Clinical and histological aspects of malignant inverted sinonasal papilloma. Two case reports.

The inverted sino-nasal papilloma is a benign epithelial lesion, ranging from 1% to 5% of the tumors that reside in this area. It is characterized by a tendency towards local bone destruction, recurrence and malignant transformation. This is a presentation of two cases diagnosed and surgically treated for malignant inverted papiloma, which started in the epithelium of the maxillary sinuses. The cases had in common the late presentation of the patient to the surgeon, thus the local destruction was significant with extension towards the eye socket and the base of the skull. The treatment of choice was the surgical resection of the maxillary bone with a prosthetic reconstruction of the defect followed by radiotherapy. After a careful analysis of the two cases, a series of statements regarding the diagnosis and treatment of this rare pathology were recommended.

The histopathological study of radicular dentinal changes in patients with chronic marginal periodontopathies.

Periodontal disease is one of the most frequent conditions in individuals, having major health and social implications. Progressing as a chronic inflammation at the level of tooth support tissues, untreated chronic periodontitis may lead to a premature loss of the dental organ. Even though the main lesions caused by the periodontal disease affect the alveolo-dental ligaments, we tried to highlight the presence of certain lesions of radicular dentine in patients with chronic marginal periodontopathy. In our study, in the patients with chronic marginal periodontopathy, at periodontium level, there was highlighted the presence of a chronic inflammatory process with numerous lymphocytes and macrophages, microhemorrhages, and also areas with tissular necrosis. At radicular dentine level, in the cases of old, untreated periodontal disease, there were observed areas of more or less extended demineralization, erosion and necrosis. Our study showed that chronic periodontal disease may affect the tooth, as well, not only its support tissues.

Cell populations involved in the processes of local mucosal defense in extended partially edentulous and completely edentulous patients. Clinical and immunohistochemical study.

Considering the fact that extended partial edentation and complete edentation have high incidence rates worldwide, the necessity for correct prosthetic treatment is very important. We performed a clinical study on 37 extended partially edentulous patients and completely edentulous patients, who were divided into three groups. We also performed a morphological study using classic techniques of histology and immunohistochemistry methods on sections obtained from oral mucosa fragments collected from these patients and processed by paraffin embedding technique. To identify the cell populations present in the inflammatory processes, we used the CD20, CD8, CD3 and CD68 markers. In the studied cases, we found the presence of changes that have interested both the epithelium and lamina propria. Epithelium showed in particular epithelial hyperplasia aspects, with orthokeratinization and parakeratinization areas and, in some sections, areas of ulceration. We found the inflammatory process present in the lamina propria to be chronic and it consists in particular of lymphocytes, plasma cells and macrophages. This process was differentiated in intensity from one case to another, but varied even within the same case, from one area to another. Inflammation was determined by the local microbial flora enhanced by the action of prosthetic appliances or by the prolonged edentulous state. We observed more intense changes in denture wearers patients. The inflammatory response indicates the reactivity of the edentulous mucosa in response to local aggression, the specific defense mechanism coexisting with the nonspecific defense mechanism, with predominance of cellular immune defense.