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1.
Commun Biol ; 5(1): 962, 2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104423

RESUMO

Periodontitis is a highly prevalent disease leading to uncontrolled osteoclastic jawbone resorption and ultimately edentulism; however, the disease onset mechanism has not been fully elucidated. Here we propose a mechanism for initial pathology based on results obtained using a recently developed Osteoadsorptive Fluogenic Sentinel (OFS) probe that emits a fluorescent signal triggered by cathepsin K (Ctsk) activity. In a ligature-induced mouse model of periodontitis, a strong OFS signal is observed before the establishment of chronic inflammation and bone resorption. Single cell RNA sequencing shows gingival fibroblasts to be the primary cellular source of early Ctsk. The in vivo OFS signal is activated when Toll-Like Receptor 9 (TLR9) ligand or oral biofilm extracellular DNA (eDNA) is topically applied to the mouse palatal gingiva. This previously unrecognized interaction between oral microbial eDNA and Ctsk of gingival fibroblasts provides a pathological mechanism for disease initiation and a strategic basis for early diagnosis and treatment of periodontitis.


Assuntos
Reabsorção Óssea , Periodontite , Animais , Reabsorção Óssea/metabolismo , Catepsina K/genética , Catepsina K/metabolismo , Catepsina K/farmacologia , DNA/metabolismo , Fibroblastos/metabolismo , Gengiva/metabolismo , Gengiva/patologia , Camundongos , Periodontite/genética , Periodontite/metabolismo , Periodontite/patologia
2.
J Appl Oral Sci ; 30: e20220076, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35830121

RESUMO

OBJECTIVE: The purpose of this study is to investigate the pathogenic role of PPARα in periodontal antigen treated gingival cells in vitro and in experimental periodontitis in vivo . METHODOLOGY: Gingival fibroblasts, gingival epithelial cells and splenocytes were isolated from C57BL/6J wild type (WT) mice and treated with fixed P. gingivalis at for 48 hours. The mRNA levels of PPARs, TNFα, IL-1ß and IL-10 were detected by Real-time quantitative PCR. Silk ligatures after being soaked in the P.gingivalis suspension were tied around both maxillary second molars of WT mice or PPARα knock-out (KO) mice for two weeks. PPARα agonist fenofibrate and vehicle control were injected into the different side of the palatal gingiva on days 3, 6, and 9. At day 14, bone resorption and gingival mRNA expression levels of PPARs, TNFα, IL-1ß and IL-10 were measured by micro-computed tomography and RT-qPCR respectively. RESULTS: P. gingivalis treatment downregulated the expression of PPARα, but not PPARß or PPARγ, and increased the expression of TNF-α and IL-1ß in Gingival fibroblasts, gingival epithelial cells and splenocytes from WT mice. Gingival mRNA levels of PPARα were significantly decreased in experimental periodontitis in WT mice. The bone loss of PPARα KO mice in experimental periodontitis was significantly higher than WT mice and was not reduced by fenofibrate treatment. Gingival TNFα protein expressions were significantly increased by P. gingivalis associated ligation and decreased by fenofibrate treatment in WT mice but not in PPARα KO mice. CONCLUSION: This study suggests that PPARα plays an essential role in periodontitis.


Assuntos
Perda do Osso Alveolar , Fenofibrato , PPAR alfa , Periodontite , Perda do Osso Alveolar/patologia , Animais , Fenofibrato/farmacologia , Gengiva/patologia , Interleucina-10/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , PPAR alfa/metabolismo , Periodontite/metabolismo , Periodontite/patologia , Porphyromonas gingivalis/metabolismo , RNA Mensageiro/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Microtomografia por Raio-X
3.
J Int Med Res ; 50(7): 3000605221113408, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35883281

RESUMO

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide; however, cases with metastasis to the oral cavity are extremely rare. Herein, we report a 68-year-old man who was diagnosed with HCC. Ten months after surgical removal of the right half of his liver, the patient developed gingival metastasis. Unfortunately, the patient died 4 months after the diagnosis. We discuss treatment options, pathological results, and disease prognosis. When a mandibular gingival mass is found, metastatic tumors should be considered in the differential diagnosis. In this regard, the patient's medical history and physical examination are valuable indicators for the diagnosis of mandibular gingival metastasis. This case provides a basis for the clinical diagnosis of metastatic HCC involving the oral cavity.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Abdome/patologia , Idoso , Carcinoma Hepatocelular/patologia , Diagnóstico Diferencial , Gengiva/patologia , Gengiva/cirurgia , Humanos , Neoplasias Hepáticas/patologia , Masculino
4.
Oral Oncol ; 132: 105995, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35759858

RESUMO

BACKGROUND: Oral squamous cell carcinoma (OSCC) of the gingiva represents less than 6% of intraoral carcinomas. CASE REPORT: A 51-year-old male patient presented with a history of a symptomatic red spot with periods of remission and recurrence in the mandibular gingiva. On clinical examination red and white areas were observed in the gingiva, particularly around the left lower molars. Diagnosis of gingival lichen planus was suspected and topical corticosteroids was prescribed. A good clinical response was observed with reduction of symptom. The patient remained in regular follow-up and after 9 months, the lesion suddenly changed, became ulcerated and diagnosis of OSCC was established. CONCLUSION: The clinical manifestation of OSCC can eventually mimic other even more common lesions of the oral mucosa, highlighting the importance of considering OSCC as differential diagnosis of any unexplained and persistent lesion in the oral cavity.


Assuntos
Carcinoma de Células Escamosas , Líquen Plano Bucal , Líquen Plano , Neoplasias Bucais , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Gengiva/patologia , Humanos , Líquen Plano Bucal/patologia , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia
5.
Mol Immunol ; 148: 18-33, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35665658

RESUMO

Colonization of mucosal tissues throughout the body occurs by a wide array of bacteria in the microbiome that stimulate the cells and tissues, as well as respond to changes in the local milieu. A feature of periodontitis is the detection of adaptive immune responses to members of the oral microbiome that show specificity and changes with disease and treatment. Thus, variations in antibody responses are noted across the population and affected by aging, albeit, data are still unclear as to how these differences relate to disease risk and expression. This study used a nonhuman primate model of experimental periodontitis to track local microbiome changes as they related to the use and expression of a repertoire of immunoglobulin genes in gingival tissues. Gingival tissue biopsies from healthy tissues and following ligature-placement for disease initiation and progression provided gene expression analysis. Additionally, following removal of the ligatures, clinical healing occurs with gene expression in disease resolved tissues. Groups of 9 animals (young: <3 yrs., adolescent: 3-7 yrs., adult -12 to 15 yrs.; aged: 17-22 yrs) were used in the investigation. In healthy tissues, young and adolescent animals showed levels of expression of 78 Ig genes that were uniformly less than adults. In contrast, ⅔ of the Ig genes were elevated by > 2-fold in the aged samples. Specific increases in an array of the Ig gene transcripts were detected in adults at disease initiation and throughout progression, while increases in young and adolescent animals were observed only with disease progression, and in aged samples primarily late in disease progression. Resolved lesions continued to demonstrate elevated levels of Ig gene expression in only young, adolescent and adult animals. The array of Ig genes significantly correlated with inflammatory, tissue biology and hypoxia genes in the gingival tissues, with variations associated with age. In the young group of animals, specific members of the oral microbiome positively correlated with Ig gene expression, while in the older animals, many of these correlations were negative. Significant correlations were observed with a select assortment of bacterial OTUs and multiple Ig genes in both younger and older animal samples, albeit the genera/species showed little overlap. Incorporating this array of microbes and host responses clearly discriminated the various time points in transition from health to disease and resolution in both the young and adult animals. The results support a major importance of adaptive immune responses in the kinetics of periodontal lesion formation, and support aging effects on the repertoire of Ig genes that may relate to the increased prevalence and severity of periodontitis with age.


Assuntos
Microbiota , Periodontite , Animais , Bactérias , Progressão da Doença , Gengiva/patologia , Imunoglobulinas/genética , Macaca mulatta/genética , Transcriptoma
7.
J Periodontal Res ; 57(4): 780-798, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35582846

RESUMO

OBJECTIVE: This study used a nonhuman primate model of ligature-induced periodontitis to document the characteristics of immunoglobulin (Ig) gene usage in gingival tissues with disease and affected by age. BACKGROUND: Adaptive immune responses to an array of oral bacteria are routinely detected in local gingival tissues and the systemic circulation across the human population. The level and diversity of antibody increases with periodontitis, reflecting the increased quantity of B cells and plasmacytes in the tissues at sites of periodontal lesions. METHODS: Macaca mulatta (n = 36) in four groups (young - ≤3 years; adolescent >3-7 years; adult - 12-15 years; aged - 17-23 years) were used in this study. Gingival tissues were sampled at baseline (health), 2 weeks (initiation), 1 and 3 months (progression), and 5 months (resolution) of the lesion development and transcriptomic analysis included 78 Ig-related genes. RESULTS: The results demonstrated extensive variation in Ig gene usage patterns and changes with the disease process that was substantially affected by the age of the animal. Of note was that the aged animals generally demonstrated elevated expression on multiple Ig genes even in the baseline/healthy gingival tissues. The expression levels revealed 5 aggregates of Ig gene change profiles across the age groups. The number of gene changes were greatly increased in adult animals with the initiation of disease, while the young and adolescent animals showed extensive changes with disease progression. Elevated Ig gene transcripts remained with disease resolution except in the aged animals. The response profiles demonstrated selective heavy/light change gene transcripts that differed with age and clustering of the transcript expression was dominated by the age of the animals. CONCLUSIONS: The results suggested potential critical variations in the molecular aspects of Ig gene expression in gingival tissues that can contribute to understanding the kinetics of periodontal lesions, as well as the variation in episodes, rapidity of progression, and role in resolution that are impacted by age.


Assuntos
Envelhecimento , Genes de Imunoglobulinas , Periodontite , Envelhecimento/genética , Animais , Perfilação da Expressão Gênica , Gengiva/patologia , Macaca mulatta , Periodontite/genética
8.
Med. oral patol. oral cir. bucal (Internet) ; 27(3): e216–e222, may. 2022. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-204658

RESUMO

Background: Corona Virus Disease-2019 (COVID-19) is perhaps the disastrous medical emergencies that has ever hit globally with multiple strains. Amongst various sequelae, mucormycosis may be considered as the most debilitating one. Post COVID-19 mucormycosis is formally regarded as corona virus disease associated mucormycosis (CAM). The aim of the current paper is to present twelve cases of CAM with unique clinical presentation with a detailed histopathological correlation of the gingival biopsied material. Material and Methods: Twelve cases of CAM were included in the study who presented initially with non-purulent swelling of the gingiva. The clinic-demographic data pertaining to age, gender, location, laterality and presence of co-morbidities was collected along with histopathological examination of biopsied specimen. Results: The patients ranged from 31-65 years (mean age 47.33 years). There was a male predominance. Clearly, maxillary right gingiva was mostly affected and all cases presented with non purulent, non tender swelling of the gingiva. The incisional biopsy from the gingiva consistently showed pseudoepitheliomatous hyperplasia of the surface epithelium along with vacuolar degeneration, extensive stromal edema, massive mixed inflammatory reaction, congested blood vessels, hemorrhage and abundant multinucleated giant cells. Potassium hydroxide (10% KOH) mount served no additional diagnostic advantage. After two initial biopsies any suspected case of CAM with these features was treated with appropriate antifungal therapy and conservative excision. Conclusions: Gingival swelling with aforementioned histopathological features resembling post COVID-19 histological alterations could be alarming early signs of CAM and are candidate of prompt antifungal therapy rather than repeat biopsy for confirmation.(AU)


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Antifúngicos/uso terapêutico , Coronavirus , Comorbidade , Mucormicose/complicações , Mucormicose/diagnóstico , Mucormicose/tratamento farmacológico , Gengiva , Gengiva/patologia
9.
Arch Oral Biol ; 140: 105466, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35640321

RESUMO

OBJECTIVE: Implication of human caspase-4 in periodontitis and in sensing periodontal pathogens by gingival epithelial cells (GECs) is unclear. This study aimed to determine caspase-4 and interleukin (IL)-18 expressions in gingival tissues affected with periodontitis and to investigate caspase-4 involvement in mediating innate immune responses in GECs. DESIGN: Ex vivo, caspase-4 and IL-18 expressions in gingival biopsies, obtained from healthy participants with periodontitis or clinically healthy gingiva (N = 20 each), were determined by immunohistochemistry. In vitro, caspase-4 activation in cultured GECs stimulated with Porphyromonas gingivalis or Fusobacterium nucleatum was analyzed by immunoblotting. mRNA expressions of human ß-defensin-2 (hBD-2), IL-8, and IL-18 in stimulated GECs in the presence or absence of a caspase-4 inhibitor were assayed by RT-qPCR. RESULTS: Ex vivo, compared with healthy gingival epithelium, the epithelium affected with periodontitis displayed a significant decrease in caspase-4 expression (P = 0.015), whereas IL-18 expression was significantly increased (P = 0.012). Moreover, the expression of caspase-4, but not IL-18, was found to be a predictor of periodontitis (P = 0.007). In vitro, caspase-4 was activated in cultured GECs challenged with P. gingivalis, but not F. nucleatum. mRNA upregulations of hBD-2, IL-8, and IL-18 upon P. gingivalis stimulation were significantly reduced when caspase-4 was inhibited (P < 0.05), whereas the inhibitor failed to suppress those inductions by F. nucleatum. CONCLUSIONS: Caspase-4 expression is diminished in the epithelium affected with periodontitis while that of IL-18 is enhanced. Caspase-4 activation in P. gingivalis-infected GECs upregulates the three innate immune effector molecules, suggesting a possible sensing mechanism of caspase-4 in GECs in periodontal disease pathogenesis.


Assuntos
Infecções por Bacteroidaceae , Caspases Iniciadoras , Gengiva , Periodontite , Porphyromonas gingivalis , Infecções por Bacteroidaceae/enzimologia , Infecções por Bacteroidaceae/microbiologia , Infecções por Bacteroidaceae/patologia , Caspases Iniciadoras/biossíntese , Células Cultivadas , Epitélio/enzimologia , Epitélio/microbiologia , Epitélio/patologia , Gengiva/enzimologia , Gengiva/microbiologia , Gengiva/patologia , Humanos , Interleucina-18/biossíntese , Interleucina-8/biossíntese , Periodontite/enzimologia , Periodontite/microbiologia , Periodontite/patologia , Porphyromonas gingivalis/metabolismo , RNA Mensageiro/metabolismo
10.
PLoS One ; 17(3): e0265486, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35298525

RESUMO

Periodontitis is one of the most common infectious diseases in humans. It is characterized by a chronic inflammation of the tooth-supporting tissue that results in bone loss. However, the role and source of the pro-inflammatory cytokine interleukin-17 (IL-17) and of the cells producing it locally in the gingiva is still controversial. Th17 αß T cells, CD4+ exFoxP3+ αß T cells, or IL-17-producing γδ T cells (γδ17 cells) seem to be decisive cellular players in periodontal inflammation. To address these issues in an experimental model for periodontitis, we employed genetic mouse models deficient for either γδ T cells or IL-17 cytokines and assessed the bone loss during experimental periodontal inflammation by stereomicroscopic, histological, and µCT-analysis. Furthermore, we performed flow-cytometric analyses and qPCR-analyses of the gingival tissue. We found no γδ T cell- or IL-17-dependent change in bone loss after four weeks of periodontitis. Apart from that, our data are complementary with earlier studies, which suggested IL-17-dependent aggravation of bone loss in early periodontitis, but a rather bone-protective role for IL-17 in late stages of experimental periodontitis with respect to the osteoclastogenicity defined by the RANKL/OPG ratio.


Assuntos
Perda do Osso Alveolar , Periodontite , Perda do Osso Alveolar/patologia , Animais , Citocinas , Gengiva/patologia , Inflamação , Interleucina-17/genética , Camundongos
11.
Dermatol Ther ; 35(6): e15475, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35352853

RESUMO

Pemphigus is a group of autoimmune diseases characterized by flaccid lesions on the skin and mucous membranes. In pemphigus vulgaris, the most common subtype of pemphigus, lesions might be appeared anywhere on the oral mucosa, mostly in the buccal mucosa. However, the gingiva is a less frequently affected site. Here, we performed a retrospective study at Tehran University of Medical Sciences, covering a two-year period to identify pemphigus patients with active lesions confined to the gingiva. Considering 1787 initially evaluated pemphigus cases, 512 (28.6%) were found to have a history of gingival involvement. Among them, 31 patients had only gingival involvement during their last visit, including 29 (93.5%) women and only two (6.5%) men. The mean of disease duration in this group was 5.29 ± 3.46 years, and they had gingival involvement for a mean of 23.9 ± 19.3 months. Of 28 patients, nine were negative for anti-Dsg3 and 24 were negative for anti-Dsg1. In 24 patients, who received rituximab, the mean pemphigus disease area index specifically for gingiva was 4.76 ± 0.74 at baseline, which had changed to 4.13 ± 0.75 and 3.26 ± 0.63 three and 6 months after rituximab administration, respectively. After 3 months, gingival lesions were either entirely resolved (n = 3), partially resolved (n = 11), remained unchanged (n = 2), or progressed (n = 7). Gingiva-confined presentation of lesions in pemphigus could be non-anti-Dsg1/3 dependent in some patients. Such patients do not respond well to conventional treatments and rituximab therapy. More studies on the pathogenesis of gingiva-confined presentation of pemphigus are required.


Assuntos
Pênfigo , Autoanticorpos , Desmogleína 1 , Feminino , Gengiva/patologia , Humanos , Irã (Geográfico) , Masculino , Mucosa Bucal/patologia , Pênfigo/diagnóstico , Pênfigo/tratamento farmacológico , Estudos Retrospectivos , Rituximab
12.
Dent Med Probl ; 59(1): 105-110, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35349228

RESUMO

BACKGROUND: The gingiva is a common site for neoplastic or non-neoplastic lesions. Neoplasms refer to progressive autonomous growth that can have either a benign or a malignant course. On the other hand, non-neoplastic lesions are mainly inflammatory, or occur as a reaction to some kind of irritation or lowgrade injury. OBJECTIVES: Assessing the frequency distribution of gingival lesions is important to optimize oral health care services. The present study retrospectively analyzed the frequency distribution of gingival lesions on the basis of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. The secondary objective was to compare this system with the 1999 International Workshop classification system. MATERIAL AND METHODS: The hematoxylin and eosin (H&E)-stained histopathological slides of the gingival lesions reported over the last 3 years (2018-2020) were retrieved from the archive of the Division of Oral Pathology and Microbiology at a tertiary care hospital in New Delhi, India. Correlating clinical, radiological and pathological details enabled the categorization of lesions according to the new classification system. RESULTS: In total, 73 gingival lesions were analyzed. Among these, reactive processes were the most frequent (39.73%), followed by inflammatory and immune conditions and lesions (26.03%), malignant tumors (21.92%), benign epithelial lesions (5.48%), and oral potentially malignant disorders (OPMDs) (5.48%). Genetic/developmental disorders were the least frequent (1.37%). However, as per the 1999 American Academy of Periodontology (AAP) system, the majority of lesions belonged to a non-specified category. CONCLUSIONS: The frequency distribution of biopsied gingival lesions according to the 2017 World Workshop classification in comparison with the previous classification system showed that differences between the 2 systems could be attributed to heterogeneous terminology rather than to real geographical variations.


Assuntos
Gengiva , Doenças da Boca , Gengiva/patologia , Humanos , Índia , Doenças da Boca/patologia , Estudos Retrospectivos
13.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 53(2): 214-219, 2022 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-35332720

RESUMO

Gingival epithelial barrier is the first line of defense of periodontal tissues against the invasion of pathogenic bacteria. The destruction of gingival epithelial barrier is closely related to the development of periodontal disease. Studies have shown that periodontal pathogenic bacteria and their inflammatory microenvironment can inhibit the expression of gingival epithelial junctional proteins via molecular mechanisms such as the downregulation of the expression of grainyhead-like protein family and the upregulation of the methylation level of gene promoter of epithelial connexin, and thus cause damage to the gingival epithelial barrier and the development of periodontitis. We herein reviewed the effects of bacteria and inflammatory factors induced by bacterial infection on gingival epithelial intercellular junctions and related mechanisms, and summarized the research progress on the relationship between gingival epithelial intercellular junctions and periodontal pathogenic bacteria in recent years. Most recent studies were focused on i n vitro cytological experiments and animal models of infections caused by a single kind of bacterium. We have suggested that building gingival epithelial organoid model and combining multi-omics approaches with high resolution three-dimensional electron microscopy are expected to help pinpoint the key microorganisms and their most important virulence factors that trigger periodontal microecologcal imbalance and cause functional damage to the gingival epithelial barrier, to reveal the key molecular mechanisms involved in the maintenance and destruction of gingival epithelial barrier function, and to provide new perspectives on the pathogenesis and the clinical prevention and treatment of periodontitis.


Assuntos
Infecções Bacterianas , Periodontite , Animais , Bactérias , Gengiva/patologia , Junções Intercelulares/metabolismo , Periodontite/metabolismo
14.
Vet Pathol ; 59(3): 463-466, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35220854

RESUMO

Oral squamous cell carcinomas (OSCCs) are common cancers of cats. While papillomaviruses (PVs) are an important cause of human OSCCs, there is currently little evidence that PVs cause squamous cell carcinomas (SCCs) of the mouth or other mucosal surfaces in cats. In the present cat, in situ carcinomas developed on the gingiva and nictitating membrane. Neoplastic cells within both cancers contained prominent PV-induced cellular changes consistent with those caused by Felis catus PV3 (FcaPV3), and FcaPV3 DNA was amplified from both cancers. Neoplasms also contained intense nuclear and cytoplasmic p16CDKN2A protein (p16) immunolabeling, suggesting PV-induced degradation of retinoblastoma protein. The molecular and histological features strongly suggested the cancers were caused by FcaPV3 infection. This is the first report of an association between PV infection and the development of an in situ carcinoma of the mucosa of cats. The identification of these lesions suggests that PVs might cause a proportion of OSCCs, and SCCs from other mucosal surfaces, in cats.


Assuntos
Carcinoma in Situ , Carcinoma de Células Escamosas , Doenças do Gato , Neoplasias Bucais , Infecções por Papillomavirus , Animais , Carcinoma in Situ/veterinária , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/veterinária , Gatos , DNA Viral/genética , Gengiva/metabolismo , Gengiva/patologia , Neoplasias Bucais/veterinária , Membrana Nictitante/patologia , Papillomaviridae/genética , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/veterinária
15.
Int J Esthet Dent ; 17(1): 28-40, 2022 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-35175006

RESUMO

Connective tissue graft (CTG) surgery has been performed since the 1980s with the principal aim of root coverage. Various types of CTG surgery have been reported, not only for root coverage but also as a preprosthetic treatment for the prevention of gingival recession and to alleviate gingival discoloration. Although there have been numerous reports on the prognosis of such treatment, few observational case reports of 10 years or more have been published. The present article reports on five patients who were monitored from between 13 to 23 years after CTG surgery through the use of intraoral findings, CBCT, and histologic evaluation. The hypothesis of the present authors is that growth factors are released gradually from connective tissue placed either above or below the periosteum. Furthermore, stimulated by the optimal occlusion of the natural teeth, osteoblasts present on the periosteum and/or alveolar bone surrounding the teeth are stimulated. Similarly, the connective tissue itself ensures that the soft tissue has a certain biologic width. At the same time, it acts as a scaffold, resulting in the tissue being replaced by bone.


Assuntos
Retração Gengival , Osteogênese , Tecido Conjuntivo/transplante , Gengiva/patologia , Retração Gengival/cirurgia , Humanos , Raiz Dentária , Resultado do Tratamento
16.
Gen Dent ; 70(2): 33-36, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35225801

RESUMO

Oral lesions may be the initial or only manifestation of leukemia and can be the key to early diagnosis. The varied nature of presenting signs and dentists' general lack of familiarity with oral presentations makes diagnosis challenging. This retrospective review reports a series of cases of leukemia to familiarize dentists with the oral manifestations and facilitate earlier diagnosis or recognition of relapse of this life-threatening disease. Following institutional review board approval, the University of Florida Oral Pathology Biopsy Service archive from 1994 to 2018 was queried for all oral biopsies resulting in a diagnosis of leukemia. Cases with insufficient diagnostic information or extraoral manifestations were excluded. Demographic, clinical, and histologic findings were tabulated. Ten cases with 12 biopsy sites were identified. Men (n = 6) were affected more commonly. The mean age of the patients was 58.4 years (range of 17 to 88 years). The gingiva was the most frequently biopsied site (n = 6; 50%). Importantly, 40% of the patients (n = 4) had no prior diagnosis of leukemia. A wide spectrum of clinical impressions was rendered, pyogenic granuloma being the most common, and the reported duration of lesions ranged from several weeks to 6 months. The rarity of patients presenting with leukemia may lead to low levels of clinical suspicion, misdiagnosis, and delays in treatment. However, oral lesions may be the first and only manifestation of leukemia, and clinicians should be aware of the clinical characteristics of these oral presentations to ensure early diagnosis and treatment, thereby helping to reduce disease-related morbidity and mortality.


Assuntos
Leucemia , Úlceras Orais , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Odontólogos , Gengiva/patologia , Humanos , Leucemia/complicações , Leucemia/diagnóstico , Leucemia/patologia , Masculino , Pessoa de Meia-Idade , Papel Profissional , Adulto Jovem
17.
Gen Dent ; 70(2): 28-32, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35225800

RESUMO

Maxillofacial metastases are rare but represent advanced disease progression and a poor prognosis. The primary purpose of this article is to describe a patient with previously diagnosed and treated invasive ductal breast carcinoma who developed a metastatic lesion in the maxillary gingiva. In addition, this article presents a brief literature review of case reports on metastatic breast cancer manifestations in the gingiva. In the present case, a 68-year-old woman had been diagnosed and treated for invasive ductal breast carcinoma. At the 6-month follow-up after treatment for breast cancer, she complained of pain in the right leg and spine, swelling in the right arm associated with redness, and a nodular growth in the maxillary gingiva that was painful, friable, and associated with tooth mobility. Imaging examinations and microscopic analysis of an oral biopsy specimen revealed disease progression to the oral cavity, femur, lung, and brain. Because of the advanced disease, the patient died within a few weeks. The literature review identified 6 articles that reported varied clinical presentations of metastatic breast cancer in the gingiva. Invasive ductal carcinoma was the most common histologic type. Routine dental follow-up of patients with cancer is essential for the identification and diagnosis of oral lesions to ensure early intervention for lesions that may be distant metastases mimicking benign lesions.


Assuntos
Adenocarcinoma , Neoplasias da Mama , Adenocarcinoma/patologia , Idoso , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Feminino , Gengiva/patologia , Humanos
18.
Am J Orthod Dentofacial Orthop ; 161(6): 838-848, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35219553

RESUMO

INTRODUCTION: This study compared the changes of gingiva and alveolar bone parameters, including cortical and cancellous bones between thick and thin gingival biotypes after en-masse retraction. METHODS: Thirty-two adult subjects (mean age, 20.6 years) with maxillary anterior teeth protrusion and proclination were studied and divided into 2 equal groups: thick gingival biotype (TKB) and thin gingival biotype (TNB). Maxillary anterior teeth were retracted using nickel-titanium coil springs at 150 g of force bilaterally for 4 months. Lateral cephalograms, study models, and cone-beam computed tomography scans were taken before retraction and 3 months after 4 months of retraction. Nonparametric tests compared the changes within the groups at these periods and between the groups. RESULTS: The gingiva gained thickness and length (P <0.01) on the labial and palatal sides. The gingival thickness gained more on the palatal side (P <0.01), whereas the length gained equally in both groups. Labial alveolar bone showed increased thickness and height (P <0.01) as opposed to the palatal alveolar bone that presented with loss of thickness and height (P <0.01). The height loss occurred more in TNB (P <0.01). Labial cortical bone increased in thickness and height (P <0.01), whereas palatal cortical bone thinned (P <0.01) at levels in which no cancellous bone was present at the crestal level for TKB and the crestal and midroot levels for TNB. TKB showed slower incisor movement and less retroclination than the TNB (P <0.01) with minimal incisor extrusion. CONCLUSIONS: Favorable gingiva and labial bone responses after en-masse retraction were found in both gingival biotypes, whereas more palatal alveolar bone height loss was presented in TNB. Cortical bone thickness decreased when cancellous bone was absent.


Assuntos
Gengiva/fisiologia , Maxila , Adulto , Perda do Osso Alveolar/etiologia , Tomografia Computadorizada de Feixe Cônico/métodos , Gengiva/diagnóstico por imagem , Gengiva/patologia , Técnicas de Retração Gengival , Humanos , Incisivo , Palato , Adulto Jovem
19.
Med Sci Monit ; 28: e932191, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34983919

RESUMO

BACKGROUND This study aimed to compare the effectiveness of subgingival scaling and root planing with the Twinlight laser, Er: YAG laser, and hand instrumentation on the removal of endotoxin and attachment of human gingival fibroblasts (HGFs) to cementum surfaces in vitro. MATERIAL AND METHODS Single-rooted teeth extracted for periodontal disease were collected and divided into 3 groups: group A, root planing with Gracey curet no. 5/6; group B, irradiation with Er: YAG laser; group C, irradiation with Er: YAG laser and Nd: YAG laser. Endotoxins were determined by the limulus amebocyte lysate test. Cell attachment and proliferation of HGFs on root specimens were evaluated by cell counting kit-8 assay. The root surface and cell morphology were observed by scanning electron microscope. RESULTS A flat root surface with scratches was found in group A, Group B had a homogeneous rough morphology without carbonization, and group C had a non-homogeneous rough morphology with ablation. The endotoxin concentration was highest in group A (P<0.05) and lowest in group C (P>0.05). HGFs cultured in group B showed significantly increased adhesion and proliferation compared with groups A and C (P<0.05). HGFs in group B were well attached, covered densely by pseudopodia. HGFs in group A were round with poor extension and short pseudopodia, while the cells in the group C were in narrow, triangular, or polygonal shapes. CONCLUSIONS Twinlight laser-assisted periodontal treatment effectively improved the biocompatibility of root surface and promoted the attachment and proliferation of fibroblasts by removing calculus and reducing the concentration of endotoxins.


Assuntos
Fibroblastos/fisiologia , Gengiva , Terapia a Laser , Lasers de Estado Sólido/uso terapêutico , Doenças Periodontais , Aplainamento Radicular/métodos , Adesão Celular , Gengiva/microbiologia , Gengiva/patologia , Humanos , Terapia a Laser/instrumentação , Terapia a Laser/métodos , Microscopia Eletrônica de Varredura/métodos , Doenças Periodontais/microbiologia , Doenças Periodontais/fisiopatologia , Doenças Periodontais/terapia , Propriedades de Superfície
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