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. 2020 Oct-Dec;61(4):1287-1294.
doi: 10.47162/RJME.61.4.29.

Gingival proliferative growth - stress and cytoarchitecture related with fixed and mobile orthodontic therapy

Cătălin Petru Simon  1 , Andrei Gheorghe Marius Motoc, George Alexandru Simon, Diana Brezovan, Florin Muselin, Romeo Teodor Cristina, Dana Cristina Bratu
Affiliations

Gingival proliferative growth - stress and cytoarchitecture related with fixed and mobile orthodontic therapy

Cătălin Petru Simon et al. Rom J Morphol Embryol. 2020 Oct-Dec.

Abstract

The fixed orthodontic measures taken induce significant stress to the gingival growth process during arch wire maneuvers of aligning and leveling. We observed, for a period of one to four years, fixed orthodontic devices in 80 human subjects. From these, we selected 44 subjects (22 women and 22 men) where the inflammatory process exhibited following the orthodontic fixed treatment, and with vacuum-formed orthodontic retainers (VFR) succeeding to fixed treatment. Samples were collected from each patient and histological and immunohistochemical (IHC) methodology was made to analyze the cytoarchitecture. Statistics were made after one-way analysis of variance (ANOVA), with the Bonferroni's correction. The IHC examination performed in the early stage revealed the presence in the inflammatory infiltrate of CD8-type T-lymphocytes, and of dendritic cells in large numbers. The examination performed in the late stage revealed the presence in the inflammatory infiltrate of CD20-type B-lymphocytes, which are mature cells capable of immunoglobulin synthesis, their activation being an important step in the maturation of the antibody response. The stress generated by arch wires in both genders was significantly higher than in the case of VFR. This observation was pointed out also by the cytohistological investigation outcome but was also based on an original scale conceived by our research team, following gingival hyperplasia evaluation. Also, with statistical significance, the comparative obtained values for men (p=0.01) and for women (p=0.001) illustrate clinical observations, allowing to affirm that, in our case, men were more stressed in bearing arch wire devices (AWD) and VFR, in comparison with women.

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Conflict of interest statement

The authors declare no conflict of interests.

Figures

Figure 1
Figure 1
Image of gingival mirror from a male subject during arch wire devices (AWD) therapy
Figure 2
Figure 2
Image of gingival mirror from a male subject during vacuum-formed retainers (VFR) therapy
Figure 3
Figure 3
Microscopic image of the gingival mucosa showing its overall hypertrophy. On the surface, there is a thickened gingival epithelium, with deep epithelial ridges, acanthosis, and hyperkeratosis in the superficial layers. HE staining, ×40
Figure 4
Figure 4
In the deep areas of the gingival epithelium, the widening of the intercellular spaces was noticed with the highlighting of the intercellular “spines” (desmosomes) because of an edema present both in the epithelium and at the level of the lamina propria (gingival chorion). HE staining, ×200
Figure 5
Figure 5
Image of abundant inflammatory infiltrate in the papillae of the lamina propria. HE staining, ×100
Figure 6
Figure 6
Microscopic image from the deep area of the gingival epithelium showing the presence of an intraepithelial edema and infiltration with lymphocytes and neutrophilic granulocytes. HE staining, ×200
Figure 7
Figure 7
Image of papilla from the lamina propria, with numerous vessels of angiogenesis, congested and moderately inflammatory infiltrate, consisting mainly of lymphocytes. HE staining, ×200
Figure 8
Figure 8
Abundant inflammatory infiltrate in an area of the lamina propria, associated with vascular congestion. HE staining, ×200
Figure 9
Figure 9
The area of the lamina propria is strongly infiltrated with lymphocytes. Immunolabeling with anti-CD45RO antibody, ×200
Figure 10
Figure 10
Gingival chorion infiltrated with numerous inflammatory cells, but with a relatively low macrophage. Immunolabeling with anti-CD68 antibody, ×200
Figure 11
Figure 11
Superficial gingival chorion image with a rich inflammatory infiltrate but a relatively small number of T-lymphocytes. Immunolabeling with anti-CD3 antibody, ×200
Figure 12
Figure 12
Gingival chorion area rich in T-lymphocytes. Immunolabeling with anti-CD3 antibody, ×200
Figure 13
Figure 13
Deep gingival chorion infiltrated with a moderate amount of B-lymphocytes. Immunolabeling with anti-CD20 antibody, ×200
Figure 14
Figure 14
Superficial chorion area infiltrated with lymphocytes, especially B-lymphocytes. Immunolabeling with anti-CD20 antibody, ×100
Figure 15
Figure 15
Superficial chorion with numerous angiogenesis vessels. Immunolabeling with anti-CD34 antibody, ×200
Figure 16
Figure 16
The scale of gingival hyperplasia clinical evaluation and ANOVA statistics for observed patients (where: **p=0.01 is statistically significant and ***p=0.001 is highly statistically significant). ANOVA: Analysis of variance; FixedO: Fixed orthodontics; M: Men; ns: Not significant; VFR: Vacuum-formed retainers; W: Women
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