In this study, E-cadherin expression was decreased and associated with increased N-cadherin expression, a hallmark of EMT.26, 27These changes will compromise the integrity of the gingival epithelial barrier, which is evident during periodontal disease initiation and progression.11, 22, 28This event is likely attributed to the microbial dysbiosis induced by the ligature as the literature indicates the role of these bacteria and their virulence factors in driving epithelial barrier function-related gene/protein expression via E-cadherin dysregulation. The gene discussed is CDH2; the disease is periodontal disorder.