Unifocal Langerhans cell histiocytosis of the oral mucosa.

A 24-year-old man was admitted for a painful gingival ulcer. Histology and immunohistochemistry of a lesional biopsy revealed the diagnosis of Langerhans cell histiocytosis (LCH). To rule out multifocal disease, a complete staging was performed. There was no evidence of bony lesions or any other organ involvement. The diagnosis of LCH restricted to the oral mucosa was established. The complete oral lesion was ablated by CO(2) laser and subsequently treated topically with triamcinolone acetonide. The patient is still in remission after one year of follow-up. LCH confined to the oral mucosa is rare. It presents usually as an inflammatory or ulcerative lesion, easily leading to misinterpretation and delayed diagnosis. Patients with limited unifocal mucocutaneous disease, as in the present case, usually have an excellent prognosis. However, the oral lesion may represent an early sign of LCH, predating and progressing to an aggressive life-threatening multiorgan disease.

[Sinus floor elevation and implantation--a retrospective study]. / Sinusbodenelevation und Implantation--eine retrospektive Untersuchung.

A retrospective analysis of sinusfloor elevation and implantation should evaluate in a sense of quality control the clinical results and complications during or after sinusfloor elevation. In our institution we performed 98 sinusfloor elevations in 80 patients (44 women, 36 men) between August 9, 1995 and November 18, 2002. In those elevated sinuses, 201 implants were inserted till October 16, 2003. Dates were sampled from the patient medical histories. Sinusfloor elevation and implantation in posterior maxillary bone have a good prognosis. Nevertheless implant survival depended on the chosen implant system (Kaplan-Meier-analysis). Implant survival was 98% for Straumann implants and 80% for Frialit-II implants after two years. A significant correlation between Frialit-II implants and Straumann implants (p=0.0119) was identifiable. There was no difference in healing between different augmentation materials (autogenous bone, Ceros 82, Algipore), but case numbers were too small for a relevant validity. In one-stage procedures implant loss was 8%, in two-stage procedures it was 18%. Implant losses in smokers were generally higher than in non-smokers. The period of consolidation of the augmentation's material introduced in two-stage procedures was about 10.3 months, healing time of implants 9.2 months. In one-stage procedures healing time of implants was about 7.7 months. Membrane perforations during surgery occurred in 11% and were not related to the development of postoperative sinusitis as described in literature.

[Proliferative verrucous leukoplakia]. / Proliferative verruköse Leukoplakie. Ein Fallbericht.

Proliferative verrucous leukoplakia (PVL) is a seldom form of oral leukoplakia (OL) with high transformation tendency. It starts as a bold hyperkeratosis changing into an exophytic verrucous form spreading in the oral cavity. The clinical diagnosis therefore is a retrospective one.

Metastases and primary tumors around dental implants: A literature review and case report of peri-implant pulmonary metastasis.

OBJECTIVE: To perform a literature review on peri-implant metastases and primary malignoma and report a case of a pulmonary metastasis around dental implants of the anterior mandibular jaw that mimicked peri-implantitis. METHOD AND MATERIALS: A literature search of publications from June 1980 to June 2011 in the PubMed/Medline database was performed to collect information about the type, incidence, and localization of malignant primary tumors and metastases around dental implants and to evaluate potential risk factors. A descriptive statistic was performed based on the collected data with regard to the type and/or origin of tumor, its localization, and the patient's age and sex. RESULTS: A total of 1,795 articles were considered for evaluation. Peri-implant metastases are described in three articles, and peri-implant primary tumors were found in 14 publications. Of all peri-implant metastases, no associated risk factors are mentioned. Those of the peri-implant tumors are alterations of the peri-implant mucosa (such as oral lichen planus, verrucous leukoplakia, and ulcer). Most of the primary tumors are squamous cell carcinoma. The mean age of the patients with peri-implant metastases was 68 years; for the peri-implant primary tumors, it was 71 years. CONCLUSION: Peri-implant metastases and primary tumors are rare. Every untypical or refractory reaction to the treatment of peri-implantitis is suspicious for malignancy as long as the contrary remains unproven.