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[Bacillary angiomatosis of the oral cavity in AIDS. A differential diagnosis of mucosal Kaposi's sarcoma].

The diagnosis of bacillary angiomatosis (BA) was performed on a biopsy of a reddish nodular lesion of the gingival mucosa, in a patient seropositive for the H.I.V. It was based on the histopathological features, and by the demonstration of bacilli both on the Warthin-Starry stain and the electron microscopic study. A treatment by erythromycin was quickly effective. BA is an opportunistic infection seen essentially in patients with A.I.D.S., most often causing cutaneous involvement. The causative pathogen is Rochalimaea henselae. BA of the oral cavity is very rare. This infection can be mistaken with Kaposi sarcoma on its clinical appearance.

AIDS-Related Opportunistic Infections↗

Managing a peripheral ossifying fibroma.

The Peripheral Ossifying Fibroma is an inflammatory lesion which most often appears in twenty-five to thirty-four-year-old females. It averages 1.0 cm at its greatest dimension. This case reports a seven-year-eight-month-old female who presented with a peripheral ossifying fibroma lesion which measured 2.7 cm by 1.5 cm by 1.0 cm. A review of peripheral ossifying fibroma, and the management and postsurgical sequelae of this child are discussed.

Child↗

[The value of tracing amyloid in the gingiva in the diagnosis of general amyloidosis (author's transl)].

50% of patients with periodontopathy, exhibited the presence of amyloid in the clinically-altered gums. The biopsy specimen of the gums was examined microscopically by means of the crossed polar method. Seemingly-normal gum biopsies were, in all cases, amyloid positive. Amyloid was detected in two out of ten cases of healthy mucosa libera of the cheek. It was assumed that this deposition of amyloid was the consequence of a locally-limited pathological process. These results cast doubt on the possibility of tracing the pericollagenic form of general amyloidosis through gingival biopsy. An alternative procedure would be to biopsy the mucosa libera of the cheek.

Adult↗

The effectiveness of an amine fluoride/stannous fluoride dentifrice on the gingival health of teenagers: results after six months.

The objectives of the present study included examining the effect of non-supervised tooth brushing with an amine fluoride/stannous fluoride (AmF/SnF2) dentifrice on gingival health of teenagers in a field trial over six months. Jerusalem high-school adolescents (246) participated in a double-blind study with a NaF dentifrice serving as control. No oral hygiene instruction or supervision was given. Examinations took place at baseline, three weeks, three months and six months. In all examinations, no differences were revealed for plaque levels. Other results indicated a consistent advantage for the AmF/SnF2 group. Gingival Index (GI) scores were significantly lower in the test group at the three month examination (GI = 0.85, compared to GI = 0.89; p = 0.036) and at the six month examination (GI = 0.72, compared to 0.78; p = 0.042) than among controls. Mean bleeding on probing scores were lower in the AmF/SnF2 than in the control group at the six month examination (0.53, compared to 0.63; p = 0.041). No side effects, including staining, were reported, nor found, among the AmF/SnF2 group. In addition to the well established caries preventive role of fluoride dentifrice, these data indicate an additional and important public health role of a AmF/SnF2 dentifrice, in preventing gingivitis.

Adolescent↗

The peripheral giant cell granuloma.

A peripheral giant cell granuloma can be seen as a pedunculated or broad-based lesion. Such lesions occur after age 20 years, with 50 percent of patients 40 to 59 years old. Frequently, there is a history of trauma to the region.

Adult↗

Using sound dental principles to salvage the compromised implant case.

Implant failure can usually be determined by biologic and biomechanical factors that were not addressed during treatment planing and case design. In order to salvage the failing implant-supported prosthesis, these factors must be identified and corrected. Long-term success can only be achieved when prosthetic design, osseous and soft tissue architecture, and implant biomechanics are diagnosed and corrected.

Aged↗

Absence of exogenous interleukin-4-induced apoptosis of gingival macrophages may contribute to chronic inflammation in periodontal diseases.

Inflamed gingival tissues are enriched in macrophages (MOs) and CD4-positive T cells; however, T helper-type cytokines such as interleukin (IL)-2 and IL-4 are absent. Therefore, we investigated whether a relationship exists between IL-4 receptor (IL-4R) expression and MO persistence in the absence of exogenous IL-4. Gingival MOs, when compared with monocyte(MN)/MOs from peripheral blood mononuclear cells, expressed high levels of IL-4R mRNA. Furthermore, in vitro cultures of gingival MOs remained viable whereas identically treated peripheral blood MN/MOs rapidly lost viability. However, when gingival MOs were incubated with recombinant IL-4 (rIL-4), the cell viability was dramatically reduced. When the frequency of apoptotic cells was assessed in rIL-4-treated gingival MO cultures, higher numbers of apoptotic cells were noted in rIL-4-treated versus control cultures. Furthermore, rIL-4-treated MOs from inflamed gingiva showed DNA fragmentation as assessed by electrophoresis. These findings clearly show that addition of exogenous rIL-4 to gingival MO cultures leads to cell death by apoptosis. This finding would suggest that topical application of rIL-4 may inhibit the persistence of MOs in adult periodontitis, which could then lead to decreased inflammation.

Adult↗

CXCL12 and CXCR4 expression by human gingival fibroblasts in periodontal disease.

CXCL12 is a CXC chemokine that is related to lymphocyte infiltration and angiogenesis in inflammatory sites such as arthritis. However, the expression and roles of CXCL12 in periodontal disease are uncertain. The aim of this study was to assess the expression of CXCL12 and its receptor, CXCR4, in periodontal tissue and to investigate the properties of CXCL12 and CXCR4 expression by human gingival fibroblasts (HGF). RT-PCR analysis revealed that CXCL12 and CXCR4 mRNA were expressed in both normal gingival tissues and periodontal diseased tissues. Immunohistochemistry disclosed that CXCL12 was expressed and CXCR4 positive cells were found in both normal and periodontal diseased gingival tissues. Our in vitro experiments elucidated that HGF constitutively produced CXCL12, and the levels were enhanced by stimulation with tumour necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma), transforming growth factor-beta (TGF-beta), regulated upon activation normal T cell expressed and secreted (RANTES) and macrophage inflammatory protein 3(alpha) (MIP-3(alpha)). On the other hand, heat killed Porphyromonas gingivalis (P. gingivalis) and P. gingivalis LPS reduced the CXCL12 production by HGF. Flow cytometry analysis clarified that CXCR4 was highly expressed on HGF, and CXCR4 expression was abrogated by TNF-alpha, IFN-gamma and P. gingivalis LPS. Moreover, CXCL12 induced vascular endothelial growth factor (VEGF) production by HGF. Our results demonstrated that CXCL12 might be related to CXCR4+ cells infiltration and angiogenesis both in normal periodontal tissues and periodontal diseased tissue. P. gingivalis, a known periodontal pathogen, inhibits the production of CXCL12 and the expression of CXCR4 by HGF. This fact means that P. gingivalis may inhibit CXCR4+ cells infiltration and neovascularization in periodontal tissue and escape from the immune response.

Cells, Cultured↗

Treatment of gingival Crohn's disease with laser therapy.

Crohn's disease is an inflammatory disease of unknown etiology. Oral manifestations appear most frequently on the lips, gingival tissue and buccal mucosa. The case presented here shows how a patient with oral lesions resulting from Crohn's disease can be treated by laser therapy and obtain optimal esthetic results.

Adolescent↗