus (DM) and periodontal disease.The study was achieved on gingival tissue from 40 patients with DM and specific symptoms of periodontal disease. We used Hematoxylin-Eosin and trichromic Goldner-Szekely staining and CD20cy and CD45RO antibodies.In patients with DM under 10 years, we found an intense periodontal lymphocyte inflammatory infiltrate and in patients with a DM evolution more than 10 years, the lymphocyte inflammatory infiltrate had a less intensity. The pattern was mostly diffuse in lamina propria. Many patients had a very abundant plasmocyte infiltrate. During immunohistochemical exam, 25 cases presented CD20 positive immunostaining. The intensity of the inflammatory infiltrate with B-lymphocytes was very low (score 1). All immunohistochemical analyzed cases presented CD45RO positive immunostaining, with a mixed pattern of the T-cell lymphocyte infiltrate.The nflammatory infiltrate in diabetic periodontal disease was polymorph, mostly with a diffuse pattern in gingival chorion. The intensity of the lymphocyte infiltrate was higher in patients with chronic periodontitis and DM less than 10 years. Positive CD45RO T-lymphocytes were more numerous compared to positive CD20 B-lymphocytes and they were present intra and under epithelial in the gingival of all the patients, no matter of the DM time evolution.

The clinical use of the alternative therapies in traumatology is conditioned by the knowledge and understanding of their actions on the bone tissue. The hereby study aims at the comparative assessment of the effectiveness of the direct current and ultrasounds in treating the fractures. Thus, we have proceeded to a comparative histological study of the bone tissue in the fractured area and the biomechanical description and the three-dimensional model of the stimulated bone's behavior by using micro-CT X-rays and the finite element analysis. The findings clearly show that the bone, which has been stimulated during a period of two weeks, has regained its functions, that is 85% of the compression one and 95% of the shearing one. These values prove that 90% of the bone structure has healed.

In this study, we aim to compare the levels of matrix metalloproteinase 9 (MMP9) in the gingival crevicular fluid (GCF), as indicators for healing, in two groups of patients - operated with a classic periodontal surgical technique and the same technique but using a dental microscope.We included 14 patients with ages between 12 and 26 years, average 14±6.2 years. Eight patients were women and six men. All patients presented gingival hypertrophy because of the orthodontic treatment on the mandibular arch. We performed gingivectomy on one-half of the mandibular arch by classic periodontal surgery and on the other half of the mandibular arch by a microscope-assisted gingivectomy.In the hypertrophied gingiva, the expression of MMP9 was identified using immunohistochemical-staining techniques. For immunological determination of MMP9 in GCF we performed Elisa tests.We found different levels in different moments of the healing process for the two hemiarcades.We consider that faster healing in case of microscope-assisted gingivectomy may be related to the expression of MMP-9 in the GCF.

Endometriosis is defined by the presence of ectopic and endometrial islands outside the uterus. The significance of its finding is also outlined by its less frequent localizations (intestine, gall bladder, lungs) and by its differentiated symptoms complicating the differential diagnosis. The definitive diagnosis can only be reached through a histopathological examination as the detection of this affliction may lead to severe therapeutic errors (radical resection). The importance of an early diagnosis may help in preventing and delaying the effects of this affliction.

Levels of metalloproteinase 8 (MMP8) in gingival crevicular fluid were studied in case of treatment with fixed orthodontic appliances. It were found a relationship between its levels and stages of the treatment under a good control of the bacterial plaque. Gingival overgrowth (GO) during the orthodontic treatment was traditionally considered as an inflammatory reaction consecutive of bacterial plaque accumulation because of difficult hygiene in those patients. Our study starts from the hypothesis that the gingival volume growth during the fixed orthodontic treatment appears at the beginning, without any inflammatory signs, as a result of the mechanical stress and periodontal remodeling during the orthodontic dental movement, the MMP8 acting as an indicator of this situation.Twenty-two patients received a fixed orthodontic treatment. Periodontal examination took place one hour before and one hour, four and eight hours and weekly after until eight weeks. At each session gingival crevicular fluid (GCF) was sampled and the level of MMP8 was determined. At the appearance of gingival overgrowth (GO) gingivectomy was performed.In the 13 patients that did not develop gingival overgrowth, the levels of MMP8 increased in the first 4-8 hours after orthodontic appliance and then fall to the initial level. In the nine patients with gingival overgrowth, the MMP8 levels in GCF continued to rise until the appearance of GO. In cases of GO with inflammation the levels of MMP8 were significantly higher than in cases of GO without inflammation. The expression of MMP8 in hypertrophied gingiva was more intensive in cases of GO with inflammation.It is possible that the MMP8 values in GCF to be a marker of the GO onset. MMP8 determination and monitoring at shorter time intervals may lead to a better control of the bacterial plaque and avoidance of gingival inflammation.

The inflammatory answer of the dental pulp in front of an antigen presents a series of particularities caused by its special anatomical conditions. The evaluation of the inflammatory answer in the evaluation tests of the biocompatibility of the dental materials is made by histological methods without defining precise quantitative criteria to measure the pulp reaction. In this study, we followed the reaction of the pulp tissue to five antibodies (CD20, CD45Ro, CD4, CD8, and CD68) in order to evaluate the inflammatory aspects of the dental pulp. We did not find positive answers for the CD20 protein, specific for B-lymphocytes, for the fragments of normal pulp tissue taken into study. Even if they are in small number among the pulp cells, the T-lymphocytes that express the protein CD45Ro may be also found in the normal dental pulp. Of the two subsets of T-lymphocytes, we found positive answers on the studied preparations only for the CD8 protein. For the CD68 protein, strongly expressed by the macrophages, we obtained positive results both for the inflammated pulp tissue, and for the normal dental pulp, yet in a very small amount. The use of immunohistochemical techniques, with well-defined markers of the pulp inflammation, can offer better results for a highly accurate evaluation of the inflammatory answer of the dental pulp.

In spite of the progresses achieved in surgical treatment, radiotherapy and chemotherapy, the survival rate in oral squamous cell carcinoma (OSCC) remain unchanged among past three decades, which made this neoplasia a major problem of health in the entire world. There were investigated 42 cases of OSCC with different sites and various grades of differentiation, by histological and immunohistochemical techniques (by LSAB/HRP method), using E-cadherine and CD44. Considering the differentiation grade, the cases were histopathologically classified as 9 cases of well-differentiated squamous carcinoma, 14 cases of moderately differentiated squamous carcinoma, and 19 cases of poorly differentiated squamous carcinoma. The E-cadherine immunoexpression study indicated an immunostaining degree 3 in well-differentiated squamous carcinoma, 2 in moderately differentiated squamous carcinoma, and 1 in poorly differentiated squamous carcinoma. The results of CD44 immunostaining indicated in most of the cases an immunostaining degree 2, especially in moderately differentiated OSCC. The immunostaining degree 3 corresponded to nine cases of well-differentiated OSCC, and other two cases of moderately differentiated OSCC. Immunostaining degree 1 corresponded to poorly differentiated OSCC. The results indicate the possibility of using the two-immunohistochemical markers as prognostic factors in OSCC.

Sarcomas are relatively uncommon tumors, accounting for 1% of all malignancies. Sarcomas are commonly classified according to their site of origin: soft tissues or bone. The purpose of the clinic study was to focus the symptoms and the clinic signs. The radio-imaging study is essential in the evaluation of the maxilla tumors. The histopathologic study was done to determine the histological type, the differentiation level, the invasion level as well as the presence or absence of the metastases in drainage ganglia. The correlation of the findings of this study leads to a clear and correct clinic diagnosis, an adequate local or general therapy and a prognostic. The diagnostic role of imaging is essential and often permits the orientation to benignity or, on the contrary, requires biopsy if the image is an aggressive one or of uncertain nature. Advances in diagnostic imaging have contributed substantially to the management of tumors. The strong collaboration among the physician, imaging personnel and anatomo-pathologist serves the patient's benefit.