title: Increased early inflammatory response and osteoclastic activity in gingival tissues following conventional osseous resective surgery compared with the fibre retention technique: a pilot study.
abstract: OBJECTIVE
  The retention of suprabony connective fibres attached into the root cementum during fibre retention osseous resective surgery (FibReORS) 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 FibReORS and ORS in the early postsurgical phase.
  
  
  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 FibReORS 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 (CD14; 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 FibReORS gingival samples (p < 0.001). This was accompanied by increased numbers of CD14-positive and TRAP-positive cells.
  
  
  CONCLUSIONS
  Retention of the supracrestal connective fibres appears to reduce the postsurgical intensity of the host-mediated inflammatory response.
authors.affiliation: Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Turin, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Romano
authors.affiliation: Department of Anatomy, Section of Histology, University of Pavia, Pavia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Graziano
authors.affiliation: Department of Experimental Medicine, Tissue Engineering and Regenerative Medicine Laboratory, Second University of Naples, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Spina
authors.affiliation: Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Turin, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Ercoli
authors.affiliation: Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Turin, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Audagna
authors.affiliation: Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Turin, Italy.
authors.forename: G M
authors.initials: GM
authors.lastname: Mariani
authors.affiliation: Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Turin, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ferrarotti
authors.affiliation: Department of Surgical Sciences, C.I.R. Dental School, Section of Periodontology, University of Turin, Turin, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Aimetti
mesh_terms: D055113:Chronic Periodontitis / Q000601:surgery; D005260:Female; D005881:Gingiva / Q000601:surgery*; D005890:Gingivectomy / Q000379:methods; D005891:Gingivitis / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism; D053582:Interleukin-1alpha / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010010:Osteoclasts / Q000378:metabolism*; D010865:Pilot Projects; D054380:Receptors, CXCR5 / Q000378:metabolism
chemical_list: C095085:CXCR5 protein, human; C508584:IL1A protein, human; D053582:Interleukin-1alpha; D054380:Receptors, CXCR5; D007371:Interferon-gamma
keywords: bone loss/periodontal; bone resorption; inflammation mediators; periodontitis/surgery