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Type II testicular germ cell tumors (TGCTs) represent the most frequent malignancy in Caucasian males (20-40 years). Even if diagnosed with disseminated disease, > 80% of patients are cured; however, a small percentage of cases progress and result in death. It is commonly accepted that these cancers arise from a disturbed testicular embryonic niche that leads to the block of gonocyte differentiation. The subsequent development of the invasive seminomas and nonseminomas is due to a combination of genetic, epigenetic and microenvironmentbased alterations (genvironment). Hepatocyte growth factor (HGF) is present in the testicular microenvironment, together with its receptor c-MET, from early embryonic development to an adult stage. In addition, c-MET is a well-known proto-oncogene involved in the onset and progression of various human cancers. Herein, we have investigated the expression and availability of HGF and c-MET in TCam-2, NCCIT and NT2D1 cells, which are type II (T)GCT representative cell lines, and the effect of c-MET activation/repression on the regulation of cancerous biological processes. We found that NT2D1 cells increase their proliferation, polarized migration, and invasion in response to HGF administration. NCCIT cells respond to HGF stimulation only partially, whereas TCam-2 cells do not respond to HGF, at least according to the investigated parameters. Interestingly, the immunohistochemical study of c-MET distribution in TGCTs confirm its presence in both seminoma and non-seminoma lesions with different patterns. Notably, we found the highest c-MET immunoreactivity in the epithelial elements of the various components of TGCTs: teratoma, yolk sac tumor and choriocarcinoma. Type II testicular germ cell tumors (TGCTs) represent the most frequent malignancy in Caucasian males (20-40 years). Even if diagnosed with disseminated disease, > 80% of patients are cured; however, a small percentage of cases progress and result in death. It is commonly accepted that these cancers arise from a disturbed testicular embryonic niche that leads to the block of gonocyte differentiation. The subsequent development of the invasive seminomas and nonseminomas is due to a combination of genetic, epigenetic and microenvironmentbased alterations (genvironment). Hepatocyte growth factor (HGF) is present in the testicular microenvironment, together with its receptor c-MET, from early embryonic development to an adult stage. In addition, c-MET is a well-known proto-oncogene involved in the onset and progression of various human cancers. Herein, we have investigated the expression and availability of HGF and c-MET in TCam-2, NCCIT and NT2D1 cells, which are type II (T)GCT representative cell lines, and the effect of c-MET activation/repression on the regulation of cancerous biological processes. We found that NT2D1 cells increase their proliferation, polarized migration, and invasion in response to HGF administration. NCCIT cells respond to HGF stimulation only partially, whereas TCam-2 cells do not respond to HGF, at least according to the investigated parameters. Interestingly, the immunohistochemical study of c-MET distribution in TGCTs confirm its presence in both seminoma and non-seminoma lesions with different patterns. Notably, we found the highest c-MET immunoreactivity in the epithelial elements of the various components of TGCTs: teratoma, yolk sac tumor and choriocarcinoma.

OBJECTIVES: Stem cells have the ability to rescue and/or repair injured tissue. In humans, it is possible to isolate different types of stem cells from the body. Among these, dental pulp stem cells (DPSCs) are relatively easily obtainable and exhibit high plasticity and multipotential capabilities. In particular they represent a gold standard for neural-crest-derived bone reconstruction in humans and can be used for the repair of body defects in low-risk autologous therapeutic strategies. SOURCES: An electronic search was conducted on PubMed databases and supplemented with a manual study of relevant references. RESULTS: All research described in this review highlight that DPSCs are mesenchymal stem cells that could be used in clinical applications. Unfortunately, very few clinical trials have been reported. Major obstacles imposed on researchers are hindering the translation of potentially effective therapies to the clinic. Both researchers and regulatory institutions need to develop a new approach to this problem, drawing up a new policy for good manufacturing practice (GMP) procedures. We strongly suggest that only general rules be standardized rather than everything. Importantly, this would not have an effect on the safety of patients, but may very well affect the results, which cannot be identical for all patients, due to physiological diversity in the biology of each patient. Alternatively, it would be important to study the role of specific molecules that recruit endogenous stem cells for tissue regeneration. In this way, the clinical use of stem cells could be successfully developed. CONCLUSIONS: DPSCs are mesenchymal stem cells that differentiate into different tissues, maintain their characteristics after cryopreservation, differentiate into bone-like tissues when loaded on scaffolds in animal models, and regenerate bone in human grafts. In summary, all data reported up to now should encourage the development of clinical procedures using DPSCs. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved Objectives: Stem cells have the ability to rescue and/or repair injured tissue. In humans, it is possible to isolate different types of stem cells from the body. Among these, dental pulp stem cells (DPSCs) are relatively easily obtainable and exhibit high plasticity and multipotential capabilities. In particular they represent a gold standard for neural-crest-derived bone reconstruction in humans and can be used for the repair of body defects in low-risk autologous therapeutic strategies. Sources: An electronic search was conducted on PubMed databases and supplemented with a manual study of relevant references. Results: All research described in this review highlight that DPSCs are mesenchymal stem cells that could be used in clinical applications. Unfortunately, very few clinical trials have been reported. Major obstacles imposed on researchers are hindering the translation of potentially effective therapies to the clinic. Both researchers and regulatory institutions need to develop a new approach to this problem, drawing up a new policy for good manufacturing practice (GMP) procedures. We strongly suggest that only general rules be standardized rather than everything. Importantly, this would not have an effect on the safety of patients, but may very well affect the results, which cannot be identical for all patients, due to physiological diversity in the biology of each patient. Alternatively, it would be important to study the role of specific molecules that recruit endogenous stem cells for tissue regeneration. In this way, the clinical use of stem cells could be successfully developed. Conclusions: DPSCs are mesenchymal stem cells that differentiate into different tissues, maintain their characteristics after cryopreservation, differentiate into bone-like tissues when loaded on scaffolds in animal models, and regenerate bone in human grafts. In summary, all data reported up to now should encourage the development of clinical procedures using DPSCs.

Item does not contain fulltext We report on a negroid male suffering from porokeratosis of the scrotum. Porokeratosis in the genital area is rare, as is its occurrence in negroid people. In our patient, we found an asymptomatic non-HIV associated immunosuppression. In this case, the disease might be called porokeratosis of Mibelli. The diagnosis should be suspected in patients not belonging to one of the classical at-risk ethnical groups if the skin lesions seem typical.

BACKGROUND: N-Cadherin (CDH2) is a calcium-dependent adhesion protein, whose de novo expression, re-expression, up-regulation and down-regulation in human tumors has been demonstrated. The aim of the present work was to define the prognostic role of N-Cadherin in a large series of oral squamous cell carcinomas (OSCCs). MATERIALS AND METHODS: A total of 94 selected OSCCs were quantitatively and qualitatively analyzed by immunohistochemistry for N-Cadherin. The association between protein expression and clinico-pathological parameters was assessed by statistical analysis. RESULTS: In neoplastic tissue, N-Cadherin levels were more evident than in normal peritumoral epithelium (p

Purpose: To analyse and compare the dimensional changes of unassisted extraction sockets with alveolar ridge preservation (ARP) techniques and investigate any factors that impact the resorption of the alveolar bone. Materials and methods: A systematic search was conducted to identify randomised clinical trials (RCTs). All data were extracted, and a meta-analysis was performed for the changes in all buccolingual ridge width, midbuccal and midlingual ridge height, and mesial and distal ridge height, and horizontal width at reference points apical to the crestal area. Results: Based on 14 RCTs, the effectiveness of ARP in reducing the dimensions of the postextraction alveolar socket was confirmed. The clinical magnitude of this effect was 1.95 mm in the buccolingual ridge width, 1.62 mm in the midbuccal ridge height, and 1.26 mm on the midlingual ridge height. Additionally, 0.45 mm and 0.34 mm for mesial and distal ridge height, and 1.21 mm, and 0.76 mm for ridge width changes at points 3 and 5 mm apical to the crest were noted. Meta-regression analyses revealed that the reflection of flaps and primary wound coverage during ARP may have detrimental effects on bone remodelling, while no statistical significance was observed for any of the bone graft substitutes or the percentage of molar sockets. Conclusions: Regardless of the protocol, ARP can only minimise ridge resorption. ARP is most effective on horizontal ridge width, providing the most benefit coronally (approximating the crest), followed by the midbuccal ridge height.

The aim of this work was to describe a case of unicystic ameloblastoma located in the left posterior mandibular body and angle of a 14-year-old Caucasian male. The tumour was described at clinical and histological level; moreover, its histopathological phenotype was depicted. Finally, the problems of differential diagnosis with odontogenic or congenital cyst and the most appropriate therapeutic procedures are discussed.

Photodynamic Therapy (PDT) is a minimally invasive treatment that has shown promising results in treating preneoplasticlesions. PDT reckons on the administration of a drug (photosensitizer), which can be used in a topical or systemic form. Photodynamic therapy has been successfully used in the management of a variety of pathologies from different anatomical sites, including the head, neck, brain and lungs, hepatobiliary tree and other gastrointestinal and urological pathologies, skin, gynaecological conditions and in vascular anomalies. Starting from these same considerations, PDT has also been adopted for oral malignant and premalignant lesions’ treatment, and should be kept under investigation as a promising therapeutic management of leukoplakia and preneoplastic lesions of the oral cavity. Photodynamic Therapy (PDT) is a minimally invasive treatment that has shown promising results in treating preneoplasticlesions. PDT reckons on the administration of a drug (photosensitizer), which can be used in a topical or systemic form. Photodynamic therapy has been successfully used in the management of a variety of pathologies from different anatomical sites, including the head, neck, brain and lungs, hepatobiliary tree and other gastrointestinal and urological pathologies, skin, gynaecological conditions and in vascular anomalies. Starting from these same considerations, PDT has also been adopted for oral malignant and premalignant lesions’ treatment, and should be kept under investigation as a promising therapeutic management of leukoplakia and preneoplastic lesions of the oral cavity.

The occurrence of lymphoepithelial carcinoma in the oral cavity is extremely rare and a case with involvement of minor salivary glands is very uncommon. We describe a case of LELC of the oral cavity with involvement of the upper lip and of minor salivary glands. The tumour was described at the clinical and instrumental level; moreover, its histopathological phenotype was defined. Finally, the problems of differential diagnosis and the most appropriate therapeutic approaches are discussed.

Leiomyomas are uncommon in the oral cavity and rare on gingiva. They account only for 0.42% of all soft tissue lesions in the oral cavity. We present an extremely rare case of leiomyoma localized to the attached gingival, simulating an epulis in a healthy 14-year-old boy. The tumour was described at the clinical and instrumental level; moreover, its histopathological phenotype was depicted. The treatment of the choice was the radical excision. The wound was closed by surgical dressing with 2-0 silk suture.The post-operative course was uneventful. The surgical wound healed in one week with normal scarring. Finally, the problems of differential diagnosis with other tumours of the oral cavity and the most appropriate therapeutic procedures are discussed.

Numerous studies have established statistical associations of the IL-1 gene cluster polymorphisms with various inflammatory diseases. Deriving from that, the present study was intended to determine whether single-nucleotide polymorphisms (SNPs) in these gene are also associated with periodontal disease in a Linkage disequilibrium analysis. This investigation also created two haplotype blocks, both consisting of two different SNPs. Recent theoretical analyses indicate that research with an interpretation of periodontal disease as a complex, oligogenic disorder, with IL-1 genetic variation contributes an important but not exclusive influence on disease risk. Further studies are needed to confirm these results and to understand the mechanisms behind the observed association between IL-1 SNPs and periodontal disease. Numerous studies have established statistical associations of the IL-1 gene cluster polymorphisms with various inflammatory diseases. Deriving from that, the present study was intended to determine whether single-nucleotide polymorphisms (SNPs) in these gene are also associated with periodontal disease in a Linkage disequilibrium analysis. This investigation also created two haplotype blocks, both consisting of two different SNPs. Recent theoretical analyses indicate that research with an interpretation of periodontal disease as a complex, oligogenic disorder, with IL-1 genetic variation contributes an important but not exclusive influence on disease risk. Further studies are needed to confirm these results and to understand the mechanisms behind the observed association between IL-1 SNPs and periodontal disease.

Custom-cast posts and cores are usually used to treat endodontically treated teeth. However, several researches have underlined how these devices may be a much higher elastic modulus than the supporting dentine and the difference in the modulus could lead to stress concentrating in the cement lute, leading to failure. The role of the cement seems to play a fundamental role in order to transfer the strength during the chewing phases. Aim of this research is to record the rate of cytotoxicity of five different dual-cured resin cements used for fiber posts cementation. We tested the cytotoxicity of this five materials on MG63 osteoblast-like cells through two different methods: MTT ([3-4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide succinate) assay which tests for mito­chondrial enzyme activity6 and xCELLigence® system.

Oral soft tissue lesions are commonly seen in the daily dental practice. The quick diagnosis of oral potentially malignant disorders and oral precancer disease is of highest clinical importance given the mortality rate of late stage disease. Since the oral cavity is more accessible to complete examination, it could be used in early detection of precancerous and cancerous lesions. But either due to ignorance or inaccessibility of medical care, the disease gets detected in the later stages. Thus, there is a need for improvement in early detection of oral disease, because in the initial stages, treatment is more effective and the morbidity is minimal. Aim of this report is to highlight how collagen membrane graft application seems to offer a perfect healing of the soft tissue after the lesion removal. Some reports and the microstructure of the collagen used have been recorded. The healing of the soft tissue, the bleeding control and the management of postoperative discomfort seem to be more favorable by avoiding a intraoral soft tissue graft and applying a collagen membrane. Oral soft tissue lesions are commonly seen in the daily dental practice. The quick diagnosis of oral potentially malignant disorders and oral precancer disease is of highest clinical importance given the mortality rate of late stage disease. Since the oral cavity is more accessible to complete examination, it could be used in early detection of precancerous and cancerous lesions. But either due to ignorance or inaccessibility of medical care, the disease gets detected in the later stages. Thus, there is a need for improvement in early detection of oral disease, because in the initial stages, treatment is more effective and the morbidity is minimal. Aim of this report is to highlight how collagen membrane graft application seems to offer a perfect healing of the soft tissue after the lesion removal. Some reports and the microstructure of the collagen used have been recorded. The healing of the soft tissue, the bleeding control and the management of postoperative discomfort seem to be more favorable by avoiding a intraoral soft tissue graft and applying a collagen membrane.

Aim To analyse the prevalence and the distribution of displaced, buccal/palatal maxillary canines, and the association with sagittal and vertical skeletal relationships in a southern Italian population. Materials and methods Consecutive records of patients were examined. Inclusion criteria were: age 7-12 years, 1-2 cervical vertebral maturation (CVM) stage, initial dental casts, intraoral photographs, panoramic, lateral and periapical radiographs. Subjects with at least one canine in Lindauer II, III or IV sector and/or α angle > 31° were included in displaced maxillary canine (DMC) group, whereas those with both canines in sector I and α angle ≤31° were used as control group (CTR). According to canine bulges and/or x-ray examinations, DMC were then divided in palatal and buccal displaced canines (PDC/ BDC). Sagittal and vertical skeletal relationships were evaluated using ANB and SN/GoMe angles. Chi-square tests were performed to compare the prevalence rates of skeletal features.Results The sample consisted of 123 children, 40 DMC and 83 CTR. The DMC group included 11 PDC and 29 BDC subjects. The M:F ratio was 1:3 in PDC and BDC, 1:1 in CTR group. The unilateral-to-bilateral ratio was 1:1 and 3:1 in PDC and BDC subjects. The most common sector combination regarding unilateral and bilateral displacements was "II" and "II,II". PDC occurred more in Class I and in hyperdivergents, whereas BDC in Class I or II and in normodivergents. Conclusions DMC occurred more often in females than in males. BDC was more common than PDC and unilateral displacements occurred more frequently than bilateral ones. No significant correlation with skeletal features was observed. Aim To analyse the prevalence and the distribution of displaced, buccal/palatal maxillary canines, and the association with sagittal and vertical skeletal relationships in a southern Italian population. Materials and methods Consecutive records of patients were examined. Inclusion criteria were: age 7-12 years, 1-2 cervical vertebral maturation (CVM) stage, initial dental casts, intraoral photographs, panoramic, lateral and periapical radiographs. Subjects with at least one canine in Lindauer II, III or IV sector and/or α angle > 31° were included in displaced maxillary canine (DMC) group, whereas those with both canines in sector I and α angle ≤31° were used as control group (CTR). According to canine bulges and/or x-ray examinations, DMC were then divided in palatal and buccal displaced canines (PDC/ BDC). Sagittal and vertical skeletal relationships were evaluated using ANB and SN/GoMe angles. Chi-square tests were performed to compare the prevalence rates of skeletal features.Results The sample consisted of 123 children, 40 DMC and 83 CTR. The DMC group included 11 PDC and 29 BDC subjects. The M:F ratio was 1:3 in PDC and BDC, 1:1 in CTR group. The unilateral-to-bilateral ratio was 1:1 and 3:1 in PDC and BDC subjects. The most common sector combination regarding unilateral and bilateral displacements was "II" and "II,II". PDC occurred more in Class I and in hyperdivergents, whereas BDC in Class I or II and in normodivergents. Conclusions DMC occurred more often in females than in males. BDC was more common than PDC and unilateral displacements occurred more frequently than bilateral ones. No significant correlation with skeletal features was observed.

Hereditary gingival fibromatosis (HGF) is a rare oral condition that may appear as an isolated entity or as part of a genetic disease or syndrome. Molecular and biochemical mechanisms that trigger this pathologic process are not completely understood. In this article, we present a rare case of hereditary gingival fibromatosis in conjunction with a syndromic phenotype, associated with a rare missense mutation of the KCNK4 gene. This mutation induces a change in the structure of the TRAAK channel belonging to the 2-pore potassium channels. The gain of function promoted by the mutation could represent the pathogenetic basis of gingival fibromatosis.

In the field of biology and medicine, one hears often about stem cells and their potential. The dental implant new surfaces, subjected to specific treatments, perform better and allow for quicker healing times and better clinical performance. The purpose of this study is to evaluate from a biological point of view the interaction and cytotoxicity between stem cells derived from dental pulp (DPSCs) and titanium surfaces. Through the creation of complex cells/implant, this study is aimed at analyzing the cytotoxicity of dental implant surfaces (Myth (Maipek Manufacturer Industrial Care, Naples, Italy)) and the adhesion capacity of cells on them and at considering the essential factors for implant healing such as osteoinduction and vasculogenesis. These parameters are pointed out through histology (3D cell culture), immunofluorescence, proliferation assays, scanning electron microscopy, and PCR investigations. The results of the dental implant surface and its interaction with the DPSCs are encouraging, obtaining results increasing the mineralization of the tissues. The knowledge of this type of interaction, highlighting its chemical and biological features, is certainly also an excellent starting point for the development of even more performing surfaces for having better healing in the oral surgical procedures related to dental implant positioning.

Objectives To investigate the role of gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) in the development of dental disorders. Methods The first outcome was review of the role of reflux in the development of dental disorders in adults. The second outcome was review of the potential pathophysiological mechanisms underlying the association between reflux and dental disorders. Three investigators screened publications for eligibility and exclusion based on predetermined criteria through a literature search conducted on PubMed, Cochrane Library, and Scopus according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results From 386 publications, 24 studies were kept for analysis. Objective approaches were used in 16 studies to confirm GERD diagnosis. Pharyngeal reflux episodes (LPR) were considered in 2 studies. No study considered nonacid reflux. The study results supported a higher prevalence of dental erosion and caries in reflux patients compared with healthy individuals. Patients with dental erosion have a higher prevalence of reflux than controls. The pathophysiological mechanisms would involve changes in the saliva physiology. No study investigated the microbiota modifications related to reflux although the findings are supporting the critical role of microbiota change in the development of dental disorders. There is an important heterogeneity between studies about diagnostic methods and clinical outcome evaluation. Conclusion The involvement of reflux in the development of dental disorders is not formally demonstrated and requires future investigations considering pharyngeal acid and nonacid reflux episodes and in particular their potential impact on oral microbiota., SCOPUS: re.j, info:eu-repo/semantics/published

Oral squamous cell carcinoma (OSCC) is a common type of cancer characterized by a low survival rate, mostly due to local recurrence and metastasis. In view of the importance of predicting tumor behavior in the choice of treatment strategies for OSCC, several studies have attempted to investigate the prognostic value of tissue biomarkers, including microRNA (miRNA). The purpose of this study was to perform a systematic review and meta-analysis to evaluate the relationship between miRNA expression and survival of OSCC patients. Studies were identified by searching on MEDLINE/PubMed, SCOPUS, Web of Science, and Google Scholar. Quality assessment of studies was performed with the Newcastle-Ottawa Scale. Data were collected from cohort studies comparing disease-free survival and overall survival in patients with high miRNA expression compared to those with low expression. A total of 15 studies featuring 1,200 OSCC samples, predominantly from Asia, met the inclusion criteria and were included in the meta-analysis. Poor prognosis correlated with upregulation of 9 miRNAs (miR-21, miR-455-5p, miiR-155-5p, miR-372, miR-373, miR-29b, miR-1246, miR-196a, and miR-181) and downregulation of 7 miRNAs (miR-204, miR-101, miR-32, miR-20a, miR-16, miR-17, and miR-125b). The pooled hazard ratio values (95% confidence interval) related to different miRNA expression for overall survival and disease-free survival were 2.65 (2.07–3.39) and 1.95 (1.28–2.98), respectively. The results of this meta-analysis revealed that the expression levels of specific miRNAs can robustly predict prognosis of OSCC patients. Oral squamous cell carcinoma (OSCC) is a common type of cancer characterized by a low survival rate, mostly due to local recurrence and metastasis. In view of the importance of predicting tumor behavior in the choice of treatment strategies for OSCC, several studies have attempted to investigate the prognostic value of tissue biomarkers, including microRNA (miRNA). The purpose of this study was to perform a systematic review and meta-analysis to evaluate the relationship between miRNA expression and survival of OSCC patients. Studies were identified by searching on MEDLINE/PubMed, SCOPUS, Web of Science, and Google Scholar. Quality assessment of studies was performed with the Newcastle-Ottawa Scale. Data were collected from cohort studies comparing disease-free survival and overall survival in patients with high miRNA expression compared to those with low expression. A total of 15 studies featuring 1,200 OSCC samples, predominantly from Asia, met the inclusion criteria and were included in the meta-analysis. Poor prognosis correlated with upregulation of 9 miRNAs (miR-21, miR-455-5p, miiR-155-5p, miR-372, miR-373, miR-29b, miR-1246, miR-196a, and miR-181) and downregulation of 7 miRNAs (miR-204, miR-101, miR-32, miR-20a, miR-16, miR-17, and miR-125b). The pooled hazard ratio values (95% confidence interval) related to different miRNA expression for overall survival and disease-free survival were 2.65 (2.07–3.39) and 1.95 (1.28–2.98), respectively. The results of this meta-analysis revealed that the expression levels of specific miRNAs can robustly predict prognosis of OSCC patients.

Introduction The role of this study is to highlight a correlation between patients with Marfan syndrome and oral health status by evaluating and reviewing the relevant scientific literature. The syndrome is characterized by an abnormal production of the fibrillin1 protein. The manifestations of Marfan syndrome affect organs that contain connective tissue such as the skeletal system, the eyes, the heart and the blood vessels, the lungs and the fibrous membranes that cover the brain and the spine. The facial bony and soft structures can therefore be affected, influencing the stage of tooth formation and the structure of the teeth, we also want to analyze in this study, the periodontal complications and the management of the latter, with the use of surgical techniques that include the use of biomaterials. Materials and methods A comprehensive review of the literature was conducted according to PRISMA guidelines. After a careful analysis of the work obtained by two independent academics, there have been 18. All data from the studies were compared and many of these highlighted the presence of abnormalities in the oral district. Results The studies taken into consideration a whole series of oral manifestations related to the Marfan syndrome. Oral mucosa, periodontal, dental abnormalities, bone abnormalities or joint dysfunction are frequently involved in patients affected by this disease. Conclusions All the research have given positive results in terms of dental or oral anomalies. This information may be essential to limit and intervene early improving the oral health of syndromic patients.

Ameloblastoma is the second most common odontogenic tumor arising in the maxillary bones. The WHO classified ameloblastoma in: solid/multicystic (SMA); unicystic; peripheral and desmoplastic. A conservative or radical approach may be performed for SMA treatment to achieve total excision of the lesion. In this case report, a 47-year-old woman, presented a deformation of the left mandibular region and paresthesia of the left hemi-labium, at the ortopanoramic x-ray (OPT) a multilocular osteolytic lesion and the rhizalysis of dental elements 3.7, 3.6, 3.5, 3.4 and the inclusion of 3.8 was appreciated; the CT exam showed erosion of the mandibular canal roof and of the vestibular cortex in the mental nerve region. The patient was subjected to the extraction of the elements in rhizalysis and of 3.8 and subsequently to the enucleation of the lesion followed by an extensive peripheral ostectomy performed with a piezoelectric device. The patient underwent to OPT and CT examinations follow-up and after 5 years was subjected to implant surgery, at the same time of the implant's placement, bone biopsies were performed using core drills in order to evaluate the bone histologically. The patient showed complete clinical and radiographic healing; the histological examination demonstrates the formation of lamellar bone.

Background: Nodular fascitiis is a myofibroblastic neoplasm of the soft tissue that rarely affects oral cavity. With a broad pattern of presentation, sometimes Nodular Fascitiis can have a rapid growth and appear highly cellular with local aggressiveness on biopsies, thus simulating a sarcoma. The aim of this paper is to present a case of troublesome diagnosis of nodular fascitiis mimicking a Malignant Fibrous Histiocytoma, with the purpose of alert clinicians and pathologists on the difficulties that can be met in the differential diagnosis between these 2 lesions. A 42-year-old male presented an exophytic lesion on the cheek. After the excisional biopsy, histological and immunohistochemical evaluations revealed a picture of doubtful significance. With a careful analysis, the diagnosis of nodular fasciitis was made and the patient was not further treated. At a 3-year follow-up, no recurrence was found. Differential diagnosis within myofibroblastic neoplasm can be a real challenge for both Clinicians and Pathologist. A coordinated team-work is mandatory to avoid clinical malpractice and unnecessarily aggressive treatment.

The aim of this paper was to highlight the most widely antibiotic protocols applied to the dental field, especially in the surgical treatment of impacted wisdom teeth. Once these protocols were screened, all the possible advantages or disadvantages for each drug and each posology were recorded in this review. In recent years, the need to use these protocols has been debated in the literature. The data obtained by this review underlined how antibiotic protocols applied to oral surgery treatments only included surgeries performed on patients who did not present other systemic pathologies. The first literature review obtained 140 results, and then after the application of the inclusion criteria, 12 papers were selected. The results showed that the most commonly used protocol involved the use of penicillin and clavulanate, obtaining safe clinical and prophylactic results in the management of infections. This widely used protocol seems to guarantee high predictability and safety. The presented review highlights the current possibility of antibiotic resistance affecting patients due to drug misuse. Further clinical studies are required to state specific guidelines; however, oral surgeons involved in third molar surgery should evaluate the local and general health conditions of the patients before suggesting any drug measures for patients. The aim of this paper was to highlight the most widely antibiotic protocols applied to the dental field, especially in the surgical treatment of impacted wisdom teeth. Once these protocols were screened, all the possible advantages or disadvantages for each drug and each posology were recorded in this review. In recent years, the need to use these protocols has been debated in the literature. The data obtained by this review underlined how antibiotic protocols applied to oral surgery treatments only included surgeries performed on patients who did not present other systemic pathologies. The first literature review obtained 140 results, and then after the application of the inclusion criteria, 12 papers were selected. The results showed that the most commonly used protocol involved the use of penicillin and clavulanate, obtaining safe clinical and prophylactic results in the management of infections. This widely used protocol seems to guarantee high predictability and safety. The presented review highlights the current possibility of antibiotic resistance affecting patients due to drug misuse. Further clinical studies are required to state specific guidelines; however, oral surgeons involved in third molar surgery should evaluate the local and general health conditions of the patients before suggesting any drug measures for patients.

The surgical removal of impacted lower third molar is an ordinary intervention. The treatment of choice in this pathology is an intraoral or, seldom, extraoral surgical approach. Various surgical procedures have been described to remove ectopic mandibular teeth. The more common technique is an intraoral approach (so named "conservative"), even when the tooth is located in an ectopic area. However, the "intraoral approach" is often related with the difficulty of view, the bleeding of the surgical site, and with the possible lesions of inferior alveolar or lingual nerve. From the other side, a nonconservative surgical approach like "extraoral pathway" may be associated with no aesthetic cutaneous postoperative scar tissue. The aim of those 2 study cases is to highlight the management of infected ectopic third molars located close to the lower border of the mandibular body, underlining the anatomical land markers of the submandibular area. The authors have applied the extraoral pathway using an incision of small size. From our analysis, the treatment of those typical can be managed by using a "mini-skin-incision" (so termed as mini-submandibular approach) respecting the cosmetic expectations of the patients. The surgical removal of impacted lower third molar is an ordinary intervention. The treatment of choice in this pathology is an intraoral or, seldom, extraoral surgical approach. Various surgical procedures have been described to remove ectopic mandibular teeth. The more common technique is an intraoral approach (so named ''conservative''), even when the tooth is located in an ectopic area. However, the ''intraoral approach'' is often related with the difficulty of view, the bleeding of the surgical site, and with the possible lesions of inferior alveolar or lingual nerve. From the other side, a nonconservative surgical approach like ''extraoral pathway'' may be associated with no aesthetic cutaneous postoperative scar tissue. The aim of those 2 study cases is to highlight the management of infected ectopic third molars located close to the lower border of the mandibular body, underlining the anatomical land markers of the submandibular area. The authors have applied the extraoral pathway using an incision of small size. From our analysis, the treatment of those typical can be managed by using a ''mini-skin-incision'' (so termed as mini-submandibular approach) respecting the cosmetic expectations of the patients.

Fibro-osseous lesions (FOL) represent a heterogeneous group of lesions that exhibit a variety of clinic-pathological features. Recently, based on the new World Health Organization classification system, these lesions were reclassified as follows: (1) fibrous dysplasia (FD), (2) osseous dysplasia, and (3) ossifying fibroma. Nevertheless, the nosologic placement of FOL may be problematic because of substantial overlap in the histopathological findings. In this study, we analyzed 10 cases of FD by both optical and confocal laser scanning microscopy, a research technique based on the laser light microscopic analysis of stained biological samples that allows improved tissue imaging and bidimensional pictures with high resolution at the cellular level to provide a better understanding of the diagnosis of this disease. Fibro-osseous lesions (FOL) represent a heterogeneous group of lesions that exhibit a variety of clinic-pathological features. Recently, based on the new World Health Organization classification system, these lesions were reclassified as follows: (1) fibrous dysplasia (FD), (2) osseous dysplasia, and (3) ossifying fibroma. Nevertheless, the nosologic placement of FOL may be problematic because of substantial overlap in the histopathological findings. In this study, we analyzed 10 cases of FD by both optical and confocal laser scanning microscopy, a research technique based on the laser light microscopic analysis of stained biological samples that allows improved tissue imaging and bidimensional pictures with high resolution at the cellular level to provide a better understanding of the diagnosis of this disease.

OBJECTIVE: The major challenge for contemporary dentistry is restoration of missing teeth; currently, dental implantation is the treatment of choice in this circumstance. In the present study, we assessed the interaction between implants and Dental Pulp Stem Cells (DPSCs) in vitro by means of 3D cell culture in order to better simulate physiological conditions. METHODS: Sorted CD34+ DPSCs were seeded onto dental implants having either a rough surface (TriVent) or one coated with a ceramic layer mimicking native bone (TiUnite). We evaluated preservation of DPSC viability during osteogenic differentiation by an MTT assay and compared mineralized matrix deposition with SEM analysis and histological staining; temporal expression of osteogenic markers was evaluated by RT-PCR and ELISA. RESULTS: Both surfaces are equally biocompatible, preserve DPSC viability, stimulate osteogenic differentiation, and increase the production of VEGF. A slight difference was observed between the two surfaces concerning the speed of DPSC differentiation. SIGNIFICANCE: Our study of the two implant surfaces suggests that TriVent, with its roughness, is capable of promoting cell differentiation a bit earlier than the TiUnite surface, although the latter promotes greater cell proliferation. Copyright © 2015. Published by Elsevier Ltd. KEYWORDS: Biocompatibility; Cell proliferation; DPSCs; Osteodifferentiation; Surface texture; Titanium implants Objective The major challenge for contemporary dentistry is restoration of missing teeth; currently, dental implantation is the treatment of choice in this circumstance. In the present study, we assessed the interaction between implants and Dental Pulp Stem Cells (DPSCs) in vitro by means of 3D cell culture in order to better simulate physiological conditions. Methods Sorted CD34+ DPSCs were seeded onto dental implants having either a rough surface (TriVent) or one coated with a ceramic layer mimicking native bone (TiUnite). We evaluated preservation of DPSC viability during osteogenic differentiation by an MTT assay and compared mineralized matrix deposition with SEM analysis and histological staining; temporal expression of osteogenic markers was evaluated by RT-PCR and ELISA. Results Both surfaces are equally biocompatible, preserve DPSC viability, stimulate osteogenic differentiation, and increase the production of VEGF. A slight difference was observed between the two surfaces concerning the speed of DPSC differentiation. Significance Our study of the two implant surfaces suggests that TriVent, with its roughness, is capable of promoting cell differentiation a bit earlier than the TiUnite surface, although the latter promotes greater cell proliferation.

Purpose: The objective of this investigation is to study prosthodontics and internal components resistance to the masticatory stress and considering different force directions by using Finite Element Method analysis (FEM). The structural materials of the components are usually Titanium alloy grade 4 or 5 and thus, guarantee the integration of the fixture in the bone due to the osteointegration phenomena. Even if the long-term dental implant survival rate is easy to be obtained and confirmed by numerous researches, the related clinical success, due to the alteration of the mechanical and prosthodontics components is still controversial. Methods: By applying engineering systems of investigations like FEM and Von Mises analyses, it has been investigated how dental implant material was held against the masticatory strength during the dynamic masticatory cycles. A three-dimensional system involved fixture, abutment and the connection screws, which were created and analyzed. The elastic features of the materials used in the study were taken from recent literature data. Results: Data revealed a different response for both types of devices, although implant neck and dental abutment showed better results for all conditions of loading while the abutment screw represented aweak point of the system. Conclusion: The data of this virtual model showed all the features of different prosthetic retention systems under the masticatory load. Clinicians should find better prosthetic balance in order to better distribute the stress over the component and to guarantee patients’ clinical long-term results. Purpose: The objective of this investigation is to study prosthodontics and internal components resistance to the masticatory stress and considering different force directions by using Finite Element Method analysis (FEM). The structural materials of the components are usually Titanium alloy grade 4 or 5 and thus, guarantee the integration of the fixture in the bone due to the osteointegration phenomena. Even if the long-term dental implant survival rate is easy to be obtained and confirmed by numerous researches, the related clinical success, due to the alteration of the mechanical and prosthodontics components is still controversial. Methods: By applying engineering systems of investigations like FEM and Von Mises analyses, it has been investigated how dental implant material was held against the masticatory strength during the dynamic masticatory cycles. A three-dimensional system involved fixture, abutment and the connection screws, which were created and analyzed. The elastic features of the materials used in the study were taken from recent literature data. Results: Data revealed a different response for both types of devices, although implant neck and dental abutment showed better results for all conditions of loading while the abutment screw represented aweak point of the system. Conclusion: The data of this virtual model showed all the features of different prosthetic retention systems under the masticatory load. Clinicians should find better prosthetic balance in order to better distribute the stress over the component and to guarantee patients’ clinical long-term results.

The enamel defects (EDs) may present with a variety of clinical manifestations with increasing severity from the sole appearance of pale discoloration to remarkable structural alterations. EDs are responsible for higher caries receptivity. In vivo reflectance confocal microscopy (RCM) allows to image in vivo at microscopic resolution of the dental surface, thus avoiding the tooth extraction and the sample preparation because of its ability to optically scan living tissues along their depth. Aim of this study is the in vivo assessment at microscopic resolution of dental surfaces affected by EDs without resorting to invasive methods such as teeth extractions, to define histological findings occurring in chromatic and/or structural EDs. For the purpose, 15 children, referring at the Dental Clinic of the Second University of Naples, affected by several degrees of EDs, were enrolled and underwent in vivo RCM imaging to microscopically define the ED confocal features using a commercially available hand-held reflectance confocal microscope with neither injuries nor discomfort. Totally, 29 teeth were imaged. Results demonstrated images good in quality and the capability to detect EDs such as unevenness, grooves, and lack of mineralization according to their clinical degree of disarray. The present in vivo microscopic study on EDs allowed to highlight structural changes in dental enamel at microscopic resolution in real-time and in a non-invasive way, with no need for extraction or processing the samples. Further experiments could define the responsiveness to remineralizing procedures as therapeutic treatments The enamel defects (EDs) may present with a variety of clinical manifestations with increasing severity from the sole appearance of pale discoloration to remarkable structural alterations. EDs are responsible for higher caries receptivity. In vivo reflectance confocal microscopy (RCM) allows to image in vivo at microscopic resolution of the dental surface, thus avoiding the tooth extraction and the sample preparation because of its ability to optically scan living tissues along their depth. Aim of this study is the in vivo assessment at microscopic resolution of dental surfaces affected by EDs without resorting to invasive methods such as teeth extractions, to define histological findings occurring in chromatic and/or structural EDs. For the purpose, 15 children, referring at the Dental Clinic of the Second University of Naples, affected by several degrees of EDs, were enrolled and underwent in vivo RCM imaging to microscopically define the ED confocal features using a commercially available hand-held reflectance confocal microscope with neither injuries nor discomfort. Totally, 29 teeth were imaged. Results demonstrated images good in quality and the capability to detect EDs such as unevenness, grooves, and lack of mineralization according to their clinical degree of disarray. The present in vivo microscopic study on EDs allowed to highlight structural changes in dental enamel at microscopic resolution in real-time and in a non-invasive way, with no need for extraction or processing the samples. Further experiments could define the responsiveness to remineralizing procedures as therapeutic treatments.

In recent scientific literature, oral infections and systemic manifestations, or correlations between oral health and systemic diseases are a topic of discussion. Porphyromonas gingivalis is one of the bacteria implicated in the biofilm formation of bacterial plaque, and plays an important role in the progression of periodontal disease. In this systematic review authors have evaluated the literature of the last 10 years on P. gingivalis and all the systemic implications proven. This study therefore evaluates all the districts of the organism in which this bacterium may have implications. From the results it emerges that P. gingivalis has implications in the onset of different systemic pathologies, including rheumatoid arthritis, cardiovascular pathologies, and neurodegenerative pathologies. Surely, understanding the mechanisms of diffusion of this bacterium, it would be possible to prevent a series of pathologies. Thus, putting the dentist clinician at the center of prevention for these diseases.

A wide range of diseases may present with radiographic features of osteolysis. Periapical inflammation, cysts and benign tumours, bone malignancies, all of these conditions may show bone resorption on radiograph. Features of the surrounding bone, margins of the lesion, and biological behaviour including tendency to infiltration and root resorption, may represent important criteria for distinguishing benign tumours from their malign counterpart, although the radiographic aspect of the lesion is not always predictive. Therefore a critical differential diagnosis has to be reached to choose the best management. Here, we report a case of giant cell tumour (GCT) whose radiological features by computed tomography (CT) suggested the presence of bone malignancy, whereas the evaluation of a routine OPT scan comforted us about the benign nature of the lesion. A brief review of the literature on such a benign but locally aggressive neoplasm is also provided.

Introduction Facial growth changes the position of the jaws (in particular vertical position of the maxilla and antero-posterior position of the mandible) and may, in turn, modify the position of the tongue and the hyoid bone, thus, generating modifications of the upper airway space. In the present paper, effects on upper airway space and tongue position of a new functional appliance, the swallowing occlusal contact intercept appliance (SOCIA) have been investigated. Materials and methods Retrospective cephaolmetric study of twenty-four children (mean age 9.46 ± 1.60) with hyperdivergent Class II malocclusion with mandibular retrusion and atypical deglutition, was performed on radiographs taken before and after 24 months treatment with “SOCIA” appliance. The variables considered in this study, and analysed by means of a Paired t-test with a 5% level of significance, included the distance between the base of epiglottis (EB) and the tip of the tongue (TT), the distance from the tongue dorsum to EB-TT (TGH), the distance between the posterior nasal spine PNS and EB (VAL), SPAS, MAS and IAS (i.e. superior, medium and inferior pharyngeal airspace width). Results Our findings showed a significant increase in tongue length (TT-EB) and tongue height (TGH); thus, confirming the reposition of the tongue from a lower posture to its physiological position onto the palatal spot. These modifications of the tongue posture had effects on the upper airway space. The most important modifications were observed in SPAS, with a significant 5.9 mm increase. Some increase was found also for MAS (0.83 mm) and IAS (1.1 mm) but without statistical significance. A significant increase (7.75 mm) was also found for VAL, probably as a result of the augmentation of posterior facial height. Conclusions SOCIA appliance is capable to improve tongue position and the superior posterior airway space, and, consequently, to improve deglutition, phonation and respiratory function.

Oral Lichen Planus (OLP) is a common disease of unknown aetiology affecting oral mucosae by T-cell mediated chronic inflammation. OLP diagnosis is made by evaluating both clinical and histological criteria. Pharmacological treatment is useful in symptomatic cases. Life-long clinical follow-up is essential, due to low-risk of malignant transformation. In vivo Reflectance Confocal Microscopy (RCM) offers a real-time virtual biopsy of the being tissues and does not require surgical excision nor histopathological processing. RCM was used to capture OLP lesions in order to clinically differentiate them from other clinical entities.

Aim: To evaluate the impact that immediate implant placement may have on bone remodelling in comparison with adjacent sockets left to heal spontaneously. Materials and methods: In a beagle dog model (N = 16 dogs), mandibular premolars were extracted, and implants were placed in each distal socket (test) with the corresponding mesial site left to heal undisturbed (control). Healing was assessed measuring both the vertical distance between buccal and lingual crest (B'L') and the width of buccal and lingual walls at different levels. Five healing periods were evaluated. Differences between means for each variable and for each healing period between test and control were compared (Kruskal-Wallis test; Friedman test). Results: At 2 and 8 weeks of healing, the B'L' distance revealed significant higher values at test compared to control sites, being this difference three times higher at the end of the study (P < 0.05). In the test group, the width of the crest was reduced between baseline (0.37 [0.04]) and 8 weeks healing (0.13 [0.64]), demonstrating a 62% reduction of the initial width. These differences were not observed in the control group. Conclusions: Immediate implant placement into fresh extraction sockets may jeopardize the vertical bone remodelling of the socket. Furthermore, a tendency towards greater buccal horizontal resorption was observed in the most coronal aspect of the buccal bone crest.

The oral cavity is home to numerous viruses and micro-organisms recognized as having a role in various oral diseases as well as in infections in other parts of the body. Indeed, in general a microbial infection underlies or is believed to underlie the ample spectrum of oral diseases, from tooth enamel decay to periodontal lesions, from candidiasis to virus-induced oral squamous cell carcinomas, and bullous autoimmune oral disorders. This clinico-pathological context stresses the need of targeted therapies to specifically kill infectious agents in a complex environment such as the oral cavity, and explains the current interest in exploring peptide-based therapeutic approaches in oral and dental research. Here, we review the therapeutic potential of antimicrobial peptides such as LL-37, beta defensins, adrenomedullin, histatins, and of various peptides modulating gene expression and immuno-biological interaction(s) in oral diseases.

The aim of this study was to evaluate the behavior of human Dental Pulp Stem Cells (DPSCs), as well as human osteoblasts, when challenged on a Biocoral scaffold, which is a porous natural hydroxyapatite. For this purpose, human DPSCs were seeded onto a three-dimensional (3D) Biocoral scaffold or on flask surface (control). Either normal or rotative (3D) cultures were performed. Scanning electron microscopic analyses, at 8, 24 and 48 h of culture showed that cells did not adhere on the external surface, but moved into the cavities inside the Biocoral structure. After 7, 15 and 30 days of culture, morphological and molecular analyses suggested that the Biocoral scaffold leads DPSCs to hook into the cavities where these cells quickly start to secrete the extra cellular matrix (ECM) and differentiate into osteoblasts. Control human osteoblasts also moved into the internal cavities where they secreted the ECM. Histological sections revealed a diffuse bone formation inside the Biocoral samples seeded with DPSCs or human osteoblasts, where the original scaffold and the new secreted biomaterial were completely integrated and cells were found within the remaining cavities. In addition, RT-PCR analyses showed a significant increase of osteoblast-related gene expression and, above all, of those genes highly expressed in mineralized tissues, including osteocalcin, OPN and BSP. Furthermore, the effects on the interaction between osteogenesis and angiogenesis were observed and substantiated by ELISA assays. Taken together, our results provide clear evidence that DPSCs differentiated into osteoblasts, forming a biocomplex made of Biocoral, ECM and differentiated cells.

Fibrous histiocytoma is a benign soft tissue tumour arising as a fibrous mass everywhere in the human body. The involvement of the oral cavity is rare. We report two cases of benign fibrous histiocytoma that localized in the oral cavity. The clinical and histological features of the lesion are reported. Finally, a literature revision of this pathology at the level of the oral cavity is reported.

Purpose : The aim of this investigation was to assess bone healing of sinus lift procedure in which the augmentation has been performed by using calcium sulphate like bone substitutes. The methods of this investigation how the use of Cone Beam Computed Tomography (CBCT) may be a valid instrument to support reconstructive surgery of the jaws. Patients and Methodology: 25 Patients presented large bone defects after tooth extractions located in the upper jaw posterior area. Vertical bone volume was assessed by CBCT examinations before and about six months after sinus lift surgery. Results: Examined defects treated with sinus lift surgery and evaluated by CBCT showed a strong increasing on the bone volume at 6 months follow up control. Conclusion: Calcium sulphate application in sinus lift surgery represent a safe and predictable option in the place of autologous bone. Therefore the application of CBCT investigation may give the clinicians the opportunity of evaluating with high precision value, the consistence of the bone defects before the surgery.