Histological and Immunohistochemical Evaluation of Rh-BMP2: Effect on Gingival Healing Acceleration and Proliferation of Human Epithelial Cells.

This study aims to histologically and immunohistochemically evaluate the effect recombinant human bone morphogenetic protein (rh-BMP2) injected in gingival tissue has on the acceleration of the epithelial migration from the wound edges and epithelial cell proliferation after implant surgery. MATERIAL AND METHODS: The study includes 20 patients who underwent bilateral implant surgeries in the premolar-molar region of the mandible, followed by guided bone regeneration. Each patient received an implant in both locations, but rh-BMP2 was only on the right side. At 9 days from the surgery, a gingival biopsy was performed 3 mm distally to the last implant. In total, 20 samples were collected from the left side (control group #1) and 20 from right (test group #1). This was repeated at a 4-month interval during healing abutment placements. Tissues were processed and stained with hematoxylin-eosin and then immunohistochemically for the expression of Ki-67 and further histological examination. RESULT: Complete closure of the epithelium with new cell formation was observed in the 55% test group and 20% control group after 9 days. At 4 months, although 100% samples of all groups had complete epithelial closure, the test group showed that the epithelial cells were more organized and mature due to the increased number of blood vessels. The average number of new epithelial cells was 17.15 ± 7.545 and 16.12 ± 7.683 cells per mm in test group, respectively, at 9 days and 4 months and 10.99 ± 5.660 and 10.95 ± 5.768 in control groups. CONCLUSION: Evident from histological observations, rh-BMP-2 can accelerate the closure of gingival wounds, the healing process of epithelial gingival tissue, and the formation of epithelial cells in patients undergoing dental implant treatment.

Effect of rh-BMP-2 in the Initiation of Neovascularization in Human Gingival Tissue: A Split-Mouth Clinical Study.

The aim of this study is to evaluate the effect on the initiation of new blood vessel formation of rh-BMP-2 administration in the human gingival tissue during bone regeneration surgery. MATERIAL AND METHODS: The randomized controlled clinical trial included twenty patients with bilateral partial edentulous of the mandibular premolar and molar region. Each patient received one implants on each side. Only one side received a 0.25 µg injection of rhBMP-2 into the gingival flap and grafted material during guided bone regeneration (GBR) for dental implantation. And the other side received GBR without injection. Three samples were collected from each patient as follows: one from the anterior area of the mandible (control group #1) collected at the time of all implant surgeries, and the two other samples during the placement of healing abutments at 4 months of follow-up, from treated side with rh-BMP-2 (test group) and untreated ones (control group #2). A total of 60 gingival samples were collected. Samples were stained with hematoxylin-eosin, and immunohistochemistry was performed with a vascular endothelial growth factor marker. The number of new vessels in each sample was counted. RESULT: Statistical analyses showed a significantly higher number of new vessels in the gingival tissue of the test group. CONCLUSIONS: Rh-BMP-2 injections into the gingival flap significantly improved new blood vessel formation.

Advanced Case of Squamous Cell Carcinoma of the Posterior-Lateral Border of the Tongue Invading the Floor of the Mouth.

Background: Squamous cell carcinoma (SCC) is a common cancer of the oral cavity. It mainly affects patients aged over 50 with male-to-female ratio 2:1. Most of the cases of oral SCC are linked to tobacco and alcohol use. Objective: In this report, we present a case of a 67-year-old male with a mass on the posterior-lateral border of the tongue. Case report: In this report, we present a case of a 67-yearold male with a mass on the posterior-lateral border of the tongue. Being heavy smoker and alcoholic since a young age, he was at high-risk of developing oral cancer. After thorough clinical, histopathological, and imaging assessments a poorly differentiated stage III (T3, N1, M0) SCC was confirmed. He underwent left hemiglossectomy with marginal mandibulectomy and radical neck dissection followed by radiation therapy. Conclusion: SCCs of the tongue can be often asymptomatic and identified at advanced phase leading to a poor prognosis. Therefore, their early diagnosis/management, and regular postoperative follow-ups are mandatory for better treatment outcome and recurrence prevention.

An evaluation of prophylactic and therapeutic antibiotic prescribing in Lebanese dental practice.

OBJECTIVES: To evaluate antibiotic prescribing patterns and correlates among Lebanese dentists. METHODS: A descriptive observational study was conducted, from the first of April to the end of May 2017. Dentists who specialized in oral dental surgery or general dental practitioners were eligible to participate in this study. All patients who sought consultation with the selected dentists over a 1 month period were included. KEY FINDINGS: A total of 2323 oral and dental procedures were performed by 60 dentists; 553 antibiotic prescriptions were prescribed, representing 23.8% (52.35% for prophylactic purposes and 47.65% for curative purposes). Prophylactic indications were mainly for implant surgery (36.3%) with only 1% appropriate. Curative use was mainly for periodontal abscesses/abscesses (indeterminate) (22.8%), followed by pulpal diseases and periradicular complications (20.5%); it was appropriate in only 1.7 and 1.9% of cases respectively. Amoxicillin-clavulanic acid was the antibiotic that was mostly prescribed for both curative and prophylactic uses (57.6 and 55.9%, respectively), followed by amoxicillin for prophylactic purposes and a combination of spiramycin plus metronidazole for curative purposes. Adherence to guidelines was low for both curative and prophylactic purposes (17.4 and 21.8%, respectively), but was better in patients who were younger [adjusted odds ratio(aOR) = 0.96], male (aOR = 0.40), or had cardiac disease with moderate or high infective endocarditis risk (aOR = 21.72), and when prescribed by oral surgeons (aOR = 0.15). CONCLUSIONS: This study showed evidence of the overuse of antibiotics among Lebanese dentists. It can serve as a basis for future studies to optimize antibiotic use among dentists in Lebanon.

Prevalence and Distribution of Oral Mucosal Lesions by Sex and Age Categories: A Retrospective Study of Patients Attending Lebanese School of Dentistry.

BACKGROUND: Prevalence and distribution of oral mucosal lesions in a sample of Lebanese population attending the School of Dentistry of Lebanese University is necessary to evaluate their oral health situation. OBJECTIVES: The aim of the present study was to determine the prevalence and distribution of oral mucosal lesions of patients attending the School of Dentistry. METHODS: A descriptive study was carried out by retrospectively examining a total of 231 medical and clinical examination record files of patients, attending the School of Dentistry Lebanese University for multidisciplinary dental treatments. 178 medical records were retained. Each medical and clinical examination record was done by an undergraduate student and then evaluated by a doctor. The record file included a civil status, chief complaint, medical history, and extraoral and intraoral clinical examination during the period between October 2014 and May 2015. Exclusion criteria were lack of written information in their medical and clinical examination record and being nonevaluated by a doctor. Data regarding age, gender, socioeconomic status, chief complaint, systemic diseases, and drugs intake were collected by using a questionnaire while the type of extraoral and oral mucosal lesions by clinical examination. RESULTS: The sample consisted of 102 (57.3%) females and 76 (42.7%) males. The age ranged from 10 to 92 years with a mean age of 40.1 years. Among these subjects, 110 (61.8%) presented with one or more lesions. All patients were Lebanese. The most common lesion diagnosed was coated/hairy tongue affecting 17.4% of the subjects, followed by melanotic macule (11.2%), gingivitis (9.6), linea alba (6.2%), tongue depapillation (5.1), leukoplakia (5.1), traumatic fibroma (4.5), frictional keratosis (3.9%), fissured tongue (3.9%), hemangiomas (3.9%), Fordyce granules (3.9%), dry mucosa (3.4), angular cheilitis (2.2), gingival hyperplasia (2.2), and crenulated tongue (1.7%). Overall, the prevalence of oral mucosal lesions did not significantly differ between sex and age groups. CONCLUSIONS: The high prevalence of oral mucosal lesions necessitates adequate awareness and management of these lesions in the general population. Dental clinicians should be knowledgeable and familiar with the etiopathogenesis, clinical presentation, diagnosis, and management of these lesions.

Histological Study of Induced Incisions on Rabbits' Tongues with Three Diode Lasers with Different Wavelengths in Continuous Mode.

OBJECTIVE: Diode lasers have multiple indications in everyday dental practice. They allow carrying out incisions, coagulation of soft tissue, and Low-Level Laser Therapy. The goal of this study is to compare histologically the tissue interaction zones and edges of an induced laser incision on rabbits' tongues with three different wavelengths of 810, 940, and 980 nm in continuous mode. METHODS: Fourteen male rabbits were divided into six groups. Each animal underwent three incisions of 10 mm length on the right ventral face of the tongue, carried out in continuous mode with three diode lasers with different wavelengths of 810, 940, and 980 nm. Rabbits were sacrificed at 0, 1, 2, 6, and 15 hours and 14 days. Five rabbits were sacrificed at 0 hours and 2 hours and one rabbit was sacrificed at 1, 6, and 15 hours and at 14 days. The appearance of neutrophils marked the onset time of the inflammatory reaction. Histological study of the incisions was chosen to evaluate the edges and to measure the depth and width of carbonization and necrotic and inflammatory zones. Healing was evaluated at 14 days. Friedman test was used to assess statistical differences between groups. RESULTS: In the experimental adopted conditions, the carbonization zone was marked by degradation of vacuoles and an elongation of nuclei and was observed on the edges of incisions. Carbonization and necrotic and inflammatory zones were measured for rabbits sacrificed at 0, 1, 2, 6, and 15 hours but the onset of inflammation zone marked by the infiltration of neutrophils did not appear before 6 hours. The neutrophils infiltration was higher at 15 hours than at 6 hours. Complete healing was shown at 14 days. According to the time for the regularity of the edges, the interpretation was qualitative without a statistical test. The statistical analysis of the three different diode lasers in this study showed nonsignificant difference between the different groups for the depth (p = 0.121) and width (p = 0.376) of the incisions, the carbonization zone (p = 0.692), and the necrotic zone (p = 0.223). For the inflammation zone at 6 and 15 hours, statistical analysis was not carried out; only one rabbit was enough to evaluate onset of neutrophils infiltration and to compare its density for 6 and 15 hours. CONCLUSION: These results indicate that diode laser used in the continuous mode is predictable for induced incision. The use of three diode lasers with different wavelengths of 810, 940, and 980 nm did not reveal a significant statistical difference according to depth and width of the incision and for carbonization and necrotic zone. The appearance of neutrophils was marked between 4 and 6 hours and was higher at 15 hours.

Adenomatoid Odontogenic Tumor Associated with an Impacted Maxillary Lateral Incisor: A Case Report with Five-Year Follow-Up.

Adenomatoid odontogenic tumor (AOT), a benign (hamartomatous) lesion of odontogenic origin, is an uncommon tumor which affects mainly females in the second decade. This lesion is most commonly associated with an impacted maxillary canine. This paper reported a case of AOT, in a 16-year-old female, associated with an impacted maxillary left lateral incisor. The evolution of this tumor was followed over 36 months and 24 months after excision.

Is the homozygous region on chromosome 16q12.2 responsible for a fifth mandibular incisor?

The presence of a fifth mandibular incisor, a eumorphic supernumerary tooth, has rarely been described in the literature. Recently we reported on a large Lebanese consanguineous family where 4 individuals displayed 5 mandibular incisors with the same shape and size. This type of familial clustering of the trait has not been previously described. We previously postulated several theories to explain the etiology of this anomaly. The possibility of an autosomal recessive inheritance for this nonsyndromic trait was discussed. We now report the use of homozygosity mapping to identify a homozygous region with different alleles at chromosome 16q12.2, located at the marker D16S415, which likely harbors the gene underlying this anomaly.