Cholesterol granuloma of the maxillary sinus in association with a dental implant-A case report.

BACKGROUND: Cholesterol granuloma is typically a benign granulomatous growth seen mostly in the mastoid process and the petrous temporal bone. Although cholesterol granuloma in maxillary sinus was first reported in the scientific literature in 1978, the occurrence is very rare and it is usually clinically and radiographically manifested ambiguously as maxillary sinusitis. PURPOSE: The presence of cholesterol granuloma in the maxillary sinus in association with a dental pathology or prosthesis has been scarcely known. In this case report, we present a case of cholesterol granuloma in the maxillary sinus of a middle-aged male who had previously undergone dental implant placement in relation to that anatomical location. MATERIALS AND METHODS: A 64-year-old man reported to the Dental OP with a chief complaint of oral malodor, swelling, and tenderness over the right middle third of the face for the past 3 months. A cone beam computed tomography scan showed a well-defined radio-opaque lesion along with sclerosis and thinning of bone within the right maxillary antrum in relation to the dental implant placed in the 16 regions. The left maxillary sinus appeared normal. The Caldwell-Luc procedure was performed and a solitary soft lesion with yellowish-gray contents was evident within the right maxillary sinus. Histopathological examination revealed cholesterol clefts surrounded by foreign body giant cell reaction and granulation tissue formation, along with the presence of old and recent hemorrhage. A final diagnosis of cholesterol granuloma was made based on the histopathological examination report. CONCLUSION: Based on the evidence available in the present case, we hypothesize that the localized trauma and hemorrhage initiated by implant placement in this particular anatomical location could have plausibly resulted in the occurrence of cholesterol granuloma in our patient.

Changes in Transforming Growth Factor-ß1 in Gingival Crevicular Fluid of Patients with Chronic Periodontitis Following Periodontal Flap Surgery.

INTRODUCTION: The aim of the study was to assess changes in Transforming Growth Factor- ß1 (TGF-ß1) levels in gingival crevicular fluid (GCF) and examine correlation of TGF-ß1 levels and periodontal parameters: probing pocket depth (PPD) and clinical attachment level (CAL) in sites with chronic periodontitis at various time intervals before and after periodontal surgery. MATERIALS AND METHODS: The effects of non-surgical and surgical therapy on periodontal parameters and GCF TGF-ß1 levels in 18 sites affected with chronic periodontitis were assessed upto 6 weeks post conventional flap surgery. GCF was collected and PPD, CAL recorded at Baseline. GCF was collected and PPD, CAL recorded at Pre-surgery and flap surgery performed. GCF was collected from all sites at Two Weeks Post-surgery. GCF was collected and PPD, CAL recorded at Six Weeks Post-surgery. The concentration of TGF-ß1 in GCF was determined using a human TGF-ß1 enzyme immunometric assay kit. RESULTS: Mean TGF-ß1 concentrations were significantly reduced at Pre-surgery, at Two Weeks Post-surgery and at Six Weeks Post-surgery (p<0.05) when compared to Baseline TGF-ß1 values. There was a statistically significant reduction in PPD and gain in CAL following non-surgical and surgical therapy when compared to baseline (p<0.05). CONCLUSION: RESULTS indicate that TGF-ß1 may play a role in the pathogenesis and diagnosis of periodontal disease and could be considered as a disease predictive biomarker.