Associated lesions of peri-implant mucosa in immediate versus delayed loading of dental implants.

Currently, immediate loading of dental implants is very attractive as a standard protocol for prosthetic restorations in edentulous patients. The aim of this study is to find out the intimate peri-implant mucosa response depending on timing of implant loading, immediate or delayed. Fifty-one screw implants Alpha Bio (Alpha-Bio Tec, Israel) were inserted in 42 partially edentulous patients according to standardized surgical techniques. At six months of loading, samples of peri-implant mucosa were harvested from 27 immediate loaded, respectively 24 delayed loaded implants, and subjected to microscopic examination. Peri-implant mucosa in both loadings revealed a continuous and stable stratified squamous epithelium with moderate acanthosis and slight hyperkeratosis. Severe fibrosis and tendency to scar-like lesions were present mainly in immediate loading. Slight to moderate density of inflammatory chronic cell populations of non-uniform feature was common to both loading protocols. As compared to lymphocytes, higher scores of plasma cells were encountered in immediate loading. In immediate and delayed loading, the peri-implant mucosa as a new generated structure does not reveal different tissue responses. After six month of prosthetic loading, the healthy peri-implant mucosa is compatible with fibrosis and minor chronic inflammatory reactions.

Study of CK18 and GDF5 immunoexpression in oral squamous cell carcinoma and their prognostic value.

Oral cavity cancer remains one of the most common cancers worldwide, with an increased incidence in young adults, although there has been lately a decrease tendency in the incidence of this form of cancer. Lingual localization has a very high mortality and tends to be more aggressive becoming frequently metastatic at the regional lymph nodes. The purpose of this study is to investigate the immunohistochemical expression of cytokeratin 18 (CK18) and the reactivity to GDF5 (CDMP-1), called the morphogenetic protein-1, cartilage-derived, in lingual squamous cell carcinoma and the correlation between the immunoreactivity of this panel of antibodies, and the clinical stage, the degree of differentiation and the invasion pattern. In this regard, we studied the immunohistochemical behavior of these markers in 15 cases of lingual squamous cell carcinoma. In our study, we observed the correlation of CK18 and GDF5 expression with the clinical stage, differentiation degree and invasion pattern, the highest levels of immunoreactivity being recorded in poorly differentiated forms, in high-level invasion patterns and in the most advanced stages. The markers used can become therapeutic targets, which could help increase the quality of life and life expectancy for these patients.

Clinical and histological aspects of malignant inverted sinonasal papilloma. Two case reports.

The inverted sino-nasal papilloma is a benign epithelial lesion, ranging from 1% to 5% of the tumors that reside in this area. It is characterized by a tendency towards local bone destruction, recurrence and malignant transformation. This is a presentation of two cases diagnosed and surgically treated for malignant inverted papiloma, which started in the epithelium of the maxillary sinuses. The cases had in common the late presentation of the patient to the surgeon, thus the local destruction was significant with extension towards the eye socket and the base of the skull. The treatment of choice was the surgical resection of the maxillary bone with a prosthetic reconstruction of the defect followed by radiotherapy. After a careful analysis of the two cases, a series of statements regarding the diagnosis and treatment of this rare pathology were recommended.

The histopathological study of radicular dentinal changes in patients with chronic marginal periodontopathies.

Periodontal disease is one of the most frequent conditions in individuals, having major health and social implications. Progressing as a chronic inflammation at the level of tooth support tissues, untreated chronic periodontitis may lead to a premature loss of the dental organ. Even though the main lesions caused by the periodontal disease affect the alveolo-dental ligaments, we tried to highlight the presence of certain lesions of radicular dentine in patients with chronic marginal periodontopathy. In our study, in the patients with chronic marginal periodontopathy, at periodontium level, there was highlighted the presence of a chronic inflammatory process with numerous lymphocytes and macrophages, microhemorrhages, and also areas with tissular necrosis. At radicular dentine level, in the cases of old, untreated periodontal disease, there were observed areas of more or less extended demineralization, erosion and necrosis. Our study showed that chronic periodontal disease may affect the tooth, as well, not only its support tissues.

Cell populations involved in the processes of local mucosal defense in extended partially edentulous and completely edentulous patients. Clinical and immunohistochemical study.

Considering the fact that extended partial edentation and complete edentation have high incidence rates worldwide, the necessity for correct prosthetic treatment is very important. We performed a clinical study on 37 extended partially edentulous patients and completely edentulous patients, who were divided into three groups. We also performed a morphological study using classic techniques of histology and immunohistochemistry methods on sections obtained from oral mucosa fragments collected from these patients and processed by paraffin embedding technique. To identify the cell populations present in the inflammatory processes, we used the CD20, CD8, CD3 and CD68 markers. In the studied cases, we found the presence of changes that have interested both the epithelium and lamina propria. Epithelium showed in particular epithelial hyperplasia aspects, with orthokeratinization and parakeratinization areas and, in some sections, areas of ulceration. We found the inflammatory process present in the lamina propria to be chronic and it consists in particular of lymphocytes, plasma cells and macrophages. This process was differentiated in intensity from one case to another, but varied even within the same case, from one area to another. Inflammation was determined by the local microbial flora enhanced by the action of prosthetic appliances or by the prolonged edentulous state. We observed more intense changes in denture wearers patients. The inflammatory response indicates the reactivity of the edentulous mucosa in response to local aggression, the specific defense mechanism coexisting with the nonspecific defense mechanism, with predominance of cellular immune defense.

Histological patterns in orbital malignant tumors.

There is a wide variety of tumors affecting the orbit. The most encountered histological type of malignant orbital tumor is the basal cell carcinoma followed by the malignant melanoma and the squamous cell carcinoma. The authors conducted a retrospective review of the malignant orbit tumors from the Department of Oral and Maxillofacial Surgery, University Emergency Hospital of Sibiu, Romania. The main surgical methods implied were tumor resection, exenteration and extended exenteration. The reconstruction was performed with the help of local flaps using different techniques: advancement, translation or rotation. The use of local flaps allowed for a good esthetic outcome and a decrease in the healing time.

Malignant ameloblastoma in an 8-year-old child with metastasis to the lung: case report with a clinicopathologic analysis.

Ameloblastomas are rare tumors of odontogenic origin, accounting for 1% of all oral tumors. They are benign, but locally highly aggressive tumors. We report here the unusual case of an 8-year-old patient with multicystic mandibular ameloblastoma, who was submitted to surgery for two relapses in six years and metastasized to the lung two years after initial surgery. The first lesion, diagnosed as follicular ameloblastoma, was treated conservatively with enucleation and curettage. Two years later the tumor relapsed into multicystic granular form. A marginal conservative resection was performed, keeping the basilar contour of the mandible, due to the age of the patient. Three months later, on a routine follow-up examination, a lung metastasis was detected with no signs of tumor in the mandibular bone and the patient was submitted to upper right lobectomy. Three years later a new recurrent tumor was detected in the alveolar process and another marginal resection was performed. Histologically, the tumor showed the follicular growth pattern. After a disease-free period of over five years, the patient was again submitted to surgery for mandibular reconstruction. The mandibular bony defect was filled with iliac bone blocks and four dental implants. He underwent oral rehabilitation with an implant-supported overdenture. With a follow-up period of 22 years since first surgery, the patient is currently free of disease.

Reconstruction dynamics of recorded holograms in photochromic glass.

We have investigated the dynamics of the record-erase process of holograms in photochromic glass using continuum Nd:YVO4 laser radiation (λ=532 nm). A bidimensional microgrid pattern was formed and visualized in photochromic glass, and its diffraction efficiency decay versus time (during reconstruction step) gave us information (D, Δn) about the diffusion process inside the material. The recording and reconstruction processes were carried out in an off-axis setup, and the images of the reconstructed object were recorded by a CCD camera. Measurements realized on reconstructed object images using holograms recorded at a different incident power laser have shown a two-stage process involved in silver atom kinetics.