The results of this study show that pregnancy had an effect only on the gingivae and not on periodontal attachment levels. The effects of oestrogen and progesterone could give rise to a more florid response to the irritant effects of plaque, resulting in severe gingivitis.

No abstract

Usage of contraceptive preparations containing oestrogen and progesterone resulted in hormonal changes similar to those seen in pregnancy, associated with increased prevalence of gingivitis. There was significantly higher LA with prolonged usage of hormonal contraceptives, compared with controls.

Although tumours of the young patients showed more nuclear aberrations, OSCC of the older patients is proliferative and showed higher metastatic rate.

The non-antimicrobial properties of tetracyclines such as anti-inflammatory, proanabolic and anti-catabolic actions make them effective pharmaceuticals for the adjunctive management of chronic inflammatory diseases. An over-exuberant inflammatory response to an antigenic trigger in periodontitis and other chronic inflammatory diseases could contribute to an autoimmune element in disease progression. Their adjunctive use in managing periodontitis could have beneficial effects in curbing excessive inflammatory loading from commonly associated comorbidities such as CHD, DM and arthritis. Actions of tetracyclines and their derivatives include interactions with MMPs, tissue inhibitors of MMPs, growth factors and cytokines. They affect the sequence of inflammation with implications on immunomodulation, cell proliferation and angiogenesis; these actions enhance their scope, in treating a range of disease entities. Non-antimicrobial chemically modified tetracyclines (CMTs) sustain their diverse actions in organ systems which include anti-inflammatory, anti-apoptotic, anti-proteolytic actions, inhibition of angiogenesis and tumor metastasis. A spectrum of biological actions in dermatitis, periodontitis, atherosclerosis, diabetes, arthritis, inflammatory bowel disease, malignancy and prevention of bone resorption is particularly relevant to minocycline. Experimental models of ischemia indicate their specific beneficial effects. Parallel molecules with similar functions, improved Zn binding and solubility have been developed for reducing excessive MMP activity. Curbing excessive MMP activity is particularly relevant to periodontitis, and comorbidities addressed here, where specificity is paramount. Unique actions of tetracyclines in a milieu of excessive inflammatory stimuli make them effective therapeutic adjuncts in the management of chronic inflammatory disorders. These beneficial actions of tetracyclines are relevant to the adjunctive management of periodontitis subjects presenting with commonly prevalent comorbidities addressed here.

The modulation of androgen metabolism by oestrogen and progesterone in HGF has been investigated, to elucidate hormone modulatory mechanisms, in periodontal disease presentation and healing responses. Duplicate incubations of HGF were performed in Eagle's MEM for 24 h with either 14C-testosterone/14C-4-androstenedione as substrate and serial concentrations of oestradiol-17beta, or progesterone (0.01-50 microg/ml). The effect of the anti- oestrogen tamoxifen on the action of oestradiol in HGF was also investigated. The medium was analysed and quantified for steroid metabolites. When 14C-testosterone was used as substrate, oestradiol stimulated the synthesis of 5alpha-dihydrotestosterone (DHT), 4- androstenedione (4-A) and the diols by 35%, 25% and 2-10-fold respectively (n=4; p<0.01), at optimal concentrations. Tamoxifen inhibited the stimulatory effects of oestradiol. Similarly, when 14C-4-androstenedione was used as substrate, there were 60% and 2-fold increases in the yields of DHT and testosterone respectively, with significant increases in the formation of the diols in response to oestradiol (n=4; p<0.001). Progesterone inhibited the formation of DHT and 4-A by 10-fold and 3-5-fold at effective inhibitory concentrations (n=4; p<0.001), when 14C- testosterone was used as substrate. Similarly, when 14C-4-androstenedione was used as substrate, progesterone decreased the yields of testosterone, DHT and the diols substantially. These results reinforce the potentially anabolic and catabolic roles of oestradiol and progesterone, respectively. This may partly explain the modulatory mechanisms involved, in periodontal disease presentation during altered hormonal states and healing responses in the inflamed periodontium.

The modulatory effects of estradiol-17beta and progesterone on androgen metabolism may influence disease presentation and the progress of healing responses in the inflamed periodontium.

Human gingival fibroblasts obtained from chronically inflamed tissue of nondiabetic patients demonstrated that the inhibitory effects of glucose and nicotine on androgen metabolism can be overcome by insulin, in varying degrees.