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Crohn disease is a chronic granulomatous inflammatory disease of the gastrointestinal tract of unknown etiology. Oral lesions are significant, as they may occasionally precede intestinal and systemic manifestations. In this retrospective study, clinical and histopathologic data were reviewed from the files of 5 patients with Crohn disease diagnosed at the Department of Oral Medicine and Maxillofacial Pathology School of Dentistry, Aristotle University, Thessaloniki, Greece, and Division of Stomatology and Oral Surgery, Faculty of Medicine, University of Geneva, Switzerland. In the 5 patients, clinical signs included erosions, deep ulcers, cobblestoning of the buccal mucosa, mucosal tags, and lip swelling. Histopathologic examination revealed a granulomatous inflammation with noncaseating granulomas and deep fissuring of the oral mucosa. In all 5 patients, oral lesions were the early signs of the disease. The diagnosis of Crohn disease was confirmed by a colonoscopy and a biopsy of colonic lesions. Oral lesions may be significant and/or initial signs of Crohn disease. Recognition of the lesions may provide an early diagnosis. [ABSTRACT FROM AUTHOR]

This paper reports an implant periapical lesion (IPL) with a previously unreported etiology. The presence of an osteolytic area around the apex and around the middle portion of a stable Straumann hollow-screw implant was found on periapical radiographs 3.5 years after implant placement. Case management involved curettage of the soft tissue surrounding the implant apex as well as resection of the nonosseointegrated portion of the implant. Histopathologic examination revealed a connective fibrous tissue containing a dense chronic inflammatory infiltrate with a foreign-body material. Polarized light microscopy and Fourier transform infrared microspectroscopy identified the foreign-body material as starch particles. Etiology of this IPL was thus related to a foreign-body reaction to starch particles. This exogenous contamination probably originated from starch-coated gloves during the surgical procedure. This case report suggests that IPL may successfully be treated by debridement and implant resection instead of implant removal. Peri-implant apical soft tissue should be systematically submitted for histopathologic examination. [ABSTRACT FROM AUTHOR]

Purpose: Evaluation of prosthetic complication was performed on 236 patients treated with 528 implants in an 8-year private practice experience. Materials and Methods: The study sample included 55 overdentures (ODs) and 265 fixed partial dentures (FPDs). Among the latter, 231 FPDs were cemented and 34 were screw-retained. The type and frequency of prosthetic incidents were recorded, including adjustments and complications. Statistical analysis was performed using a chi-square test to identify risk factors associated with complications. Results and Discussion: Over this period, 1 abutment fractured and 2 became loose, leading to a cumulative implant component success rate of 99.2%. Patients with removable prostheses had more complications than those with fixed ones, 66.0% versus 11.5%; the difference was significant (P < .001). Posterior fixed prostheses had more complications than anterior ones, 11.0% versus 0%; however, the difference was not significant (P = .16). The complication rates for cemented and screw-retained prostheses did not differ significantly (10.4% versus 5.9%; P = .61). Prostheses with an extension cantilever had more complications, 29.4% versus 7.9%; the difference was significant (P = .01). In the OD group, the ball-retained prostheses had a significantly higher rate of complications than the bar-retained ones (77.5% versus 42.9%; P = .04). In the FPD group, complications were not recurrent; most occurred during the first 2 years, and the rate of complications did not increase with time. In the OD group, 1.3 incidents per prosthesis were recorded. Incidents were often recurrent, and the rate of complications did not decrease with time. Conclusions: Removable and fixed prostheses were associated with complications at different frequencies and of different types. In the removable group, adjustments and foreseeable complications were numerous, recurrent, and usually easy to manage. Bar-retained prostheses had fewer complications than ball-retained ones. In the fixed group, complications were limited in number and did not increase with time. Complications were restricted to the posterior region. [ABSTRACT FROM AUTHOR]