8 research outputs found

    Should we call this oral granuloma 'telangiectatic' instead of 'pyogenic'? a case report

    Full text link
    Telangiectatic granuloma, traditionally known as pyogenic granuloma, is a benign vascular tumor that appears in the oral mucosa in response to irritant, inflammatory, or traumatic stimuli. This case has a strong academic focus and will be of interest to dental surgeons. Clinicians should be alert to any gingival overgrowth. We present the case of a 79-year-old patient with a profuse lesion on a gingival papilla. Complete excision was performed followed by a confirmatory pathology study. We review the terminology, semiology, etiopathogenesis, and incidence of the lesion. Soft tissue enlargements of the oral cavity often present a major challenge because they may be produced by a diverse group of pathological processes. A tumor-like growth may be the result of a variation in normal anatomic structures, inflammation, cysts, development anomalies, or a neoplasm. We propose a differential diagnosis with other entities based on histopathology, and stress the importance of close follow-up from the time of diagnosis until surgical treatment and resolution. This case report does not query the validity of pyogenic expression but somehow, it might be misleading. We conclude that, in our case, the term 'telangiectatic' is more appropriate than 'pyogenic.

    Manifestaciones orales y periodontales de la enfermedad inflamatoria intestinal

    Get PDF
    La Enfermedad Inflamatoria Intestinal (EII) incluye la enfermedad de Crohn y la colitis ulcerosa. Numerosos estudios relacionan dichas afectaciones con la manifestación de determinadas lesiones orales. Respecto a la enfermedad periodontal algunos autores la correlacionan con la EII tanto en su prevalencia como en su grado de actividad. Se ha apuntado la alteración de los PMN como posible factor común en la patogénesis de ambas entidades. El propósito de nuestro artículo es revisar las manifestaciones orales que presentan los pacientes afectos de una EII, así como dilucidar su implicación con la enfermedad periodontal. Además se repasa el manejo del paciente odontológico con EII sometido a corticoterapia

    On the cellular and molecular mechanisms of drug-induced gingival overgrowth

    Full text link
    Introduction:Gingival overgrowth has been linked to multiple factors such as adverse drug effects, inflammation, neoplastic processes, and hereditary gingival fibromatosis. Drug-induced gingival overgrowth is a well-established adverse event. In early stages, this gingival enlargement is usually located in the area of the interdental papilla. Histologically, there is an increase in the different components of the extracellular matrix.Objective:The aim of this manuscript is to describe and analyze the different cellular and molecular agents involved in the pathogenesis of Drug-induced gingival overgrowth.Method:A literature search of the MEDLINE/PubMed database was conducted to identify the mechanisms involved in the process of druginduced gingival overgrowth, with the assistance of a research librarian. We present several causal hypotheses and discuss the advances in the understanding of the mechanisms that trigger this gingival alteration.Results:In vitro studies have revealed phenotypic cellular changes in keratinocytes and fibroblasts and an increase of the extracellular matrix with collagen and glycosaminoglycans. Drug-induced gingival overgrowth confirms the key role of collagenase and integrins, membrane receptors present in the fibroblasts, due to their involvement in the catabolism of collagen. The three drug categories implicated: calcineuron inhibitors (immunosuppressant drugs), calcium channel blocking agents and anticonvulsant drugs appear to present a multifactorial pathogenesis with a common molecular action: the blockage of the cell membrane in the Ca2+/Na+ ion flow. The alteration of the uptake of cellular folic acid, which depends on the regulated channels of active cationic transport and on passive diffusion, results in a dysfunctional degradation of the connective tissue. Certain intermediate molecules such as cytokines and prostaglandins play a role in this pathological mechanism. The concomitant inflammatory factor encourages the appearance of fibroblasts, which leads to gingival fibrosis. Susceptibility to gingival overgrowth in some fibroblast subpopulations is due to phenotypic variability and genetic polymorphism, as shown by the increase in the synthesis of molecules related to the response of the gingival tissue to inducing drugs. The authors present a diagram depicting various mechanisms involved in the pathogenesis of drug-induced gingival overgrowth.Conclusion:Individual predisposition, tissue inflammation, and molecular changes in response to the inducing drug favor the clinical manifestation of gingival overgrowth

    Dental root elevator embedded into a subgingival caries: a case report

    Get PDF
    Background: Breakage of surgical instruments is a rare complication. A mistake in operator technique or sub-standard/aged tools could lead to this type of accident. A tooth elevator is an instrument used in minor oral surgical procedures to luxate the tooth or fractured root from its socket. The authors have not found any previously published cases reporting the breakage of a tooth elevator tip which then remained as a foreign body in a hidden caries cavity. Case presentation: A 28-year-old African black male was referred to a hospital in Tanzania for an intraoral radiography. The patient explained that six months previously his mandibular left third molar had been extracted. Whilst the healing process had been satisfactory, he had recently experienced acute oral pain in this region. The dental X-ray showed an image consistent with a piece of broken metal embedded in a distal subgingival caries at the mandibular left second molar. Conclusion: Oral and dental surgeons should take particular care when employing metal instruments with strong force in poorly visible areas. A radiographic study should be carried out when instrument breakage occurs. If an unexpected accident takes place during a surgical procedure, the patient must be informed in accordance with ethical codes, and suitable measures adopted to resolve the issue

    Estudio celular y molecular en cultivos de fibroblastos tratados con fármacos inductores de agrandamiento gingival

    Get PDF
    [spa] El Agrandamiento gingival farmacológico -AGIF- es un dismorfismo gingival provocado por la inducción de fármacos antiepilépticos -Fenitoína-, antagonistas del calcio -Nifedipina- e inmunosupresores -Ciclosporina-. En los primeros casos de AGIF, se creía que la alteración histopatológica residía en un aumento de la población celular de los fibroblastos -Hipótesis nula-. Este estudio quiere demostrar que esta alteración se produce en la matriz extracelular -fibras colágenas y glicosaminoglicanos de la sustancia fundamental: Los fármacos inductores del Agrandamiento gingival no provocan una hiperplasia gingival secundaria a la proliferación celular de fibroblastos -Hipótesis alternativa-. Para ello se proponen unos objetivos: 1-Determinar si cultivos de fibroblastos de encía humana son sensibles a la acción de fármacos inductores de Agrandamiento gingival. 2-Observar el efecto de estos fármacos en cultivos primarios de fibroblastos procedentes de las muestras examinadas -estudio de la viabilidad celular-. 3-Cuantificar si hay efecto farmacológico en la transcripción génica del Factor de Crecimiento Transformador ß (TGFß), del colágeno y de la colagenasa. 4-Observar si hay efecto farmacológico en la síntesis del colágeno y del TGFß. Se tomaron muestras gingivales de pacientes, una de ellas sin relación con la administración de fármacos inductores conocidos de Agrandamiento gingival. Otra muestra se tomó de un paciente transplantado renal sometido desde hacía 2 años a ciclosporina -125 mg/12h-. Se observaron las muestras a microscopía óptica para ver las características histopatológicas y una porción se fragmentó en explantes y se cultivó en medio esencial para conseguir un número determinado de fibroblastos. Se aplicaron los tres fármacos inductores a unas dosis preestablecidas -según estudios in Vitro consultados- y se observó la Viabilidad de los fibroblastos para el análisis de la proliferación celular. En una segunda fase, se estudió la expresión del mRNA de tres proteínas implicadas en la patogenia del AGIF -colágeno, colagenasa y TGFβ-. Finalmente se observó la traducción proteica del colágeno y del TGFβ. Los resultados permitieron comprobar que no se produjeron cambios en la proliferación fibroblástica para la inducción con nifedipina y ciclosporina. Fenitoína produjo una reducción de esta proliferación como si hubiera un efecto tóxico del fármaco. En la transcripción génica de las proteínas consideradas se observaron aumentos para los tres fármacos inductores. En la expresión proteica del colágeno tampoco se apreciaron cambios. En base a las muestras analizadas se puede considerar que hay una afectación en la matriz extracelular por la inducción farmacológica al comprobar aumentos significativos en mRNA de colágeno, TGFβ y colagenasa. Aunque hay factores que pueden actuar en la post-transcripción que alteren la expresión de estas proteínas y la actividad de la colagenasa. Las conclusiones del estudio han sido: 1. Los fibroblastos gingivales de cultivos primarios son sensibles a fármacos inductores de Agrandamiento gingival -fenitoína, nifedipina y ciclosporina-. 2. Los fármacos inductores de Agrandamiento gingival no provocan hiperplasia gingival secundaria a la proliferación celular de fibroblastos. 3. Los fármacos inductores provocan un incremento significativo de la transcripción del TGFß, colágeno y colagenasa. 4. Los fármacos inductores no producen un incremento de la traducción del colágeno, con repercusión en la matriz extracelular

    Manifestaciones orales y periodontales de la enfermedad inflamatoria intestinal

    No full text
    La Enfermedad Inflamatoria Intestinal (EII) incluye la enfermedad de Crohn y la colitis ulcerosa. Numerosos estudios relacionan dichas afectaciones con la manifestación de determinadas lesiones orales. Respecto a la enfermedad periodontal algunos autores la correlacionan con la EII tanto en su prevalencia como en su grado de actividad. Se ha apuntado la alteración de los PMN como posible factor común en la patogénesis de ambas entidades. El propósito de nuestro artículo es revisar las manifestaciones orales que presentan los pacientes afectos de una EII, así como dilucidar su implicación con la enfermedad periodontal. Además se repasa el manejo del paciente odontológico con EII sometido a corticoterapia

    Dental root elevator embedded into a subgingival caries: a case report

    No full text
    Background: Breakage of surgical instruments is a rare complication. A mistake in operator technique or sub-standard/aged tools could lead to this type of accident. A tooth elevator is an instrument used in minor oral surgical procedures to luxate the tooth or fractured root from its socket. The authors have not found any previously published cases reporting the breakage of a tooth elevator tip which then remained as a foreign body in a hidden caries cavity. Case presentation: A 28-year-old African black male was referred to a hospital in Tanzania for an intraoral radiography. The patient explained that six months previously his mandibular left third molar had been extracted. Whilst the healing process had been satisfactory, he had recently experienced acute oral pain in this region. The dental X-ray showed an image consistent with a piece of broken metal embedded in a distal subgingival caries at the mandibular left second molar. Conclusion: Oral and dental surgeons should take particular care when employing metal instruments with strong force in poorly visible areas. A radiographic study should be carried out when instrument breakage occurs. If an unexpected accident takes place during a surgical procedure, the patient must be informed in accordance with ethical codes, and suitable measures adopted to resolve the issue
    corecore