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Odontogenic fibroma (OF), a rare odontogenic tumor of mesodermal origin, has been thought to originate from either dental follicle, periodontal ligament, or dental papilla [1]. Different studies reported high variability in the incidence rate as being between 3 and 23% of all odontogenic tumors [2,3]. OF manifests a dual character at the histopathological examination showing odontogenic epithelial structures mimicking those observed in biopsy of ameloblastoma and, in addition, peculiar fragments of cellular stroma. The clinical and radiological features of OF are similar to other odontogenic and/or non-odontogenic tumours and the differential diagnosis may first occur at fine-needle aspiration biopsy.

ABSTRACTThe aim of this report is to illustrate the case of a patient whose myofascial pain syndrome was misdiagnosed as odontogenic pain, and who was treated using irreversible dental procedures. Even if dental pain commonly has an odontogenic etiology, it is also possible that pain arising from different orofacial sites such as jaw muscles, maxillary sinus, or nervous structures can be referred to the teeth. When the etiology of a dental pain condition cannot be clearly identified, it is necessary to consider all possible causes of dental pain, which may also be nonodontogenic. The need for comprehensive examination and careful diagnosis before irreversible dental treatment is emphasized.

Background:The purpose of this longitudinal study was to determine the clinical status and the composition of the subgingival microbiota of dental implants and natural teeth in patients with a history of periodontitis. Methods: Twenty‐five partially edentulous patients treated for moderate to advanced adult periodontitis and having a total of 42 implants participated in this 3‐year study. The assessment of clinical status was done 1, 2, and 3 years after prosthetic loading (T1, T2, and T3, respectively). Clinical parameters evaluated included probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI). The subgingival microbiota at peri‐implant and periodontal sites were analyzed at T1 and T2. Results:No significant difference in clinical parameters between implants and teeth and within the 2 groups between different time points was observed through the study. PD and CAL measurements of sampled periodontal and peri‐implant sites did not show any statistically significant difference through the study and between the 2 groups. PI of sampled periodontal sites showed a statistically significant improvement during the study. From the morphological observation of the subgingival microbiota, a significant difference in the composition of motile rods between implants and teeth was found at T1. There were no differences detected in the subgingival microbiota, culturally identified at peri‐implant and periodontal sites for the duration of the study. Conclusions:In conclusion, implants were colonized by the indigenous periodontal microbiota and were well maintained in patients with a history of periodontitis. No significant association between progressing or non‐progressing periodontal or peri‐implant sampled sites in terms of loss of attachment and infection with at least one of the searched periodontal pathogens was found, suggesting that the presence of putative periodontopathogens at peri‐implant and periodontal sites may not be associated with future attachment loss or implant failure. J Periodontol 1999;70:1322‐1329

The aim of this studywas to examine the subgingival microflora associated with failing implants, and to determine their susceptibility to commonly used antibiotics in periodontal therapy and dental practice. Thirteen partially edentulous patients with 19 failing implants were selected. Clinical examination included probing depth, attachment level, gingival index, plaque index, and radiographic analyses. Two subgingival plaque samples were taken from each failing implant and analyzed for microbial composition. Fusobacterium nucleatum, Porphyromonas gingivalis, and Prevotella intermediawere the prevalent cultivable microflora. Antimicrobial susceptibility of isolates was determined by the agar dilution technique. Antibacterial activity of penicillin G, amoxicillin, amoxicillin‐clavulanate, and the combination amoxicillin‐metronidazole was significantly higher than with other antibiotics tested. These data indicated that the commonly‐used antibiotics were highly effective against bacteria isolated around failing implants, which would suggest the use of these antibiotics to control peri‐implant infections. J Periodontol 1995; 66:69–74.

The periodontal status and subgingivalmicroflora of insulin‐dependent juvenile diabetic (JD) patients (n = 16, mean age = 11.3) were compared with that of their non‐diabetic cohabiting healthy siblings (HS, n = 16, mean age = 13.2). JD patients were monitored every 3 months for levels of glycosylated hemoglobin (HbAlc) and clinical and microbial parameters were measured 6 weeks before drawing blood for levels of HbAlc(M% = 8.76). Clinical indices, measured for the entire permanent dentition, included: probing depth (PD), attachment level (AL), sulcus bleeding index (SBI), and plaque index (PI). Subgingival plaque samples were obtained at 2 sites from each subject; whenever possible, the site with the deepest probing depth and the mesial aspect of the maxillary right first molar were used. Microbial analyses were determined by cultural characteristics and biochemical tests. No significant differences were detected in any of the clinical indices for the entire dentition. The mean AL for JD sites was 2.32 ± 0.83 mm and for HS sites was 2.2 ± 0.85 mm. Mean percentage of total cultivable anaerobic microflora included Capnocytophagaspp. (JD, 13.21%; HS, 11%) and Porphyromonas gingivalis(JD, 5.1%; HS, 7.9%). Differences between the two groups were not statistically significant. When cluster analysis was performed on sampled sites, one cluster group in JD patients showed significantly elevated P. gingivalisand lower Capnocytophagaspp. levels as compared to the overall mean. The clinical parameters of this cluster were characterized by statistically significant greater loss of attachment and probing depth. These data would suggest few differences between JD patients and their HS in this population. J Periodontol 1995;66:452–461.

This study examined for3 yearsthe changes in periodontal status and the possible correlations with selected subgingival microbiota and diabetic conditions in a group of 16 insulin‐dependent diabetes mellitus (IDDM, JD) patients as compared with their 16 healthy cohabiting siblings (HS). JD patients were monitored every 3 months for levels of glycosylated hemoglobin (HbA1c). Clinical and microbiological parameters were measured 6 weeks before drawing blood to determine levels of HbA1c. Periodontal parameters were measured at baseline (T0), year 2 (T2), year 3 (T3) and included: probing depth (PD), attachment level (AL), sulcus bleeding index (SBI), and plaque index (PI). Two sites in each patient were selected for microbial samples: a mesio‐facial aspect of the maxillary right first molar (defined as constant site, CS) and a site with the greatest probing depth (defined as deepest site, DS). Microbial samples were analyzed by culture techniques. No significant differences in clinical parameters were found between diabetics and healthy siblings at any examination. The SBI in the non‐diabetic group at T2 and at T3 was significantly lower than at baseline. PD and AL of constant sites in the diabetic group at T3 were significantly higher than baseline. There was a significant increase in Prevotella intermediaat T3 as compared with baseline for deepest sites in the diabetic group. Cluster analysis revealed, in a former study, two clusters (IV and V) at baseline which were significantly different from the overall mean regarding composition of Porphyromonas gingivalisand Capnocytophagaspp. They were not significantly different for periodontal parameters from T0 to T3. These data would suggest no significant differences in clinical parameters between the diabetics and non‐diabetic siblings throughout this 3‐year longitudinal study. J Periodontol 1998;69:120–128.

The case of a family, followed for 5 years and showing an exceptionally high prevalence of Generalized Juvenile periodontitis (GJP), is presented. Two siblings were affected by a severe form of GJP meanwhile the dycorial twin of one was periodontally healthy. Both the affected siblings showed infection by Actinobacillus actinomycetemcomitans(Aa), but only one presented a reduced Chemotaxis of the peripheral PMNs. The dycorial twin consistently displayed a freedom from Aa and a reduction in the peripheral PMNs Chemotaxis. The extraction of the compromised teeth in the two affected siblings has been followed by colonization of new sites by Aa; only repeated administration of systemic tetracyclines seems to protect the subjects from colonization of other sites. These findings may contribute to the understanding of the etiology, pathogenesis, and therapy of juvenile periodontitis. J Periodontol 1990;61:590–596.

The purpose of this studywas to evaluate the recolonization patterns of the subgingival microflora of adult periodontitis patients after a single session of scaling and root planing. In each of eight patients, three clinically diseased sites were investigated microbiologically by darkfield microscopy and cultural analysis. After initial clinical and microbiological parameters were determined, each subject received a single session of scaling and root planing but no oral hygiene instructions. Clinical indices were measured and microbial parameters were reassessed 7, 21, and 60 days after treatment in a manner such that each of the test sites was sampled only once after treatment. Recolonization was evaluated by matching any single site with its own preoperative site. A significant improvement in probing depth was noted for up to 60 days after treatment, while the gingival index did not change markedly during the course of the study. The microbial composition of treated sites 7 days after scaling and root planing, as determined by both cultural and darkfield data, was similar to that of periodontally healthy sites. Differences between cultural and darkfield data became apparent at the 21 day sampling point. The darkfield data showed that the sites consisted of cocci with few spirochetes. Cultural data demonstrated that the majority of the cocci were anaerobic, namely Streptococcus intermedius, Veillonella parvula, and Peptostreptococcus micros. At 60 days, there was no significant variation in any of the parameters from pretreatment levels. The most prevalent anaerobic rods prior to and 60 days after therapy were Fusobacterium nucleatum, Bacteroides gingivalis, and B. intermedius. These results indicate that a single session of scaling and root planing is clearly insufficient to maintain a healthy subgingival microflora. The conflicting findings between darkfield microscopy and cultural microbiology and between darkfield microscopy and clinical gingival inflammation suggest that darkfield microscopy is inadequate to identify a pathogenic microflora. J Periodontol 1990; 61:579–584.