Changes in the distribution of nerve fibers immunoreactive to calcitonin gene-related peptide according to growth and aging in rat molar periodontal ligament

Calcitonin gene-related peptide regulates periodontal tissue regeneration

Calcitonin gene-related peptide (CGRP), a neuropeptide composed of 37 amino acids secreted from the sensory nerve endings, reportedly possesses various physiological effects, such as vasodilation and neurotransmission. Recently, there have been increasing reports of the involvement of CGRP in bone metabolism; however, its specific role in the pathogenesis of periodontitis, particularly in the repair and healing processes, remains to be elucidated. Therefore, this study aimed to investigate dynamic expression patterns of CGRP during the destruction and regeneration processes of periodontal tissues in a mouse model of experimental periodontitis. We also explored the effects of CGRP on periodontal ligament cells, which can differentiate to hard tissue-forming cells (cementoblasts or osteoblasts). Our findings demonstrated that CGRP stimulation promotes the differentiation of periodontal ligament cells into hard tissue-forming cells. Experimental results using a ligature-induced periodontitis mouse model also suggested fluctuations in CGRP expression during periodontal tissue healing, underscoring the vital role of CGRP signaling in alveolar bone recovery. The study results highlight the important role of nerves in the periodontal ligament not only in sensory reception in the periphery, as previously known, but also in periodontal tissue homeostasis and tissue repair processes.

Microcirculation and somatosensory profiling of patients with periodontitis: a preliminary case control report

OBJECTIVES

The purpose of this preliminary study was to explore blood microcirculation and somatosensory profiles in periodontitis patients before and after non-surgical periodontal therapy.

MATERIALS AND METHODS

Twenty patients (10 men and 10 women, 20 to 30 years old) and 20 age- and gender-matched healthy controls were included. Non-surgical periodontal therapy was performed for all patients. Clinical examination including pocket probing depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP) were performed at baseline (BL), 1 week (1W), and 4 weeks (4W) after non-surgical periodontal therapy on 6 sites of tooth 32 and 42. Laser Doppler flowmetry (LDF) and quantitative sensory testing (QST) were applied at the attached gingiva of tooth 32 and 42 at BL, 1W, and 4W after non-surgical periodontal therapy. Data were analyzed with a two-way mixed-model of ANOVA.

RESULTS

The PPD, CAL and BOP significantly improved after non-surgical periodontal therapy (p < 0.001). Periodontitis patients demonstrated a higher tissue microvascular blood cell concentration (p = 0.015) and a significant gain in thermal (p = 0.037) and mechanical (p = 0.003) somatosensory function compared to controls. After non-surgical periodontal therapy, the flux (p = 0.002) and speed (p = 0.008) of blood flow decreased significantly and thermal (p = 0.029) and mechanical (p < 0.001) somatosensory function were reversed.

CONCLUSION

Gingival microcirculation and somatosensory function seem impaired in patients with periodontitis and are reversed following non-surgical periodontal therapy.

CLINICAL RELEVANCE

LDF and QST may be appropriate tools to further characterize gingival inflammation and treatment responses in periodontitis.

Periodontal CGRP contributes to orofacial pain following experimental tooth movement in rats

Calcitonin-related gene peptide (CGRP) plays an important role in orofacial inflammatory pain. The aim of this study was to determine whether periodontal CGRP contributes to orofacial pain induced by experimental tooth movement in rats. Male Sprague-Dawley rats were used in this study. Closed coil springs were used to deliver forces. Rats were euthanized on 0d, 1d, 3d, 5d, 7d, and 14d following experimental tooth movement. Then, alveolar bones were obtained for immunostaining of periodontal tissues against CGRP. Two hours prior to euthanasia on each day, orofacial pain levels were assessed through rat grimace scale. CGRP and olcegepant (CGRP receptor antagonist) were injected into periodontal tissues to verify the roles of periodontal CGRP in orofacial pain induced by experimental tooth movement. Periodontal CGRP expression levels and orofacial pain levels were elevated on 1d, 3d, 5d, and 7d following experimental tooth movement. The two indices were significantly correlated with each other and fitted into a dose-response model. Periodontal administration of CGRP could elevate periodontal CGRP expressions and exacerbate orofacial pain. Moreover, olcegepant administration could decrease periodontal CGRP expressions and alleviate orofacial pain. Therefore, periodontal CGRP plays an important role in pain transmission and modulation following experimental tooth movement. We suggest that it may participate in a positive feedback aiming to amplify orofacial pain signals.

Healing of periodontal defects and calcitonin gene related peptide expression following inferior alveolar nerve transection in rats

The roles of nerve and neuropeptides in the process of bone formation and remolding have been studied previously. However, the effects of nervous system and neuropeptide on periodontal alveolar bone formation remained unknown. The aim of this study was to assess the effect of innervation on regeneration of alveolar bone and expression levels of calcitonin gene related peptide (CGRP) in periodontal tissues of rats, so as to have a better understanding of the effect of nerve and its related neuropeptide on periodontal tissue regeneration. Rats received transection of the left inferior alveolar nerve and a surgery to produce bilateral periodontal defect, then the alveolar tissue was obtained from animals of each group at week 1, 2, 4, 6 and 8 weeks after operation, respectively. Hematoxylin and eosin staining, and Masson staining were performed to evaluate the ability to restore and repair periodontal tissues at 4, 6 and 8 after surgery. Then new bone formation area and mineralized area were quantified using imagepro-plus6.0 software after pictures were taken under the microscope and SPSS17.0 was used for statistical analysis. Immunohistochemical staining was applied to investigate the expression of CGRP at 1, 2, 4, 6 and 8 weeks. Rats received transection of the left inferior alveolar nerve surgery and were then sacrificed at day 1, 3, 7, 14, 21, 28 after the operation. The change of CGRP expression in periodontal tissue was detected using immunohistochemical methods. The results showed that the volume of new bone formation was not significantly difference between the experimental and control groups, but the mineralized new bone area between the two groups was statistically significant. The level of CGRP expression was lower than normal at week 1, and then it began to rise in the next stage. The plateau, at higher than normal level, was reached at 6 weeks post-surgery. Results of transection of the left inferior alveolar nerve demonstrated the expression of CGRP was decreased in early stage; it reached the lowest level at day 7. Then the expression level began to increase until it returned to normal level at day 28. The results of this study suggest that nerve and its related neuropeptide CGRP are the important factors that can affect the quality of regenerated alveolar bone by reducing bone density during the mineralization process.