Effect of desquamative gingivitis on periodontal status: a pilot study

Objective:  Desquamative gingivitis (DG) represents the gingival manifestation associated with several mucocutaneous disorders and systemic conditions. Little is known of whether or not DG could influence the onset or progression of plaque-related periodontitis. In this study, the potential impact of DG on plaque-related attachment loss and pocket formation has been evaluated. Methods:  A cross-sectional evaluation of 12 patients with DG [eight oral lichen planus (OLP), four mucous membrane pemphigoid (MMP)], never treated for DG lesions or plaque-related periodontitis, was carried out. Probing depth (PD), clinical attachment loss (CAL), full-mouth plaque (FMPS), and bleeding (FMBS) scores …

Legal liability in bisphosphonate-related osteonecrosis of the jaw

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an adverse reaction that may occur in patients administered with bisphosphonates (BP). This condition can cause high morbidity and hinder quality of life. Its treatment is complex and often unsatisfactory, and prevention strategies may have limited effectiveness, if any. Thus, managing patients treated with BP may result in exposure of the practitioner to legal liability or malpractice claims: legal actions pursuant to BRONJ are reported to be underway on three continents. Nonetheless, the attribution of liability, if any, is a complex process requiring, on the basis of current knowledge, a robust and pragmatic approach to the facts…

Long-term effect on adenoid dimensions and craniocervical angulation after maxillary expansion with fixed or functional appliances

Background Maxillary expansion is a common orthodontic procedure that could have a positive effect also on airway patency. The aim of the present study was to evaluate the long-term effects of rapid maxillary expansion (RME) on nasopharyngeal area and cranio-cervical angulation in growing patients, compared to controls treated with a function-generating bite appliance (FGB). Material and methods Sixty patients aged 6-14 consecutively treated with RME or FGB were selected retrospectively and divided into two groups. Lateral cephalograms taken before and after treatment were retrieved, and the nasopharyngeal area, delimited superiorly by a sella-posterior nasal spine (PNS) line and inferiorly…

Immunoflogosi e declino cognitivo dell'anziano. Contributo delle infezioni batteriche croniche: il modello umano della parodontite.

La parodontite (PD) è un'infezione periferica polimicrobica ad elevata prevalenza, associata a batteri anaerobi gram-. Nella PD l'equilibrio tra batteri e risposta dell'ospite è alterato, risultando in un'infiammazione incontrollata caratterizzata da alti livelli di mediatori infiammatori (IL-1, IL-6, IL-17, TNF-a) e bassi livelli di molecole anti-infiammatorie (IL-10). Localmente, tali molecole interagiscono amplificando la flogosi ed attivando i meccanismi responsabili della distruzione tissutale. Inoltre, nei pazienti con PD, chemochine (IL-8, Monocyte chemotactic protein-1 (MCP-1) e citochine (IL-1ß, IL-6, IL-17, TNF- a) infiammatorie sono elevate anche nel plasma, contribuendo al caric…

Post-orthodontic position of lower incisors and gingival recession: A retrospective study

Background To evaluate if changes in lower incisor position following orthodontic treatment are correlated with development of gingival recessions. Material and methods Pre- and post-treatment digital models and lateral cephalograms of 22 subjects were collected retrospectively. The clinical crown length, gingival scallop, and papilla height of the central lower incisor were measured along with the cephalometric incisor's inclination, the distance from the mandibular plane, and the distance between the Infradentale and Menton points. Statistical correlations between gingival and cephalometric variables were studied. In addition, two groups were defined based on the post-treatment incisor in…

Diagnostic Pathways and Clinical Significance of Desquamative Gingivitis

The term desquamative gingivitis (DG) refers to a clinical manifestation that can be caused by several disorders. Many of them are immunologically mediated; in addition to the oral cavity, they can affect extraoral mucocutaneous sites, e.g., larynx, conjunctiva, esophagus, nasal and genital mucosa, and the skin. The degree of oral, periodontal, and systemic involvement determines the overall morbidity and, sometimes, the mortality of these disorders. We comprehensively review disorders commonly associated with DG and highlight diagnostic pathways, guidelines for differential diagnosis, and oral, periodontal, and systemic implications. More rare conditions are reviewed as well. Mucous membra…

Biomarkers of periodontal tissue remodeling during orthodontic tooth movement in mice and men: overview and clinical relevance

Biologically active substances are expressed by cells within the periodontium in response to mechanical stimuli from orthodontic appliances. Several possible biomarkers representing biological modifications during specific phenomena as simile-inflammatory process, bone resorption and formation, periodontal ligament changes, and vascular and neural responses are proposed. Citations to potentially published trials were conducted by searching PubMed, Cochrane databases, and scientific textbooks. Additionally, hand searching and contact with experts in the area were undertaken to identify potentially relevant published and unpublished studies. Selection criteria were as follows: animal models i…

Inhibiting proliferation in KB cancer cells by RNA interference-mediated knockdown of nicotinamide N-methyltransferase expression.

The enzyme Nicotinamide N-methyltransferase (NNMT) catalyzes the methylation of nicotinamide and other pyridines, playing a pivotal role in the biotransformation and detoxification of many drugs and xenobiotic compounds. Several tumours have been associated with abnormal NNMT expression, however its role in tumour development remains largely unknown. In this study we investigated expression levels of Nicotinamide N-methyltransferase in a cancer cell line and we evaluated the effect of shRNA-mediated silencing of NNMT on cell proliferation. Cancer cells were examined for NNMT expression by semiquantitative RT-PCR and Western blot analysis. A HPLC-based catalytic assay was performed to asses…

Use of Optical Coherence Tomography in Patients with Desquamative Gingivitis: A Case Series

Expansion of permanent first molars with rapid maxillary expansion appliance anchored on primary second molars

Background To evaluate how the amount of expansion of the primary second molars, the patient's age, and the skeletal maturation stage influence the amount of expansion at the level of the permanent first molars. Material and methods Fifty-five patients aged between 6 and 11 years with a cervical vertebral maturation stage of CS1 or CS2 were retrospectively selected. The intermolar width was measured before and after expansion to evaluate the amount of expansion achieved at the level of the primary second molars and the permanent first molars. Stepwise multiple linear regression was used to evaluate how the amount of primary molars expansion, the patient's age, and the cervical vertebral mat…

Long-standing oral ulcers: proposal for a new `S-C-D classification system’

Persistent oral ulcers and erosions can be the final common manifestation, sometimes clinically indistinguishable, of a diverse spectrum of conditions ranging from traumatic lesions, infectious diseases, systemic and local immune-mediated lesions up to neoplasms. The process of making correct diagnosis for persistent oral ulcers still represents a challenge to clinicians. Major diagnostic criteria should include the clinical appearance of both ulcer and surrounding non-ulcerated mucosa, together with the evaluation of associated signs and symptoms, such as: number (single or multiple), shape, severity of the ulcer(s), conditions of remaining mucosa (white, red or with vesiculo-bullous lesio…

Necrotizing fasciitis of the face: A life-threatening condition

Necrotizing fasciitis (NF) is a highly aggressive infectious process, polymicrobial in nature, involving soft tissues with a high risk of rapid spread through superficial and deep fascial planes and muscular layers. Cervical NF is quite rare, is mostly of odontogenic origin, and may be complicated by descendant mediastinitis with a very high mortality rate. Systemic conditions impairing the patient's immune competence, such as diabetes, may play a predisposing role. An effective treatment strategy includes prompt diagnosis (clinical findings, local microbiological tests, blood culture and, if deemed necessary, histopathology), broad-spectrum antibiotic therapy as early as possible which sho…

Aging and Oral Health: Effects in Hard and Soft Tissues

Changing demographics, including an increase in life expectancy and the growing numbers of elderly has recently focused attention on the need for geriatric dental care. Ageing affects oral tissues in addition to other parts of the human body, and oral health (including oral mucosa, lips, teeth and associated structures, and their functional activity) is an integral component of general health; indeed, oral disease can cause pain, difficulty in speaking, mastication, swallowing, maintaining a balanced diet, not to mention aesthetical considerations and facial alterations leading to anxiety and depression. The World Health Organization recommends the adoption of certain strategies for improvi…

Maxillary bone lesions in McCune-Albright syndrome:a case report

Abstract Objectives In this study, we report on the clinical maxillary manifestations of a patient affected by McCune-Albright syndrome and the implications for orthodontic therapy. Materials and methods A male, 8-year-old patient was examined at the Department of Orthodontics of the University of L’Aquila for a problem of anterior open-bite. In the clinical examination, a small swelling of the left hemi-maxilla was seen in the area corresponding to the root apex of 16 and under the tooth buds of 14 and 15. In a panoramic radiograph, a radio-opaque area was detected in this zone. From the computer tomography examination, a bone lesion was identified. Results Identification of this bone lesi…

Candidal carriage in untreated OSCC

Changes in pharyngeal aerobic microflora in oral breathers after palatal rapid expansion.

Abstract Background The purpose of this study was to investigate in oral breathing children the qualitative and quantitative effects on aerobic and facultatively anaerobic oropharyngeal microflora of respiratory function improved by rapid palatal expansion (RPE). Methods In an open clinical trial, we studied 50 oral breathers, aged 8 to 14 years and suffering from both maxillary constriction and posterior cross-bite. At baseline, patients were examined by a single otorhinolaryngologist (ENT), confirming nasal obstruction in all subjects by posterior rhino-manometric test. Patients were evaluated three times by oropharyngeal swabs:1) at baseline (T = 0); 2) after palatal spreading out (T = 1…

Determinants of maxillary canine impaction : retrospective clinical and radiographic study

Background: The aim of this study is to evaluate determinants of maxillary canine impaction taking into account both canine position related variables and the pattern of facial growth. Material and Methods: A retrospective clinical and radiographic analysis was carried out on 109 patients aged between 9 and 10 years at the time of first evaluation. At baseline, SN-GoMe angle, the interincisal angle, the canine angle a and the canine distance d were used to characterize canine location and vertical facial growth. At the end of a two years follow up period the eruption state of each canine of each patient was recorded and accordingly classified as erupted or impacted on a clinical and radiogr…

Long-standing oral ulcers: proposal for a new ‘S-C-D classification system’: Authors’ reply

Condylar position indicator and T-scan system II in clinical evaluation of temporomandibular intracapsular disease.

The pathogenesis of temporomandibular joint intracapsular disease (TMJI) is multifactorial and its diagnosis is not easy. In this work authors show two types of clinical analysis: the Condylar Position Indicator (CPI) and T-Scan 2 system.Twenty patients (mean age of 24.5 years) with TMJI problem and 10 healthy matched subjects (mean age: 25.4 years) were selected. Analysis of TMJI was performed on each patient by means of Condylar Position Indicator (CPI) and T-Scan System II tests.Eight patients presented vertical symmetrical condylar distraction greater than healthy subjects (P-value0.001). T-Scan showed a difference of Percentage of Force (POF) not greater than 5%. Seven patients showed …

Saliva analysis by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) in orthodontic treatment: first pilot study.

Abstract Objective SELDI-TOF-MS (Surface-Enhanced Laser Desorption/Ionization Time-Of-Flight Mass Spectrometry) allows the generation of an accurate protein profile from minimal amounts of biological samples and may executes proteomic profile of saliva. The aim of this work is to compare the proteomic profile of saliva of patients in orthodontic treatment to the beginning of treatment and after three months by using the surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) technology. Materials and methods Saliva was collected from 14 patients, between the 11 and 17 years, to the beginning of the orthodontic treatment and after three months. Specimens …