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In head and neck district, major salivary gland diseases seem to have a considerable epidemiological and clinical impact, especially in obstructive disease. Major salivary glands, in fact, having a ductal system can develop several diseases: sialoadenitis, sialodochitis and sialoceles. Particularly, the obstructive sialoadenitis, with or without sialolithiasis, are the most frequent inflammatory disorder, especially for submandibular gland. In the clinical practice, the diagnostic approach for obstructive sialoadenitis up to now consisted of traditional Rx, ultrasonographic technique, scintigraphy technique, C.T., sialography technique with contrast or sialography M.R. Since '9O years, lithotripsy and, later, sialendoscopy have been introduced as gold standard diagnostic procedures in case of obstructive sialoadenitis and also as therapeutic tool when possible. In this way, it has been possible to offer a valid alternative in place of traditional surgical techniques, with a less invasive and more efficacious approach.

Summary. HSP27 belongs to the Heat shock protein (HSP) family, which plays essential functions in cells under physiological conditions and prevents stressinduced cellular damage. The aim of this study was to investigate the biological role of HSP27 in oral tumorigenesis. Materials and methods: Seventy-nine cases of oral squamous cell carcinoma and 10 cases of normal mucosa were analysed for HSP27 expression by immunohistochemistry. Moreover, the western blot analysis was performed on two cases of normal mucosa and five cases of OSCC. Results: Normal oral mucosa showed a suprabasal expression of HSP27. Twenty-four cases of SCC (30.7%) showed a diffuse staining for HSP27, and 48 cases (60.3%) showed instead a decrease in staining, which was diffuse, homogeneous, or with alternation of positive and negative areas in a single tumor (“mosaic” pattern). Only 7 cases of OSCC (7.5%) were completely negative for HSP27. Frequency of lymph node metastases was higher in HSP27-negative tumours (3/7, 42.8%) than in HSP-reduced (16/48, 33.3%) or positive ones (5/26, 19.2%). Regard staging, stages I and II had a higher score than stages III and IV (stage I > stage II > stage III > stage IV). There was also a statistically significant correlation between HSP27 expression and grade: HSP27 expression was reduced in poorly differentiated tumours (P < 0.05). When analysed for prognostic significance, patients with negative/reduced HSP27 expression had poorer survival rates than the group with positive HSP27 expression (P < 0.05). The statistical analysis of these findings showed no significant correlation between HSP27 expression, sex, and tumour size. Conclusion: Cases with reduced expression were more aggressive and poorly differentiated. These data suggest that HSP27 expression may be useful in order to identify cases of oral squamous cell carcinoma with more aggressive and invasive phenotype providing novel diagnostic and prognostic information on individual patient survival with oral cancers.

Several recent medical reports have focused attention on the possible application of skeletal scintigraphy imaging in odontostomatology. The aim of the present report was to assess the influence of a new implant surface on peri-implant osteoblastic activity through bone scintigraphy.Implants were placed in one healthy subject. A nuclear medicine investigation with single-photon emission-computed tomography (SPECT) was performed at 30 and 90 days after implant placement. The study was completed with acquisition of planar images of the skull in an anterior view and the use of regions of interest (ROIs) of the same size in the area corresponding to new surfaces implants and in the opposite maxilla (at the control sites). Count density ratios (counts/pixel) obtained from each ROI were used for a quantitative/relative assessment. Tomographic images were evaluated with a qualitative method.Routine planar methodology provided a direct measure of cellular activity of the examined areas. The difference in count density ratio registered from the same ROI between the first and the second scintigraphy revealed the course of peri-implant osteoblastic activity, which was very high in the first month and then declined during subsequent months.In spite of the small number of involved patients, the results obtained from this pilot study suggest that nuclear medicine investigation held advantages in oral implantology to clarify those aspects still unknown dealing with osteoblastic activity.

Introduction: Survivin is a member of the Inhibitor of Apoptosis (IAP) proteins family, broadly expressed in most solid and haematological malignancies, but almost undetectable in normal adult tissues. Regarding Oral Squamous Cell Carcinoma (OSCC), Survivin expression seems to be correlated with aggressive phenotype and unfavorable outcome. In this work, the effectiveness of Survivin detection in saliva samples as diagnostic tool was investigated. Methods: 55 saliva samples from patients with histological diagnosis of OSCC and 30 samples from healthy controls matched for age and gender were collected. All samples from OSCC were collected before therapy. Saliva was analyzed using Assay Designs human Total Survivin TiterZyme® Enzyme Immunometric Assay (EIA) kit for Survivin detection and quantification. Survivin concentration (pg/ml) was studied in relationship to clinical data. Univariate statistical analysis was performed. Results: 35/55 (63.6%) among OSCC patients were found to be positive for surviving expression in saliva vs 12/30 (40%) among health controls; but the mean value was found to be higher in OSCC group (8,69 pg/ml ± 10,15 vs 2.44 pg/ml ± 4.22) reaching statistical significance (p

BACKGROUND, AIMS:Orofacial granulomatosis (OFG) is a descriptive term used for granulomatous disorders of the face and oral cavity that may occur for a variety of reasons, some of which result in significant morbidity and mortality. Although rarely, a granular enlargements of the gingiva may be the first clinical manifestation of OFG, preceding other local or systemic manifestations. METHOD:We will report a case of OFG that showed an atypical and monosymptomatic onset with a generalized hyperplastic gingivitis that preceded other facial and mucosal features by several weeks. RESULT:Considering the variable clinical onset of OFG and its apparent increase in incidence, we emphasize that in some cases, the periodontologist, as first consulted health care professional, plays an important role to detect this disorder. Early diagnosis of OFG is a crucial step to prevent and cure its unsightly sequelae and sometimes avoid progression of systemic potentially life-threatening OFG-related diseases. CONCLUSION:Thus, when none of the common causes of gingival enlargement can be detected, OFG diagnosis should be suspected.

BACKGROUND:Pemphigus vulgaris (PV) is a rare, chronic, intraepithelial bullous disease with a potentially fatal outcome. Oral lesions are a hallmark of PV and occur in almost all cases, and represent the preliminary symptom in more than half of the patients. Gingival lesions are very common and, when solitary, often first recognized by periodontist. METHOD:In the literature, gingival localization of PV are usually described as desquamative gingivitis (DG) and/or as vesiculobullous lesions of the free and attached gingiva; in our experience, early lesions only rarely appears as extensive erythema and erosions. CONCLUSIONS:PV at the onset may frequently appear on gingiva as isolated blisters and/or erosions mainly located to the free gingiva, very little in extension and hardly to recognize as bullous lesions.

BACKGROUND:This study evaluated the clinical use of a corticosteroid in three preparations (topical clobetasol propionate ointment, clobetasol propionate in an oral analgesic base, and clobetasol propionate in an adhesive denture paste). METHODS:Fifty-four patients (34 males and 20 females) with a history of vesiculo-ulcero-erosive oral lesions were selected: 24 with oral erosive lichen planus and 30 with aphthae. The subjects enrolled were randomly divided into three groups, each of 18 patients (10 with aphthae and 8 with lichen planus): the first was treated with topical clobetasol propionate ointment (0.05%) directly on the lesion(s) three times a day; the second with clobetasol propionate in an adhesive denture paste in equal amounts (1:1) two times a day; the third with clobetasol propionate in an oral analgesic base (Orabase-B) in equal amounts (1:1) two times a day. Each subject scored his or her symptoms daily from most severe (7) to none (0) by verbal assessments using a categorical scale. RESULTS:In all cases, the administration of the corticosteroid was effective in producing remission of symptoms in each group of patients. Significant differences (P

Systemic corticosteroids remain the mainstay of therapy for pemphigus. Their use has transformed what was almost invariably a fatal illness into one whose mortality is now below 10%. Unfortunately, the high doses and prolonged administration of corticosteroids that are often needed to control the disease result in numerous side effects, many of which are serious or even life-threatening. Sixteen patients affected by oral pemphigus vulgaris were retrospectively examined to illustrate the natural course of the disease and to describe the efficacy of the treatment we utilised. Deflazacort, used with azathioprine, is the steroid of first choice in our therapeutic protocols, while cyclophosphamide and methylprednisolone "pulse therapy" are reserved for cases unresponsive to high doses of oral corticosteroids. In addition, the literature on oral pemphigus vulgaris was reviewed with respect to clinical history, signs and symptoms, management, and treatment outcome.

Verrucous carcinoma (also known as Ackerman tumor) is an uncommon exophytic low-grade well-differentiated variant of squamous cell carcinoma. This neoplasm typically involves the oral cavity, larynx, genitalia, skin, and esophagus. It is well known for its locally aggressiveness and for its clinically slow-growing behaviour with minimal metastatic potential. Verrucous carcinoma of oral cavity is so closely aligned with the use of snuff and chewing tobacco that it has been called the “snuff dipper's cancer”. Recent studies have proved the role of HPV. The typical clinical presentation of oral verrucous carcinoma has long been known, as its remarkably innocuous appearance and biological behaviour. In this work, we report a review of the scientific literature and describe a troublesome case of oral verrucous cancer.

Catenins belong to a family of proteins that mediate the binding between intracytoplasmic domain of cadherins and cytoskeleton. Few data on distribution of beta and gamma catenins in non-neoplastic tissues are available from current literature. This study aims to evaluate distribution of beta and gamma catenins in oral epithelium.Nine formalin-fixed and paraffin-embedded samples of oral epithelium were retrieved from files of Department of Oral Pathology of the University of Naples "Federico II". These samples were tested with anti-beta and anti-gamma monoclonal antibodies revealed by standard streptavidin-biotin-peroxidase technique. Sections have been evaluated by two observers by optical microscope using a 40X objective. The number of positive cells has been evaluated using a semi-quantitative method.The results of this study show that beta and gamma catenins were mostly distributed in the upper two-thirds of oral epithelial thickness, except for keratinized areas which appear negative. Basal layer is positive except for the basal side of basal cells. Keratinized layers are negative for beta and gamma catenins.In physiologic conditions staining pattern for beta and gamma catenins is almost exclusively membranous, sometimes cytoplasmic but never nuclear. This staining is well-represented even in conditions of chronic inflammation and leucoplakia.