Systematic Review of Experimental Gingivitis Induction Methods: Methodological Variations and Their Impact on Inflammation Progression.

AIM: The purpose of this systematic review was to evaluate methodological variations and outcome patterns in experimental gingivitis studies in human populations. Specifically, differences in induction duration, plaque control strategies, participant characteristics, and their influence on clinical, molecular, and immunologic markers of gingival inflammation were assessed.

METHODS

A systematic review of clinical trials and interventional studies involving experimental gingivitis induction via oral hygiene cessation or mechanical plaque accumulation was conducted. Eligible studies involved human participants and reported clinical (gingival index, bleeding on probing, plaque index) or biomarker outcomes. Data sources included peer-reviewed publications obtained through comprehensive database searches. Risk of bias and study quality were assessed. Findings were synthesized narratively due to heterogeneity in design and outcome measures.

RESULTS

The included studies (n = 10) varied in induction duration (9-28 days) and plaque accumulation method (full-mouth vs stent-based models). Clinical indicators consistently increased during induction phases, though magnitudes varied by methodology and participant profile. Studies identified "fast", "slow", and "low" responder phenotypes, underscoring inter-individual variability. Increased pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) and transcriptomic shifts were observed during active inflammation, with reversal during recovery. Methodological inconsistencies and a lack of standardization limited cross-study comparability.

CONCLUSION

Experimental gingivitis (EG) models reliably induce acute, reversible inflammation. However, methodological heterogeneity and insufficient adjustment for patient-related confounders hinder direct comparisons. Future research should adopt standardized protocols and incorporate stratified analyses to refine causal insights and support clinical translation.