Expression and Localization of aquaporin‐1 in Temporomandibular Joint Disc with Internal Derangement

Background: Internal derangement is the most frequent arthropathy affecting the temporomandibular joint, where its commonest form is anterior disc displacement with or without reduction. Despite the frequency of the disorder, the biochemical features of displaced discs are still unclear. Methods: We investigated the expression pattern and localization of aquaporin‐1, an important channel protein involved in plasma membrane water permeability, in patients with anterior disc displacement (both with and without reduction), with a view to assessing the characteristics of local tissue responses to the microenvironmental changes induced by abnormal mechanical loading of the displaced disc. Protein expression was studied by immunohistochemistry in different areas of discs from 18 patients with anterior disc displacement with or without reduction and in four normal controls. Results: A greater proportion of cells immunopositive for aquaporin‐1 were detected in diseased than in normal discs. Whereas protein expression was substantially similar in the different areas of normal discs, a significantly larger number of immunopositive cells were detected in the posterior band of displaced discs without reduction and in the anterior and intermediate bands of those with reduction. Conclusions: These findings suggest that aquaporin‐1 is expressed and upregulated in temporomandibular joint with anterior disc displacement (both with and without reduction)

MMP-7 and MMP-9 Are Overexpressed in The Synovial Tissue from Severe Temporomandibular Joint Dysfunction

Matrix metalloproteinases (MMPs) are tissue-enzymes that play a key role during the remodeling process, such as in inflammatory diseases. MMP-7 and MMP-9 have been shown to be implicated in extracellular matrix homeostasis and in joint disc remodeling. The objective of this study was to determine the relation of MMP-7 and MMP-9 expression with severe temporomandibular joint dysfunction, in particular with anterior disk displacement without reduction (ADDwoR), using an immunohistochemical approach. Therefore, twenty human temporomandibular synovia in the test group and ten in the control group were collected. The results showed there was a statistically significant difference (P\u3c0.001) for morphometric and densitometric analysis of both detected MMPs in control and test groups. In conclusion, MMP-7 and MMP-9 were overexpressed in the synovial tissue of patients with ADDwoR

Human beta-defensin 4 expression in Gianotti-Crosti Syndrome

The Gianotti-Crosti syndrome is a relatively common children dermatosis characterized by a monomorphus erythematous papular rash limited to the face and extensor surface of the arms and legs. Although the pathogenesis is still unclear, infections are considered as the most important factor. Human b-defensins are cationic antimicrobial peptides closely related to bacterial and viral infections of many epithelia. We herein report a case of Gianotti-Crosti syndrome in a 7 year-old Caucasian girl presented with a prominent eruption, consisting of dome-shaped lichenoid papules on her upper and lower extremities, with a spontaneous resolution. Skin biopsy revealed a dense lichenoid lymphohistiocytic infiltrate and showed strong cytoplasmic immunopositivity for human b-defensin-4 in the stratum corneum, stratum granulosum, and stratum spinosum. Considering that b-defensins have been described to be induced by infections, we investigated the expression of human b-defensin-4 by immunohistochemistry in a case of Gianotti-Crosti syndrome, in order to demonstrate that it represents a cutaneous response to skin infections. </p

MRONJ in breast cancer patients under bone modifying agents for cancer treatment-induced bone loss (CTIBL): a multi-hospital-based case series

BackgroundCancer treatment-induced bone loss (CTIBL) is the most common adverse event experienced by patients affected by breast cancer (BC) patients, without bone metastases. Bone modifying agents (BMAs) therapy is prescribed for the prevention of CTIBL, but it exposes patients to the risk of MRONJ.MethodsThis multicentre hospital-based retrospective study included consecutive non-metastatic BC patients affected by MRONJ related to exposure to low-dose BMAs for CTIBL prevention. Patients' data were retrospectively collected from the clinical charts of seven recruiting Italian centres.ResultsMRONJ lesions were found in fifteen females (mean age 67.5 years), mainly in the mandible (73.3%). The mean duration of BMAs therapy at MRONJ presentation was 34.9 months. The more frequent BMAs was denosumab (53.3%). Ten patients (66.7%) showed the following local risk factors associated to MRONJ development: periodontal disease (PD) in three cases (20%) and the remaining six (40%) have undergone PD-related tooth extractions. One patient presented an implant presence-triggered MRONJ (6.7%). In five patients (33.3%) no local risk factors were observed.ConclusionsThis is the first case series that investigated BC patients under BMAs for CTIBL prevention suffering from MRONJ. These patients seem to have similar probabilities of developing MRONJ as osteo-metabolic ones. Breast cancer patients under BMAs for CTIBL prevention need a regular prevention program for MRONJ, since they may develop bone metastases and be treated with higher doses of BMAs, potentially leading to a high-risk of MRONJ

TLR4 expression in ex-Lichenoid lesions—oral squamous cell carcinomas and its surrounding epithelium: the role of tumor inflammatory microenvironment

Abstract: Toll-like receptors (TLRs) regulate innate and adaptive immune responses. Moreover, TLRs can induce a pro-survival and pro-proliferation response in tumor cells. This study aims to investigate the expression of TLR4 in the epithelium surrounding oral squamous cell carcinomas (OSCC) in relation to its inflammatory microenvironment. This study included 150 human samples: 30 normal oral control (NOC), 38 non-lichenoid epithelium surrounding OSCC (NLE-OSCC), 28 lichenoid epithelium surrounding OSCC (LE-OSCC), 30 OSCC ex-non oral lichenoid lesion (OSCC Ex-NOLL), and 24 OSCC ex-oral lichenoid lesion (OSCC Ex-OLL). TLR4 expression was investigated by immuno histochemistry and the percentage of positive cells was quantified. In addition, a semiquantitative analysis of staining intensity was performed. Immunohistochemical analysis revealed that TLR4 is strongly upregulated in LE-OSCC as compared to normal control epithelium and NLE-OSCC. TLR4 expression was associated with the inflammatory environment, since the percentage of positive cells increases from NOC and NLE-OSCC to LE-OSCC, reaching the highest value in OSCC Ex–OLL. TLR4 was detected in the basal third of the epithelium in NLE-OSCC, while in LE-OSCC, TLR4 expression reached the intermediate layer. These results demonstrated that an inflammatory microenvironment can upregulate TLR4, which may boost tumor development

3D Imaging Advancements and New Technologies in Clinical and Scientific Dental and Orthodontic Fields

The recent technological updates in medical field are irrevocably changing the clinical work-flow of dentists, from the diagnosis to the treatment plan approaches and decision-making activities [...

Intracapsular fractures of mandibular condyle: Diagnosis, treatment, and anatomical and pathological evaluations

The aim of this study was to attempt to establish a correlation between condylar localized fracture, onset of anatomicopathological lesions of the articular structures, and determination of ankylosis so as to define appropriate diagnostic and therapeutic procedures. Clinical, arthroscopic, and histological studies were carried out in two patients with a severe temporomandibular joint disorder after a condylar localized fracture. Treatment included removal of the displaced fragments, condylar surface remodeling, suture of retrodiskal perforations, and diskal repositioning. The histological study of the condylar specimens revealed signs of osteoarthrosis of the articular surface and chondroid metaplasia of the bilaminar zone with early onset of ankylosis. Results of this study confirmed the presence of causal relations between condylar localized fracture and ankylosis with alterations in retrodiskal tissue. These relations are found in 1) tissue damage caused by bony fragments remaining in the articular cavity (underestimated and poorly treated fractures), 2) the lesion that occurs in association with mechanical trauma; and, particularly, c) the disk and retrodiskal impairments caused by catabolic and degenerative osteoarthrotic changes secondary to condylar marrow damage. Thus, timeliness and accuracy of the diagnosis of condylar localized fracture are most important, as are correct diagnosis and treatment before the onset of degenerative anatomicopathological lesions

Alveolar bone changes after rapid maxillary expansion with tooth-born appliances: a systematic review

Background: During rapid maxillary expansion (RME), heavy forces are transmitted to the maxilla by the anchored teeth causing buccal inclination and buccal bone loss of posterior teeth. Objective: To systematically review the literature in order to investigate whether RME causes periodontal sequelae, assessed by cone-beam computed tomography (CBCT). Search methods: Fifteen electronic databases and reference lists of studies were searched up to March 2017. Selection criteria: To be included in the systematic review, articles must be human studies on growing subjects, with transversal maxillary deficiency treated with RME and with assessment of buccal bone loss by CBCT images. Only randomized and non-randomized trials were included. Data collection and analysis: Two authors independently performed study selection, data extraction, and risk of bias assessment. Study characteristics (study design, sample size, age, sex, skeletal maturity, type of appliance, daily activation, evaluated linear measurements, observation period, CBCT settings), and study outcomes (loss of buccal bone thickness and marginal bone) were reported according to the PRISMA statement. Results: On the basis of the applied inclusion criteria, only six articles, three randomized clinical trials and three controlled clinical trials were included. An individual analysis of the selected articles was undertaken. The risks of bias of the six trials were scored as medium to low. Limitations: The results of the present systematic review are based on a limited number of studies and only one study included a control group. Conclusions and implications: In all considered studies, significant loss of buccal bone thickness and marginal bone level were observed in anchored teeth, following RME. Further prospective studies correlating the radiological data of bone loss to the periodontal soft tissues reaction after RME are required. A preliminary evaluation of the patient-related risk factors for RR may be advisable when considering to administering RME

Limited Fatty Infiltration Due to Apoptosis in Human Degenerated Temporomandibular Joint Disks: An Immunohistochemical Study

In this study, we hypothesized that caspase 3, which plays a central role in the execution phase of cell apoptosis, could be involved in limiting fatty degeneration of the temporomandibular joint (TMJ) disks and therefore inhibit the TMJ disk tissue from completely degenerating into fatty tissue. Therefore, caspase 3 immunohistochemical expression in human TMJ degenerated disks was studied. Fifty-nine degenerated TMJ disks were stained with Harry\u27s hematoxylin, and they were then examined with light microscopy to detect any pathologic changes typical of fatty degeneration. Sections from the same TMJ disk were immunostained also by a polyclonal anti-caspase 3 antibody. On morphologic observations, 11 disks of 59 degenerated ones also presented a fatty infiltration. Immunostaining with caspase 3 antibody was detected on adipocytes in the cytoplasm as well as the nuclei. Our results sustain the hypothesis that fatty degeneration is limited by apoptosis, being adipocytes immunolabeled by caspase 3 antibody. Hence, apart from the several factors that can trigger degeneration changes in TMJ disk, their appearance, spread, and permanence, at least for fatty degeneration, seem to be influenced by apoptosis

Evaluation of mandibular changes after rapid maxillary expansion: a CBCT study in youngsters with unilateral posterior crossbite using a surface-to-surface matching technique

Objectives: The purpose of this study was to evaluate mandibular asymmetry in youngsters with posterior unilateral crossbite (PUXB), through cone-beam computed tomography and reverse engineering technique, before and after rapid maxillary expansion (RME) treatment. Materials and methods: Forty cone-beam computed tomography (CBCT) images were obtained from all patients at two time points, namely T0 acquired before the placement of a Hyrax expander and T1 after appliance removal. The CBCT scans were segmented and volume rendered into a surface there-dimensional (3D) mesh model. Thereafter, mandibular models were digitally registered by using a “best-fit” algorithm. Surface and volumetric changes, between T0 and T1, were compared by using Student’s t tests. Results: A slight increase of 0.45 cm3 of the total mandibular volume was found at T1 when compared with T0 (p < 0.001). The mandibular hemi-volume on the crossbite side (CB) was slightly smaller than the non-crossbite side both at T0 and T1. However, the mean differences of hemi-volume from the CB (crossbite) and non-CB side between T0 and T1 show a decrease of 0.26 cm3 (p < 0.001). Findings for the surface-to-surface deviation analysis demonstrated a fine percentage of matching at T0 which slightly improved at T1 (p < 0.001). Conclusions: Youngsters affected by PUXB showed a very slight and not statistically significant volumetric and morphological asymmetry between CB side and non-CB side at T0. However, the change in mean differences of 0.26 cm cannot be considered clinically relevant. Clinical relevance: Mandibles in young PUXB patients exhibit only a very mild mandibular asymmetry. Although the statistically significant mean change found right after RME removal cannot be considered clinically relevant, a more consistent sample and a longer follow-up could be of interest in explaining the short-term findings