Local Peptidergic Innervation of Gingiva in Smoking and Non‐Smoking Periodontitis Patients

Abstract

Background: The present study aimed to investigate the local peptidergic innervation of diseased and healthy periodontia in smokers and non‐smokers. Methods: Fifteen smokers and 12 non‐smokers, all with localized chronic periodontitis, participated in the study. Periodontally diseased and healthy tooth sites were selected in smokers (groups 1 and 2, respectively) and non‐smokers (groups 3 and 4, respectively). Local peptidergic innervation was assessed by the concentrations of two neuropeptides, substance P (SP) and calcitonin gene‐related peptide (CGRP), in the gingival biopsies obtained from the groups. Clinical data and biopsies were collected from the same two tooth sites in each group. SP and CGRP levels were measured by enzyme immunosorbent assay in the supernatants of gingival samples. Results: Increased probing depth and attachment loss were found in group 1 compared to group 3 (P <0.05). SP was higher in group 1 compared to groups 2, 3, and 4, and it was higher in group 3 compared to groups 2 and 4 (P <0.05). CGRP was higher in group 1 than in groups 2, 3, and 4, but it was lower in group 3 than in groups 2 and 4 (P <0.05). Conclusion: The study results suggested that 1) although smoking may affect the neurogenic inflammation in the presence of periodontitis by increasing local peptidergic innervation, this effect may not be seen in periodontal health, and 2) SP may be regarded as an indicator of periodontitis, whereas CGRP may be important in the acute and/or initial periodontal inflammation.

Evaluating the Periodontal Status and Oral Hygiene Habits Among Dental Patients

“…It has been shown in many studies that the severity of gingivitis and periodontitis among smokers is higher than that among non-smokers (28,29). It has been determined that compared to non-smokers, smokers place less importance on oral health care; thus, plaque accumulation is more common among smokers, and they are more prone to periodontal disease (30).…”

Heme oxygenase-1 protects human periodontal ligament cells against substance P-induced RANKL expression

“…Substance P is also detected in gingival tissues and gingival crevicular fluid, which is correlated with the degree of periodontal inflammation; it has been shown that a reduction in inflammation as a result of effective periodontal treatment is associated with a reduction in the level of SP in gingival crevicular fluid (14,15). Furthermore, Norevall et al (16) reported that the expression of SP was increased after orthodontic tooth movement in rat periodontal ligament specimens, and Sakalliog˘lu et al (17) found increased SP concentrations in periodontitis sites compared with healthy sites in the mouths of smokers. These observations suggest that SP is involved in remodeling the periodontal ligament and alveolar bone in periodontitis or during orthodontic tooth movement.…”

“…(16) reported that the expression of SP was increased after orthodontic tooth movement in rat periodontal ligament specimens, and Sakallioğlu et al. (17) found increased SP concentrations in periodontitis sites compared with healthy sites in the mouths of smokers. These observations suggest that SP is involved in remodeling the periodontal ligament and alveolar bone in periodontitis or during orthodontic tooth movement.…”

Neurogenic inflammation in periimplant and periodontal disease: A case–control split‐mouth study

“…Sensory fibres of the maxillary and mandibular divisions of trigeminal nerve innervate periodontal tissues, and this sensory innervation is closely associated with blood vessels (Lundy & Linden, ). The immunomodulatory role of certain neuropeptides in periodontal disease has become reasonably acceptable after the identification of several neuropeptides in the gingival crevicular fluid (GCF) (Luthman et al, ; Luthman, Johansson, Ahlström, & Kvint, ; Sakallıoğlu et al, ) and gingiva (Bartold, Kylstra, & Lawson, ). During the neurogenic inflammatory state vasodilatation, plasma extravasation and immune cell recruitment are modulated by sensory neuropeptides, and, peptide‐containing nerve fibres close to immune cells and their functional neuropeptide receptors on the immune cells have been identified in periodontium (Lundy & Linden, ; Luthman et al, ; Sakallıoğlu et al, ).…”

“…The immunomodulatory role of certain neuropeptides in periodontal disease has become reasonably acceptable after the identification of several neuropeptides in the gingival crevicular fluid (GCF) (Luthman et al, ; Luthman, Johansson, Ahlström, & Kvint, ; Sakallıoğlu et al, ) and gingiva (Bartold, Kylstra, & Lawson, ). During the neurogenic inflammatory state vasodilatation, plasma extravasation and immune cell recruitment are modulated by sensory neuropeptides, and, peptide‐containing nerve fibres close to immune cells and their functional neuropeptide receptors on the immune cells have been identified in periodontium (Lundy & Linden, ; Luthman et al, ; Sakallıoğlu et al, ). Therefore, the neurogenic response in inflammatory reactions, called as the neurogenic inflammation, is also speculated to be involved in periodontal disease (Lundy & Linden, ; Luthman et al, ; Sakallıoğlu et al, ).…”