Evaluation of prolidase activity and oxidative stress in patients with oral lichen planus and oral lichenoid contact reactions.

OBJECTIVE: The aim of this study was to evaluate prolidase activity and oxidative stress in patients with oral lichen planus (OLP) and oral lichenoid contact reactions (OLCR) using serum and salivary samples and to compare these biomarkers with each other as well as with a group of healthy subjects in order to be able to opine their role in the estimation of OLP and OLCR. PATIENTS AND METHODS: Eighteen recently diagnosed patients with OLP, 32 patients with OLCR and 18 healthy controls with matched periodontal status were recruited to the study. Prolidase activity, lipid peroxidation product malondialdehyde (MDA), sialic acid (SA), and advanced oxidation protein products (AOPPs) levels in both serum and saliva were determined. Additionally, salivary flow rate and its buffering capacity were estimated. Statistical analyses were performed using the chi-square test, t-test, Mann-Whitney U-test, and Spearman's rho correlation coefficient. RESULTS: No statistically significant differences were observed between the study groups and the control group regarding to the basic characteristics and the periodontal status (P > 0.05). There were no statistically significant differences between OLP and OLCR groups regarding to the distribution of lesions' type, severity, and location (P > 0.05). No significant differences were found between the two study groups with regard to Prolidase activity, MDA, SA, and AOPPs (P ˃ 0.05), whereas statistically significant differences were found between the two study groups and the control group with regard to all evaluated parameters except of serum prolidase (P ˂ 0.01). Moderate correlation was found between salivary MDA and the OLP/OLCR lesion severity, whereas a weak correlation was observed between serum SA and the OLP/OLCR lesion severity (P ˂ 0.05). CONCLUSIONS: The findings of this study suggest an increased prolidase activity and oxidative stress and imbalance in the antioxidant defense system in biological fluids of patients with OLP and OLCR when compared with the healthy subjects. Both OLP and OLCR patients revealed almost similar prolidase activity and oxidative stress levels although these two conditions have different etiopathogenesis.

Oral manifestations and prosthetic rehabilitation in hereditary sensory and autonomic neuropathy (HSAN)type IV: a case report.

Hereditary sensory and autonomic neuropathies (HSAN) are rare genetic syndromes of unknown etiology. They are seen in early childhood and are categorized into six different types by their symptoms. HSAN type 4 demonstrates autosomal recessive transmission pattern, with such major characteristics as loss of sense of pain, self-mutilation, anhydrosis and mental retardation. Sympathetic innervations are deficient despite the existence of sweat glands. Sufferers are hypotonic without any tendon reflexes, and neuro-motor development is retarded. In some cases tactile sensation and vibration may be intact. Biting injuries due to lack of pain sensation cause laceration, ulceration and scarring of the tongue, lips and other parts of oral mucosa. Tooth luxation and severe dental attrition have been observed. This case report presents oral and dental findings, surgical treatments and prosthetic rehabilitation of an 11- year-old boy with HSAN type 4.

Comparative evaluation of various miniplate systems for the repair of mandibular corpus fractures.

Miniplates have been used during the last decade to facilitate stability between bony fragments in the maxillofacial region and are currently the preferred surgical method for the fixation of fractures and osteotomies. The aim of this study was to evaluate and compare the biomechanical behaviors of six different types of miniplates used to reconstruct mandibular body fractures: Group 1 (straight, 2 holes, 12.0 mm spacing), Group 2 (straight, 4 holes, 9.0 spacing), Group 3 (straight, 6 holes, 9.0 mm spacing), Group 4 (L-shaped, 4 holes, 9.0 mm spacing, right hand plate), Group 5 (Y-shaped, 5 holes, 12.0 mm spacing), and Group 6 (double Y-shaped, 6 holes, 9.0 mm spacing). Thirty bovine hemimandibles and a custom-made 3-point biomechanical test frame mounted on a Shimadzu universal test machine were used to evaluate the six different miniplate systems. Results revealed that Group 1 (straight, 2 holes, 12.0 mm spacing) and Group 4 (9.0 mm spacing, right hand plate) had the lowest biomechanical stability, whereas Group 6 (6 holes, 9.0 mm spacing) had the highest biomechanical stability. Group 6 also provided statistically greater resistance to displacement than Group 1 and Group 4.

Refractory Pigmentation Associated with Laugier-Hunziker Syndrome following Er:YAG Laser Treatment.

The present report describes a case of Laugier-Hunziker syndrome (LHS), a rare benign condition. A patient with LHS develops acquired melanotic pigmentation of the lips and buccal mucosa, often with pigmentation of the nails occurring. No systemic symptoms are associated with this syndrome. Normally, no treatment is required for this condition, unless for aesthetic reason, mainly due to pigmentation on the lip mucosa. We present a case of LHS, 37-year-old female, whose pigmentations on her lip and in the oral cavity were treated with an Er:YAG laser. At the postoperative 12th month followup, the lesions recurred. The effects of any surgical attempt to treat pigmentations associated with LHS were discussed.

Comparison of two different labial salivary gland biopsy incision techniques: a randomized clinical trial.

OBJECTIVE: To compare the reliability of two different labial salivary gland biopsy (LSGB) incision techniques (vertical versus horizontal incision techniques) and to report the related complications and discomfort. STUDY DESIGN: 163 patients who underwent LSGB were included in this study. Patients were randomly divided as vertical incision group (n=81) and horizontal incision group (n=82). Demographic and clinical information of each patient were recorded. A questionnaire was prepared and applied together with Visual Analog Scale (VAS) on the subjects verbally at the 7th day, postoperatively. Intraoperative, short- term and delayed complications were evaluated. RESULTS: The mean age of patients (117 female, 46 male) was 47.3 years (range 19-79 years). Vertical incision technique was associated with less pain (p<0.001), less swelling (p<0.05), less scar formation (p<0.05) and less difficulty in eating (p<0.05) when compared with horizontal incision technique. No statistically significant differences were observed between the 2 groups in terms of hematoma, parasthesia and speech difficulty (p>0.05). Additionally, two subjects in the horizontal incision group revealed permanent paresthesia during the follow-up period of two years. CONCLUSION: This prospective study demonstrated that the subjects in the vertical incision group had less complication rates and discomfort after labial salivary gland procedure than those in the horizontal incision group.

Implant-supported oral rehabilitation of a patient with pemphigus vulgaris: a clinical report.

Pemphigus vulgaris (PV) is a rare mucocutaneous vesiculobullous disease characterized by the development of autoantibodies against the desmosomal proteins. Current treatment is largely based on systemic immunosuppression using systemic corticosteroids. Immunosuppressive drugs used in the treatment of the disease may increase the risk of infection and delayed healing, which are of concern in dental treatment procedures in this group of patients. The clinical outcomes of implants in PV have not been investigated. We present a case of PV rehabilitated with an implant-supported prosthesis with a 32-month follow-up and discuss the important points in the surgical and prosthodontic phases.

Removal of a Maxillary Third Molar Displaced into Pterygopalatine Fossa via Intraoral Approach.

The removal of impacted maxillary third molars is one of the most common procedures performed in oral and maxillofacial surgery units with low rates of complications and morbidity. A few cases of accidental displacement of third molars into adjacent anatomical spaces, such as the infratemporal fossa, the pterygomandibular space, the maxillary sinus, buccal space, or the lateral pharyngeal space, during surgical interventions have been reported. In this paper, a case of a maxillary third molar accidentally displaced into the pterygopalatine fossa is presented, and the removal of the tooth via intraoral approach is described.

The evaluation of fibrin sealants and tissue adhesives in oral surgery among patients with bleeding disorders.

OBJECTIVE: The aim of this study was to evaluate the efficiency of two local hemostatic agents administered with apreoperative dose of replacement therapy in patients with bleeding disorders undergoing oral surgery. MATERIAL AND METHODS: The study included 21 patients that were randomly divided into 3 groups. Patients in Group1 (n = 7) received preoperative replacement therapy and postoperative fibrin sealant applied to the surgical site. Patientsin Group 2 (n = 7) received preoperative replacement therapy and postoperative tissue adhesive applied to the surgicalsite. Patients in Group 3 (n = 7) were given replacement therapy pre- and postoperatively. RESULTS: Postoperative bleeding was not observed in 17 of the 21 patients, including 5 in Group 1 (71.42%), 6 in Group2 (85.71%), and 6 in Group 3 (85.71%). Hemorrhagic complications occurred in only 4 of the 21 patients. CONCLUSION: The use of fibrin sealant and tissue adhesive was beneficial, as they reduced the level of factor concentratesused for replacement therapy and resulted in rapid hemostasis at the surgical site, facilitating the ability to performserial surgical procedures concurrently.

Oral postinflammatory pigmentation: an analysis of 7 cases.

Oral postinflammatory pigmentation (OPP) is a discoloration of the oral mucosa caused by an excess of melanin production and deposition within the basal layer of the epithelium and connective tissue of areas affected by chronic inflammation. Therefore, it is mandatory to demonstrate the association with a previous or concomitant inflammatory process in the same area of oral mucosa. Clinically OPP appears as a localized or diffuse, black to brown pigmentation. OPP may persist for many years even though the disappearing of the pigmentation after the resolution of the inflammatory state has been reported. We reviewed retrospectively the medical records and, when performed, biopsy examinations of 7 cases of OPP. Four cases were associated with oral lichen planus, two cases with lichenoid lesions and one case with proliferative verrucous leukoplakia. Despite a possible high prevalence of OPP, only a few reports concerning diagnosis, etiopathogenesis and clinical manifestation have been published so far.

Evaluation of oxidative stress and antioxidant profile in patients with oral lichen planus.

OBJECTIVE: The aim of this study was to assess oxidative stress and antioxidant profile in patients with oral lichen planus (OLP) using serum and salivary samples and to compare these biomarkers in a group of healthy subjects. PATIENTS AND METHODS: Twenty-one recently diagnosed patients with OLP and 20 healthy controls with matched periodontal status were recruited to the study. Total antioxidant activity (TAA) and lipid peroxidation product malondialdehyde (MDA) in both serum and saliva were determined. Univariate comparisons between the two groups were made for quantitative and categorical variables to determine any significant differences. RESULTS: In OLP patients, total antioxidant defense (TAA) was significantly lower than that in healthy subjects in their serum samples (P = 0.01). Salivary MDA levels were significantly higher in the OLP group compared with healthy subjects (P = 0.03). A significant correlation was found between serum and saliva TAA estimates in patients with OLP (r = 0.714 and P = 0.0001) and in the control group (r = 0.69 and P = 0.001). Significant correlation was also found between serum and saliva MDA values in control group (r = 0.464 and P = 0.04). A significant inverse correlation was found between salivary MDA and TAA values in the control group (r = -0.598 and P = 0.005). CONCLUSIONS: The findings of this study suggest an increased oxidative stress and imbalance in the antioxidant defense system in biological fluids of patients with OLP. These findings may reflect the disease phenomenon of OLP rather than a causal effect and their role in pathogenesis and transformation of OLP to cancer, if any, needs further elucidation.

Implant-supported oral rehabilitation of a patient with systemic lupus erythematosus: case report and review of the literature.

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease with multisystemic involvement. Immune-suppressive drugs used in the treatment of the disease can increase the risk of infection and delay healing, which are of concern in dental-treatment procedures. Because of the involvement of the salivary glands, the composition and amount of saliva released are usually altered in patients with SLE. Significantly lowered salivary flow rate causes difficulties during dental procedures and makes it difficult to maintain oral hygiene and conserve both fixed and removable prostheses. This case report presents a patient who had an extremely dry mouth and oral lesions due to SLE and describes how oral rehabilitation was achieved with implant-supported fixed dentures. To the best of our knowledge, this is the first report of the use of oral implants in a patient with SLE. Dental practitioners should consider dental implants as a preferred treatment choice in the oral rehabilitation of patients with SLE.

Oral status and Candida colonization in patients with Sjögren's Syndrome.

OBJECTIVE: To determine the oral status, salivary flow rate, Candida carriage in saliva, and prevalence of Candida albicans colonization in several areas of the mouth in patients with primary and secondary Sjögren's syndrome as opposed to those of healthy subjects. STUDY DESIGN: Thirty-seven patients with Sjögren's syndrome (SS), [14 patients with primary SS (SS-1) and 23 patients with secondary SS (SS-2)], along with 37 healthy controls were examined in regard to number of teeth, pro-bing pocket depth (PPD), approximal plaque index (API), bleeding on probing (BOP), presence of prosthetic appliances and smoking habits. Salivary flow rate (SFR), Candida carriage in saliva, presence of Candida albicans colonization on buccal, angular, palatal and sulcular areas, on dentures and on the tongue's dorsal surface were determined. Statistical analyses were performed using the 2-tailed Fisher exact and Kruskal-Wallis test. RESULTS: No statistically significant difference was found between SS-1 and SS-2 groups based on the parameters analysed. Statistically significant differences were observed between patients with SS and healthy subjects in terms of SFR, oral signs and symptoms, API, BOP, C. albicans colonization on tongue and buccal area, and Candida carriage in saliva. In the gingival crevicular fluid positive C. albicans colonization was found in only one subject of SS subgroup. CONCLUSIONS: SS patients carry a higher risk of having periodontitis and are more predisposed to develop candidiasis. C. albicans is scarcely detected in gingival crevicular fluid despite high scores on C. albicans colonization in different areas of the oral cavity in SS patients.

Heterotopic ossification in the maxillary sinus.

We report a case of heterotopic ossification of the maxillary sinus in a 30-year-old female who was treated surgically in our department. Heterotopic ossification (HO) refers to the formation of mature lamellar bone in nonosseous tissues. We present the radiographic and computed tomographic appearance, and discuss the surgical treatment, histopathologic results, and differential diagnosis. To the best of our knowledge, no other case of HO of the maxillary sinus has been reported yet.

Prosthodontic rehabilitation after traumatic tooth and bone loss: a clinical report.

Traumatic injuries from motor vehicle accidents may cause anatomic deficiencies in soft and hard tissues. Successful treatment of patients with such deficiencies may include preprosthetic surgery using osseointegrated implants to increase prosthesis retention and stability. This article describes the treatment of a motor vehicle accident victim whose anterior teeth and supporting tissues were lost.

Maxillofacial and dental manifestations in a patient with mandibulo-acral dysplasia.

Mandibulo-acral dysplasia (MAD) is a rare condition characterized by mandibular hypoplasia, acroosteolysis, delayed cranial suture closure, hypoplastic clavicles, stiff joints, dental crowding, atrophy of the skin of the hands and feet, progeroid facial appearance, alopecia and short stature. This report presents a patient with MAD, suffering from difficulty in mastication and speech, together with limited lip closure and aesthetic problems related to the clinical outcomes of the syndrome. The aim of reporting this case is to detail the first widely determined dental and maxillofacial abnormalities of a rare syndrome, mandibulo-acral dysplasia, and to contribute to the data regarding the etiology of consanguinity.