[Gingival hypertrophy due to cyclosporine. A clinico-statistical study in 82 patients]. / Ipertrofia gengivale da ciclosporina. Indagine clinico-statistica in 82 pazienti.

Eighty-two patients were observed at the Dental Department at Parma University. Seventy-six of them had renal transplant and 6 liver transplant. They were in immunosuppressive therapy with cyclosporina, 42 of them were also in calcium antagonist therapy. Gingival hypertrophy was observed in 52 subjects (63.4%) 25 (30%) patients underwent surgical operation, 6 of them (24%) showed a relapse about 3 months after the first operation. Clinical data were measured in accordance with 5 indicators: the level of oral hygiene, cyclosporinemia, contemporaneous use of calcium antagonist, the duration of therapy and the DMF index. By the results obtained, it's possible to suppose that the gravity of the disease is related to the contemporaneous use of calcioantagonist, but it wasn't highly significant (p < 0.05). The degree of oral hygiene was decidedly in relation to the most severe forms of gingival hyperplasia (grade 2-3), (p < 0.001). No relation was found for the duration of therapy, distribution of the DMF index and the level of drugs in the blood.

[Oral lichen planus (OLP). Therapeutic guidelines and clinical experience with 71 patients]. / Lichen planus orale (OLP). Orientamenti terapeutici ed esperienza clinica in 71 pazienti.

The authors report the results of a study performed in 71 patients suffering from lichen planus of the mucous membranes and skin. They discuss dermatological and stomatological clinical data in relation to possible basal diseases (hepatopathies, dermopathies, diabetes, hypertension, gastrointestinal diseases, etc.) and other anamnestic data (psychological aspects, drug taking, working activity, etc.). Moreover, they report the results of the clinical protocol used (betamethasone in a gel and vitamin A base) with a follow-up of 5 years and examine the other therapeutic possibilities reported in the literature.

[Gingival hypertrophy due to cyclosporine. A review of the literature]. / Ipertrofia gengivale da ciclosporina. Revisione della letteratura.

Cyclosporine is now the elective drug for immunosuppressive treatment in organ transplant patients. Compared to traditional immunosuppressants this molecule offers the therapeutic advantage that it does not act indiscriminately on all components of the immune system. In addition to the primary pharmacological action, cyclosporine also presents a number of undesirable effects, among which it is worth mentioning short and long-term nephrotoxicity and the development of neoplasia, in particular lymphomas. Other undesired effects of the drug are the possibility of overinfection, thrombosis, hypertension, hypertrichosis, hepatotoxicity and the development of the hypertrophic and hyperplastic gingival pathology.

Vallate, foliate and fungiform human papillae gustatory cells. An immunocytochemical and ultrastructural study.

We studied the classifications, topographic distribution and cellular lines of taste bud components in vallate, foliate and fungiform papillae of young, mature and old men with light microscopy, SEM, and TEM. By identifying ultrastructural and immunocytochemical characteristics, three distinct sensorial cells were identified, along with a few basal cells: dark type I cells, light type II cells and light type III cells. These cells extend from the epithelial basal lamina to the gustatory canal, where their apical cytoplasm sends long microvillous expansions. Excluding those of the fungiform papillae-which never go beyond the lower third of the gustatory canal, and are always void of dense substance-the microvillous expansions continue to the external border of the taste pore. Dark type I cells are rich in free ribosomes, tubular RER and large dense granules. Light type II cells with scarce ribosomes and RER, do not have enough peculiar ultrastructural characteristics to be considered effector or phagocyte elements. Light type III cells are characterizes by dense core vesicles whose peculiar ultrastructural characteristics in the foliate and vallate papillae, should be considered a consequence of different functional phases. After comparative evaluation the authors hypothesized on the functional value of some ultrastructural aspects and on the dense core vesicles which are immunoreactive to 5-HT. They observed that all gustatory cells are involved in taste transduction based on behaviours caused by microvilli in the gustatory canal and gustatory cell relationships with nerve endings. Moreover the authors noted that age does not seem to influence taste perception.

[11 cases of erythema multiforme. The etiological correlations and therapy]. / Undici casi di eritema multiforme. Correlazioni etiologiche e terapia.

Erythema multiforme (EM) is characterised by a polymorphous eruptive complex which many involve the cutis and oral, genital and conjunctival mucous. Its etiopathogenesis is unclear: it is thought to be associated with various viral or bacterial infective agents (herpes virus, Coxsackie virus, mycoplasmas, etc.), numerous drugs, physical therapy, systemic pathologies of various types. The authors report their experience in relation to 11 patients suffering from EM; the clinical characteristics of each case are reported, together with the course of disease, and the diagnostic and therapeutic protocol adopted. The discussion examines the possible cause of disease: in 5 patients the etiology was traced back to viral infections (4 herpes and 1 coxsackie) and to the administration of drugs in the remaining cases (4 in relation to anti-phlogistic agents and 2 regarding antibiotics).

Dimensional stability of silicone-based impression materials.

This study attempts to demonstrate that the polymerization reaction is not the only factor that affects the shrinkage of silicone-based impression materials because evaporation of the constituents also contributes to the shrinkage. These factors can be evaluated by the study of time-dependent dimensional changes. This is shown both by chemical kinetics and by experimental testing of condensation and addition polymerizing impression materials with different viscosities. Comparison of the different materials shows that the two contributions, polymerization shrinkage, and evaporation shrinkage, can be assessed separately by analysis of the time-dependent shrinkage diagrams. The instability due to the polymerization reaction is complete after a few hours, but the contribution of the constituent evaporation, if present, can have a significant long-term role.

[Functional velopalatal insufficiency. Therapeutic possibilities]. / Insufficienze funzionali velopalatine. Possibilità terapeutiche.

The function of the soft palate is complex; it takes part in speech, swallowing, and masticatory mechanisms. Its pathology ranges from morphological deficits to functional ones; these are commonly due to a central nervous system damage. The clinical analysis is based upon examination and instrumental prove, and leads to an optimum choice between surgical and prosthetic solutions. The latter is the best one in terms of quick execution, low costs and future possibilities of improvement.

[Individual cast posts for single anterior implants]. / Perni moncone individuali fusi per impianti singoli anteriori.

The Authors utilized in order to replace anterior missing teeth osseointegrated implants provided with individual angled posts. These types of abutment are used to allow a good parallel situation between implants with different angulation and also between implants and proximal teeth. The head of this abutment is thread to receive the screw that allows the crown to be fastened.

[Handicapped situations in dentistry]. / Situazione di handicap in odontoiatria.

Moving from the general definition of "handicap" "the Authors suggest a classification system based upon the most important altered function of a patient. A handicap situation happens when a patient needs special care in a dental office, both for particular oral changes due to his primary pathology or related therapy and for increased operatory risks.

[Headaches and craniofacial pains with dental involvement in the classification of the International Headache Society (1988)]. / Cefalee e algie cranio-facciali di interesse stomatologico nella classificazione della International Headache Society (1988).

Facial pain often presents complex diagnosis, requiring other specialists' consultation. The use of different terminology and protocols can affect the information exchange negatively. These problems in the field of headache, cranial neuralgias and facial pain lead the International Headache Society to introduce a new classification in 1988. The chief difference with the previous ones is the presence of strictly codified diagnostic principles. Its target is research, but it can help the general practice as well. We discuss the most interesting points to the stomatologist.

[Magnetic stimulation of the scalp: the responses of the masseter muscles. I]. / Stimolazione magnetica allo scalpo: risposte nei masseteri. Parte I.

Magnetic stimulation of nervous elements is a new neurophysiological technique. It easily succeeds in stimulating the brain motor cortex. We applied this technique to the trigeminal motor system, recording responses in masseter muscles. The magnetic stimulations at 4 cm laterally to the vertex on the biauricular line elicited responses in the contralateral masseter due to activation of motor cortex or adjacent elements along the cortico-nuclear pathway. The ipsilateral responses to the same stimuli and to more lateral ones presented shorter latencies and they were ascribed to direct stimulation of the trigeminal nerve, probably its intracisternal portion. The latency values were 6.9 +/- 0.71 ms and 3.6 +/- 0.3 ms respectively.

[Magnetic stimulation of the scalp: the responses of the masseter muscles. II]. / Stimolazione magnetica allo scalpo: risposte nei masseteri. Parte II.

Magnetic stimulation of nervous elements is a new technique of investigation in intact alert man. Electromyographic responses of the masseter muscles were recorded in normal volunteers and in two patients with hemispheric or capsular lesions, both by surface and needle electrodes. In the patients "cortical" responses were absent when stimulating the affected hemisphere and present when stimulating the unaffected one. These findings suggest that the direct facilitating cortico-nuclear projections for the masseter muscle are mainly crossed. Nevertheless the presence of clear ipsilateral responses after stimulation of the unaffected hemisphere demonstrates the existence of uncrossed projections; in fact only the ipsilateral motor cortex can be the site of origin of the responses in these patients.

[Masseteric responses following electrical stimulation of the scalp]. / Risposte masseterine seguenti stimolazioni elettriche allo scalpo.

Electromyographic responses of the masseter muscles following electric transcranial stimulations by a conventional constant current stimulator were recorded with surface and needle electrodes. Ipsilateral motor evoked responses following both anodic and cathodic bipolar electrical stimulations performed at 7 and 11 cm laterally to the vertex on the biauricular line were recorded, with latencies ranging from 2 to 3.6 ms. Contralateral responses were not elicited. The ipsilateral responses to stimuli were ascribed to direct stimulation of the trigeminal nerve, probably its intracisternal portion.

Motor-evoked potentials in masseter muscle by electrical and magnetic stimulation in intact alert man.

The electromyographic responses of the masseter after different types of transcranial stimulation were recorded with surface and needle electrodes. Magnetic stimulation at 4 cm lateral to the vertex on the biauricular line elicited MEPs in the contralateral masseter (latency 6.9 ms) due to activation of motor cortex or adjacent elements along the cortico-nuclear pathway. The ipsilateral responses to the same stimuli and to more lateral ones had shorter latencies and were ascribed to direct stimulation of the trigeminal nerve, probably its intracisternal portion. This was also the probable origin of the ipsilateral MEPs after both anodic and cathodic bipolar electrical stimulation at 7 and 11 cm lateral to the vertex on the biauricular line.

[Electromyographic evaluation of silent periods in the elevator muscles of the mandible in dysfunctional pathology of the temporo-mandibular joint]. / Valutazione elettromiografica dei periodi inibitori nei muscoli elevatori della mandibola in corso di patologia disfunzionale dell'articolazione temporo-mandibolare.

After a brief review of the features and physiology of the silent period, its modifications in painful temporomandibular dysfunction are assessed with particular reference to their reliability in practical diagnosis. Six patients with the classic signs and symptoms as well as 7 healthy volunteers acting as controls were examined. In view of the results obtained as well as the discrepancies reported in the literature and the numerous variations in the methods used in stimulating, recording and measuring the silent period, it is concluded that this study can play no more than a supporting role in the diagnosis of the syndrome despite its value in experimental research.