ArticleBMC oral health2025
A comparative immunohistochemical and histomorphometric analysis of human gingiva in smokers and non-smokers with periodontitis : a cross-sectional study.
Article in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- The association between periodontal disease and lung cancer: a re-evaluation of independent causal relationships in the presence of smoking as a confounder and an exploration of potential mechanisms.Frontiers in cellular and infection microbiology · 2026Review
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4 authors.
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Abstract
aimThis cross-sectional study aimed to investigate histological, immunohistochemical, and histomorphometric differences in gingival epithelial thickness, vascular elements, and connective tissue in smokers vs. non-smokers with Stage II Grade B generalized periodontitis.
methodsSixty gingival tissue samples [smokers (n = 30) and non-smokers (n = 30)] were harvested from patients undergoing modified Widman flap surgery. All participants were systemically healthy, with probing pocket depth (PPD) ≤ 5 mm and clinical attachment loss of 3-4 mm. Histological analysis was performed using hematoxylin & eosin staining, Masson's trichrome staining, and immunohistochemical staining with CD34 and CD105. Morphometric evaluations, including epithelial thickness, epithelial cell and nuclear area, collagen fibre density, and microvascular density, were conducted using an image analysis software. Statistical comparisons between groups were analyzed using unpaired t-tests, Pearson correlation and multivariate linear regression with p-values < 0.05 considered significant.
resultsSmokers exhibited significantly increased gingival epithelial thickness (p = 0.001), epithelial cell area (p < 0.001), and nuclear area (p < 0.0001) compared with non-smokers. The collagen fibre density was reduced in smokers (p < 0.0001). Microvascular density (MVD) was did not differ in smokers (p = 0.001), but vascular calibre [CD34, (p = 0.89)] and neovascular potential [CD105, (p = 0.99)] were comparable between groups.
conclusionSmoking induces significant histological and vascular changes in the gingiva, including epithelial thickening, reduced collagen density, and decreased microvascular density, while maintaining the neovascular potential. These findings highlight smoking as a critical modulator of periodontal tissue pathogenesis, and reinforce the importance of smoking cessation in mitigating periodontal disease progression.
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