Concomitant use of Congo red staining and confocal laser scanning microscopy to detect amyloidosis in oral biopsy: A clinicopathological study of 16 patients.

Twenty oral biopsies from 16 patients were analyzed both by traditional microscopy and by confocal laser scanning microscopy. Using conventional histopathological techniques, the diagnosis of amyloidosis was confirmed only in 15 biopsies. Using confocal laser scanning microscopy, amyloid deposits were detected in all of the samples. The current study shows that confocal laser scanning analysis helps to identify minimal amyloid deposits that could be overlooked using traditional microscopy, thus raising the sensitivity of oral biopsy up to 100%.

Confocal Laser Scanning Microscopy Analysis of 10 Cases of Craniofacial Fibrous Dysplasia.

Fibro-osseous lesions (FOL) represent a heterogeneous group of lesions that exhibit a variety of clinic-pathological features. Recently, based on the new World Health Organization classification system, these lesions were reclassified as follows: (1) fibrous dysplasia (FD), (2) osseous dysplasia, and (3) ossifying fibroma. Nevertheless, the nosologic placement of FOL may be problematic because of substantial overlap in the histopathological findings. In this study, we analyzed 10 cases of FD by both optical and confocal laser scanning microscopy, a research technique based on the laser light microscopic analysis of stained biological samples that allows improved tissue imaging and bidimensional pictures with high resolution at the cellular level to provide a better understanding of the diagnosis of this disease.

Cellular populations of periimplant tissues: cytological analysis with sulcular microbrushing.

PURPOSE: Cellular populations of gingival crevicular fluid cytological analysis of integrated implants sites have been investigated by using sulcular cytological brushing, as a means of providing an objective and reproducible technique for monitoring periimplant tissue health. MATERIALS AND METHODS: A total of 60 patients with osteointegrated implants bearing at least for 2 years were divided in 2 groups, A and B. Group A consisted of 30 subjects who presented scarce oral hygiene. In Group B, 30 subjects with a good oral hygiene were included. RESULTS: Comparative analysis of the data obtained by sulcular microbrushing of the 2 groups put into evidence significative differences in the expression of the microbiological and the cytological parameters. CONCLUSION: Clinical monitoring of parodontal and periimplant tissues makes use of several diagnostic tests ranging from clinical and radiological tests to biological assays. However, none of these techniques allows to evaluate periimplant tissue cytological status. This preliminary study suggested sulcular microbrushing might be a useful tool in the early diagnosis and in the micrological monitoring of peri-implantitis.

Lateral ridge augmentation using an equine flex bone block infused with recombinant human platelet-derived growth factor BB: a clinical and histologic study.

This paper reports on a patient who underwent horizontal ridge augmentation using recombinant human platelet-derived growth factor BB (rhPDGF-BB) in combination with a collagenate equine block. Ninety days after the first surgery, 8 mm of new bone was noted on a computed tomography scan, and three 5-mm implants were placed. Histology, performed using confocal laser scanning microscopy, showed a large amount of newly formed bone well characterized with osteon and resorption lacunae, which demonstrated the intense bone remodeling. This study supports the use of rhPDGF-BB in combination with allograft blocks.

Calcifying odontogenic cysts associated with odontomas: confocal laser scanning microscopy analysis of 13 cases.

The so-called calcifying odontogenic cyst (COC) represents a heterogeneous group of lesions that exhibit a variety of clinico-pathologic features. It is an uncommon lesion and represents less than 2% of all odontogenic cysts and tumors. Recently, these lesions have been reclassified as calcifying cystic odontogenic tumors (CCOT), according to the new World Health Organization (WHO) classification. CCOT are frequently found in association with, or containing areas histologically identical to, various types of odontogenic tumors, such as complex/compound odontomas. This work analyzed clinical and histological data deriving from 13 patients affected by CCOT associated with odontomas. Moreover, a confocal laser scanning microscope (CLSM) analysis was undertaken to further a better understanding of the nature of this peculiar lesion.

The ß-adrenoceptor agonist isoproterenol promotes the activity of respiratory chain complex I and lowers cellular reactive oxygen species in fibroblasts and heart myoblasts.

A study is presented on the effect of the ß-adrenoceptor agonist isoproterenol on mitochondrial oxygen metabolism in fibroblast and heart myoblast cultures. Isoproterenol treatment of serum-limited fibroblasts and proliferating myoblasts results in the promotion of mitochondrial complex I activity and decrease of the cellular level of reactive oxygen species. These effects of isoproterenol are associated with cAMP-dependent phosphorylation of complex I subunit(s). Addition of okadaic acid, inhibitor of protein phosphatase(s), reverses the decline of complex I activity in serum-limited fibroblast cultures and activates the complex in proliferating myoblast cultures. The effects of isoproterenol on complex I activity and reactive oxygen species balance can contribute to the therapeutic effect of the drug.

Oral lichen planus: update on etiopathogenesis, diagnosis and treatment.

Lichen planus is an inflammatory mucocutaneous disorder. Skin, oral and genital mucosal surfaces, scalp, and nails can be affected. Its development is chronic, with a possible malignant degeneration. Spontaneous remission is rare. Although the etiology of oral lichen planus is still unclear, there is evidence that it is a complex immunologic disease mediated by cytotoxic cells directed against basilar keratinocytes and resulting in vacuolar degeneration and lysis of basal cells. In long-standing, atrophic and erosive forms, the treatment is usually aimed at relieving pain and may include immunosuppressive agents, especially corticosteroid, topical cyclosporin, or tacrolimus, topical and systemic retinoids. However, the use of these drugs may be accompanied by several side effects. For this reason clinicians, currently, have focused their attention to new biological agents which provide selective immunological results with less side effects than generic immunosupressants.

Dens invaginatus: a qualitative-quantitative analysis. Case report of an upper second molar.

Dens invaginatus (D.I.) is a developmental anomaly caused by the infolding of the surface of a tooth crown before calcification has occurred. Its aetiology is controversial and remains unclear. It occurs in all dentitions with a prevalence that ranges from 0.25% to 7.74% and is mostly seen in the maxillary permanent incisors, particularly in the lateral incisors. Posterior teeth are infrequently involved. The purpose of this study was to investigate the morpho-structure of a second upper molar dens invaginatus compared with a control tooth. Ground and decalcified sections were prepared and histo-morphological evaluation of dental tissues was performed by using light microscopy, microradiography, and confocal laser scanning microscopy analysis (CLSM). The mechanical behaviour was tested by means of microhardness (HV) test. The results of our investigation showed structural anomalies of hard tissues, such as a difference in enamel prism diameter, in number and diameter of peripulpal dentinal tubules and in surface and diameter of cementocyte lacunae between D.I. and control tooth.

Oral pulse granuloma: histological findings by confocal laser scanning microscopy.

Pulse granuloma is a rare benign entity considered to be a foreign-body reaction to vegetables particles. It occurs most frequently in the oral cavity of edentulous patients wearing a complete mobile denture, associated with impacted lower third molar or in postextractive alveolar sockets. The authors analyzed 2 cases by both optical and confocal laser scanning microscopy, a research technique based on laser light microscopic analysis of biological samples stained for fluorescence observation. CLSM allowed improved tissue imaging, bidimensional pictures with better resolution at cellular level, and, in particular, the possibility of a three-dimensional image reconstruction. In conclusion, this study reports the fine definition of pulse granuloma at microscopic level by CLSM and the results warrant the use of this technique for further analyses.

Confocal laser scanning microscopy of liesegang rings in odontogenic cysts: analysis of three-dimensional image reconstruction.

Liesegang rings are concentric noncellular lamellar structures, occasionally found in inflammatory tissues. They have been confused with various parasites, algas, calcification, and psammoma bodies. The authors examined Liesegang rings from oral inflammatory cysts by both optical and confocal laser scanning microscopy, and perfomed a three-dimensional reconstruction. These investigations indicate that Liesegang rings are composed of multiple birefringent concentric rings, resulting from a progressive deposition of organic substances, with an unclear pathogenesis.

Pathogenetic mechanisms in hereditary dysfunctions of complex I of the respiratory chain in neurological diseases.

This paper covers genetic and biochemical aspects of mitochondrial bioenergetics dysfunction in hereditary neurological disorders associated with complex I defects. Three types of hereditary complex I dysfunction are dealt with: (i) homozygous mutations in the nuclear genes NDUFS1 and NDUFS4 of complex I, associated with mitochondrial encephalopathy; (ii) a recessive hereditary epileptic neurological disorder associated with enhanced proteolytic degradation of complex I; (iii) homoplasmic mutations in the ND5 and ND6 mitochondrial genes of the complex, coexistent with mutation in the nuclear PINK1 gene in familial Parkinsonism. The genetic and biochemical data examined highlight different mechanisms by which mitochondrial bioenergetics is altered in these hereditary defects of complex I. This knowledge, besides clarifying molecular aspects of the pathogenesis of hereditary diseases, can also provide hints for understanding the involvement of complex I in sporadic neurological disorders and aging, as well as for developing therapeutical strategies.

Oral lichenoid lesions in HIV-HCV-coinfected subjects during antiviral therapy: 2 cases and review of the literature.

Some dental materials and certain drugs may induce epithelial alterations, which clinically resemble oral lichen planus (OLP), on oral mucosa. But these alterations do not have all the clinical and/or the histological features of OLP; these lesions are known as oral lichenoid lesions (OLLs). Some researchers describe the onset and/or the worsening of OLL/OLP after the administration of anti-hepatitis C virus (HCV) therapy. In this article, we describe the development of symptomatic OLLs, as a consequence of anti-HCV therapy (interferon-alpha and ribavirine), in 2 human immunodeficiency virus-HCV-coinfected subjects. An immunological cause related to coinfection and administration of different medications could be responsible for the onset of OLLs. These new cases, together with the previous reports of a possible association between OLP and/or OLL and anti-HCV therapy, highlight the absolute need to monitor carefully the human immunodeficiency virus-HCV-coinfected subjects who are about to start the anti-HCV therapy and to define better the clinical and histopathological criteria to distinguish OLP from OLL.

Analysis of collagen distribution in human crown dentin by confocal laser scanning microscopy.

The authors used confocal laser scanning microscope to analyze human crown dentin. Specimens from 10 teeth were divided in two groups, one of which was decalcified and stained with hematoxylin and eosin. In the second group an undecalcified section was analyzed. Both groups were scanned by confocal microscope to generate optically sectioned images. All of the analyzed samples presented an intense autofluorescent that was ascribed to collagens. The degree of autofluorescence intensity was variable and might be due to collagen expression. The results indicate that a confocal microscope may be of help in analyzing and defining the nature and extent of collagen fibrils in human dentin.

Unusual case of adverse reaction in the use of sodium hypochlorite during endodontic treatment: a case report.

Sodium hypochlorite (NaOCl) is currently used in the debridement and disinfection of the root canal system, supporting the mechanical procedures. Although it is considered a safe irrigant, the literature reports a few cases of adverse reaction caused by NaOCl: They range from injection through the apical foramen to air emphysema and allergic reactions as complications during endodontic treatment. The present report shows the possible severe clinical consequences of concentrated NaOCl extruding through the periapical tissues during root canal irrigation in a patient not allergic to NaOCl.

Oral lesions in HIV and HCV co-infected individuals in HAART era.

BACKGROUND: During recent years, a new population of HIV and HCV co-infected subjects has emerged presenting particular oral problems. The aim of our study was to determine the prevalence of oral lesions in HIV+ subjects and HIV and HCV co-infected subjects, to assess whether co-infection is a risk factor for the presence of oral lesions. METHODS: 200 HIV+ subjects were consecutively enrolled, divided into two groups: Group 1 (130 HIV+ subjects) and Group 2 (70 HIV-HCV co-infected subjects) and visited by two oral medicine specialists. Epidemiological, laboratory and clinical parameters were gathered to determine the possible risk factors for oral lesions. RESULTS: 52 on 200 subjects (26%) presented oral lesions: in Group 1, 25 on 130 subjects (19.23%) presented oral lesions, whereas in Group 2, 27 on 70 subjects (38.57%) presented oral lesions. Multivariate analysis showed that the following variables are statistically associated with the presence of oral lesions: HIV-HCV co-infection (OR = 2.32; 95% CI = 1.01-5.33: P < 0.05) and the use of drugs for the treatment of systemic diseases not associated with HIV (OR = 4.34; 95% CI = 1.78-5.33: P = 0.005). CONCLUSIONS: It is possible to assess, on the basis of our results, that co-infected patients are more prone than HIV mono-infected patients to develop oral lesions and thus should undergo strict oral medicine monitoring.

Confocal laser scanning microscopy of human cementocytes: analysis of three-dimensional image reconstruction.

In order to define a practical method for a quantitative-qualitative analysis of dental hard tissue cells, we have studied cementocytes of human teeth using Confocal Laser Scanning Microscopy (CLSM), a research technique based on laser light microscopic analysis of biological samples stained for fluorescence observation. One thousand and eight hundred cementocyte images were analyzed. CLSM allowed improved tissue imaging, bi-dimensional pictures with better resolution at cellular level and, in particular, the possibility of a three-dimensional image reconstruction, thus providing a dynamic view of the cell under different situations. CLSM allowed a careful morphological observation and dimensional analysis of cementocytes at cellular resolution: cementocyte dimensional parameters like cell body without cell processes, cell dimensions with cell processes, and the number of cellular processes could be obtained. In conclusion, this study reports the fine definition of cementocytes at microscopic level by CSLM and the results warrant the use of this technique for further comparative analyses between normal and pathological cementocyte cells, e.g. cementum neoplasia and periodontal disease which still await a clear analytical description at cellular level.

Analysis of ghost cells in calcifying cystic odontogenic tumors by confocal laser scanning microscopy.

OBJECTIVE: The confocal laser scanning microscope represents an effective tool for studying biological samples stained for fluorescence observation. In this study we have used the confocal microscope to analyze ghost cells in calcifying cystic odontogenic tumors. STUDY DESIGN: Specimens from 15 calcifying cystic odontogenic tumor cases were stained with hematoxylin and eosin, and scanned by a confocal laser scanning microscope to generate optically sectioned images. RESULTS: All of the analyzed samples presented autofluorescent cells that were identified as ghost cells. The degree of autofluorescence intensity was variable and may be a result of the presence of hard keratin. CONCLUSION: The confocal laser scanning microscope may be of help in analyzing and defining the nature and extent of keratinization processes in calcifying cystic odontogenic tumor ghost cells.