Periodontal disease in diabetic patients - clinical and histopathological aspects.

Periodontal disease is one of the most frequent diseases affecting people all over the world. The relation between periodontal disease and diabetes mellitus raised the interest both of dentists and doctors treating metabolic diseases, as the two conditions influence one another. In our study, we analyzed a number of 75 patients with diabetes mellitus and periodontal disease that presented to the medical consultory for conditions of the dental maxillary system. The clinical study showed that periodontal disease and diabetes may affect young adults as well, still this pathological association more frequently appears after the age of 50. The disease was identified especially in the women living in urban area. The clinical examination of the dental maxillary system identified the presence of gingival ulcerations, dental calculus, gingival bleeding, radicular leftovers with anfractuous margins, fixed prostheses with an inappropriate cervical adjustment. Of the systemic diseases associated to periodontal disease and diabetes mellitus, there was observed that 66.66% of the patients also suffered from cardiovascular diseases (high blood pressure, ischemic cardiopathy, heart failure), and 37.33% suffered from obesity. The histopathological and immunohistochemical tests highlighted the presence of an inflammatory chronic, intense reaction, mainly formed of lymphocytes, plasmocytes, macrophages and granulocytes, heterogeneously disseminated and alteration of the structure of marginal and superficial periodontium. The inflammatory reaction in the patients with periodontal disease and diabetes was more intense than in the patients with periodontal disease without diabetes.

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.

Microscopic aspects of angiogenesis and lymphangiogenesis in oral squamous cell carcinoma.

Despite various great scientific and financial efforts, head and neck carcinomas represent a public health problem, being the eighth cause of cancer death worldwidely. The rate of tumor growth, its local expansion, as well as the metastasis of cancerous cells depend on the tumor vascularization, on the ability of blood vessels to provide a constant supply of nourishing substances and oxygen and to eliminate the residual products resulted from tumor growth. That is why angiogenesis and lymphogenesis are considered to be essential processes within the neoplastic process. The assessment of tumoral neoformed blood vessels in oral squamous carcinomas, using the CD34 antibody, showed a significant growth of the microvascular density, the average number being 504.66±177.65 vessels/mm². The diameter of angiogenesis vessels varied between 3.42 and 121.27 µm. The density of lymphogenesis vessels was 508.78±235.93 vessels/mm², while the diameter varied from 2.82 to 165.28 µm. Both angiogenesis and lymphogenesis vessels were more numerous in the areas where the inflammatory infiltrate was more abundant, which suggests that chronic inflammation plays the part of a promoter factor of neoplastic lesions.

Squamous cell carcinoma of the oral cavity: clinical and pathological aspects.

Oral cavity cancer is a public health problem as the sixth leading cause of cancer worldwide. Most tumor lesions are detected in stage III and IV, leading to a poor prognosis, five-year survival rate ranging between 10% and 40%. Oral cancer etiology is multifactorial, known still incomplete. The main etiopathogenic factors are exposure to cigarette smoke and alcohol consumption. We conducted a retrospective study of oral cavity tumors hospitalized in 2008-2012 in Oral and Maxillofacial Surgery Clinic of the Emergency County Hospital of Craiova, Romania. Of 143 tumors of the oral cavity, 125 were malignant, and of these, 115 (92%) were represented by squamous cell carcinoma. Tumor lesions were more common in males (69%), patients from rural areas (64%) and those over 50-year-old (87.71%).

Microscopic aspects of pulpal changes in patients with chronic marginal periodontitis.

Chronic periodontitis is one of the most frequent and severe diseases involving the tooth. Untreated, they can lead to tooth loss. Our study involved 67 patients with chronic marginal periodontitis who underwent tooth extraction, of which 29 had moderate periodontal lesions and 38 severe periodontal lesions. The microscopic study of the dental pulp revealed significant changes in all patients. In patients with moderate periodontitis the pulp tissue was found to be the site of an enhanced process of collagenous fibrosis associated with a moderate inflammatory infiltrate, dystrophic mineralization, reduced blood vascularization and arteriolosclerosis. The dental pulp of patients with severe periodontitis showed an abundant chronic inflammatory infiltrate associated with pulpal necrosis, vascular congestion, microhemorrhages, dentin demineralization and odontoblast impairment.