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Bone grafts are used for bone augmentation to ensure optimal implant placement. However, this procedure may sometimes cause sinusitis. The case of a 44-year-old woman with the diagnosis of recurrent and chronic sinusitis of her right maxillary sinus with a history of dental implant surgery is presented. After several attempts with normal standard sinusitis therapy, unrecognized bone substitute was removed from the sinus cavity, which finally led to resolution of the sinusitis. This case reiterates the importance of a careful examination, consultation, and second opinion for the selection of optimal treatment. [ABSTRACT FROM AUTHOR]

It was hypothesized that peri-implant tissue around loosening dental implants may contain cytokines with a potential to regulate osteoclasts. Peri-implant and/or gingival samples from loosened implants, chronic periodontitis (CP), and normal controls (n = 10 samples in each group) were analyzed using immunohistochemical staining to observe tumor necrosis factor alpha (TNF-alpha), interleukin 1-alpha (IL-1alpha), IL-6, platelet-derived growth factor A (PDGF-A), and transforming growth factor alpha (TGF-alpha). These cytokines were found in foreign-body giant cells, macrophages, fibroblasts, and epithelial cells. TNF-alpha, IL-1alpha, and IL-6 were increased (P < .05; unpaired t test) in peri-implantitis and CP, whereas PDGF-A and TGF-alpha were not. In conclusion, cytokines with a potential to activate osteoclasts were found in both peri-implantitis and CP, but the cytokine profiles differed in that IL-1alpha was the most prevalent cytokine in the former and TNF-alpha was the most common in the latter. These cytokines may contribute to peri-implant bone loss/loosening by stimulating formation and activity of osteoclasts and might be an amenable target for local therapies with cytokine modulators. [ABSTRACT FROM AUTHOR]

PURPOSE: Attachment of bacteria to titanium may differ not only between bacterial species but also between strains within a species. The aim of the present in vitro study was to examine differences in bacterial attachment using 4 gram-negative anaerobic species of bacteria that are considered potential periodontal pathogens. MATERIALS AND METHODS: The attachment of clinical and laboratory strains (n = 23) representing 2 Fusobacterium nucleatum subspecies, Porphyromonas gingivalis, and Prevotella intermedia to smooth, commercially pure titanium was examined using scanning electron microscopy. RESULTS: All bacterial strains were attached to the smooth titanium surface by their outer membrane. F nucleatum cells were poorly attached to the titanium, unlike P gingivalis or P intermedia cells, but only slight differences were observed in the quantity of attached cells between the strains within each bacterial group. DISCUSSION: In favorable conditions, some anaerobes can attach directly to an inert titanium surface. Microbial adhesion and subsequent colonization on the dental implant surface can lead to infection of the peri-implant tissue. CONCLUSION: The results indicated that the avidity of bacterial attachment to a smooth titanium surface varies between species of oral gram-negative anaerobes but not between strains. [ABSTRACT FROM AUTHOR]

AIMS: To investigate whether involvement of the temporomandibular joint (TMJ) can occur in men with Reiter's disease (RD). METHODS: Forty-nine men with RD and 49 individually matched (gender, age and dentition type) controls with no known general joint disease were screened for findings in the TMJ by panoramic tomography. RESULTS: Duration of subjective symptoms (e.g., pain) in the masticatory system correlated with duration of RD (P = .05). In the RD group, severity of clinical signs of symptoms correlated with the progressive form of RD (P = .01), number of affected joints (P = .0001), and involvement of the cervical (P = .0001) and lumbar spine (P = .05). Patients with RD more frequently had radiographic findings (33%) in the condyle of the TMJ than did controls (10%) (P = .002). The most characteristic radiographic sign in the condyle in the RD group was unilateral erosion (12%). CONCLUSION: Patients with RD often have erosion causing pain and dysfunction in the TMJ. Potential masticatory system problems for such patients should be brought to the attention of dentists and physicians. [ABSTRACT FROM AUTHOR]

Objectives: Healthy human labial salivary glands produce epidermal growth factor (EGF). In Sjögren's syndrome (SS), EGF staining is diminished. SS is also associated with chronic autoimmune corpus gastritis. We therefore hypothesized that EGF secretion would be diminished in SS and that this could affect gastric target cells.Methods: Salivary EGF secretion in SS was compared to that in healthy controls using an enzyme-linked immunosorbent assay (ELISA). EGF receptor (EGFR) immunoreactive cells in the gastric corpus of healthy human subjects were analysed using immunostaining.Results: Salivary secretion of EGF was diminished in SS patients (232.4, range 52.6-618.4, vs. 756.6, range 105.3-1631.6 pg/min, p = 0.002). Proton-pump positive parietal cells were mostly EGFR immunoreactive whereas very few pepsinogen I (PGI)-positive cells were EGFR positive.Conclusions: As EGF is relatively acid resistant, salivary gland-derived EGF might participate in an exo/endocrine mode of parietal cell maintenance in the gastric corpus. Deficiency of salivary gland-derived EGF in SS patients may cause impairment of gastric parietal cells resulting in exposure of immunogenic cryptic antigens and loss of immunological self-tolerance. [ABSTRACT FROM AUTHOR]

Objectives Oral lichen planus ( OLP) is an autoimmune disease characterized by a band-like T-cell infiltrate below the apoptotic epithelial cells and degenerated basement membrane. We tested the hypothesis that the high-affinity histamine H4 receptors (H4Rs) are downregulated in OLP by high histamine concentrations and proinflammatory T-cell cytokines. Materials and Methods Immunohistochemistry and immunofluorescence staining, image analysis and quantitative real-time polymerase chain reaction of tissue samples and cytokine-stimulated cultured SCC-25 and primary human oral keratinocytes. Results H4R immunoreactivity was weak in OLP and characterized by mast cell ( MC) hyperplasia and degranulation. In contrast to controls, H4R immunostaining and MC counts were negatively correlated in OLP ( P = 0.003). H4R agonist at nanomolar levels led to a rapid internalization of H4Rs, whereas high histamine concentration and interferon- γ decreased HRH4-gene transcripts. Conclusion Healthy oral epithelial cells are equipped with H4R, which displays a uniform staining pattern in a MC-independent fashion. In contrast, in OLP, increased numbers of activated MCs associate with increasing loss of epithelial H4R. Cell culture experiments suggest a rapid H4R stimulation-dependent receptor internalization and a slow cytokine-driven decrease in H4R synthesis. H4R may be involved in the maintenance of healthy oral mucosa. In OLP, this maintenance might be impaired by MC degranulation and inflammatory cytokines. [ABSTRACT FROM AUTHOR]

Objectives It was hypothesized that beta 2 defensin ( BD-2) is increased in RAU lesions compared with healthy controls to promote anti-microbial host defence. Methods RAU and control mucosa samples were subjected to quantitative real-time PCR and immunostained for BD-2, CD68, mast cell tryptase and 4-hydroxynonenal (4 HNE). The effect of tumour necrosis factor- α ( TNF- α) ± interleukin-17C ( IL-17C), without and with vitamin K3, was studied on BD-2 expression in epithelial SCC-25 cells. Results Although BD-2 mRNA did not differ between healthy and RAU mucosa, BD-2 stained strongly in acute-phase RAU epithelium ( P = 0.001). In controls, subepithelial BD-2+ cells were mast cells and macrophages, whereas in RAU, most infiltrating leucocytes were BD-2+ ( P = 0.004). In cell culture, BD-2 was increased 124-fold by TNF- α ( P < 0.0001) and 208-fold synergistically together with IL-17C ( P < 0.0001). 4HNE staining of RAU epithelium was not significantly increased, and vitamin K3-induced reactive oxygen species (ROS) did not affect BD-2. Conclusions Anti-microbial BD-2 was not affected by oxidative stress but was highly increased in the epithelial and immigrant cells in the acute-phase RAU lesions, probably in part synergistically by TNF- α and epithelial IL-17C, which are known to be induced by activation of danger-signal receptors by pathogen- and/or damage-associated molecular patterns. [ABSTRACT FROM AUTHOR]

Objective To study non-osteoclastic sources of cathepsin K in periodontitis. Materials and Methods Tissue samples were obtained from 10 otherwise healthy periodontitis pati-ents during routine periodontal flap operations and 10 systemically and periodontally healthy individuals who underwent extraction operations for retained third molars. Methods used were immunohistochemistry, image analysis, immunofluorescence double-staining, gingival fibroblast culture, tumour necrosis factor- α ( TNF- α) stimulation and Western blotting. Results Macrophage-like cells, fibroblast-like cells, vascular endothelial cells and gingival epithelial cells were more intensively stained for cathepsin K and also more frequent in periodontitis than in controls (665 ± 104 vs 258 ± 40 cells mm−2, P < 0.01). Some cathepsin K+ cells in periodontal tissues were CD68+, but some were CD68− and probably fibroblasts. Indeed, in gingival fibroblast culture, resting fibroblasts released cathepsin K, more 43 kD procathepsin K than 29 kD active cathepsin K. TNF- α increased the release of the activated cathepsin K 4- to 5-fold. Conclusions Results suggest that GCF-cathepsin K is not only osteoclast-derived, but in periodontitis, also other cells contribute to it. GCF-cathepsin K, perhaps together with intracellular, lysosomal collagenolytically active cathepsin K in fibroblasts, macrophages and gingival epithelial cells, can contribute to the loss of attachment and destruction of the periodontal ligament. [ABSTRACT FROM AUTHOR]

Oral Diseases (2012) 19, 46-58 Sjögren's syndrome (SjS) is one of the most common autoimmune rheumatic diseases, clinically characterized by xerostomia and keratoconjunctivitis sicca. We investigated the following controversial topics: (i) Do we have reliable ways of assessing saliva production? (ii) How important are the quantity and quality of saliva? (iii) Are only anti-SSA/Ro and anti-SSB/La relevant for the diagnosis of SjS? (iv) Are the American-European Consensus criteria (AECC) the best way to diagnose SjS? Results from literature searches suggested the following: (i) Despite the fact that numerous tests are available to assess salivation rates, direct comparisons among them are scarce with little evidence to suggest one best test. (ii) Recent developments highlight the importance of investigating the composition of saliva. However, more research is needed to standardize the methods of analysis and collection and refine the quality of the accumulating data. (iii) In addition to anti-Ro/La autoantibodies, anti α-fodrin IgA and anti-MR3 autoantibodies seem to be promising diagnostic markers of SjS, but more studies are warranted to test their sensitivity and specificity. (iv) AECC are classification, not diagnostic criteria. Moreover, recent innovations have not been incorporated into these criteria. Consequently, treatment directed to patients diagnosed using the AECC might exclude a significant proportion of patients with SjS. [ABSTRACT FROM AUTHOR]

Oral Diseases (2012) 18, 255-259 Objectives: (i) To determine whether salivary cortisol and electrolyte levels differ between patients with Sjogren's syndrome (SjS) and healthy individuals. (ii) To assess correlations between whole-saliva cortisol and some clinical manifestations in patients with SjS. Methods: A total of 24 healthy women (mean age 49.3 ± 9.8) served as controls (C) vis-à-vis 17 patients with SjS (mean age 55.5 ± 15.7). Salivary cortisol concentration was determined, and sialochemistry analysis was performed. Results: Significantly lower saliva flow rates and higher salivary chloride (Cl−), potassium (K+), and Ca2+ levels were found in the SjS group. No significant differences or correlations were found in other parameters, including sodium (Na+), magnesium (Mg2+), phosphate (−), urea (U), and salivary cortisol levels. Conclusion: Increased whole-salivary output of Cl− and K+ in SjS may reflect release from apoptotic rests of acinar cells after secondary necrosis. Normal levels of salivary Na+, Mg2+, and − argue against concentration effect, deranged tubular function or cortisol (mineralocorticosteroid) effect as the cause for these findings. Increased salivary Ca2+ levels probably reflect leakage of plasma Ca2+ through the injured oral mucosa in SjS. In spite of disease-associated stress, salivary cortisol, a stress biomarker, was not increased, suggesting insufficient hypothalamus-pituitary-adrenal (HPA) axis response and/or local consumption of cortisol by lymphocyte infiltrates. [ABSTRACT FROM AUTHOR]

Usually no distinction is made between female and male salivary glands although cyclic changes of and / or differences in serum and salivary sex steroid concentrations characterize women and men. Moreover, sexual dimorphism is well recognized in salivary glands of rodents. Salivary glands contain estrogen and androgen receptors and are, according to modern high throughput technologies, subjected to gender differences not explainable by gene dose effects by the X chromosome alone. Because sex steroids are lipophilic, it is often thought that approximately 10% of them passively diffuse from plasma to saliva. Indeed, saliva can find use as sample material in sports medicine, pediatrics, veterinary medicine and behavioral sciences. Last but not least, humans and other primates are unique in that they have a reticular zone in their adrenal cortex, which produces dehydroepiandrosterone and androstendione pro-hormones. These are processed in peripheral tissues, not only in female breast and uterus and male prostate, but also in salivary glands by an intracrine enzymatic machinery to active 17 beta-estradiol, dihydrotestosterone and others, to satisfy and buffer against a constantly changing needs caused by circadian, menstrual, pregnancy and chronobiological hormonal changes in the systemic circulation. Female dominance of Sjogren's syndrome and certain forms of salivary gland cancer probably reflect these gender-based differences. [ABSTRACT FROM AUTHOR]