Buccal Gingiva Research Articles

Polymer powerhouse: Methyl methacrylate – A breakthrough blend for superior adhesion to gingiva

The goal of this study was to develop a new poly(methyl methacrylate) (PMMA)-based conjugate with enhanced mucoadhesive features for gingiva. Five MMA-based conjugates with varying amounts of hydroxyethyl maleimide (HEM) and poly(ethylene glycol) (PEG) were synthesized and characterized using infrared spectroscopy and proton nuclear magnetic resonance. Quantification of attached HEM and PEG was performed using assay kits and established protocols. Mucoadhesiveness was tested through rheological measurements, retention time, and tensile strength studies. Results showed successful unification of MMA with HEM and PEG, with varying degrees of modification and no toxic effects. Dynamic viscosity was enhanced up to 13-fold for MMA-100Mal, decreasing incrementally for MMA-75Mal, MMA-50Mal, MMA-25Mal, and MMA-0Mal. Retention time improved up to 120-fold for MMA-100Mal, decreasing to 37.5-fold for MMA-0Mal. Mucoadhesiveness followed the order: MMA-100Mal > MMA-75Mal > MMA-50Mal > MMA-25Mal > MMA-0Mal. In conclusion, the novel modification of MMA with increased mucoadhesive features to buccal gingiva suggests its potential as a long-term total denture base material, paving the way for more patient-friendly prostheses.

Fusion of Supernumerary Teeth to the Mandibular Permanent Central Incisors: a case report

Aim: The fusion of supernumerary teeth with mandibular incisors is a rare occurrence. This case study presents the clinical presentation and management of an 8-year-old child with mandibular permanent central incisors affected by fusion with supernumerary teeth, leading to delayed eruption. Case Report: An 8-year-old girl with no history of medical issues was referred to the Orthodontics Department of Yazd Dental School, Iran. Clinical and radiographic examinations showed that two supernumerary teeth were fused to the buccal aspects of the mandibular permanent central incisors, with the incisal portions erupting into the buccal gingiva. Conclusion: The existence of one or more supernumerary teeth usually leads to occlusal and functional problems and interference with tooth eruption. In these cases, thorough clinical and radiographic examinations with precise history taking should be performed to plan a suitable surgical-orthodontic treatment.

Oral fibrolipoma in dogs: Retrospective case series study and comparative review.

Fibrolipoma is defined as a typical lipoma transected by variable amounts of paucicellular and collagenous fibrous components. Oral and lingual fibrolipomas are well-recognized histological entities in human medicine that are slightly more prevalent in females, occur most commonly after the fourth decade, and arise from the buccal mucosa. The documentation of this neoplasm in the oral cavity is lacking in veterinary medicine. Through a multi-institutional retrospective compilation of cases submitted to diagnostic pathology services, here we describe the clinical and pathologic features of oral fibrolipomas in dogs. A total of 112 cases of oral fibrolipomas in dogs were retrieved. The mean age was 10.1 years (range 2-16 years, ±2.63 years standard deviation), with an average tumor size of 1.7 cm (range 0.2-8 cm, ±1.1 cm standard deviation). The most common location was the tongue (57.1%, 64/112), followed by the buccal mucosa (15.2%, 16/112), sublingual area (8.0%, 9/112), gingiva and lip (4.5%, 5/112 each), and palate (1 case). The anatomical location of oral fibrolipomas only differed significantly among the dog breeds (P < .001) but not among sex, age, anamnesis, or reason for submission. The tumor was most commonly reported in males (69.7%, 78/112), and in 62.5% (70/112) of the cases, the tumor was an incidental finding. Fibrolipoma should be considered a differential diagnosis when considering benign lingual and other oral soft tissue masses in dogs.

The impact of mandibular partial edentulous distal extension on virtual occlusal record accuracy when using two different intraoral scanners: An in vitro analysis

ObjectivesThis in vitro study was formulated to clarify how mandibular partial edentulous distal extension involving three missing teeth affects the virtual occlusal record (VOR) accuracy, in terms of both trueness and precision, when using two different intraoral scanners (IOSs) – the Primescan (PS) and Trios 4 (TR) scanners. MethodsA typodont model missing the left mandibular second premolar, first molar, and second molar as well as the right mandibular first molar was mounted on a semi-adjustable articulator. Four implants were placed at the sites of the missing mandibular teeth. Six pairs of stainless steel markers (diameter: 0.5 mm) were affixed to the maxillary and mandibular casts in the buccal gingiva adjacent to the implants and on the facial surfaces of teeth as reference positions for measurements. The model was digitized with an inEox X5 laboratory scanner to create a reference dataset. Intraoral scans were performed with the PS and TR scanners, with each scan duplicated 10 times to generate 20 paired IOS files. Automatic VOR generation followed the bilateral buccal scan protocol, divided into PS and TR groups (n = 10). Six subgroups of linear distances between interarch markers were assessed with Geomagic Control software, comparing deviations from the reference scan. Data normality was confirmed with the Shapiro-Wilk test. Trueness was evaluated with two-way ANOVAs and pairwise comparisons performed with Tukey's test, whereas precision was assessed with the Levene test (α=0.05). ResultsThe mean linear deviation (Δd) and standard deviation (SD) of VOR were both significantly affected by marker position (P < 0.001), and a significant position × scanner interaction was detected (P < 0.001). Negative mean deviations were observed for the distally extended edentulous areas in both groups. PS scans exhibited trueness that was significantly better than that for TR scans in the D16–46, D13–43, D23–33, and D27–37 subgroups (P < 0.05), whereas there were no significant differences in the D25–35 or D26–36 subgroups. PS scanning was associated with significantly better precision than TR scanning (P < 0.001), and worse precision was observed at D27–37 for both tested IOSs. ConclusionsMandibular partial edentulous distal extension can significantly affect VOR accuracy. The type of IOS could also affect VOR accuracy depending on the area being scanned, with better overall performance observed for the Primescan device as compared to the Trios 4 scanner. Both of these IOSs tended to underestimate VOR occlusal dimensions in mandibular distally extended edentulous areas. Clinical SignificanceMandibular distal edentulous areas can contribute to occlusal dimensions that are underestimated in digital workflows, which may result in infraocclusal discrepancies that arise when performing restorations. IOSs and VOR scanning protocols should thus be carefully considered in order to minimize these risks.

Is micronucleus assay a useful marker in gingiva, tongue, and palate for evaluating cytogenetic damage induced by chemical, physical, and biological agents in vivo? A systematic review with meta-analysis.

The present systematic review (SR) aims to evaluate manuscripts in order to help further elucidate the following question: is the micronucleus assay (MA) also a useful marker in gingiva, tongue, and palate for evaluating cytogenetic damage in vivo? A search was performed through the electronic databases PubMed/Medline, Scopus, and Web of Science, all studies published up to December 2023. The comparisons were defined as standardized mean difference (SMD), and 95% confidence intervals (CIs) were established. Full manuscripts from 34 studies were carefully selected and reviewed in this setting. Our results demonstrate that the MA may be a useful biomarker of gingival tissue damage in vivo, and this tissue could be a useful alternative to the buccal mucosa. The meta-analysis analyzing the different sites regardless of the deleterious factor studied, the buccal mucosa (SMD = 0.69, 95% CI, - 0.49 to 1.88, p = 0.25) and gingiva (SMD = 0.31, 95% CI, - 0.11 to 0.72, p = 0.15), showed similar results and different outcome for the tongue (SMD = 1.19, 95% CI, 0.47 to 1.91, p = 0.001). In summary, our conclusion suggests that the MA can be a useful marker for detecting DNA damage in gingiva in vivo and that this tissue could be effective site for smearing.

Modified approach of regenerative treatment for distal intrabony defect beneath non-keratinized mucosa at terminal molar: A case report

BACKGROUND Intrabony defects beneath non-keratinized mucosa are frequently observed at the distal site of terminal molars. Consequently, the application of regenerative treatment using the modified wedge-flap technique is considered impractical for these specific dental conditions. CASE SUMMARY This article proposes a modified surgical procedure aimed at exposing the distal intrabony defect by making a vertical incision in the keratinized buccal gingiva. The primary objective is to maintain gingival flap stability, thereby facilitating periodontal regeneration. The described technique was successfully employed in a case involving the left mandibular second molar, which presented with an intrabony defect without keratinized gingiva at the distal site. In this case, an incision was made on the disto-buccal gingival tissue, creating a tunnel-like separation of the distal non-keratinized soft tissue to expose the intrabony defect. Subsequently, bone grafting and guided tissue regeneration surgeries were performed, resulting in satisfactory bone fill at 9 mo postoperatively. CONCLUSION This technique offers a regenerative opportunity for the intrabony defects beneath non-keratinized mucosa and is recommended for further research.

Association of Connective Tissue Grafts in Immediate Implants: Systematic Review and Meta-Analysis.

The increase in soft tissue (ST) around implants can benefit peri-implant health and aesthetic results. The objective was to compare the gingival and esthetic health benefits of immediate implant placement (IIP) with simultaneous or delayed connective tissue graft (CTG) compared to IIP without CTG. A systematic review was carried out by two reviewers in Medline-Pubmed, Scopus, and Cochrane. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were considered. Randomized Clinical Trials (RCTs) that were published between April 2017 and February 2024 were used. Studies that analyzed the performance of a simultaneous or deferred CTG after the placement of an implant in the aesthetic zone, with or without immediate provisionalization, without previous regeneration, with a follow-up of 6 months, and that were performed in humans were included. Quantitative analysis was performed using data provided by the RCTs. The five RCTs that were selected analyzed a total "n" of 245 subjects who met the inclusion criteria and focused on the subject of the study. In the quantitative analysis, four RCTs were included. The studies evaluated buccal gingiva levels when placing the IIP with and without CTG, obtaining a mean buccal gingiva level difference of 0.09 mm (95% CI: -0.54 to 0.72, p = 0.05), statistically not significant, but with a favorable trend. The use of CTG associated with the II can maintain the gum level but not increase the volume. CTG is favorable for achieving successful esthetic results when immediate placement of an implant with a provisional prosthesis is planned.

Analysis of PD-L1 expression in locally advanced head and neck squamous cell carcinoma and its correlation with the efficacy of neoadjuvant immunotherapy + chemotherapy: A retrospective real-world study.

6074 Background: The incidence rate of HNSCC in Hunan China are notably higher than in other regions, likely due to the high prevalence of betel nut chewing. Therefore, we conducted a study to examine the PD-L1 expression in newly diagnosed locally advanced (stage III-IVB) HNSCC patients. Methods: 1. We conducted a retrospective analysis of the PD-L1 expression (represented as CPS) in pre-treatment biopsy tissues from locally advanced HNSCC. 2. 57 patients received neoadjuvant treatment consisting of nab-paclitaxel+ cisplatin+ pembrolizumab. The efficacy of the treatment was evaluated using pathology assessments. Results: 1. A total of 373 patients were included. The top five primary sites of the tumors were the tongue(32.17%), Buccal oris (20.91%), oropharynx (10.19%), hypopharynx(9.92%), and gingiva(7.77%). The proportion of patients with PD-L1 CPS≥20 (55.23%) was significantly higher than the 43.20% reported in the KEYNOTE-048 study. Furthermore, the subgroup was even higher in the buccal oris (70.51%) and gingiva (72.41%). 2. A total of 57 patients were tested for PD-L1 CPS and received neoadjuvant treatment.After surgery, 22/57 (38.60%) achieved pathological complete response (pCR) or major pathological response (MPR), 29/57 (50.88%) achieved partial pathological response (pPR), resulting in an overall response rate (ORR) of 89.47%. In the PD-L1 CPS ≥20 group, the ORR was as high as 91.89% (34/37). 3. Among the 57 patients, 36 patients had lymph node metastasis. After treatment, 15/36 patients (41.67%) achieved pCR/MPR in lymph nodes, 7/36 patients (19.44%) achieved pPR, resulting in an ORR was 61.11% (22/36). Conclusions: 1. The oral cavity is the most common primary in HNSCC in Hunan,China. In the locally advanced , the proportion of PD-L1 CPS ≥20 is higher than reported in other studies. 2. Regardless of PD-L1 expression, neoadjuvant treatment with nab-paclitaxel+ cisplatin+ pembrolizumab has shown a high rate of local disease control in newly diagnosed HNSCC patients. Additionally, the use of neoadjuvant therapy has improved the delineation of surgical safety margins, leading to 100% R0 resections in all 57 patients. 3. The response of the primary lesion in patients treated with neoadjuvant therapy is better than that of the lymph node. Patients with a well-responding primary lesion but multiple lymph node metastases should be closely monitored for the possibility of short-term systemic metastasis. [Table: see text]

Corticosteroids and Immunosuppressants on Oral Lichen Planus’ Treatment

Dear Editor, Lichen planus (LP), a chronic inflammatory condition primarily targeting skin and mucous membranes, was first outlined by Wilson in 1869 and histologically by Dubreuilh in 1906 [1]. It predominantly affects women in their 4th and 5th decades [2]. Oral lichen planus (OLP) occurs mainly on the buccal mucosa, gingiva, and tongue, presenting in six types, with erosive ones causing eating discomfort. While 25% of LP cases manifest solely orally, some lesions can appear in areas like the anogenital region and esophagus [2]. OLP is postulated to be a T cell-mediated response to antigens, with potential ties to chronic liver diseases and higher prevalence in regions like Japan and Southern Europe [3]. Comorbidities like diabetes, hypertension, and stress may also contribute [4]. Dental materials can mimic OLP, and specific drugs, including NSAIDs and beta-blockers, might induce it in some individuals [5]. Asymptomatic OLP lesions generally need no treatment. For symptomatic forms, treatment targets symptom alleviation and lesion removal, primarily using topical corticosteroids. Resistant lesions may require intralesional or systemic corticosteroids, with alternatives like immunosuppressives, retinoids, antifungals, and metronidazole also being effective [6]. OLP has a premalignant nature with a 0.4-1.74% risk of turning malignant, typically from its atrophic or erosive form [7]. Treatment aims to alleviate pain, heal ulcers, minimize cancer risks, extend symptom-free periods, and uphold oral health. This report presents intralesional corticosteroid therapy for three patients with symptomatic OLP, presenting symptoms like pain and burning.

Difference in Buccal Gingival Thickness between the Mandible and Maxilla in the Aesthetic Zone: A Systematic Review and Meta-Analysis.

Background: Fragile gingival tissue is a risk factor for the development of gingival recessions. Despite the fact that gingival recessions are more commonly seen around anterior mandibular teeth, previous research has predominantly concentrated on the gingival dimensions in the anterior maxilla. The objective was to systematically compare buccal gingival thicknesses between the upper and lower jaws in individuals with healthy gingival conditions in the aesthetic zone. Methods: A comprehensive search of three databases was carried out until October 2023. Gingival thickness differences between the maxilla and mandible were evaluated by calculating the mean differences along with the corresponding 95% confidence interval (CI). Subgroup analysis was conducted based on the measurement area, measurement method, and tooth category. Results: A total of seventeen studies were included in this systematic review. Eleven studies were included in the quantitative analysis. Quantitative analysis comparing gingival thickness around 2100 teeth in the anterior mandible to 2056 teeth in the anterior maxilla revealed a statistically significant thinner buccal gingiva in the mandible (mean difference: 0.16 mm; 95% CI [-0.24, -0.07]; p = 0.0003). Conclusions: The present systematic review revealed a more delicate buccal gingiva in the anterior mandible. However, further scientific validation is required due to the considerable heterogeneity in study design and the potential presence of confounding variables.

Clinical encounters of giant cell fibroma: A comprehensive report on two distinct cases, exploring varied clinical presentations

A giant-cell fibroma (GCF) is a benign, localized mucosal mass composed of fibrous tissue that exhibits clinical similarities to other fibro-epithelial growths. Its differentiation from other lesions relies on its distinctive histopathological characteristics. GCF is a rare oral fibrous lesion, often misdiagnosed as other fibrous growths. The first case involves a 24-year-old female with a GCF located near mandibular buccal gingiva. The second case centers on a 14-year-old boy who developed GCF on the incisive papilla region. These cases shed light on the diverse clinical manifestations and histopathological markers used in the diagnosis of GCF. The report delves into the clinical presentation, histological features, and differential diagnoses, offering valuable insights for oral healthcare professionals. Understanding the occurrence of GCF on different aspects of the gingiva is crucial for accurate diagnosis and effective treatment. This report contributes to the growing body of knowledge regarding this rare oral lesion and emphasizes the importance of considering GCF in the differential diagnosis of gingival growths.

Evaluation of Post-Operative Morbidity and Palatal Wound Healing after Implant Uncovering Surgical Procedure Performed with Apically Positioned Flap (APF) and Leukocyte and Platelet-Rich-Fibrin (L-PRF): An Original Technique.

Background and Objectives: Dental implants are recognized as an effective treatment in the management of edentulous patients; controversies surround the connection between the sufficiency of keratinized gingiva (KG) and peri-implant health. Maintaining an ample amount of peri-implant KG is crucial for minimizing gingival inflammation, highlighting the need for regular consideration of soft-tissue augmentation. Among the diverse periodontal plastic surgical procedures, the apically positioned flap (APF) is notable for its ability to enhance the width of keratinized tissue while minimizing patient morbidity. The aim of this study was to evaluate the effects of L-PRF on palatal wound healing and patient discomfort after surgery. Materials and Methods: Twenty patients with two adjacent submerged fixtures in the maxilla and buccal keratinized gingiva widths < 2 mm were treated with APF and L-PRF. Clinical evaluations were performed at 1, 2, 3, and 4 weeks post-surgery, focusing on parameters such as complete wound epithelialization (CWE), postoperative discomfort (D), changes in feeding habits (CFH), alteration of sensitivity (AS) around the wound area, and the consumption of analgesics. Results: Our data revealed CWE in 5 patients by the end of the second week, with the remaining 15 achieving CWE by the end of the third week. For D and CHF, a statistically significant improvement was recorded for all cases between the first and second weeks, as well as AS, although less substantial, by the third week. No significant changes were noted for AS over the initial two weeks. Conclusions: These findings suggest that L-PRF may enhance wound healing and decrease patient discomfort following APF for fixture uncovering.

Integrated correlation analysis of the thickness of buccal bone and gingiva of maxillary incisors.

This study aimed to validate the integrated correlation between the buccal bone and gingival thickness of the anterior maxilla, and to gain insight into the reference plane selection when measuring these two tissues before treatment with implants. Cone beam computed tomography (CBCT) and model scans of 350 human subjects were registered in the coDiagnostiX software to obtain sagittal maxillary incisor sections. The buccal bone thickness was measured at the coronal (2, 4, and 6 mm apical to the cementoenamel junction [CEJ]) and apical (0, 2, and 4 mm coronal to the apex plane) regions. The buccal gingival thickness was measured at the supra-CEJ (0, 1mm coronal to the CEJ) and sub-CEJ regions (1, 2, 4, and 6 mm apical to the CEJ). Canonical correlation analysis was performed for intergroup correlation analysis and investigation of key parameters. The mean thicknesses of the buccal bone and gingiva at different levels were 0.64~1.88 mm and 0.66~1.37 mm, respectively. There was a strong intergroup canonical correlation between the thickness of the buccal bone and that of the gingiva (r=0.837). The thickness of the buccal bone and gingiva at 2 mm apical to the CEJ are the most important indices with the highest canonical correlation coefficient and loadings. The most and least prevalent subgroups were the thin bone and thick gingiva group (accounting for 47.6%) and the thick bone and thick gingiva group (accounting for 8.6%). Within the limitations of this retrospective study, the thickness of the buccal bone is significantly correlated with that of the buccal gingiva, and the 2 mm region apical to the CEJ is a vital plane for quantifying the thickness of these two tissues.

Prognosis of South Asian Buccal Mucosa Cancer Patients in the United States: Association of Race with Overall Survival.

Squamous Cell Carcinoma (SCC) of the buccal mucosa and gingiva accounts for approximately 10% of oral and pharyngeal cancers diagnosed in the United States each year, with a disproportionally higher incidence in individuals of South Asian descent. However, little has been documented regarding trends pertaining to overall survival. Thus, this research serves to identify predictors of survival and determine if overall survival (OS) differs for South Asians compared to other races once they develop non-metastatic buccal mucosa or gingiva squamous cell carcinoma. A population-based, cohort study of patients registered in the National Cancer Database® (NCDB) between the years 2004-2016 was performed. Kaplan-Meyer Survival Curves were executed to examine overall survival, while univariable (UVA) and multivariable analysis (MVA) was performed to determine the effect of multiple variables on OS. South Asians had longer median OS at 88.7 months, compared to 58.6 months and 38.3 months for Caucasians and African Americans respectively (p<0.001). In UVA, race was highly significant, but when the cohort was selected to include only those who had undergone surgical resection, no statistically significant difference remained. On MVA, lack of surgery, older age, higher grade, higher T and N stage, use of chemotherapy, higher comorbidity scores were associated with worse OS, but race was not significant. South Asians in the US with non-metastatic buccal mucosa or gingiva SCC have better OS compared to Caucasians or African Americans, likely due to younger age at diagnosis (median 59 vs. 71 and 62 years old) and more frequent surgical resection (75% vs. 72% and 64%). In MVA, South Asians have similar OS as Caucasians.

Oral Infection by Lichen Planus: Types, Relevance, and Significance: A Review

Lichen planus is a chronic inflammatory condition that affects the skin. It is referred to as oral lichen planus (OLP) when it develops inside the mouth. The condition may only occur in the mouth or also affect other body parts at the same time. It can also occur in the genitals, nails, and scalp. The condition is marked by the onset of a non-infectious, itchy rash. The rash is often small with an irregular shape. It also has a flat top and appears as pink or purple bumps. OLP affects about 1% of the population. OLP is sometimes triggered by the body's reaction to metals placed in the mouth. Examples are dental fillings and metal braces. There have also been reports of the disorder occurring due to mouth mannerisms. Examples are biting the cheeks or tongue. Clinically, six types of OLP, namely reticular, popular, plaque-like, atrophic/erosive, ulcerative, and bullous types, can be identified. OLP more commonly affects the buccal mucosa, tongue, and gingiva. It is important to note that OLP is not an infection. It is also not contagious. It is not passed on from person to person. It is also not linked to nutrition or nutritional deficiency. However, eating certain fruits, tomato-based products, and spicy food has been found to make the symptoms worse. OLP is more common in women than men. It is often diagnosed in patients aged 40 and above. However, it can also affect children and young adults.

Hereditary Gingival Fibromatosis: A Case Report and Review of Literature

Hereditary gingival fibromatosis (HGF) has been defined as a rare disorder characterized by a benign, nonhemorrhagic, fibrous gingival overgrowth that can appear in isolation or as part of a syndrome. Because it has no specific cause, it is also known as idiopathic gingival fibromatosis. HGF starts in its mildest form and progresses very slowly to reach a severe form that can cover the teeth, causing severe functional and cosmetic problems. Clinically, it appears as diffuse or localized gingival overgrowth, pinkish, and firm in consistency that could be seen in both the buccal and lingual gingiva of both the mandible and maxilla. There could be ulceration and bleeding secondary to traumatic biting on the lesion. We report a case of a 12-year-old boy who presented with 5-year history of multiple gingival lesions clinically diagnosed with HGF. The relevant literature and important aspect in the management of this condition has also been discussed.

The activin/BMP-2 chimera AB204 promotes periodontal tissue regeneration in a buccal dehiscence model: a pilot study.

A combination of activin and bone morphogenetic protein-2 (BMP-2), termed AB204, has been shown to improve osteogenic potential with fewer side effects than BMP-2 alone. This study was performed to evaluate the effect of AB204 on periodontal tissue regeneration in a dog buccal dehiscence model. Buccal dehiscence defects were created on the maxillary premolars (P1, P2, and P3) of 6 mongrel dogs. After 5 weeks, the dogs were randomly assigned to 1 of 3 groups: the control, collagen matrix (CM), and CM/AB204 groups. Grafting procedures were then performed. The dogs were sacrificed 8 weeks after the grafting procedure, and volumetric and histological analyses were conducted. The thickness of the buccal gingiva in the CM/AB204 group was greater than those in the other groups at 2 weeks (P<0.05). The ridge width in the AB204/CM group exceeded the width in the other groups at 4 and 8 weeks; however, the difference was not statistically significant. Histological analysis revealed that the CM/AB204 group demonstrated the formation of new bone surrounded by newly formed periodontal ligament and cementum (P=0.035). The combined application of CM and AB204 shows promise in facilitating the regeneration of periodontal attachment, including the formation of new bone, cementum, and periodontal ligament.

Implant-supported crowns on maxillary laterals and canines—a long-term follow-up of aesthetics and function

ObjectivesTo assess the long-term aesthetic and functional aspects of implant-supported crowns in lateral (ISC-L) and canine positions (ISC-C).Materials and methodsThirty-two patients (14 males, 18 females, mean age: 23.1, SD:2.0) with an ISC-L or ISC-C participated in this prospective cohort study at baseline (T0) and in the long-term follow-up (T1, mean years: 11.1, SD: 1.0). Twenty-four patients (11 males, 13 females) participated in T1. Patient-reported outcomes (PROM) were rated using surveys with questions related to aesthetics and function. The colour of the implant crown and the buccal gingiva, the appearance of the papilla, periodontal health and temporomandibular disorder (TMD) outcomes were assessed in a clinical examination. The Mann-Whitney, Chi-square and Signed Rank tests were performed.ResultsPatients with an ISC-L and ISC-C were equally satisfied with the crown shape and colour at T0 and T1. No differences in TMD outcomes were reported by the patients and no clinical signs of TMD were observed. At T1, ISC-C had more bleeding on probing and a three mm greater pocket depth than ISC-L (p = 0.03, p = 0.01, respectively). At T0, operators graded the crown colour of ISC-L as being too dark (35%) and ISC-C as being too light (40%). At T1, no difference was seen between the two groups regarding crown colour, gingiva colour and the papilla (p = 0.2749, p = 0.2099, p = 0.8053, respectively).ConclusionsThe PROM and clinical examination show that ISC-L and ISC-C are equivalent with regard to aesthetics and function in the long term.Clinical relevanceAlthough ISC-L and ISC-C are aesthetically and functionally comparable in the long term, ISC-Cs are more likely to impact periodontal health.

Evaluation of the Histological Changes as Effect of Type 2 Diabetic Mellitus on the Oral Epithelium (Buccal Mucosa and Gingiva)

Background: Exfoliative cytology considered as one of the best technique to obtain the epithelial cells lining buccal mucosa in oral cavity. Diabetes mellitus type 2 is one of the most distributed disorder wild world which cause deferent histological and cytological defects in all body organs. Aim: To realize the histological changes in oral epithelium (of buccal and gingival mucosa) in patients suffering from type 2 diabetic mellitus. Material and methods: Sample composed of two groups, the study group represented by ten male diabetic patients, their age between (50-65) years attending the teaching hospital of college of Dentistry/ Tikrit university, and the control group (10 male 50-65 years old), the smear taken from oral epithelia from buccal mucosa, gingiva and saliva using cotton swab. The samples were carried on glass slides and stained by using Giemsa dye.Results: The microscopical examination revealed a number of histological changes, as presence of binucleated cells, budding in nuclei and decay (karyolysis) of other nuclei with the observation of fragmentation (karyorrhexis) of others, besides, some of vasicular degeneration seen with the cytoplasm of number of cells and hypertrophy in others.Conclusion: Diabetes mellitus type 2 cause many histological changes in oral epithelia of buccal mucosa and gingiva which detected by exfoliative cytology.

Intraoral Nevi of Gingiva - A Case Report

Intraoral nevus is a benign skin and mucosal tumour characterised by the presence of melanin-producing, neuroectodermal derived cells that can range in colour from light to dark brown, reddish brown, blue, or red. It comes in a variety of shapes, from oval to spherical. Oral melanotic nevi, which causes localised pigmentation, are a rare oral lesion. In a major survey, they were found in only 0.1 % of the population. Nevi can be acquired over time or be present from birth. Congenital nevi are hamartomas, but acquired nevi are benign neoplasms. They are most typically found on the palate, but they can also be found on the buccal mucosa, gingiva, and lips. A case report of an intramucosal nevus of gingiva in a 25-year-old woman and its surgical excision is presented in this article.