Biomedical subjects
Publications and source records attributed to M Bonanini.
The nevoid basal cell carcinoma syndrome (NBCCS) or Gorlin-Goltz Syndrome is an autosomal dominant disorder principally characterized by cutaneous basal cell carcinomas, multiple keratocysts, and skeletal anomalies. The present report reviews current knowledge of this disorder that has profound relevance to specialists in Oral and Maxillo-Facial Surgery, Oral Medicine and Radiology.
Several studies, during the last 20 years, tried to explain the pathogenetic mechanisms of the cyclosporine (CS) induced gingival overgrowth (and in general, of the drugs induced gingival overgrowth), but they are still poorly understood. The relationship between the drug and the different pharmacokinetic variables (dosage, duration of therapy, plasmatic and salivary Cs concentration) is still on discussion. It is accepted that a threshold concentration is necessary, in the gingival tissues, to begin or to enhance the morphostructural changes of the gums, but the total Cs weight, from the beginning of the therapy to the time of clinical examinations, has to be evaluated. The pharmacokinetic variables are associated with many other factors (first of all the oral hygiene score) that are probably connected with the developing of the gingival lesions. Gingival inflammation could be very important in the pathogenesis of gingival overgrowth. It has been shown by several cross-sectional studies a strong association between plaque and gingival lesions, but it is not yet clear if plaque accumulation is a causal factor or a consequence of the morphological gums changes. It would seem that the morphological alterations, in drug-induced gingival overgrowth, could be started by the plaque induced inflammation, and this would lead to an hyperemic and edematous gingival tissue. Oral hygiene (professional and at home) is more difficult and represents an irritation factor that makes the pathological cycle to go on. Other factors, probably connected with the cyclosporine induced gingival overgrowth, are represented by age, gender, genetic predisposition, alterations of gingival connective homeostasis and metabolism, inflammatory alterations, interactions with the growth factors and protective or synergic effects of other drugs.
The burning mouth syndrome (BMS) is a very common disorder frequently seen in practical dentistry. It is a particular condition with a complex of strange burning sensation localized in the oral mucosa which is clinically normal. It is very important for the dentist to recognize and classify this particular syndrome in order to exclude other factors which can cause the same symptoms. On the basis of personal experience on 75 patients, the complex management of this particular group of patients has been evaluated to make a right diagnosis and a correct treatment.
Lichen planus is described like a well-characterized dermatological condition affecting the skin and the oral and genital mucosa. Over the years, different authors have expressed the possible oral lichen planus premalignant nature, but this is still controversial. This criticism is due to the insufficiency of the clinical and histopathological data to support the initial diagnosis of oral lichen planus, the occurrence of some wrong diagnostic criteria for this pathology, the contemporary presence in the same region of the oral lichen planus lesions and of neoplasia. The malignant transformation of oral lichen planus rate varies, according to authors, from 0.4 to 3.7%. The aim of this study is to review the literature from 1910 to 1999, focusing on the suggested possible premalignant nature of oral lichen planus.
The possible malignant transformation of oral lichen planus is still controversial. It is not clear if this is in fact due to the premalignant nature of oral lichen planus or to the presence of some risk-factors in patients with this pathology. The risk co-factors that may he involved in this malignant transformation are numerous. Some authors suggested a correlation between oral lichen planus and HCV or HGV, or with the presence of some oncogenic viruses (EBV, HSV, HPV). Cases of this malignant transformation on oral and genital mucosa with lichen are reported, hut none on the skin lesions. The aim of this study is to investigate, through the literature, these correlations that may have a role in the malignant transformation of oral lichen planus.
An He-Ne scanning laser beam was used to measure for the first time the linear shrinkage of light-cured microfilled composites. A low-power beam, which has a wavelength (632.8 nm) different from the polymerization wavelength (approximately 450 nm), was used. In these conditions no shrinkage is induced by the laser light. This method of measurement makes it possible to analyse small samples with a very low error (1.1 microns). Five different materials were tested using 10-20 mg specimens, and the shrinkage process was examined in detail over 2 days. All these materials showed shrinkage of more than 50% of their original length after 1 min of irradiation and approximately 99% of the total shrinkage occurred 4 h after irradiation.
We examined 6 normal volunteers (3 males and 3 females, age 26-30). They were requested to clench as hard as they could until they felt pain. The experiment was repeated one hour later. Emg was recorded during the fatiguing exercise and the recovery period. We couldn't determine the muscle conduction velocity, probably because of the anatomy of the temporal muscle. The mean of the power spectrum showed wide variability and proved unsuitable for clinical applications, both for diagnosis and follow-up.
Erythema multiforme (EM) is characterised by a polymorphous eruptive complex which many involve the cutis and oral, genital and conjunctival mucous. Its etiopathogenesis is unclear: it is thought to be associated with various viral or bacterial infective agents (herpes virus, Coxsackie virus, mycoplasmas, etc.), numerous drugs, physical therapy, systemic pathologies of various types. The authors report their experience in relation to 11 patients suffering from EM; the clinical characteristics of each case are reported, together with the course of disease, and the diagnostic and therapeutic protocol adopted. The discussion examines the possible cause of disease: in 5 patients the etiology was traced back to viral infections (4 herpes and 1 coxsackie) and to the administration of drugs in the remaining cases (4 in relation to anti-phlogistic agents and 2 regarding antibiotics).
The function of the soft palate is complex; it takes part in speech, swallowing, and masticatory mechanisms. Its pathology ranges from morphological deficits to functional ones; these are commonly due to a central nervous system damage. The clinical analysis is based upon examination and instrumental prove, and leads to an optimum choice between surgical and prosthetic solutions. The latter is the best one in terms of quick execution, low costs and future possibilities of improvement.
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The electromyographic responses of the masseter after different types of transcranial stimulation were recorded with surface and needle electrodes. Magnetic stimulation at 4 cm lateral to the vertex on the biauricular line elicited MEPs in the contralateral masseter (latency 6.9 ms) due to activation of motor cortex or adjacent elements along the cortico-nuclear pathway. The ipsilateral responses to the same stimuli and to more lateral ones had shorter latencies and were ascribed to direct stimulation of the trigeminal nerve, probably its intracisternal portion. This was also the probable origin of the ipsilateral MEPs after both anodic and cathodic bipolar electrical stimulation at 7 and 11 cm lateral to the vertex on the biauricular line.
The Authors utilized in order to replace anterior missing teeth osseointegrated implants provided with individual angled posts. These types of abutment are used to allow a good parallel situation between implants with different angulation and also between implants and proximal teeth. The head of this abutment is thread to receive the screw that allows the crown to be fastened.
Facial pain often presents complex diagnosis, requiring other specialists' consultation. The use of different terminology and protocols can affect the information exchange negatively. These problems in the field of headache, cranial neuralgias and facial pain lead the International Headache Society to introduce a new classification in 1988. The chief difference with the previous ones is the presence of strictly codified diagnostic principles. Its target is research, but it can help the general practice as well. We discuss the most interesting points to the stomatologist.
Electromyographic responses of the masseter muscles following electric transcranial stimulations by a conventional constant current stimulator were recorded with surface and needle electrodes. Ipsilateral motor evoked responses following both anodic and cathodic bipolar electrical stimulations performed at 7 and 11 cm laterally to the vertex on the biauricular line were recorded, with latencies ranging from 2 to 3.6 ms. Contralateral responses were not elicited. The ipsilateral responses to stimuli were ascribed to direct stimulation of the trigeminal nerve, probably its intracisternal portion.
Magnetic stimulation of nervous elements is a new neurophysiological technique. It easily succeeds in stimulating the brain motor cortex. We applied this technique to the trigeminal motor system, recording responses in masseter muscles. The magnetic stimulations at 4 cm laterally to the vertex on the biauricular line elicited responses in the contralateral masseter due to activation of motor cortex or adjacent elements along the cortico-nuclear pathway. The ipsilateral responses to the same stimuli and to more lateral ones presented shorter latencies and they were ascribed to direct stimulation of the trigeminal nerve, probably its intracisternal portion. The latency values were 6.9 +/- 0.71 ms and 3.6 +/- 0.3 ms respectively.
Magnetic stimulation of nervous elements is a new technique of investigation in intact alert man. Electromyographic responses of the masseter muscles were recorded in normal volunteers and in two patients with hemispheric or capsular lesions, both by surface and needle electrodes. In the patients "cortical" responses were absent when stimulating the affected hemisphere and present when stimulating the unaffected one. These findings suggest that the direct facilitating cortico-nuclear projections for the masseter muscle are mainly crossed. Nevertheless the presence of clear ipsilateral responses after stimulation of the unaffected hemisphere demonstrates the existence of uncrossed projections; in fact only the ipsilateral motor cortex can be the site of origin of the responses in these patients.
An experimental evaluation of the effectiveness of two different interproximal carving methods of class II amalgam restorations is described. The results showed Deppeler HZ8 carving instrument was more effective than dental floss in preventing overhangs at the restoration's gingival margin.
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