Diagnosis and treatment of dens invaginatus with open apex in a young adult patient by using cone-beam computed tomography and operative microscope.

BACKGROUND: Dens invaginatus is a developmental anomaly that can affect both deciduous and permanent dentition. The anomaly is caused by the invagination of the enamel organ into the dental papilla prior to the calcification of the dental tissues. The treatment option changes according to the classification, from the simple filling of the invaginated enamel area to root canal treatment with or without retrograde surgery, intentional re-implantation, or the extraction of the affected tooth. CASE REPORT: In this study we report a case of a maxillary lateral incisor invaginatus in a young adult patient. The periapical endoral X-ray showed the presence of a periapical radiolucency in tooth 22, that had a structure similar to a tooth inside it and an immature apex. Cold thermal testing showed that it was not a vital tooth. CBCT confirmed the diagnosis of Oehler Class II dens invaginatus. The treatment plan involved root canal treatment of both the "true" and the "invaginated" canal using calcium hydroxide-based intermediate medication. Then, after removing the hard internal structure with the aid of an operative microscope, MTA was used to close the immature apex. Finally, the large endodontic space was filled with self-etching, self-adhesive, dual curing resin cement. The patient was included in a follow-up programme to monitor and verify the complete healing of the periapical bone of the affected tooth. CONCLUSION: The use of technology and of special materials allowed an adequate management and resolution of the case reported.

Psychopathological comorbidities in medication-overuse headache: a multicentre clinical study.

BACKGROUND AND PURPOSE: In medication-overuse headache (MOH) patients, the presence of psychopathological disturbances may be a predictor of relapse and poor response to treatment. This multicentre study aimed to assess the occurrence of psychopathological disorders in MOH patients by comparing the incidence of psychopathological disturbances with episodic migraine (EM) patients and healthy controls (HC). METHODS: The psychopathological assessment of patients and HC involved the administrations of the Beck Depression Inventory, the Beck Anxiety Inventory, the Modified Mini International Neuropsychiatric Interview (M-MINI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Leeds Dependence Questionnaire. RESULTS: The MOH, EM and HC groups (88, 129 and 102 subjects, respectively) differed significantly from each other for the presence of moderate/severe anxiety, whereas mood disorder and depression were revealed in similar proportions for both MOH and EM patients. By stratifying the M-MINI questionnaire results according to the number of psychiatric disorders, it was found that MOH patients had a more complex profile of psychiatric comorbidity. Furthermore, clinically relevant obsessive-compulsive disturbances for abused drugs assessed by Y-BOCS appeared to be more represented in the MOH group, whilst the prevalence of this trait in the EM group was comparable to that of HC (12.5%, 0.8% and 0%, respectively). CONCLUSIONS: Our study indicates the multiple presence of psychopathological comorbidities in patients with MOH. In light of this, it is recommended that the assessment of the psychopathological profile be included in an evaluation of MOH patients, allowing the clinician to more rapidly start an appropriate behavioural treatment, which would greatly improve MOH management.

Rapid palatal expansion: the role of microcirculation.

AIM: Transverse palate modifications fall under expansive orthopedic therapy of the upper maxilla. The only practical approach to the problem on the transverse plane is that of performing the expansion of the maxillary arch through an opening of the median palatal suture. It is important to understand the changes of the vascular network in midpalatal suture following the starting of rapid maxillary expansion. It is critical to maintain the blood supply and circulation for the osteogenesis and bone remodeling after the expansion. The aim of this research was to evaluate the effects of rapid orthopedic expansion (REP) at the microcirculatory level through capillaroscopic examination. METHODS: Fifteen patients in their developing years between 9 and 15 years of age (average age 12.16 years) were examined. The application of the REP was the first step in the planning of orthopedic-orthodontic treatment which foresaw further stages in the odonto-osseous movement. The method of Biomicroscopic Video-Imaging of the microcirculation of oral mucosa is performed through the technique of computerized capillaroscopy and the related software. RESULTS: From the results it is evident that immediately after achieving the expansion of the upper maxilla (t1), a slight decrease in the number of vessels per mm² can be observed. In addition, a slight ectasia can be observed in these vessels in comparison to t0. Comparing the videocapillaroscopic images of t1 and t2, an increase in the capillaries per mm² can be observed. CONCLUSION: Ectasia of the capillaries, though subject to strictly individual variables, can be considered perfectly normal and it is compatible with the normal biology and physiology of vessel microcirculation.

Clinical and stabilometric measures predicting falls in Parkinson disease/parkinsonisms.

OBJECTIVES: Clinical predictors of falls in patients with Parkinson disease (PD) are fairly inaccurate. Stabilometric measures appear useful in investigating the relationship between balance, sensory disturbance, and falls. The aim of the study was to identify the best combination of clinical and stabilometric tests to predict falls prospectively. MATERIALS & METHODS: Fifty-three consecutive subjects with PD or parkinsonisms at risk of falls were included and followed for 6 months. Clinical variables were used as fall predictors: the Unified Parkinson Disease's Rating Scale (motor section) and the Longitudinal Aging study Amsterdam Physical Activity Questionnaire (LAPAQ). Variables from stabilometric platform underwent a principal component analysis. Multivariate logistic models were used to predict fallers using fall status (fallers: 1 + falls; recurrent fallers: 2 + falls) as dependent variable. RESULTS: Seven patients were lost to follow up, leaving 46 evaluable subjects. Of these, 32 (70%) were fallers and 22 (48%) were recurrent fallers. The only variable predicting fallers was the LAPAQ (odd ratio [OR] 0.99 (95% confidence interval [CI] 0.98-1.00); accuracy 71.7%; sensitivity 87.5%; specificity 35.7%). For recurrent fallers, Factor 2 (body sway velocity) (OR 2.37; 95% CI 1.01-5.58) and, in part, LAPAQ (OR 0.99; 95% CI 0.98-1.00) retained significance in the multivariate model, showing an accuracy of 76.9%, a sensitivity of 77.8%, and a specificity of 76.2%. CONCLUSIONS: A combination of clinical and instrumental tools is useful to identify fallers in PD or parkinsonisms. Body sway velocity and ability to perform the activities of daily living are the best predictors of recurrent falls.

In vivo evaluation of periodontal microcirculatory changes associated with endodontic treatment.

AIM: The purpose of this study was to investigate in vivo the gingival microcirculatory changes associated with endodontic treatment using the continuous wave of condensation technique. MATERIALS AND METHODS: Twenty necrotic one canal roots of 20 cooperative patients of both sexes, aged between 20 and 43 years, were selected. All patients were examined by capillaroscopy before, immediately after endodontic treatment, and after 7 days. The last examination was carried out by the same operator, and repeated twice for each examined area: masticatory, buccal and labial mucosa corresponding to the endodontically treated root. All canals were prepared using a simultaneous technique with Ni-Ti files (MTwo files). RESULTS: The images of the masticatory mucosa after root canal obturation showed evident micro-areas of extravasation, with significant bleeding and angio-morphological alterations due to heat. One hour after the endodontic treatment evident extravasation was observed, but a decrease of all altered parameters, was present. After seven days from treatment, in the periodontal tissues, a complete healing was observed. The in vivo evaluation of the vascular pattern during root canal obturation with System B showed that the high temperature in the canal determines visible effects on the vasculature of adjacent sites. It was found that microangiotectonic alterations decrease up to a complete healing after 7 days from treatment. CONCLUSION: All the changes in microcirculation, due to thermal shock of periodontal tissues, are reversible.

Evaluation of gingival microcirculation in patients undergoing fixed orthodontic treatment: a pilot study.

AIM: Among the many biological effects which occur during orthodontic movement, we decided to investigate gingival microcirculation. The aim of the study was to evaluate the biological microvascular response to the application of orthodontic force in vivo. MATERIALS AND METHODS: Forty patients (case group) between 9-22 years of age (average± DS 12±3.01) were selected for the study (M/F ratio: 20/20). They needed fixed orthodontic treatment due to several types of malocclusion. Forty healthy subjects (control group) were also recruited (M/F ratio 20/20; average age 12 years ± 4.01; Mean±SD =10.04±1.7). A videocapillaroscopic examination was performed on each patient on the buccal alveolar mucosa at the pre- treatment time (t0), 1 month after the beginning of the treatment (t1), after 2 months (t2), after 6 months (t3), and after 12 months (t4). RESULTS: Capillary density increases significantly from t0 to t1. Between t1 to t2, t2 to t3 the density underwent another increase. Between t3 and t4 (69.22 ± 3.63) the density showed no increase. In the control group no statistical differences were observed. CONCLUSION: Videocapillaroscopy allows the in vivo evaluation and quantification of the microcirculatory changes consequent to the application of orthodontic force, managing to detect subclinical changes in angiogenesis. In fact, the study revealed an increase in the density of the capillaries which is directly proportionate to the application time of the orthodontic device, i.e. the exogenous mechanical force. This research offers new perspectives for the future of monitoring fixed orthodontic therapy.

Validation of healthcare administrative data for the diagnosis of epilepsy.

BACKGROUND: Administrative databases have become an important tool to monitor diseases. Patients with epilepsy could be traced using disease-specific codes and prescriptions, but formal validation is required to obtain an accurate case definition. The aim of the study was to correlate administrative data on epilepsy with an independent source of patients with epilepsy in a district of Lombardy, Northern Italy, from 2000 to 2008. METHODS: Data of nearly 320 600 inhabitants in the district of Lecco collected from the Drug Administrative Database of the Lombardy Region were analysed. Among them were included patients who fulfilled the International Classification of Diseases 9 (ICD-9) codes and/or the disease-specific exemption code for epilepsy and those who had at least one EEG record and took antiepileptic drugs (AEDs) as monotherapy or in variable combinations. To ascertain epilepsy cases, 11 general practitioners (GPs) with 15 728 affiliates were contacted. Multiple versions of the diagnostic algorithm were developed using different logistic regression models and all combinations of the four independent variables. RESULTS: Among the GP affiliates, 71 (4.5/1000) had a gold standard diagnosis of epilepsy. The best and most conservative algorithm included EEG and selected treatment schedules and identified 61/71 patients with epilepsy (sensitivity 85.9%, CI 76.0% to 92.2%) and 15 623/15 657 patients without epilepsy (specificity 99.8%,CI 99.7% to 99.8%). The positive and negative predictive values were 64.2% and 99.9%. Sensitivity (86.7%) and the positive predictive value (68.4%) increased only slightly when patients with single seizures were included. CONCLUSIONS: A diagnostic algorithm including EEG and selected treatment schedules is only moderately sensitive for the detection of epilepsy and seizures. These findings apply only to the Northern Italian scenario.

Microcirculation in the healing of surgical wounds in the oral cavity.

The aim of this research is to evaluate in vivo the characteristics of microcirculation after taking a biopsy sample from the oral mucosa. 20 patients were recruited to the study and all underwent an oral mucosa biopsy for the excision of benign neoformations. The modifications in the oral microcirculation were evaluated in vivo in correspondence to the surgical site through videocapillaroscopy at three different times: 30 min before the biopsy; 48 h after the biopsy; and 7 days after the biopsy. The statistical significance was checked with the Mann-Whitney U-test (P<0.05). The analysis of videocapillaroscopic patterns showed statistically significant variations relative to the capillary loop density; the diameter of the outgoing loop; and the length of the capillary loop. In conclusion, the study describes a simple and reproducible model for the study of wound healing from a microcirculatory point of view.

Headache, eating and sleeping behaviors and lifestyle factors in preadolescents and adolescents: preliminary results from an Italian population study.

Several dietary and lifestyle habits can be associated with headaches or with their progression to chronic forms in adults. We report the results of the first population study performed in Italy on a sample of preadolescent and adolescent students to assess the possible association between headache and specific habits and lifestyle factors. Preliminary data from 800 questionnaires showed that 365 subjects had headaches, which were of moderate-severe intensity, associated with anorexia, and caused absence from school in more than 50 % of students. The main finding was the evidence of a clear association between headache and irregular intake of meals (especially irregular breakfast) and sleep disturbance with significant differences when subjects with and without headache were compared. If confirmed, these results are likely to influence clinical practice as well to address educational programs in preadolescents and adolescents.

Trauma and amyotrophic lateral sclerosis: a case-control study from a population-based registry.

BACKGROUND AND PURPOSE: Published reports on the association between amyotrophic lateral sclerosis (ALS) and trauma are controversial suggesting the need for a new case-control study done in a large population. METHODS: A case-control study was undertaken in Italy to assess this association. Cases were patients with newly diagnosed ALS from four population-based registries. For each case, two hospital controls were selected, matched for age, sex, and province of residence, one with a neurological (non-degenerative) disease and one with a non-neurological disease (other than orthopedic or surgical). Traumatic events (defined as accidental events causing injuries requiring medical care) were recorded with details on type, site, timing, severity, and complications. The risks were assessed as odds ratios (ORs) with 95% confidence intervals (CI), crude and adjusted for age, sex, education, interviewee (patient or surrogate), physical activity, smoking, alcohol, and coffee. RESULTS: The study population comprised 377 patients in each of the three groups. One or more traumatic events were reported by 225 cases (59.7%), 191 neurological controls (50.7%), and 179 non-neurological controls (47.5%) (P < 0.01) (OR 1.63; 95% CI 1.25-2.14) (P < 0.01). The ORs were 3.07 (95% CI 1.86-5.05) for patients reporting 3+ traumatic events and 2.44 (95% CI 1.36-4.40) for severe traumatic events. The ORs remained significant when the analysis was limited to events that occurred 5+ and 10+ years before ALS onset, to incident ALS, and direct informant. CONCLUSION: Antecedent trauma, repeated trauma, and severe trauma may be risk factors for ALS.

High prevalence of major neurological disorders in two Albanian communities: results of a door-to-door survey.

BACKGROUND: There are few epidemiological studies on neurological disorders in Albania. METHODS: A door-to-door survey was undertaken in two geographical areas (Tirana and Saranda) with different socioeconomic backgrounds. Two random samples of the local population underwent a structured interview to ascertain headache, epilepsy, dementia, parkinsonism, multiple sclerosis, polyneuropathy, stroke and cerebral palsy. Each diagnosis was made using standard criteria for epidemiological studies and was confirmed by history, neurological examination and, where available, the review of personal medical records. Lifetime prevalence ratios with 95% confidence intervals were calculated. RESULTS: Of the 9,869 individuals screened (Tirana 4,953; Saranda 4,916), 4,867 were males aged 1-91 years (median 39 years) and 5,002 were females aged 1-96 years (median 37 years). Crude prevalence ratios (per 1,000) were: headache 241.9 (233.5-250.3), polyneuropathy 32.5 (29.0-36.0), epilepsy 14.2 (11.7-16.3), stroke 12.4 (10.2-14.6), dementia 9.6 (7.7-11.5), parkinsonism 8.0 (6.2-9.8), cerebral palsy 4.8 (3.4-6.2), and multiple sclerosis 0.3 (0.0-0.6). Prevalence varied with age and gender, with differences across diseases. Except for polyneuropathy (Tirana 39.8; Saranda 25.2), ratios were not different in the two study areas. CONCLUSIONS: The prevalence of selected neurological disorders in Albania is higher than in other countries. Differences may be explained by study design, population structure and/or genetic and environmental factors.

Photocatalytic degradation of acridine dyes using anatase and rutile TiO2.

The adsorption and photodegradation of acridine orange (AO) and acriflavine (AF) dyes on two mesoporous titania crystalline phases, anatase and rutile, were experimentally studied. Anatase and rutile were characterized by nitrogen adsorption, electron scanning and transmission microscopy, and X-ray diffraction. The adsorption capacity of rutile was higher than that of anatase, while the reverse is observed for photodegradation of both dyes. The adsorption of AF on both adsorbents was higher than that of AO, which was related with the smaller size of AF molecules compared with those of AO, therefore the access of AF to the adsorption sites is favored.

Good oral health and diet.

An unhealthy diet has been implicated as risk factors for several chronic diseases that are known to be associated with oral diseases. Studies investigating the relationship between oral diseases and diet are limited. Therefore, this study was conducted to describe the relationship between healthy eating habits and oral health status. The dentistry has an important role in the diagnosis of oral diseases correlated with diet. Consistent nutrition guidelines are essential to improve health. A poor diet was significantly associated with increased odds of oral disease. Dietary advice for the prevention of oral diseases has to be a part of routine patient education practices. Inconsistencies in dietary advice may be linked to inadequate training of professionals. Literature suggests that the nutrition training of dentists and oral health training of dietitians and nutritionists is limited.

In vivo evaluation of labial microcirculation in diabetics: a comparison with healthy subjects.

AIM: Diabetes mellitus, a systemic chronic disease considered an epidemic by the World Health Organization (WHO) due to the rate of increase in the prevalence of diabetes, is a cause of microvascular and macrovascular complications leading to a significant burden for the individual and society. The aim of this study was to evaluate in vivo the effects of type II diabetes mellitus on the microcirculation of oral mucosa. METHODS: Forty-six subjects, 23 patients with type II diabetes mellitus (10 men, 13 women) and 23 healthy patients (9 men, 14 women) were examined in our laboratory. Oral microcirculation was evaluated on labial mucosa using oral video-capillaroscopy: a diagnostic method that permits the in vivo analysis of oral microcirculation. RESULTS: Capillary density, total loop length and total diameter resulted significantly altered in diabetics. The density of loops, observed on labial mucosa, is on average lower in diabetics than in healthy patients. The length and total diameter of loops are increased in diabetics. CONCLUSION: This study shows the capillary alterations that occur in the oral mucosa of diabetics. The loop density decrease is probably a symptom of peripheral microangiopathy. Ultimately, this study demonstrates that there is peripheral damage to microcirculation at the level of the labial mucosa in diabetic subjects and that these alterations are instrumentally "objectivable" and "quantifiable" through the videocapillaroscope technique.

"In vivo" evaluation of the vascular pattern in oral peri-implant tissues.

INTRODUCTION: The vascularisation of the peri-implant tissue represents the key factor in obtaining a successful result in implantology, since an adequate vascular supply allows wound healing and the presence of numerous growth factors that promote osteogenesis. The aim of this study was to analyse "in vivo" the vascular pattern of the peri-implant mucosa in subjects that received implant treatment. MATERIALS AND METHODS: In the study 22 subjects were examined, 11 of whom (test group) received dental implants (Straumann Dental Implant System) while 11 were in the control group; the analysis was performed in the peri-implant masticatory mucosa. The evaluation of the microcirculation was performed "in vivo" using the optical probe videocapillaroscopy technique equipped with 200× lenses. The following parameters were recorded: capillary density, vascular areas, microhaemorrhages and angioarchitecture. RESULTS: The values indicating the capillary density were significantly different in the test group compared to the control group, indicating an angiogenic process taking place "in vivo". In the test group the capillary loops were arranged parallel (30%) as well as perpendicular to the surface; in contrast, in the control group the gingival margin was always perpendicular to the surface (100%). CONCLUSIONS: The peri-implant vascular pattern exhibits special characteristics that differ both in morphology and density from the gingival one.

Risk of periodontal disease: is there a correlation with the type of antihypertensive medication?

INTRODUCTION: The purpose of this study was to evaluate the effects of long-term oral antihypertensive treatment using centrally acting sympatho-inhibitory drugs (clonidine) and beta-blockers (metoprolol) on capillary microcirculation in the labial and periodontal mucosa. METHODS: Sixty subjects were recruited for the study: 20 patients affected by hypertension in treatment with centrally-acting sympatho-inhibitory drugs (64.28 ± 11.78 years); 20 patients in treatment with beta-blockers (62.03 ± 9.84 years) and 20 healthy subjects (62.06 ± 6.72 years). We use the videocapillaroscopic technique to evaluate in vivo the microcirculation of the labial mucosa corresponding to the lower lip and of the periodontal mucosa corresponding to the central superior incisor. RESULTS: Capillaroscopy revealed a significant increase in the length, diameter, tortuousity and density (P <0.05) of capillaries in patients affected by hypertension in treatment with centrally acting sympatho-inhibitory drugs, while beta-blockers had a lower effect on the labial and periodontal microcirculation compared to the healthy population. CONCLUSIONS: The capillaroscopic has revealed substantial modifications of the oral microcirculatory pattern in hypertensive patients in treatment with centrally-acting sympatho-inhibitory drugs than with beta-blockers.

Burning mouth syndrome: is acupuncture a therapeutic possibility?

BACKGROUND: Burning mouth syndrome is a chronic pathology of unknown ethiopathogenesis. The aim of this study was to evaluate whether acupuncture can produce a reduction of the burning sensation by influencing the oral microcirculation. METHODS: Thirty patients (10 male and 20 female; mean age +/- SD = 65.4 +/- 2.17) and 30 healthy subjects (10 male and 20 female; mean age +/- SD = 62.06 +/- 6.72) were recruited for the study. The patients were treated with acupunctural techniques based on traditional Chinese medicine. Microcirculation was observed in vivo using videocapillaroscopy at three different times: t(0)) in the absence of acupuncture; t(1)) 1 minute after the insertion of the needles; and t(2)) 5 minutes after the insertion of the needles and following their stimulation. RESULTS: The capillaroscopic observation revealed a significant increase of the capillary tortuousness and density, a reduction of the arborescence and a reduction of burning sensation in such patients. CONCLUSION: The study shows that acupuncture influences oral microcirculation, resulting in a significant variation of the vascular pattern to which is associated a significant reduction of the burning sensation after three weeks of therapy. Such reduction of the burning sensation has been permanent for the 18 months following the acupuncture therapy. Acupuncture appears a valid therapeutic choice in the management of such patients.

The effect of acupuncture on oral microcirculation in healthy volunteers: an exploratory study.

BACKGROUND: acupuncture is a therapeutic technique currently used in the treatment of many pathologies. The aim of this study is to evaluate the potential effect of acupuncture on "in vivo" variations in oral microcirculation in healthy subjects. METHODS: an exploratory study was conducted on 40 healthy subjects: 20 cases (mean 55.90, SD 16.04) and 20 controls (mean 51, SD 11.91). Videocapillaroscopy was used to detect variations in oral microcirculation. This method permits an accurate and non-invasive in vivo study of the capillaries of the oral mucous. The site selected for this pilot study is the lower lip since it is the simplest to investigate and is more readily accessible. Assessments were carried out in three phases: t(0) before the application of the needles; t(1) one minute after the application; t(2) five minutes after the application; similar time points were used for the control group. Data were compared using the Mann-Whitney test. RESULTS: the study showed characteristic changes in oral microcirculation induced by acupuncture. The tortuousness of capillary loops and in the diameter of the afferent loop changed significantly (p<0.05) over time in the acupuncture group but not in the controls. CONCLUSIONS: the findings lend support to our expectation that acupuncture may generate significant variations in oral microcirculation in healthy adults. Further research is needed to confirm these findings and evaluate the therapeutic role of acupuncture in oral pathologies.

Evaluation of labial microvessels in Sjogren syndrome: a videocapillaroscopic study.

UNLABELLED: Sjögren's syndrome (SS) is a chronic autoimmune rheumatic disease characterized by a progressive lymphocytic infiltration of exocrine glands, especially salivary and lachrymal ones, leading to xerostomia, parotid gland enlargement, and xerophtalmia. SS may occur alone (primary) or in association with almost any of the autoimmune rheumatic diseases (secondary), the most frequent being rheumatoid arthritis. The aim of this study is to describe the capillaroscopic pattern of the labial mucosa in patients with SS. METHODS: A total of 20 patients affected by SS and 20 healthy controls were examined. The patients with conditions that compromise microcirculation, such as diabetes, hypertension, hyperlipidemia or some pharmacological treatments, were not included in the study. All the patients were non-smokers. Labial capillaroscopy has been used to investigate the features of microcirculation. Visibility, course, tortuosity, as well as the possible presence of microhemorrhage, the average calibre of the capillary loops and the number of visible capillary loops per square millimetre were evaluated for each patient. RESULTS: The results show evident alterations in the capillaries and a typical conformation of the labial microcirculation in SS patients. CONCLUSION: Labial microcirculation alterations occur in SS patients. The study of the microcirculation in autoimmune pathology such as SS could provide new understanding on the dynamics of the pathology and could help to complete the diagnosis.

Correlation of " in vivo" microcirculation and degeneration of the basal cells of the epithelium in lingual lichen planus.

BACKGROUND: Oral lichen planus is an inflammatory chronic disease with an autimmune pathogenesis and unknown etiology that affects oral mucosa, with or without the involvement of the skin and other mucous membranes. The principal histological characteristics are the degeneration of the basal cell layer and the abnormal infiltration of inflammatory cells into the subepithelial layer of connective tissue. OBJECTIVES: This study is aimed to appraise if lingual lichen planus (LLP) is sustained by alteration of the oral microcirculation and if this abnormal vascularisation increases the degeneration of basal keratinocytes and the disruption of the basement membrane. MATERIALS AND METHODS: Fifteen patients with a histological diagnosis of LLP with higher degree of degeneration of the basement membrane, fifteen LLP patients with lower degree of basement membrane (BM) degeneration and fifteen healthy patients were included in the study. The microcirculation of the left margin of the lingual mucosa of all the patients and subjects was analysed with the videocapillaroscopy. The following parameters were analyzed on each capillaroscopic image: c0 apillary loop length, loop diameter, and capillary density. The results obtained by videocapillaroscopy software were subjected to statistical analysis using Mann Whitney U-test (P < 0.001). Statistical analysis was performed using PAST software, v. 1.53. RESULTS: Capillary density, loop length, and total diameter showed statistically significant differences between LLP patients with histologically lower degree of BM degeneration and healthy subjects and a meaningful significant difference between LLP patients with higher degree of BM degeneration. CONCLUSIONS: A remarkable increase in capillary density was showed by videocapillaroscopic exam. The increased value of the density could be associated with angiogenesis mechanism and it could be an indicator of the evolutionary condition of LLP. Videocapillaroscopy may be useful for the evaluation of the evolution or regression of the disease.