The purpose of this study was to examine the effect of smokeless tobacco (ST) on gingival inflammation as assessed clinically and biochemically by gingival crevicular fluid (GCF) levels of PGE2, IL-1 alpha, and IL-1 beta. These parameters were compared in ST users (n = 12) and control, non-tobacco using subjects (n = 8) matched for plaque and probing depth levels. Both GI and GCF PGE2 concentration were significantly (P < 0.05) elevated at ST placement sites compared to sites in control subjects. A short-term longitudinal trial spanning 7 days also was undertaken within ST users (n = 18) to study the dynamics of gingival inflammation when ST is moved to a new site. At day 0 habitual ST placement sites exhibited a significantly (P < 0.05) higher GI compared to non-tobacco placement sites. Following transfer of ST to a new placement site, 48 hour GI scores were increased (P < 0.05) at this region. Although GCF parameters were not significantly altered, over 80% of the subjects developed dramatic inflammatory reactions in the alveolar mucosa, ranging from erythema to ulceration, at the new site of placement. This observation of a more severe response in alveolar mucosa compared to gingiva may be related to the physical location of ST or differences in tissue characteristics.
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