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Increased early inflammatory response and osteoclastic activity in gingival tissues following conventional osseous resective surgery compared with the fibre retention technique: a pilot study
Author(s) -
Romano F.,
Graziano A.,
Spina A.,
Ercoli E.,
Audagna M.,
Mariani G. M.,
Ferrarotti F.,
Aimetti M.
Publication year - 2017
Publication title -
journal of periodontal research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 83
eISSN - 1600-0765
pISSN - 0022-3484
DOI - 10.1111/jre.12400
Subject(s) - proinflammatory cytokine , connective tissue , medicine , bleeding on probing , periodontitis , crown lengthening , cd14 , chemokine , osteoclast , gingival margin , dentistry , pathology , immune system , inflammation , immunology , receptor , crown (dentistry)
Background and Objective The retention of suprabony connective fibres attached into the root cementum during fibre retention osseous resective surgery (FibRe ORS ) results in a more conservative intrasurgical removal of bone, and limits further bone loss and patient morbidity during healing, compared with conventional osseous resective surgery ( ORS ). This may be a result of the protective effect of preserved connective tissue over the interproximal sites and the lower activation of the inflammatory mechanisms. Thus, the aim of this pilot study was to compare the expression of inflammatory and osteoclastic activity markers in gingival tissues following FibRe ORS and ORS in the early postsurgical phase. Material and Methods Twenty‐six posterior sextants requiring osseous resective surgery were selected in 13 patients with chronic periodontitis: 13 sextants were randomly assigned to ORS and 13 to FibRe ORS in a split‐mouth design. Gingival biospies were collected during the surgical sessions and at suture removal. Tissue samples were analysed to evaluate the expression of proinflammatory and immunity regulatory mediators (interleukin‐1α, C‐X‐C motif chemokine ligand 5, interferon‐γ and tumour necrosis factor‐α), cluster of differentiation 14 ( CD 14; a monocyte/macrophage marker) and TRAP (an osteoclast marker) using immunohistochemical, immunofluorescence and cytofluorimetric analyses, respectively. Results Postsurgery, a higher number of inflammatory cells and stronger expression of proinflammatory cytokines were observed in the epithelium and connective tissue of ORS gingival samples compared with FibRe ORS gingival samples ( p < 0.001). This was accompanied by increased numbers of CD 14‐positive and TRAP ‐positive cells. Conclusion Retention of the supracrestal connective fibres appears to reduce the postsurgical intensity of the host‐mediated inflammatory response.