Oral lichen planus, hepatitis C virus, and HIV: no association in a cohort study from an area of high hepatitis C virus endemicity.

OBJECTIVES: We sought to assess the age-specific prevalence of oral lichen planus (OLP) in Mediterranean patients with chronic hepatitis C virus (HCV) and to evaluate the features of OLP in relation to sex, smoking, HCV genotype, HIV-1 coinfection, and antiviral treatments. METHODS: In all, 178 anti-HCV-positive adults (60 women and 118 men; age range 20-66 years) recruited from two cohorts (104 HIV-negative patients and 74 patients with HIV coinfection) underwent oral examination. RESULTS: Overall prevalence of OLP was 2.8% (5 of 178) (male/female ratio 0.2; odds ratio=0.119; 95% confidence interval=0.013-1.106), only among HIV-negative participants, always in the reticular pattern, and in the adult age. HCV genotype, tobacco smoking, and treatment (interferon alfa/ribavirin) were not significantly associated to OLP. CONCLUSIONS: Among HCV-infected patients, we found a low prevalence of OLP. The absence of OLP in HIV-coinfected patients suggests immunosuppression secondary to defective CD4 functions.

Gastric and gingival localization of mucosa-associated lymphoid tissue (MALT) lymphoma. An immunohistochemical, virological and clinical case report.

Non-Hodgkin's lymphomas (NHL) of the mucosa-associated lymphoid tissue (MALT) are characterized by their mucosal and glandular tissue localization. The case described here falls into the European-American classification of a low-grade B-cell lymphoma of the MALT type, with a gingival lesion 2 years after a gastric lesion. The pathogenetic mechanisms of NHL in oral MALT and the diagnosis and treatment are discussed.

Gender differences in human immunodeficiency virus-related oral lesions: an Italian study.

OBJECTIVE: The purpose of this study was to investigate the relationship between oral lesions and gender, age, CD4(+) cell count, human immunodeficiency virus-1 (HIV-1) viral load, antiretroviral therapy, and route of transmission in a group of HIV-infected (HIV+) persons from the Mediterranean region. STUDY DESIGN: The participants in this study were HIV+ adults who sought dental care between January 1999 and June 1999 in the Department of Oral Medicine (University of Palermo, Italy). RESULTS: One hundred thirty-six HIV+ adults came in for an initial oral examination. Their mean age was 35.2 years (SD +/- 7.97), and 33% were women. Their mean CD4(+) cell count was 325.3 x 10(6) /L (SD +/- 225.8), and their HIV-1 viral load was 39,168.3 copies/mL (SD +/- 144,256.1). Oral lesions were found in 47% of the study group, as well as in 56.5% of women (n = 46) versus 45.5% of men (n = 90; P =.05). Oral candidiasis was the most common disease; it is significantly associated with women (P =.004), CD4(+) cell count (P =.005), and HIV-1 viral load (P =.0003). No significant relationships were found between any types of oral lesions and age, antiretroviral therapy, or route of transmission (P >.2). CONCLUSION: The prevalence of HIV-related oral lesions was significantly higher in women than in men, especially for oral candidiasis, the most common lesion observed related to immune status and HIV-1 viral load.

[Epulides: the histopathological and epidemiological aspects]. / Epulide: aspetti istopatologici ed epidemiologici.

The authors examined 195 epulides in order to point out distribution of this pathology in relation to some clinical, epidemiological and histopathological parameters. The Authors have found that the epulis is more prevalent in the female sex and in the anterior sextants. The epulides were subdivided on the basis of histopathological findings into: pyogenic granuloma (GP), giant cell granuloma (GGC), fibrous hyperplasia (IF), peripheral fibroma with calcification (FPC) and variety lympho-plasma-cellular (LP). Furthermore investigating the correlation between sex and histopathological variety it was found a significant prevalence of the GGC in the male sex, whereas the correlations within the age's sets are the followings: the LP is more prevalent in the IV age set (46-60 years), whereas the GP is more prevalent in the III age set (31-45 years) and in the V age set (greater than 60 years). This finding revaluates the hormone's influence in the vascular proliferation of the GP. IF and FPC are, in percentage, less frequent than others histopathological variety regarding to the size, it was found that GGC is the bigger than the other types, whereas IF is the smaller.

[Changes in the alveolar bone after periodontal therapy. A follow-up by computerized radiographic analysis]. / Le modificazioni dell'osso alveolare dopo terapia parodontale. Monitoraggio mediante analisi radiografica computerizzata.

In this study the authors evaluated radiographic variations of alveolar bone treated with periodontal therapy, through computerized analysis. Five adult patients with severe periodontitis were included in this study. In everyone of these patients, three sites were selected and treated in the following ways: 1) root planing (LCC), 2) open flap debridement (LCA) and 3) guided tissue regeneration with polytetrafluoroethylene membrane (GTR-PTFE). Every site was subjected to radiographic examination before treatment and six, eight, twelve and twenty-four weeks later. Radiographic images were evaluated through digital processing in order to show and compare one to another changes of alveolar bone of sites treated with different therapeutic procedures. Analysis of data indicated that sites treated by GTR-PTFE developed better than sites treated with other therapeutic procedures and evolution of sites treated with surgery was usually characterized by a beginning phase of alveolar bone loss and by a phase of variable bone regeneration later. Early variations of alveolar bone have been pointed out by mean of this computerized analysis.

The epulis vascularity. A morphometric study.

BACKGROUND: A computerised morphometric analysis of some vascularisation aspects of epulides is presented. The aim of this study is to evaluate the correlation between morphometric aspects and histological classification of epulides and to investigate its usefulness for the histopathologic diagnosis. METHODS: The study was carried out on epulides from 72 patients (30 males, 42 females, age-range 16-60). Epulides were fixed in alcohol, paraffin embedded, and stained with haematoxyilin eosin, thereafter epulides were histopathologically classified as granulomatous epulides, fibrous epulides and giant cell epulides. Images of histological samples were then digitised, and by an image analysis system some morphometric vessels characteristics were evaluated: percent image area occupied by vessels, vessels number, mean vessels area and standard deviation of vessels area. Finally, the correlation between morphometric data and the histological classification of epulides was evaluated. RESULTS: The statistic evaluation of morphometric data allowed to classify epulides in six groups characterised by a various degree of vascularisation, these groups showed a good correlation with histopathological classification. CONCLUSIONS: The morphometric analysis of vessels is a powerful aid for the histopathologic diagnosis and for a better knowledge of the etiopathogenetic factors of epulides.

Neutrophil dysfunction in prepubertal periodontitis associated with Papillon-Lefèvre syndrome.

Although prepubertal periodontitis (PP) is often associated with the Papillon-Lefèvre (PLS), the etiopathogenetic mechanism in this disease has not been clarified as yet. A three and half year old female with leukocyte chemotaxis deficiency and decrease of T-lymphocytes is presented. The immunohistochemical evaluation of neutrophils showed a reduction of myeloperoxidase content, whereas ultrastructural studies revealed no particular change. The possible role of such a deficiency in the pathogenesis of the periodontal lesion is discussed.

[Physiopathology of alveolar bone]. / Fisiopatologia dell'osso alveolare.

Bone tissue is a dynamic system in which the net balance between resorption and apposition defines the final osseous form. This process occurs in minute asynchronous foci and results from a cascade of activations, cooperations and inhibitions of specialized cells (osteoblasts and osteoclasts). The alveolar bone resorption due to periodontal disease is a complex and dynamic chain reaction in which both osteoclasts and osteoblasts have a role in the hormonal interactions occurring during the course of the resorption activity. Both microbial and host factors as prostaglandins, endotoxins and lipoteic acid seems to be able in activating bone resorption. However bone resorption can be interchanged with repair formative episodes, more or less intense, which can delay the destructive process.

[Crevicular fluid: active site marker]. / Fluido sulculare: marker di sito attivo.

The qualitative studies of gingival crevicular fluid can be used for a reliable diagnosis of the beginning of active periodontal disease. Some changes in the crevicular fluid components are correlated with rising inflammation both in gingivitis and in periodontitis; the degradation products of the connective tissue as hydroxyproline, and inflammation mediators, as prosaglandine, can be find in it. The concentration of these components in crevicular fluid can be used as a reliable marker to individuate precociously the rising of an active site where an early treatment of periodontal disease can be effected.

[Radiographic examination in periodontology: evolution and prospectives]. / L'esame radiografico in parodontologia: evoluzione e prospettive.

Dental radiography has long been considered useful in the diagnosis of periodontal disease, it was employed in epidemiological studies in longitudinal studies, in the morphological and volumetrical evaluation of bone lesions and in the diagnosis and prognosis of periodontitis. However the radiographic technique and its interpretation were not always accurate. We can divide the evolution of the radiographic interpretation of periodontitis in three periods: the first period is comprised from the early years of the periodontal science to the seventies; in this period in spite of the evolution of the radiographic technique, there wasn't a standardization of the diagnostic criteria because of the un-understanding of the etiopatogenesis of periodontitis. In the second period, that is comprised from the seventies to the present, the understanding of the etiopatogenesis and of the evolution of periodontal breakdown, made possible the standardization of trials and diagnostic criteria and the fixation of limitations and indications of the radiographic interpretation of periodontitis. The third period, that is a prospect for the future as clinical application, at the present has application only in research. In this period use of new techniques, as scintigraphy and computerized analysis of radiographic image, made possible an higher sensibility of the radiographic technique.

Oral mucosal lesions and risk habits among men in an Italian study population.

A randomly selected study population of 118 male subjects (> or = 40 years) living on the Mediterranean island of Pantelleria (southwest of Sicily, Italy) was examined for the presence of oral mucosal lesions, with particular emphasis on the early diagnosis of oral precancerous and cancerous lesions. The study population was interviewed for socioeconomic and behavioural information, and clinically examined using WHO criteria. The prevalence of oral mucosal lesions observed, and data obtained about oral hygiene, tobacco smoking, alcohol drinking and exposure to actinic radiation, were analysed. Alcohol drinking was the most common habit in the study population (73%), followed by tobacco smoking (58.5%, of whom 96% were cigarette smokers). Only 3% showed good oral hygiene and 25% were edentate. Oral lesions were observed in 81.3% of the study group, mainly coated tongue (51.4%), leukoplakia (13.8%), traumatic oral lesions (traumatic ulcers and frictional white lesions) in 9.2%, actinic cheilitis (4.6%), and squamous cell carcinoma in one case (0.9%). Statistically significant associations were found between the prevalence of coated tongue and tobacco smoking (P<0.0001), and between the prevalence of actinic cheilitis and tobacco smoking/alcohol drinking (P<0.05). Analysis of clinical and anamnestic data underlined the effective presence, in the population examined, of the behavioural risk factors for oral precancerous and cancerous lesions, and the lack of cultural motivation towards primary prevention activities, such as the elimination of risk habits.

[Diet analysis and correlation of food cariogenicity and DMF]. / Analisi della dieta e correlazione fra cariogenicita degli alimenti e DMFT/dmft.

The authors evaluate the distribution of the intake of some fundamental foods in diet of 6-11 years-old school children group. The authors evaluate proteinic, lipidic and glycidic components of diet and total calories. Besides the authors calculate the alimentary cariogenicity in relation to DMFT/dmft.

[Costs and dental operating levels in a group of Palermo children]. / Costi e livelli operativi odontoiatrici in un campione di bambini nella citta' di Palermo.

The authors, after evaluating the necessity of dental treatment in a school children sample, analyzed operative time and costs. the collected data show these therapeutic time and costs are very high. these therapeutic procedures will determinate a significative decrease of complexes therapeutic trails.

[Dietary habits and oral health indices in a group of public school children]. / Abitudini alimentari e indici di salute orale in un campione di bambini della scuola dell'obbligo.

The authors explain some fundamental concepts regarding the effect of diet on chemical plaque composition and the influence of carbohydrates on some bacterial species. They besides report the results of their epidemiological research in order to emphasize the influence of the alimentary habits on some index of oral health.

Treatment of prepubertal periodontitis. A case report and discussion.

This paper reports the treatment of prepubertal periodontitis in a 3-year-old girl with Papillon-Lefèvre Syndrome. Initially, the patient was found to have a myeloperoxidase deficiency and microbiological tests have identified Bacteroides and Fusobacterium, in 60% and 25%, respectively of the total number of microbial flora cultivated. The initial treatment was extraction of all the primary teeth with grade 3 mobility, scaling, root planing and daily subgingival irrigation with a 0.2% solution of chlorhexidine. Several months before the eruption of the first permanent molars, the rest of the primary teeth were extracted. The patient was treated with daily subgingival irrigation of chlorhexidine and weekly professional oral hygiene. At the age 6 1/2 years, the permanent teeth have normal gingiva and crevice depths; microbiological investigation reveals a prevalence of the coccoid forms, and radiographs show no evidence of periodontal pathology.

[Motivation for seeking periodontal care in a Palermo population]. / Motivazione alla richiesta di visita parodontale in un campione delle città di Palermo.

The Authors find a disagreement between symptomatology referred by patients and clinical pictures of pathology observed by sanitary operators. For instance a large percentage of patients considers bleending less important than the presence of calcolus. It is necessary a better information and secondary prevention increased.

Primary angiosarcoma of the alveolar mucosa in a haemodialysis patient: case report and discussion.

A case of a haemodialysis patient with a primitive angiosarcoma of the alveolar mucosa is reported. The vascular origin of the tumor was confirmed by the immunohistochemical data which showed strong positivity for Factor VIII-related antigen and for vimentin, whereas stains for desmin and cytokeratins were negative.

Cyclosporin- and nifedipine-induced gingival overgrowth in renal transplant patients: correlations with periodontal and pharmacological parameters, and HLA-antigens.

The factors associated with cyclosporin A (CsA)- and nifedipine (Nif)-induced gingival overgrowth were investigated in 113 renal transplant recipients receiving CsA alone (Group 1) [n = 61], CsA and Nif (Group 2) [n = 28], or azathioprine (Aza) (Control Group) [n = 24]. Periodontal and pharmacological parameters were assessed for each patient. The patients with a gingival overgrowth index (GOI) score >1 were considered responders (R); those with a score 0.05). It is concluded that the prevalence and severity of gingival overgrowth are greater in patients receiving CsA+Nif. As overgrowth appeared to be unrelated to local irritants, gingival inflammation or pharmacological parameters, it may be related to individual susceptibility.