Expression of type III collagen in hypertrophic gingival tissue of patients with orthodontic treatment: a pilot study




Gingival hypertrophy, Collagen, Immunohistochemistry, Orthodontics, Type III collagen


Introduction: gingival hypertrophy (GH) is the uncontrolled increase in gingival volume induced by different etiological factors, including orthodontic treatment. This pathology is characterized by changes in epithelial and connective tissue, including modifications in the extracellular matrix. The present study determined the presence and distribution of type III collagen in tissues of patients with GH wearing fixed orthodontic appliances. Methods: 12 samples of gingival tissue were obtained from patients undergoing periodontal surgery. They were divided into two groups, the first with healthy patients (control; n = 6) and the second with patients diagnosed with GH and orthodontic treatment (patients; n = 6). Each obtained sample was subjected to the hematoxylin-eosin stain, Masson-Goldner staining, and type III collagen immunohistochemistry. Results: the hematoxylin-eosin and Masson-Goldner histological stains showed hypertrophia of epithelial tissue and connective tissue with a marked collagen fiber increase in the gingival tissue of orthodontic wearers with GH compared to individuals in the control group. The gingival tissue of patients with GH caused by orthodontic treatment showed a distribution and location of type III collagen near the basal lamina, around the blood vessels, but unlike the control group, its location was noticeable throughout the connective tissue. Conclusion: the gingival tissues of orthodontic wearers with GH experience an increase in the number and density of collagen fibers. Type III collagen seems to lose its usual location in the gingival tissues of orthodontic wearers with GH.

= 242 veces | PDF
= 183 veces| | HTML
= 3 veces|


Download data is not yet available.

Author Biographies

Víctor Hugo Simancas-Escorcia, Universidad de Cartagena

DDS. Specialist in Pedagogy and Teaching. MSc in Cellular Biology, Physiology and Pathology. PhD in Physiology and Pathology, Université de Paris, France. Researcher at the GITOUC group, School of Dentistry, Universidad de Cartagena.

Jocsan Steven Leal-Betancur, Universidad de Cartagena

School of Young Researchers, GITOUC Group, School of Dentistry, Universidad de Cartagena, Colombia.

Antonio Díaz-Caballero, Universidad de Cartagena

DDS. Specialist in Periodontics. MSc in Education. PhD in Biomedical Sciences, Universidad de Cartagena. Head of the GITOUC Research Group. Professor, Universidad de Cartagena


Seixas MR, Costa-Pinto RA, Martins-Araujo T. Gingival esthetics: an orthodontic and periodontal approach. Dental Press J Orthod. 2012; 17(5): 190–201. DOI:

Alnazeh A, Kamran MA, Alshahrani I, Ali AH, Saad OM, Fahad A. Effect of fixed orthodontic appliance therapy on periodontal health status of patients evaluated through community periodontal index. J Biol Regul Homeost Agents. 2020; 34(3). DOI:

Rodríguez Vásquez AG, Fernández García LK, Valladares Trochez EH. Prevalencia de agrandamiento y retracción gingival en pacientes con tratamiento de ortodoncia. Portal de la ciencia. 2018; 13: 21-31. DOI:

Campolo González A, Nuñez Castañeda L, Romero Romano P, Rodriguez Schneider A, Fernandez Toro M, Donoso Hofer F. Agrandamiento gingival por ciclosporina: reporte de un caso. Rev Clin Periodoncia Implantol Rehabil Oral. 2016; 9(3): 226-30.

Hasan S, Khan NI, Reddy LB. Leukemic gingival enlargement: Report of a rare case with review of literature. Int J App Basic Med Res. 2015; 5(1): 65 – 67. DOI:

Stern J, Stern I, De Rossi S, Zemse S, Abdelsayed R. Kaposi sarcoma presenting as “diffuse gingival enlargement”: report of three cases. HIV AIDS Rev. 2016; 15(2) : 80-7. DOI:

Manzur-Villalobos I, Díaz-Rengifo IA, Manzur-Villalobos D, Díaz-Caballero AJ. Agrandamiento gingival farmacoinducido: serie de casos. Univ Salud. 2018; 20(1): 89-96. DOI:

Cacciola D, Muñoz G. Relación entre periodoncia y ortodoncia: complicaciones gingivales y efectos del tratamiento ortodóntico en el periodonto. Revista Biociencias. 2018; 13(2).

Zanatta FB, Ardenghi TM, Antoniazzi RP, Pinto TMP, Rosing CK. Association between gingivitis and anterior gingival enlargement in subjects undergoing fixed orthodontic treatment. Dental Press J Orthod. 2014; 19(3): 59-66. DOI:

Hosadurga R, Nabeel Althaf MS, Hegde S, Rajesh KS, Arun Kumar MS. Influence of sex hormone levels on gingival enlargement in adolescent patients undergoing fixed orthodontic therapy: a pilot study. Contemp Clin Dent. 2016; 7(4): 506-11. DOI:

Kapadia JM, Agarwal AR, Mishra S, Joneja P, Yusuf AS, Choudhary DS. Cytotoxic and genotoxic effect on the buccal mucosa cells of patients undergoing fixed orthodontic treatment. J Contemp Dent Pract. 2018; 19(11): 1358-62. DOI:

Gómez Arcila V, Mercado Camargo J, Herrera Herrera A, Fang Mercado L, Díaz Caballero A. Níquel en cavidad oral de individuos con agrandamiento gingival inducido por tratamiento ortodóncico. Rev Clin Periodoncia Implantol Rehabil Oral. 2014; 7(3): 136–41. DOI:

Drăghici EC, CrăiŢoiu Ş, MercuŢ V, Scrieciu M, Popescu SM, Diaconu OA, et al. Local cause of gingival overgrowth. Clinical and histological study. Rom J Morphol Embryol. 2016; 57(2): 427–35.

Şurlin P, Rauten AM, Pirici D, Oprea B, Mogoantă L, Camen A. Collagen IV and MMP-9 expression in hypertrophic gingiva during orthodontic treatment. Rom J Morphol Embryol. 2012; 53(1): 161–5.

Simancas-Escorcia Víctor, Díaz-Caballero Antonio. Fisiología y usos terapéuticos de los fibroblastos gingivales. Odous Científica. 2019; 20(1): 41-57.

Redlich M, Shoshan S, Palmon A. Gingival response to orthodontic force. Am J Orthod Dentofacial Orthop. 1999; 116(2): 152–58. DOI:

Gawron K, Ochała-Kłos A, Nowakowska Z, Bereta G, Łazarz-Bartyzel K, Grabiex A et al. TIMP-1 association with collagen type I overproduction in hereditary gingival fibromatosis. Oral Dis. 2018; 24(8): 1581-90. DOI:

Martelli-Junior H, Cotrim P, Graner E, Sauk JJ, Coletta RD. Effect of transforming growth factor-beta1, interleukin-6, and interferon-gamma on the expression of type I collagen, heat shock protein 47, matrix metalloproteinase (MMP)-1 and MMP-2 by fibroblasts from normal gingiva and hereditary gingival fibromatosis. J Periodontol. 2003; 74(3): 296-306. DOI:

Carlson R, Boyd K, Webb D. The revision of the Declaration of Helsinki: past, present and future.Br J Clin Pharmacol. 2004; 57(6); 695–713. DOI:

Ramirez A, Brunet L, Lahor E, Miranda J. On the cellular and molecular mechanisms of drug – induced gingival overgrowth. Open Dent J. 2017; 11: 420 – 35. DOI:

Pego S, De Faria P, Santos L, Coletta R, De Aquino S, Martelli-Junior H. Ultrastructural evaluation of gingival connective tissue in hereditary gingival fibromatosis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016; 122(1): 81 – 2. DOI:

Romanos GE, Schroter–Kermani C, Hinz N, Herrmann D, Strub JR, Bernimoulin JP. Extracellular marix analysis of nidefipine–induced gingival overgrowth: immunohistochemical distribution of different collagen types as well as the glycoprotein fibronectin. J. Periodont Res. 1993; 28(1): 10 – 6. DOI:

Pascu E, Psoschi C, Andrei A, Munteanu M, Rauten A, Scrieciu M et al. Heterogeneity of collagen secreting cells in gingival fibrosis: an immunohistochemical assessment and a review of the literature. Rom J Morphol Embryol. 2015; 56(1): 49–61.

Surlin P, Rauten AM, Mogoanta L, Silosi I, Oprea B, Pirici D. Correlations between the gingival crevicular fluid MMP8 levels and gingival overgrowth in patients with fixed orthodontic devices. Rom J Morphol Embryol. 2010; 51(3): 515–9.

Jadhav T, Bhat KM, Bhat GS, Varghese JM. Chronic inflammatory gingival enlargement associated with orthodontic therapy: a case report. J Dent Hyg. 2013; 87(1): 19–23.

Kantarci A, Augustin P, Firatli E, Sheff MC, Hasturk H, Graves DT et al. Apoptosis in gingival overgrowth tissues. J Dent Res. 2007, 86(9): 888–92. DOI:

Meng L, Huang M, Ye X, Fan M, Bian Z. Increased expression of collagen prolyl 4-hydroxylases in Chinese patients with hereditary gingival fibromatosis. Arch Oral Biol. 2007; 52(12): 1209–14. DOI:

Chen JT, Wang CY, Chen MH. Curcumin inhibits TGF-β1-induced connective tissue growth factor expression through the interruption of Smad2 signaling in human gingival fibroblasts. J Formos Med Assoc. 2018; 117(12): 1115-23. DOI:




How to Cite

Simancas-Escorcia, V. H., Leal-Betancur, J. S., & Díaz-Caballero, A. (2020). Expression of type III collagen in hypertrophic gingival tissue of patients with orthodontic treatment: a pilot study. Revista Facultad De Odontología Universidad De Antioquia, 32(2), 53–63.