In most cases, gingivitis develops because of the accumulation of plaque (a soft, colorless substance composed of mucus, food particles, saliva and bacteria) on the teeth and gums. Regular toothbrushing and flossing prevents plaque but this needs to be organized based on a daily routine. If not inflamation of the gum tissue causing swelling and bleeding. Gingivitis is seens as warning flag pointing towards diseases as diabetes or leukemia.

Mast cells and gingivitis

Mast cells are the normal components of the connective tissues. Numbers of mast cells were found increased on inflamed tissues comparing to healthy tissues. This increase is closely related with the degree of inflammation ^[1] 

Mast cells are present in all tissues of the oral cavity and these cells clearly play a role in the development of oral inflammation. The bacteria Porhyromonas gingivalis is widely recognized as a major pathogen of gingivitis and periodontitis.

Experiments indicate that P. gingivalis activates mast cells to generate and release proinflammatory mediators and most probably mast cells are involved in the emergency of inflammatory processes evolved in response to P gingivalis infection.^[2] 

In periodontal disease mast cell numbers are increased and most probaby play a role in the destructive events as well as in the defense mechanism of periodontal disease via secretion of cytokines and cellular migration and healing processes.^[3]  

Detection of mast cells in gingiva in 1955: 

CARRANZA, F. A., and CABRINI, R. L. Mast Cells in Human Gingiva, Oral Surg., Oral Med., Oral Path., 8:1093, 1955.

STELLA, A. Sobre los mastzellen de la encia humana, Anales fac. odont. Montevideo, 2:125, 1955. 

Mast cell inhibition by adelmidrol (prodrug of palmitoylethanolamide) 

One animal model study showed that local administration of adelmidrol significantly decreased weight and neo-angiogenesis in granulomatous tissue.^[4] The working mechanism is simmilar to palmitoylethanolamide, and one of its mechanism is the inhibition of mast cell degranulation, and thus this novel molecule has an anti-inflammatory effect. ^[5] Just as other analogues, such as N-stearoyl ethanolamine is endowed with marked anti-inflammatory properties. All these ethanolamines are bioactive signalling lipids capable of downregulating inflammation.

Chronic gingiva inflammation can be a difficult to treat medical problem in dogs. A simmilar anti-inflammatory effect was observed in these dogs, treated with a adelmidrol gel to reduce gingival inflammation.^[6]Twenty dogs were randomised to the adelmidrol gel and placebo. After 30 and 45 days, the dogs using the adelmidrol gel had significantly less inflammation of the gingiva. 

In the vetenary world a product entered the market, Restomyl®, which can be used to aid the normalization of the oral mucosa in association with specialist dental procedures (e.g. scaling and polishing of teeth, tooth extractions, and reduction of periodontal pockets). Restomyl® can also be usefully used as an adjuvant in treating inflammatory and/or allergic periodontal disorders in dogs (e.g. gingivitis, stomatitis and periodontitis) and cats (e.g. chronic feline stomatitis), even in the presence of oral mucosal ulcers (e.g. indolent ulcers of the cat). 

Jan M. Keppel Hesselink, January 2011 

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