Alejandra Martínez

In vitro and in vivo activity of melaleuca alternifolia mixed with tissue conditioner on Candida albicans

OBJECTIVE The aim of this study was to identify in vitro and in vivo activity of Melaleuca alternifolia oil mixed with different tissue conditioners on the Candida albicans strain. STUDY DESIGN Microbiological tests were used to isolate Candida albicans from patients with denture stomatitis. The in vitro antifungal activity of Melaleuca alternifolia against Candida albicans was determined when it was applied directly and when it was mixed with tissue conditioners (Fitt, Lynal, Coe-Comfort). The responses of 27 denture stomatitis patients treated with Melaleuca alternifolia mixed with Coe-Comfort (n = 9), Nystatin mixed with Coe-Comfort (n = 9), and Coe-Comfort (Control Group, n = 9), were evaluated over a period of 12 days. RESULTS In the in vitro study, Coe-Comfort or Fitt conditioners mixed with 1 mL, 20% (vol/vol) of Melaleuca alternifolia oil exhibited a total inhibition of Candida albicans. Patients treated with M. alternifolia mixed with Coe-Comfort showed a significant decrease in palatal inflammation compared with those treated with Coe Comfort (P = .001). In addition, a significant inhibition of C. albicans growth was observed with M. alternifolia mixed with Coe-Comfort compared with only Coe-Comfort (P = .000004). CONCLUSION M. alternifolia oil mixed with Coe-Comfort tissue conditioner is effective in treating denture stomatitis.

Denture plaque and palatal mucosa in denture stomatitis: scanning electron microscopic and microbiologic study.

Denture plaque is an etiologic factor in denture stomatitis. In this study, denture and mucosa samples from nine patients were examined in the SEM and processed for microbiologic cultures. Denture plaque in patients with denture stomatitis showed a considerable thickness containing cocci, filaments, rods, yeasts, and desquamated epithelial cells. Some microorganisms were revealed in the connective tissue in one patient and phagocytizing polymorphonuclear leukocytes were found in the palatal mucosa of the patients with denture stomatitis.

Epithelial expression of p53, mdm-2 and p21 in normal lip and actinic cheilitis

The p53 pathway is commonly altered during oral and skin carcinogenesis. The lip is a transition tissue between skin and oral mucosa, which in response to UVB exposure also exhibits alterations in the expression of p53 and p53-related genes that could lead to malignant transformation. To assess if the p53-regulated proteins murine-double-minute (mdm)-2 and p21 are altered during early lip carcinogenesis, biopsies from normal lip (n=16) and the premalignant lip lesion, actinic cheilitis (AC) (n=26) were processed for the immunohistochemical detection of p53, p21 and mdm-2 in serial co-localized sections. Epithelial co-expression of p53 and mdm-2 was significantly increased in AC as compared to normal lip (P<0.001). No differences in epithelial p21 expression were found between normal lip and AC. While in normal lip mdm-2 and p21 were significantly correlated with p53, in AC only mdm-2 was associated with p53 expression. Multivariate logistic regression analysis of the three markers (Wald stepwise) showed that p53 is the only predictor of AC. The results point to alterations in the p53 pathway during early lip carcinogenesis, highlighting p53 as a potential marker of early malignancy of the lip.

Actinic cheilitis: epithelial expression of COX-2 and its association with mast cell tryptase and PAR-2.

Cyclooxygenase-2 (COX-2) is overexpressed in various types of human malignancies, including oral cancers. Recent studies have shown that mast cell-derived protease tryptase can induce COX-2 expression by the cleavage of proteinase-activated receptor-2 (PAR-2). Actinic cheilitis (AC) is a premalignant form of lip cancer characterized by an increased density of tryptase-positive mast cells. To investigate the possible contribution of tryptase to COX-2 overexpression during early lip carcinogenesis, normal lip (n=24) and AC (n=45) biopsies were processed for COX-2, PAR-2 and tryptase detection, using RT-PCR and immunohistochemistry. Expression scores were obtained for each marker and tested for statistical significance using Mann-Whitney and Spearmanns correlation tests as well as multivariate logistic regression analysis. Increased epithelial co-expression of COX-2 and PAR-2, as well as, elevated subepithelial density of tryptase-positive mast cells were found in AC as compared to normal lip (P<0.001). COX-2 overexpression was found to be a significant predictor of AC (P<0.034, forward stepwise, Wald), and to be correlated with both tryptase-positive mast cells and PAR-2 expression (P<0.01). The results suggest that epithelial COX-2 overexpression is a key event in AC, which is associated with increased tryptase-positive mast cells and PAR-2. Therefore, tryptase may contribute to COX-2 up-regulation by epithelial PAR-2 activation during early lip carcinogenesis.

Adenomatoid odontogenic tumor concomitant with cystic complex odontoma: Case report

This case report describes a 10-year-old female patient with an adenomatoid odontogenic tumor developing together with a cystic complex odontoma. This occurrence is considered very unusual. Immunohistochemical detection of cytokeratins AE1/AE3, CK5, CK8, CK10, CK14, CK19 and Ki-67 was performed.

Increased fibroblast density in actinic cheilitis: association with tryptase-positive mast cells, actinic elastosis and epithelial p53 and COX-2 expression.

BACKGROUND Actinic cheilitis (AC) is characterized by epithelial and connective tissue alterations caused by ultraviolet sunlight overexposure known as photodamage. Fibroblasts have been linked to photodamage and tumor progression during skin carcinogenesis; however, their role in early lip carcinogenesis remains unknown. The aim of this study was to assess the density of fibroblasts in AC and normal lip (NL) samples and determine their association with markers of lip photodamage. METHODS Fibroblasts, mast cells, p53, COX-2, and elastin were detected in NL (n = 20) and AC (n = 28) biopsies using immunohistochemistry/histochemistry. Mast cell and fibroblast density and epithelial p53 and COX-2 expression scores were then obtained. Elastosis was scored 1-4 according to elastin fiber density and tortuosity. RESULTS Fibroblasts, mast cells, p53, COX-2, and elastosis were increased in AC as compared to NL (P < 0.001). Multivariate analysis showed an association between fibroblast and mast cell density at the papillary and reticular areas of AC and NL (P < 0.05). Papillary fibroblast density was also associated with epithelial p53 and COX-2 expression (P < 0.05). Increased fibroblast density, both papillary and reticular, was found in the high elastosis group (scores 3-4) as compared to the low elastosis group (scores 1-2) (P < 0.01). Increased reticular mast cell density was detected only in the high elastosis group (P < 0.01). CONCLUSIONS Fibroblasts are increased in AC, and they are associated with mast cell density, epithelial p53 and COX-2 expression, and actinic elastosis. Therefore, fibroblasts may contribute to lip photodamage and could be considered useful markers of early lip carcinogenesis.

Reduction of syndecan-1 expression during lip carcinogenesis.

BACKGROUND Actinic cheilitis (AC) is an oral pre-cancerous lesion that sometimes develops into lip squamous cell carcinoma (SCC). Syndecan-1, a transmembrane heparan sulfate proteoglycan, modulates cell-proliferation, adhesion, migration and angiogenesis. Malignant epithelial cells often down-regulate their own syndecan-1 production, and are capable of inducing aberrant syndecan-1 expression in stromal cells. The aim of this study was to evaluate the variations in syndecan-1 expression during lip carcinogenesis, in normal lip (NL), AC and well-differentiated lip SCC. METHODS Biopsies of NL vermillion (n = 19), AC (n = 23) and lip SCC (n = 24) were stained immunohistochemically for syndecan-1. RESULTS Syndecan-1 expression was significantly reduced in AC and lip SCC as compared to NL (P < 0.05), with a significant reduction in lip SCC as compared to AC (P < 0.0001). In lip SCC lesions, syndecan-1 expression at the epithelium overlying the tumor was increased when compared to the tumor itself (P < 0.03), but was significantly reduced as compared to AC and NL (P < 0.001). CONCLUSION The results showed that epithelial syndecan-1 expression is reduced as lip carcinogenesis progresses (NL>AC>lip SCC), suggesting that syndecan-1 could be a useful marker of malignant transformation in the lip.

Mandibular Overdentures Retained by Two Mini-Implants: A Seven-Year Retention and Satisfaction Study.

PURPOSE Patients with atrophic edentulous ridges generally have problems with retention, therapeutic satisfaction, and comfort with their complete dentures. An alternative treatment to assist in improving retention and stability involves the use of mini-implants. The aim of this study was to evaluate the retention of mandibular overdentures connected to two mini-implants and overall patient satisfaction with them. MATERIALS AND METHODS Seven patients with atrophic mandibular ridges (Type 4D Misch classification), aged 62 to 74 years old were rehabilitated with complete dentures. In each patient, two mini-implants measuring 15 or 13 mm in length and 1.8 mm in diameter were placed. After 15 days, overdentures were connected to the mini-implants with O-ring attachments. In each patient, retention of the overdentures was measured, and a survey of therapeutic satisfaction before and after connection to the mini-implants was administered. Prosthesis retention was measured with a digital dynamometer at 1 month, 6 months, and 2, 3, 5, and 7 years after mini-implant placement. Patient satisfaction was assessed with a survey. Data were analyzed with Students t-test (satisfaction survey) and the Friedman test (retention measurements and satisfaction survey). RESULTS The initial retention values (0.34 to 0.63 N without mini-implants) varied significantly (p ≤ 0.050). These values were less than the subsequent measurements of 3.92 to 9.64 N, taken after placement of the mini-implants and connecting them to the dentures. Satisfaction was good to very good over the 7-year observation period. Mucosa and peri-implant bone showed no pathological changes. CONCLUSIONS In this limited sample size clinical study the results indicated that after connecting mandibular overdentures to two mini-implants, patient satisfaction significantly increased and retention significantly improved during the 7-year observation period.

In vitro activity of terpenes against Candida albicans and ultrastructural alterations

OBJECTIVE The purpose of this study was to investigate the in vitro activity of terpene blends combined with tissue conditioner against Candida albicans and the effect on its morphology and sub-micro structure. STUDY DESIGN The minimal inhibitory concentration (MIC) of terpenes, obtained from a by-product of kraft pulping, was determined using broth microdilution against C. albicans strains, and the activity of terpenes combined with Coe-Comfort tissue conditioner was assessed. Cell morphologic alterations were evaluated using scanning electronic microscopy and transmission electronic microscopy. Data was analyzed using Students t test P < .05. RESULTS The MIC of terpene blends fluctuated between 0.097% and 0.39% (v/v). Coe-Comfort tissue conditioner mixed with terpenes exhibited a total inhibition of C. albicans (P < .05). Terpenes induced ultrastructural alterations, even at the MIC value, including an increase in size, shape modification, cell wall damage with perforations, pronounced disconnection between cell wall and cytoplasm, and cytoplasmic vacuoles. CONCLUSIONS Terpenes had pronounced effects against C. albicans alone and in combination with Coe-Comfort tissue conditioner, which mainly resulted in cell wall damage.

Central giant cell granuloma of the mandibular condyle. Case-report

Summary This case report describes a 19-year-old female patient with a central giant cell granuloma in the left mandibular condyle, treated with en bloc resection and reconstruction with fibula graft. This occurrence is considered very unusual.