Metastatic sarcomas of the oral cavity: A systematic review.

Oral metastatic sarcomas (OMSs) occur only occasionally, and information about their characteristics is based on the restricted number of cases reported in the literature. This study aims to systematically review the English literature to recognize the clinicopathologic characteristics of OMSs. An electronic search was performed in PubMed Central and Scopus databases. The search included all the published articles (human case reports and case series) up till April 2023, with no time restrictions. OMSs were slightly more prevalent in males in their fifth to seventh decades of life. However, a high percentage of OMSs has been reported in the second decade of life. Lower extremities, breasts and uterus are the most common primary origin of metastatic sarcoma. Gingiva and mandible were common locations in the oral cavity for metastatic deposits. Generally, they demonstrated widespread affliction. The mean time interval between primary tumor detection and diagnosis of the oral metastasis was about 33.54 ± 36.19 months. Death was reported in 83 patients (67.48 %) with a mean survival rate of 7.98 ± 10.30 months. The most common microscopic tumor types were leiomyosarcoma (n = 21, 17 %), followed by angiosarcoma (n = 20, 16.26 %) and osteosarcoma (n = 18, 14.63 %). In conclusion, while oral metastases of sarcomas are not common, those should be considered in the differential diagnosis of the oral lesions. Although OMSs show a high occurrence in the 7th decade of the life, the average age of patients with oral involvement is lower than the overall metastatic lesions. OMSs may present as widespread disease with poor prognosis.

Effect of simultaneous and sequential use of TGF-ß1 and TGF-ß3 with FGF-2 on teno/ligamentogenic differentiation of periodontal ligament stem cells.

OBJECTIVE: The periodontal ligament is a crucial part of the periodontium, and its regeneration is challenging. This study compares the effect of simultaneous and sequential use of FGF-2 and TGF-ß1 with FGF-2 and TGF-ß3 on the periodontal ligament stem cells (PDLSCs) teno/ligamentogenic differentiation. DESIGN: This study comprises ten different groups. A control group with only PDLSCs; FGF-2 group containing PDLSCs with a medium culture supplemented with FGF-2 (50 ng/mL). In other experimental groups, different concentrations (5 ng/mL or 10 ng/mL) of TGF-ß1&-ß3 simultaneously or sequentially were combined with FGF-2 on the cultured PDLSCs. TGF-ß was added to the medium after day 3 in the sequential groups. Methyl Thiazolyl Tetrazolium (MTT) assay on days 3, 5, and 7 and Quantitative Real-time Polymerase Chain Reaction (RT-qPCR) analysis after day 7 were conducted to investigate PLAP1, SCX, and COL3A1, RUNX2 genes. All experiments were conducted in a triplicate. The One-way and Two-way ANOVA with Tukey post hoc were utilized to analyze the results of the MTT and RT-qPCR tests, respectively. A p-value less than 0.05 is considered significant. RESULTS: The proliferation of cells on days 3, 5, and 7 was not significantly different among different experimental groups (P > 0.05). A higher expression of the PLAP1, SCX, and COL3A1 have been seen in groups with sequential use of growth factors; among these groups, the group using 5 ng/mL of TGF-ß3 led other groups with the most amount of significant upregulation in PLAP1(17.69 ± 1.11 fold; P < 0.0001), SCX (5.71 ± 0.38 fold; P < 0.0001), and COL1A3 (6.35 ± 0.39 fold; P < 0.0001) expression, compared to the control group. The expression of the RUNX2 decreased in all groups compared to the control group; this reduction was more in groups with sequential use of growth factors. CONCLUSION: The sequential use of growth factors can be more effective than simultaneous use in teno/ligamentogenic differentiation of PDLSCs. Moreover, treatment with 5 ng/mL TGF-ß3 after FGF-2 was more effective than TGF-ß1.

Growth Factors in Periodontal Complex Regeneration.

The ultimate goal of periodontal treatments is the regeneration of all lost periodontal tissues including bone, cementum and the periodontal ligament (PDL). Until now, the clinical methods for periodontal regeneration have been associated with significant failure or incomplete success. Various studies have reported the promising effects of growth factors/cytokines on periodontal regeneration. Growth factors/cytokines include proteins or steroid hormones that bind to cellular receptors, known as signalling molecules, and that trigger cellular responses that eventually stimulate cell proliferation and differentiation. The present review aims to provide an overview of the main growth factors that play an important role in and have been used in the regeneration of periodontal components.

Peri-implant squamous cell carcinoma mimicking peri-implantitis: a case report.

Peri-implant oral lesions, benign or malignant, may be misdiagnosed as peri-implantitis. Squamous cell carcinoma is the most common cancer reported around dental implants. Malignant peri-implant lesions are life-threatening, and their resemblance to peri-implantitis, especially in their early stage, necessitates a precise differential diagnosis. This report presents a case of a 55-year-old woman with a peri-implant squamous cell carcinoma mimicking peri-implantitis.

Periodontal Ligament Stem Cell Isolation Protocol: A Systematic Review.

Despite the plethora of literature regarding isolation and characterization of periodontal ligament stem cells (PDLSCs), due to the existence of controversies in the results, in this comprehensive review, we aimed to summarize and compare the effect of isolation methods on PDLSC properties, including clonogenicity, viability/proliferation, markers expression, cell morphology, differentiation, and regeneration. Moreover, the outcomes of included studies, considering various parameters, such as teeth developmental stages, donor age, periodontal ligament health status, and part of the teeth root from which PDLSCs were derived, have been systematically discussed. It has been shown that from included studies, PDLSCs can be isolated from teeth at any developmental stages, health status condition, and donor age. Furthermore, a non-enzymatic digestion method, named as an explant or outgrowth technique, is a suitable protocol for PDLSCs isolation.

Clinicoradiographic Features and Histopathologic Variations of Intraosseous Lipoma: Report of a Case and Review of the Literature.

Intraosseous lipoma is a very rare lesion, and the jaw is its least common bone location. Fibrolipoma is a microscopic variant of lipoma which is characterized by a significant fibrous component intermixed with lobules of fat cells. Intraosseous fibrolipoma of the jaw is a rare lesion, and to the best of our knowledge, only two cases have been reported from 1948 in English literature. This paper presents a 39-year-old man with a chief complaint of tooth displacement in the anterior region of the mandible. Radiographic evaluation revealed a unilocular radiolucent lesion with sclerotic borders located between the left lateral incisor and canine. Histopathologic evaluation after an excisional biopsy confirmed the diagnosis of intraosseous fibrolipoma. We also reviewed the literature on this rare lesion.

Different techniques in transalveolar maxillary sinus elevation: A literature review.

Dental implant treatment in the posterior maxilla encounters bone quality and quantity problems. Sinus elevation is a predictable technique to overcome height deficiency in this area. Transalveolar sinus elevation is a technique that is less invasive and less time-consuming, first introduced for ridges with at least 5 mm of bone height. Many modifications and innovative equipment have been introduced for this technique. This review aimed to explain the modifications of this technique with their indications and benefits. An exhaustive search in PubMed Central and Scopus electronic databases was performed until December 2020. Articles were selected that introduced new techniques for the transalveolar maxillary sinus approach that had clinical cases with full texts available in the English language. Finally, twenty-six articles were included. The data were categorized and discussed in five groups, including expansion-based techniques, drill-based techniques, hydraulic pressure techniques, piezoelectric surgery, and balloon techniques. The operator's choice for transalveolar approach techniques for sinus floor elevation can be based on the clinician's skill, bone volume, and access to equipment. If possible, a technique with simultaneous implant placement should be preferred.

Effects of raw vegan diet on periodontal and dental parameters.

OBJECTIVES: Macronutrients and micronutrients present in different types of diet could influence different aspects of both inflammatory and immune responses; thereby, diets could influence oral health and the periodontal condition. The raw vegan diet is a subset of vegetarianism in which only uncooked plant-derived foods are consumed. The present study's aim was to evaluate the effect of the raw vegan diet on periodontal and dental health parameters. MATERIALS AND METHODS: A total of 118 participants (59 raw vegans and 59 controls) were interviewed about their level of education and oral health habits. Samples of unstimulated whole saliva were collected for pH analysis, and dental and periodontal parameters were examined. Then, statistical analysis was performed. RESULTS: Raw vegans had better oral hygiene (P = 0.001). The decayed-missing-filling indices were relatively equal in both groups. The probing depth, bleeding on probing (BOP), and simplified oral hygiene index were significantly lower in raw vegans (P = 0.047, P = 0.017, and P = 0.001, respectively). Multiple regression analyses disclosed that probing depth and BOP were significantly related to debris index. CONCLUSION: Based on this study's results, it can be presumed that the better periodontal condition in raw vegans is a result of their better oral care and lifestyle.

Oral rehabilitation of Papillon-Lefèvre syndrome patients by dental implants: a systematic review.

OBJECTIVES: Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder. These patients lose their teeth at a young age and are in need of prosthetic rehabilitation. The aim of this systematic review was to assess the success of dental implant placement in these patients. MATERIALS AND METHODS: An electronic search was performed in PubMed Central, Scopus, and Web of Science using the keyword "Papillon-Lefèvre syndrome" AND "dental implant" OR "prosthodontics". Articles reporting implant placement in patients with PLS until July 2019 were included. RESULTS: Assessment of the included 11 articles reporting 15 cases showed 136 implant placements in these patients. Implant failure occurred in 3 patients (20 implants). The peri-implantitis and failure rate was higher in the maxilla. Meta-analysis showed the probability of failure to be 7% (95% confidence interval [CI] 0%-31%) for maxillary implants and 2% (95% CI 0%-9%) for mandibular implants. The follow-up time ranged between 1 and 20 years. Healing after bone graft and implant placement in these patients was uneventful. CONCLUSION: Dental implants may be a viable treatment option for PLS patients. Implantation can help preserve alveolar bone if the patients' immunological and growing conditions are well-considered and proper oral hygiene and compliance with the maintenance program are continued.

Melanotic Neuroectodermal Tumor of Infancy, a Rapidly Growing Maxillary Alveolar Mass: A Case Report.

Melanotic neuroectodermal tumor of infancy is a rare, rapidly growing, painless, pigmented neoplasm with neural crest derivation. It usually occurs during the first year of life and there is a prominent predilection for the maxilla. The purpose of the present report is to describe additional case of melanotic neuroectodermal tumor of infancy of maxilla in a 6-month-old infant male. The treatment included surgical excision with safe margins. No attempt was made for immediate grafting of the surgery site due to high proliferation rate of tissues and self-renewal during infancy. The facial growth was normal and the surgical cleft was tightly closed. Due to the rarity of tumor, essential knowledge on characteristics of this lesion would contribute to a proper diagnosis and benefit treatment planning.

Recurrence of periodontitis and associated factors in previously treated periodontitis patients without maintenance follow-up.

Background: Preventive dentistry, including supportive periodontal therapy (SPT), is one of the most critical areas of attention. Despite SPT's importance in the long-term success of periodontal treatment, the patients' adherence to it is weak. The present study aimed to evaluate of periodontal disease's recurrence rate and its related factors in periodontal patients without regular follow-up. Methods: A cross-sectional study was set in a specialized periodontics clinic in Tehran, Iran. Patients with periodontitis who completed periodontal therapy during 2005-2014 and did not adhere to the maintenance phase were evaluated. The periodontal history of the patients was updated. The previous diagnoses of patients according to their previous periodontal charts were revised by AAP 2015 criteria. Then, periodontal parameters were assessed, and current periodontal status was evaluated. Statistical analyses consisted of Fisher's exact test, t-test, Man-Whitney test, and Kruskal-Wallis test. Spearman's correlation coefficient was used to assess the relationship between factors and variables. Results: Fifty patients were evaluated, including 29 males and 21 females. There was a significant relationship between the initial diagnosis and recurrence rate of periodontitis (P=0.017). There was also a significant relationship between the recurrence of periodontitis and the years elapsed since the initial treatment (P=0.027, r = 0.353). Smoking significantly affected tooth loss (P=0.001). Conclusion: Patients with severe periodontitis need more attention to participate in supportive periodontal care. The patients must be aware of the disadvantages of neglecting this phase and be reminded of regular follow-up.

Oral cyst-like nodule caused by a long standing unusual embedded foreign object: Report of a case.

Traumatic implantation of foreign material in the oral mucosa is unusual and may occur. In this article, we report the presence of an unusual foreign object associated with a cyst-like inflammatory response in a 50-year-old male. The patient presented with a painless recurrent soft tissue swelling in the anterior vestibule of maxilla of at least 2-year duration. The lesion was surgically excised and a retained shrapnel-like object within a cyst-like and thick-walled structure was obtained. Histopathologically, the cyst-like structure exhibited a lymphohistiocytic infiltrate in the wall and a luminal synovial metaplasia-like change, predominantly composed of histiocytes. Immunohistochemical stain of CD163 highlighted the histiocytes. The patient stated a history of traumatic implantation of shrapnel fragments in the area that occurred 30 years ago due to an explosion in the Iran-Iraq war.

Periopathogens in atherosclerotic plaques of patients with both cardiovascular disease and chronic periodontitis.

BACKGROUND: Atherosclerosis and periodontitis are both chronic inflammatory diseases. Although a strong relationship between the two has already been established, the underlying mechanism is unknown. The present study was conducted aiming to detect the deoxyribonucleic acid (DNA) of Aggregatibacter actinomycetemcomitans (A.a), Campylobacter rectus (C.r), and Porphyromonas gingivalis (P.g) in subgingival and atherosclerotic plaques of patients with both chronic periodontitis and cardiovascular disease (CVD). METHODS: In this cross sectional study, patients with coronary artery disease (CAD) and moderate to severe periodontitis which were scheduled for coronary artery bypass grafting (CABG) were enrolled in the study. The subgingival plaques were collected before surgery. All samples were examined for the detection of selected periopathogens using polymerase chain reaction (PCR). RESULTS: The subgingival and atherosclerotic plaque samples of 23 patients were examined. The DNA of P.g, A.a, and C.r were found to be positive in 43.47%, 43.47%, and 78.26% of subgingival plaques, and 13.04%, 17.39%, and 8.69% of atherosclerotic plaques, respectively. In all cases, the bacterial species found in atherosclerotic plaques were also found in the subgingival plaques of the same patient. CONCLUSION: This study demonstrated the presence of periopathogens in atherosclerotic plaques of patients with chronic periodontitis. More studies are required to ascertain the exact role of these periopathogens in atherosclerotic plaque formation.

Myofibroma as a Rapidly Growing Gingival Mass in a 4-year-old Boy: a Case Report.

Solitary myofibroma is an uncommon benign soft tissue neoplasm of myofibroblastic origin exhibiting head and neck region predilection but its presence in the jaws is rare. Myofibroma presents as painless mass and may demonstrate rapid enlargement and growth that clinically mimic malignancies. This report presents a 4-year-old male patient with a rapidly growing mandibular gingival mass with some evidence of underlying alveolar bone destruction. Incisional biopsy was performed and the specimen was stained with hematoxylin and eosin and immunohistochemical antibodies for αSMA, CD34, S100 and desmin. The diagnosis of myofibroma was made and the lesion was completely excised. The knowledge about microscopic features of this rare neoplasm helps to have a proper diagnosis and avoid unnecessary treatment.

Reactive oral lesions associated with dental implants. A systematic review.

Reactive lesion formation around dental implants a complication that has been given much consideration. These lesions can lead to marginal bone loss, and consequently, implant failure. In the present systematic review, all reported reactive lesions associated with dental implants in the literature were assessed. An electronic search was performed using PubMed Central, Scopus, Google Scholar, and Science Direct. The search strategy was limited to human studies (case reports and case series), full-text English language articles, published until May 2017. A total of 19 articles reporting 27 lesions in 25 cases were included. Peripheral giant cell granuloma and pyogenic granuloma were the most reactive lesions found around dental implants. The mean age of the patients was 51.28 ± 14.48 years, with a slight female predilection. Posterior mandibular gingiva was the most common location for these lesions. The recurrence rate of lesions was 33.33%, and the chance of implant removal was 29.62%. Due to the clinical significance of these lesions, early histopathologic examination is recommended to exclude the presence of such pathological lesions.

Effect of non-surgical periodontal treatment on clinical signs of rheumatoid arthritis.

Background: Several studies have shown the association between periodontitis and rheumatoid arthritis (RA) and some similarities in the pathogenesis of these two diseases but clinical trials which have evaluated the effect of periodontal therapy on clinical signs of active RA are scarce, particularly in Iran. The aim of this study was to evaluate the effect of non-surgical periodontal treatment on the improvement of clinical signs of patients with RA. Methods: Fifty-six patients with active RA and generalized moderate-to-severe chronic periodontitis were selected and divided into case (periodontal treatment) and control (without periodontal treatment) groups. Periodontal parameters and RA disease activity scores (DAS28 index) were compared at 6- and 12-week intervals. Results: In the case group, a significant reduction in all the periodontal indices was observed 6 weeks after treatment. At the 12-week evaluation, periodontal indices showed a significant reduction in comparison with baseline and a little increase in comparison with 6-week interval. Six weeks after treatment, DAS28 decreased significantly in the case group (P<0.05). DAS28 also decreased at 12-week interval but its reduction was not significant in comparison with 6-week interval. DAS28 in the case group at 12-week interval was significantly less than that in the control group (P<0.05). Conclusion: Since periodontal care as a part of treatment protocol in RA patients can be effective in improving clinical signs, the recall intervals are better to be 3 months or shorter.

Malignant Tumors of Tongue in Iranian Population.

BACKGROUND: The incidence of oral cancers varies from one country to another, which can be clarified by the difference in the distribution of the risk factors and the possible etiologies. Tongue is a main segment of oral cavity and malignant lesions of this region accounts for nearly 30% of all oral cancers. OBJECTIVES: In the present study, we evaluated the pattern of tongue cancer in Iranian population and compared these findings with those previously reported in the other countries. METHODS: In this multicenter, retrospective cross-sectional study recorded cases of the malignant tongue tumors in the cancer research center (CRC) of Shahid Beheshti University of Medical Sciences were extracted. The patient records and their microscopic reports were retrieved from the archives and age, sex and microscopic types were evaluated. It is to be noted that the CRC has been serving as a cancer registry center for major hospitals all over the country since the year of 2003. Thus, the obtained statistics are highly reliable. RESULTS: During the years 2003 to 2008, a total number of 952 new cases of the tongue cancer were recorded in the CRC. Most cases are diagnosed in the sixth and seventh decades of life. 450 cases (47.2%) occurred in men and 489 cases (51.36%) in women. Four different types of malignant lesions (epithelial, salivary gland, hematopoietic and mesenchymal) were diagnosed. Epithelial tumors were the most prevalent malignancies (93%) of which squamous cell carcinoma (SCC) made up 87.39% of all lesions. Salivary gland tumors had the second place with 3.15% of the total lesions. CONCLUSIONS: In Iranian population, squamous cell carcinoma is the most prevalent malignancy of tongue and it is notable that the ratio of female to male population was equal. These lesions were prevalent in the sixth and seventh decades of life. Thus screening examination of tongue by dentist especially in elderly patients is necessary for early detection of cancerous lesions.

Pyostomatitis Vegetans: A Clue for Diagnosis of Silent Crohn's Disease.

Pyostomatitis vegetans is a very rare oral manifestation with unknown pathogenesis. Skin and other mucous membrane involvement may be seen. This lesion has strong association with Inflammatory Bowel Disease (IBD) and may be the first sign of it. The management of Pyostomatitis vegetans is usually based on the management of underlying bowel disease. We present a case of Pyostomatitis vegetans involving gingiva and oral mucosa with no skin lesion which led to the diagnosis of Crohn's disease to emphasize important role of dentists in diagnosis of rare oral lesions and management of patients' systemic disease.