Granular cell myoblastoma. Review of the literature and report of a case.

The origin and nature of granular cell myoblastoma (GCM) have been debated since the original description of a granular cell tumor by Abrikossoff in 1926. Many cell types have been implicated in its histogenesis, including muscle cells, histiocytes, fibroblasts, neural sheath cells and undifferentiated mesenchymal cells, but the origin of the lesion remains still controversial. The authors present a review of the clinical features and the histopathologic and histochemical findings of this nebulous entity. They also report a case of granular cell myoblastoma of the tongue.

Effect of pretreatment with ketorolac tromethamine on post-operative pain following periodontal surgery.

A double-blind, randomized, single-dose clinical trial to evaluate the analgesic efficacy of preoperative ketorolac tromethamine administration on periodontal postoperative pain was designed. One group received 20 mg ketorolac immediately before periodontal flap surgery, and the other group received placebo. Naproxen sodium was allowed postoperatively as rescue medication. The visual analog scale was used to estimate pain. Postoperative pain was assessed hourly for the first 10 h on the day of surgery, and 4 x daily on the 1st and 2nd postsurgical days. Timing and dose of rescue analgesic remedication were also recorded. Results indicated that preoperative treatment with ketorolac significantly reduced initial pain intensity and delayed the onset of postoperative pain as compared to placebo. Incidence and amount of naproxen consumption was similarly small in both ketorolac- and placebo-treated groups. No adverse reactions related to preoperative medication were observed.

Effect of tetracycline HCl on periodontally-affected human root surfaces.

Scanning electron microscopy was used to evaluate surface characteristics of periodontitis-exposed instrumented human cementum and dentin surfaces following topical application of tetracycline HCl (TTC). Specimens were randomly assigned to application of sterile saline for 1 minute (control); TTC (10 mg/ml) for 1 minute and 4 minutes, respectively; and TTC (100 mg/ml) for 1 minute and 4 minutes, respectively. Solutions were applied with a cotton pellet using a burnishing technique. Control specimens exhibited an amorphous irregular surface smear layer. TTC treatment of cementum for 1 minute resulted in a relatively debris-free, nonhomogeneous surface. The 4-minute application resulted in a surface exhibiting a densely fibrillar, mat-like texture. Dentin specimens conditioned for 1 minute showed a smooth surface with many tubule openings partially occluded by debris. The 4-minute treatment exposed a 3-dimensional network of intertubular and peritubular collagen fibrils. No consistent morphologic differences were observed between cementum or dentin specimens treated with TTC at concentrations of 10 and 100 mg/ml, respectively. The results suggest that topical application of TTC produces morphologic alterations of periodontitis-exposed cementum and dentin that appear related to application interval rather than concentration of the drug.

Effects of tetracycline HCl conditioning and fibrin-fibronectin system application in the treatment of buccal gingival recession with guided tissue regeneration.

A split-mouth clinical trial was designed to evaluate the effect of treating deep wide buccal gingival recession with guided tissue regeneration using expanded polytetrafluoroethylene membrane combined with tetracycline HCl (TTC) root conditioning and fibrin-fibronectin sealing system (FFSS) application. Eight patients, aged 25 to 57 years, each presenting two similar mucogingival defects, were selected. The two bilateral recessions were randomly assigned in each patient to either test or control treatment procedure. After initial therapy, each patient was examined for assessment of plaque, gingivitis, recession depth (RD), probing depth (PD), probing attachment level (PAL), and keratinized tissue width (KT). The test procedure included the elevation of mucoperiosteal flap at the buccal aspect of the alveolar process. The root was debrided and demineralized with 100 mg/ml TTC solution for 4 minutes using a burnishing technique with cotton pellets. A teflon membrane was secured and a film of FFSS was applied between the membrane and the root surface. The buccal flap was sutured to completely submerge the membrane. Control treatment included gingival flap surgery with barrier membrane alone. After 6 weeks, the membrane was removed. Healing was evaluated 6 months after surgery. Both test and control procedures resulted in highly significant recession reduction (3.0 mm +/- 1.1 and 2.6 mm +/- 1.2, respectively) and attachment gain (3.6 mm +/- 1.7 and 2.6 mm +/- 1.1, respectively). Mean root coverage was of 67% in the TTC + FFSS treated sites and 60% in membrane-only treated sites. However, only treatment with TTC + FFSS significantly reduced PD and increased KT (P < 0.05). When treatments were compared, changes in PD and PAL were significantly greater in TTC + FFSS treated sites (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical evaluation of plaque removal by counterrotational electric toothbrush in orthodontic patients.

In the present crossover clinical trial, the plaque-removing efficacy of a counterrotational toothbrush was compared to that of a normal toothbrush in orthodontic patients. Twenty subjects, aged 11 to 26 years, who had orthodontic brackets on all fully erupted teeth of at least one arch were selected. At the first appointment, a prophylaxis was given to bring the plaque score to 0. Ten subjects received counterrotational brushes, and 10 subjects received manual brushes according to a randomized list. At 14 days, plaque scores were recorded and another prophylaxis was given. The subjects who were using the electric brush were assigned to the manual brush and vice versa. At 28 days, plaque scores were reassessed. Results showed that the counterrotational brush was significantly more effective in removing supragingival plaque from bracketed teeth than was the manual brush. The differences in plaque-removing effectiveness were particularly consistent on the proximal surfaces of the teeth.

[Gingival overgrowth in patients under cyclosporin-A treatment. A clinical study]. / Aumento di volume gengivale nei pazienti in trattamento con cyclosporina-A. Studio clinico.

The aim of the present study was to investigate possible background factors causing gingival overgrowth (GO) among transplant patients treated with cyclosporine-A (Cy-A). Nineteen subjects were evaluated with regard to Cy-A therapy including: whole blood concentration, oral dosage, duration of therapy, cumulative exposure factor. Periodontal condition was assessed using Plaque Index, probing depth and probing attachment level. GO was assessed on plaster study models by a semiquantitative method. The occurrence of GO was 88%, with a total 35.9% of gingival sites presenting overgrowth. Statistical analysis showed no correlation between GO score on one hand, oral dosage, exposure factor and plaque score on the other. ANOVA revealed a significant relationship between GO score and percentage of affected sites.

[The psychological aspects of patients with the burning mouth syndrome]. / Aspetti psicologici nei pazienti affetti da Burning Mouth syndrome.

Burning mouth syndrome (BMS) is a distinct clinical entity characterized by a chief complaint of unremitting oral burning concomitant with no oral mucosal clinically observable lesions. Numerous causes of this condition have been suggested, including local factors, systemic factors, and psychogenic disorders. A total of 33 consecutive subjects, 29 women and 4 men, complaining of BMS, who had attended the Dental Clinic of the University of Ferrara during a period of 2 years, was studied. The results obtained using a specific questionnaire to assess the psychological status of BMS patients were reported. Psychological factors were present in more than two thirds of the subjects (67%). Anxiety was the predominant disorder and the most recalcitrant obstacle to cure. On the other side, an improvement of the psychogenic state was observed in relation to burning reduction. Furthermore, a remission or resolution of the oral symptoms following a reassurance alone as to the benign nature of the condition was found in 24% of the patients. These results seem to suggest an association between oral complaint and personality disturbance. However, whether the psychogenic disorder is causative or whether it is a result of the burning sensation is still uncertain.

[The burning mouth syndrome. A clinical study]. / Burning mouth syndrome. Studio clinico.

Burning mouth syndrome (BMS) is a distinct clinical entity characterized by a chief complaint of unremitting oral burning concomitant with no oral mucosal clinically observable lesions. Numerous causes of this condition have been suggested, including local factors, systemic factors, and psychogenic disorders. A total of 36 consecutive subjects, 32 women and 4 men, complaining of BMS, who had attended the Dental Clinic of the University of Ferrara during a period of 2 years, was studied. The method of assessment followed closely a strictly co-ordinated management protocol based on conventional guidelines, namely history, clinical examination and special investigations. A detailed history was taken of duration of the condition, site affected, and pattern of burning. The severity and the response to treatment were assessed with a Visual Linear Analogue Scale (VLAS). A full medical history was taken, with regard to xerostomia-inducing drug assumption. The presence and the severity of menopausal symptoms were explored. Inquiries were made on use of mouthwashes. For the denture-wearers, specific questioning was directed to the length of denture-wearing experience, temporal association of the symptom with the wearing of dentures, relationship to burning sensation of any relines or repairs, denture cleaning technique, and use of fixatives. A complete routine intraoral and extraoral examination was performed. The presence of parafunctional habits, such as tongue thrusting, clenching, grinding, lip and cheek biting, was investigated. If dentures were worn, their design and condition were examined. In particular, the relation between the vertical and horizontal components of the jaw and the denture base extension was assessed and the freeway space measured.(ABSTRACT TRUNCATED AT 250 WORDS)

[Oral symptoms in the climacteric. A prevalence study]. / Sintomi orali in climaterio. Studio di prevalenza.

The female climacteric is attributed to physiological ovarian failure with the consequent decrease in the secretions of oestrogen, progestones and androgens. Numerous metabolic, psychological and physical changes have been associated with this event. Oral discomfort, including the burning mouth syndrome and the dry mouth syndrome, has been described as a menopausal symptom. However, the relationship between the hormonal changes related to climacteric and the onset of oral discomfort is still controversial. The purpose of the present study was to evaluate the prevalence of oral symptoms, with particular regard to burning sensation, xerostomia, altered taste and recurrent oral ulcerations. The relationship between oral and climacteric symptoms and psychological status of the patients was also evaluated. A questionnaire was administered to 136 women (mean age: 51.2 years, range 40-62) being consecutively referred to the University Hospital Menopause Clinic from October 1991 to March 1992. The questionnaire included informations regarding menopausal state, oral symptoms, drug assumption, wearing of partial or total dentures, parafunctions (lip and cheek biting, bruxism, tongue thrusting). Climacteric symptoms including flushes/sweats, palpitations, headache, arthralgia/myalgia, vaginal dryness, decreased concentration, tiredness, decreased libido, insomnia, vertigo were evaluated. Visual analogue scale (VAS) was used where appropriate. Information regarding the alteration of the psychological status was collected by means of the Hospital Anxiety and Depression Scale Statistical analysis was performed by chi 2 test or Fisher's Exact Probability Test and Mann-Whitney U-test. The level of significance accepted was 5%. The subjects in this study were divided into two groups on the basis of their answers to the questionnaire: group I (no. 39), premenopausal women; group II (no. 97), menopausal women.(ABSTRACT TRUNCATED AT 250 WORDS)