Cytokines,matrix metalloproteinases and tissue inhibitor of metalloproteinases‐1 in gingival crevicular fluid from patients with Papillon‐Lefèvre syndrome

The aim of the present study was to compare concentrations of cytokines, matrix metalloproteinases (MMPs) and a metalloproteinase inhibitor (TIMP‐1) in gingival crevicular fluids (GCF) from sites with gingival inflammation in 28 young patients with Papillon‐Lefèvre syndrome (PLS), and in age‐ and gender‐matched controls. Each group consisted of 17 females and 11 males with a mean age of 11.0 years (range 4–22 years). In both groups, anterior upper sites with a clinical diagnosis of gingival inflammation and with pockets ≤3?mm were selected for sampling of GCF, which was carried out with filter disks inserted into the gingival crevice until saturated. The concentrations of cytokines (IL‐1α, IL‐1β, TNF‐α, and IL‐8), matrix metalloproteinases (MMP‐1, MMP‐3, MMP‐8, and MMP‐9), and their tissue inhibitor (TIMP‐1) were analysed using commercial ELISA kits. Significantly higher levels of IL‐1β (P?P?P?P?P?相似文献   

Cytokines, matrix metalloproteinases and tissue inhibitor of metalloproteinases-1 in gingival crevicular fluid from patients with Papillon-Lefèvre syndrome

The aim of the present study was to compare concentrations of cytokines, matrix metalloproteinases (MMPs) and a metalloproteinase inhibitor (TIMP-1) in gingival crevicular fluids (GCF) from sites with gingival inflammation in 28 young patients with Papillon-Lefèvre syndrome (PLS), and in age- and gender-matched controls. Each group consisted of 17 females and 11 males with a mean age of 11.0 years (range 4-22 years). In both groups, anterior upper sites with a clinical diagnosis of gingival inflammation and with pockets < or = 3 mm were selected for sampling of GCF, which was carried out with filter disks inserted into the gingival crevice until saturated. The concentrations of cytokines (IL-1alpha, IL-1beta, TNF-alpha, and IL-8), matrix metalloproteinases (MMP-1, MMP-3, MMP-8, and MMP-9), and their tissue inhibitor (TIMP-1) were analysed using commercial ELISA kits. Significantly higher levels of IL-1beta (P < 0.001) and MMP-8 (P < 0.05) were disclosed among the PLS patients compared with their controls, while the opposite was found for IL-8 (P < 0.05) and MMP-1 (P < 0.001). The individual variations were considerable in both groups. When comparing the expression of cytokines, MMPs, and TIMP-1 in PLS patients with clinically active and non-active periodontitis, the non-active PLS patients showed significantly higher values of IL-1beta than the patients with active periodontal disease (ANOVA, P < 0.01). In conclusion, this study was unable to demonstrate a clear-cut pathognomonic expression of cytokines or MMPs in patients with PLS, but further studies on cytokine and MMP output are warranted.     

A new multilayered membrane for tissue engineering of oral hard- and soft tissue by means of melt electrospinning writing and film casting – An in vitro study

Membranes that form a mechanical barrier not only for cells but also for the bacterial flora of the oral cavity may be helpful in infection-free wound healing for guided tissue regeneration (GTR) applications in the field of oral- and maxillofacial surgery. Controlled wound healing without interference from bacterial contamination appears to be achievable in combination with surface scaffolds for bone- and soft tissue regeneration. As this has not yet been realized, we developed multilayered membranes in this study consisting of specific surface scaffolds for bone- and mucosal regeneration as well as bacteria-tight core membranes. These membranes were evaluated in terms of cell growth of osteoblast- (MG63), keratinocyte- (HaCaT), and fibroblast (L929) cell lines. Scaffolds were fabricated via melt electrospinning writing (MEW), while the core membrane was produced via film casting. All constructs were made of medical-grade poly(ε-caprolactone) (PCL). The bacteria-tightness was tested via a bacterial transmigration-assay. PCL scaffolds and core membranes alone demonstrated good cytocompatibility for all cell lines, which was even enhanced by fusing both components together. The core membrane displayed complete bacteria-tightness over two weeks. These bacteria-tight, individually-designed membranes from medical-grade PCL represent a high-potential, clinically oriented method of GTR in the field of oral- and maxillofacial surgery.     

Inter- and intra-observer agreement on Miller’s classification of gingival tissue recessions

Miller’s is the most commonly used classification of gingival tissue recessions, defined as the displacement of the soft tissue margin apical to the cemento-enamel junction. However, data on the reliability of this classification are missing so far, although reliability, which reflects the consistency of repeated measurements, is regarded as a prerequisite for judging the utility of a classification. The aim of the present study was to evaluate inter- and intra-observer agreement on Miller’s classification of gingival tissue recessions. Two hundred photographs (50 of each region: maxillary/mandibular anterior/posterior teeth) of gingival tissue recessions were evaluated twice by four observers with different degrees of experience in Miller’s classification, gingival phenotype, tooth shape, and identifiability of the cemento-enamel junction. The following inter- and intra-observer agreements were found: Miller’s classification, 0.72 and 0.73–0.95; gingival phenotype, 0.29 and 0.45–0.58; tooth shape, 0.39 and 0.44–0.59; and identifiability of the cemento-enamel junction, 0.21 and 0.30–0.59. A higher agreement was detected for anterior teeth. Further, gingival phenotype (thin-high scalloping) significantly correlated with tooth shape (long-narrow) (ρ = 0.662, p < 0.001). Miller’s classification of gingival tissue recessions was evaluated by four examiners using 200 clinical photographs and yielded substantial to almost perfect agreement, with higher agreement for anterior teeth. Although limited to photographic assessment, the present study offers the so far missing proof on the sufficient inter- and intra-observer agreement of this classification.     

Does removal of the original pulp tissue before autotransplantation influence ingrowth of new tissue in the pulp chamber?

Abstract – In an attempt to extend the indication area for autotransplantation of vital teeth, two possibilities can be proposed: (i) The enlargement of the apical foramen, with the aim to facilitate revascularization and ingrowth of new tissue. The ingrowth of tissue will eliminate the need for endodontic treatment when mature teeth are transplanted and (ii) the cryopreservation of teeth in case they cannot be transplanted immediately to the receptor site. Teeth with an ideal stage of root formation can be cryopreserved to perform transplantation later. Although pulpcell cultures survive crypreservation in vitro, the pulp tissue cannot survive the cryopreservation procedures when it is kept inside the pulpchamber. Therefore, the pulp tissue has to be removed before cryopreservation. It has been demonstrated that revascularization and ingrowth of new tissue can occur in an empty pulp chamber ( 1 ). The aim of this study was to find out if revascularization and ingrowth of new pulp tissue is influenced by removal of the original pulp tissue before autotransplantation. Twenty nine single‐rooted teeth from three adult beagle dogs were transplanted after resection of the root tip. One group of teeth (n = 14) had the pulp tissue removed before transplantation. The other group (n = 15) had the original pulp left in situ. The transplanted teeth were histologically analysed 90 days post‐transplantation. In the group with the tissue left in situ, 12 teeth (80%) showed a pulp chamber totally filled or at least 1/3 to 2/3 filled with viable tissue. In the group with the pulp tissue removed, 11 teeth (79%) had no or little vital tissue in the pulp chamber. The necrotic masses that develop in the original pulp tissue immediately after transplantation are a possible stimulating factor in the repair process of the pulp. As a conclusion, it can be stated that in case of autotransplantation of teeth, it is advisable to leave the pulp tissue in situ to stimulate the revascularization and ingrowth of new tissue after transplantation.     

Multiple primary enoral soft tissue manifestations of a Hodgkin lymphoma—case report and literature review

Background

Hodgkin lymphoma (HL) are lymphoproliferative neoplasms, histologically comprising of mononuclear and multinucleated Hodgkin and Reed Sternberg cells (HRS). About 4 % of all lymphatic malignancies of the head and neck are HL. The typical disease presents itself as a nodal lesion. Extranodal, enoral soft tissue involvement by HL is very rare.

Case report

A 73-year-old man with a suspect, ulcerating lesion in the left retromolar region of the mandible was assigned to our hospital. Prior anti-inflammatory therapy has been without success. Subsequently, three biopsies were taken which could only show inflammation. Finally, two biopsies from the left retromolar region and the left inner cheek showed HRS cells with positive expressions of CD15 and CD30 corresponding to a Hodgkin lymphoma. No lymphatic node or bone involvement could be detected. The patient was designated to receive radio-chemotherapy, but died 3 weeks after diagnosis of multiple organ failure. In a literature review, together with this report, nine cases were found concerning primary HL of the oral mucosa. Accordingly, this is the first case of primary multiple extranodal HL in the oral mucosa in absence of lymphatic node involvement.

Discussion

Neither clinical features nor radiological appearances of HL presenting as primary enoral lesions are pathognomonic. Especially when only small biopsy specimens are available, histological diagnosis remains challenging, may lead to a delay in therapy and may result in a significant worse prognosis.     

The influence of plaque and/or excessive loading on marginal soft and hard tissue reactions around Brånemark implants: a review of literature and experience

High implant survival rates are published with more than 15 years of observation time. Failures over time are often caused by ongoing marginal bone loss. Therefore, the need for reliable monitoring of the stability of periimplant attachment and/or bone level is extremely important. Marginal bone loss around osseointegrated implants has often been associated with periimplantitis, but clinical observations cannot prove this relationship. Otherwise, the impact of excessive loading on periimplant bone has been shown in animal studies and has been positively related to implant failure in terms of implant mobility and marginal bone loss. Some clinical observations support this hypothesis.     

Which hard and soft tissue factors relate with the amount of buccal corridor space during smiling?

OBJECTIVE: To investigate which hard and soft tissue factors relate with the amount of buccal corridor area (BCA) during posed smiling. MATERIALS AND METHODS: The samples consisted of 92 adult patients (19 men and 73 women; 56 four first bicuspids extraction and 36 nonextraction treatment cases; mean age = 23.5 years), who were treated only with a fixed appliance and finished with Angle Class I canine and molar relationships. To eliminate the crowding effect on the buccal corridor area, lateral cephalograms, dental casts, and standardized frontal posed smile photographs were obtained at debonding stage and 28 variables were measured. Pearson correlation analysis, multiple linear regression analysis, and independent t-test were used to find variables that were related with buccal corridor area ratio (BCAR). RESULTS: Among the lateral cephalometric and dental cast variables, FMA, lower anterior facial height, upper incisor (U1) exposure, U1 to facial plane, lower incisor (L1) to mandibular plane, L1 to N-B, Sn (subnasale) to soft tissue menton (Me'), Sn to stomodium superius (stms), stms to Me', and interpremolar width were significantly negatively correlated with BCAR. Occlusal plane inclination and buccal corridor linear ratio did not show any significant correlation with BCAR. Multiple linear regression analysis generated a three-variable model: Sn to Me', U1 exposure, and sum of tooth material (STM) (R(2) = 0.324). There was no significant difference in BCAR between extraction and nonextraction groups. CONCLUSIONS: To control the amount of BCA for achieving a better esthetic smile, it is necessary to observe the vertical pattern of the face, amount of upper incisor exposure, and sum of the tooth material.     

Histological and immunohistochemical analysis of initial and early subepithelial connective tissue attachment at chemically modified and conventional SLA®titanium implants. A pilot study in dogs

The aim of the present pilot study was to histologically/immunohistochemically investigate initial and early subepithelial connective tissue attachment at transmucosal parts of modified (mod) and conventional sandblasted, large grit and acid-etched (SLA) titanium implants. Implantation of modSLA and SLA implants was performed bilaterally in both the mandible and maxilla of four beagle dogs. The implants were submerged to prevent bacterial contamination. The animals were killed after 1, 4, 7 and 14 days. Peri-implant tissue reactions were assessed histologically (Masson Goldner Trichrome stain-MG) and immunohistochemically (IH) using monoclonal antibodies to fibronectin (FN) and proliferating cell nuclear antigen (PCNA). The surgical procedure of implant submerging resulted in the formation of an artificial gap in the transmucosal area of both types of implants. After 14 days of healing, MG stain revealed the formation of well-organized collagen fibres and numerous blood vessels in a newly formed loose connective tissue zone adjacent to modSLA. While some fibres were oriented in a parallel direction, others have started to extend and attach partially perpendicular to the implant surface. In contrast, SLA implants appeared to be clearly separated by a dense connective tissue zone with parallel-running collagen fibres and rare blood vessel formation. First signs of a positive FN and PCNA staining adjacent to both implant surfaces were observed at day 4. Within the limits of a pilot study, it might be concluded that modSLA titanium surfaces might possess the potential to promote subepithelial connective tissue attachment at the transmucosal part of the implant.     

Are posts necessary for the restoration of root filled teeth with limited tissue loss? A structured review of laboratory and clinical studies

Guidelines for post placement are lacking in respect of the amount of tooth structure, particularly in cases in which ≥50% of coronal structure is preserved. The aim of this review was to provide evidence‐based principles for the use of posts in the restoration of root filled teeth with limited tissue loss. A literature search of laboratory and clinical studies published between 2000 and 2014 was conducted in PubMed. Included studies contained at least one study group with root filled teeth restored without a post, presented at least one group with root filled teeth with limited tissue loss, and, in the case of laboratory studies, performed mechanical cycling prior to a fracture resistance test. Based on the evidence from laboratory studies, root filled premolars and molars with limited tissue loss can be restored without posts, particularly when total coverage is planned. However, when no cusp protection is provided, post placement appears to be beneficial in premolars. Evidence regarding the best restoration option for root filled incisors with limited tissue loss remains controversial. When total coverage is intended, reconstruction seems to be successfully performed by restoration with composite. However, some reports consider that post insertion increases fracture loads. The review of clinical studies demonstrated that survival of teeth with substantial tooth tissue is not influenced by the use of posts. Exceptions were found when only premolars were investigated; in these cases, post placement was associated with greater survival rates in crowned teeth and fewer root fractures in teeth without cusp protection.     

Matrix metalloproteinases: do they play a role in mucosal pathology of the oral cavity?

Matrix metalloproteinases (MMPs) are critical factors in maintaining the integrity of mucosa and mediating normal biological processes. An imbalance between tissue levels of these mediators and their natural inhibitors is believed to underlie the pathophysiology of many diseases, including those affect the gastrointestinal and oral mucosae. The ongoing development of synthetic inhibitors of these mediators may provide opportunities to develop treatment modalities for patients suffering from these diseases. Understanding the role of MMPs in the pathophysiology of many diseases, however, is far from complete, and the improvement of pharmaceutical management strategies can only be achieved if the underlying process of these diseases is completely comprehended. This paper reviews the functions of matrix metalloproteinases and addresses their role in mediating mucosal pathologies with emphasis on oral mucosa.     

Tissue expanders for soft tissue reconstruction in the head and neck area—requirements and limitations

Objectives

The repair of skin defects in the head and neck region still poses a significant problem for many clinicians. Tissue expansion is described as a treatment option providing good color, texture, and thickness match of the expanded skin. Unfortunately, the complication rates for tissue expansion range from 0 to 48 %. Therefore, the purpose of this study was to investigate risk factors for the use of tissue expanders in head and neck reconstructions.

Materials and methods

Forty-nine patients with skin deficits in the head and neck area underwent tissue expansion. Sixty-two implanted expanders were analyzed regarding the various complications and the success rate.

Results

The success rate of treated patients was 37 (75.5 %) of all 49 included patients. The most frequent cause for the skin deficit was a tumor resection near the tip of the nose followed by skin deficits resulting after craniectomy. Interestingly, a higher number of expanders and a larger volume were significantly associated with a worse outcome. There was a trend of association between larger defect size and failure, too.

Conclusions

The internal tissue expansion is a suitable technique for skin reconstruction in the head and face area. Compared to distant or free flaps, it often offers a better cosmetic outcome. In very large defects (>100 cm²) or when more than two expanders are needed, the failure rate increases. In these cases, other treatment options are recommended.

Clinical relevance

The internal tissue expansion is a suitable technique for skin reconstruction in the head and face area.