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Biomedical subjects

A Piattelli

Publications and source records attributed to A Piattelli.

At least 55 records · Page 3Linked to original sources
PubMed2001

Oral focal mucinosis of the gingiva: case report.

BACKGROUND: Oral focal mucinosis is a rare disease of unknown etiology, where the connective tissue undergoes a focal myxoid degeneration. METHODS: We describe a 48-year-old patient who was referred for a firm, tender mass located on the gingiva of the left central mandibular incisor. The first clinical impression at examination was that of a periodontal abscess. RESULTS: The lesion underwent a biopsy, and the final microscopic diagnosis was oral focal mucinosis. CONCLUSIONS: It must be stressed that in most focal gingival lesions, a preoperative diagnosis can be almost impossible.

Diagnosis, Differential↗
PubMed2001

Immediate loading of Osseotite implants: a case report and histologic analysis after 4 months of occlusal loading.

A growing number of clinical reports show that early and immediate loading of endosseous implants may lead to predictable osseointegration; however, these studies provide mostly short- to mid-term results based only on clinical mobility and radiographic observation. Other methods are needed to detect the possible presence of a thin fibrous interposition of tissue that could increase in the course of time and lead to clinical mobility A histologic evaluation was performed on two immediately loaded Osseotite implants retrieved after 4 months of function from one patient. He had received a total of 12 implants in the mandible, of which six were immediately loaded and six were left to heal in a submerged way Clinical and histologic osseointegration was consistently achieved for both of the retrieved immediately loaded implants. Osteogenesis and bone remodeling on the Osseotite surface were not impeded by immediate loading as shown by histomorphometric evaluation, which revealed high levels of bone-to-implant contact ranging from 78% to 85%. This immediate loading protocol involving bilateral splinting of six Osseotite implants in the mandible proved to be successful after 4 months of loading. Further long-term clinical and histologic studies are needed before introducing this immediate loading protocol as a routine procedure in implant therapy.

Bone Remodeling↗
PubMed2001

Periodontal healing in humans using anorganic bovine bone and bovine peritoneum-derived collagen membrane: a clinical and histologic case report.

The authors report the clinical and histologic data on the healing of a severe periodontal lesion obtained in a one-walled intrabony defect using anorganic bovine bone under a bovine peritoneum-derived collagen membrane. Eight months after surgery, a bone-like tissue replaced the lost tissues. A biopsy of this tissue was carried out. In the part of the specimen closer to the residual bony wall of the original defect, anorganic bone particles (ABP) appeared to be surrounded by a layer of newly formed bone; its osteocyte lacunae were colonized by osteocytes from the host, and actively secreting osteoblasts were observed in many microscopic fields. No resorption phenomena were observed in the ABP Newly formed cementum with actively secreting cementoblasts was present on the tooth surface, and well-oriented fibers inserting in both newly formed cementum and bone were observed. In an area far from residual bone, all ABP did not appear to be surrounded by newly formed bone. Osteocytic lacunae appeared not to be colonized by cells, and ABP was surrounded by dense connective tissue without osteoblasts near the grafted particles. A very limited amount of newly formed bone, without relations with ABP, was observed close to the root surface. From a clinical point of view, anorganic bone in association with a collagen membrane can be effective in the treatment of bony defects characterized by an unfavorable architecture. From a histologic point of view, the clinical appearance of bone regeneration is not always confirmed in the part of the defect far from the bony walls.

Adult↗
PubMed2000

Spindle-cell lipoma of the cheek: a case report.

Spindle-cell lipoma (SCL) is a distinct histological variant of lipoma. Clinically, it appears as a solitary, subcutaneous, circumscribed lesion. SCL accounts for about 1.5% of all adipocytic tumours. Only nine cases of intraoral SCL were found in the literature. Microscopically, mature adipocytes and spindle cells are immersed in a myxoid stroma. SCL needs only local excision, and it does not recur.

Cheek↗
PubMed2000

Primary intraoral leiomyosarcoma of the tongue: an immunohistochemical study and review of the literature.

Leiomyosarcoma is a relatively uncommon mesenchymal tumor that exhibits smooth-muscle differentiation. We report a new case of leiomyosarcoma involving the tongue of a 67-year-old male. Histologically, the tumor was composed of variably oriented fascicles of spindle-shaped cells with 'cigar-shaped' nuclei and eosinophilic cytoplasm, containing occasional PAS-positive granules. Atypical mitotic figures and necrotic foci were frequently detected. Consistent desmin, alpha-smooth muscle-specific and sarcomeric actin, and vimentin immunoreactivity was demonstrated in the tumor cells, whereas cytokeratins, CD 30, CD 31, CD 34, CD 45, CD 68, EMA, GFAP, HMB 45 and S-100 protein were negative. The patient underwent wide surgical excision of the tumor and is alive and disease-free at a 5-year follow-up. This report emphasizes the difficulties in the differential diagnosis of these uncommon tumors in an intra-oral location.

Aged↗
PubMed2000

Considerations preliminary to the application of early and immediate loading protocols in dental implantology.

In oral implantology, a 3-6 month stress-free healing period is presently accepted as a prerequisite to achieve bone apposition without interposition of a fibrous scar tissue. This protocol was introduced by Brånemark and co-workers in 1977. The aim of the present paper is to review the reasons that led Brånemark and collaborators to require long delayed loading periods. It is shown that the requirement for long delayed loading periods was drawn from the initiation and development periods of their original clinical trial. Demanding conditions were met involving simultaneously: 1) patients with poor bone quality and quantity, 2) non-optimized implant design, 3) short implants, 4) non-optimized surgical placement, 5) non-optimized surgical protocol and 6) biomechanically non-optimized prosthesis. Extrapolation of the requirement for long healing periods from these particular conditions to more standard situations involving refined surgical protocols and careful patient selection might be questioned. Albeit premature loading has been interpreted as inducing fibrous tissue interposition, immediate loading per se is not responsible for fibrous encapsulation. It is the excess of micromotion during the healing phase that interferes with bone repair. A threshold of tolerated micromotion exists, that is somewhere between 50 microns and 150 microns. It is suggested that loading protocols might be shortened through 2 different approaches. The first way would be to decrease stepwise the delayed loading period for free-standing implants below the presently accepted 3-6 months of healing. The second way would be to identify immediate loading protocols that are capable of keeping the amount of micromotion beneath the threshold of deleterious micromotion. Immediate loading protocols for implants-retained overdentures and fixed bridges are reviewed. It is shown that successful premature loading protocols require a careful and strict patient selection aimed to achieve the best primary stability. These various protocols need to be further documented in order to assess their predictability.

Clinical Protocols↗
PubMed2000

Hepatitis C virus-associated oral lichen planus: no influence from hepatitis G virus co-infection.

There is a variable geographic distribution in the prevalence of hepatitis C virus (HCV)-related oral lichen planus (OLP), which appears unrelated to either HCV genotype or HCV epidemiology. The present study investigated whether hepatitis G virus (HGV) co-infection may be a feature of patients with HCV-related OLP, which might explain these phenomena. HGV co-infection was detected in 6 of 39 Italian patients with HCV-related OLP, but the presence of HGV did not influence the clinical presentation of OLP. It is concluded that HGV co-infection is unlikely to influence the clinical detection of HCV-related OLP.

Adult↗
PubMed2000

bcl-2, p53, and MIB-1 in human adult dental pulp.

Little is known about the renewal of some groups of cells in dental pulp, and the occurrence and significance of physiological cell death in dental pulp is not yet understood. The possibility of odontoblast disappearance by apoptosis has been proposed, and the presence of apoptotic cells in the rat and human odontoblastic and subodontoblastic layers has been recently described. bcl-2 and p53 are proteins involved in the apoptotic pathway, whereas MIB-1 is a proliferating cell marker. The aim of our study was an immunohistochemical evaluation of bcl-2, p53, and MIB-1 in healthy normal pulps of young human subjects. With bcl-2 immunostaining, some positive cells were found in the odontoblastic and subodontoblastic layers, whereas with MIB-1, only a few stromal cells were positive, and all odontoblasts were consistently negative. No cells were positive to p53. The bcl-2 immunoreactivity of the cells of the odontoblastic and subodontoblastic layers could help to explain the presence of apoptotic cells found in these regions.

Adolescent↗
PubMed2000

Idiopathic root resorption: report of a case.

A case of multiple idiopathic apical root resorption in a 26-yr-old female patient is presented. A review of the literature revealed that extensive idiopathic root resorption is unusual. Neither local nor systemic etiological factors were found in our case. Examination of parents and siblings did not reveal a familiar tendency. Radiographs and clinical evaluation showed a very poor prognosis for most of the teeth present in the mouth of our patient.

Adult↗
PubMed2000

Hemangioma of the mandible presenting as a periapical radiolucency.

A case of an hemangioma of the mandible in a 53-yr-old female patient is presented. The lesion was removed, and no atypia or mitotic cells were found. The excision was curative, and the overall prognosis was excellent. A differential diagnosis of radiolucent periapical lesions of the mandibular symphysis is presented.

Diagnosis, Differential↗
PubMed2000

Central (intraosseous) adenoid cystic carcinoma of the mandible: report of a case with periapical involvement.

Primary intraosseous salivary gland tumors are rare, with mucopidermoid carcinoma being the most frequent histotype. The authors present a case of adenoid cystic carcinoma, located in the mandibular incisor region, associated with pain. Endodontic treatment resulted in increased pain and progressive mandibular expansion. An apicoectomy was conducted, and an intraosseous adenoid cystic carcinoma was diagnosed at histological examination. The patient was treated by wide surgical resection, and is alive and well without recurrences or distant metastases 14 yr after the original diagnosis. The case presented herein calls attention to the preoperative clinical diagnosis of periapical lesions. Radiologically, focal sclerosing osteitis, cementoblastoma, cementifying and ossifying fibroma, periapical cemental dysplasia, complex odontoma, and calcifying epithelial odontogenic tumor should be considered in the differential diagnosis. In addition the unusual occurrence of salivary gland tumors in intraosseous location stresses the importance of systematic histological examination of any tissue sample obtained after endodontic procedures.

Apicoectomy↗
PubMed2000

Implant periapical lesion: a clinical and histologic case report.

A new pathologic entity called implant periapical lesion has been recently described. This lesion could be produced by contamination of the implant surface, overheating of bone, overloading of the implant, presence of a pre-existing bone pathology, presence of residual root fragments and foreign bodies in bone, implant placement in an infected maxillary sinus, implant placement in a poor bone quality site, or lack of biocompatibility. A 49-year-old female patient underwent the placement of a screw-shaped titanium dental implant in the premolar region of the right mandible Six months after implant insertion, the patient presented with a persistent pain resistant to analgesics. No fistula was present at a clinical intraoral examination. A periapical x-ray showed the presence of a radiolucency at the apical portion of the implant; this image was confirmed by a CT Scan. The implant was removed. After implant removal, the pain disappeared completely. The specimen was processed to obtain thin ground sections. The histologic examination showed the presence of necrotic bone in the external and apical portion of the antirotational hole of the implant. The etiology of the implant failure in this instance could be related, probably, to an implant contamination of the apical portion of the implant.

Dental Implantation, Endosseous↗
PubMed2000

Immediate postextraction implants: a histologic and histometric analysis in monkeys.

The aim of this study was to evaluate the reaction of peri-implant tissues to immediately placed titanium plasma-sprayed implants into extraction sockets. Six macaca fascicularis monkeys were used in the study. A total of 36 titanium plasma-sprayed implants (PHI, Legnano, Italy) were inserted in both arches (18 in the posterior maxilla and 18 in the posterior mandible). The two premolars and the first molars of the maxilla and the mandible of all animals were extracted, and immediate postextraction implants were placed. After a releasing periosteal incision, the flap was coronally repositioned and sutured. No barrier membranes were used, and the only graft material used was autogenous bone chips. The implants were loaded after 2 months. Six months after implant loading, a block section was carried out, the remaining defects were filled with nonresorbable hydroxyapatite, and all 36 implants were retrieved. The implants were treated with the Precise System (Assing, Rome, Italy), to obtain thin ground sections. A total of three slides were cut for each implant and were examined under normal and polarized light. A histomorphometrical analysis was done. All implants were covered by compact, mature bone under examination in light microscopy. A very high bone-implant contact percentage (65-70%) was observed. No bone loss was present after the loading period. These results indicate that implants placed into fresh extraction sites grafted with autogenous bone chips will heal in a predictable way.

Animals↗
PubMed2000

Bone regeneration using Bioglass: an experimental study in rabbit tibia.

Bioglass (BG) has been shown recently to be osteoconductive and osteopromotive in different experimental and clinical conditions. The aim of the present study was to evaluate BG particles in bone defects in rabbit tibia. In control sites, bone was observed only in the peripheral areas of the defects, while in test sites, newly formed bone was found around all BG particles, even those located in the central portion of the defect. Osteoblasts were actively secreting osteoid matrix directly on the granules' surface. BG seems to be a highly osteoconductive material.

Animals↗
PubMed2000

Gingival metastasis from a medullary thyroid carcinoma: case report.

BACKGROUND: Metastatic tumors to the oral cavity are rare, representing about 1% of oral tumors, and they affect jaws more often than the oral soft tissues. METHODS: Fifteen cases of metastases to the jaw bones from thyroid carcinoma were found in a recent review, with no cases located in the oral mucosa. RESULTS: The authors describe the first cases of gingival metastasis from a thyroid medullary carcinoma. CONCLUSIONS: Periodontists must recognize oral soft tissue metastases because they can be the first sign of an undiscovered malignancy, and they can be easily mistaken with several different benign lesions.

Calcitonin↗