Inflammatory Gingival Hyperplasia Research Articles

Evaluation of ABCB5 immunostained epithelial stem cells in oral squamous cell carcinoma, inflammatory gingival hyperplasia and normal mucosa

ABSTRACTOral cancer is the most prevalent head and neck cancer. Although tumor markers have been investigated for detecting the progression and prognosis of oral cancer, no reliable marker has been identified. We investigated the expression of ATP binding cassette subfamily B member 5 (ABCB5) positive stem cells in oral squamous cell carcinoma (OSCC) and in inflammatory gingival hyperplasia. We used tissue samples from normal subjects, patients with inflammatory gingival hyperplasia, and patients with OSCC. Samples were investigated using anti-ABCB5 monoclonal antibody immunohistochemistry to detect epithelial stem cells. Staining density, intensity, and immunoreactive scores of ABCB5 were analyzed for the three study groups. We found ABCB5 immunostaining in all three study groups, but different distributions of ABCB5 expression in different layers of the epithelium. We found no significant difference in staining intensity between inflammatory hyperplasia and normal mucosa, but we found significantly stronger expression in OSCC compared to normal and inflammatory hyperplasia individually. Elevated expression of ABCB5 in OSCC suggests an increased subpopulation of tumor cells with an undifferentiated stem cell phenotype, which facilitates cancer initiation and progression.

Peripheral ossifying fibroma – A case report

Peripheral ossifying fibroma – A case report - IDJSR- Print ISSN No: - 2394-708X Online ISSN No:- 2278-3784 Article DOI No:- 10.18231/j.idjsr.2019.011, International Dental Journal of Student's Research-Int Dent J Stud Res

CRYOTHERAPY AS AN ALTERNATIVE THERAPY FOR JUVENILE SPONGIOTIC GINGIVAL HYPERPLASIA: PRELIMINARY FINDINGS ON TWO CASES

Juvenile spongiotic gingival hyperplasia (JSGH) is a subtype of inflammatory gingival hyperplasia, commonly observed in children, with a female predominance. JSGH usually shows lack of response to traditional periodontal treatment, and interestingly, after surgical excision, a recurrence rate of 6% to 16% is related. We report 2 female patients (9 and 11 years old) who presented with multifocal red patches along the maxillary and mandibular labial gingiva. All lesions had a granular surface texture with no signs of bleeding. Both cases showed no regression of the lesions after prophylactic interventions. Surgical excision of the focal lesion in each case was performed, being diagnosed as JSGH. In both cases, the lesions had recurrence. Hence, cryotherapy sessions in all lesions over 8 weeks were performed. After 3-month follow-up, meaningful lesional regression and restoration of gingival texture were observed. In conclusion, cryotherapy appears to be successful in JSGH, with good tolerance by pediatric patients.

Assessment of reactive gingival lesions of oral cavity: A histopathological study.

Background:In the literature, many studies were attempted to analyze the distribution of oral reactive lesions in terms of age, gender and location. However, very few studies have focused on the detailed histopathological features of these reactive lesions of oral cavity. Thus, the purpose of this paper is to document the occurrence, distribution and various histopathological features of reactive gingival lesions.Materials and Methods:This study is a retrospective archival review of reactive gingival lesions of oral cavity such as irritational fibroma (IF), inflammatory gingival hyperplasia (IGF), pyogenic granuloma (PG), peripheral giant cell granuloma (PGCG) and peripheral ossifying fibroma involving gingival tissues. All the cases were histopathologically reviewed on some microscopical parameters according to the criteria given by Peralles et al.Results:Regarding epithelial morphology, atrophy, ulceration and hyperplasia were found predominantly in PG. Connective tissue was predominantly dense in IGF and IF with fibroblastic proliferation; whereas loose connective tissue was seen in PG. Vascular proliferation, especially capillary, was commonly present in PG and inflammatory gingival hyperplasia (IGH). Inflammatory cell infiltrate was intense in both PG and IGH. Mineralization showed a marked affinity for peripheral cement-ossifying fibroma, and bone/bone-like areas were found in about ten cases of them. The Foreign body type of multinucleated giant cells was found exclusively on PGCG.Conclusion:Despite their clinical similarities, the findings of this study reports that all reactive gingival lesions show some differences in age, type, location, duration and histopathological features. Nevertheless, the differing histological pictures are a range of a single lesion in diverse stages of maturation. Essential in the treatment of reactive lesions is the total removal of the lesion with local irritants such as defective restorations or calculus formation.

歯科における炭酸ガスレーザー

Currently,the carbon dioxide gas laser approved in the dental field is only at the wavelength of 10,600 nm. The application to the actual oral cavity condition can be applied to the actual oral pathology by abscess incision, chronic periodontal inflammation, evaporation for aesthetic improvement of pigmented gingiva, frenectomy, tumor resection, secondary surgery after implantation of dental implant, gingival fenestration of difficulty eruptive tooth, application to stomatitis, gingivectomy, evaporation of defective granulation tissue, evaporation of inflammatory edematous gingival hyperplasia tissue, treatment for hypersensitivity of teeth. Some of them are introduced.

Effects of interdental/intermaxillary wiring on teeth and periodontal tissues in the management of dentoalveolar and jaw fractures

Objectives: To evaluate immediate and late probable side effects of interdental/intermaxillary wiring used in treatment of jaw fractures on gingival and other deeper structures. Methods: 30 patients undergoing wiring procedure as an aid for treatment of jaw fractures were selected. The immediate and late effects with a six month follow up were studied using various parameters that were Plaque index, Modified gingival index, Ramfjord’s periodontal disease index, tooth mobility (graded as ‘normal or pathological’), tooth vitality using gutta-percha hot stick and checking for ankylosis or root resorption clinically as well as radiographically. Results: Immediate effects noticed after placement of wiring were increased accumulation of plaque, inflammatory gingival hyperplasia with bleeding on probing, deepening of gingival sulcus and increased tooth mobility. Most of the changes had totally reversed after 6 months follow up. Conclusions: The late deleterious effects on teeth and periodontal tissues from interdental wiring in the treatment of jaw fractures are minimal and hardly of any significance. Key words: Interdental/Intermaxillary Wiring, Jaw Fractures, Modified Gingival Index, Plaque Index, Ramford’s Periodontal Index.

Prevalence of Oral Lesions at the Oral Medicine Outpatient Clinic at Hemocentro Campinas/Unicamp

The oral outpatient clinic at Hemocentro Campinas/Unicamp provides dental treatment and oral diagnosis for oncohematological patients. This study evaluated the prevalence of oral lesions in this specific group of patients. Materials and Methods: A retrospective analysis studied biopsies and oral cytology results obtained between 2009 and 2012. Results: A total of 121 biopsies were carried out, with 44 (33.4%) of these in patients undergoing hematopoietic stem cell transplant (HSCT). Three patients (2.5%) showed oral non-Hodgkin's lymphoma, 20 (16.5%) had inflammatory gingival hyperplasia, and 7 (5.8%) had squamous cell carcinoma, among others.

Retrospective analysis of the clinical features of 530 cases of reactive lesions of oral cavity

Background: Most common localized reactive lesions of oral cavity are focal fibrous hyperplasia, pyogenic granuloma (PG), irritational fibroma, peripheral giant cell granuloma (PGCG), peripheral ossifying fibroma (POF), fibro-epithelial hyperplasia/polyp, inflammatory fibrous hyperplasia and inflammatory gingival hyperplasia. Clinically, these reactive lesions often present diagnostic challenges because they mimic different groups of pathologic processes. The aim of this paper is to document the occurrence, distribution of clinical features of reactive lesions of oral cavity in 15 years of clinical practice in Raichur, Karnataka. Materials and Methods: This study is a retrospective archival review of 530 cases of focal reactive lesions of the oral cavity. The cases for inclusion in this study were PG, PGCG, POF, irritational fibroma, fibro-epithelial hyperplasia/polyp, inflammatory fibrous hyperplasia and inflammatory gingival hyperplasia. Clinical data of each patient such as age, gender, location, and treatment were retrieved from the records. Results: Inflammatory gingival hyperplasia was the most prevalent lesion and followed by PG. The age ranged from 7 to 63 years, with a mean age of 40.5 years. 261 cases were males and 269 cases were females. Male to female ratio being 1:1. With the exception of PG and inflammatory gingival hyperplasia, all reactive lesions were more common in males. Gingiva with 470 cases was the most frequent site of reactive lesions, followed by buccal mucosa and palate. Conclusion: Reported results on the age, gender, and location of the individual types of lesions are not consistent in different studies. Some of the differences may be attributed to the geographic or ethnic factors. Nevertheless, there is need for more epidemiological studies to establish a better and adequate program to educate general population. Inaddition an early diagnosis and elimination of such lesions may minimize possible dentoalveolar complications.

A quantitative analysis of mast cells in inflammatory periapical and gingival lesions.

The aim of the study was to quantify the presence of mast cells in various inflammatory lesions like periapical granuloma, periapical cyst, inflammatory gingival hyperplasia and pyogenic granuloma. Mast cell degranulation and association with lymphocytes were also recorded in an attempt to understand the role of mast cells in the pathogenesis of these inflammatory lesions. The quantification of mast cells was done on toluidine blue stained sections of all the four groups of lesions, using the image analyzer software, Image-Pro-Express (Media Cybernetics, USA). An increased number of mast cells in various inflammatory lesions with a significant difference between the four groups were noted. Mast cell number tended to be greater in the lesions present in the anterior region of the mouth than in the posterior region of the oral cavity. The mean mast cell number decreased with the increasing age which was directly correlated with the age of the patients. Mast cell site, distribution, degranulation and its association with fibroblasts, lymphocytes and blood vessels were noted. The location of mast cells in different areas, their association with lymphocytes, fibroblasts, endothelial cells, and the phenomenon of degranulation helps to appreciate the release of various mediators and multiple interactions among these cells, leading to increased vascular permeability, angiogenic response, collagen synthesis, regulation of inflammation, bone resorption, and extracellular matrix destruction, thus contributing to the pathogenesis of these inflammatory lesions.

Is Titanium Sensitivity Associated with Allergic Reactions in Patients with Dental Implants? A Systematic Review

A worrying correlation which seems to be overlooked by clinicians is allergic reactions to titanium (Ti) in patients with dental implants. The aim of the present review study was to assess whether or not Ti sensitivity is associated with allergic reactions in patients with dental implants. To address the focused question "Can Ti cause allergic reactions in patients with dental implants?", databases were explored from 1977 until May 2010 using a combination of the following keywords: "allergy,""dental,""hypersensitivity,""implant,""oral," and "Titanium." Letters to the editor and unpublished data were excluded. Seven studies (six clinical and one experimental) were included. The participants were aged between 14.3 and 84.1 years. In five clinical studies, Ti implants were inserted in the mandible. Five studies reported dermal inflammatory conditions and gingival hyperplasia as allergic reactions in patients with Ti dental implants. A case report presented swelling in submental and labial sulcus and hyperemia of soft tissues in a patient with Ti dental implants. Two studies reported that Ti implants are well tolerated in host tissues. The patch test was performed in two clinical studies for the diagnosis of allergic reactions. Memory lymphocyte immunostimulation assay and lymphocyte transformation tests were also performed. The significance of Ti as a cause of allergic reactions in patients with dental implants remains unproven.

Immunohistochemical expression of Tenascin in embryogenesis, tumorigenesis and inflammatory oral mucosa

ObjectiveTenascin is a large extracellular matrix glycoprotein that plays specific role in cell matrix interaction. This protein is mainly attracted because of its oncofetal predominance expression at epithelial–mesenchymal interaction and also been associated with inflammatory response. Thus the aim was to study the expression of Tenascin within the oral cavity in a developing tooth, normal oral mucosa, squamous cell carcinoma and inflammatory mucosa and further to compare its expression in inflammatory mucosa with that of squamous cell carcinoma. DesignA total numbers of 92 cases were included, with 22 being all morphological stages of developing tooth, 10 cases of normal oral mucosa, 30 cases each of inflammatory gingival hyperplasia and oral squamous cell carcinoma. The intensity and pattern of expression was assessed immunohistochemically using anti-human mouse monoclonal Tenascin antibody. Results and conclusionTenascin expression in developing tooth was seen mainly at epithelial–mesenchymal junctions, but temporally reduced at cap stage. In normal mucosa TN expression was restricted only at basement membrane zone. Inflammatory gingival hyperplasia intensity of expression was enhanced at the juxtraepithelial stroma and showed reticular pattern of expression. In oral squamous cell carcinoma, intensity of expression was seen in superficial front of the stroma and also around tumour islands with intraepithelial expression and predominantly showed fibrillar pattern of expression. Furthermore, Tenascin expression was noticed around neovascularization. Hence, there is a regulatory system in Tenascin expression and plays a vital role in embryogenesis, tumerogenesis and inflammation in remodelling the stroma for cell migration and also for healing.

Processos proliferativos gengivais não neoplásicos em paciente sob tratamento ortodôntico

INTRODUÇÃO: a aparatologia ortodôntica dificulta a higiene bucal e pode contribuir para a formação de lesões gengivais, como os processos proliferativos gengivais não neoplásicos. Essas lesões, dependendo de alguns fatores - como o tempo de evolução, constituintes histopatológicos e condições bucais -, podem ser reversíveis, em alguns casos, por meio da orientação sobre higiene bucal e da terapia periodontal básica. Entretanto, na maioria das vezes há necessidade de tratamento cirúrgico. OBJETIVO: o propósito deste trabalho é relatar o caso de uma paciente portadora de aparatologia ortodôntica fixa que apresentou duas lesões gengivais distintas, diagnosticadas como granuloma piogênico e hiperplasia gengival inflamatória. Foram discutidas as características clínicas e histopatológicas, incidência e frequência, modalidades terapêuticas e prevenção de ambas as lesões, demonstrando a importância do encaminhamento do material colhido ao exame histopatológico, dada a possibilidade de diversas hipóteses diagnósticas. Em ambas as lesões foi realizada a exérese cirúrgica. RESULTADOS: a lesão na arcada superior, diagnosticada como granuloma piogênico, apresentou recorrência, sendo necessária terapia periodontal básicae repetiçãodoprocedimento cirúrgico. Alesão na arcada inferior foi diagnosticada como hiperplasia gengival, sendo removida cirurgicamente e acompanhada clinicamente, com prescrição de orientação da higiene bucal ao paciente

A Doença Periodontal como Fator Etiopatogênico à Hiperplasia Gengival Inflamatória

The inflammatory gingival hyperplasia is considered a non-neoplasic reactional proliferative process usually related to low intensity chronic irritative factors. Thus, the presence of periodontal diseases may lead to the development of this gingival hyperplasia by the presence of calculus and dental biofilm and to the gingival infection or inflammatory processes itself. The purpose of this paper is to review the possible ethiopathogenic mechanisms of this relationship as well as the clinical and histopathologic characteristics incidence and frequency differential diagnosis and treatment modalities applied on the inflammatory gingival hyperplasia.

Localized juvenile spongiotic gingival hyperplasia

We report 52 cases of a unique and pathologically distinctive form of inflammatory gingival hyperplasia in young patients. Clinically, the average age of patients in this study was 11.8 years, with a 2.3:1 female predominance. Caucasians comprised 77% of the cases, and nearly all of the lesions were located on the anterior gingiva, with 81% affecting maxillary gingiva. The most classic clinical presentation was a papillary, often pedunculated, red and easily bleeding gingival overgrowth in young patients. Histopathologically, the lesions exhibited a subtle papillary epithelial hyperplasia with prominent intercellular edema and neutrophilic exocytosis of the hyperplastic surface squamous epithelium. Based on the characteristic clinical and histologic features, we conclude that this lesion is a distinct subtype of gingival hyperplasia. Although previously described as juvenile spongiotic gingivitis, we propose the term localized juvenile spongiotic gingival hyperplasia as a more accurate designation.

Gingival and alveolar hyperplastic reactive lesions: clinicopathological study of 90 cases

Hyperplastic reactive gingival/alveolar lesions are one of the most common subgroups of oral lesions, however few studies have focused their clinical and microscopic characteristics on our population. The aim of this study was to analyze the socio-demographic, clinical and microscopical features of 90 hyperplastic reactive gingival/alveolar lesions from an Oral Pathology Laboratory from Rio de Janeiro, Brazil. Inflammatory gingival hyperplasia (IGH) and pyogenic granuloma (PG) were the most common diagnosis in this group. Females on their 3 rd to 4 th decades of life were the predominant group affected and most cases affected the anterior portion of the oral cavity. Histopathology revealed that all cases were associated to chronic inflammatory infiltrate and vascular proliferation was prominent in PG. Epithelial alterations were also more common in PG, but mineralization showed marked affinity for peripheral cemento-ossifying fibroma (PCOF). Fibroblastic proliferation was more evident on PCOF and peripheral giant cell lesion (PGCL) and multinucleated giant cells were found exclusively on PGCL. Clinical and socio-demographic findings alone were not enough for distinguishing all lesions from this group, and our findings showed that few cases were suggestive of an evolutionary process.

Diagnosis: Oral leishmaniasis

Diagnosis: Oral leishmaniasis

Clubbed Fingers in a Patient with Inflammatory Gingival Hyperplasia

The association of clubbing with miscellaneous diseases and its diagnostic implications are such that its detection should prompt consideration of the underlying etiology. We encountered a 48-year-old woman with clubbed fingers and a cauliflower-like gingival swelling on the hard palate of the upper jaw. There were no conventionally well-known causes for clubbing. Histological examination of gum biopsy specimen revealed a diagnosis of inflammatory gingival hyperplasia. As an etiology of clubbed fingers, gingivitis was suggested, since clubbing was regressed in parallel with remission of the gingivitis after the treatment by extraction of anterior teeth. Possible involvement of an autoimmune process in the pathogenesis was also considered, because of concomitant elevation of serum anti-double strand DNA antibodies. We recommend examination of the oral cavity for search of an inflammatory disease in cases with clubbed fingers, particularly when other common causes are not apparent.

The fixed mandibular implant: A 6-year review

In a review of 102 consecutive cases of the fixed mandibular implant there were no failures; all appeared clinically to be osseointegrated and functioning well. There were an unexpected number of gingival infections and instances of inflammatory gingival hyperplasia, but these have been reversible and manageable. A change in sleeve nut design has improved gingival health. The Fixed Mandibular Implant (Hall Reconstructive Systems, Carpinteria, CA) offers immediate denture stability and function, and provides the opportunity for a fixed, fixed removable, or overdenture prosthetic reconstruction.

The relationship of initial clinical parameters to the long-term response in 112 cases of periodontal disease.

The purpose of the present study was to determine whether any of the clinical parameters recorded during an initial periodontal examination would relate to the course of periodontal cases maintained for long periods of time. Based on available documentation, cases which had a downhill course were assembled from a population previously studied. In addition, long-term cases currently under maintenance care were drawn from our private practice. On average, the patients had been under care for 23 years. The study population was heavily weighted toward downhill cases to better compare these cases with those usually found in periodontal practice. Positive statistical correlations were found between the amount of subgingival calculus and the degree of gingival inflammation at initial examination. Disease severity initially was positively correlated to long-term course of disease. The amount of subgingival calculus did not relate to the long-term result. There was a strong correlation between inflammatory gingival hyperplasia initially and good long-term maintenance. The results suggest that, in combination, initial characteristics of periodontal cases coupled with long-term results of treatment may aid in further subclassifying the periodontal diseases.

Telescope retainers for removable partial dentures

Telescope crowns used in removable partial dentures reduce the destructive horizontal and rotational occlusal forces by directing them more axially an less traumatically than other retainers. These properties are combined with excellent conditions for cross-arch and multiple abutment splinting. If one of the abutment teeth needs extracting, the denture can be repaired with acrylic resin simply by remaking the secondary crown into a pontic. The single copings can be easily cleaned due to the good accessibility around their gingival margins. They also protect the abutment teeth against caries and thermal irritation. Soldering of the primary copings or their connection with accessory bars is not necessary in rigidly constructed telescope crowns, because the secondary crowns incorporated in the superstructure provide sufficient rigidity. In addition, the splinted copings often cause inflammatory gingival hyperplasia because the solder joints are too close to the gingival margins, preventing proper hygiene maintenance. The taper configuration or vertical height of the coping, which determines the amount of load transferred to each abutment, can be planned to suit each tooth's condition and designated function in the restoration. In a fixed restoration, the load is always evenly distributed among all the abutment teeth regardless of their condition, because the crowns are permanently cemented to them. In the telescope denture, the amount of force can be individually regulated by modifying the form and leverage of the retainers, according to their position, bone support, and occlusal conditions.