Pietro Messina

HLA-A, B, C, DR, MT, and MB antigens in recurrent aphthous stomatitis

In this report we have investigated the frequencies of HLA-A, B, C, DR, MT, and MB markers in 26 Sicilian subjects affected by recurrent aphthous stomatitis (RAS) and in 84 healthy controls. Our data show that the frequency of HLA-DR7 antigen is significantly increased in RAS-affected persons (61.5% versus 21.4%; pc less than 0.0025), whereas the B5 antigen frequency is decreased significantly (absent in patients versus 27.3% in controls; pc = 0.04). Thus, present results suggest that HLA-linked genetic factors may play a role in the development of RAS.

Periodontal alteration of the microcirculation and hypercholesterolemia: a possible correlation?

Objective: We evaluated the morphological and parametric characteristics of the periodontal microcirculation in patients diagnosed as having hypercholesterolemia and high levels of low-density lipoprotein (LDL). Methods: Forty patients were recruited, 20 of whom were affected by hypercholesterolemia and 20 of whom were considered healthy. A videocapillaroscopic examination was carried out on the periodontal mucosa in the proximity of the frenulum (II, V sextant). Results: The difference between the parameters of the hypercholesterolemia group and the control group was evaluated with the Mann-Whitney U-test for non-parametric ordinal data; the level of significance being P < 0.05. The videocapillaroscopy documented extremely significant differences between the two groups, regarding the following parameters: total diameter of the loop (P = 0.0017), diameter of the afferent loops (P = 0.0004), diameter of the efferent loops (P = 0.00008) and periodontal density (P = 0.0001). Conclusions: The capillaroscopic examination revealed a morphological alteration of the periodontal microcirculation in patients with hypercholesterolemia, which is an expression of peripheral vascular phlogosis.

Periodontal Disease and Sjögren Syndrome: A Possible Correlation?

Sjögren syndrome (SS) is a chronic autoimmune rheumatic disease characterized by a progressive lymphocytic infiltration of exocrine glands, especially salivary and lachrymal ones, leading to xerostomia, parotid gland enlargement, and xerophthalmia. The aim of this study is to describe the capillaroscopic pattern of the interdental papilla in patients with SS and to evaluate a possible correlation with periodontal disease. Methods: A total of 25 patients affected by SS and 25 healthy controls were examined. The patients with conditions that compromise microcirculation, such as diabetes, hypertension, hyperlipidemia, or some pharmacological treatments, were not included in the study. All the patients were nonsmokers. Periodontal capillaroscopy has been used to investigate the features of microcirculation. Visibility, course, tortuosity, as well as the possible presence of microhemorrhage, the average caliber of the capillary loops, and the number of visible capillary loops per square millimeter were evaluated for each patient. Results: The results show evident alterations to the capillaries and a typical conformation of the interdental papilla microcirculation in patients with SS; it was possible to observe a reduced caliber of capillaries, as well as a greater number and tortuosity of capillary loops. Conclusion: This study shows that capillary alterations to patients with SS occur in gingival microcirculation.

Anatomical evaluation of oral microcirculation: capillary characteristics associated with sex or age group.

BACKGROUND There are various types of oral mucosa specific to different parts of the mouth and each of these has a unique histological structure. The variations in the epithelial structure are consistently related to observable differences in the underlying microcirculation: i.e. differences in the course, conformation, and density of capillaries. The aim of this research has been to investigate oral microcirculatory differences between men and women as well as between various age groups, in order to map the oral mucosa, and to highlight changes occurring during aging. METHODS A total of 45 healthy subjects were enrolled for this study (12 men and 33 women; mean age 60.37; range 30-82). A complete in-vivo videocapillaroscopic mapping of the oral mucosa was done on each subject. RESULTS The capillaroscopic patterns of the various areas differ particularly in the course of the loops in relation to the mucosal surface. On the basis of statistical analysis of the collected data, it emerges that there are many differences in capillary loop density between men and women and between different age groups. CONCLUSION This study demonstrates the necessity of approaching the investigation of patient microcirculation in different ways depending on sex or age.

Modifications of interdental papilla microcirculation: a possible cause of periodontal disease in Hashimoto's thyroiditis?

BACKGROUND Hypothyroidism is defined by a decrease in thyroid hormone production and thyroid gland function. The aim of the present research has been to evaluate the morphologic interdental papilla microcirculation of patients suffering from Hashimoto thyroiditis (HT) and to evaluate a possible correlation with the associated periodontal disease. METHODS Fifteen healthy subjects and 15 patients suffering from HT were examined. The patients who showed conditions known to compromise microcirculation, such as diabetes, hypertension and pharmacological treatments, were not included in the group of healthy patients. All patients were non-smokers. Gingival capillaroscopy was used to investigate the characteristics of microcirculation. Visibility, course, tortuosity, the average caliber of the capillary loops and the number of visible capillary loops per square millimeter were evaluated for each patient. RESULTS An interdental papilla vascular modification results in HT. In patients suffering from HT, it was possible to observe a reduced caliber of capillaries, as well as a greater number and tortuosity of capillary loops. CONCLUSIONS This study shows that capillary alterations in patients suffering from HT occur in gingival microcirculation.

Lack of correlation between HLA-B35 resistance against herpes labialis and antibody titers to HSV-1

To investigate whether genetic factors linked to the human leukocyte antigens (HLA) might influence individual resistance to recurrent herpes labialis (RHL), we studied the frequencies of HLA-A, -B, and -C antigens in a sample of Sicilian population. The frequency of HLA-B35 was significantly decreased in the patient group (p corrected = 0.018). Consequently, the relative risk of development of RHL in a subject positive for HLA-B35 was 20 times smaller than in a subject who does not bear B35. Furthermore, a study was made of the possible relationship between the presence of HLA-B35 antigen and antibody titers to herpes simplex virus type 1 (HSV-1) in 62 persons affected or not by RHL. Significantly elevated titers to HSV-1 were found in the diseased group (p less than 0.001), but the geometric mean of antibody titers in HLA-B35 positive subjects was not different from that of B35 negative subjects either of RHL-affected or in healthy persons. These data are in a good agreement with the hypothesis that humoral immune responses play a marginal role in the protection from HSV-1 recurrences.

Oral microcirculation in post-menopause: a possible correlation with periodontitis

OBJECTIVES The reduction in the level of oestrogen, typical in menopause, has some effect on the health of the oral cavity. In fact, post-menopausal women present more severe periodontal disease than pre-menopausal women. Numerous factors can be held to be responsible for this increase, among which are the effects of oestrogens on the oral epithelium, on the salivary glands, on bone tissue and on the endothelium. Our double blind study aims to evaluate the possible variations in oral microcirculation in post-menopausal women. METHODS Twenty-seven women in post-menopause (age: Mean ± SD: 57.3 ± 8.73) and 27 women in pre-menopause (age: Mean ± SD: 27.77 ± 3.56) were examined. Oral microcirculation was investigated using oral videocapillaroscopy. RESULTS The study showed significant differences between cases and controls for the following parameters: decrease in diameter of loops (mean ± SD: 0.038 ± 0.008; 0.045 ± 0.005), increase in tortuosity (mean ± SD: 3.83 ± 1.13; 1.83 ± 1.06) in labial mucosa and decrease in density in periodontal mucosa (Mean ± SD: 28.86 ± 10.92; 89.62 ± 17.83). CONCLUSION The decrease in periodontal density may compromise the epithelium tropism, making it prone to inflammation. The tortuosity may indicate a greater permanence of inflammatory factors, increased in post-menopausal women.

Microvascular characteristics of the human interdental papilla.

The aim of this study was to observe the microcirculation characteristics of the human interdental papilla in healthy patients in vivo. Twenty healthy patients were examined. Capillaroscopy was used to investigate the characteristics of microcirculation of the human periodontal mucosa. Visibility, course, tortuosity, as well as the average caliber of the capillary loops and the number of visible capillary loops per square millimeter were evaluated for each patient. The investigation of gingival mucosa revealed capillary loops with a course both parallel and perpendicular to the surface. Our study has pointed out that capillaroscopy is a reliable method to study periodontal microcirculation in vivo. This method could be applied to the study of microcirculation in periodontal diseases. Future studies might evaluate whether microcirculation in that area is compromised or not during systemic pathologies involving peripheral microcirculation alterations.

A non-parametric segmentation methodology for oral videocapillaroscopic images

We aim to describe a new non-parametric methodology to support the clinician during the diagnostic process of oral videocapillaroscopy to evaluate peripheral microcirculation. Our methodology, mainly based on wavelet analysis and mathematical morphology to preprocess the images, segments them by minimizing the within-class luminosity variance of both capillaries and background. Experiments were carried out on a set of real microphotographs to validate this approach versus handmade segmentations provided by physicians. By using a leave-one-patient-out approach, we pointed out that our methodology is robust, according to precision-recall criteria (average precision and recall are equal to 0.924 and 0.923, respectively) and it acts as a physician in terms of the Jaccard index (mean and standard deviation equal to 0.858 and 0.064, respectively).

Periodontal microcirculation in diabetics: An in vivo non-invasive analysis by means of videocapillaroscopy

Summary Background Diabetes mellitus is today considered a society-wide disease of a chronic/degenerative nature. Among the secondary effects of diabetes, the one that interests the dental surgeon most is diabetic parodontopathy. The aim of this study was to underline and objectify microcirculatory variations at a periodontal mucous level in type 2 diabetics. Material/Methods The study enrolled 80 subjects: 40 subjects with a diagnosis of diabetes mellitus type II (18 males and 22 females, between 44 and 85 years of age); and 40 healthy subjects (17 males and 23 females, between 44 and 78 years of age). All the subjects, both diabetic and healthy, were submitted to a videocapillaroscopic examination of the mucosa of the oral cavity. Results The measurements concerning the density (expressed in the number of loops/mm2) of the capillary loops presented differences between the healthy subjects and the diabetic subjects. The average periodontal capillary density (DC-P) was clearly superior in diabetic subjects (35.62±10.40 n°loop/mm2) compared to healthy subjects (17.55±3.88 n°loop/mm2). The statistical analysis was performed by means of the Mann Whitney test. The value of P (p=0.000000986), well below the level of significance, demonstrates the high significance of the results obtained. Conclusions The increase in capillary density could suggest the presence of active inflammatory phenomena or, more probably, a tendency to a greater susceptibility to inflammatory phenomena. Ultimately, this study shows that there is some peripheral damage to microcirculation at the masticatory mucous level in diabetic subjects and that such alterations can be instrumentally objectified and quantified through the videocapillaroscopic method.