Clinical features and treatment outcomes of immunoglobulin g4-related sclerosing sialadenitis.

Idiopathic enlargement of salivary glands used to be confusing in diagnosis until immunoglobulin G4 (IgG4)-related sclerosing sialadenitis was proposed as a possible answer. In this case series, we reported the clinical features and management outcomes in 16 patients with IgG4-related sclerosing sialadenitis. We retrospectively studied 16 patients in clinical examination, serology, pathology, and sonography features. All patients were treated by corticosteroids and followed up for at least 3 months. The results of clinical features showed that all of the patients presented persistent, symmetric bilateral swelling of the salivary glands, elevated levels of serum IgG4, and/or IgG4-positive plasmacytes infiltration and tissue fibrosis. The results of all autoantibody tests were negative. The typical sonographic manifestation revealed multiple hypoechoic foci with an irregular netlike diffuse lesion in salivary glands. Most patients showed excellent response to steroids treatment. We conclude that, for patients who present (1) symmetric swelling of bilateral salivary glands for more than 3 months, (2) elevated serum IgG4 level (>135 mg/dL), and (3) enlargement in bilateral salivary glands with multiple hypoechoic areas (irregular netlike appearance) in the sonography, the diagnosis of IgG4-related sclerosing sialadenitis should be considered. A comprehensive understanding of the medical condition and appropriate pathology examination are the key to diagnose. Steroids treatment is effective, and a treatment plan should be set up and followed in the long-term.

Lysine acetyltransferase 6A maintains CD4+ T cell response via epigenetic reprogramming of glucose metabolism in autoimmunity.

Augmented CD4+ T cell response in autoimmunity is characterized by extensive metabolic reprogramming. However, the epigenetic molecule that drives the metabolic adaptation of CD4+ T cells remains largely unknown. Here, we show that lysine acetyltransferase 6A (KAT6A), an epigenetic modulator that is clinically associated with autoimmunity, orchestrates the metabolic reprogramming of glucose in CD4+ T cells. KAT6A is required for the proliferation and differentiation of proinflammatory CD4+ T cell subsets in vitro, and mice with KAT6A-deficient CD4+ T cells are less susceptible to experimental autoimmune encephalomyelitis and colitis. Mechanistically, KAT6A orchestrates the abundance of histone acetylation at the chromatin where several glycolytic genes are located, thus affecting glucose metabolic reprogramming and subsequent CD4+ T cell responses. Treatment with KAT6A small-molecule inhibitors in mouse models shows high therapeutic value for targeting KAT6A in autoimmunity. Our study provides novel insights into the epigenetic programming of immunometabolism and suggests potential therapeutic targets for patients with autoimmunity.

Clinical, radiographic, and esthetic evaluation of immediate implant placement with buccal bone dehiscence in the anterior maxilla: A 1-year prospective case series.

OBJECTIVES: To evaluate the clinical, radiographic, and esthetic outcomes of immediate implant placement with buccal bone dehiscence in the anterior maxilla. METHODS: In this case series, implants were inserted immediately after tooth extraction in sockets with buccal bone dehiscence. Guided bone regeneration (GBR) with a papilla preservation flap and simultaneous connective tissue grafting (CTG) was used. The following outcome variables were measured: mid-facial mucosal recession, probing depth, bleeding on probing, Pink Esthetic Score (PES), marginal bone loss, and thickness of buccal bone plate (TBP). RESULTS: 12 patients were recruited. Stable mid-facial mucosal level (-0.03 ± 0.17 mm) and excellent soft-tissue esthetic outcomes (PES, 9.17 ± 0.72) were achieved at 1 year. The TBP at platform level was 2.01 ± 0.31 mm at 1-year follow up with a resorption rate of 28.90% ± 15.14%. CONCLUSIONS: Immediate implant placement using GBR performed with a papilla preservation approach and simultaneous CTG is a feasible treatment procedure in compromised extraction sockets in the anterior region. Favorable esthetic outcomes and buccal bone thickness were obtained. Further studies were needed to evaluate the long-term tissue alteration.

Early loading of ITI implants supporting maxillary fixed full-arch prostheses.

OBJECTIVE: To evaluate the predictability of the early-loaded sand-blasted, large-grit and acid-etched (SLA) implants supporting maxillary-fixed full-arch prostheses. MATERIAL AND METHODS: Ninety-one ITI SLA implants were placed in 12 edentulous maxillae. The impressions were taken at 4 weeks post-surgery. The abutments were tightened and the final fixed prostheses were cemented at 6 weeks after implant placement. Resonance frequency analysis (RFA) was conducted on the day of the surgery, at 4 and 6 weeks post-surgery. Panoramic radiographs were taken immediately after surgery, at 4 weeks post-surgery, immediately after prostheses attachment (baseline) and at the yearly follow-ups. RESULTS: The survival rate of implants was 98.90%. The success rate of prostheses was 100% during the follow-ups. The radiographic result showed no radiolucency around the implants and the marginal bone level revealed no significant resorption compared with the baseline. The marginal bone level remained coronally beyond the first thread. The RFA results revealed Implant Stability Quotient (ISQ) values of 63.44+/-4.32, 57.14+/-4.25 and 66.43+/-3.78 for the three time points. CONCLUSIONS: The findings of this study indicated that early loading of ITI implants supporting maxillary fixed full-arch prostheses should be predictable.

Evaluation of soft-tissue alteration around implant-supported single-tooth restoration in the anterior maxilla: the pink esthetic score.

PURPOSE: To evaluate the alterations of soft tissue around a single-tooth implant in the anterior maxilla with a new defined pink esthetic score (PES) at the time of crown placement and 6 months post-loading. MATERIAL AND METHODS: According to the case inclusion criteria, 29 patients subjected to single-tooth replacement with ITI implant-supported restoration in the anterior maxilla were included. Assessments of soft tissue after crown placement (baseline) and at 6 months (follow-up) were performed by two orthodontists with PES. RESULTS: No statistically significant difference was found between the two observers. PES for the single-tooth implant varied from 6.90 to 9.55 at 6-month follow-up. The scores of the mesial and distal papilla, level of soft-tissue margin, soft-tissue contour, soft-tissue color and soft-tissue texture increased significantly at follow-up. The highest percentage of improvement in PES was found in the cases scoring 0-4 at the baseline. CONCLUSIONS: The esthetic outcome of soft tissue around the single-tooth implant had improved significantly at follow-up compared with baseline according to PES assessment. The results suggested that the potential for significant changes in soft-tissue levels after restorative therapy needs to be considered for single-implant therapy in the anterior maxilla.

Function of the parotid gland in juvenile recurrent parotitis: a case series.

Our aim was to find out how the parotid gland functions in 44 patients with juvenile recurrent parotitis, and to assess the value of measuring the serum amylase activity. Clinical and personal details were recorded, and all patients had their serum amylase activity measured together with sialography during the chronic phase. The function of the gland was classified by sialographic images. The chi square test and Spearman's rank correlation coefficient were used in the statistical analyses. There was a significant association between the degree of glandular function and serum amylase activity (p=0.014). The patients with unilateral and bilateral disease differed significantly in their degree of glandular function (p=0.020), those with bilateral disease having poorer function. There were no significant correlations between other clinical variables and glandular function. Serum amylase activity is an important diagnostic variable in juvenile recurrent parotitis, and poor parotid function reflects the severity of the disease.

[Diagnostic value of dental implants in the posterior maxilla using cone beam computed tomography].

PURPOSE: To compare the diagnostic value of cone beam computed tomography (CBCT) with orthpantomography(OPG) for dental implants at the posterior maxilla. METHODS: 75 patients (89 positions) with dental implants in the posterior maxilla were assessed with CBCT and orthopantomography. The horizontal height from the top of the alveolar bone to the floor of sinus was measured through CBCT and OPG. The results were processed statistically with SPSS 11.5 software package for Chi-square test. RESULTS: Bone deficiency was detected in 30.34% and 16.85% cases by CBCT and OPG respectively with significant difference(P=0.034). Bone osteointegration was detected in 4.95% and 11.88% cases with CBCT and OPG respectively without significant difference(P=0.413). CONCLUSIONS: The quantity of bone could be evaluated more precisely by CBCT than OPG. The peri-implant bone could be demonstrated more clearly by CBCT than OPG.