Gingival salivary gland choristoma

A unique example of a gingival salivary gland choristoma together with a gingival cyst is described in a human autopsy specimen of periodontal tissues. A choristoma is a tumor-like growth which is derived from primordial cells which have been displaced from their original tissue or organ. Only 6 other examples of the gingival salivary gland choristoma have been described in the world literature.     

Dimensions of hard and soft tissue around adjacent,compared with single-tooth,zirconia implants

Preservation or regeneration of the papilla has always been a challenge around consecutive implants or with implants next to teeth, and many studies have evaluated the papilla’s behaviour and patterns based on surgical technique and prosthetic design, though evidence about its behaviour around zirconia implants is scarce. The aim of this study was to evaluate papilla behaviour between implants and teeth (tooth-implant group) and between consecutive implants (implant–implant group). Ninety patients with 122 zirconia implants (Straumann^® PURE Ceramic Implant) were examined at the one-year follow up. We measured the effect of the distance: first from the base of the contact point of the crowns to the contact with bone at the implant site (D1); secondly, to the contact with the bone at the neighbouring tooth or implant site (D2); and thirdly on the papillary deficit (D3). In both the tooth-implant group and the implant–implant group, D1 and D2 correlated significantly with the papillary deficit (D3), whereas D2 was the major determinant factor (Spearman’s rho = 0.60). In both groups, when D1 and D2 were <6 mm, the papilla was present every time. The papillary deficit was significantly greater in the tooth-implant group than in the implant–implant group (p = 0.048). We conclude that the ideal distance from the base of the contact point to the bone contact at the implant and to the bone contact at the adjacent tooth in both groups is <6 mm. The height of the bone on the teeth adjacent to implants has a significant impact on that of the papilla.     

Alpha 2 integrin gene (ITGA2) polymorphism in renal transplant recipients with and without drug induced gingival overgrowth

Background

Variances in fibroblasts’ α2β1 integrin intensity may lead to altered adhesion to type I collagen and consequently to suppression of phagocytosis which may be one of the mechanisms for drug induced gingival overgrowth. The present study aimed to evaluate the genotype and allele frequencies of α2 integrin +807 gene in renal transplant patients with and without gingival overgrowth.

Material and methods

Seventy renal transplant patients with cyclosporine A (CsA)-induced gingival overgrowth (CsA GO+) were enrolled. Renal transplant patients without GO medicated with CsA (CsA GO−; n = 79) and tacrolimus (Tac; n = 52) served as controls. DNA was obtained from peripheral blood and ITGA2 +807C/T polymorphism was genotyped by polymerase chain reaction and restriction fragment length polymorphism method. Clinical parameters including probing depth and plaque, papilla bleeding and hyperplasia indexes were recorded. Chi-square, Kruskal–Wallis and Mann–Whitney tests were used in statistical analysis.

Results

Clinical parameters of CsA GO+ group were significantly higher than those of the CsA GO− and Tac groups (p < 0.05). ITGA2 807C/T genotype and allele frequencies of study groups were similar (p > 0.05).

Conclusion

Within the limits of the present study it can be concluded that ITGA2 +807 gene polymorphism is not associated with susceptibility to CsA-induced GO.     

Metastatic Tumors to the Gingiva and the Presence of Teeth as a Contributing Factor: A Literature Analysis

Background: Gingiva that is prone to inflammation may serve as a pre‐metastatic niche for the attraction of circulating malignant cells. The aim of this study is to analyze cases of metastatic lesions to the gingiva compared with cases metastasizing to other oral mucosal sites. The pathogenesis of gingival metastases is discussed, with emphasis on the role of inflammation. Methods: The English‐language literature between 1916 and 2011 was searched for cases of metastatic lesions to the oral mucosa; only cases metastasizing in the oral mucosa, gingiva, and periodontium were included. Results: Two hundred seven cases were included. The gingiva was the most common site (60.4%), followed by tongue and tonsil. The most common primary sites were lung (24.2%), kidney (13.5%), skin (10.6%), and breast (8.7%). In 27%, the oral lesion was the first sign of a malignant disease. In most cases, the lesion appeared as an exophytic mass (96%) diagnosed clinically as a reactive gingival lesion. The presence of teeth was significantly associated with the development of gingival metastases: in 108 of 125 gingival metastases, the lesion was found adjacent to teeth (P <0.001; odds ratio = 8.2). The average life expectancy after diagnosis of the metastasis was 3.7 months. Conclusions: The gingiva is the most common site for metastases to oral soft tissues, with strong association with the presence of teeth. This finding may be related to the role of inflammation in the attraction of metastatic cells to chronically inflamed gingiva.     

The color of human gingiva and mucosa: visual measurement and description of distribution

No soft tissue shade guide is available for matching the color of denture resins to human intraoral soft tissues. To determine the color of both the gingiva and the alveolar mucosa, intraoral soft tissue colors of 150 men and women were assessed under standardized lighting conditions. Colors of the papilla, attached gingiva, and alveolar mucosa in the central incisor region of the maxilla and mandible were examined using Munsell color tabs and their corresponding notations (value, hue, chroma). Statistical evaluation was performed by using frequency tables and multiple regression (level of significance p=0.05). Color ratings for the maxillary interincisal papilla lay in the yellow hue spectrum. A high incidence of ratings was found between 7/6 2.5R and 7/4 5R (Munsell color notations). Two further peaks were identified for the colors 3/6 2.5 R and 8/4 10R. Five peaks with the highest frequency of ratings were present with regard to the color of the mucosa in the maxillary incisal region: 6/6 2.5R, 7/6 2.5R, 6/8 5R, 5/8 7.5RP, and 5/6 10RP. In the mandible, a similar pattern was found. Using the results from visual matching tests, five color frequency peaks were identified. They could be used to construct an intraoral soft tissue shade guide.     

96例牙龈出血的治疗情况分析

目的探讨96例牙龈出血的临床疗效。方法采用回顾性分析的方法,分析收治的96例牙龈出血患者,依据牙龈出血原因,分别采取局部压迫出血、含漱法治疗及缝扎止血法等方法治疗。结果局部压迫出血56例,含漱法治疗20例,缝扎法20例;显效76例(79.2%)、有效20例(20.8%),总有效率100%,无其他并发症发生。结论针对牙龈出血原因进行合理的分析和总结,选择合适的治疗方法,注意全身性疾病的针对性治疗,对于有效快速的治疗牙龈出血,避免贻误治疗时机具有重要的临床意义。     

Shadeeye NccⅡ型电脑比色仪测量成年人健康牙龈颜色及其影响因素*

背景：牙体颜色的研究发展较为迅速,而牙龈颜色的研究却相对滞后。对健康牙龈颜色的研究是制作牙龈比色板,进行牙龈配色的基础。 目的：分析解剖部位、性别、年龄、是否经常喝有色饮料、刷牙次数等方面对牙龈颜色的影响,在牙龈、牙槽嵴缺损较大需制作义龈修复时,指导临床配色。 设计、时间及地点：对比观察,于2006-09/2007-01在泸州医学院附属口腔医院修复科、口腔内科完成。 对象：采用分层抽样的方法,抽取泸州市具有健康牙龈颜色的市民160名,按年龄分为4组,分别为20~29岁组、30~39岁组、40~49岁组、50岁以上组,每组40名,且男女比例接近1∶1。 方法：在自然光线下,用Shadeeye NccⅡ型电脑比色仪测定每位受访者上颌侧切牙的龈乳头(分为近中和远中两个部位)、游离龈(位于侧切牙牙体中部所对应的牙龈)、附着龈(距离侧切牙的牙颈部3 mm),左右对称的牙龈各测1次。测试时比色仪的探头应轻触牙龈各部分,以不压牙龈为准。每次测试前用仪器自带的校正器校正1次。 主要观察指标：A、B两区侧切牙牙龈的L*a*b*值;上颌侧切牙的4个牙龈部位的L*a*b*值;不同性别、年龄组观察对象牙龈L* a*b*值。 结果：A、B两区的同名对称牙牙龈的L*a*b*值差异无显著性意义(P > 0.05)。同侧上前牙边缘龈、近远中龈乳头和附着龈的L*a*b*值不全相同(P < 0.01),两两比较后,总的来说附着龈的L*a*b*值与前三者之间的差异较明显(P < 0.05),而边缘龈与近远中龈乳头的L*、a*值不全相同(P < 0.05),且存在一定规律。男女上前牙牙龈L*、b*值差异无显著性意义(P > 0.05);男女上前牙牙龈a*值之间的差异有显著性意义(P < 0.05),男性的a*值大于女性。4个年龄组上颌侧切牙的不同部位牙龈的L*和a*值差异不无显著性意义(P > 0.05);b*值不全相同(P < 0.05)。50岁以上组在不同部位牙龈的b*值都最小。游离龈、附着龈的b*值与年龄成负相关,其相关系数分别为-0.18,-0.13,其余值与年龄不存在相关关系。 结论：牙龈、牙槽嵴缺损较大需制作义龈修复时,比色配色应注意考虑部位和性别的影响。     

Differences in p63 expression in SCCHN tumours of different sub-sites within the oral cavity

Squamous cell carcinoma of the head and neck, SCCHN, the sixth most common cancer in the world, comprises tumours of different anatomical sites. The overall survival is low, and there are no good prognostic or predictive markers available. The p53 homologue, p63, plays an important role in development of epithelial structures and has also been suggested to be involved in development of SCCHN. However, most studies on p63 in SCCHN have not taken into account the fact that this group of tumours is heterogeneous in terms of the particular site of origin of the cancer. Mapping and comparing p63 expression levels in tumours and corresponding clinically normal tissue in SCCHN from gingiva, tongue and tongue/floor of the mouth revealed clear differences between these regions. In normal samples from tongue and gingiva, tongue samples showed 2.5-fold higher median p63 expression and also more widespread expression compared to gingival samples. These results emphasise the importance of taking sub-site within the oral cavity into consideration in analyses of SCCHN.     

A non-invasive method for the assessment of gingival thickness in the aesthetic zone and the concept of the gingival geometric ratio in an Asian population

The aim of this study was to investigate the gingival thickness and biologic width in the aesthetic zone (maxillary central and lateral incisors) in an Asian population using cone beam computed tomography (CBCT) as a non-invasive measurement method, prior to immediate implant placement. The gingival geometric ratio is introduced as a new parameter for assessing soft tissue stability and hence predicting the aesthetic outcome. The gingival thickness, biologic width category (normal, high, and low crest), and gingival geometric ratio (shape and configuration of the gingival tissues) were assessed for 171 central and 175 lateral incisors on high-resolution CBCT images. Thick gingivae were found in 93.6% of the central incisors and 64% of the lateral incisors (P < 0.001). The difference in thickness between the central and lateral incisors was statistically significant (P < 0.001). Regarding the biologic width of the facial gingival tissue, the majority of central (64.8%) and lateral (64.3%) incisors were categorized as low crest (>3 mm). The study found that most of the gingivae of the maxillary central incisors were thick, while thin gingivae were more prevalent in the lateral incisors. Therefore, an individual patient may have different gingival thickness types, and ‘one individual, one gingival biotype’ may not be true. Furthermore, the majority of the facial gingival tissues of the maxillary incisors were found to be low crest.     

Gingival Condition Associated with Partial Orthodontic Treatment

A longitudinal clinical study on gingival condition was made on seventy-five patients treated with fixed orthodontic appliances in one or both dental arches. Fifty-three non-treated subjects of comparable age were included for further reference. The prevalence and severity of gingivitis about the maxillary teeth were compared for partial (i.e. banding of all maxillary teeth) and full (i.e. banding of all maxillary and mandibular teeth) orthodontic treatment. Plaque accumulation and gingival status were assessed according to the Plaque and Gingival Index systems. Gingival hyperplasia was recorded by linear measurements using pocket probes.

The results demonstrated that all patients developed generalized gingivitis during the period of active treatment. The proximal areas were invariably more affected than the buccal areas, and posterior teeth more than anterior teeth. Although the GI, PII and pocket depth values were constantly lower when treatment was limited to the maxillary teeth, the differences were small and generally not significant. Also the healing of the gingiva after removal of the appliances was more rapid when partial treatment was used. In neither orthodontic group, however, any permanent damage to the periodontal tissues could be demonstrated with the methods used.