الفهرس 
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Abstract
Epithelial- mesenchymal transition (EMT) is a process by which epithelial cells acquire a mesenchymal- like phenotype. This may be induced by exposure to gram- negative bacteria. However, it has been proposed that EMT is responsible for the pathogenesis of several diseases, the relationship between EMT process and the severity of periodontitis has not previously been investigated.
Therefore, the aim of this study was to investigate the possibility of the presence of EMT indicators (TGF- β1, Vimenten, E-Cadherin) in the gingival tissue samples taken from periodontally diseased individuals as compared to tissue samples taken from individuals with healthy gingival tissues. Methods: Total of 36 participants have been recruited in this study. The participants were divided according to their periodontal status into two main groups (healthy and periodntitis groups). The periodontitis group was further subclassified into mild, moderate and severe periodontitis subgroups, 9 patients in each group. Gingival tissue samples have been harvested during periodontal surgery and extraction of the periodontally hopeless teeth for the periodontitis patients. Healthy gingival tissues have been taken during the premolar extraction (Orthodontic ttt) or third molar extraction for the healthy controls.
The dissected gingival samples were processed to be embedded in paraffin wax. Sections of five microns were cut and mounted on glass slides then deparaffinized, rehydrated in descending grades of alcohol and subjected to histological staining by hematoxylin eosin and histomorphometric analysis by digital image analysis. Samples were also subjected to quantitative real-time polymerase chain reaction for transforming growth factor-β1, Vimenten and E-Cadherin.
Results: The H & E stained sections from the normal gingival group showed normal epithelium and connective tissue appearance with no clear signs of inflammation.
The H & E stained sections from mild periodontitis subgroup showed similar appearance to that of the healthy group with slight increase in the epithelial thickness and inflammatory cells count.
The H & E stained sections from both moderate and severe periodontitis subgroups showed epithelial hyperplasia, perinuclear haloing, flattening of the granular cell layer and marked increase in the inflammatory cells count that infiltrated both the epithelium and the CT as compared to to the control group.
Conclusion: There is a direct correlation between the severity of the periodontal disease and the expression of EMT process markers including TGF-β1 (growth factor) E-cadherin (epithelial marker) and vimentin (mesnecyhmal marker). This correlation supported that EMT plays an important role in the pathogenesis of the periodontal disease.