Un caso singular de granuloma de cèlulas plasmáticas y actinomicosis en encía / A singular case of plasma cell granuloma and actinomycosis in the gum

Antecedentes: El granuloma de cèlulas plasmáticas (GCP) es una patología poco común que se caracteriza por una lesión roja e hiperplasia que presenta una gran afinidad a cualquier tejido blando con mayor frecuencia a nivel pulmonar y de manera poco usual a nivel oral como los labios, lengua y encía como un caso muy singular, histológicamente se caracteriza por un gran número de cèlulas plasmáticas. Objetivo: Reportar un caso poco común de GCP en encía con el abordaje, complicaciones y èxito del tratamiento del mismo. Descripción del caso: paciente femenino de 60 años de edad, acude a consulta por una lesión roja nivel de la encía marginal y adherida del maxilar superior. Al examen intraoral se observa una hiperplasia localizada Con diagnostico presuntivo de granuloma de cèlulas plasmáticas, donde se le realizaron exámenes radiográficos, posteriormente una biopsia, confirmando dicho diagnóstico. Conclusión: GCP se caracteriza clínicamente por presentar una hipertrofia gingival en la encía adherida, una de los lugares menos frecuentes a nivel oral. Esta patología al presentar ciertas similitudes clínica e histológicamente es muy difícil realizar un correcto diagnóstico de dicha patología (AU)

Background: Plasma cell granuloma (PCG) is an uncommon pathology characterized by a red lesion and hyperplasia that has a high affinity to any soft tissue, more frequently at the lung level and in an unusual way at the oral level such as lips, tongue and gingiva as a very unique case, histologically characterized by a large number of plasma cells. Objective: To report a rare case of GCP in the gingiva with the approach, complications and success of its treatment. Description of the case: a 60-year-old female patient comes to the clinic for a red lesion at the level of the marginal and attached gingiva of the upper jaw. Intraoral examination revealed localized hyperplasia with a presumptive diagnosis of plasma cell granuloma, where radiographic examinations were performed, followed by a biopsy, confirming said diagnosis. Conclusion: GCP is clinically characterized by presenting gingival hypertrophy in the attached gingiva, one of the least frequent places at the oral level. This pathology, as it presents certain clinical and histological similarities, is very difficult to make a correct diagnosis of said pathology. (AU)

Gingival and alveolar mucosal reactive hyperplastic lesions: a retrospective clinical and histological study of 996 cases

Background: gingival/alveolar mucosal reactive hyperplastic lesions (GRHL), including fibrous hyperplasia (FH), pyogenic granuloma (PG), peripheral ossifying fibroma (POF) and peripheral giant cell lesion (PGCL), are a common group of oral diseases. The aim of the present study was to access the frequency and distribution of the clinical and histological features of these disorders in a Brazilian population. Material and methods: all specimens diagnosed as GRHL in three Oral Pathology laboratories were selected for the study. Clinical information was retrieved from the laboratory biopsy forms and hematoxylin and eosin stained histological slides were reviewed for analysis of the histological characteristics. Results: final sample was composed of 996 specimens, including 463 FH (47%), 280 PG (28%), 183 POF (18%) and 70 PGCL (7%). Females were more affected by FH, PG, and POF, and most cases affected adults with mean ages ranging from 40 to 53 years. FH, PG, and POF were more common in the upper gingiva/alveolar mucosa. Most PG, POF and PGCL were pedunculated, in contrast with FH (p<0.001). PG, FH and POF were mostly red or normal mucosal in color, while PGCL were mostly red/purple (p<0.001). PGCL were larger, followed by POF, FH and PG (p<0.001). Some histological features were characteristically found in some conditions, but they were also encountered in other lesions with variable frequencies. Conclusions: Oral medicine specialists, oral pathologists and periodontists are usually the professionals in contact with patients presenting GRHL and it is of upmost relevance that they should be familiarized with their clinical and histological profile. (AU)

Oral paracoccidioidomycosis: a retrospective study of 95 cases from a single center and literature review

Background: The ecoepidemiological panorama of paracoccidioidomycosis (PCM) is dynamic and still ongoing in Brazil. In particular, data about the oral lesions of PCM are barely explored. The aim of this study was to report the clinicopathological features of individuals diagnosed with oral PCM lesions at an oral and maxillofacial pathology service in Rio de Janeiro, Brazil, in the light of a literature review. Material and methods: A retrospective study was conducted on oral biopsies obtained from 1958 to 2021. Additionally, electronic searches were conducted in PubMed, Embase, Scopus, Web of Science, Latin American and Caribbean Center on Health Sciences Information, and Brazilian Library of Dentistry to gather information from large case series of oral PCM. Results: Ninety-five cases of oral PCM were surveyed. The manifestations were more frequent among males (n=86/90.5%), middle-aged/older adults (n=54/58.7%), and white individuals (n=40/51.9%). The most commonly affected sites were the gingiva/alveolar ridge (n=40/23.4%) and lip/labial commissure (n=33/19.3%); however, one (n=40/42.1%) or multiple sites (n=55/57.9%) could also be affected. In 90 (94.7%) patients, "mulberry-like" ulcerations/moriform appearance were observed. Data from 21 studies (1,333 cases), mostly Brazilian (90.5%), revealed that men (92.4%; male/female: 11.8:1) and individuals in the fifth and sixth decades of life were the most affected (range: 7-89 years), with the gingiva/alveolar ridge, palate, and lips/labial commissure being the sites most frequently affected. Conclusions: The features of oral PCM lesions are similar to those reported in previous studies from Latin America. Clinicians should be aware of the oral manifestations of PCM, with emphasis on the clinicodemographic aspects and differential diagnoses, especially considering the phenomenon of the emergence of reported cases in rural and/or urban areas of Brazil. (AU)

Peripheral ossifying fibroma: A 20-year retrospective studywith focus on clinical and morphological features

Background: Peripheral Ossifying Fibroma (POF) is a reactive hyperplastic lesion that exclusively occurs in thegingiva and is characterized by the deposition of dystrophic calcification, cementum-like tissue, and immatureand mature bone within the connective tissue. The objective of the present study was to perform a retrospectiveanalysis of clinicopathologic features of POF.Material and Methods: Clinical and histopathological data were obtained from biopsy records and histopathological reports from a Brazilian reference service in Oral Pathology (1999 - 2020). Morphological analysis wasperformed to evaluate features related to the mesenchymal component, inflammatory infiltrate, ulceration, andmineralized tissue.Results: A total of 270 POFs were diagnosed during the study period. A higher frequency was observed in females(71.9%) between the third (22.9%) and fourth (23.3%) decades of life. The anterior upper gingiva (29.1%) wasthe most affected region. Mature (86.7%) and immature (52.6%) bone tissue were the most frequent. There was asignificant association between immature bone deposition and lesions with size ≤ 1.7 cm (p = 0.041); immaturebone and cement-like tissue deposition with an evolution time ≤ 16 months (p < 0.001); deposition of immaturebone and mesenchymal hypercellularization (p < 0.001); deposition of dystrophic calcification and the presenceof ulceration (p < 0.001).Conclusions: The clinical characteristics corroborate the findings in the literature. The heterogeneous distributionand quantity of mineralized tissues found in the analyzed cases support the theory that the different mineralizedtissues constitute a spectrum of clinical maturation of POF. (AU)

Histopathological analysis of soft tissue changes in gingival biopsied specimen from patients with underlying corona virus disease associated mucormycosis (CAM)

Background: Corona Virus Disease-2019 (COVID-19) is perhaps the disastrous medical emergencies that has ever hit globally with multiple strains. Amongst various sequelae, mucormycosis may be considered as the most debilitating one. Post COVID-19 mucormycosis is formally regarded as corona virus disease associated mucormycosis (CAM). The aim of the current paper is to present twelve cases of CAM with unique clinical presentation with a detailed histopathological correlation of the gingival biopsied material. Material and Methods: Twelve cases of CAM were included in the study who presented initially with non-purulent swelling of the gingiva. The clinic-demographic data pertaining to age, gender, location, laterality and presence of co-morbidities was collected along with histopathological examination of biopsied specimen. Results: The patients ranged from 31-65 years (mean age 47.33 years). There was a male predominance. Clearly, maxillary right gingiva was mostly affected and all cases presented with non purulent, non tender swelling of the gingiva. The incisional biopsy from the gingiva consistently showed pseudoepitheliomatous hyperplasia of the surface epithelium along with vacuolar degeneration, extensive stromal edema, massive mixed inflammatory reaction, congested blood vessels, hemorrhage and abundant multinucleated giant cells. Potassium hydroxide (10% KOH) mount served no additional diagnostic advantage. After two initial biopsies any suspected case of CAM with these features was treated with appropriate antifungal therapy and conservative excision. Conclusions: Gingival swelling with aforementioned histopathological features resembling post COVID-19 histological alterations could be alarming early signs of CAM and are candidate of prompt antifungal therapy rather than repeat biopsy for confirmation.(AU)

Bacteria associated with periodontal disease are also increased in health

BACKGROUND: The objective of this cross-sectional clinical study was to analyze the differences in the microbiome in gingival sulci of adult patients in the presence or absence of chronic periodontitis. MATERIAL AND METHODS: Patients with or without periodontal disease were included in this cross-sectional study. Subgingival biofilm samples were collected and analyzed by 16S massive pyrosequencing. Functional analyses were also performed. RESULTS: A total of 15 phyla, 154 genera and 351 species were detected globally. Differences between disease and non-disease samples were observed in all taxonomical levels which suggest functional profile changes in the community. It was found that the main species associated with non-disease samples were reduced in disease but not completely suppressed. Analysis of the functional potential of the biofilms revealed a significantly higher activity related to endocytosis and phosphatidylinositol signaling in the disease group but lower cell adhesion molecules. CONCLUSIONS: Specific differences between health and disease suggest functional profile changes in the community, although bacteria associated with periodontal disease are also increased in health. Transcriptome studies should be conducted to confirm and deepen metabolic dysfunctions

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Is measurement of the gingival biotype reliable? Agreement among different assessment methods

BACKGROUND: To determine agreement among the most commonly used methods for assessing the gingival biotype. MATERIAL AND METHODS: An electronic survey was sent to a sample of dentists practicing in Spain. The question-naire was based on the evaluation of 5 cases involving different gingival biotype assessment methods. Dentists were required to classify the cases as having a "thin", "thick" or "not able to classify" biotype. Each case was as-sessed using a frontal intraoral photo of the anterior teeth; an enlarged photo of the buccal aspect of the tooth with a periodontal probe inserted inside the sulcus; and the real thickness measured in mm with a calibrated needle. Agreement among the classifications was assessed using Cohen's kappa coefficient. RESULTS: A total of 104 surveys were analyzed. The most commonly used assessment method was visual evaluation of the morphology of the gingiva and the teeth (62.5%). Concordance among the three different methods was weak (kappa = 0.278). Agreement among the classification methods was greater in extreme cases (thinner and thicker gingival thickness). CONCLUSIONS: The most commonly used methods for assessing gingival biotype are not reliable. The three tested methods show poor to weak agreement, which leads to non-reliable estimation of the gingival biotype

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Perfil bacteriano del biofilm dental supragingival en niños con dentición temporal y mixta temprana utilizando la técnica de secuenciación de próxima generación (HOMINGS) / Bacterial profile of the supragingival dental biofilm in children with deciduous and early mixed dentition using next generation sequencing (HOMINGS) technique

OBJETIVO: Describir el perfil bacteriano del biofilm supragingival de niños con dentición temporal (NDT) y dentición mixta temprana (NDMT), con la técnica de secuenciación de próxima generación HOMINGS. MÉTODO: Se realizó un estudio descriptivo comparativo con 30 niños de 5 a 7 años de edad sistémicamente sanos de escuelas públicas de Cartagena (Colombia). Todos los participantes estaban libres de caries, según los criterios del Sistema Internacional de Detección y Evaluación de Caries (ICDAS II) y sin experiencia de caries según el índice de dientes cariados, perdidos y obturados (DCPO). Se recolectaron muestras de biofilm supragingival. Se extrajo el ADN bacteriano y se usó para su análisis mediante HOMINGS (identificación de microorganismos orales humanos utilizando secuenciación de próxima generación) basado en la secuenciación de la región V3-V4 del gen 16S rRNA con la plataforma Illumina MiSeq. RESULTADOS: Se identificaron 360 especies específicas y 65 géneros específicos de las sondas: Streptococcus, Actinomyces, Veillonella y Fusobacterium (29,2% del total de ADN bacteriano presente), mientras que en el grupo de dentición mixta temprana se encontraban Streptococcus, Leptotrichia, TM7 y Porphyromonas (24,5% del ADN bacteriano presente). Las especies bacterianas con mayor abundancia relativa en el microbioma oral de biofilm de NDT fueron Streptococcus sanguinis, Rothia aeria, Gemella haemolysans, mientras que en NDMT fueron S. sanguinis, Leptotrichia sp. HOT-417, Leptotrichia sp. HOT-498. El índice de diversidad de Shannon fue 2,77 (DE = 0,26) para NDT y 3,01 (DE = 0,39) para NDMT (p = 0,06). CONCLUSIONES: El análisis del perfil bacteriano del biofilm dental supragingival en niños con NDMT mediante HOMINGS mostró baja diversidad microbiológica tanto en presencia como en abundancia relativa a nivel de género y de especies bacterianas

OBJECTIVE: Tdescribe the bacterial profile of the supragingival biofilm of children with temporary dentition (CTD) and early mixed dentition (CEMD), with the next-generation sequencing (HOMINGS) technique. METHOD: A comparative descriptive study was carried out with 30 systemically healthy children aged between 5 and 7 years old from public schools in Cartagena-Colombia. All participants were caries-free applying the criteria of the International Caries Detection and Assessment System (ICDAS II) and had no caries experience according to the Decayed, Missing and Filled Teeth (DMFT) index. Supragingival biofilm samples were collected. Bacterial DNA was extracted and used for analysis using HOMINGS (Human Oral Microbe Identification using Next-Generation Sequencing) based on the sequencing of the V3-V4 region of the 16S rRNA gene using the Illumina MiSeq platform (V3-V4 primers). RESULTS: A total of 360 species-specific and 65 genus-specific probes were identified. The bacterial genus most predominant in CTD were Streptococcus, Actinomyces, Veillonella and Fusobacterium (29.2% of all bacterial DNA present), while in CEMD the most predominant were Streptococcus, Leptotrichia, TM7 and Porphyromonas (24.5% of all bacterial DNA present). The bacterial species with the highest relative abundance in the oral biofilm microbiome from CTD were Streptococcus sanguinis, Rothia aeria, Gemella haemolysans, while in CEMD they were S. sanguinis, Leptotrichia spp. HOT-417 and Leptotrichia spp. HOT-498. The Shannon diversity index was 2.77 (SD = 0.26) for CTD and 3.01 (SD = 0.39) for CEMD (P = 0.06). CONCLUSIONS: The analysis of the bacterial profile of the supragingival dental biofilm in children with DMFT, by means of HOMINGS showed low microbiological diversity both in presence and in relative abundance in terms of genus as well as bacterial species

Influencia del suero fetal bovino en el cultivo de fibroblastos gingivales / Influence of bovine fetal serum in the culture of gingival fibroblasts

Introducción: Los fibroblastos gingivales (FGs) son células responsables del mantenimiento de la homeostasis, cicatrización y tolerancia inmunitaria del tejido conjuntivo gingival. Por sus características fisiológicas, los FGs pueden ser un candidato en la terapia celular. Sin embargo, la conservación de su fenotipo en cultivo celulares requiere de condiciones estrictamente definidas. Una de ellas es la concentración de Suero Fetal Bovino (SFB). Nuestro objetivo es evaluar el efecto concentración-dependiente de la suplementación de SFB en el medio de cultivo sobre el comportamiento, crecimiento, proliferación y supervivencia de los fibroblastos gingivales humanos. Materiales y métodos: FGs fueron cultivados con DMEM (Dulbecco's modification of Eagle médium) y concentraciones de 0%, 0.5% y 10% de SFB durante tres semanas. Análisis morfológico, de proliferación e inmunohistoquímicos fueron llevados a cabo en el presente trabajo. Se llevó a cabo un análisis factorial de varianza (ANOVA) por medio el software R Project. Los resultados fueron considerados significativos con un valor de p<0,05. Resultados y Discusión: Los FGs cultivados con 10% de SFB alcanzaron un desarrollo morfológico más notorio y en menor tiempo comparados con los FGs cultivados a 0.5% y 0% de SFB. La efectividad de la concentración del SFB 0,5% fue mucho más alta en relación a la concentración del SFB 10%. La inmunodetención de la actina, vimentina y fibronectina fueron más notorias en los FGs tratados con 10% y 0.5% de SFB. Este estudio concluye que los FGs humanos presentan una mejor capacidad de supervivencia, desarrollo y proliferación cuando son cultivados en presencia de SFB

Introduction: Gingival fibroblasts (FGs) are cells responsible for the maintenance of homeostasis, healing and immune tolerance of the gingival connective tissue. Due to their physiological characteristics, FGs can be a candidate in cell therapy. However, the conservation of their phenotype in cell culture requires strictly defined conditions. One of them is the concentration of Bovine Fetal Serum (FBS). Our aim is to evaluate the concentration-dependent effect of SFB supplementation in the culture medium on the behavior, growth, proliferation and survival of human gingival fibroblasts. Materials and methods: FGs were cultured with DMEM (Dulbecco's modification of Eagle medium) and concentrations of 0%, 0.5% and 10% of SFB for three weeks. Morphological, proliferation and immunohistochemical analyzes were carried out in the present work. A factorial analysis of variance (ANOVA) was carried out using the R Project software. The results were considered significant with a value of p <0.05. Results and discussion: The FGs grown with 10% FBS reached a more noticeable morphological development and in a shorter time compared to the FGs grown at 0.5% and 0% FBS. The effectiveness of the concentration of the SFB 0.5% was much higher in relation to the concentration of the SFB 10%. The immunodetention of actin, vimentin and fibronectin were more evident in the FGs treated with 10% and 0.5% FBS. This study concludes that human FGs have a better capacity for survival, development and proliferation when they are grown in the presence of FBS

Effect of total sonicated Aggregatibacter actinomycetemcomitans fragments on gingival stem/progenitor cells

BACKGROUND: Aggregatibacter-actinomycetemcomitans (A.actinomycetemcomitans) are strongly associated with localized-aggressive-periodontitis (LAgP). The study's aim was to test for the first time the effect of total sonicated A.actinomycetemcomitans-bacterial-fragments on gingival mesenchymal stem/progenitor cells' (G-MSCs) proliferation and regenerative gene expression in-vitro. MATERIAL AND METHODS: G-MSCs were isolated, characterized, expanded and stimulated by total sonicated A.actinomycetemcomitans-bacterial-fragments (0 (negative-control), 15, 60, 120 and 240μg/ml; serovar-b; n=6/group). Cellular proliferation and NF-κβ (NFKB1), Alkaline Phosphatase (ALPL), Collagen-I (COL1A1), Collagen-III (COL3A1), Osteonectin (SPARC) and Osteopontin (SPP1) m-RNA expression were assessed via reverse-transcription-polymerase-chain-reaction (RT-PCR) at 24, 48 and 72 hours and CFUs-ability evaluated at twelve days. RESULTS: G-MSCs demonstrated stem/progenitor cells' characteristics. A.actinomycetemcomitans-bacterial-fragments (up to 72 hours) resulted in marked G-MSCs' proliferation over-time (p < 0.001) and elevated NFKB1 (p= 0.017), COL1A1 (p = 0.025), SPARC (p = 0.025), decreased ALPL (p = 0.017), with no significant differences for COL3A1 and SPP1 expression or stimulation times (p > 0.05; Friedman-test). Longer-term stimulation for twelve days reduced G-MSCs' CFUs. CONCLUSIONS: Sonicated A.actinomycetemcomitans-bacterial-fragments' exert beneficial short-term effects on G-MSCs' proliferative and non-mineralized tissue forming aptitude. Results shed new light on the importance of periodontal treatment for LAgP patients, using power driven sonic/ultrasonic devices, which, in addition to reducing the subgingival microbial load, produces cell-stimulatory A.actinomycetemcomitans-bacterial-fragments, with positive attributes on tissue reparative/regenerative responses of tissue resident stem/progenitor cells in their niche

A report on the clinical-pathological correlations of 788 gingival lesion

Background: The diagnosis and treatment of a variety of non-plaque related gingival diseases have become an integrated aspect of everyday dentistry. The aim of this study was to analyse the relationship between clinical appearance and histopathological features of gingival lesions in a large Northern Italian population. Material and Methods: A retrospective study of 788 cases of gingival and alveolar mucosal biopsies was set up. Statistical analysis was performed by calculating the odds ratio and 95% confidence interval (C.I.), in order to assess the degree of association between the clinical parameters considered (primary lesions) and the single pathologies, statistically evaluated by Mantel-Haenszel tests. The correlation between clinical and histological diagnosis was classified as follow: 1) expected data (ED): provisional clinical diagnosis; 2) real data (RD): final histopathology diagnosis; 3) concordant data (CD): correspondence between the expected data and real data. The correlation was calculated as follow: CC (complete concordance) = CD x 100 / ED, this expressing the percentage in which the clinical and the histological diagnosis overlapped. Results: The most frequently observed and biopsied primary lesions resulted to be exophytic, followed by mucosal colour changes and finally by losses of substance. The statistically significant association between primary lesion and their manifestation in gingival pathologies was reported. Volume increases, for instance, were positively correlated to plasma cell epulis, pyogenic granuloma, fibrous reactive hyperplasia and hemangioma. Verrucous-papillary lesions were most often seen in verrucous carcinoma, verrucous leukoplakia and mild dysplasia. White lesion resulted to be related to leukoplakia or oral lichen planus. Red lesions resulted to be related only oral lichen planus. Erosive vesicle-bullous lesions were linked to disimmune pathologies. Ulcerative lesions were positively associated to oral squamous cell cancer. Finally, potentially malignant disorders have the most percentage high concordance. Among the malignant lesions, the correlation increased up to the squamous cell carcinoma and leukaemia. Conclusions: This article presented the frequency and the clinico-pathological concordance of all primary lesions and the histopathological diagnosis of gingival lesions. For every primary lesion, it is possible to correlate a specific histopathological diagnosis in a statistical manner. This can be a valuable aid for not specialist clinicians who daily observe mucosae and have the opportunity to intercept major diseases (AU)

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Histological differences in the adherence of connective tissue to laser-treated abutments and standard abutments for dental implants. An experimental pilot study in humans

Background: The goal of the current study is to assess the difference in connective tissue adherence to laser microtextured versus machined titanium abutments. Material and Methods: Six patients were selected and each of them received 2 implants, one combined with a laser treated abutment and one with a machined abutment. After three months, the abutments were retrieved together with their surrounding gingival tissue for histological analysis. Qualitative and quantitative evaluation of microscopical images was performed to assess the presence or absence of adherence between the soft tissues and the abutment, and the percentage of soft tissue adhered to the two different surfaces. Results: Intimate adherence between connective tissue and the laser treated abutments, while on machined abutments no adherence was detected. A significant difference was found in the percentage of surface in contact with soft tissue between both implant abutments p=0.03. Conclusions: Within the limitation of the current study, it can be concluded that connective tissues show enhanced adherence to microtextured abutments compared to machined abutments (AU)

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Sarcoma de Ewing extraóseo en cabeza y cuello: revisión de la literatura a propósito de un caso / Extraskeletal Ewing's sarcoma of the head and neck: a case report and a literature review

Introducción. El sarcoma de Ewing extraesquelético (SEE) es un tumor maligno muy poco frecuente. La región de la cabeza y el cuello es una localización primaria inusual para este tipo de tumor. Material y métodos. El objetivo de esta revisión es identificar las principales localizaciones dentro de cabeza y cuello. Para ello se realizó una búsqueda en la base de datos MEDLINE. Se analizaron múltiples variables. Se realiza la revisión a propósito un caso clínico de un paciente con SEE en la mejilla. Resultados. De un total de 31 pacientes, se reportan 18 casos en cabeza y 13 en cuello. Conclusiones. En nuestra revisión no pudimos determinar ninguna localización que sea de mayor frecuencia en esta región. Las pruebas de imagen son útiles para estadificar, y son necesarios estudios anatomopatológicos para confirmar el diagnóstico. El tratamiento intensivo es el de mayor eficacia (AU)

Introduction. Extraskeletal Ewing's sarcoma (EES) is a rare malignant neoplasm. It is a highly unusual finding in the head and neck region. Material and methods. The aim of this review is to identify the main sites in the head and neck region, by searching in the MEDLINE database. A wide range of variables were analysed. This review was carried out due to a case report of a patient with EES of the cheek. Results. Out of a total of 31 patients, there were 18 cases in the head and 13 in the neck. Conclusions. In our review it was not possible to determine a more frequent head and neck location. The imaging studies are useful for staging, and the histology to confirm the diagnosis. An aggressive treatment has demonstrated to be more effective (AU)

TLR expression profile of human gingival margin-derived stem progenitor cells

BACKGROUND: Gingival margin-derived stem/progenitor cells (G-MSCs) show remarkable periodontal regenerative potential in vivo. During regeneration, G-MSCs may interact with their inflammatory environment via toll-likereceptors (TLRs). The present study aimed to depict the G-MSCs TLRs expression profile. MATERIAL AND METHODS: Cells were isolated from free gingival margins, STRO-1-immunomagnetically sorted and seeded to obtain single colony forming units (CFUs). G-MSCs were characterized for CD14, CD34, CD45, CD73, CD90, CD105, CD146 and STRO-1 expression, and for multilineage differentiation potential. Following G-MSCsˇŻ incubation in basic or inflammatory medium (IL-1¦Â, IFN-¦Ă, IFN-¦Á, TNF-¦Á) a TLR expression profile was generated. RESULTS: G-MSCs showed all stem/progenitor cellsˇŻ characteristics. In basic medium G-MSCs expressed TLRs 1, 2, 3, 4, 5, 6, 7, and 10. The inflammatory medium significantly up-regulated TLRs 1, 2, 4, 5, 7 and 10 and diminished TLR 6 (pˇÜ0.05, Wilcoxon-Signed-Ranks-Test). CONCLUSIONS: The current study describes for the first time the distinctive TLRs expression profile of G-MSCs under uninflamed and inflamed conditions

Hereditary gingival fibromatosis: clinical and ultrastructural features of a new family

OBJECTIVE: This article describes the diagnosis, clinical and microscopic (histopathology and ultrastructural) features and treatment of a new family with hereditary gingival fibromatosis (HGF) and highlights the importance of this genetic condition. Study DESIGN: To characterize the pattern of inheritance and the clinical features, members of a new family with HGF were examined. The pedigree was reliably constructed including the four latest generations of family. Hematoxylin and eosin staining and ultrastructural analysis were performed with the gingival tissue. RESULTS: Examination of the family pedigree revealed that the patient III-2 represent the index patient of this family(initial patient with a mutation), which was transmitted to her daughter through an autosomal dominant mode of inheritance. The affected patients showed a generalized gingival overgrowth. The patient was treated with surgical procedures of gingivectomy and gingivoplasty. The diagnosis was confirmed by histopathology examination that showed a well-structured epithelium with elongated and thin papillae inserted in fibrous connective tissue with increased amount of collagen. The ultrastructural aspects of the tissue show collagen fibrils exhibiting their typically repeating banding pattern with some fibrils displaying loops at their end. Moreover, it was possible to seen in some regions fibrillar component presenting tortuous aspects and loss of the alignment among them. CONCLUSIONS: This HGF frequently resulted in both esthetic and functional problems. The genetic pattern of this Brazilian family suggested a new mutation, which was later transmitted by an autosomal dominant trait

Optimization of buffer solutions to analyze inflammatory cytokines in gingival crevicular fluid by multiplex flow cytometry

OBJECTIVE: the aim of this study was to test two buffer solutions in order to attain a reliable and reproducible analysis of inflammatory cytokines (IL-Beta, IL-6, TNF-alpha, OPG, OPN and OC), in gingival crevicular fluid (GCF)by flow cytometry. MATERIAL AND METHODS: GCF samples from healthy volunteers were collected with perio-paper strips and diluted either in phosphate buffered saline (PBS) or Tris-HCl buffer, with and without protease inhibitors (PI). Cytokine immunoassays were carried out by flow cytometry (Luminex Xmap 200) generating standard curves. RESULTS: standards curves generated with the use of phosphate-buffered saline (PBS) demonstrated best adjustment for cytokines IL-1beta, IL-6 and TNF- α levels, when using Tris-HCl (p < 0.05). CONCLUSIONS: The use of PBS buffer with the addition of PI provided reliable measurements of inflammatory bi-omarkers in GCF samples of healthy volunteers

Effect of posterior gingival smile on the perception of smile esthetics

OBJECTIVES: To evaluate and compare the influence of posterior gummy smile on the perception of smile esthetics by orthodontists, general-dentists and laypersons. Study DESIGN: A frontal photograph of a smile with normal gum exposure was chosen and manipulated digitally using Adobe Photoshop C3 to generate three further images with posterior gum exposure of 4, 6 and 8 mm. These four images were assessed by the three evaluator groups: orthodontists (n = 40), general-dentists (n=40) and lay-persons (n=40). Both orthodontists and dentists had at least ten years professional experience and lay-persons were aged between 40-50 years. The proportion of men to women was 20:20 in each group. Evaluators awarded a score to the smile esthetics of each image: 1=acceptable, 2=moderately acceptable, 3=unacceptable. Afterwards, each evaluator placed the four images in order of esthetic preference. RESULTS: No significant differences (p > 0.05) were detected between the three evaluator groups for the photo with-out posterior gummy smile. The perception of smile esthetics for a the 4mm posterior gummy smile (median for orthodontists=2, general-dentists= 1, lay-persons=1), the 6mm (median for orthodontists=2, general-dentists=1, laypersons=1) and the 8mm (median for orthodontists=3, general-dentists=2, laypersons=2) was significantly dif-ferent between orthodontists and the other two evaluator groups (p < 0.0017).The three evaluator groups coincided in placing the image with the 6mm gum exposure in first place in order of esthetic preference. CONCLUSIONS: Posterior gummy smile influences the perception of smile esthetics more negatively among ortho-dontists than the rest of the groups

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Técnicas para el manejo del tejido gingival en prótesis fija. Una revisión sistemática / Methods used in order to manage the gingival tissue in fixed prostheses. A systematic review

Antecedentes: Durante los tratamientos protésicos fijos, el proceso de impresión de dientes pilares puede verse afectado por la encía marginal, la hemorragia y los fluidos gingivales. El propósito de la retracción gingival es efectuar un desplazamiento temporal del margen gingival y control de los fluidos, para exponer adecuadamente la línea de terminación. Métodos de acción mecánica, mecánica-química y del campo de la cirugía son propuestos para este fin. Objetivo: Efectuar una revisión de literatura crítica sobre los distintos métodos de retracción gingival, al considerar la posibilidad de lesiones en los tejidos blandos y la efectividad de estos. Metodología: Se desarrolló una búsqueda de literatura en las bases de datos sciverse (science direct), Ovid (MEDLINE), Pubmed, Dentistry & Oral Sciences Source (EBSCO-Host) y Google scholar, desde 1970 hasta diciembre de 2011. Con palabras claves como: Gingival retraction, gingival retraction methods, retraction cords, retraction agents, electrosurgery, tissue displacement. Una vez obtenida una muestra, se efectuó la confrontación con la literatura por medio de una discusión. Resultados y discusión: El sondeo de artículos bajo ciertos criterios permitió la selección final de una muestra de 8 artículos. Las comparaciones sobre resultados clínicos e interacción con los tejidos son frecuentes, y los resultados no son homogéneos, por lo que distintos puntos de vista y tratamientos son sugeridos (AU)

Background: During the fixed prosthetic treatments, the printing process abutment teeth can be affected by the marginal gingiva, bleeding and gingival fluids. The purpose of gingival retraction is to get a temporary displacement of the gingival margin and control of fluids, from properly expose the finish line. Methods of mechanical action, chemical and mechanical-surgery field are proposed for this purpose. Objective: We conducted a critical literature review on the different methods of gingival retraction, when considering the possibility of damage soft tissue and the effectiveness to them. Methods: We developed a literature search in the databases sciverse (science direct), Ovid (MEDLINE), PubMed, Dentistry & Oral Sciences Source (EBSCO-Host) and Google Scholar, since 1970 to December 2011. Using keywords like: Gingival retraction, gingival retraction Methods, retraction cords, retraction agents, electrosurgery, tissue displacement. After obtaining a sample, we was compared it with the literature through a discussion. Results and discussion: The survey of articles under certain criteria it allowed the final selection of a sample of 6articles. Comparisons of clinical outcomes and interaction with tissue are frequent, and there are not results homogeneous, so that different positions and treatments are suggested (AU)

Presencia de micronúcleos en células epiteliales de encías, como marcador de inestabilidad cromosomal. Revisión sistemática / Presence of micronuclei in oral epithelium cells, as marker of chromosomal instability. Systematic review

Introducción. El daño genético es probablemente la causa más importante para el desarrollo de anomalías y enfermedades degenerativas pero son pocos los estudios que se centran en la medición y evaluación de los efectos genotóxicos de los productos que día a día van adquiriendo una mayor utilidad en la sociedad, las sustancias que hacen parte del ambiente, procedimientos médicos como radiación y agentes químicos, deficiencia de nutrientes como el ácido fólico, hábitos como alcoholismo, tabaquismo, drogadicción, stress, estilos de vida, al igual que factores genéticos tales como alteraciones en el metabolismo y/o reparación del DNA. Objetivo. Conducir un análisis crítico sobre el ensayo de micronúcleos como medida de inestabilidad genética, su aplicabilidad desde la odontología y su relación con el desarrollo del cáncer. Materiales y métodos. Se identificaron los artículos más relevantes mediante una búsqueda sistemática enbases de datos electrónicas como Ovid, Ebsco Host, Science Direct y Pubmed. Resultados. Se obtuvo un total de 282872 artículos de los cuales se seleccionaron los que cumplieron con los requisitos de inclusión y fueron posteriormente analizados y discutidos teniendo en cuenta título, autores, revista, año, volumen, mes y páginas. Conclusión. Los resultados del análisis de la revisión de la literatura apoyan la hipótesis que relaciona la frecuencia de micronúcleos con el desarrollo de cáncer partiendo del hecho que una proporción sustancial dela inestabilidad genética de las células cancerosas se debe a defectos estructurales específicos en la segregación cromosómica (AU)

Introduction. Damage of the genome is probably the most important cause of the development of anomalies and degenerative diseases but just few studies focus on measurement and evaluation of the genotoxic effects of products that every day are becoming more useful in our society, substances that are part of the environment, medical procedures such as radiation and chemical agents, nutrients deficiency like folic acid, habits as alcoholism, smoking, drug addiction, stress, lifestyle and genetic factors such as changes in metabolism and/or DNA repair. Objective. To guide a critical analysis of the micronucleus test as a measure of genetic instability, its applicability from dentistry and its relationship with cancer development. Materials and methods. The most relevant papers were identifies through a systematic search on electronic databases such as Ovid, Ebsco Host, Science Direct and PubMed. Results. A total of 282872 articles were obtained of which were selected which fulfilled the criteria inclusion and were subsequently analyzed and discussed taking into account title, author, journal, year, volume, month and page. Conclusion. The results of this analysis of the literature review support the hypothesis that frequency of micronucleus is related to cancer development based on the fact that a substantial proportion of genetic instability of cancer cells is due to specific structural defects in chromosome segregation (AU)

Morphology and dimensions of the dentogingival unitin the altered passive eruption

Objetives: This study define altered passive eruption (APE) and evaluate the morphology of the dentogingival unit.Material and Methods: 123 individuals subjected to clinical examination and parallel profile radiography of the upper central incisor. An evaluation was made of the correlation between the clinical diagnosis of APE and the degree of gingival overlap; by using a 19% overlap to define APE (Kappa concordance index = 0.7). The MannWhitney / Wilcoxon test was used to identify the variables influencing APE.Results: Statistically significant differences were observed between the teeth with and without APE: gingival width (p = 0.0073), clinical crown length (p = 0.0000), smiling exposed gums (p = 0.0000), bone crest thickness (p = 0.0030), connective tissue attachment thickness (p = 0.0003) and biological width (p = 0.0015). Conclusions: The APE is characterized by: a gingival overlapping of over 19% of the length of the anatomical crown, increased gingival width and gingival smile; furthermore is associated to a thick bone crest and connective tissue attachment. Statistical analysis confirms two morphological patterns of APE (AU)