Immunohistochemical study of biomarker "P53" in premalignant lesions

Precancerous lesions of the oral mucosa offer a particularly interesting area of research for understanding the process of cancer formation and its prevention. This study was conducted to investigate P 53 protein expression in cancerous, precancerous conditions and adjacent normal mucosa using an immunohistochemical technique, in an attempt to study its role in the progression of oral premalignant lesions. The immunohistochemical results were further correlated with the clinicopathological parameters of the studied patients. This study included 6 cases of oral squamous cell carcinoma [OSCC], 6 cases of oral lichen planus [OLP] and 6 cases of leukoplakia. The results revealed that P53 accumulation was more strongly observed in OSCC than OLP and leukoplakia. A positive significant correlation was found between the severity of P53 immunoreactivity and smoking, and the frequency of samples showing dysplastic changes. While no significant correlation was found between P53 severity and the age of the patients or lesion duration. It appears that immunohistochemical evaluation of P53 expression may be a practical tool to select cases of oral lichen planus and leukoplakia with a high risk of neoplasia

Clinical and radiographic evaluation of copolymerized polyactic/polyglycolic acids [PLA - PGA] as a bone filler in combination with acellular dermal matrix graft around immediate implants

This study was conducted to evaluate clinically and radiographically the use of acellular dermal matrix allograft [alloderm] in combination with PLA -PGA [Fisiograft] in management of osseous defects around seven immediate dental implants in the maxillary anterior region. Patients were seeking treatment with implants for their hopeless maxillary teeth. Preoperative study casts were constructed. Periapical radiographs and orthopantomographs were taken. Phase-I surgery, including plaque control measures, scaling and root planning, was performed for each patient. The selected teeth were extracted atraumatically after the reflection of full-thickness flaps buccally and palatally. One -piece HR implants were placed immediately into the sockets after drilling 3 to 4 mm beyond the root apex. Fisiograft in powder form was applied in the osseous defects around the implants and the alloderm membranes were placed over the graft material and secured under the flaps and the wounds were sutured. The implants were immediately restored with provisional crowns free from occlusion. Patients were evaluated both clinically at 1, 3, and 6 months after loading and radiographically at 1 and 6 months after implant placement. Results showed that the materials used fulfilled the aims that they were used for. The Fisiograft functioned well as space maker and scaffolding material. The alloderm performed well as a membrane to be used in association with immediate implants as well as its potentiality to increase the width of keratinized gingiva which is an important feature for implant esthetics

Evaluation of doxycycline hyclate gel and chlorhexidine gel as root conditioners on healthy root surface: a comparative scanning electron microscopic study

Since critical events in periodontal regeneration involve cementogenesis and the attachment of new connective tissue to the root surface, a considerable amount of research has been aimed at evaluating whether chemical agents can transform the root surface to a biologically suitable one. A number of agents have been used including tetracycline, citric acid, EDTA gel, phosphoric acid, fibronectin, enamel matrix proteins and growth factors. The purpose of the present study was to evaluate and compare by scanning electron microscope [SEM] the surface changes of human root dentin on topical application of doxycycline hyclate gel and chlorhexidine gel. A total of 26 dentin specimens were used in the present study. They were divided into three groups. The first group comprised 10 specimens conditioned with doxycycline hyclate gel. The second group also comprised 10 specimens conditioned with chlorhexidine gel. The third group comprised 6 specimens used as controls. The specimens in group I and II were burnished for 3 minutes with the two gels. Immediately following treatment procedures, the specimens were rinsed, dehydrated and prepared for SEM. Measurements of the width of 10 randomly selected dentinal tubules orifices were done in the control and each of the conditioned groups. The results of the present study indicate that doxycycline hyclate causes a great degree of morphologic alteration in root dentin. This was reflected by the presence of a large number of patent dentinal tubules in the studied specimens. The difference in tubule diameter between the doxycycline group and control group was statistically significant and insignificant between the doxycycline group and chlorhexidine group, in spite of the greater number of wide tubules and the higher mean diameter of tubules in doxycycline group. Removal of smear layer was demonstrated in several areas while present in few areas in both studied groups

Clinical and radiographic comparison between enamel matrix derivative [emdogain] and autologous platelet gel in management of furcation defects in patients with chronic periodontitis

This study was carried out to evaluate and compare clinically and radiographically the efficacy of enamel matrix derivative [EMD] and autologous platelet gel [APG] in management of furcation defects in patients with chronic periodontitis. A total of 14 defects were chosen from 10 patients for this study. All patients were subjected to thorough clinical examination in selected sited including plaque index, gingival index, probing depth and probing attachment level. All these clinical parameters were taken prior to surgery and at 3 and 6 months post-surgically. The furcation defects were divided into two groups, the first group was treated with APG, while the second group was treated with EMD. Chemical root biomodification was performed in both groups using EDTA. The selected sites were subjected to densitometric evaluation before and at 3 and 6 months post-surgery. The results of the present study showed that both treatment modalities resulted in a significant reduction in probing depth and attachment loss throughout the follow up period, however, no significant difference between both groups was observed. A more favorable clinical outcome was noticed in furcation defects treated with APG as evidenced by the greater percentage of change in this group. An improvement in mineral content was detected in both treated groups. On comparing both groups, no significant difference in optical densities was observed at various periods of follow up, however, the percentage of change was in favor of group I treated with platelet gel

Expression of CD[14], CD[16] on peripheral blood monocytes in patients with type II diabetes mellitus

The aim of the present study was to investigate the percentage of CD[14+] and CD[16+] monocytes in patients with type II diabetes. Peripheral blood samples were obtained from 10 patients with type 2 diabetes [group I], 10 non-diabetic patients with chronic periodontitis [group II] and 7 systemically and periodontally healthy donors who served as controls [group III]. Patients in group I and group II were selected with nearly similar plaque, gingival and periodontal scores. EDITA-treated venous blood was collected from both patients and control subjects. Flow cytometry and appropriate anti-human CD14, CD16 monoclonal antibodies were used for phenotyping analysis of peripheral blood monocytes. The results of the present study showed that both group I and group II showed a significantly increased expression of membrane bound CD[14] [mCD[14]] and membrane bound mCD[16] [mCD[16]] when compared to healthy controls. On comparing group I [patients with type 2 diabetes] and group II [non-diabetic patients with periodontitis] a significant difference in favor of group I was observed. The results of the present study implies that the increased expression of membrane bound CD[14] and CD[16] receptors on peripheral blood monocytes in patients with type 2 diabetes may play an important role in the pathogenesis of this disease as well as the increased inflammatory process observed in these patients. Also the increased expression of these receptors in patients with periodontitis may indicate a role of these receptors in inflammatory response and periodontal tissue destruction observed in these patients

Clinical and radiographic evaluation of autologous platelet gel in the management of osseous defects in adult periodontitis

The present study was conducted in order to evaluate the use of "platelet gel" - the autologous source of growth factors - in management of osseous defects in patients with adult periodontitis. Twenty periodontal osseous defects in ten patients suffering from moderate to advanced adult periodontitis were treated in this study [split mouth design]. One defect from each patient was treated surgically with placement of platelet gel, while the other was treated by mucoperiosteal flap without placement of gel. All patients were subjected to thorough clinical examination in selected sites, including; plaque index, papillary bleeding index, probing pocket depth and probing attachment level. All these clinical parameters were taken prior to surgery and at 3, 6 and 9 months post-surgically. These patients were also subjected to radiographic and densitometric evaluations before and at 3, 6 and 9 months after surgery, in order to record the changes in bone height of selected osseous defects using the "Schei method" and also to evaluate the changes in bone density in these defects using a densitometer. The results of the present study showed the following: Platelet gel, used in this study as an autologous source of growth factors, was well tolerated by human periodontal tissues. Both treatment modalities showed significant reduction in plaque index, papillary bleeding index probing pocket depth and probing attachment level between pre- and post-surgical follow up periods. Throughout the follow up period, no significant difference was found with respect to plaque index on comparing test and control sites, while significant difference was detected at 3, 6 and 9 months post-surgically with respect to papillary bleeding index and probing attachment level, and at 6 and 9 months for probing pocket depth in the favor of the test sites. Radiographic analysis revealed improvement in bone height between pre- and post-surgical follow up periods in both test and control sites, but this improvement was not significant. On comparing test and control sites, it was found that test sites showed greater increase in bone height, particularly at 6 and 9 months post-surgically. However, also this increase was not significant. An improvement in mineral content was detected in both test and control sites throughout the observation periods. A statistically significant difference was detected between test and control sites at 3, 6 and 9 months post-surgically with the test sites exhibiting greater improvement

Gingival crevicular fluid osteocalcin before and after treatment of human periodontal osseous defects with collagen membrane [biomend] alone or in combination with alendronate

The objective of this study was to evaluate the effect of Biomend as GTR alone or in combination with local application of alendronate in management of interproximal osseous defects in chronic periodontitis. Furthermore, to investigate the effect of these modalities of treatment on the crevicular fluid levels of osteocalcin. A total of 14 matched defects were chosen from 8 patients with severe chronic periodontitis. Seven defects were treated with collagen membrane in combination with local application of alendronate sodium, while 7 defects were treated with collagen membrane only. All patients were subjected to thorough clinical examination in selected sites, including gingival index, probing depth and probing attachment level. These parameters were taken before surgery and at 3 and 6 months post-surgically. These patients were also subjected to densitometric evaluation before and at 3 and 6 month post-surgically. Gingival crevicular fluid [GCF] was collected from selected sites presurgically and at 3 and 6 months post-surgically. An enzyme linked immunoassay kit [Gla type Osteocalcin Ela Kit] was utilized for the detection of osteocalcin. The results of the present study showed that both treatment modalities were effective in management of interproximal osseous defects, however, the adjunctive use of alendronate to GTR offered a more favorable clinical outcome as well as better improvement in bone density. A significant increase in GCF osteocalcin was noticed after both treatment modalities, particularly in the alendronate group. However, on comparing both groups, no significant difference was observed at various periods of follow up. Also, a significant correlation was found between GCF osteocalcin and bone density at the end of follow up period. This increase in GCF osteocalcin might be a result of bone remodeling associated with an increased osteoblastic activity which occurred during healing. It appears that osteocalcin acted as a bone formation marker during this stage of healing

Anatomical study of the superficial branch of the radial nerve

Objective: To study the detailed anatomy and the branching patterns of the superficial branch of the radial nerve as well as variability of its digital innervations and its clinical correlation

Methods: 20 upper extremities of preserved cadavers were dissected to examine the superficial branch of the radial nerve and the division point of it in relation to the base of radial styloid process

Result: The nerve was found tn emerge between the tendonsof the brachioradialis and extensor carpi radialis longus and became subcutaneous at a mean distance of 9.39 cm proximal to the radial styloid process. The superficial branch of the radial nerve branched at a mean distance of 5.14 cm proximal to the radial styloid process. Innervation to dorsum of the digits was variable, in 8 specimens [40%], the superficial branch of radial nerve was innervating the radial 3 digits, in 7 specimens [35%] it was innervating the radial 2.5 digits and in the remaining 5 specimens [25%] it was innervating the radial 3.5 digits. 13 specimens [65 %] showed communication between superficial branch of radial nerve and dorsal branch of ulnar nerve. 16 specimens [80%] showed communication between ventral branch of supetjicial branch of the radial nerve and lateral cutaneous nerve of the forearm

Conclusion: Better understanding of the anatomy of the superficial branch of the radial nerve will aid in its protection during surgical procedure in its vicinitth will also aid in localization of the nerve for repair. Knowledge of the anatomy with respect to palpable landmarks will facilitate regional nerve block

Clinical and histological evaluation of [3-tricalcium-phosphate [cerasorb] alone or in combination with autologous platelet gel in management of osseous defects in chronic periodontitis

The purpose of the present study was to provide a clinical and histologic evaluation of b-tricalciunvphosphate [p-TCP] [cetasotb] alone 01 in combination with autologous platelet gel [APG] in management of osseous defects in chronic periodontitis A total of 16 infrabony interproximal osseous defects were chosen from 10 patients for this study. All patients were subjected to thorough clinical examination in selected sites including plaque index, gingival index, probing depth and probing attachment level. All these clinical parameters were taken prior to surgery and at 3 and 6 months post surgically. The interproximal osseous defects were divided into 2 groups, the first group comprised 8 osseous defects which were treated with full thickness mucoperiosteal flap and filled with cerasorb only. The second group comprised 8 osseous defects which were treated with cerasorb in combination with autologous platelet gel Intra oral standard periapical radiographs using long cone paralleling technique were obtained tor each defect treated in this study pre and 4 months post surgery An experimental study on 6 dogs was also included in this study, 12 surgically produced osseous defects were created in the 6 dogs. Two defects in premolar area in each dog. The defects were made similar as much as possible as regard number of osseous wall remaining depth and width. One defect was filled with cerasorb while the other was filled with cerasorb + platelet gel. 3 dogs were scarified at 2 weeks while the other 3 were scarified at 1 month. Mesio-distal sections were prepared and stained for histological examination It had been found that clinically, both treatment modalities resulted in significant improvement of probing depth and gain of attachment. Histologically, the adjunctive use of p-TCP + APG offered a more impressive regenerative potential than the use of p-TCP alone, thus it is considered to be an effective valuable mode of treatment of infrabony defects in chronic periodontitis

Tumor necrosis factor [alpha] in peripheral blood in patients with recurrent apthous oral ulcers before and after treatment with pentoxifylline

The present study was carried out in order to evaluate the effectiveness of pentoxifylline [PTX] medication in the management of both minor and major recurrent aphthous stomatitis patients. Also, to investigate the level of tumor necrosis factor-alpha in serum of these patients before [RAS] and alter treatment with pentoxifylline. A total number of forty subjects participated in this study, they were divided into two groups, the first group consisted of twenty patients with RAS. Ten patients suffered from minor RAS and ten patients suffered from major RAS. They all received PTX 400 mg three times daily for one month. The second group consisted of twenty healthy subjects who served as controls. A history about the aphthous lesion was taken from each patient regarding number, duration, location pain severity and frequency. Oral mucosa of selected patients was examined for aphthous lesions to record, size duration, frequency and number of aphthous lesions. The patients were followed up weekly during the six months period of follow up clinical examination of plaque index [P.I.] and papillary bleeding index [PB1] was performed at baseline, at the end of dose period and at the end of follow up period [6 months]. Serum tumor necrosis factor and [TNF-alpha] was estimated for both control and RAS group before and after PTX administration. Pentoxifylline led to significant clinical improvement in pain, size, duration number and frequency of aphthous lesion throughout the 6 months study period. TNF-alpha level was significantl increased in RAS patierits compared with control subjects. A significant increase was detected in major RAS patients compared with minor RAS patients. Both forms of aphthous lesion demonstrated a significant decrease in TNF- alpha after PTX treatment. No significant correlation was observed between [TNF- alpha] level PI and PBI. Also no correlation between PI and age, number, size pain and duration of aphthous lesions was observed while a negative correlation was found regarding the number of PAS lesion. A significant correlation between [TNF- alpha] level and size, duration, pain and RAS score was observed

effect of bleaching on fibronectin in human gingival crevicular fluid and its effect on gingiva of dogs

The present study was undertaken to determine the effect of a home bleaching agent on various clinical parameters, as well as, on the levels of fibronectin in human GCF and in gingival tissue and bone of dogs. Also, histological changes that occurred in gingival tissue of dogs were studied. The results revealed that the levels of fibronectin in GCF of human was significantly decreased after application of bleaching agent. Also, the levels of FN in gingival tissue and alveolar bone of dogs were significantly decreased in the bleaching site when compared with the control site. Histological study of gingival tissue of dogs revealed variable areas of destruction in the epithelium and connective tissue

Evaluation of DNA in gingival tissue of patients with early-onset periodontitis

A total number of 30 subjects participated in this study, 24 patients with EOP and 6 control subjects. Gingival biopsies were obtained from EOP patients and control group and were prepared for measurement of DNA content and for quantitative assessments of cells in the cell cycle phases. The results showed that no changes were found in DNA content in gingival tissue of EOP patients when compared with control group. Also, a significant difference was observed in cell image analysis of intermitotic phases of cell cycle between PP and RPP when compared with controls in both epithelium and connective tissue cells while no significant difference was observed between JP and PJP when compared with controls