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Clinical Oral Investigations
Published in: Clinical Oral Investigations 9/2014

01-12-2014 | Original Article

Association study between clinicopathological variables and periodontal breakdown in gingival pyogenic granuloma

Authors: Leonor V. González-Pérez, Diana M. Isaza-Guzmán, Sergio I. Tobón-Arroyave

Published in: Clinical Oral Investigations | Issue 9/2014

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Abstract

Objective

The aim was to investigate a possible association between the immunoexpression of interleukin (IL)-4 and clinicopathological parameters with the periodontal breakdown observed in gingival pyogenic granuloma (PG).

Materials and methods

Paraffin-embedded samples of gingival PG (n = 46) were prepared for histological and immunohistochemical assessment. Demographic and clinical parameters were assessed by criteria based on age stratum, gender, smoking habit, evolution course, location, lesion size, macroscopic appearance, predisposing factors, recurrence, and periodontal breakdown. Histological assessment included the appearance of epithelial lining, microvessel density, inflammatory infiltrate density, interstitial fibrosis, and histological arrangement. A staining intensity distribution (SID) score was used to assess IL-4 immunoreactivity. The association between candidate predictor variables and periodontal breakdown was analyzed individually and adjusted for confounding using a bivariate binary logistic regression model.

Results

Mean IL-4 SID values were significantly increased for long-standing and large lesions, presence of periodontal breakdown, high microvessel density, and moderate-to-severe inflammatory infiltrate density. While bivariate and univariate analyses revealed a positive association of the evolution course ≥12 months, lesion size >1 cm, high microvessel density, moderate-to-severe inflammatory infiltrate density, and IL-4 SID score ≥8.04 with periodontal breakdown, after bivariate logistic regression analysis, only the evolution course ≥12 months, moderate-to-severe inflammatory infiltrate density, and IL-4 SID score ≥8.04 remained as robust predictors of periodontal damage. Confounding and interaction effects between candidate predictor variables were also noted.

Conclusion

These findings suggest that while evolution course, inflammatory infiltrate density, and the overexpression of IL-4 may act as predictors of periodontal breakdown in gingival PG, there are mutual confounding and synergistic biological interactive effects with respect to the lesion size and microvessel density in the susceptible host that may be also associated with the bone resorption and tissue destruction.

Clinical relevance

Although the first-line therapy of gingival PG continues to be the surgical excision, this approach poses unwanted complications such as severe mucogingival defects and recurrence. Hence, early diagnosis and detection of these three significant predictor variables as well as timely surgical excision might help prevent the periodontal tissue destruction observed in some of these lesions.
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Metadata
Title
Association study between clinicopathological variables and periodontal breakdown in gingival pyogenic granuloma
Authors
Leonor V. González-Pérez
Diana M. Isaza-Guzmán
Sergio I. Tobón-Arroyave
Publication date
01-12-2014
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 9/2014
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-014-1195-4

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