Peri-implant tissue response following connective tissue and bone grafting in conjunction with immediate single-tooth replacement in the esthetic zone: a case series.

PURPOSE: This case series evaluated the peri-implant tissue response following extraction and immediate placement and restoration of an implant in conjunction with subepithelial connective tissue grafting (SCTG) and bone grafting in the esthetic zone. Implant success rates and the peri-implant tissue response were also reported. METHODS AND MATERIALS: Ten patients (four men, six women) with a mean age of 48 years (range, 35 to 70) underwent extraction and immediate tooth replacement with SCTG and were evaluated clinically and radiographically presurgically (T0), immediately after immediate tooth replacement and SCTG (T1), and at 3 months (T2), 6 months (T3), and 12 months (T4) after surgery. Data was analyzed using Friedman and Wilcoxon signed-ranks tests at the significance level of a = .05. RESULTS: At 1 year, all implants remained osseointegrated, with an overall mean marginal bone change of +0.10 mm and a mean facial gingival level change of -0.05 mm. Modified Plaque Index scores showed that patients were able to maintain a good level of hygiene throughout the study. Papilla Index scores indicated that at T4, more than 50% papilla fill was observed in 80% of all sites. CONCLUSIONS: The results of this case series suggest that, in addition to a favorable implant success rate and peri-implant tissue response, the facial gingival level around single immediately placed implants can also be maintained following connective tissue grafting when proper three-dimensional implant positioning is achieved and bone is grafted into the implant-socket gap.

Prognostic value of LYVE-1-positive lymphatic vessel in tongue squamous cell carcinomas.

The density of lymphatic vessels in 52 cases of human tongue squamous cell carcinoma (TSCC) and normal portions was analyzed. TSCC specimens were immunostained with antibodies against lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1) and podoplanin monoclonal antibody (D2-40). The significance of the LYVE-1-positive vessel density (LVD) was calculated in 6 topographic areas and investigated on the basis of specific clinical and histo-pathological parameters. LYVE-1 positivity was more evident in the muscular area than the submucosal area, while small D2-40-positive lymphatic vessels were not demonstrable in muscular endomysium. The LVD in peri-tumoral submucosal and peri-tumoral muscular areas was lower than in normal counterparts (p<0.01). LVD was higher in the tumor invasion front as compared to tumor-associated stroma (p<0.01). Low LVD in invasion front and peri-tumoral submucosal area was significantly related to regional lymph node metastasis (p<0.05 and p<0.01, respectively). The decrease of LYVE-1-positive lymphatic vessels in the invasion front and peri-tumoral submucosal area would seem to predict cervical lymph node metastasis in TSCC.

Detection of fascin and CCR-7 positive mature dendritic cells in oral lichen planus.

BACKGROUND: Dendritic cells (DC) play a crucial role in the pathogenesis of oral lichen planus (OLP) with respect to antigens presented to T cells. We performed immunohistochemical analysis to elucidate the process of activation of DC in OLP. METHODS: Thirty biopsy specimens were obtained from the patients with OLP. The expressions of CD1a, Langerin, S-100, fascin, chemokine receptor-7 (CCR-7), D2-40, cyclooxygenase-2 (COX-2), and microsomal prostaglandin E synthase-1 (mPGES-1) in DC from OLP and disease free control were investigated using specific antibodies. The distribution and number (1 mm(2)) of DC were assessed in the intra-epithelium and the submucosa specimens. Correlation between the number of DC and epithelium thickness was also determined. RESULT: Immature DC (Langerin(+), CD1a(+), and S-100(+)) were identified in the epithelia from OLP patients and control, though the numbers of Langerin(+) and CD1a(+) positive cells were decreased in the OLP samples as compared to the control. Mature DC (fascin(+)) were identified in the submucosa specimens, not found in the epithelium from OLP or control. Double immunostaining revealed DC positive for fascin and CCR-7 in the submucosa, which had migrated into D2-40(+) lymph vessels. Furthermore, keratinocytes expressed both Prostaglandin E(2) (PGE(2)) converting enzymes, COX-2, and mPGES-1, indicating PGE(2) synthesis in the epithelial layer of the OLP specimens. CONCLUSION: Our results indicate that DC change from immature to mature in the epithelium and are then drawn out to the submucosa. We demonstrate that mature DC localized in the submucosa, it consequently migrates into lymph vessels. This maturation process of DC is an important immunopathological feature of OLP.