Peri-Implant Response and Microflora in Organ Transplant Patients 1 Year after Prosthetic Loading: A Prospective Controlled Study.

BACKGROUND: A recent study conducted in humans demonstrated for the first time that bone loss in the immediate period after implant insertion before loading did not significantly differ in organ transplant recipients with respect to normal subjects. PURPOSE: The purpose of this study is to evaluate bone and periodontal response and peri-implant microflora in a group of organ-transplanted patients 1 year after prosthetic loading. MATERIALS AND METHODS: The study population included 13 consecutive organ-transplanted (11 hearts, two livers) patients and 13 normal (healthy) control subjects who received 29 and 28 submerged dental implants, respectively. Crestal bone level, peri-implant probing depth (PIPD), and bleeding on probing were evaluated at prosthetic loading and after 1 year. Samples for microbiological testing were taken from the subgingival microbiota of each implant 1 year after loading and analyzed with polymerase chain reaction. All samples were examined for the presence of five microorganisms: Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, Tannarella forsythensis, and Actinobacillus actinomycetemcomitans. RESULTS: A mean bone loss of 0.17 ± 0.10 and 0.20 ± 0.10 mm at 1 year was observed in the group of transplant recipients and in controls, respectively (N.S.). Similar results were obtained considering PIPD changes at 1 year (respectively 0.06 ± 0.71 mm in transplants vs 0.11 ± 0.74 mm in controls). Detection frequencies of pathogens were not statistically different between normal and transplanted patients. CONCLUSIONS: The present pilot study seems to indicate that bone and periodontal response and microbiological status around submerged dental implants in immunocompromised organ-transplanted patients do not differ 1 year after loading from those observed in control patients and that this particular population of patients may be successfully rehabilitated with dental implants.

Bone response to submerged implants in organ transplant patients: a prospective controlled study.

PURPOSE: To compare the short-term outcome of dental implant therapy in a group of organ transplant patients with that of a control group. MATERIALS AND METHODS: The study population included consecutive organ transplant patients and consecutive normal (healthy) subjects as controls. Two films were taken of all patients: one at baseline (implant placement) and one after 3 months of healing. All radiographs were analyzed twice (15 days apart) blindly by two independent trained radiologists. Crestal bone level (CBL) was measured, defined as the perpendicular distance from the reference point on the implant to the first visible apical bone-to-implant contact. RESULTS: The study population included 10 organ transplant patients (eight hearts, two livers) and 10 control patients, who received 20 and 12 submerged dental implants, respectively. At the 3-month follow-up visit, no implants showed any exposed cover screws. CBL increased in both groups, without any significant difference between the groups (CBL increased from 0.08±0.09 mm to 0.28±0.20 mm in transplant patients and from 0.11±0.16 mm to 0.42±0.32 mm in controls). Multiple analysis of variance showed that the mean bone loss of 0.21±0.18 mm observed in the group of transplant patients was not statistically different from that (0.32±0.25 mm) seen in the control group and was not influenced by any of the variables considered. CONCLUSIONS: The present pilot study seems to indicate that the bone response around submerged dental implants in immunocompromised organ transplant patients does not differ from that observed in control patients and that this particular population of patients may be successfully rehabilitated with dental implants.

Clinical and histologic healing of lichenoid oral lesions following amalgam removal: a prospective study.

OBJECTIVE: This study aimed to see whether clinical healing after amalgam removal corresponds to histologic healing, i.e., a complete disappearance of any histologic sign of lichenoid lesion. STUDY DESIGN: The study evaluated 64 patients with lichenoid lesions and at least one amalgam filling. RESULTS: After amalgam removal, complete clinical healing was obtained in 14 patients (22%) and was significantly related to lesion topography (χ(2) 4.7; P < .05) and positive patch test (χ(2) 6.3; P < .01). Complete histologic healing was obtained in only 7 cases (50% of clinically healed patients), and was significantly related to the combination of positive patch test and strict contact with amalgams (Fisher's exact test P < .01). CONCLUSIONS: Contact with amalgams and positive patch testing are good but not absolute indicators of the beneficial effect of amalgam replacement. In addition, complete clinical healing does not necessarily mean a disappearance of the histologic characteristics of OLL/OLP lesions.

A rare case of congenital epidermoid cyst of the hard palate.

Epidermoid cysts are benign conditions that are thought to derive from abnormally situated ectodermal inclusions in the oral cavity. They are generally found in hands, fingers, feet, ovaries and testicles but in oral cavity they represent a very rare event. This is the first case of an intraosseous epidermoid cyst situated in the hard palate. Healing was uneventful and there was no sign of recurrence in 2-years follow-up.

Iodine in evolution of salivary glands and in oral health.

The authors hypothesize that dietary deficiency or excess of iodine (I) has an important role in oral mucosa and in salivary glands physiology. Salivary glands derived from primitive I-concentrating oral cells, which during embryogenesis, migrate and specialize in secretion of saliva and iodine. Gastro-salivary clearance and secretions of iodides are a considerable part of "gastro-intestinal cycle of iodides", which constitutes about 23% of iodides pool in the human body. Salivary glands, stomach and thyroid share I-concentrating ability by sodium iodide symporter (NIS) and peroxidase activity, which transfers electrons from iodides to the oxygen of hydrogen peroxide and so protects the cells from peroxidation. Iodide seems to have an ancestral antioxidant function in all I-concentrating organisms from primitive marine algae to more recent terrestrial vertebrates. The high I-concentration of thymus supports the important role of iodine in the immune system and in the oral immune defence. In Europe and in the world, I-deficiency is surprisingly present in a large part of the population. The authors suggest that the trophic, antioxidant and apoptosis-inductor actions and the presumed antitumour activity of iodides might be important for prevention of oral and salivary glands diseases, as for some other extrathyroidal pathologies.