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Objective: We present our preliminary experience with the use of autologous cell cultures of buccal mucosa (BM) in urethral repair., Patients and Methods: Five patients with urethral stenosis underwent staged urethral reconstruction with MB autologous cell culture grafts. MB biopsies were obtained from each patient. Keratinocytes and fibroblasts were isolated. This cellular suspension was seeded into Petri dishes. The cultures were kept in chemically specific ground for keratinocyte cultures. Once they reached the proper confluence and extension for urethral reconstruction, the cultures were transplanted in the patients. During the first stage of surgery, after the removal of healing tissues, the MB culture grafts were transplanted in order to recreate a neo-urethral plate. Six months later, the neo-urethral plate was re-tubularized., Results: Average follow-up was 24 mo. We reported successful staged reconstruction in 2 cases (40%). Three cases (60%) were unsuccessful. One patient developed a scar retraction of the grafts after the first stage of surgery, which prevented broad urethral reconstruction. Two patients who had completed the staged reconstructive process,developed a re-stenosis. There were no reported graft site infections and none of the grafts was rejected., Conclusions: We report the procedure in order to obtain and use an MB homologous cell culture. Using autologous material reduced the surgical time and wiped out the risk of rejection; on the other hand, the tissue was so thin and with no adequate scaffold that the healing retraction of the graft was increased, thus compromising the urethral reconstruction. Preliminary results confirm that bio- engineering applied to urethral surgery is far from obtaining adequate tissue with reference to extension, thickness and biological features.

Aim: The study was designed to evaluate the clinical treatment outcome of placing transmucosal implants into extraction. The purpose of the present clinical study was to test whether peri-implant bone defects can successfully be filled by applying both the bone and the bioresorbable materials for the guided tissue regeneration., Methods: Twelve patients who required extraction of a single molar were treated with immediate placement of an ITI implant (Dental Implant System). Guided bone regeneration (GBR) technique was always applied simultaneously using deproteinized bovine bone mineral. Implants and bone were covered with a resorbable collagen membrane. Clinical measurements were taken at 6 sites around each implant. Radiological and clinical parameters were measured at the time of implant placement and at follow-up after 1, 3, 6, 12 and 24 months. Prosthetic rehabilitation was performed 3 months after surgery using a porcelain fused to metal crown., Results: Soft tissue healing, at all sites, was free of complications, independently on the width of bone defect. Radiographs showed strength contact between peri-implant bone and the fixture without any defect between bone and implant. Clinical examination showed absolute implant stability complying with Albrekts-son's requirements., Conclusions: The use of GBR with resorbable membrane to cover Bio-oss, in association with immediate implant insertion at posterior sites when there is a wide bone defect, also allows early defect filling and good stability, already in the first month, with the possibility of prosthetic loading after only 3 months.

The nervous system contributes to the pathophysiology of peripheral inflammation and a neurogenic component has been implicated in many inflammatory disease, including oral diseases. Neurogenic inflammation should be regarded as a protective mechanism wich forms the first line of defense and protects tissue integrity. However, prolonged noxius stimulation may result in the inflammatory response. This review focuses on the evidence suggesting that neuropeptides have a pivotal role in the complex cascade of chemical activity associated with oral diseases. The pathophysiology is complex and neuropeptides are not solely responsible for the initiation and progression of the disease. However, since neuropeptides and inflammatory modulators are released together during the inflammatory response, it will be impossible to assign a specific role to each until work with selective antagonists is completed.

Verruciform xanthoma is a rare benign lesion of unknown etiology and pathogenesis, although an inflammatory process seems to be implicated in its origin. It usually shows a slow-growing small lesion which can be sessile or pedunculated and has a typical rough and granular surface. A clinical case of an asymptomatic verruciform xanthoma of the ventral surface of the tongue in a 24-year-old male is reported. The lesion was noticed for the first time during a routine dental examination and it appeared as a sessile whitish verrucous lump hard in texture. An incisional biopsy followed by the excision of the whole lesion was performed. The histological and immunohistochemistry examinations were carried out using antibodies CD68-KP1, CD68-PGM1, alpha-1-antitrypsin and vimentin, desmin, cytokeratins, NSE and S-100. Histology showed epithelial degeneration. The connective tissue papillae were entirely occupied by foamy cells that were positive for CD68-KP1, CD68-PGM1, alpha-1-antitrypsin and vimentin and negative for desmin, cytokeratins, NSE and S-100. The foamy cells were characterized by a large granulous cytoplasm and small picnotic nuclei. In accordance with the literature, the immunohistochemistry analysis confirmed that foamy cells are likely to have a macrophagic origin and that epithelial degeneration could be correlated with the pathogenesis of this lesion.

Dysphagia, defined as a difficulty in swallowing of fluids and/or food, is one of the most frequent symptoms of oesophageal, gastrointestinal or ENT diseases. Interestingly, dysphagia can be also the initial or late symptom of several oral diseases: e.g. traumatic ulcerations, immunomediated or infectious lesions, malignant neoplastic disease or mucositis in chemio-radiotherapy. The presence of this frequent symptom, with or without oral evident lesions, can suggest the presence of oral or perioral diseases, promoving adequate diagnostic-therapeutic management. In this paper, authors describe aetiology, pathogenesis and clinical aspects of oral diseases, as being more frequently associated with dysphagia; moreover, they describe the most important clinical and epidemiological features of systemic diseases associated with dysphagia.

Utiling zirconium characteristics, a biomaterial with high affinity with bone and gum, we have positioned in the same patient 2 transmucosal implants in titanium with a coronal ring in zirconium in 2 different manners. The first fixture was positioned with the ring in zirconium at the same level of the gum in order to obtain a good periodontal healing and esthetic without metallic transparencies. The second postestractive implant was positioned with the zirconium ring at the level of the crestal bone in order to reduce the gap between the fixture and the alveolar bone and to avoid the use of a resorbable barrier relying on the osteointegrative properties of zirconium.

Vatous observations carried out in the course of the years have shown that certain neuropeptides have a possible role to play as inflammation mediators. The substances on which attention has been principally focused are: substance P, calcitonin gene-related peptide, capsaicin an histamine. Knowledge acquired in this field, however, does not yet permit us to sufficiently clarify the role, not to speak of the possible action mechanism, on the basis of which these neuropeptides act, although it is confirmed that these substances have been found first in laboratory animals and later also in human tissues in the course of experimentally induced neurogenic inflammation. The need to know more and more about inflammatory mechanisms and the increasingly complex possibilities offered by the application of technology in the field of medical research have led to many small advance in our knowledge of what is involved in inflammation. In fact it has been understood that behind the typical signs of inflammation (the famous four cardinal signs of Celsus: pain, redness, swelling, heat) no abstract entities or strange alchemies are concealed, but a series of well-known, classified substance, the so-called "inflammation mediators", namely a variety of substances of cellular or plasmatic origin united by the fact that exist, in stationary state conditions, in the form of inactive precursors, or sequestered in intracellular sites where they are unable to carry out their action. Following an inflammatory stimulus, they are activated, or their synthesis can be induced, or their release from intracellular sequestration sites in favoured; in any case they are stored in the disturbance district in concentrations that are such as to act on their respective targets, triggering event s that characterise the various stages of the inflammatory process.

Surgery for impacted third molar is often characterized, in the postoperative period, by pain, trismus and swelling. The study evaluates temperature variations of mucosa and skin after application of ice packs, in three different modalities, to the region overlying the surgical site. The goal was to identify any correlation between variations of temperature and postoperative clinical symptoms. For this purpose we selected 54 patients programmed for impacted third molar surgery. The patients were divided into three groups of 18. Time and frequency of application of the ice pack varied in the three groups; 5'/30' (group 1); 10'/60' (group 2); 20'/60' (group 3). During the four hours following surgery, temperatures of mucosa and of skin at the surgical site were measured with high-precision thermocouples, maximum response 5". The results indicate that application of an ice pack for 5'/30' or for 10'/60' controls the temperature of the mucosa post-surgery more effectively, and that the duration of surgery appears not to influence temperature variations. In the postoperative phase we recommend a rational application of ice packs appropriate to the constitution of each patient.

Oral mucosa is frequently involved in a group of genetic diseases, which affect the skin and other organs, particularly the central nervous system. The lesions may be of characterized by inflammations in neurocutaneous syndromes and by tumoral lesions in those diseases with defects of DNA repair. The teeth are mainly involved in progeria, while jaw keratocysts are highly characteristic in Gorlin's syndrome.

Background: The replacement of lost teeth by fixed or removable dentures is very important in order to re-establish a correct phonetic and masticatory function and to restore a good aesthetical appearance to the patient. However when dental prosthesis, particularly the removable ones, become inadequate they may be responsible for a series of more or less dangerous lesions of the oral tissues. In this work a clinical and epidemiological study regarding the modality and the state of preservation of dentures in time has been carried out; moreover the possible presence of mucous membrane lesions in subjects with removable dentures has been investigated., Methods: Seventy-height subjects with partial or totally removable dentures have been examined. After a general and stomatological anamnesis a thorough objective examination of the oral cavity was carried out in order to evaluate the removable denture state and the possible presence of mucous lesions correlated to them., Results: Women from sixty to seventy represent the greatest part of the subjects with removable dentures examined in this study. Nine years is the medium range of removable denture permanence in the mouth; in the greatest part of acrylic dentures the resin has never been replaced, they are inadequate and show a poor state of preservation. Twenty-height percent of the subjects examined report different troubles and in 46% of the cases the presence of dentures causes mucous lesions., Conclusions: Since the greatest part of removable dentures examined in this study are inadequate and badly preserved, patients with removable dentures had better check them more often in order to allow the dentist to evaluate the functionality and the care of the dentures and to discover in time the possible presence of mucous lesions.

Mucositis are a common problem in patients undergoing active treatment: oral complications can be painful, impact on quality of life and contribute to significant compliance problems that may require suspension of the treatments. There is no agreement on oral care prevention and treatment protocols and on the scientific bases of the measures recommended. Seventy articles published from 1980 to 1996 were identified using the key-words mucositis, antineoplastic agents, chemotherapy and radiotherapy and 42 double-blind clinical trials were selected and analysed. The limitedness of sample sizes, the heterogeneity of patients' treatments (chemo and radiotherapy, different dosages and drugs) and oral care protocols (frequency of oral care, products used), the differences in evaluation scales used and in the outcomes selected (effect on pain, number of ulcers, severity of ulcers) did not allow to compare studies, and therefore to arrive to a consensus on the effectiveness of the treatments studied. Unfortunately, to date, there are no solutions to such a problem and, once the mucositis occurs, the best results can be obtained only on pain control.

Professional diseases and stomatomucositis due to allergic factors represent two important aspects of odontostomatology in which there is a clear relationship with environmental factors. The paper analyses the etiopathogenetic and clinical aspects of the most common forms of disease which lead to alterations of the oral mucous.

The authors describe the therapeutic modalities for the care of epidermoid carcinoma of the buccal mucosa. Surgery and radiotherapy are equally effective in the early lesions, while for the advanced disease the therapy should always be combined.

A series of 25 cases with clinical signs indicative of oral lichen planus was examined. Samples stained with haematoxylin-eosin as for traditional histology and others for DIF were taken in each case. The results obtained by both techniques were then compared with the clinical picture. It is concluded that DIF is a valuable diagnostic aid in doubtful cases.

The literature on the subject is reviewed, special attention being paid to the complex problems of aetiological and pathogenetic classification involved by such lesions in the oral cavity. Stress in salso laid on topographical and histological aspects of pigmented lesions of melanocytic origin.

The authors, though aware of not having completely exhausted the subject of the oral cavity in the elderly, believe that in this paper they have made a further contribution to knowledge and clinical classification of some diseases affecting the oral mucosa of elderly dentistry patients. They then point out that the stomatologist cannot longer ignore this pathology, which is increasingly encountered as a result of the higher number of elderly patients requiring dental therapy.