Autogenous free tooth transplantation in man by a 2-stage operation technique. A longitudinal intra-individual radiographic assessment.

Insufficient nutrition to the root surface of autotransplanted mature human teeth after transplantation could be an explanation for the high rates of complications such as root resorption and loss of the tooth transplant. Insufficient nutrition is suggested as being due to the distance between the recipient site tissue and the root surface, and the presence of a blood-clot between the tissues. Improved nutrition could be achieved by transplanting into contact with the vascularised connective tissue of a healing wound. To test this hypothesis, a series of human teeth with fully developed roots were autotransplanted to recipient sites prepared and left to heal for 14 days before transplantation. This study is a follow-up of 57 transplants with a minimum observation time of 1 year. Periodic radiographic examinations of the teeth were performed up to 5 years after transplantation. The results presented, showed a lower incidence of root resorption and extractions than previously reported for teeth with fully developed roots.

Intralesional T lymphocyte phenotypes and HLA-DR expression in Melkersson-Rosenthal syndrome.

An immunohistochemical double-staining technique was used to characterize the infiltrating mononuclear lymphocytes in frozen sections from 3 patients with Melkersson-Rosenthal syndrome. The in situ expression of HLA-DR antigens on different cell types was also investigated. The majority of mononuclear cells could be classified as T-lymphocytes because of their Leu 4 antigen expression. Most of the T-lymphocytes were confined to the helper/inducer lymphocyte subset since they reacted with Leu 3a antibodies. However, big infiltrates of suppressor/cytotoxic lymphocytes with the Leu 2a phenotype were noted in some specimens. These cells were situated between the ducts of the salivary glands. Virtually all mononuclear infiltrating cells carried HLA-DR antigens. HLA-DR expressing keratinocytes were found in the biopsy from one patient. The present study indicates that a local immune response may be important in the pathogenesis of the oro-facial lesions in Melkersson-Rosenthal syndrome.

Changes in temporomandibular joint pain-dysfunction after surgical correction of dentofacial anomalies.

20 patients with dentofacial anomalies were investigated with respect to signs and symptoms of temporomandibular joint pain-dysfunction, which was a common reason for requesting treatment. After surgical correction of the malocclusions, the patients were re-examined 1 week after removal of intermaxillary fixation (IMF), 6 months after surgery and, finally, after 1 to 2 1/2 years. Several of the patients complained of recurrent headaches before surgery and also reported several other subjective symptoms of temporomandibular joint pain-dysfunction. At final control, a statistically significant reduction in headache frequency, as well as for the anamnestic dysfunction index as a whole, was noted. An impairment of clinical signs of temporomandibular joint pain-dysfunction was noted 1 week after removal of IMF, but the situation then returned to that found preoperatively. At final control, a statistically significant reduction of the clinical dysfunction index used was noted. In line with other previous investigations, the patients were satisfied with the aesthetic result of the treatment. A statistically significant increase in number of occluding pairs of teeth was recorded postoperatively and the patients reported an improvement of chewing ability. It is concluded that surgical correction of dentofacial anomalies has a beneficial effect not only on aesthetic and dental occlusion but also upon signs and symptoms of temporomandibular joint pain-dysfunction.

Periodontal conditions of teeth autogenously transplanted by a two-stage technique.

Inflammatory reactions of the marginal periodontal tissues and loss of attachment could partly account for the often occurring rejection of autogenously transplanted mature teeth. The periodontal conditions of transplanted teeth were investigated from 1 month up to 5 years postoperatively. The parameters plaque, bleeding on probing to the bottom of the pocket, probing pocket depth (PPD), gingival recession and probing attachment loss were analysed by multiple regression analysis. No significant difference was found between transplanted and control teeth in bleeding on probing the bottom of the pockets up to 5 years postoperatively with the exception of increased bleeding on probing of the transplanted teeth at the 1-month postsurgery examination. No significant difference of the mean probing depth between transplanted teeth and control teeth was found at the mesio- and distobuccal surfaces. The transplanted teeth at the buccal surface showed increase of the mean pocket depth during the observation period. Increased mean probing depth without progression over time was found at the transplanted teeth compared to the controls at the distolingual, lingual and mesiolingual surfaces. A small mean gingival recession at the transplants was observed. Loss of attachment was recorded at 13% of the surfaces. Totally 50% of the transplants showed loss of attachment and 5% were removed because of extensive attachment loss. On 13% of the transplanted teeth with loss of attachment, root resorption was also found.

Autogenous free tooth transplantation by the two-stage operation technique. An analysis of treatment factors.

Teeth were autogenously transplanted by the 2-stage technique in adult patients and examined up to 5 years after surgery for the prevalence of, and correlation between, tooth graft loss, root resorption, ankylosis, periodontal attachment loss, tooth mobility, and pain. The influence on the dependent variables of independent variables related to the patient, the donor tooth, the recipient site, and the transplantation procedure was examined. Pain was correlated to transplanted teeth, later extracted, and teeth with periodontal attachment loss. The expected correlation of root resorption to periodontal attachment loss was not verified owing to incomplete follow-up. The older the patient was, the less root resorption was found. Variables indicative of infection of the recipient bed and of traumatic injuries to the donor tooth at the transplantation were found to be detrimental to the tooth transplant.

Oral restoration with fixed partial dentures on transplanted abutment teeth.

Thirty-five fully developed teeth were autogenously transplanted for 24 partially edentulous adult patients to enable the placement of fixed partial dentures. Restoration was successfully carried out on 22 patients during the follow-up period up to 13 years after surgery. Two restorations failed, one because of root fracture and another as a result of ankylosis of the transplanted tooth. Six transplanted abutment teeth showed root resorption and/or loss of attachment without consequence for the dental restoration. The proportion of successful tooth transplantations was 97% after 1 year, 94% after 2 years, and 88% from 6 to 13 years. Transplantation of teeth using a two-stage surgical technique could provide the necessary dental support for fixed partial dentures even for patients with atrophic alveolar bone.

Multiple lesions of the lip exhibiting the "Jadassohn phenomenon". Review of the literature and report of a case.

The clinical and microscopic features of multiple, superficial lesions of the lip and adjacent mucosa in an elderly woman are reported. The lesions had been present for many years apparently without symptoms. A histologically confusing picture gave rise to diagnostic problems. Characteristic nests of basaloid cells were present at all levels of the acanthotic epithelium together with microcysts, horn pearls and squamous cell eddies. Review of the literature revealed no previous report on similar lesions of the oral mucosa and it is suggested that the lesions closely coincide with the Jadassohn type of intra-epidermal epithelioma.

Phenotypes of peripheral blood leukocytes in Melkersson-Rosenthal syndrome.

Peripheral blood leukocytes from 5 patients with Melkersson-Rosenthal syndrome (MRS) were characterized with an immunoenzymatic staining technique utilizing ten different mouse monoclonal antibodies to cell surface antigens. No gross abnormalities could be found in the various T and B cell subpopulations. However, the proportion of cells expressing the IL-2 receptor was slightly increased, indicating the occurrence of activated lymphocytes in the circulation. Furthermore, in all 5 patients a large proportion of a non-phagocytic, Leu-M1-expressing, granulocyte-like cells of low density was found, probably reflecting the presence of activated granulocytes in the blood in MRS patients. The findings suggest that activation of both the lymphocyte and the granulocyte systems may be of importance in the pathogenesis of MRS.