Clinicopathologic data of individuals with oral lichen planus : a Brazilian case series

The aim of the present series was to analyze the sociodemographic characteristics, clinicopathologic features, and oral health-related quality of life of 41 individuals with oral lichen planus (OLP). In a retrospective analysis (1998-2018), individuals with a clinical diagnosis of OLP from a referral service of Oral Medicine of Brazil were invited for follow-up. The individuals were assessed using the Oral Health Impact Profile-14 (OHIP-14) form. Histopathological data were reviewed according to the latest criteria proposed by the American Academy of Oral and Maxillofacial Pathology (AAOMP/2016). This series mainly consisted of females (70.7%) in their forties (31.7%). The buccal mucosa (68.2%) was the most commonly affected site. Reticular (56.1%) and erosive (34.3%) appearances were the most frequent. According to OHIP-14, individuals with OLP at multiple sites in the oral cavity showed worse values in the handicap domain and those who did not respond to corticosteroids showed a higher score on the psychological discomfort domain. The findings of the present study, using the AAOMP/2016 criteria, agree with case series and retrospective studies reported in the literature. Besides, OLP in its more severe clinical forms had an influence on patient quality of life

Evaluation of peripheral nerve fibers and mast cells in burning mouth syndrome

Abstract Emerging evidence has revealed a cross-talk in the etiopathogenesis of burning mouth syndrome (BMS) related to peripheral nerve fibers (NF) and neuropeptides secreted by mast cells. Here, we investigated the S-100+ density and PGP 9.5+ integrity of peripheral NF and the tryptase+ mast cell density in the oral mucosa of BMS patients and healthy individuals. A total of 23 oral mucosa specimens (12 BMS and 11 controls) were evaluated. The clinical diagnosis of BMS was based on a careful examination, excluding other local and systemic causes. Samples were taken from an incisional biopsy of the tongue mucosa of individuals with symptomatic BMS, while the margins of the non-neoplastic tongue biopsy served as controls of healthy individuals. Immunohistochemistry was performed to determine the density/mm2 of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells. Similar densities of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells were found in cases of BMS, with a median value of 3.70, 0.70, and 29.24/mm2, respectively, and in the control group, with a median value of 2.60, 0.80, and 26.01/mm2, respectively (p > 0.05). Moreover, the relationship between S100+ and PGP 9.5+ peripheral NF was the same in both groups (p = 0.70). This study demonstrated that there were no alterations in the density and integrity of peripheral NF in the tongue of symptomatic BMS patients. However, the sensitization of peripheral NF in this disease may not depend on mast cell density

Clinical assessment of jaw bone tissue prior to endosseous dental implant palcement : a systematic literature review

Objectives: The aim was to evaluate the evidence for diagnostic accuracy of clinical methods to assess bone density, bone quantity or bone quality prior to and during dental implant placement. Methods: A PubMed literature search with specific indexing terms and a hand search were made. Three reviewers read retrieved titles and abstracts using inclusion and exclusion criteria. Included articles were read in full text and data extracted. Then, relevant original studies were assessed with the aid of QUADAS (Quality Assessment of Diagnostic Accuracy Studies) tool. Results: The literature search yielded 145 titles, of which 71 were selected based on including/excluding criteria and read in full text. After that only 13 original studies, which elucidated the efficacy of clinical methods, remained. Six studies presented the results of the test method as compared to those of a reference method. Four presented their results as diagnostic accuracy expressed as relevant measures. Diagnostic imaging methods were the only method used to assess bone tissue prior to implant placement. The other clinical methods reviewed evaluated the bone tissue but at the time of implant placement. Conclusions: Considering the few number of original studies that had a reference method, there is insufficient evidence for the diagnostic accuracy of clinical methods to assess bone density, bone quantity and bone quality prior to or during endosseous dental implant placement

Efficacy of clinical methods to assess jawbone tissue prior to and during endosseous dental implant placement : a systematic literature review

PURPOSE: To evaluate the evidence for the diagnostic accuracy of clinical methods to assess bone density, quantity, or quality prior to and during dental implant placement. MATERIALS AND METHODS: A PubMed literature search with specific indexing terms and a hand search were made. From the retrieved titles and abstracts, 3 reviewers selected publications on the basis of predetermined inclusion and exclusion criteria. Data were extracted from the selected publications using a protocol. Original studies were interpreted with the aid of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. RESULTS: The literature search yielded 145 titles and abstracts, of which 71 were selected and read in full text. Seven studies were judged relevant. In 1 study, no method was presented as the test method. In 6 studies, the results of the test method were compared to those of a reference method. However, only 1 study presented the results in terms of percentage of correct diagnoses. In that study, the use of periapical radiography together with reference images yielded correct assessment of the trabecular pattern of the mandible in 3 categories in 58% of the sites. The kappa index of interobserver agreement was 0.35 and intraobserver agreement was 0.67. Corresponding kappa values for 4 classes of bone quality presented by Lekholm and Zarb were 0.33 and 0.43, respectively. No study examined the accuracy of the method originally described by Lekholm and Zarb. CONCLUSION: The evidence for the efficacy of clinical methods to assess jawbone tissue prior to and during endosseous dental implant placement is sparse. This emphasizes the need for studies that incorporate accepted methodologic criteria for diagnostic efficacy. PMID: 17465355 [PubMed - indexed for MEDLINE

Marginal bone level changes and implant stability after loading are not influenced by baseline microstructural bone characteristics : 1-year follow-up

ObjectiveThe aim of this study was to investigate the influence of different bone tissue characteristics of implant sites on changes in marginal bone level and implant stability over time. Material and methodsOne hundred and one implants were inserted in 41 patients. Cortical bone thickness of the alveolar ridge was measured on computed tomography (CT) images. Histomorphometric and microtomographic analyses (microCT) were performed in bone specimens obtained by using a trephine bur, at first drilling. Implant stability quotient (ISQ) measured by resonance frequency analysis (RFA) was registered at implant insertion. Implant stability quotient was measured also at the stages of uncovering, loading and at the 1-year follow-up, when standardized periapical radiographs were taken to measure the marginal bone level (MBL). Descriptive statistics, Spearman's rho correlation and multiple linear regression were used for data analysis (P0.05). Bivariate correlation also showed no association among these microstructural parameters and the outcomes evaluated. There was no correlation between cortical thickness and MBL changes (r=-0.029; P=0.832) and between cortical thickness and ISQ changes (r=0.145; P=0.292). ConclusionMicrostructural bone characteristics of implant sites have no effect on changes in marginal bone level and implant stability as measured by RFA. Bone morphology cannot predict implant treatment success over time

Bone tissue microarchitectural characteristics at dental implant sites. Part I : Identification of clinical-related parameters

Abstract Objective: To identify the characteristics of bone tissue microarchitecture by microCT at dental implant bone sites, describing them in terms of clinical parameters. Material and methods: Forty-six bone implant sites of the maxilla and mandible from 32 volunteers were evaluated by conventional radiographs and CT scans. During the installation of each implant, bone biopsies were removed using a trephine bur at the first drilling to prepare the socket implant. Each sample was evaluated by microCT and dimensional parameters measured. Results: Factor analysis summarized the microparameters into four components, which accounted for 92.8% of the total variance. The identified factors were (1) architecture - variables affecting 3D trabecular bone configuration and organization, (2) density - variables relating to surface/volume ratios and volume/volume ratios, (3) bulk - variables relating to the amount of bone and (4) spacing - variable related to the distance between trabeculae and the quantity and organization of marrow spaces. Conclusion: These four summarized factors correspond to clinical and radiographically recognizable parameters used for routine bone quality evaluation for implant treatment planning, which can potentially influence the primary stability of dental implants. The understanding of factors related to bone microarchitecture might reveal important aspects of its mechanical properties, essential for implant success. To cite this article: De Oliveira RCG, Leles CR, Lindh C, Ribeiro-Rotta RF. Bone tissue microarchitectural characteristics at dental implant sites. Part 1: Identification of clinical related parameters. Clin. Oral Impl. Res. xx, 2011; 000-000. doi: 10.1111/j.1600-0501.2011.02243.x. © 2011 John Wiley & Sons A/S

Käkarnas benvävnad : tandläkarens undersökning och bedömning av stor betydelse

Röntgenbilder som tas i kliniken är av stor betydelse. Röntgenbilden kan resultera i en diagnos, användas till att göra en prognos, att förutsäga framtida händelser men är även viktig vid utvärdering av ett behandlingsresultat