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Sample records for acute necrotizing gingivitis

  1. Epidemiology of acute necrotizing ulcerative gingivitis.

    PubMed

    Melnick, S L; Roseman, J M; Engel, D; Cogen, R B

    1988-01-01

    In the last 60 years, there have been approximately 50 studies of various suspected risk factors associated with acute necrotizing ulcerative gingivitis. Two thirds of these studies have been either surveys or case reports; nearly all the rest have been case-control studies. There have been only a few longitudinal and population-based studies, most of which were in high-risk populations. The findings of many studies pertain to gingivitis in general rather than in acute necrotizing ulcerative gingivitis in particular; the findings of other studies are based on small numbers or solely on case histories without the inclusion of control subjects. There are comparisons between the epidemiology of acute necrotizing ulcerative gingivitis as it occurs in military populations and the epidemiology of meningococcal meningitis (98-103). Both diseases have been reported in closed communities such as in young recruits away from home and in new surroundings. A temporal trend upward in disease frequency was described for both infections during World War II. Both infections appear to be characterized by low communicability, with no documented transmission by fomites or vectors. Furthermore, active disease in both cases is associated with markedly increased numbers of normally indigenous flora: B. intermedius in the case of acute necrotizing ulcerative gingivitis and Neisseria meningococcus in the case of epidemic meningococcal meningitis. Risk factors associated with both diseases include crowding, physical fatigue, increased stress, low socioeconomic status, and failure of host defense mechanisms. In general, there is potential for longitudinal studies of young people such as new military recruits and college students who are undergoing the transition from dependence to independence. It is intriguing that these young adults are suddenly at increased risk of this disease in late adolescence when they should be at peak fitness and, just as suddenly, at decreased risk after their

  2. The phylum Synergistetes in gingivitis and necrotizing ulcerative gingivitis.

    PubMed

    Baumgartner, Angelica; Thurnheer, Thomas; Lüthi-Schaller, Helga; Gmür, Rudolf; Belibasakis, Georgios N

    2012-11-01

    The clinical manifestation of necrotizing ulcerative gingivitis (NUG) is distinct from that of common gingivitis in that it is characterized by local necrosis of the gingival tissues, rapid onset, pain and extensive bleeding. The phylum Synergistetes is a novel bacterial phylum consisting of Gram-negative anaerobes, with evidence of presence in biofilms associated with periodontal and endodontic infections. To date, the involvement of members of this phylum in NUG has not been investigated. This study aimed to evaluate the presence and levels of known human oral Synergistetes bacterial clusters in dental plaque from patients with NUG and compare them with those found in gingivitis. Marginal dental plaque samples from 21 NUG and 21 gingivitis patients were analysed quantitatively by fluorescent in situ hybridization and microscopy for members of two oral Synergistetes clusters (A and B) and for Jonquetella anthropi. Synergistetes cluster A bacteria were detected in all samples but at higher levels (9.4-fold) and proportions (2.5-fold) in NUG patients than in gingivitis patients. However, with regard to Synergistetes cluster B bacteria, there were no differences between NUG and gingivitis patients. J. anthropi was detected in only half of the samples and at lower levels than the other taxa. In conclusion, these data demonstrate that Synergistetes cluster A bacteria, but not cluster B bacteria or J. anthropi, are more strongly associated with NUG than with gingivitis.

  3. Treponema parvum sp. nov., a small, glucoronic or galacturonic acid-dependent oral spirochaete from lesions of human periodontitis and acute necrotizing ulcerative gingivitis.

    PubMed

    Wyss, C; Dewhirst, F E; Gmür, R; Thurnheer, T; Xue, Y; Schüpbach, P; Guggenheim, B; Paster, B J

    2001-05-01

    Small oral spirochaetes with a strict dependence on either glucuronic acid (GluA) or galacturonic acid (GalA) were isolated from European patients with periodontitis and from Chinese patients with either gingivitis or acute necrotizing ulcerative gingivitis (ANUG). Thirteen such isolates were similar phenotypically to Treponema pectinovorum ATCC 33768T and this classification was confirmed by 16S rRNA sequencing. However, four isolates differed from T. pectinovorum by their small cell size, by a prominent beta-glucuronidase activity, by a distinct protein and antigen profile, by an inability to grow on pectin as sole source of carbohydrate and by a markedly enhanced growth rate when supplied with a second carbohydrate (L-arabinose, D-galactose, D-glucose, D-fructose, D-mannitol, D-mannose, pectin, D-ribose or D-xylose) in addition to the essential GluA/GalA. By 16S rRNA sequencing these four isolates clustered in the recently described phylotype 'Smibert-2'. T. pectinovorum (14 strains) and 'Smibert-2' (four isolates with beta-glucuronidase activity) could each be subdivided into two serotypes based on immunoblot reactivity with two mAbs. Representatives of the two groups, including T. pectinovorum ATCC 33768T, showed a 1:2:1-type periplasmic flagellar arrangement. 'Smibert-2' is described as a novel species, Treponema parvum sp. nov., with isolate OMZ 833T (= ATCC 700770T) proposed as the type strain and OMZ 842 (= ATCC 700773) as reference strain for a second serotype.

  4. [Acute necrotizing enteritis].

    PubMed

    Marincaş, M; Bratucu, E; Straja, D; Daha, C; Boru, C

    2003-01-01

    The authors present a retrospective clinical study done on a 13-pacients basis diagnosed during surgery with acute necrotizing enteritis. This study follows the complexity of pathogenic factors and the difficulties one confronts with when establishing a diagnosis since the clinical manifestations are non-specifical and shows the contribution of laboratory data to an earliest possible diagnosis. Both medical and surgical treatment are analyzed depending on the results achieved with an attempt to determine a therapeutic approach as beneficial as possible, aiming at making clear either enterectomy or a conservatory surgical decision should be made. Mortality rate under such therapeutical approach was 38%.

  5. Acute necrotising ulcerative gingivitis in an immunocompromised young adult.

    PubMed

    Hu, Jessie; Kent, Paul; Lennon, Joshua M; Logan, Latania K

    2015-01-01

    Acute necrotising ulcerative gingivitis is an acute onset disease characterised by ulceration, necrosis, pain and bleeding in gingival surfaces. It is predominantly seen in severely malnourished children and young adults with advanced HIV infection. We present a unique presentation in a young adult with high-grade osteogenic sarcoma.

  6. Apoptotic and necrotic influence of dental resin polymerization initiators in human gingival fibroblast cultures.

    PubMed

    Masuki, Kouhei; Nomura, Yuji; Bhawal, Ujjal Kumar; Sawajiri, Masahiko; Hirata, Isao; Nahara, Yukinori; Okazaki, Masayuki

    2007-11-01

    The aim of this study was to examine the apoptotic and necrotic influence of four dental resin polymerization initiators--namely benzoyl peroxide (BPO), camphorquinone (CQ), dimethylaminoethyl methacrylate (DMAEMA), and dimethyl-para-toluidine (DMPT)--on human gingival fibroblast (HGF) cells. To this end, the growth inhibition of HGF cells with 1 mM BPO, CQ, and DMAEMA, and 500 microM DMPT was evaluated using Cell Counting Kit-8. Then, cell cycle analysis by flow cytometry was used to assess propidium iodide-stained cells (distribution of cells in G0/G1, S, G2/M phases). All four dental resin polymerization initiators induced G0/G1 cell cycle arrest. As for the patterns of cell death (necrosis and/or apoptosis), they were analyzed using Annexin V-FITC/PI staining with flow cytometry. All four dental resin polymerization initiators most likely induced necrosis.

  7. Granulomatosis with polyangiitis (Wegener’s) as a necrotizing gingivitis mimic: a case report

    PubMed Central

    2014-01-01

    Introduction Granulomatosis with polyangiitis poses a significant diagnostic dilemma due its diverse presentations. Seemly isolated sites of disease, such as oral ulcers, may present to physicians working in primary care settings, the emergency room, and subspecialty fields as well as to dentists. Oral presentations are particularly challenging to identify and require a high index of suspicion and a detailed knowledge of the condition in order to diagnose and treat. We detail a case of granulomatosis with polyangiitis presenting as necrotizing gingivitis, one of the first of its kind to be reported. Case presentation An otherwise healthy 32-year-old, Caucasian woman presented to various physicians with progressive, painful oral ulcers. Following consultations with multiple primary care physicians and subspecialties, an initial diagnosis of severe infectious necrotizing gingivitis was made resulting in combination antibiotic treatment as well as surgical debridement involving extraction of all maxillary and three mandibular teeth. With the discovery of a positive cytoplasmic anti-neutrophil cytoplasmic antibody and a constellation of associated systemic symptoms, our patient was subsequently diagnosed with granulomatosis with polyangiitis. The treatment regimen of rituximab and methylprednisone was chosen in consideration of our patient’s desire for future fertility and has been successful in inducing and maintaining remission. Conclusions Following the case presentation, we review the current literature regarding granulomatosis with polyangiitis presentation, diagnosis and treatment. In discussing features of granulomatosis with polyangiitis presentation, diagnostic tests, and important new treatment options, we seek to enable physicians of all specialties to better recognize and begin appropriate treatment for this complex condition. PMID:25196320

  8. [Acute necrotizing esophagitis (black esophagus) with secondary severe stenosis].

    PubMed

    Gómez, Álvaro A; Guerrero, Diego; Hani, Albis C; Cañadas, Raúl

    2015-01-01

    We report the case of a 67 years old patient with a history of diabetes mellitus, atrial fibrillation and chronic renal failure, who developed diabetic ketoacidosis and severe sepsis, later presenting an acute necrotizing esophagitis, and then a esophageal stenosis requiring treatment with self-expanding esophageal prosthesis with good clinical results. PMID:26802889

  9. Acute necrotizing pancreatitis as first manifestation of primary hyperparathyroidism

    PubMed Central

    Lenz, Jeroen I; Jacobs, Jimmy M; Op de Beeck, Bart; Huyghe, Ivan A; Pelckmans, Paul A; Moreels, Tom G

    2010-01-01

    We report the case of a female patient with severe acute necrotizing pancreatitis associated with hypercalcemia as first manifestation of primary hyperparathyroidism caused by a benign parathyroid adenoma. Initially the acute pancreatitis was treated conservatively. The patient subsequently underwent surgical resection of the parathyroid adenoma and surgical clearance of a large infected pancreatic pseudocyst. Although the association of parathyroid adenoma-induced hypercalcemia and acute pancreatitis is a known medical entity, it is very uncommon. The pathophysiology of hypercalcemia-induced acute pancreatitis is therefore not well known, although some mechanisms have been proposed. It is important to treat the provoking factor. Therefore, the cause of hypercalcemia should be identified early. Surgical resection of the parathyroid adenoma is the ultimate therapy. PMID:20556845

  10. Predicting development of infected necrosis in acute necrotizing pancreatitis.

    PubMed

    Dambrauskas, Zilvinas; Pundzius, Juozas; Barauskas, Giedrius

    2006-01-01

    The incidence of severe acute pancreatitis is about 30 cases per 100,000 inhabitants, and it carries an overall mortality rate of 10-15%. Infection of pancreatic necrosis occurs in 20-30% of patients with severe acute pancreatitis and triples the mortality rate. Therefore, early prediction and diagnosis of infection in necrotizing pancreatitis are extremely important. The aim of the studies included in this review was to investigate the potential of specific prognostic factors to predict the development of secondary pancreatic infection in severe acute pancreatitis. This is seen as an important tool allowing to perform a computed tomography- or ultrasound-guided fine needle aspiration for bacteriological sampling at the right moment, to confirm the diagnosis, and, finally, to select the subgroup of patients who would benefit from the antibiotic prophylaxis. Precise patients' selection could possibly result in more rational use of antibiotics in patients with acute necrotizing pancreatitis and reduction of multi-resistant bacteria. Recent studies show that C-reactive protein is an important prognostic marker of pancreatic necrosis with the highest sensitivity and negative prognostic value in this respect. Procalcitonin alone or in combination with interleukin-6 best identifies patients not at risk for infection. However, a review of the clinical studies suggests that we still do not have an optimal model, thus there is a need for new more reliable biochemical and/or clinical predictive systems.

  11. Gingivitis

    MedlinePlus

    Symptoms of gingivitis include: Bleeding gums (blood on toothbrush even with gentle brushing of the teeth) Bright ... help remove plaque deposits. These include special toothpicks, toothbrushes, water irrigation, or other devices. You still must ...

  12. Specific HLA genotypes confer susceptibility to acute necrotizing encephalopathy.

    PubMed

    Hoshino, A; Saitoh, M; Miyagawa, T; Kubota, M; Takanashi, J-I; Miyamoto, A; Tokunaga, K; Oka, A; Mizuguchi, M

    2016-09-01

    Acute necrotizing encephalopathy (ANE) is a rare and severe syndrome of acute encephalopathy triggered by viral infections. Cytokine storm is considered as the main pathogenetic mechanism of ANE. ANE is prevalent in East Asia, suggesting the association of host genetic factors. To elucidate the genetic background of Japanese ANE, we examined genotypes of human leukocyte antigen (HLA)-A, C, B, DRB1, DQB1 and DPB1 in 31 patients. Significant positive association was observed in both the allele frequency and positivity of DRB1*09:01 (P=0.043 and 0.025, respectively), as well as those of DQB1*03:03 (P=0.034 and 0.026, respectively). The carrier frequency of DRB1*09:01 and DQB1*03:03 alleles was higher in the patients (45.16%) than in controls (28.57%). These alleles are more common in East Asian than in European populations, and are reportedly associated with various autoimmune diseases in Japanese patients. Our data provide further evidence that altered immune response based on individual HLA genotypes may contribute to ANE pathogenesis. PMID:27467284

  13. Occurrence of yeasts, enterococci and other enteric bacteria in subgingival biofilm of HIV-positive patients with chronic gingivitis and necrotizing periodontitis

    PubMed Central

    Gaetti-Jardim Júnior, Elerson; Nakano, Viviane; Wahasugui, Thais C.; Cabral, Fátima C.; Gamba, Rosa; Avila-Campos, Mario Julio

    2008-01-01

    The purpose of this study was to determine the prevalence of enteric bacteria and yeasts in biofilm of 80 HIV-positive patients with plaque-associated gingivitis or necrotizing periodontitis. Patients were subjected to extra, intra oral and radiographic examinations. The oral hygiene, bleeding on probing, gingival conditions, and attachment loss were evaluated. Clinical specimens were collected from gingival crevices or periodontal pockets, transferred to VMGA III, diluted and transferred to Sabouraud Dextrose agar with 100 μg/ml of chloramphenicol, peptone water, EVA broth, EMB agar, SS agar, Bile esculin agar and Brilliant green agar. Isolation of yeasts was carried out at room temperature, for 3-7 days; and for the isolation of enteric microorganisms plates were incubated at 37°C, for 24-48 h. The yeasts identification was performed according to the carbon and nitrogen assimilation, fermentation of carbohydrates and germ tube formation. Bacteria were identified according to their colonial and cellular morphologies and biochemical tests. Yeasts were identified as Candida albicans and its occurrence was more common in patients with CD4+ below 200/mm3 and was affected by the extension of periodontal involvement (P = 0.0345). Enteric bacteria recovered from clinical specimens were identified as Enterobacter sakazakii, Enterobacter cloacae, Serratia liquefaciens, Klebsiella oxytoca and Enterococcus sp. Enterobacteriaceae and enterococci were detected in 32.5% of clinical samples from patients with necrotizing periodontitis. In conclusion, non-oral pathogenic bacteria and C. albicans were more prevalent in periodontal sites of HIV-positive patients with necrotizing periodontitis and chronic gingivitis. PMID:24031212

  14. Multiple Ascending Aortic Mural Thrombi and Acute Necrotizing Mediastinitis Secondary to Acute Pancreatitis

    PubMed Central

    Chong, Byung Kwon; Yun, Jae Kwang; Kim, Joon Bum; Park, Do Hyun

    2016-01-01

    The formation of aortic thrombi is an extremely rare complication of acute pancreatitis. Here we report a case of acute pancreatitis complicated by a paraesophageal pseudocyst, necrotizing mediastinitis, and the formation of multiple thrombi in the ascending aorta. The patient was successfully treated by surgical therapy, which included extensive debridement of the mediastinum and removal of the aortic thrombi under cardiopulmonary bypass. Although esophageal resection was not carried out concomitantly, the lesions were resolved and the patient remained free of complications over 2 years of follow-up care. PMID:27734004

  15. Acute Necrotizing Pancreatitis Associated with Mycoplasma pneumoniae Infection in a Child.

    PubMed

    Yang, Aram; Kang, Ben; Choi, So Yoon; Cho, Joong Bum; Kim, Yae-Jean; Jeon, Tae Yeon; Choe, Yon Ho

    2015-09-01

    Mycoplasma pneumoniae is responsible for approximately 20% to 30% of community-acquired pneumonia, and is well known for its diverse extrapulmonary manifestations. However, acute necrotizing pancreatits is an extremely rare extrapulmonary manifestation of M. pneumoniae infection. A 6-year-old girl was admitted due to abdominal pain, vomiting, fever, and confused mentality. Acute necrotizing pancreatitis was diagnosed according to symptoms, laboratory test results, and abdominal computed tomography scans. M. pneumoniae infection was diagnosed by a 4-fold increase in antibodies to M. pneumoniae between acute and convalescent sera by particle agglutination antibody assay. No other etiologic factors or pathogens were detected. Despite the occurrence of a large infected pseudocyst during the course, the patient was able to discharge without morbidity by early aggressive supportive care. This is the first case in Korea of a child with acute necrotizing pancreatitis associated with M. pneumoniae infection. PMID:26473143

  16. Paeoniflorin ameliorates acute necrotizing pancreatitis and pancreatitis-induced acute renal injury

    PubMed Central

    Wang, Peng; Wang, Weixing; Shi, Qiao; Zhao, Liang; Mei, Fangchao; Li, Chen; Zuo, Teng; He, Xiaobo

    2016-01-01

    Acute renal injury caused by acute necrotizing pancreatitis (ANP) is a common complication that is associated with a high rate of mortality. Paeoniflorin is the active ingredient of paeonia radix and exhibits a number of pharmacological effects, such as anti-inflammatory, anticancer, analgesic and immunomodulatory effects. The present study detected the potential treatment effects of paeoniflorin on acute renal injury induced by ANP in a rat model. The optimal dose of paeoniflorin for preventing acute renal injury induced by ANP was determined. Then, the possible protective mechanism of paeoniflorin was investigated. The serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 were measured with enzyme-linked immunosorbent assay kits. Renal inflammation and apoptosis were measured by immunohistochemistry and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay. The expression of nitric oxide in kidney tissues was also evaluated. The p38 mitogen-activated protein kinases (MAPKs) were measured by western blotting. The results shown that paeoniflorin may ameliorate acute renal injury following ANP in rats by inhibiting inflammatory responses and renal cell apoptosis. These effects may be associated with the p38MAPK and nuclear factor-κB signal pathway. PMID:27279569

  17. Necrotizing fasciitis in a young patient with acute myeloid leukemia – a diagnostic challenge

    PubMed Central

    2014-01-01

    Background Necrotizing fasciitis is characterized by a fulminant destruction of the soft tissue with an alarmingly high mortality rate. One of the main reasons for the continued high mortality is due to the challenge to punctual recognize and diagnose this disease, as specific cutaneous signs can vary or even be missing early in its evolution – especially in case of simultaneous first manifestation of an acute leukemia. Case presentation An untypical case of necrotizing fasciitis disease in a young patient with the first diagnosis of acute myeloid leukemia is presented. After her induction chemotherapy the only presenting clinical sign was fever in the presence of severe neutropenia without an evident infectious focus. After a few days a painless confluent, erythematous, pustular skin rash with a central necrosis on lateral thigh appeared. Escherichia coli was isolated from blood cultures. Surgical debridement was performed and showed subcutaneous tissue, fascia and underlying muscle around the site of initial cutaneous manifestation with typical necrosis on exploration. But, initially taken skin biopsy did not show any typical histopathological findings like bacteria or inflammatory cells confirming necrotizing fasciitis. Nevertheless, the intraoperative findings were impressive and highly indicative for a necrotizing soft tissue infection, so that the patient was treated according to clinical guidelines with extensive recurrent surgical debridement, broad-spectrum antibiotics and intensive care therapy. After recovering from NF, she successfully underwent further chemotherapy and stem cell transplantation. Conclusion The presented case highlights the risk of potential misinterpretation, delayed diagnosis and treatment of necrotizing fasciitis in patients presenting with an untypical clinical and histopathological manifestation of necrotizing fasciitis as a result of severe neutropenia following chemotherapy for acute myeloid leukemia. PMID:25002906

  18. Neutrophil Extracellular Traps Form a Barrier between Necrotic and Viable Areas in Acute Abdominal Inflammation

    PubMed Central

    Bilyy, Rostyslav; Fedorov, Volodymyr; Vovk, Volodymyr; Leppkes, Moritz; Dumych, Tetiana; Chopyak, Valentyna; Schett, Georg; Herrmann, Martin

    2016-01-01

    Neutrophils form neutrophil extracellular traps (NETs) of decondensed DNA and histones that trap and immobilize particulate matter and microbial pathogens like bacteria. NET aggregates reportedly surround and isolate large objects like monosodium urate crystals, which cannot be sufficiently cleared from tissues. In the setting of acute necrotizing pancreatitis, massive tissue necrosis occurs, which is organized as pancreatic pseudocysts (1). In contrast to regular cysts, these pseudocysts are not surrounded by epithelial layers. We hypothesize that, instead, the necrotic areas observed in necrotizing pancreatitis are isolated from the surrounding healthy tissues by aggregated NETs. These may form an alternative, putatively transient barrier, separating necrotic areas from viable tissue. To test this hypothesis, we investigated histological samples from the necropsy material of internal organs of two patients with necrotizing pancreatitis and peritonitis accompanied by multiple organ failure. Tissues including the inflammatory zone were stained with hematoxylin and eosin and evaluated for signs of inflammation. Infiltrating neutrophils and NETs were detected by immunohistochemistry for DNA, neutrophil elastase (NE), and citrullinated histone H3. Interestingly, in severely affected areas of pancreatic necrosis or peritonitis, chromatin stained positive for NE and citrullinated histone H3, and may, therefore, be considered NET-derived. These NET structures formed a layer, which separated the necrotic core from the areas of viable tissue remains. A condensed layer of aggregated NETs, thus, spatially shields and isolates the site of necrosis, thereby limiting the spread of necrosis-associated proinflammatory mediators. We propose that necrotic debris may initiate and/or facilitate the formation of the NET-based surrogate barrier. PMID:27777576

  19. Influenza Virus-Associated Fatal Acute Necrotizing Encephalopathy: Role of Nonpermissive Viral Infection?

    PubMed Central

    Mungaomklang, Anek; Chomcheoy, Jiraruj; Wacharapluesadee, Supaporn; Joyjinda, Yutthana; Jittmittraphap, Akanitt; Rodpan, Apaporn; Ghai, Siriporn; Saraya, Abhinbhen; Hemachudha, Thiravat

    2016-01-01

    In 2014, two unusual peaks of H1N1 influenza outbreak occurred in Nakhon Ratchasima Province, in Thailand. Among 2,406 cases, one of the 22 deaths in the province included a 6-year-old boy, who initially presented with acute necrotizing encephalopathy. On the other hand, his sibling was mildly affected by the same influenza virus strain, confirmed by whole-genome sequencing, with one silent mutation. Absence of acute necrotizing encephalopathy and other neurological illnesses in the family and the whole province, with near identical whole viral genomic sequences from the two siblings, and an absence of concomitant severe lung infection (cytokine storm) at onset suggest nonpermissive infection as an alternative pathogenetic mechanism of influenza virus. PMID:27812294

  20. [Necrotizing tonsillitis and renal vein thrombosis due to acute myeloid leukaemia].

    PubMed

    Akram, Javed; Josefsson, Pernilla; Rømeling, Frans

    2012-09-01

    A 37-year-old woman was admitted to hospital with severe tonsillitis with unilateral necrotizing tonsillitis. She suddenly got fever, malaise, difficulties swallowing, pain in the throat and deterioration despite four days of penicillin treatment. During hospitalisation, she experienced abdominal pain, and blood tests showed pancytopenia. She was transferred to a haematological department, where a bone marrow biopsy showed acute myeloid leukaemia. Subsequently, an abdominal computed tomography with intravenous contrast revealed bilateral renal vein thrombosis, probably because of coagulopathy due to leukaemia.

  1. Effects of ORP150 on appearance and function of pancreatic beta cells following acute necrotizing pancreatitis.

    PubMed

    Deng, Wen-Hong; Chen, Chen; Wang, Wei-Xing; Yu, Jia; Li, Jin-You; Liu, Lei

    2011-06-15

    Pancreatic beta cells produce and release insulin, which decreases the blood glucose level. Endoplasmic reticulum stress caused pancreatic beta cell dysfunction and death in acute necrotizing pancreatitis (ANP). The 150kD oxygen-regulated protein (ORP150) took part in the process of endoplasmic reticulum stress. This study investigated the effect of ORP150 on appearance and function of pancreatic beta cells in ANP. Acute necrotizing pancreatitis relied on retrograde infusion of 5% sodium taurocholate into the bile-pancreatic duct. The severity of ANP was estimated by serum amylase, secretory phospholipase A(2,) and pancreatic histopathology. The changes in appearance and function of pancreatic beta cells were detected by light and electron microscopy and the levels of serum glucose, insulin, and C-peptide. ORP150 expression was studied using western blot and immunohistochemisty assay. The expression of ORP150 mainly appeared on pancreatic beta cells and decreased gradually during the pathogenesis of ANP. The results of light and electron microscopy indicated pancreatic beta cell dysfunction and death, concomitant with elevation of serum glucose, insulin, and C-peptide in ANP. These results imply a probable role of ORP150 in the changes in appearance and function of pancreatic beta cells following acute necrotizing pancreatitis, through the pathway of endoplasmic reticulum stress.

  2. Continuous Regional Arterial Infusion Therapy for Acute Necrotizing Pancreatitis Due to Mycoplasma pneumoniae Infection in a Child

    SciTech Connect

    Nakagawa, Motoo Ogino, Hiroyuki; Shimohira, Masashi; Hara, Masaki; Shibamoto, Yuta

    2009-05-15

    A case of acute necrotizing pancreatitis due to Mycoplasma pneumoniae infection was treated in an 8-year-old girl. She experienced acute pancreatitis during treatment for M. pneumoniae. Contrast-enhanced computed tomographic scan revealed necrotizing pancreatitis. The computed tomographic severity index was 8 points (grade E). A protease inhibitor, ulinastatin, was provided via intravenous infusion but was ineffective. Continuous regional arterial infusion therapy was provided with gabexate mesilate (FOY-007, a protease inhibitor) and meropenem trihydrate, and the pancreatitis improved. This case suggests that infusion therapy is safe and useful in treating necrotizing pancreatitis in children.

  3. Vascular Access System for Continuous Arterial Infusion of a Protease Inhibitor in Acute Necrotizing Pancreatitis

    SciTech Connect

    Ganaha, Fumikiyo; Yamada, Tetsuhisa; Yorozu, Naoya; Ujita, Masuo; Irie, Takeo; Fukuda, Yasushi; Fukuda, Kunihiko; Tada, Shimpei

    1999-09-15

    We used a vascular access system (VAS) for continuous arterial infusion (CAI) of a protease inhibitor in two patients with acute necrotizing pancreatitis. The infusion catheter was placed into the dorsal pancreatic artery in the first patient and into the gastroduodenal artery in the second, via a femoral artery approach. An implantable port was then connected to the catheter and was secured in a subcutaneous pocket prepared in the right lower abdomen. No complications related to the VAS were encountered. This system provided safe and uncontaminated vascular access for successful CAI for acute pancreatitis.

  4. The relative safety of MRI contrast agent in acute necrotizing pancreatitis.

    PubMed Central

    Werner, J; Schmidt, J; Warshaw, A L; Gebhard, M M; Herfarth, C; Klar, E

    1998-01-01

    OBJECTIVE: To validate the safety of gadolinium-diethylenetriamine pentaacetic acid (GD-DTPA) by measuring its effect on pancreatic capillary perfusion and acinar injury in acute pancreatitis. BACKGROUND: Contrast-enhanced computed tomography (CECT) is proposed as a gold standard for early evaluation of acute necrotizing pancreatitis. However, iodinated contrast media used for CECT have been shown in these circumstances to reduce pancreatic capillary flow and increase necrosis and mortality. Recent reports suggest that post-GD MRI provides images comparable to CECT in the assessment of severe acute pancreatitis. METHODS: Necrotizing pancreatitis was induced in 14 Wistar rats by intraductal glycodeoxycholic acid (10 mM/L) and intravenous caerulein (5 microg/kg/h) over 6 hours. Intravital microscopic quantitation of pancreatic capillary blood flow was performed using fluorescein isothiocyanate-labeled erythrocytes after induction of pancreatitis and 30 and 60 minutes after an intravenous bolus of either Ringer's solution or GD-DTPA (0.2 mL/kg). RESULTS: The two study groups were comparable with regard to mean arterial pressure, heart rate, arterial blood gases, hematocrit, amylase, lipase, and trypsinogen activation peptide production throughout the experiment. GD-DTPA did not reduce capillary flow (1.93 +/- 0.05 nL/capillary/min) compared to animals infused with Ringer's solution (1.90 +/- 0.06 nL/capillary/min). CONCLUSIONS: Intravenous injection of GD-DTPA does not further impair pancreatic microcirculation or increase acinar injury in acute necrotizing pancreatitis. Because of this advantage over CT contrast medium, further development of MRI as a staging tool in acute pancreatitis seems desirable. PMID:9445117

  5. Diagnosis of acute myeloid leukemia in a dental hospital; report of a case with severe gingival hypertrophy.

    PubMed

    Misirlioglu, M; Adisen, M Z; Yilmaz, S

    2015-01-01

    Acute myeloid leukemias (AMLs) are aggressive hematopoietic neoplasms that, if untreated, can lead to death within days. Owing to its high morbidity rate, early diagnosis and appropriate medical therapy is essential. Oral lesions may be the presenting feature of acute leukemias and are, therefore, important diagnostic indicators of the disease. Erythematous or cyanotic gingival hyperplasia with or without necrosis is reported to be the most consistent symptom leading to a diagnosis of acute leukemia that directs the patient to seek early dental consultation. This report refers to a patient with AML that was provisionally diagnosed in the dental hospital due to severe gingival enlargements.

  6. Necrotizing acute pancreatitis current status - emerging new strategies in surgical management.

    PubMed

    Sakorafas, George H; Sampanis, Dimitrios; Lappas, Christos; Kokoropoulos, Panayiotis; Mastoraki, Aikaterini; Smyrniotis, Vassilios

    2012-04-01

    Despite that pancreatic necrosis complicates only 15 % of cases of acute pancreatitis (AP), it is associated with high morbidity and considerable mortality. In an attempt to improve prognosis, many surgical strategies have been described during the last few decades. Currently, necrosectomy remains the cornerstone in the surgical treatment of infected pancreatic necrosis and in selected cases of sterile necrotizing pancreatitis. Following necrosectomy, continuous closed lavage is recommended by many authors, while closed abdominal packing /drainage and repeated planned necrosectomies- commonly using the zipper technique-are also acceptable alternative strategies. Open abdomen (laparostomy) is rarely indicated in carefully selected cases (typically in abdominal compartment syndrome associated with necrotizing AP). During the last decade, minimally invasive techniques (including percutaneous drainage, retroperitoneal endoscopic approach, transgastric endoscopic approach etc) have been extensively studied by some groups not only in the management of pancreatic abscesses and / or pseudocysts, but also as primary methods of treatment of necrotizing AP. Results have been impressive, but experience currently is limited to only a few centers around the world. PMID:22420515

  7. [Role of computerized tomography in percutaneous drainage of acute infected necrotic-hemorrhagic pancreatitis].

    PubMed

    Leone, A; Violino, P; Ghirardo, D; Fioranti, L; Borrelli, M; Scarrone, A; Pancione, L; Ambrogi, C; Ferro, C

    1996-09-01

    In the last few years, Computed Tomography (CT) has emerged as the most sensitive and reliable imaging technique to diagnose acute pancreatitis (AP). Besides assessing the extent of damage to the pancreas and to periglandular tissue. CT can recognize the major early and late complications of the disease promptly and with extreme accuracy. We investigated the diagnostic capabilities of CT in controlling AP development and tried to assess the role of interventional radiology as a therapeutic support after or instead of surgery in treating the necrotic forms of pancreatitis complicated by sepsis. From 1989 to 1995, acute pancreatitis mostly due to biliary tract disease and alcoholism was diagnosed in 228 patients. Necrotic processes were identified in 105 of them since disease onset; septic complications developed in 57 patients. Surgery was performed in 42 patients, but the result was poor in 11 of them (30%) and CT showed the persistence of some infectious pancreatic exudate which had been drained insufficiently. Since sepsis persisted in these patients, the exudate was aspirated percutaneously after positioning appropriate drainage means guided by abdominal CT. Sepsis resolved completely in 10 patients, while one required subsequent surgery. Percutaneous drainage catheters were positioned in 15 patients as the treatment of choice, under CT and US guidance. Sepsis resolved in 7 cases only (45%), while 3 of the extant patients died and 5 needed surgery. The results of our experience demonstrate the effectiveness of percutaneous drainage under CT guidance. However, this technique should be used after and as a support to surgery, the latter remaining the treatment of choice for infectious necrotic AP. Thus, in our experience, the use of percutaneous aspiration instead of surgery proved to be a less effective tool in curing this condition and its use should therefore be limited to high-risk surgical patients.

  8. Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution.

    PubMed

    Pezzi, Mario; Giglio, Anna Maria; Scozzafava, Annamaria; Filippelli, Orazio; Serafino, Giuseppe; Verre, Mario

    2016-01-01

    The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe. PMID:27651958

  9. Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution

    PubMed Central

    Giglio, Anna Maria; Scozzafava, Annamaria; Filippelli, Orazio; Serafino, Giuseppe; Verre, Mario

    2016-01-01

    The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe. PMID:27651958

  10. Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution.

    PubMed

    Pezzi, Mario; Giglio, Anna Maria; Scozzafava, Annamaria; Filippelli, Orazio; Serafino, Giuseppe; Verre, Mario

    2016-01-01

    The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe.

  11. Spider Bite: A Rare Case of Acute Necrotic Arachnidism with Rapid and Fatal Evolution

    PubMed Central

    Giglio, Anna Maria; Scozzafava, Annamaria; Filippelli, Orazio; Serafino, Giuseppe; Verre, Mario

    2016-01-01

    The spider bites are quite frequent and often resolve quickly without leaving outcomes; only some species are capable of causing necrotic and systematic lesions in humans. Among them, we should mention the genus Loxosceles. The venom released from the spider bite of Loxosceles species is composed of proteins, enzymes, and nonenzymatic polypeptides. The phospholipase D family was identified as the active component of the venom. This family of enzymes is responsible for the local and systemic effects observed in loxoscelism. Phospholipases D interact with cell membranes triggering alterations which involve the complement system and activation of neutrophils and they cause the dermonecrotic skin lesions and systemic effects. We describe a fatal case of acute intoxication caused by a spider bite probably belonging to the species Loxosceles. The initial lesion was localized to a finger of a hand. Clinical course was worsening with deep necrotic lesions on limb, shock, hemolysis, acute kidney failure, and disseminated intravascular coagulation. All therapies were ineffective. This is the first fatal case described in Europe.

  12. Gingival Enlargement

    MedlinePlus

    ... 2017 Annual Meeting Orlando, FL Our Partners Gingival Enlargement Gingival (Gum) enlargement, also known as gingival hyperplasia or hypertrophy, is an abnormal overgrowth of gingival tissues. There ...

  13. [APPLICATION OF PRESEPSIN IN DIAGNOSIS AND TREATMENT OF PURULENT-SEPTIC COMPLICATIONS OF ACUTE NECROTIC PANCREATITIS].

    PubMed

    Rotar, O V

    2016-01-01

    In 70 patients, suffering an acute necrotic pancreatitis (ANP), and 10 practically healthy persons a content of presepsin in a blood plasm, using immunochemiluminescent method and conducted bacteriological investigations, were analyzed. The infection occurrence is accompanied by plausible upgrading of a presepsin level in a blood plasm, depending on activity and severity of a septic process: in local infection--up to (677 ± 30) pg/ml, sepsis--up to (988 ± 47) pg/ml, severe sepsis--up to 2668 pg/ml; in an ANP without infection it have constituted (332 ± 38) pg/mI at average, in practically healthy persons--(184 ± 16) pg/mI. A presepsin level correlates with a state severity in accordance to APACHE I scale, what permits to estimate the patients state severity objectively, to prognosticate a favorable and unfavorable consequences of treatment, rapidly changing, depending on efficacy of treatment. PMID:27249919

  14. Effects of infliximab on bacterial translocation in experimental acute necrotizing pancreatitis

    PubMed Central

    Aydin, Sezai; Isik, A. Turan; Unal, Bulent; Comert, Bilgin; Ozyurt, Mustafa; Deveci, Salih; Ozgur, Gokhan; Cengiz, Omer; Tasci, Ilker; Mas, M. Refik

    2012-01-01

    Background & objectives: Translocation of bacteria from the gut is an important factor in the development of septic complications and mortality in acute pancreatitis (AP). The present study was designed to assess the effects of infliximab treatment on bacterial translocation (BT) in experimental acute necrotizing pancreatitis. Methods: Male Sprague-Dawley rats (n=45) were allocated into three groups. AP was induced in group II (positive control, n=15) and group III (Infliximab; n=15) by retrograde injection of taurocholate into the common biliopancreatic duct. Group I rats (Sham; n=15) received normal saline infusion into the common biliopancreatic duct as placebo. Groups I and II were treated by normal saline and group III was treated with infliximab intraperitoneally on 6, 30 and 54 h after induction of pancreatitis. All surviving animals were killed 60 h after the induction of pancreatitis, and specimens were collected for amylase measurement as well as histopathologic and microbiologic examinations. Results: Oedema, acinar cell necrosis, inflammatory infiltration, haemorrhage, fat necrosis and perivascular inflammation in group III rats were decreased with infliximab treatment when compared with group II (P<0.001). BT to mesentery lymph node in groups I, II and III were 20, 100 and 46 per cent, respectively. BT to peritoneum and pancreas in group III was lower than group II (P<0.05). Interpretation & conclusions: Infliximab administration resulted in beneficial effects on BT and histopathologic changes in the experimental necrotizing pancreatitis. Whether anti-TNF therapy has a role in prevention of complications of ANP needs to be established. PMID:22771595

  15. Protective action of luminal bile salts in necrotizing acute pancreatitis in mice.

    PubMed Central

    Gomez, G; Townsend, C M; Green, D W; Rajaraman, S; Uchida, T; Greeley, G H; Soloway, R D; Thompson, J C

    1990-01-01

    Bile salts in the intestinal lumen act to inhibit the release of cholecystokinin (CCK). Recent studies have shown that CCK may play a permissive role in the development of acute pancreatitis. In this study, the amount of luminal bile salts in female Swiss Webster mice was either decreased by feeding 4% (wt/wt) cholestyramine or increased by feeding 0.5% sodium taurocholate for 1 wk. Plasma levels of CCK were stimulated by cholestyramine and inhibited by taurocholate. Then, acute pancreatitis was induced either by caerulein injections, or by feeding a choline-deficient, ethionine-supplemented (CDE) diet. Feeding of cholestyramine significantly decreased survival from 25% to 0% in the CDE pancreatitis, and increased the magnitude of elevation of serum amylase levels and the extent of pancreatic necrosis in both models of pancreatitis; CCK-receptor blockade with CR-1409 completely abolished the adverse effects of cholestyramine. In contrast, feeding of taurocholate significantly increased survival to 100% and decreased the elevation of serum amylase and pancreatic necrosis; CCK-8 antagonized these actions of taurocholate. Luminal bile salts appear to provide a physiologic protection against necrotizing pancreatitis, at least in part, both by inhibiting the release of CCK and by promoting resistance of the pancreas to CCK excessive stimulation in vivo. Images PMID:1694866

  16. Treatment of necrotizing acute pancreatitis with peritoneal lavage and dialysis by a new simplified technique insert catheters

    PubMed Central

    Li, Qi; Zhu, Bai; Zhu, Xueyan; Piao, Chenglin; Cui, Wenpeng; Wang, Yangwei; Sun, Jing; Chen, Wenguo; Miao, Lining

    2016-01-01

    Abstract Peritoneal lavage and dialysis is an approach to treat necrotizing acute pancreatitis as it removes dialyzable toxins and reduces severe metabolic disturbances. Successful catheter implantation is important for delivering adequate peritoneal lavage and dialysis. The aim of the present study was to describe a new modified percutaneous technique for the placement of peritoneal dialysis catheters and assess the effectiveness and safety of peritoneal lavage and dialysis used for treatment of necrotizing acute pancreatitis. We conducted a retrospective data review of 35 patients of necrotizing acute pancreatitis from January 2010 to December 2014 in Jilin City Central Hospital and The First Affiliated Hospital of ZheJiang University. In total, 18 patients underwent peritoneal lavage and dialysis after inserting catheters by our new technique (group A), whereas 17 patients underwent ultrasound-guided percutaneous catheter drainage (group B). By analyzing the patients’ data, the drainage days and mean number of hours between the debut of the symptoms and the hospital admission were lower in group A (P < 0.05, P < 0.05, respectively). The complication rate of 5.6 and 17.6%, respectively (P = 0.261), and a mortality rate of 16.7 and 5.9% for each group, respectively (P = 0.316). Likewise, hospitalization time was similar for the group A: 31 ± 25.3 days compared with 42.8 ± 29.4 days in the group B (P = 0.211). Peritoneal lavage and dialysis can be used in necrotizing acute pancreatitis, and our new modified percutaneous technique offers the same complication and mortality rate as ultrasound-guided drainage but with a shorter drainage days. PMID:27281083

  17. Combination of allopurinol and hyperbaric oxygen therapy: A new treatment in experimental acute necrotizing pancreatitis?

    PubMed Central

    Comert, Bilgin; Isik, Ahmet Turan; Aydin, Sezai; Bozoglu, Ergun; Unal, Bulent; Deveci, Salih; Mas, Nuket; Cinar, Esref; Mas, Mehmet Refik

    2007-01-01

    AIM: To investigate the individual and combined effects of allopurinol and hyperbaric oxygen (HBO) therapy on biochemical and histopathological changes, oxidative stress, and bacterial translocation (BT) in the experimental rat acute pancreatitis (AP). METHODS: Eighty-five Sprague-Dawley rats were included in the study. Fifteen of the eighty-five rats were used as controls (sham, GroupI). AP was induced via intraductal taurocholate infusion in the remaining seventy rats. Rats that survived to induction of acute necrotizing pancreatitis were randomized into four groups. Group II received saline, Group III allopurinol, Group IV allopurinol plus HBO and Group V HBO alone. Serum amylase levels, oxidative stress parameters, BT and histopathologic scores were determined. RESULTS: Serum amylase levels were lower in Groups III, IV and V compared to Group II (974 ± 110, 384 ± 40, 851 ± 56, and 1664 ± 234 U/L, respectively, P < 0.05, for all). Combining the two treatment options revealed significantly lower median [25-75 percentiles] histopathological scores when compared to individual administrations (13 [12.5-15] in allopurinol group, 9.5 [7-11.75] in HBO group, and 6 [4.5-7.5] in combined group, P < 0.01). Oxidative stress markers were significantly better in all treatment groups compared to the controls. Bacterial translocation into the pancreas and mesenteric lymph nodes was lower in Groups III, IV and V compared to Group II (54%, 23%, 50% vs 100% for translocation to pancreas, and 62%, 46%, 58% vs 100% for translocation to mesenteric lymph nodes, respectively, P < 0.05 for all). CONCLUSION: The present study confirms the benefit of HBO and allopurinol treatment when administered separately in experimental rat AP. Combination of these treatment options appears to prevent progression of pancreatic injury parameters more effectively. PMID:18069760

  18. A novel autoantibody against ephrin type B receptor 2 in acute necrotizing encephalopathy

    PubMed Central

    2013-01-01

    Acute necrotizing encephalopathy (ANE) is characterized by symmetrical brain necrosis, suggested to be due to breakdown of the blood–brain barrier (BBB). We experienced a rare case of ANE complicated with systemic lupus erythematosus (SLE), and found that the patient’s serum (V10-5) had binding activity to human umbilical vein endothelial cells (HUVECs). By SARF (Serological identification system for Autoantigens using a Retroviral vector and Flow cytometry) method using V10-5 IgG, a clone bound to V10-5 IgG was isolated. This cell clone was integrated with cDNA identical to EphB2, which plays critical roles in neuronal cells and endothelial cells. HUVECs and human brain microvascular endothelial cells expressed EphB2 and the V10-5 IgG bound specifically to EphB2-transfected cells. Anti-EphB2 antibody was not detected in other SLE patients without ANE. In this report, we identified EphB2 as a novel autoantigen, and anti-EphB2 antibody may define a novel group of brain disorders. Anti-EphB2 antibody can interfere not only with endothelial cells including those of the BBB (acting as an anti-endothelial cell antibody), but also neuronal cells (acting as an anti-neuronal antibody) if the BBB has been breached. Future studies should determine the clinical prevalence and specificity of anti-EphB2 antibody, and the molecular mechanisms by which anti-EphB2 antibody mediates neuronal and vascular pathological lesions. PMID:24139226

  19. A novel autoantibody against ephrin type B receptor 2 in acute necrotizing encephalopathy.

    PubMed

    Shirai, Tsuyoshi; Fujii, Hiroshi; Ono, Masao; Watanabe, Ryu; Shirota, Yuko; Saito, Shinichiro; Ishii, Tomonori; Nose, Masato; Harigae, Hideo

    2013-10-18

    Acute necrotizing encephalopathy (ANE) is characterized by symmetrical brain necrosis, suggested to be due to breakdown of the blood-brain barrier (BBB). We experienced a rare case of ANE complicated with systemic lupus erythematosus (SLE), and found that the patient's serum (V10-5) had binding activity to human umbilical vein endothelial cells (HUVECs). By SARF (Serological identification system for Autoantigens using a Retroviral vector and Flow cytometry) method using V10-5 IgG, a clone bound to V10-5 IgG was isolated. This cell clone was integrated with cDNA identical to EphB2, which plays critical roles in neuronal cells and endothelial cells. HUVECs and human brain microvascular endothelial cells expressed EphB2 and the V10-5 IgG bound specifically to EphB2-transfected cells. Anti-EphB2 antibody was not detected in other SLE patients without ANE. In this report, we identified EphB2 as a novel autoantigen, and anti-EphB2 antibody may define a novel group of brain disorders. Anti-EphB2 antibody can interfere not only with endothelial cells including those of the BBB (acting as an anti-endothelial cell antibody), but also neuronal cells (acting as an anti-neuronal antibody) if the BBB has been breached. Future studies should determine the clinical prevalence and specificity of anti-EphB2 antibody, and the molecular mechanisms by which anti-EphB2 antibody mediates neuronal and vascular pathological lesions.

  20. A case of acute necrotizing pancreatitis: Practical and ethical challenges of a North–South partnership☆

    PubMed Central

    Samuel, Jonathan C.; Ludzu, Enock K.; Cairns, Bruce A.; Varela, Carlos; Charles, Anthony G.

    2013-01-01

    INTRODUCTION The Departments of Surgery at the University of North Carolina (UNC) and Kamuzu Central Hospital (KCH) in Lilongwe, Malawi, formed a partnership of service, training, and research in 2008. We report a case of recurrent pancreatitis leading to pancreatic necrosis treated at KCH. PRESENTATION OF CASE A 42 year-old male presented to KCH with his fourth episode of abdominal pain, nausea and vomiting. He had tachycardia, guarding, rebound tenderness, and free fluid on abdominal ultrasonography. He underwent laparotomy and had fat saponification with pancreatic necrosis. A large drain was placed, he was given antibiotics, and he recovered. He had normal lipids, no gallstones, and did not consume alcohol. He was encouraged to seek further evaluation with endoscopic retrograde cholangiopancreatography or computed tomography in South Africa, however this was prohibitively expensive. DISCUSSION This case illustrates the limitations that are often faced by surgeons visiting developing countries. What we consider standard resources and treatment algorithms in managing necrotizing pancreatitis in developed countries (such as serum lipase and percutaneous interventions) were not available. CONCLUSION Visiting surgeons and trainees must be both familiar with local resource limitations and aware of the implications of such limitations on patient care. To support training and promote advances in health care, local surgeons and trainees should understand optimal treatment strategies regardless of their particular resource limitations. North–South partnerships are an excellent means to uphold our professional obligation to humanity, promote health care as a right, and shape the future of health care in developing countries. PMID:24252412

  1. Impetigo presenting as an acute necrotizing swelling of the lower lip in an adult patient.

    PubMed

    Ghafoor, Mohammed; Halsnad, Moorthy; Fowell, Christopher; Millar, Brian G

    2012-06-01

    The authors present an unusual case of an acute swelling of the lower lip and septicemia in a 35-year-old, recent immigrant male arriving from India. The patient presented in our emergency department with a 48-hour history of a worsening, painful swelling of the lower lip. On presentation, he was pyrexial and the lip was found to be acutely inflamed with honey-colored crusting, pustular lesions, and induration . A diagnosis of impetigo leading to necrosis of the lip was established, a rare phenomenon potentially resulting in significant tissue destruction. Appropriate medical management achieved a good outcome and prevented disabling tissue loss of the orofacial region.

  2. Impetigo presenting as an acute necrotizing swelling of the lower lip in an adult patient.

    PubMed

    Ghafoor, Mohammed; Halsnad, Moorthy; Fowell, Christopher; Millar, Brian G

    2012-06-01

    The authors present an unusual case of an acute swelling of the lower lip and septicemia in a 35-year-old, recent immigrant male arriving from India. The patient presented in our emergency department with a 48-hour history of a worsening, painful swelling of the lower lip. On presentation, he was pyrexial and the lip was found to be acutely inflamed with honey-colored crusting, pustular lesions, and induration . A diagnosis of impetigo leading to necrosis of the lip was established, a rare phenomenon potentially resulting in significant tissue destruction. Appropriate medical management achieved a good outcome and prevented disabling tissue loss of the orofacial region. PMID:22677026

  3. Necrotizing fasciitis.

    PubMed

    Cherneski, C L; Embil, J M

    2001-07-01

    Necrotizing fasciitis is a devestating condition which has been recognized for several years. In North America a recent increase of cases has led to much media attention and public fear. Necrotizing fasciitis may occur as a consequence of infection with Streptococcus pyogenes or as a result of a polymicrobial synergistic infection caused by aerobic, anaerobic, gram positive and gram negative organisms, often in postoperative patients. Necrotizing fasciitis caused by Streptococcus pyogenes is mediated by superantigens. The management of necrotizing fasciitis requires a high index of suspicion for diagnosis followed by antimicrobial therapy and early surgical intervention. In cases caused by Streptococcus pyogenes with streptococcal toxic shock syndrome, intravenous immunoglobulin may be of benefit.

  4. [Necrotizing periodontal disease: a manifestation of systemic disorders].

    PubMed

    Bascones-Martínez, Antonio; Escribano-Bermejo, Marta

    2005-11-19

    Necrotizing periodontal disease (NPD) is an infection characterized by gingival necrosis presenting as "punched-out" papillae, with gingival bleeding, and pain. Prevotella intermedia and spirochetes have been associated with the gingival lesions. Predisposing factors may include emotional stress, immunosuppression, especially secondary to human immunodeficiency virus (HIV) infection, cigarette smoking, poor diet and pre-existing gingivitis. During the last few years, diagnosis of NPD has became more important not only because of its contribution to the appearance of clinical attachment loss and gingival sequelae, but also because it has been revealed as a marker for immune deterioration in HIV-seropositive patients.

  5. Necrotizing meningoencephalitis of Pug dogs associates with dog leukocyte antigen class II and resembles acute variant forms of multiple sclerosis.

    PubMed

    Greer, K A; Wong, A K; Liu, H; Famula, T R; Pedersen, N C; Ruhe, A; Wallace, M; Neff, M W

    2010-08-01

    Necrotizing meningoencephalitis (NME) is a disorder of Pug Dogs that appears to have an immune etiology and high heritability based on population studies. The present study was undertaken to identify a genetic basis for the disease. A genome-wide association scan with single tandem repeat (STR) markers showed a single strong association near the dog leukocyte antigen (DLA) complex on CFA12. Fine resolution mapping with 27 STR markers on CFA12 further narrowed association to the region containing DLA-DRB1, -DQA1 and, -DQB1 genes. Sequencing confirmed that affected dogs were more likely to be homozygous for specific alleles at each locus and that these alleles were linked, forming a single high risk haplotype. The strong DLA class II association of NME in Pug Dogs resembles that of human multiple sclerosis (MS). Like MS, NME appears to have an autoimmune basis, involves genetic and nongenetic factors, has a relatively low incidence, is more frequent in females than males, and is associated with a vascularly orientated nonsuppurative inflammation. However, NME of Pug Dogs is more aggressive in disease course than classical human MS, appears to be relatively earlier in onset, and involves necrosis rather than demyelination as the central pathobiologic feature. Thus, Pug Dog encephalitis (PDE) shares clinical features with the less common acute variant forms of MS. Accordingly, NME of Pug Dogs may represent a naturally occurring canine model of certain idiopathic inflammatory disorders of the human central nervous system.

  6. Acute necrotizing colitis with pneumatosis intestinalis in an Amazonian manatee calf.

    PubMed

    Guerra Neto, Guilherme; Galvão Bueno, Marina; Silveira Silva, Rodrigo Otavio; Faria Lobato, Francisco Carlos; Plácido Guimarães, Juliana; Bossart, Gregory D; Marmontel, Miriam

    2016-08-01

    On 25 January 2014, a 1 mo old female Amazonian manatee Trichechus inunguis calf weighing 12 kg was rescued by air transport in Guajará, Brazil, and transferred to Mamirauá Institute's Community-based Amazonian Manatee Rehabilitation Center. The calf presented piercing/cutting lesions on the back, neck, and head, in addition to dehydration and intermittent involuntary buoyancy. X-ray analysis revealed a large amount of gases in the gastrointestinal tract. Daily procedures included wound cleaning and dressing, clinical and laboratory monitoring, treatment for intestinal tympanism, and artificial feeding. Adaptation to the nursing formula included 2 kinds of whole milk. Up to 20 d post-rescue the calf presented appetite, was active, and gained weight progressively. Past this period the calf started losing weight and presented constant involuntary buoyancy and died after 41 d in rehabilitation. The major findings at necropsy were pneumatosis intestinalis in cecum and colon, pulmonary edema, and hepatomegaly. The microscopic examination revealed pyogranulomatous and necrohemohrragic colitis with multinucleated giant cells, acute multifocal lymphadenitis with lymphoid depletion in cortical and paramedullary regions of mesenteric lymph nodes, and diffuse severe acinar atrophy of the pancreas. Anaerobic cultures of fragments of cecum and colon revealed colonies genotyped as Clostridium perfringens type A. We speculate that compromised immunity, thermoregulatory failure, and intolerance to artificial diet may have been contributing factors to the infection, leading to enterotoxemia and death. PMID:27503914

  7. Necrotizing sialometaplasia.

    PubMed

    Gavron, J P; Ardito, J A; Curtis, A W

    1981-07-01

    Necrotizing sialometaplasia of salivary gland tissue is a benign, self-limiting disease usually confined to the minor salivary glands. To date only 49 cases have been reported. The clinical and histologic appearance may simulate squamous cell carcinoma, and unnecessary mutilating surgery may be performed if an erroneous diagnosis is made. The otolaryngologist must recognize this disease entity since it heals spontaneously and requires no treatment. Necrotizing sialometaplasia has no known premalignant potential.

  8. Necrotizing sialometaplasia.

    PubMed

    Sneige, N; Batsakis, J G

    1992-03-01

    Necrotizing sialometaplasia of salivary tissues is a vascular-based (lobular infarct), benign, and often self-limited disorder. Preponderantly a lesion of palatal salivary glands, it can involve any salivary gland, and it may be mistaken for carcinoma. Adherence to histopathologic criteria should obviate this mistake.

  9. Necrotizing sialometaplasia.

    PubMed

    Gavron, J P; Shugar, M A; Rice, D A

    1983-02-01

    Necrotizing sialometaplasia is a benign inflammatory disease of salivary gland origin. Because of its clinical and histologic resemblance to squamous cell carcinoma, this disease must be recognized. The cause is unknown, but it may be related to oral trauma, tobacco use or inadequate blood supply. The lesion heals spontaneously, regardless of therapy, in two to eight weeks.

  10. Necrotizing sialometaplasia.

    PubMed

    Lieberman, J; Weinstein, M

    1988-02-01

    A case of necrotizing sialometaplasia in a 29-year-old man is reported. Characterized by large, deep, well-demarcated ulcerations on the hard palate and other areas where salivary gland tissue is found, the condition is benign and resolves spontaneously. The cause is believed to be infarctive.

  11. Necrotizing fasciitis

    PubMed Central

    Puvanendran, Rukshini; Huey, Jason Chan Meng; Pasupathy, Shanker

    2009-01-01

    Abstract OBJECTIVE To describe the defining characteristics and treatment of necrotizing fasciitis (NF), emphasizng early diagnostic indications. QUALITY OF EVIDENCE PubMed was searched using the terms necrotizing fasciitis and necrotizing soft tissue infections, paired with early diagnosis. Results were limited to human studies in English. Additional articles were obtained from references within articles. Evidence is levels II and III. MAIN MESSAGE Necrotizing fasciitis is classified according to its microbiology (polymicrobial or monomicrobial), anatomy, and depth of infection. Polymicrobial NF mostly occurs in immunocompromised individuals. Monomicrobial NF is less common and affects healthy individuals who often have a history of trauma (usually minor). Patients with NF can present with symptoms of sepsis, systemic toxicity, or evidence of skin inflammation, with pain that is disproportional to the degree of inflammation. However, these are also present in less serious conditions. Hyperacute cases present with sepsis and quickly progress to multiorgan failure, while subacute cases remain indolent, with festering soft-tissue infection. Because the condition is rare with minimal specific signs, it is often misdiagnosed. If NF is suspected, histology of tissue specimens is necessary. Laboratory and radiologic tests can be useful in deciding which patients require surgical consultation. Once NF is diagnosed, next steps include early wound debridement, excision of nonviable tissue, and wide spectrum cover with intravenous antibiotics. CONCLUSION Necrotizing fasciitis is an uncommon disease that results in gross morbidity and mortality if not treated in its early stages. At onset, however, it is difficult to differentiate from other superficial skin conditions such as cellulitis. Family physicians must have a high level of suspicion and low threshold for surgical referral when confronted with cases of pain, fever, and erythema. PMID:19826154

  12. Microarray Analysis of Microbiota of Gingival Lesions in Noma Patients

    PubMed Central

    Huyghe, Antoine; François, Patrice; Mombelli, Andrea; Tangomo, Manuela; Girard, Myriam; Baratti-Mayer, Denise; Bolivar, Ignacio; Pittet, Didier; Schrenzel, Jacques

    2013-01-01

    Noma (cancrum oris) is a gangrenous disease of unknown etiology affecting the maxillo-facial region of young children in extremely limited resource countries. In an attempt to better understand the microbiological events occurring during this disease, we used phylogenetic and low-density microarrays targeting the 16S rRNA gene to characterize the gingival flora of acute noma and acute necrotizing gingivitis (ANG) lesions, and compared them to healthy control subjects of the same geographical and social background. Our observations raise doubts about Fusobacterium necrophorum, a previously suspected causative agent of noma, as this species was not associated with noma lesions. Various oral pathogens were more abundant in noma lesions, notably Atopobium spp., Prevotella intermedia, Peptostreptococcus spp., Streptococcus pyogenes and Streptococcus anginosus. On the other hand, pathogens associated with periodontal diseases such as Aggregatibacter actinomycetemcomitans, Capnocytophaga spp., Porphyromonas spp. and Fusobacteriales were more abundant in healthy controls. Importantly, the overall loss of bacterial diversity observed in noma samples as well as its homology to that of ANG microbiota supports the hypothesis that ANG might be the immediate step preceding noma. PMID:24086784

  13. Microarray analysis of microbiota of gingival lesions in noma patients.

    PubMed

    Huyghe, Antoine; François, Patrice; Mombelli, Andrea; Tangomo, Manuela; Girard, Myriam; Baratti-Mayer, Denise; Bolivar, Ignacio; Pittet, Didier; Schrenzel, Jacques

    2013-01-01

    Noma (cancrum oris) is a gangrenous disease of unknown etiology affecting the maxillo-facial region of young children in extremely limited resource countries. In an attempt to better understand the microbiological events occurring during this disease, we used phylogenetic and low-density microarrays targeting the 16S rRNA gene to characterize the gingival flora of acute noma and acute necrotizing gingivitis (ANG) lesions, and compared them to healthy control subjects of the same geographical and social background. Our observations raise doubts about Fusobacterium necrophorum, a previously suspected causative agent of noma, as this species was not associated with noma lesions. Various oral pathogens were more abundant in noma lesions, notably Atopobium spp., Prevotella intermedia, Peptostreptococcus spp., Streptococcus pyogenes and Streptococcus anginosus. On the other hand, pathogens associated with periodontal diseases such as Aggregatibacter actinomycetemcomitans, Capnocytophaga spp., Porphyromonas spp. and Fusobacteriales were more abundant in healthy controls. Importantly, the overall loss of bacterial diversity observed in noma samples as well as its homology to that of ANG microbiota supports the hypothesis that ANG might be the immediate step preceding noma.

  14. Leigh's Disease: The Acute Clinical Course of a Two-Year-Old Child with Subacute Necrotizing Encephalomyelopathy

    PubMed Central

    Zinka, Bettina; Buettner, Andreas; Graw, Matthias

    2010-01-01

    We report the untypical clinical course of a previously healthy two-year-old girl, who died suddenly and unexpectedly after an episode of vomiting. At forensic autopsy no other pathological findings could be diagnosed than multiple reddish, sunken areas in brain stem, mesencephalon, and pons. Histologically they presented as areas of spongiosis of the neuropil with prominent endothelial hyperplasia and vascular proliferation whereas nerve cells were well preserved. On the basis of the characteristic neuropathological findings in combination with the age of the child, we had to take into consideration that the child might have died from subacute necrotizing encephalomyelopathy (Leigh's Disease) despite the untypical, fulminant clinical course. PMID:20593000

  15. Leigh's Disease: The Acute Clinical Course of a Two-Year-Old Child with Subacute Necrotizing Encephalomyelopathy.

    PubMed

    Zinka, Bettina; Buettner, Andreas; Graw, Matthias

    2010-01-01

    We report the untypical clinical course of a previously healthy two-year-old girl, who died suddenly and unexpectedly after an episode of vomiting. At forensic autopsy no other pathological findings could be diagnosed than multiple reddish, sunken areas in brain stem, mesencephalon, and pons. Histologically they presented as areas of spongiosis of the neuropil with prominent endothelial hyperplasia and vascular proliferation whereas nerve cells were well preserved. On the basis of the characteristic neuropathological findings in combination with the age of the child, we had to take into consideration that the child might have died from subacute necrotizing encephalomyelopathy (Leigh's Disease) despite the untypical, fulminant clinical course. PMID:20593000

  16. Necrotizing sialometaplasia.

    PubMed

    Nilsen, R; Bernhoft, C H; Gilhuus-Moe, O

    1978-12-01

    Two cases of necrotizing sialometaplasia are reported together with a review of the literature. This self-limiting benign lesion is easily confused with malignant tumors. The lesions are characterized histologically by an extensive necrosis of the salivary gland tissue together with squamous metaplasia of the ducts. The present report of two females who had intense pain in the initial phase differs from previous reports concerning age and symptoms. The importance of rather extensive biopsy specimens is stressed. Antibiotic treatment appears to be insignificant. A clinical history of allergy and a dominance of eosinophilic granulocytes in the inflammatory exudate in both cases may indicate an allergic etiology.

  17. Necrotizing soft tissue infection

    MedlinePlus

    Necrotizing fasciitis; Fasciitis - necrotizing; Flesh-eating bacteria; Soft tissue gangrene; Gangrene - soft tissue ... Many different types of bacteria can cause this infection. A very severe and usually deadly form of necrotizing soft tissue infection is due to the ...

  18. Hypernatraemic dehydration and necrotizing enterocolitis.

    PubMed

    Clarke, A J; Sibert, J R

    1985-01-01

    Severe hypernatraemic dehydration developed over the first twelve days of life in a breastfed infant girl. Upon oral rehydration with formula milk, no acute neurological problems arose, but she subsequently developed necrotizing enterocolitis. Intravenous rehydration may be preferred to the oral route in such infants.

  19. Differential Diagnosis and Treatment Proposal for Acute Endodontic Infection.

    PubMed

    Keine, Kátia Cristina; Kuga, Milton Carlos; Pereira, Kamila Figueiredo; Diniz, Ana Carolina Soares; Tonetto, Mateus Rodrigues; Galoza, Marina Oliveira Gonçalves; Magro, Miriam Graziele; de Barros, Yolanda Benedita Abadia Martins; Bandéca, Matheus Coelho; de Andrade, Marcelo Ferrarezi

    2015-12-01

    The objective of this study was to describe the main lesions that simulate clinically and propose a treatment protocol for acute endodontic infection. Signs and clinical symptoms of periodontal abscess, gingival abscess, odontoma, herpes simplex, pericoronitis, acute pulpitis and necrotizing ulcerative gingivitis/periodontitis (NUG/NUP) were described and compared with acute endodontic infections. A treatment protocol was described by optimizing the procedures in access cavity, microbial decontamination and detoxification of the root canal, apical debridement, intracanal and systemic medication and surgical drainage procedures. The convenience of the use of 5.25% sodium hypochlorite, root canal instrumentation using a crown-down technique, intracanal medication with 2% chlorhexidine or triple antibiotic paste and the convenience of the use of antibiotics, analgesics, and surgical drainage to solve cases of acute dentoalveolar abscess was discussed.

  20. Infection-Triggered Familial or Recurrent Cases of Acute Necrotizing Encephalopathy Caused by Mutations in a Component of the Nuclear Pore, RANBP2

    PubMed Central

    Neilson, Derek E.; Adams, Mark D.; Orr, Caitlin M.D.; Schelling, Deborah K.; Eiben, Robert M.; Kerr, Douglas S.; Anderson, Jane; Bassuk, Alexander G.; Bye, Ann M.; Childs, Anne-Marie; Clarke, Antonia; Crow, Yanick J.; Di Rocco, Maja; Dohna-Schwake, Christian; Dueckers, Gregor; Fasano, Alfonso E.; Gika, Artemis D.; Gionnis, Dimitris; Gorman, Mark P.; Grattan-Smith, Padraic J.; Hackenberg, Annette; Kuster, Alice; Lentschig, Markus G.; Lopez-Laso, Eduardo; Marco, Elysa J.; Mastroyianni, Sotiria; Perrier, Julie; Schmitt-Mechelke, Thomas; Servidei, Serenella; Skardoutsou, Angeliki; Uldall, Peter; van der Knaap, Marjo S.; Goglin, Karrie C.; Tefft, David L.; Aubin, Cristin; de Jager, Philip; Hafler, David; Warman, Matthew L.

    2009-01-01

    Acute necrotizing encephalopathy (ANE) is a rapidly progressive encephalopathy that can occur in otherwise healthy children after common viral infections such as influenza and parainfluenza. Most ANE is sporadic and nonrecurrent (isolated ANE). However, we identified a 7 Mb interval containing a susceptibility locus (ANE1) in a family segregating recurrent ANE as an incompletely penetrant, autosomal-dominant trait. We now report that all affected individuals and obligate carriers in this family are heterozygous for a missense mutation (c.1880C→T, p.Thr585Met) in the gene encoding the nuclear pore protein Ran Binding Protein 2 (RANBP2). To determine whether this mutation is the susceptibility allele, we screened controls and other patients with ANE who are unrelated to the index family. Patients from 9 of 15 additional kindreds with familial or recurrent ANE had the identical mutation. It arose de novo in two families and independently in several other families. Two other patients with familial ANE had different RANBP2 missense mutations that altered conserved residues. None of the three RANBP2 missense mutations were found in 19 patients with isolated ANE or in unaffected controls. We conclude that missense mutations in RANBP2 are susceptibility alleles for familial and recurrent cases of ANE. PMID:19118815

  1. Management of necrotizing pancreatitis

    PubMed Central

    Slavin, John; Ghaneh, Paula; Sutton, Robert; Hartley, Mark; Rowlands, Peter; Garvey, Conall; Hughes, Mark; Neoptolemos, John

    2001-01-01

    Infection complicating pancreatic necrosis leads to persisting sepsis, multiple organ dysfunction syndrome and accounts for about half the deaths that occur following acute pancreatitis. Severe cases due to gallstones require urgent endoscopic sphincterotomy. Patients with pancreatic necrosis should be followed with serial contrast enhanced computed tomography (CE-CT) and if infection is suspected fine needle aspiration of the necrotic area for bacteriology (FNAB) should be undertaken. Treatment of sterile necrosis should initially be non-operative. In the presence of infection necrosectomy is indicated. Although traditionally this has been by open surgery, minimally invasive procedures are a promising new alternative. There are many unresolved issues in the management of pancreatic necrosis. These include, the use of antibiotic prophylaxis, the precise indications for and frequency of repeat CE-CT and FNAB, and the role of enteral feeding. PMID:11819813

  2. Acute necrotizing dermatitis and septicemia after application of a d-limonene-based insecticidal shampoo in a cat.

    PubMed

    Lee, Justine A; Budgin, Jeanne B; Mauldin, Elizabeth A

    2002-07-15

    A 2-year-old female spayed domestic shorthair cat was examined because of lethargy, inappetance, vocalization, and abnormal aggressive behavior of 1 day's duration. The cat had been groomed the previous day with a d-limonene-based insecticidal shampoo. Skin lesions consisted of coalescing erythematous patches. Despite supportive care, the cat's condition deteriorated. Dermatohistopathologic changes included multifocal areas of acute coagulative epidermal necrosis. The dermis was infiltrated by a dense population of bacilli. d-Limonene toxicosis has been rarely described in dogs and cats. Toxic effects such as hypersalivation, ataxia, shivering, hypothermia, scrotal irritation, hypotension, and erythema multiforme major have been reported. Treatment for septicemia and disseminated intravascular coagulation, along with intensive supportive care, may be necessary.

  3. [Infectious complications in necrotizing pancreatitis].

    PubMed

    Werner, J; Büchler, M W

    2007-10-01

    Patients with CT evidence of more than 50 % necrosis, or an increased CRP or procalcitonin are at risk of developing severe pancreatitis and septic complications and should be monitored in an intensive care unit. ERCP and sphincterotomy are indicated in patients with biliary pancreatitis and impacted gall stones, biliary sepsis, or obstructive jaundice. In septic patients with necrotizing pancreatitis, a FNA should be performed for differentiation of sterile and infected pancreatic necrosis. Adequate volume resuscitation and analgesic treatment are the most important treatment of acute pancreatitis. Antibiotic prophylaxis reduces septic complications in severe necrotizing pancreatitis and should be started early. Surgical therapy is indicated in patients with infected pancreatic necrosis. The surgical technique of choice is open necrosectomy with postoperative closed lavage of the lesser sac.

  4. Evaluation of Calendula officinalis as an anti-plaque and anti-gingivitis agent

    PubMed Central

    Khairnar, Mayur Sudhakar; Pawar, Babita; Marawar, Pramod Parashram; Mani, Ameet

    2013-01-01

    Background: Calendula officinalis (C. officinalis), commonly known as pot marigold, is a medicinal herb with excellent antimicrobial, wound healing, and anti-inflammatory activity. Aim: To evaluate the efficacy of C. officinalis in reducing dental plaque and gingival inflammation. Materials and Methods: Two hundred and forty patients within the age group of 20-40 years were enrolled in this study with their informed consent. Patients having gingivitis (probing depth (PD) ≤3 mm), with a complaint of bleeding gums were included in this study. Patients with periodontitis PD ≥ 4 mm, desquamative gingivitis, acute necrotizing ulcerative gingivitis (ANUG), smokers under antibiotic coverage, and any other history of systemic diseases or conditions, including pregnancy, were excluded from the study. The subjects were randomly assigned into two groups – test group (n = 120) and control group (n = 120). All the test group patients were advised to dilute 2 ml of tincture of calendula with 6 ml of distilled water and rinse their mouths once in the morning and once in the evening for six months. Similarly, the control group patients were advised to use 8 ml distilled water (placebo) as control mouthwash and rinse mouth twice daily for six months. Clinical parameters like the plaque index (PI), gingival index (GI), sulcus bleeding index (SBI), and oral hygiene index-simplified (OHI-S) were recorded at baseline (first visit), third month (second visit), and sixth month (third visit) by the same operator, to rule out variable results. During the second visit, after recording the clinical parameters, each patient was subjected to undergo a thorough scaling procedure. Patients were instructed to carry out regular routine oral hygiene maintenance without any reinforcement in it. Results: In the absence of scaling (that is, between the first and second visit), the test group showed a statistically significant reduction in the scores of PI, GI, SBI (except OHI-S) (P < 0

  5. Necrotizing pneumonia and acute purulent pericarditis caused by Streptococcus pneumoniae serotype 19A in a healthy 4-year-old girl after one catch-up dose of 13-valent pneumococcal conjugate vaccine.

    PubMed

    Lu, Shay; Tsai, Jeng-Dau; Tsao, Ten-Fu; Liao, Pei-Fen; Sheu, Ji-Nan

    2016-08-01

    Streptococcus pneumoniae is a common cause of infectious diseases in children that may lead to life-threatening complications. Acute purulent pericarditis is an uncommon complication of S. pneumoniae in the antibiotic era. A healthy 4-year-old girl was admitted with pneumonia and pleural effusion. She had received one catch-up dose of 13-valent pneumococcal conjugate vaccine at 2 years of age. She rapidly developed necrotizing pneumonia, complicated by bronchopleural fistula presenting as subcutaneous emphysema and pneumothorax and acute purulent pericarditis. S. pneumoniae serotype 19A was subsequently identified from blood, empyema and pericardial fluid cultures. After appropriate antibiotic therapy and a right lower lobectomy, her condition stabilized and she promptly recovered. This case highlights two rare potential clinical complications of pneumococcal disease in a child: necrotizing pneumonia and acute purulent pericarditis. This is the first report of a child who received just one catch-up dose of 13-valent pneumococcal conjugate vaccine at 2 years of age, as per the United States' Advisory Committee on Immunization Practice's recommendations, but who still developed severe invasive pneumococcal disease with life-threatening complications caused by S. pneumoniae serotype 19A.

  6. Gingival tissue transcriptomes in experimental gingivitis

    PubMed Central

    Jönsson, Daniel; Ramberg, Per; Demmer, Ryan T.; Kebschull, Moritz; Dahlén, Gunnar; Papapanou, Panos N.

    2012-01-01

    Aims We investigated the sequential gene expression in the gingiva during the induction and resolution of experimental gingivitis. Methods Twenty periodontally and systemically healthy non-smoking volunteers participated in a 3-week experimental gingivitis protocol, followed by debridement and 2-week regular plaque control. We recorded clinical indices and harvested gingival tissue samples from 4 interproximal palatal sites in half of the participants at baseline, Day 7, 14 and 21 (‘induction phase’), and at day 21, 25, 30 and 35 in the other half (‘resolution phase’). RNA was extracted, amplified, reversed transcribed, amplified, labeled and hybridized with Affymetrix Human Genome U133Plus2.0 microarrays. Paired t-tests compared gene expression changes between consecutive time points. Gene ontology analyses summarized the expression patterns into biologically relevant categories. Results The median gingival index was 0 at baseline, 2 at Day 21 and 1 at Day 35. Differential gene regulation peaked during the third week of induction and the first four days of resolution. Leukocyte transmigration, cell adhesion and antigen processing/presentation were the top differentially regulated pathways. Conclusions Transcriptomic studies enhance our understanding of the pathobiology of the reversible inflammatory gingival lesion and provide a detailed account of the dynamic tissue responses during induction and resolution of experimental gingivitis. PMID:21501207

  7. Necrotizing Periodontal Diseases in Children: A Literature Review and Adjustment of Treatment.

    PubMed

    Marty, Mathieu; Palmieri, James; Noirrit-Esclassan, Emmanuelle; Vaysse, Frédéric; Bailleul-Forestier, Isabelle

    2016-08-01

    Necrotizing ulcerative gingivitis, sometimes observed in young children, may lead to necrotizing stomatitis and noma. Therefore, its interception is a necessity and a challenge for the paediatric practitioners. First, this article aims to propose a systematic review of recent literature on the use of local antiseptic and antibiotic prescription in this particular periodontal condition. Then, a protocol is proposed to have a simple, costless and reproducible treatment on children. PMID:26966241

  8. Idiopathic Gingival Fibromatosis

    PubMed Central

    Nayak, Ullal Anand; Khandelwal, Vishal; Ninave, Nupur

    2011-01-01

    ABSTRACT Idiopathic gingival fibromatosis is a rare heriditary condition characterized by slowly progressive, nonhemorrhagic, fibrous enlargement of maxillary and mandibular keratinized gingiva caused by increase in submucosal connective tissue elements. This case report gives an overview of gingival fibromatosis in a 11-year-old female patient who presented with generalized gingival enlargement. Based on the history and clinical examination, the diagnosis was made and the enlarged tissue was surgically removed. The patient was being regularly monitored clinically for improvement in her periodontal condition as well as for any recurrence of gingival overgrowth. PMID:27616864

  9. Two cases of an atypical presentation of necrotizing stomatitis

    PubMed Central

    2015-01-01

    Purpose The purpose of this report was to describe the clinical and microbiological characteristics of two rare cases of necrotizing stomatitis, and the outcomes of a non-invasive treatment protocol applied in both cases. Methods We report two cases of necrotizing stomatitis in a rare location in the hard palate of a 40-year-old woman and a 28-year-old man. Neither had a relevant medical history and both presented with highly painful ulceration in the palate and gingival margin that was accompanied by suppuration and necrosis. 3% hydrogen peroxide was applied to the lesions using sterile swabs, and antibiotic and anti-inflammatory treatment was prescribed to both patients in addition to two daily oral rinses of 0.2% chlorhexidine. Results In both cases, radiological examination ruled out bone involvement, and exfoliative cytology revealed a large inflammatory component and the presence of forms compatible with fusobacteria and spirochetes. There was a rapid response to treatment and a major improvement was observed after 48 hours, with almost complete resolution of the ulcerated lesions and detachment of necrotic areas with partial decapitation of gingival papillae. Conclusions Necrotizing periodontal lesions can hinder periodontal probing and the mechanical removal of plaque in some cases due to the extreme pain suffered by the patients. We present a non-invasive treatment approach that can manage these situations effectively. PMID:26734496

  10. Spontaneous Gingivitis Related to Hair Penetration in Rats

    PubMed Central

    Goto, Aya; Sonoda, Jiro; Seki, Yuki; Taketa, Yoshikazu; Ohta, Etsuko; Nakano, Kyoko; Inomata, Akira; Hayakawa, Kazuhiro; Aoki, Toyohiko; Tsukidate, Kazuo; Hosokawa, Satoru

    2012-01-01

    Maxillary gingivae from male and female Crl:CD(SD) rats at 12, 16, 21, and 34 weeks of age were examined histologically. The incidence of gingivitis was approximately 40%, with no age or sex predilection, and was most frequent between the first and second molar. Lesions were characterized by acute focal neutrophilic infiltration into the gingival mucosa, occasionally with inflammatory exudate. In severe cases, inflammation extended to the periodontal ligament with abscess formation, and adjacent alveolar bone destruction/resorption. The most characteristic finding was the presence of hair shafts associated with the lesion, which was observed in approximately 80% of the rats with gingivitis. These findings suggest that molar gingivitis occurs in rats from an early age and persists thereafter, and that the main cause of gingivitis in rats is hair penetration into the gingiva. It would be prudent to keep these background lesions in mind as potential modifiers in toxicity studies. PMID:22988343

  11. Cervical Necrotizing Fasciitis Caused by Dental Extraction

    PubMed Central

    Figueiredo, Eugênia; Álvares, Pâmella; Silva, Luciano; Silva, Leorik; Caubi, Antônio; Silveira, Marcia; Sobral, Ana Paula

    2016-01-01

    Cervical necrotizing fasciitis is an unusual infection characterized by necrosis of the subcutaneous tissue and fascial layers. Risk factors for the development of necrotizing fasciitis include diabetes mellitus, chronic renal disease, peripheral vascular disease, malnutrition, advanced age, obesity, alcohol abuse, intravenous drug use, surgery, and ischemic ulcers. This report presents a case of necrotizing fasciitis in the cervical area caused by dental extraction in a 73-year-old woman. Cervical necrotizing fasciitis in geriatric patient is rare, and even when establishing the diagnosis and having it timely treated, the patient can suffer irreversible damage or even death. Clinical manifestations in the head and neck usually have an acute onset characterized by severe pain, swelling, redness, erythema, presence of necrotic tissue, and in severe cases obstruction of the upper airways. Therefore, the presentation of this clinical case can serve as guidance to dentists as a precaution to maintain an aseptic chain and be aware of the clinical condition of older patients and the systemic conditions that may increase the risk of infections. PMID:27375905

  12. Cervical Necrotizing Fasciitis Caused by Dental Extraction.

    PubMed

    Arruda, José Alcides; Figueiredo, Eugênia; Álvares, Pâmella; Silva, Luciano; Silva, Leorik; Caubi, Antônio; Silveira, Marcia; Sobral, Ana Paula

    2016-01-01

    Cervical necrotizing fasciitis is an unusual infection characterized by necrosis of the subcutaneous tissue and fascial layers. Risk factors for the development of necrotizing fasciitis include diabetes mellitus, chronic renal disease, peripheral vascular disease, malnutrition, advanced age, obesity, alcohol abuse, intravenous drug use, surgery, and ischemic ulcers. This report presents a case of necrotizing fasciitis in the cervical area caused by dental extraction in a 73-year-old woman. Cervical necrotizing fasciitis in geriatric patient is rare, and even when establishing the diagnosis and having it timely treated, the patient can suffer irreversible damage or even death. Clinical manifestations in the head and neck usually have an acute onset characterized by severe pain, swelling, redness, erythema, presence of necrotic tissue, and in severe cases obstruction of the upper airways. Therefore, the presentation of this clinical case can serve as guidance to dentists as a precaution to maintain an aseptic chain and be aware of the clinical condition of older patients and the systemic conditions that may increase the risk of infections. PMID:27375905

  13. Idiopathic gingival fibromatosis

    PubMed Central

    Dani, Nitin Hemchandra; Khanna, Dinkar Parveen; Bhatt, Vaibhavi Hitesh; Joshi, Chaitanya Pradeep

    2015-01-01

    Idiopathic gingival fibromatosis (IGF) is a rare hereditary condition characterized by slowly progressive, nonhemorrhagic, fibrous enlargement of maxillary and mandibular keratinized gingiva caused by increase in submucosal connective tissue elements, mostly associated with some syndrome. This case report describes a case of nonsyndromic generalized IGF in an 18-year-old male patient who presented with generalized gingival enlargement. The enlarged tissue was surgically removed by internal bevel gingivectomy and ledge and wedge procedure. The patient was regularly monitored clinically for improvement in his periodontal condition as well as for any recurrence of gingival overgrowth. PMID:26941525

  14. Hereditary Gingival Fibromatosis

    ERIC Educational Resources Information Center

    Nevin, N. C.

    1971-01-01

    Case studies of two siblings suffering from a gum disorder in which enlargement of the gingival mucosa is caused by a fibrosis. The disorder in the two children was felt to be an hereditary recessive trait. (CD)

  15. Hereditary gingival fibromatosis

    PubMed Central

    Dhadse, Prasad Vijayrao; Yeltiwar, Ramareddy Krishnarao; Pandilwar, Prashant K.; Gosavi, Suchitra R.

    2012-01-01

    Hereditary gingival fibromatosis is a rare benign oral condition characterised by slow and progressive enlargement of both maxillary and mandibular attached gingiva. It may develop as an isolated disorder but can feature along with a syndrome. A case of 12 year old female child who presented with generalised severe gingival overgrowth, involving both the arches and covering almost the entire dentition, and had all the teeth remaining invisible within the confinement of gingival tissues. The excess gingival tissue, in this non-syndromic case was removed by conventional gingivectomy using local as well as general anaesthesia. The post-operative result was uneventful and the patient appearance improved considerably. Good aesthetic result was achieved to allow patient to practice oral hygiene measures. After treatment regular recall visits are necessary in order to evaluate oral hygiene and stability of periodontal treatment. PMID:23492855

  16. Necrotizing soft tissue infections

    PubMed Central

    Urschel, J.

    1999-01-01

    Necrotizing soft tissue infections are a group of highly lethal infections that typically occur after trauma or surgery. Many individual infectious entities have been described, but they all have similar pathophysiologies, clinical features, and treatment approaches. The essentials of successful treatment include early diagnosis, aggressive surgical debridement, antibiotics, and supportive intensive treatment unit care. The two commonest pitfalls in management are failure of early diagnosis and inadequate surgical debridement. These life-threatening infections are often mistaken for cellulitis or innocent wound infections, and this is responsible for diagnostic delay. Tissue gas is not a universal finding in necrotizing soft tissue infections. This misconception also contributes to diagnostic errors. Incision and drainage is an inappropriate surgical strategy for necrotizing soft tissue infections; excisional debridement is needed. Hyperbaric oxygen therapy may be useful, but it is not as important as aggressive surgical therapy. Despite advances in antibiotic therapy and intensive treatment unit medicine, the mortality of necrotizing soft tissue infections is still high. This article emphasizes common treatment principles for all of these infections, and reviews some of the more important individual necrotizing soft tissue infectious entities.


Keywords: fasciitis; gas gangrene; clostridium infections; streptococcal infections; necrosis; debridement; surgical infections; soft tissue infections PMID:10621873

  17. Gingival Cyst of Newborn.

    PubMed

    Moda, Aman

    2011-01-01

    Gingival cyst of newborn is an oral mucosal lesion of transient nature. Although it is very common lesion within 3 to 6 weeks of birth, it is very rare to visualize the lesion thereafter. Presented here is a case report of gingival cyst, which was visible just after 15 days of birth. Clinical diagnoses of these conditions are important in order to avoid unnecessary therapeutic procedure and provide suitable information to parents about the nature of the lesion.

  18. Plasma cell gingivitis

    PubMed Central

    Joshi, Chandershekhar; Shukla, Pradeep

    2015-01-01

    The aim of the article is to present a report on the clinical presentation of plasma cell gingivitis with the use of herbal toothpowder. Plasma cell gingivitis [PCG] is a rare benign condition of the gingiva characterized by sharply demarcated erythematous and edematous gingivitis often extending to the mucogingival junction. As the name suggests it is diffuse and massive infiltration of plasma cells into the sub-epithelial gingival tissue. It is a hypersensitivity reaction to some antigen, often flavouring agents or spices found in chewing gums, toothpastes and lorenzes. A 27-yr old male with a chief complaint of painful, bleeding swollen mass in his lower front teeth region with prolong use of herbal toothpowder. The gingiva bled readily on probing. Patient was advised to refrain from the use of herbal toothpowder and along with periodontal treatment, no further reoccurrence was found. as more and more herbal products are gaining popularity, clinicians should be aware of effects of these products. Early diagnosis is essential as plasma cell gingivitis has similar pathologic changes seen clinically as in leukemia, HIV infection, discoid lupus erythematosis, atrophic lichen planus, desquamative gingivitis, or cicatrical pemphigoid which must be differentiated through hematologic and serologic testing. PMID:26015677

  19. [Necrotizing fasciitis after varicella].

    PubMed

    Gonçalves, E; Furtado, F; Estrada, J; Vale, M C; Pinto, M; Santos, M; Moura, G; Vasconcelos, C

    2001-01-01

    Necrotizing fasciitis is a rare and severe infection characterised by extremely rapid progressive involvement of the superficial fascias and deep dermal layers of the skin, with resultant vasculitis and necrosis. The authors present three clinical cases of necrotizing fasciitis; all three patients previously had varicella rash, rapid progressive spreading erythema with severe pain and toxic shock syndrome. Two patients had positive cultures of b-haemolytic streptococcus. Early stage differential diagnosis with celulitis, aggressive antibiotic treatment and pediatric intensive care support are essential. However, the main therapy is early extensive surgical approach involving all indurate areas, down to and including the muscle fascia.

  20. Necrotizing sialometaplasia of tongue.

    PubMed

    Randhawa, Tanu; Varghese, Ipe; Shameena, Pm; Sudha, S; Nair, Resmi G

    2009-01-01

    Necrotizing sialometaplasia, is a benign inflammatory lesion primarily involving the minor salivary glands of the hard palate. The lesion often presents itself as a deep-seated palatal ulcer with clinical and histological features similar to those of a malignant neoplasm. Here we report a case of necrotizing sialometaplasia in a 40-year-old female, present on the lateral border of the tongue, mimicking squamous cell carcinoma, clinically. A correct diagnosis to avoid mutilant surgical treatments is essential, considering that it is a self-limiting disease.

  1. A Case of Necrotizing Epiglottitis Due to Nontoxigenic Corynebacterium diphtheriae.

    PubMed

    Lake, Jessica A; Ehrhardt, Matthew J; Suchi, Mariko; Chun, Robert H; Willoughby, Rodney E

    2015-07-01

    Diphtheria is a rare cause of infection in highly vaccinated populations and may not be recognized by modern clinicians. Infections by nontoxigenic Corynebacterium diphtheriae are emerging. We report the first case of necrotizing epiglottitis secondary to nontoxigenic C diphtheriae. A fully vaccinated child developed fever, poor oral intake, and sore throat and was found to have necrotizing epiglottitis. Necrotizing epiglottitis predominantly occurs in the immunocompromised host. Laboratory evaluation revealed pancytopenia, and bone marrow biopsy was diagnostic for acute lymphoblastic leukemia. Clinicians should be aware of aggressive infections that identify immunocompromised patients. This case highlights the features of a reemerging pathogen, C diphtheriae.

  2. Foreign Body Gingivitis.

    PubMed

    Koh, Richard U; Ko, Eugene; Oh, Tae-Ju; Edwards, Paul C

    2015-03-01

    Foreign body gingivitis (FBG) is a non-plaque induced chronic inflammatory process involving the marginal and/or attached gingiva. It results from the introduction of foreign particulate material, primarily dental prophylaxis paste and restorative dental materials, into the gingival tissues. Clinical presentation varies from an erythematous to vesiculoerosive-like process that may mimic a localized form of desquamative gingivitis or an erosive lichenoid process. Rarely, it may also present with a granular appearance. We describe the clinical presentation, differential diagnosis and clinical management of a 52-year-old Woman who presented with localized chronic inflammation of the maxillary anterior and left posterior gingiva secondary to the presence of foreign material.

  3. Hereditary gingival fibromatosis

    PubMed Central

    Chaurasia, Akhilanand

    2014-01-01

    Hereditary gingival fibromatosis (HGF) is a rare condition that can occur as an isolated disease, chromosomal abnormality, or as part of a number of syndromes. The gingival enlargement in HGF can be so severe that it can cover the crowns of teeth completely, causing severe functional derangement and facial disfigurement. Through review of literature revealed that HGF is usually an autosomal dominant condition, however the recessive forms are also reported. The hyperplastic gingiva is firm on palpation and has normal color with abundant stippling on the adjacent gingiva. The buccal and lingual gingiva may be involved in both the mandible and maxilla. The degrees of gingival enlargement show both intra- and interindividual variations. Here, an interesting case report of massive HGF has been presented. PMID:25298717

  4. [The role of jejunal feeding in the treatment of acute necrotizing pancreatitis and in recurrence of chronic pancreatitis with severe necrosis].

    PubMed

    Hamvas, J; Pap, A

    1998-04-19

    Acute necrotising is the most serious form of pancreatic inflammatory diseases leading to multiorgan failure and high (15-20%) mortality. The poor nutritional and metabolic condition of the patient and secondary bacterial translocation further rise the mortality. A recently introduced method of continuous nasojejunal feeding putting the pancreas into rest with basal pattern of secretion resulted in lower mortality rate by using adequate nutrition into the second loop of jejunum bypassing duodenopancreatic stimulations via an endoscopically placed feeding tube. The better nutritional and immunological states of the patients, the restored absorption and intestinal motility promote the recovery of pancreatitis, prevent bacterial translocation, resulting in time and in financial spares. Although surgery is occasionally inevitable because of progression of pancreatitis, nasojejunal feeding improves the general condition of patients more efficiently than parenteral nutrition and makes the scheduling of the operation optimal. The authors retrospectively analyse the results of treatment in 56 patients suffering from acute necrotising pancreatitis, as well as in 30 patients with chronic pancreatitis accompanied with more than 20% of necrosis in the pancreas and admitted to their gastroenterological medical department during 5 years. The effect of parenteral nutrition were less beneficial than that of jejunal feeding regarding the mortality and the necessity of operative interventions. Chronic pancreatitis with severe necrosis behaved similarly to the acute necrotising pancreatitis. The continuous nasojejunal feeding seems to be a promising new method for acute necrotising pancreatitis preventing complications and severe catabolic state of the disease by a cost--effective manner.

  5. [Necrotizing autoimmune myopathies].

    PubMed

    Petiot, P; Choumert, A; Hamelin, L; Devic, P; Streichenberger, N

    2013-01-01

    Necrotizing autoimmune myopathies are included in the spectrum of inflammatory myopathies, together with polymyosis, dermatopolymyosis and inclusion body myositis, despite the characteristic feature of marked muscular necrosis without inflammatory infiltrates. The clinical presentation is highly variable, often similar to the other inflammatory myopathies. The most common finding is nevertheless the severe form with rhabdomyolysis. The creatine kinase level is elevated (around 10,000IU/l) and electromyography shows myopathic changes with increased spontaneous activities reflecting the importance of the muscular necrosis. Muscle biopsy is required for diagnosis, revealing active necrosis of the muscle fibers without inflammatory invasion by CDA+ or CD8+ T-cells. Deposition of a microvascular membrane attack complex (C5b9) is often noted, whereas the upregulation of MHC class 1 is rarely detected. Signs of endomysial microangiopathy are frequently reported. Necrotizing autoimmune myopathies can be associated with antisignal recognition particle (SRP) antibodies or more rarely with the usual inflammatory myopathy antibodies. Paraneoplasic forms are described but remain exceptional. Lastly, necrotizing autoimmune myopathies, sometimes associated with statin therapy, have been recently described. They are linked with an antibody directed against 3-hydroxy-3-methyglutaryl-coenzyme A. Treatment is based on corticosteroid therapy, immunosuppressive drugs or intravenous immunoglobulins. Response is variable, depending on the clinical form. PMID:23999024

  6. Gingival hypertrophy in a child: Expect the unexpected

    PubMed Central

    Ravikumar, Rekha; Manohar, Rakesh; Latha, Sneha Magatha; Scott, Julius Xavier

    2016-01-01

    Acute leukemia is the most common malignant disorder of childhood. Acute leukemia is characterized by marrow failure due to the replacement of marrow elements by leukemic blasts. Gingival hypertrophy (GH) due to acute myeloid leukemia (AML) in a child is extremely rare. Here, we report a case of AML (subtype M5 of FAB classification) in a 3-year-old male child wherein the disease primarily presented as GH. PMID:27433057

  7. Necrotizing enterocolitis: controversies and challenges

    PubMed Central

    Zani, Augusto; Pierro, Agostino

    2015-01-01

    Necrotizing enterocolitis is a devastating intestinal disease that affects ~5% of preterm neonates. Despite advancements in neonatal care, mortality remains high (30–50%) and controversy still persists with regards to the most appropriate management of neonates with necrotizing enterocolitis. Herein, we review some controversial aspects regarding the epidemiology, imaging, medical and surgical management of necrotizing enterocolitis and we describe new emerging strategies for prevention and treatment. PMID:26918125

  8. Pathogenesis of Necrotizing Enterocolitis

    PubMed Central

    Tanner, Scott M.; Berryhill, Taylor F.; Ellenburg, James L.; Jilling, Tamas; Cleveland, Dava S.; Lorenz, Robin G.; Martin, Colin A.

    2016-01-01

    Necrotizing enterocolitis (NEC) is a major cause of morbidity and mortality in premature infants. The pathophysiology is likely secondary to innate immune responses to intestinal microbiota by the premature infant's intestinal tract, leading to inflammation and injury. This review provides an updated summary of the components of the innate immune system involved in NEC pathogenesis. In addition, we evaluate the animal models that have been used to study NEC with regard to the involvement of innate immune factors and histopathological changes as compared to those seen in infants with NEC. Finally, we discuss new approaches to studying NEC, including mathematical models of intestinal injury and the use of humanized mice. PMID:25447054

  9. Necrotizing sialometaplasia: a case report.

    PubMed

    Coley-Smith, A; Ellis, S G

    1994-01-01

    Necrotizing sialometaplasia, a benign self-limiting disease of minor salivary glands, may be confused both clinically and histologically with squamous cell carcinoma or a minor salivary gland neoplasm. Its sinister appearance has lead to misdiagnosis and some patients have undergone extensive surgery unnecessarily. This paper describes the salient features of necrotizing sialometaplasia and discusses the management of a patient with the condition.

  10. Necrotizing fasciitis caused by Aeromonas caviae.

    PubMed

    Kumar, Simit; Mukhopadhyay, Prabir; Chatterjee, Mitali; Bandyopadhyay, Manas K; Bandyopadhyay, Maitreyi; Ghosh, Tapashi; Samaddar, Debopriyo

    2012-10-01

    Aeromonads are rarely associated with human intestinal and extra-intestinal diseases and syndromes, ranging from relatively mild illnesses such as acute gastroenteritis to life-threatening conditions, including septicemia, necrotizing fasciitis, and myonecrosis. Among the aeromonas species known to cause human infection, Aeromonas caviae has been associated with septicemia and only one reported case of human soft tissue infection. Most of the infections due to aeromonas occur in immunocompromised patients. Herein we describe a successfully treated case of post-traumatic skin and soft-tissue infections due to A. caviae in an otherwise immunocompetent individual.

  11. Gingival Veneer: A Novel Technique of Masking Gingival Recession

    PubMed Central

    Pillai, Arpita; Zade, R.; Amirishetty, Ramesh; Shetty, Sunaina

    2015-01-01

    One of the most distressing aspects of periodontitis is the unesthetic appearance of maxillary and mandibular anteriors. The elongation of the crowns due to root exposure and increased interdental spacing results in unesthetic appearance. Surgical procedures for gingival recession coverage do not have acceptable results in cases of severe gingival recession. So nonsurgical methods like gingival veneers should be considered as a treatment modality in such cases. This article aims to revisit the gingival veneer: its uses, advantages, disadvantages, and its fabrication. The case discussed here highlight clinical situation where the gingival veneer prosthesis helped in achieving optimum esthetics and patient satisfaction thus proving to be a feasible and simple treatment modality in certain clinical cases. This may offer a good interim solution for patients who may wish to have time to consider their options of more advanced and complex treatment. PMID:25738090

  12. Abdominal Compartment Syndrome and Necrotizing Pancreatitis Following Extracorporeal Shock Wave Lithotripsy.

    PubMed

    Gupta, S; Scambia, J; Gandillon, C; Aversano, F; Batista, R

    2016-09-01

    Extracorporeal shock wave lithotripsy (ESWL) is a common procedure in the treatment of renal calculi. There have been major complications reported with ESWL such as acute pancreatitis, bower perforation, venous thrombosis, and biliary obstruction. There are few reports in the literature of necrotizing pancreatitis secondary to ESWL. We have a case report of a 29-year-old female that developed an abdominal compartment syndrome with an acute necrotizing pancreatitis hours after extracorporeal shock wave lithotripsy. PMID:27462545

  13. Necrosis-induced TLR3 Activation Promotes TLR2 Expression in Gingival Cells.

    PubMed

    Mori, K; Yanagita, M; Hasegawa, S; Kubota, M; Yamashita, M; Yamada, S; Kitamura, M; Murakami, S

    2015-08-01

    Damage-associated molecular patterns (DAMPs), endogenous molecules released from injured or dying cells, evoke sterile inflammation that is not induced by microbial pathogens. Periodontal diseases are infectious diseases caused by oral microorganisms; however, in some circumstances, DAMPs might initiate inflammatory responses before host cells recognize pathogen-associated molecular patterns. Here, we showed that the necrotic cell supernatant (NCS) functioned as an endogenous danger signal when released from necrotic epithelial cells exposed to repeat freeze thawing. The NCS contained RNA and stimulated the production of inflammatory cytokines interleukin 6 (IL-6) and IL-8 from gingival epithelial cells and gingival fibroblasts. Targeted knockdown of Toll-like receptor 3 (TLR3) in these cells significantly suppressed the ability of the NCS to induce IL-6 and IL-8 production. Epithelial cells and fibroblasts recognized the NCS from heterologous cells. Interestingly, the activation of TLR3, rather than other TLRs, induced TLR2 mRNA expression and proteins in gingival epithelial cells, and pretreatment with the NCS or polyinosinic:polycytidylic acid (Poly(I:C)), a strong TLR3 activator, enhanced inflammatory cytokine production induced by subsequent stimulation with Porphyromonas gingivalis (P. gingivalis) lipopolysaccharide, a TLR2 agonist. Moreover, the NCS reduced the expression of epithelial tight junction molecules zona occludens 1 and occludin and increased the permeability of epithelial tight junctions. These findings suggest that endogenous danger signal molecules such as self-RNA released from necrotic cells are recognized by TLR3 and that a subsequent increase of TLR2 expression in periodontal compartments such as gingival epithelial cells and gingival fibroblasts may enhance the inflammatory response to periodontopathic microbes recognized by TLR2 such as P. gingivalis, which also disrupts epithelial barrier functions. Thus, DAMPs may be involved in the

  14. Gingival Wound Healing

    PubMed Central

    Cáceres, M.; Martínez, C.; Oyarzún, A.; Martínez, J.

    2015-01-01

    Gingival wound healing comprises a series of sequential responses that allow the closure of breaches in the masticatory mucosa. This process is of critical importance to prevent the invasion of microbes or other agents into tissues, avoiding the establishment of a chronic infection. Wound healing may also play an important role during cell and tissue reaction to long-term injury, as it may occur during inflammatory responses and cancer. Recent experimental data have shown that gingival wound healing is severely affected by the aging process. These defects may alter distinct phases of the wound-healing process, including epithelial migration, granulation tissue formation, and tissue remodeling. The cellular and molecular defects that may explain these deficiencies include several biological responses such as an increased inflammatory response, altered integrin signaling, reduced growth factor activity, decreased cell proliferation, diminished angiogenesis, reduced collagen synthesis, augmented collagen remodeling, and deterioration of the proliferative and differentiation potential of stem cells. In this review, we explore the cellular and molecular basis of these defects and their possible clinical implications. PMID:25527254

  15. Necrotizing sialometaplasia: a diagnostic dilemma.

    PubMed

    Madala, Jayakiran; Guttikonda, Venkateswara Rao; Korlepara, Rajani; Yeluri, Sivaranjani

    2014-09-01

    Necrotizing sialometaplasia is a benign self-limiting lesion of both major and minor salivary glands although more commonly the latter. The clinical and histological similarity between this entity and a malignant lesion implies a risk of unnecessary radical treatment. We report a case of necrotizing sialometaplasia in middle aged women presenting as a non-ulcerated swelling. This case illustrates the need for careful analysis of a biopsy specimen for a correct diagnosis.

  16. Heterogeneity in the gingival fibromatoses.

    PubMed

    Takagi, M; Yamamoto, H; Mega, H; Hsieh, K J; Shioda, S; Enomoto, S

    1991-11-15

    Forty-nine cases of isolated familial and idiopathic gingival fibromatoses, consisting of 12 cases from six families and 37 cases of idiopathic gingival fibromatosis, were reviewed. Pedigrees of five families revealed various penetrances and genetic heterogeneity as suggested by the presence of both autosomal dominant and autosomal recessive inheritances. Ultrastructurally, the lesions were composed of fibroblast-like cells and myofibroblast-like cells, with the former being the predominant cell type. The 267 cases of familial and idiopathic gingival fibromatoses were analyzed, and they with or without hypertrichosis, mental retardation, and/or epilepsy. These included 49 cases seen by the authors, 50 cases from the Japanese literature, and 168 cases from non-Japanese literature. Isolated gingival fibromatosis occurred more frequently after age of 12 years (P less than 0.0074). There was no significant difference in age of onset between generalized and localized forms of the idiopathic gingival fibromatosis. Gingival fibromatosis with hypertrichosis and mental retardation and/or epilepsy occurred frequently before 12 years (P less than 0.069). It has been shown that heterogeneity of the gingival fibromatosis is a result of either histologic heterogeneity, genetic heterogeneity, or a combination with other systemic disorders.

  17. Non-syndromic hereditary gingival fibromatosis

    PubMed Central

    Mohan, Ravi Prakash Sasankoti; Verma, Sankalp; Agarwal, Neha; Singh, Udita

    2013-01-01

    Hereditary gingival fibromatosis is a rare condition characterised by severe gingival hyperplasia that can occur as an isolated disease or as part of a syndrome or chromosomal abnormality. In severe cases, the gingival enlargement may cover the crowns of teeth and cause severe aesthetic, emotional and functional impairment. This case report gives an overview of gingival fibromatosis in a 22-year-old male patient who presented with generalised gingival enlargement. PMID:24031070

  18. Extensive Gingival Enlargement in Siblings

    PubMed Central

    Pushpanshu, Kumar; Kaushik, Rachna; Sathawane, R. S.; Athawale, Ravi P.

    2012-01-01

    Gingival fibromatosis is characterised by varying degrees of fibrotic gingival overgrowth that can be caused by a variety of aetiological factors. Hereditary gingival fibromatosis (HGF) is a rare genetic disorder, characterised by a slowly progressive, benign enlargement of keratinised gingiva. The condition may be found in an autosomal dominant or autosomal recessive mode of inheritance, the former being more common. It usually develops as an isolated disorder but can be one feature of a multisystem syndrome. Accordingly, HGF has been divided into two forms: non-syndromic and syndromic. The gingival enlargement can be localised or generalised, but usually involves both arches. The authors describe a case of non-syndromic generalised severe HGF, involving the maxillary and mandibular arches in two brothers. This report focuses on the diagnosis, treatment, and control of the disease. The pattern of inheritance and histopathologic characteristics are also emphasised. PMID:23275852

  19. Pure White Cell Aplasia and Necrotizing Myositis

    PubMed Central

    Kim, Peter Geon; Suh, Joome; Adelman, Max W.; Oduro, Kwadwo; Williams, Erik; Brunner, Andrew M.; Kuter, David J.

    2016-01-01

    Pure white cell aplasia (PWCA) is a rare hematologic disorder characterized by the absence of neutrophil lineages in the bone marrow with intact megakaryopoiesis and erythropoiesis. PWCA has been associated with autoimmune, drug-induced, and viral exposures. Here, we report a case of a 74-year-old female who presented with severe proximal weakness without pain and was found to have PWCA with nonspecific inflammatory necrotizing myositis and acute liver injury on biopsies. These findings were associated with a recent course of azithromycin and her daily use of a statin. Myositis improved on prednisone but PWCA persisted. With intravenous immunoglobulin and granulocyte-colony stimulating factor therapies, her symptoms and neutrophil counts improved and were sustained for months. PMID:27073704

  20. Necrotizing fasciitis and myositis: a case report.

    PubMed

    Razi-Syed, S; Jafri, S Z

    1994-01-01

    Necrotizing fasciitis is a relatively rare, potentially life-threatening infection involving the subcutaneous tissues. We report a case of group A streptococcal necrotizing fasciitis/myositis in which CT played an important role in differential diagnosis.

  1. Membranous glomerulopathy with superimposed pauci-immune necrotizing crescentic glomerulonephritis

    PubMed Central

    Fatima, Huma; Siew, Edward D.; Dwyer, Jamie P.; Paueksakon, Paisit

    2012-01-01

    We describe a 61-year-old woman with acute kidney injury, nephrotic range proteinuria and hematuria. Kidney biopsy showed membranous glomerulopathy (MG) with superimposed pauci-immune necrotizing crescentic glomerulonephritis (PNCGN). Coexistent MG and PNCGN is a rare occurrence. The diagnosis of such an exceptionally rare combination relies on the combination of renal biopsy findings and serologic testing. We also review previous reported cases and discuss possible pathogenesis of this rare dual glomerulopathy. PMID:26069808

  2. Effect of Gingivitis on Azithromycin Concentrations in Gingival Crevicular Fluid

    PubMed Central

    Jain, Nidhi; Lai, Pin-Chuang; Walters, John D.

    2012-01-01

    Aim Macrolide antibiotics yield high concentrations in inflamed tissue, suggesting that their levels in gingival crevicular fluid (GCF) could be increased at gingivitis sites. However, the increased volume of GCF associated with gingivitis could potentially dilute macrolides. To determine whether these assumptions are correct, the bioavailability of systemically-administered azithromycin was compared in GCF from healthy and gingivitis sites. Materials and methods Experimental gingivitis was induced in one maxillary posterior sextant in nine healthy subjects. Contralateral healthy sextants served as controls. Subjects ingested 500 mg of azithromycin followed by a 250 mg dose 24 hours later. Four hours after the second dose, plaque was removed from experimental sites. GCF was collected from 8 surfaces in both the experimental and control sextants and pooled separately. GCF samples were subsequently collected on the 2nd, 3rd, 8th and 15th days and azithromycin content was determined by agar diffusion bioassay. Results On days 2 and 3, the pooled GCF volume at experimental sites was significantly higher than at control sites (P <0.01) and the total azithromycin mass in 30 second GCF samples pooled from experimental sites was significantly higher than at control sites (P < 0.02). However, there were no significant differences in azithromycin concentration between the experimental and control pools at any point. Concentrations exceeded 7.3 μg/ml on day 2 and 2.5 μg/ml on day 15. Conclusions Azithromycin concentrations are similar in GCF from gingivitis sites and healthy sites, suggesting that the processes that regulate GCF azithromycin concentration can compensate for local inflammatory changes. PMID:22220766

  3. Prevention of neonatal necrotizing enterocolitis.

    PubMed

    Carrion, V; Egan, E A

    1990-10-01

    Small premature infants are often hypochlorhydric, and frequently their stomachs are colonized by enteric, gram-negative bacteria. We tested a hypothesis that gastric pH affected the colonization of the stomach with enteric bacteria and that this colonization was causally related to the risk or severity of necrotizing enterocolitis. A prospective, double-blind study was conducted that compared a group of infants supplemented with 0.01-0.02 ml of 1 N HCl/ml of milk to a group with a similar supplement of water. Gastric pH, gastric enteric bacteria counts, and the incidence and severity of necrotizing enterocolitis were monitored. The median gastric pH of the HCl-supplemented group was lower (3.0) than controls (4.0) throughout the study (p less than 0.001). The gastric enteric bacterial colonization rate and the quantitative bacterial counts were strongly correlated with gastric pH over 4 (p less than 0.001). Somatic growth rates in infants in the HCl-supplemented group were equal to, or exceeded, those in the control group. There was 1 case of necrotizing enterocolitis among the 34 infants in the HCl-supplemented group and 8 cases among the 34 in the control group (p = 0.02). It appears that acidifying the feedings of small premature infants to a pH low enough to inhibit bacterial proliferation in the stomach significantly lowers the risk of necrotizing enterocolitis.

  4. [A woman with gingival hyperplasia].

    PubMed

    van Montfort, Monique; Huisman, Linette

    2014-01-01

    A woman visited her dentist with complaints of swollen gums. If there was a serious infection of multiple teeth, the surgeon had to do a total extraction of the upper jaw. The clinical picture was suspicious for a lymphoma, a fibromatosis or a gingivitis. The biopsy showed a chronical infection. In this case the gingival overgrowth and the subsequent infection of the teeth were caused by nifedipine. Gingival enlargement can be a consequence of the administration of calcium channel blockers and can occur if these are administered during a few months or years. The incidence is 0,01-0,1% and the prevalence is 20%. Drug substitution should be considered a valid treatment option and can be successful within a few weeks.

  5. C-Reactive Protein in Peripheral Blood of Patients with Chronic and Aggressive Periodontitis, Gingivitis, and Gingival Recessions.

    PubMed

    Podzimek, Stepan; Mysak, Jaroslav; Janatova, Tatjana; Duskova, Jana

    2015-01-01

    CRP is a plasma protein that reflects a measure of the acute phase response to inflammation and is one of the markers of choice in monitoring this response. CRP can be used for the prediction and early detection of periodontal disease. The aim of this study was to compare and evaluate the systemic levels of CRP in the peripheral blood samples of patients with chronic and aggressive periodontitis, gingivitis, and gingival recessions and compare them with periodontal clinical parameters. All patients (N = 158) were examined prior to the initiation of periodontal treatment. Patients were divided into four groups. Group A consisted of 26 patients with aggressive periodontitis, Group B consisted of 111 patients with chronic periodontitis, Group C consisted of 13 patients with gingivitis, and Group D consisted of 8 patients with gingival recessions. Our study results indicate that CRP levels increase subsequently with the severity of the periodontal disease and that the bleeding on probing index showed much better positive correlation with the CRP levels compared to the pocket depth index in both periodontitis patients groups, especially in aggressive periodontitis patients.

  6. C-Reactive Protein in Peripheral Blood of Patients with Chronic and Aggressive Periodontitis, Gingivitis, and Gingival Recessions

    PubMed Central

    Podzimek, Stepan; Mysak, Jaroslav; Janatova, Tatjana; Duskova, Jana

    2015-01-01

    CRP is a plasma protein that reflects a measure of the acute phase response to inflammation and is one of the markers of choice in monitoring this response. CRP can be used for the prediction and early detection of periodontal disease. The aim of this study was to compare and evaluate the systemic levels of CRP in the peripheral blood samples of patients with chronic and aggressive periodontitis, gingivitis, and gingival recessions and compare them with periodontal clinical parameters. All patients (N = 158) were examined prior to the initiation of periodontal treatment. Patients were divided into four groups. Group A consisted of 26 patients with aggressive periodontitis, Group B consisted of 111 patients with chronic periodontitis, Group C consisted of 13 patients with gingivitis, and Group D consisted of 8 patients with gingival recessions. Our study results indicate that CRP levels increase subsequently with the severity of the periodontal disease and that the bleeding on probing index showed much better positive correlation with the CRP levels compared to the pocket depth index in both periodontitis patients groups, especially in aggressive periodontitis patients. PMID:26346216

  7. Strawberry gingivitis: A diagnostic feature of gingival Wegener's granulomatosis!

    PubMed Central

    Heera, R.; Choudhary, Kanaram; Beena, V. T.; Simon, Rency

    2012-01-01

    Wegener's granulomatosis (WG) is an immunologically mediated inflammatory disease characterized by granulomatous vasculitis of the upper and lower aerodigestive tracts together with glomerulonephritis. We are reporting a rare case of gingival WG that presented with erythematous and painful generalized gingival enlargement. Correlation of histopathology with routine hematoxylin and eosin and special stains [Grocott-Gomori methenamine-silver nitrate and Periodic Acid Schiff (PAS)], Mantoux test, peripheral blood smear and clinical presentation were established in diagnosing this rare entity. By the above-mentioned procedures and methodology, we have arrived at the diagnosis of Wegner's granulomatosis limited to the upper aerodigestive tract. Therefore, the aim of reporting this case was to emphasize that, the dental surgeon often being the first person to examine the oral cavity, should be familiar with the typical appearance of gingival WG as “strawberry gingivitis,” its clinical course as well as diagnostic parameters and adequate management. To the best of our knowledge, this is the first reported case of WG manifesting as “strawberry gingivitis” in the Indian population. PMID:23814553

  8. A rare clinical presentation of sarcoidosis; gingivitis.

    PubMed

    Güzel, Aygül; Köksal, Nurhan; Aydın, Davut; Aslan, Kerim; Gören, Fikret; Karagöz, Filiz

    2013-10-01

    Gingivitis due to sarcoidosis is a relatively rare condition. Gingivitis or isolated gingival involvement may be the first sign of systemic sarcoidosis. We report the case of a 37 year-old woman with isolated gingivitis due to sarcoidosis confirmed by biopsy. Following treatment with a systemic corticosteroid (prednisolone 40 mg/day), all clinical and radiologic findings were completely improved. In cases of chronic and intractable gingivitis, systemic sarcoidosis should be suspected. It should be confirmed with a biopsy, and the patient should be referred to a chest disease clinic to exclude other organ involvement.

  9. Necrotizing sialometaplasia of the nasopharynx.

    PubMed

    Merwin, G E; Duckert, L G; Pollak, K

    1979-01-01

    Necrotizing sialometaplasia is an uncommon salivary gland disease originally described by Abrams et al in 1973. The disease may occur wherever salivary gland tissue is found. Theories on the etiology of this disorder have been advanced, but never definitely determined. Treatment consists of adequate biopsy and observation until healing occurs at six to eight weeks. While the disease is considered benign, its similarity to more aggressive neoplasms can be both disturbing and misleading to the patient and the clinician. Such a case of necrotizing sialometaplasia of the nasopharynx is presented to demonstrate the clinical and histological similarity of this disease to carcinoma. In this case, the patient first presented with a neck mass which could easily have been mistaken for a regional metastasis. The current literature is reviewed.

  10. Hypertrichosis with hereditary gingival hyperplasia

    PubMed Central

    Winter, G. B.; Simpkiss, M. J.

    1974-01-01

    Two cases of infantile hypertrichosis who subsequently developed oral abnormalities are described. In one case generalized gingival hyperplasia was associated with retarded eruption of deciduous and permanent teeth and macrodontia. In the second case the mucosal hyperplasia was limited to the palatal surface. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6FIG. 7 PMID:4834021

  11. Paneth cells and necrotizing enterocolitis.

    PubMed

    Underwood, Mark A

    2012-01-01

    Necrotizing enterocolitis (NEC) is a common and devastating disease of premature infants. Immaturity of the innate immune system of the gut is central to the pathogenesis of NEC. Recent studies suggest a key role for Paneth cells in this disease. Addressing basic questions on the development and function of immature Paneth cells may shed light on the puzzling pathophysiology of NEC. Current animal models of NEC are limited in their capacity to answer these questions.

  12. Necrotizing fasciitis in Crohn's disease.

    PubMed

    Panter, S J; Bramble, M G; Bell, J R

    2001-04-01

    We report a case of a 34-year-old woman, presenting initially with anaemia followed by sacro-iliac pain, and subsequently found to have necrotizing fasciitis complicating Crohn's disease where the organisms were introduced via a fistulous tract. It is perhaps surprising that this is not a more common complication of fistulating Crohn's disease, but we believe this is the first case report of this particular complication. PMID:11338075

  13. Effect of bisphosphonates on the mandibular bone and gingival epithelium of rats without tooth extraction

    PubMed Central

    DE PONTE, FRANCESCO SAVERIO; CATALFAMO, LUCIANO; MICALI, GREGORIO; RUNCI, MICHELE; CUTRONEO, GIUSEPPINA; VERMIGLIO, GIOVANNA; CENTOFANTI, ANTONIO; RIZZO, GIUSEPPINA

    2016-01-01

    Osteonecrosis of the jaw (ONJ) is an adverse effect of bisphosphonate treatment that has become the subject of increasing investigations, in particular due to its poorly understood pathogenesis. Several experimental studies on animal models have been conducted; however, the majority of these replicate human ONJ following tooth extraction, and describe alterations in the bone and gingival epithelium when necrosis is manifested. The aim of the present study was to analyze the rat mandibular bone and gingival epithelium during 45 days of zoledronate treatment (which is a bisphosphonate agent), without tooth extraction. Intraperitoneal injections of zoledronate acid (0.1 mg/kg) were performed three times a week in normal male Wistar rats (n=20), while a control group of rats (n=20) was treated with saline solution for 45 days. After 7, 15, 30 and 45 days of drug treatment, all rats were sacrificed and hematoxilin and eosin staining, immunofluorescence and scanning electron microscopy analyses were performed. The results of the analyses after 7 and 15 days of treatment were similar in the treatment and control group. After 30 and 45 days of treatment, structural alterations were observed in the bone. No structural alterations to the gingival epithelium were observed. Based on these results, it was hypothesized that low doses of zoledronate act directly on the bone tissues to induce morphological alterations from bone to necrotic tissue following surgical procedures, although no cytotoxic effects were detected in the gingival epithelium. PMID:27168789

  14. Localized juvenile spongiotic gingival hyperplasia: a report of 3 cases.

    PubMed

    Solomon, Lynn W; Trahan, William R; Snow, Jesse E

    2013-01-01

    Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a recently described benign condition that affects the gingiva of children and young adults. Clinically distinctive, LJSGH presents as a localized area of erythema on the attached gingiva, with a subtly papillary surface architecture. The lesions are generally biopsied because of the lack of resolution with conservative oral hygiene therapeutic measures and esthetic concerns. The histopathology has a characteristic appearance of subtle papillary epithelial hyperplasia, acute inflammation, and numerous engorged capillary vascular spaces in the lamina propria, although clinical correlation is necessary to make the diagnosis. The purposes of this paper were to: introduce localized juvenile spongiotic gingival hyperplasia to the pediatric dental community; document its clinical and histologic features and treatment and the follow-up of three cases; and discuss the most common clinical differential diagnoses.

  15. Necrotizing sialometaplasia: frequency of histologic misdiagnosis.

    PubMed

    Mesa, M L; Gertler, R S; Schneider, L C

    1984-01-01

    Necrotizing sialometaplasia is said to mimic carcinoma, both clinically and histologically. A review of approximately 10,000 oral biopsy specimens revealed only three cases of necrotizing sialometaplasia, all of which had been misdiagnosed as other benign entities. While this suggests that necrotizing sialometaplasia represents only 0.03 percent of biopsied oral lesions, it does not deal with the frequency of cases of this condition which heal spontaneously without being biopsied.

  16. Necrotizing sialometaplasia of the nasal cavity.

    PubMed

    Chen, K T

    1982-01-01

    A case of necrotizing sialometaplasia involving the mucous membrane of a nasal turbinate is described. Necrotizing sialometaplasia is a benign, self-limited process characterized by necrosis and squamous metaplasia of the salivary or mucous glands. Typically, the lesion manifests as an ulcer of the hard palate. Nonulcerated lesions and involvement of sites other than the hard palate have also been reported. This case appears to be the second reported case of involvement of the nasal cavity by necrotizing sialometaplasia.

  17. Does gingival recession require surgical treatment?

    PubMed Central

    Chan, Hsun-Liang; Chun, Yong-Hee Patricia; MacEachern, Mark

    2016-01-01

    Gingival recession represents a clinical condition in adults frequently encountered in the general dental practice. It is estimated that 23% of adults in the US have one or more tooth surfaces with ≥ 3 mm gingival recession. Clinicians often time face dilemmas of whether or not to treat such a condition surgically. Therefore, we were charged by the editorial board to answer this critical question: “Does gingival recession require surgical treatment?” An initial condensed literature search was performed using a combination of gingival recession and surgery controlled terms and keywords. An analysis of the search results highlights our limited understanding of the factors that often guide the treatment of gingival recession. Understanding the etiology, prognosis and treatment of gingival recession continues to offer many unanswered questions and challenges in the field of periodontics as we strive to provide the best care possible for our patients. PMID:26427577

  18. Idiopathic gingival enlargement and its management

    PubMed Central

    Shetty, Arvind K.; Shah, Hardik J.; Patil, Mallika A.; Jhota, Komal N.

    2010-01-01

    Idiopathic gingival enlargement is a proliferative fibrous lesion of the gingival tissue that causes esthetic and functional problems. Both genetically and pharmacologically induced forms of gingival enlargement exist. This case report addresses the diagnosis and treatment of a case of idiopathic gingival enlargement in a 13-year-old female. The patient presented with generalized diffuse gingival enlargement involving the maxillary and mandibular arches extending on buccal and lingual/palatal surfaces and covering incisal / occlusal third of the tooth resulting in difficulty in speech and mastication since last three years. Patient also gave a history of surgical treatment being carried out four years back in upper anterior region suggesting of recurrence. Biopsy report confirmed the diagnosis of gingival hyperplasia. Gingivectomy was carried out in all four quadrants by using four different methods. PMID:21731254

  19. Disseminated histoplasmosis and necrotizing vasculitis.

    PubMed Central

    Small, P.; Levitt, P.

    1976-01-01

    A 74-year-old man with congestive heart failure was found to have Histoplasma capsulatum in a lesion of the right nasal septum. His initial treatment with amphotericin B was inadequate because of severe intolerance to the drug. Three months after initial presentation H. capsulatum was detected in his blood and bone marrow. Slightly elevated purpuric lesions on the arms, lower legs and trunk showed the typical features of necrotizing vasculitis. Cutaneous anergy was reversed after treatment with transfer factor. Skin involvement in disseminated histoplasmosis is unusual and there are no previous reports of vasculitis associated with this infection. Images FIG. 1 FIG. 2 PMID:1253047

  20. Pyoderma Gangrenosum Simulating Necrotizing Fasciitis

    PubMed Central

    de Souza, Erik Friedrich Alex; da Silva, Guilherme Almeida Rosa; dos Santos, Gustavo Randow; Motta, Heloisa Loureiro de Sá Neves; Cardoso, Pedro Afonso Nogueira Moisés; de Azevedo, Marcelo Costa Velho Mendes; Pires, Karina Lebeis; Motta, Rogerio Neves; Silva, Walter de Araujo Eyer; Ferry, Fernando Raphael de Almeida; Pinto, Jorge Francisco da Cunha

    2015-01-01

    Pyoderma gangrenosum received this name due to the notion that this disease was related to infections caused by bacteria in the genus Streptococcus. In contrast to this initial assumption, today the disease is thought to have an autoimmune origin. Necrotizing fasciitis was first mentioned around the fifth century AD, being referred to as a complication of erysipelas. It is a disease characterized by severe, rapidly progressing soft tissue infection, which causes necrosis of the subcutaneous tissue and the fascia. On the third day of hospitalization after antecubital venipuncture, a 59-year-old woman presented an erythematous and painful pustular lesion that quickly evolved into extensive ulceration circumvented by an erythematous halo and accompanied by toxemia. One of the proposed etiologies was necrotizing fasciitis. The microbiological results were all negative, while the histopathological analysis showed epidermal necrosis and inflammatory infiltrate composed predominantly of dermal neutrophils. Pyoderma gangrenosum was considered as a diagnosis. After 30 days, the patient was discharged with oral prednisone (60 mg/day), and the patient had complete healing of the initial injury in less than two months. This case was an unexpected event in the course of the hospitalization which was diagnosed as pyoderma gangrenosum associated with myelodysplastic syndrome. PMID:26783395

  1. [Digestive stenoses following ulcero-necrotizing enterocolitis].

    PubMed

    Dahreddine, M; Fremond, B; Babut, J M

    1995-01-01

    Over a 10-year period, the authors followed the course of 112 neonates treated for primary acute necrotizing enterocolitis. Ten cases of gastrointestinal stricture were diagnosed, regardless of initial treatment, after an interval of 20 days to 6 months. The site of the stricture was colonic in 6 patients, ileal in three other patients and ileal and colonic in the remaining patient. The stricture was treated surgically in 9 patients (resection-anastomosis in 6 cases, resection with gastrointestinal diversion in 2 cases and isolated gastrointestinal diversion in 1 case). A follow-up barium enema in 1 patient showed spontaneous resolution of the stricture. With a mean follow-up of 5 years, the over all result was considered to be good in 7 cases and poor in one case. Two deaths were observed, one on the 10th day and the other at the 3rd postoperative day. These complications appeared to be related to the delayed diagnosis and treatment of the stricture. PMID:8787322

  2. Disseminated necrotic mediastinitis spread from odontogenic abscess: our experience

    PubMed Central

    Filiaci, Fabio; Riccardi, Emiliano; Mitro, Valeria; Piombino, Pasquale; Rinna, Claudio; Agrillo, Alessandro; Ungari, Claudio

    2015-01-01

    Summary Aims Deep neck infections are rare but potentially fatal complication of pulpal abscess of the teeth. If an infection can progress rapidly from a toothache to a life threatening infection, then it is critical that dentists be able to recognize the danger signs and identify the patients who are at risk. Mediastinitis is a severe inflammatory process involving the connective tissues that fills the intracellular spaces and surrounds the organs in the middle of the chest. This pathology has both an acute and a chronic form and, in most cases, it has an infectious etiology. This study want to expose the experience acquired in the Oral and Maxillo-facial Sciences Department, Policlinico Umberto I, “Sapienza” University of Rome, regarding two clinical cases of disseminated necrotizing mediastinitis starting from an odontogenic abscess. Methods We report two clinical cases of disseminated necrotic mediastinitis with two different medical and surgical approaches. The radiographic and photographic documentation of the patients was collected in the pre-and post-operatively. All patients underwent a CT scan and MRI. Results Mediastinitis can result from a serious odontogenic abscess, and the extent of its inflammation process must be never underestimated. Dental surgeons play a key role as a correct diagnosis can prevent further increasing of the inflammation process. Conclusions A late diagnosis and an inadequate draining represent the major causes of the elevated mortality rate of disseminated necrotizing mediastinitis. PMID:26330907

  3. Necrotizing Fasciltis Case Presentation and Literature Review.

    PubMed

    Christensen, Louis; Evans, Heath; Cundick, David; McShane, Matt; Penna, Kevin; Sadoff, Rory

    2015-01-01

    Necrotizing fasciitis is a rare, rapidly progressing in- fection with significant morbidity and high mortality rates. Rarely does necrotizing fasciitis appear in the head and neck region; rather, it usually affects the limbs and abdomen of patients. This article presents our institution's experience with the disease and pro- vides a discussion of proposed treatment options.

  4. Vesicular, ulcerative, and necrotic dermatitis of reptiles.

    PubMed

    Maas, Adolf K

    2013-09-01

    Vesicular, ulcerative, and necrotic dermatologic conditions are common in captive reptiles. Although these conditions have distinct differences histologically, they are commonly sequelae to each other. This article examines the anatomy and physiology of reptile skin; discusses reported causes of vesicular, ulcerative, and necrotic dermatologic conditions; and reviews various management options.

  5. Amelogenesis Imperfecta and Generalized Gingival Overgrowth Resembling Hereditary Gingival Fibromatosis in Siblings: A Case Report

    PubMed Central

    Yaprak, Emre; Subaşı, Meryem Gülce; Avunduk, Mustafa; Aykent, Filiz

    2012-01-01

    Amelogenesis imperfecta (AI) is a group of hereditary disorders primarily characterized by developmental abnormalities in the quantity and/or quality of enamel. There are some reports suggesting an association between AI and generalized gingival enlargement. This paper describes the clinical findings and oral management of two siblings presenting both AI and hereditary gingival fibromatosis (HGF) like generalized gingival enlargements. The treatment of gingival enlargements by periodontal flap surgery was successful in the management of the physiologic gingival form for both patients in the 3-year follow-up period. Prosthetic treatment was also satisfactory for the older patient both aesthetically and functionally. PMID:23091740

  6. Olanzapine-Induced Hypertriglyceridemia Resulting in Necrotizing Pancreatitis

    PubMed Central

    Roy-Chaudhury, Prabir; Yadlapalli, Ganesh

    2016-01-01

    Olanzapine is an atypical antipsychotic agent that was approved by the Food and Drug Administration in 1996 for treatment of psychotic disorders, bipolar disorder, and schizophrenia. Since that time, numerous case reports have been published that describe the association of olanzapine and the development of pancreatitis. Furthermore, 3 reports suggest the mechanism of olanzapine-induced hypertriglyceridemia as the etiology of this progression. We report a case of a 36-year-old man who developed necrotizing pancreatitis secondary to olanzapine-induced hypertriglyceridemia. This case, to our knowledge, is the most severe case of this progression and the first case requiring plasmapheresis for acute management. PMID:27807566

  7. Current trends in the management of infected necrotizing pancreatitis.

    PubMed

    Sakorafas, George H; Lappas, Christos; Mastoraki, Aikaterini; Delis, Spiros G; Safioleas, Michael

    2010-02-01

    Severe acute pancreatitis is a potentially life-threatening disease. Pancreatic necrosis is associated with an aggravated prognosis, while superimposed infection is almost always lethal without surgery. Bacterial translocation mainly from the gut is the most widely accepted mechanism in the pathogenesis of infected pancreatic necrosis. Infected pancreatic necrosis should be suspected in the presence of the usual markers of systemic inflammation (i.e., fever and leukocytosis), organ failure, or a protracted severe clinical course. The diagnostic method of choice to confirm the diagnosis of pancreatic necrosis is contrast-enhanced computed tomography, where necrotic areas are evidenced as regions without enhancement. The presence of pancreatic necrotic infection should be based on a combination of clinical manifestations, results of laboratory investigation (mainly increased levels of CRP and / or procalcitonin), and can be confirmed by image-guided fine-needle aspiration and gram stain /culture of the aspirates. Surgery remains the treatment of choice for the management of infected pancreatic necrosis and involves open necrosectomy (debridement) and wide drainage of the peripancreatic areas, often in association with continuous irrigation. Planned reoperations may be required to achieve complete removal of the necrotic / infected material. The timing of surgery is of paramount importance; ideally, surgery should be performed after 2 or 3 weeks from the onset of pancreatitis. Recently, various minimally invasive approaches have been described, but they have not been compared in prospective trials with the classical open surgery. Antibiotic therapy is routinely used in patients with infected necrotizing pancreatitis, in conjunction with surgical debridement; its role, however, in the management of patients with sterile necrosis is recently questioned. Nutritional support should be taken into consideration in these patients; enteral nutrition should be preferred over

  8. Statin induced necrotizing autoimmune myopathy.

    PubMed

    Babu, Suma; Li, Yuebing

    2015-04-15

    Statin induced necrotizing autoimmune myopathy (SINAM) is a recently characterized entity belonging to the spectrum of statin myotoxicity. It is a more severe form, and is usually associated with significant proximal muscle weakness, strikingly elevated creatine kinase levels and persistent symptoms despite statin discontinuation. The characteristic pathological finding is a marked muscle fiber necrosis with minimal or no inflammation on muscle biopsy. SINAM is an autoimmune disorder associated with an antibody against 3-hydroxy-3-methyglutaryl-coenzyme A reductase (HMGCR), and the antibody titer is a useful marker for assessing treatment response. However, anti-HMGCR positive myopathies are also caused by unknown etiologies other than statin exposure, especially in the younger population. SINAM should be promptly recognized as immunosuppressive therapy can improve its clinical outcome significantly. Further research is needed to elucidate its pathogenesis and provide evidence based guidelines for management.

  9. [Periodontology and esthetics: the gingival recession].

    PubMed

    Corba, N H

    1991-06-01

    Gingival recessions are regarded by many people as an esthetical problem. Successively the etiology, the significance and the indications for therapy are discussed. Different kinds of therapy such as oral hygiene instruction, the free gingival graft and various pedicle grafts are explained. Finally it is advocated that surgical kinds of therapy have to be applied with reservedness.

  10. What next in necrotizing enterocolitis?

    PubMed

    Yurdakök, Murat

    2008-01-01

    Necrotizing enterocolitis (NEC) is a devastating disease of premature infants, with a mortality rate of 10-50%. It is uncommon in term infants and in premature infants who have not yet been fed. Most commonly NEC develops suddenly in a preterm infant who was otherwise well, with initial symptoms of abdominal distention, bilious or bloody emesis or gastric aspirates, hematochezia, and pneumatosis intestinalis, and sometimes progresses quickly to include bowel perforation, acidosis, shock, and death. Trigger factors (i.e. perinatal hypoxia, mild infection or formula feeding) cause focal mild intestinal mucosal injury. In the presence of proliferation of commensal bacteria, local breakdown of mucosal barrier may cause entry of bacterial products (e.g. lipopolysaccharides, platelet-activating factor). Endothelial platelet-activating factor and/or tumor necrotizing factor and/or direct stimulating effects of polymorphonuclear leukocytes cause proinflammatory cascade and focal necrosis, which increase the entry of large amounts of bacterial toxins, and then severe NEC, sepsis, and shock develop. Therapies for the prevention of NEC that appear to have some benefit are breastfeeding and antenatal steroids, and probably probiotics. Enteral immunoglobulin, polyunsaturated fatty acids, and arginine or glutamine supplementation are therapies for the prevention of NEC that do not appear to be of benefit. Enteral erythropoietin and enteral granulocyte colony-stimulating factor are promising novel therapies. Treatment options are limited to gut rest, parenteral nutrition, broad-spectrum antibiotics, and surgical interventions for enteral perforation. Two commonly used methods for NEC with intestinal perforation are laparotomy or primary peritoneal drainage ("patch, drain and wait"); however, the preferred method is controversial.

  11. [Pregnancy gingivitis and tumor gravidarum].

    PubMed

    Bilińska, Maria; Sokalski, Jerzy

    2016-01-01

    During pregnancy periodontal tissues may become more susceptible to internal and external factors promoting inflammation. Changes in hormone levels, alterations in the periodontal tissue structure and a predisposition to dilating blood vessels during pregnancy may lead to a painful inflammation as a response to a slightest amount of biofilm. Tumor gravidarum emerges in 5% of pregnant women during the first or second trimester - it may recede and fade completely right after the labour when hormone levels normalize. This paper explains the aetiology and potential risk factors of pregnancy gingivitis. PMID:27321105

  12. Bacterial community development in experimental gingivitis.

    PubMed

    Kistler, James O; Booth, Veronica; Bradshaw, David J; Wade, William G

    2013-01-01

    Current knowledge of the microbial composition of dental plaque in early gingivitis is based largely on microscopy and cultural methods, which do not provide a comprehensive description of oral microbial communities. This study used 454-pyrosequencing of the V1-V3 region of 16S rRNA genes (approximately 500 bp), and bacterial culture, to characterize the composition of plaque during the transition from periodontal health to gingivitis. A total of 20 healthy volunteers abstained from oral hygiene for two weeks, allowing plaque to accumulate and gingivitis to develop. Plaque samples were analyzed at baseline, and after one and two weeks. In addition, plaque samples from 20 chronic periodontitis patients were analyzed for cross-sectional comparison to the experimental gingivitis cohort. All of the healthy volunteers developed gingivitis after two weeks. Pyrosequencing yielded a final total of 344,267 sequences after filtering, with a mean length of 354 bases, that were clustered into an average of 299 species-level Operational Taxonomic Units (OTUs) per sample. Principal coordinates analysis (PCoA) plots revealed significant shifts in the bacterial community structure of plaque as gingivitis was induced, and community diversity increased significantly after two weeks. Changes in the relative abundance of OTUs during the transition from health to gingivitis were correlated to bleeding on probing (BoP) scores and resulted in the identification of new health- and gingivitis-associated taxa. Comparison of the healthy volunteers to the periodontitis patients also confirmed the association of a number of putative periodontal pathogens with chronic periodontitis. Taxa associated with gingivitis included Fusobacterium nucleatum subsp. polymorphum, Lachnospiraceae [G-2] sp. HOT100, Lautropia sp. HOTA94, and Prevotella oulorum, whilst Rothia dentocariosa was associated with periodontal health. Further study of these taxa is warranted and may lead to new therapeutic approaches

  13. Gingival fibromatosis: clinical, molecular and therapeutic issues.

    PubMed

    Gawron, Katarzyna; Łazarz-Bartyzel, Katarzyna; Potempa, Jan; Chomyszyn-Gajewska, Maria

    2016-01-01

    Gingival fibromatosis is a rare and heterogeneous group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. In severe cases, the excess tissue may cover the crowns of the teeth, thus causing functional, esthetic, and periodontal problems, such as bone loss and bleeding, due to the presence of pseudopockets and plaque accumulation. It affects both genders equally. Hereditary, drug-induced, and idiopathic gingival overgrowth have been reported. Hereditary gingival fibromatosis can occur as an isolated condition or as part of a genetic syndrome. The pathologic manifestation of gingival fibromatosis comprises excessive accumulation of extracellular matrix proteins, of which collagen type I is the most prominent example. Mutation in the Son-of-Sevenless-1 gene has been suggested as one possible etiological cause of isolated (non-syndromic) hereditary gingival fibromatosis, but mutations in other genes are also likely to be involved, given the heterogeneity of this condition. The most attractive concept of mechanism for drug-induced gingival overgrowth is epithelial-to-mesenchymal transition, a process in which interactions between gingival cells and the extracellular matrix are weakened as epithelial cells transdifferentiate into fibrogenic fibroblast-like cells. The diagnosis is mainly made on the basis of the patient's history and clinical features, and on histopathological evaluation of affected gingiva. Early diagnosis is important, mostly to exclude oral malignancy. Differential diagnosis comprises all pathologies in the mouth with excessive gingival overgrowth. Hereditary gingival fibromatosis may present as an autosomal-dominant or less commonly autosomal-recessive mode of inheritance. If a systemic disease or syndrome is suspected, the patient is directed to a geneticist for additional clinical examination and specialized diagnostic tests. Treatments vary according to the

  14. Bacterial community development in experimental gingivitis.

    PubMed

    Kistler, James O; Booth, Veronica; Bradshaw, David J; Wade, William G

    2013-01-01

    Current knowledge of the microbial composition of dental plaque in early gingivitis is based largely on microscopy and cultural methods, which do not provide a comprehensive description of oral microbial communities. This study used 454-pyrosequencing of the V1-V3 region of 16S rRNA genes (approximately 500 bp), and bacterial culture, to characterize the composition of plaque during the transition from periodontal health to gingivitis. A total of 20 healthy volunteers abstained from oral hygiene for two weeks, allowing plaque to accumulate and gingivitis to develop. Plaque samples were analyzed at baseline, and after one and two weeks. In addition, plaque samples from 20 chronic periodontitis patients were analyzed for cross-sectional comparison to the experimental gingivitis cohort. All of the healthy volunteers developed gingivitis after two weeks. Pyrosequencing yielded a final total of 344,267 sequences after filtering, with a mean length of 354 bases, that were clustered into an average of 299 species-level Operational Taxonomic Units (OTUs) per sample. Principal coordinates analysis (PCoA) plots revealed significant shifts in the bacterial community structure of plaque as gingivitis was induced, and community diversity increased significantly after two weeks. Changes in the relative abundance of OTUs during the transition from health to gingivitis were correlated to bleeding on probing (BoP) scores and resulted in the identification of new health- and gingivitis-associated taxa. Comparison of the healthy volunteers to the periodontitis patients also confirmed the association of a number of putative periodontal pathogens with chronic periodontitis. Taxa associated with gingivitis included Fusobacterium nucleatum subsp. polymorphum, Lachnospiraceae [G-2] sp. HOT100, Lautropia sp. HOTA94, and Prevotella oulorum, whilst Rothia dentocariosa was associated with periodontal health. Further study of these taxa is warranted and may lead to new therapeutic approaches

  15. [Risk factors of necrotizing enterocolitis].

    PubMed

    Tapia-Rombo, C A; Velasco-Lavín, M R; Nieto-Caldelas, A

    1993-09-01

    The purpose of the present study is to compare risk factors of necrotizing enterocolitis (NEC) between two group: group A, newborns with the disease and group B, newborns with other diseases different from NEC, in order to know if these risk factors are more frequent or not in the first group. We assessed the clinical records of all the patients hospitalized in the Neonatal Intensive Care Unit and Neonatology Service of the La Raza General Hospital between 1987 and 1991 with the diagnosis of NEC. They were compared with 65 clinical records chosen at random of patients hospitalized in the same Unit with other diagnosis at the same time, and who were discharged by improvement or deceased. In all of them were look for known risk factors for NEC generally accepted such as: prematurity, neonatal asphyxia, poliglobulia, cyanotic congenital heart disease, patent ductus arteriosus, respiratory distress syndrome, catheterization of umbilical vessels, early feeding of elevated formula increases, exchange exchange transfusion, hypoxic ischemic encephalopathy, infection, etc. Just 25 records of the possible 50 with the diagnosis of NEC full filled inclusion criteria. There were no statistically significant difference in weight, sex, mortality and known risk factors of NEC between both groups. Were concluded that NEC is a disease of unknown etiology that should be studied more thoroughly. The known risk factors must be avoided because the patient susceptibility probably play an important role. PMID:8373546

  16. Statin-associated necrotizing autoimmune myopathy.

    PubMed

    Fernandes, Geórgea Hermogenes; Zanoteli, Edmar; Shinjo, Samuel Katsuyuki

    2014-09-01

    Necrotizing autoimmune myopathy (NAM) is a severe adverse effect of statins. We report a 66-year-old Caucasian female who had progressive proximal muscle weakness after treatment with statins. Results of a muscle biopsy showed necrotizing myopathy with minimal inflammatory cell infiltrate and increased major histocompatibility class I antigen expression in muscle fibers. The clinical and laboratory parameters improved significantly with immunosuppressive treatment. Although it is a rare event, statin-induced NAM should be included as a differential diagnosis of myopathies.

  17. Fatal necrotizing fasciitis due to Vibrio damsela.

    PubMed

    Yuen, K Y; Ma, L; Wong, S S; Ng, W F

    1993-01-01

    A patient who succumbed to fulminant necrotizing fasciitis due to Vibrio damsela after injury by a rabbitfish is described. Despite the absence of any known underlying illness, he did not respond to appropriate antibiotic therapy and radical surgical intervention. This represents the first documented case of necrotizing fasciitis due to this organism, and is also the first reported case in Southeast Asia inflicted by rabbitfish.

  18. Necrotizing sialometaplasia. Report of a case.

    PubMed

    Myers, E N; Bankaci, M; Barnes, E L

    1975-10-01

    Necrotizing sialometaplasia occurred in a 46-year-old woman. This is an uncommon benign disease that typically begins with an ulcerated lesion on the hard palate and surrounding tissues. Clinical and microscopic findings show obvious similarity with a malignant neoplasm. Necrotizing sialometapiasis is a benign minor salivary gland disease. It is important since it may easily be confused with squamous cell carcinoma and mucoepidermoid carcinoma.

  19. Necrotizing sialometaplasia: an early, nonulcerative presentation.

    PubMed

    Santis, H R; Kabani, S P; Roderiques, A; Driscoll, J M

    1982-04-01

    Necrotizing sialometaplasia usually presents as a painless, deeply excavating ulcer and is considered in the differential diagnosis of large palatal ulcers along with mucoepidermoid carcinoma and adenoid cystic carcinoma. This case is presented to illustrate that the early signs and symptoms of necrotizing sialometaplasia may be swelling with a purulent exudate, diffuse, vague pain, and numbness. It also demonstrates the rapidity with which initial signs of healing become apparent. This latter clinically suggests a benign process.

  20. [Hyperthermic ulcero-necrotic parapsoriasis "en gouttes" with naso-pharyngeal lesions].

    PubMed

    Robledo; País; Tabernero; Nine; Fonseca; Cruces; Taboada; Santiago; Fernández

    1981-01-01

    The clinical history of a patient affected by a chronic relapsing eruption is presented. Successive papulopustular, necrotic and ulcerous lesions with fever and general distress appeared. There was no visceral affectation. The case corresponded to the necrotic and hyperthermic parapsoriasis "en gouttes" or acute pityriasis lichenoides as described by Degos and col., 1966. The presence of vasculitis with lymphohistiocytic inflammation invading the epidermis is described. The aspect was similar to the parapsoriasis "en gouttes" pattern even though a biopsy showed the presence of necrotizing angeitis of small vessels, as previously reported. The patient also presented oral and nasopharyngeal ulcerous lesions similar to those found in malignant midline granuloma and Wegener granulomatosis, even though histopathologically different. It is interesting to note the absence of any visceral involvement in a 12 years evolution. PMID:7022059

  1. Treatment of gingival recession in two surgical stages: Free gingival graft and connective tissue grafting.

    PubMed

    Henriques, Paulo Sergio Gomes; Nunes, Marcelo Pereira; Pelegrine, Andre Antonio

    2011-01-01

    This report describes a clinical case of severe Miller Class II gingival recession treated by two stages of surgery that combined a free gingival graft and connective tissue grafting. First, a free gingival graft (FGG) was performed to obtain an adequate keratinized tissue level. Three months later, a connective tissue graft (CTG) was performed to obtain root coverage. The results indicated that the FGG allows for a gain in the keratinized tissue level and the CTG allows for root coverage with decreased recession level after 16 months. Therefore, for this type of specific gingival recession, the combination of FGG and CTG can be used.

  2. Plasma Cell Gingivitis: An Occasional Case Report.

    PubMed

    Mishra, M B; Sharma, Swati; Sharma, Alok

    2015-01-01

    Plasma cell gingivitis, an infrequently observed oral condition, has been clinically characterized by diffuse gingival enlargement, erythema and sometimes desquamation. These lesions are usually asymptomatic, but invariably the patient will complain of a burning sensation in the gingiva and bleeding from the mouth. The diagnosis requires hematological screening in addition to clinical and histopathological examinations. This case report outlines one such case of plasma cell gingivitis in a 15-year-old female caused by use of an herbal, homemade toothpowder. The case presented here highlights the adverse effects and irrational use of herbal agents in dentifrices. At the same time, it emphasizes the need for comprehensive history taking, careful clinical examination and appropriate diagnostic tests in order to arrive at a definitive diagnosis and treatment plan for gingival conditions that are refractory to conventional therapy and to exclude certain malignancies and oral manifestations of systemic diseases.

  3. Conservative management of amlodipine influenced gingival enlargement

    PubMed Central

    Dhale, Rashmi P.; Phadnaik, Mangesh B.

    2009-01-01

    Gingival enlargement is a well recognized unwanted effect associated mainly with anticonvulsant drugs, immunosuppressant drugs and calcium channel blockers. Amlodipine influenced gingival enlargement is comparatively less prevalent amongst calcium channel blockers. It causes aesthetic disfigurement, speech disturbances, abnormal tooth movement and difficulty in mastication. The management of drug influenced gingival enlargement is a challenge for the periodontist, mainly due to less understanding of its pathogenesis, difficulties in selection of proper line of management and recurrence of the enlargement. This report discusses the importance of conservative approach (scaling and root planning along with drug replacement) in the management of a case of amlodipine influenced gingival enlargement. The need for extensive surgery was decreased after this approach. PMID:20376240

  4. Conflation of gingival overgrowth and schwannoma

    PubMed Central

    Purwar, Parth; Dixit, Jaya; Bhartiya, Kishlay; Sareen, Sagar

    2014-01-01

    The authors describe a seminal case report of a 10-year-old boy with enlarged gingivae in relation to his maxillary anterior teeth. The lesion, provisionally diagnosed as idiopathic gingival enlargement, was completely excised and divided into two sections. The histological and immunohistochemical findings in one of the sections showed it to be characteristic of schwannoma while the other section showed indications of idiopathic gingival enlargement. The patient has been followed up carefully and no recurrence has been noted. PMID:25331149

  5. Congenital generalized terminal hypertrichosis with gingival hyperplasia.

    PubMed

    Guevara-Sanginés, Esther; Villalobos, Alejandra; Vega-Memije, Ma Elisa; Mosqueda-Taylor, Adalberto; Canún-Serrano, Sonia; Lacy-Niebla, Rosa Ma

    2002-01-01

    Congenital generalized terminal hypertrichosis is a rare disease, especially when associated with gingival hyperplasia. Congenital hypertrichosis can be a clinical feature of several syndromes, so these patients must be studied by a multidisciplinary team that should include a dermatologist, geneticist, psychologist, odontologist, and an endocrinologist. We report a 7-year-old girl with congenital generalized hypertrichosis and gingival hyperplasia, and analyze the clinical approach, differential diagnosis, and treatment. PMID:11994171

  6. Gingival enlargement in partial hemifacial hyperplasia.

    PubMed

    Jagtap, Rasika Ravindra; Deshpande, Gaurav Shekhar

    2014-01-01

    Hemifacial hypertrophy is a rare developmental disorder, characterized by unilateral enlargement of facial tissues. The hemifacial hyperplasia is classified as true hemifacial hypertrophy and partial hemifacial hypertrophy. It is unilateral enlargement of viscerocranial condition in which not all structures are enlarged. We present a rare case of gingival enlargement in partial hemifacial hyperplasia highlighting the clinical and radiological findings with the corrective treatment offered for gingival enlargement.

  7. Langerhans cells in human chronic gingivitis and phenytoin-induced gingival hyperplasia.

    PubMed

    Kinane, D F; Drummond, J R; Chisholm, D M

    1990-01-01

    Langerhans cell numbers in oral epithelium increase as dental plaque accumulates. The anti-convulsant drug phenytoin predisposes to gingival hyperplasia in certain patients who take this medication for epilepsy and who also have poor oral hygiene. In this study 7 patients with phenytoin-induced gingival hyperplasia were compared with 5 subjects with chronic marginal gingivitis. On initial examination and on completion of the hygiene phase of periodontal therapy (a period ranging from 3.0 to 4.25 months), clinical indices of plaque and gingivitis were recorded and biopsies were taken from the lower anterior labial gingiva. Frozen sections were stained by an immunoperoxidase technique using the monoclonal antibody OKT6, and the number of Langerhans cells in a defined cross-sectional area was counted. In phenytoin-induced gingival hyperplasia there was a marked increase in Langerhans cells (13.8 +/- 0.45) when compared with chronic gingivitis (7.7 +/- 0.31; p less than 0.05). Both groups showed marked reductions in their plaque and gingival indices and numbers of Langerhans cells once treatment had been completed. However, levels of Langerhans cells in the drug-induced hyperplasia remained significantly higher (3.5 +/- 0.26) than in chronic gingivitis (1.5 +/- 0.22; p less than 0.05).

  8. Necrotizing sialometaplasia of palate: a case report.

    PubMed

    Garcia, N G; Oliveira, D T; Faustino, S E S; Azevedo, A L R

    2012-01-01

    Background. Necrotizing sialometaplasia (NS) is an uncommon benign reactive necrotizing inflammatory process involving minor salivary gland that often mimics malignancy both clinically and histopathologically. Case Report. We report the case of a healthy 26-year-old man with a painless swelling in the hard palate near the middle raphe, asymptomatic, well limited, and raised edges. The patient was submitted to incisional biopsy and histopathological examination. The histological diagnosis was necrotizing sialometaplasia. Discussion. The clinical and histological similarity between this entity and a malignant lesion implies a risk of unnecessary or mistreatment. Therefore, clinicians and pathologists should be aware of this lesion as to avoid errors in the diagnosis and treatment of this benign pathologic condition.

  9. Imaging of Acute Pancreatitis.

    PubMed

    Thoeni, Ruedi F

    2015-11-01

    Acute pancreatitis is an acute inflammation of the pancreas. Several classification systems have been used in the past but were considered unsatisfactory. A revised Atlanta classification of acute pancreatitis was published that assessed the clinical course and severity of disease; divided acute pancreatitis into interstitial edematous pancreatitis and necrotizing pancreatitis; discerned an early phase (first week) from a late phase (after the first week); and focused on systemic inflammatory response syndrome and organ failure. This article focuses on the revised classification of acute pancreatitis, with emphasis on imaging features, particularly on newly-termed fluid collections and implications for the radiologist.

  10. [Necrotizing sialometaplasia of the hard palate].

    PubMed

    Topstad, T K; Olofsson, J; Myking, A

    1991-11-30

    Necrotizing sialometaplasia is a benign, self-healing disease of salivary gland tissue and is usually confined to the minor salivary glands of the hard palate. It has clinical and histological features that simulate malignancies such as mucoepidermoid and squamous cell carcinomas. Wrong diagnosis has led to unnecessary mutilating surgical procedures. The etiology of the disease is unknown, but an ischaemic process is considered most likely. We describe two patients with necrotizing sialometaplasia, one with midline and one with bilateral symmetrical affection of the hard palate.

  11. Imaging of acute pancreatitis and its complications. Part 2: complications of acute pancreatitis.

    PubMed

    Türkvatan, A; Erden, A; Türkoğlu, M A; Seçil, M; Yüce, G

    2015-02-01

    The Atlanta classification of acute pancreatitis was introduced in 1992 and divides patients into mild and severe groups based on clinical and biochemical criteria. Recently, the terminology and classification scheme proposed at the initial Atlanta Symposium have been reviewed and a new consensus statement has been proposed by the Acute Pancreatitis Classification Working Group. Major changes include subdividing acute fluid collections into "acute peripancreatic fluid collection" and "acute post-necrotic pancreatic/peripancreatic fluid collection (acute necrotic collection)" based on the presence of necrotic debris. Delayed fluid collections have been similarly subdivided into "pseudocyst" and "walled of pancreatic necrosis". Appropriate use of the new terms describing the fluid collections is important for management decision-making in patients with acute pancreatitis. The purpose of this review article is to present an overview of complications of the acute pancreatitis with emphasis on their prognostic significance and impact on clinical management and to clarify confusing terminology for pancreatic fluid collections.

  12. Resection of Gingival Fibromatosis with High-power Laser.

    PubMed

    Camilotti, Renata Stifelman; Jasper, Juliana; Ferreira, Thaiana Barreto; Antonini, Fernando; Poli, Vladimir Dourado; Pagnoncelli, Rogério Miranda

    2015-01-01

    Hereditary gingival fibromatosis (HGF), also known as hereditary gingival hyperplasia, idiopathic gingival fibromatosis, and hereditary gingival overgrowth, is a rare condition but the most common form of gingival hyperplasia. Overgrowth of gingival tissue is usually slow and progressive and may delay or prevent tooth eruption, resulting in cosmetic and functional impairments. Hypertrichosis, epilepsy, and intellectual disability may be associated with HGF, which can occur in isolation or as part of a syndrome. The purpose of this case report is to describe a diode laser resection of gingival hyperplasia in a seven-year-old patient with nonsyndromic HGF and hypertrichosis. The diode laser enabled efficient removal of hypertrophic gingival tissue with good healing and minimal postoperative discomfort.

  13. Resection of Gingival Fibromatosis with High-power Laser.

    PubMed

    Camilotti, Renata Stifelman; Jasper, Juliana; Ferreira, Thaiana Barreto; Antonini, Fernando; Poli, Vladimir Dourado; Pagnoncelli, Rogério Miranda

    2015-01-01

    Hereditary gingival fibromatosis (HGF), also known as hereditary gingival hyperplasia, idiopathic gingival fibromatosis, and hereditary gingival overgrowth, is a rare condition but the most common form of gingival hyperplasia. Overgrowth of gingival tissue is usually slow and progressive and may delay or prevent tooth eruption, resulting in cosmetic and functional impairments. Hypertrichosis, epilepsy, and intellectual disability may be associated with HGF, which can occur in isolation or as part of a syndrome. The purpose of this case report is to describe a diode laser resection of gingival hyperplasia in a seven-year-old patient with nonsyndromic HGF and hypertrichosis. The diode laser enabled efficient removal of hypertrophic gingival tissue with good healing and minimal postoperative discomfort. PMID:25909843

  14. Idiopathic Gingival Fibromatosis: Case Report and Its Management

    PubMed Central

    Jaju, Prashant P.; Desai, Ankit; Desai, Rajiv S.; Jaju, Sushma P.

    2009-01-01

    Idiopathic gingival fibromatosis is a rare condition. We present a case of idiopathic gingival fibromatosis with its multidisciplinary approach of management. The clinical, radiographic, and histopathological features have been described in detail. PMID:20339448

  15. Management and prevention of gingival recession.

    PubMed

    Merijohn, George K

    2016-06-01

    Gingival recession is highly prevalent worldwide. It increases the risk for root caries and can interfere with patient comfort, function and esthetics. Progressive gingival recession also increases the risk of tooth loss secondary to clinical attachment loss. Although mitigating the causes of gingival recession decreases its incidence and severity, implementing practical management and prevention strategies in the clinical setting can be challenging. Identification of susceptible patients and evaluating them for the presence of modifiable risk exposures are essential first steps in developing action plans for appropriate interventions. This article reviews these steps and introduces chairside tools that can help in the selection of interventions designed to reduce the risk of future gingival recession and may also facilitate patient communication. Practical decision-making criteria are proposed for when and how to monitor gingival recession, for deciding when a patient is a candidate for surgical evaluation or referral to a periodontist, and, if surgery is the treatment of choice, what should be considered as key surgical outcome objectives. PMID:27045439

  16. Isolated gingival overgrowths: A review of case series.

    PubMed

    Raizada, Shruti; Varghese, Jothi M; Bhat, K M; Gupta, Kanishk

    2016-01-01

    Clinicians are often intrigued by the varied manifestations of the gingival tissue. Gingival overgrowth is a common clinical finding and most of them represent a reactive hyperplasia as a direct result of plaque-related inflammatory gingival disease. These types of growth generally respond to good plaque control, removal of the causative irritants, and conservative tissue management. This case series highlights three different cases of localized gingival overgrowth and its management with emphasis on the importance of patient awareness and motivation. PMID:27307683

  17. Isolated gingival overgrowths: A review of case series

    PubMed Central

    Raizada, Shruti; Varghese, Jothi M.; Bhat, K. M.; Gupta, Kanishk

    2016-01-01

    Clinicians are often intrigued by the varied manifestations of the gingival tissue. Gingival overgrowth is a common clinical finding and most of them represent a reactive hyperplasia as a direct result of plaque-related inflammatory gingival disease. These types of growth generally respond to good plaque control, removal of the causative irritants, and conservative tissue management. This case series highlights three different cases of localized gingival overgrowth and its management with emphasis on the importance of patient awareness and motivation. PMID:27307683

  18. Isolated gingival overgrowths: A review of case series.

    PubMed

    Raizada, Shruti; Varghese, Jothi M; Bhat, K M; Gupta, Kanishk

    2016-01-01

    Clinicians are often intrigued by the varied manifestations of the gingival tissue. Gingival overgrowth is a common clinical finding and most of them represent a reactive hyperplasia as a direct result of plaque-related inflammatory gingival disease. These types of growth generally respond to good plaque control, removal of the causative irritants, and conservative tissue management. This case series highlights three different cases of localized gingival overgrowth and its management with emphasis on the importance of patient awareness and motivation.

  19. Etiology and occurrence of gingival recession - An epidemiological study

    PubMed Central

    Mythri, Sarpangala; Arunkumar, Suryanarayan Maiya; Hegde, Shashikanth; Rajesh, Shanker Kashyap; Munaz, Mohamed; Ashwin, Devasya

    2015-01-01

    Objectives: Gingival recession is the term used to characterize the apical shift of the marginal gingiva from its normal position on the crown of the tooth. It is frequently observed in adult subjects. The occurrence and severity of the gingival recession present considerable differences between populations. To prevent gingival recession from occurring, it is essential to detect the underlying etiology. The aim of the present study was to determine the occurrence of gingival recession and to identify the most common factor associated with the cause of gingival recession. Methods: A total of 710 subjects aged between 15 years to 60 years were selected. Data were collected by an interview with the help of a proforma and then the dental examination was carried out. The presence of gingival recession was recorded using Miller's classification of gingival recession. The Silness and Loe Plaque Index, Loe and Silness gingival index, community periodontal index were recorded. The data thus obtained were subjected to statistical analysis using Chi-square test and Student's unpaired t-test. Results: Of 710 subjects examined, 291 (40.98%) subjects exhibited gingival recession. The frequency of gingival recession was found to increase with age. High frequency of gingival recession was seen in males (60.5%) compared to females (39.5%). Gingival recession was commonly seen in mandibular incisors (43.0%). Miller's class I gingival recession was more commonly seen. The most common cause for gingival recession was dental plaque accumulation (44.1%) followed by faulty toothbrushing (42.7%). Conclusion: Approximately half of the subjects examined exhibited gingival recession. The etiology of gingival recession is multifactorial, and its appearance is always the result of more than one factor acting together. PMID:26941519

  20. Necrotizing fasciitis of anterior abdominal wall following cesarean section in a low-risk patient

    PubMed Central

    Chhetry, Manisha; Banerjee, Basudeb; Subedi, Shanti; Koirala, Ashok

    2016-01-01

    We report a case of a mono-microbial post-cesarean necrotizing fasciitis caused by methicillin resistant Staphylococcus aureus, in a low-risk healthy woman who presented with acute fulminant infection, sepsis and features of multi-organ dysfunction syndrome on sixth post-operative day. Aggressive management with multiple surgical debridement and supportive therapy was the key to favorable outcome in this case. PMID:27402541

  1. Comparative Evaluation of Gingival Depigmentation using Tetrafluoroethane Cryosurgery and Gingival Abrasion Technique: Two Years Follow Up

    PubMed Central

    Kumar, Santhosh; Bhat, G. Subraya; Bhat, K. Mahalinga

    2013-01-01

    Objective: A comparative evaluation of the gingival depigmentation by using Tetrafluoroethane cryosurgery and the gingival abrasion technique – 2 years of follow up. Material and Methods: Ten systemically healthy patients who were aged 18 to 36 years were selected for the study. Tetrafluoroethane was used for the cryosurgical depigmentation and the gingival abrasion technique used a coarse flame shaped bur. The presence or absence of pigmentation was tabulated, based on the GPI (Gingival Pigmentation Index). For the statistical analysis, Freidman’s test was used. Results: The keratinization was completed within a week after the application of the cryogen and about 10 days after the gingival abrasion technique was done. The statistical analysis which was done after 90th, 180th days and 2 years. The p-value which was obtained (p<.001) showed the superiority of cryosurgery over the gingival abrasion. During the follow up period, no side effects were seen for both the techniques and the improved aesthetics was maintained upto 2 years. Conclusion: The use of cryogen Tetrafluoroethane is easy, practical and inexpensive as compared to gingival abrasion, due to its high rate of recurrence. Hence, it is more acceptable to the patients and the operator. Further studies are needed to assess the long term effectiveness of the cryosurgical method of depigmentation. PMID:23543863

  2. Angiotensin II Levels in Gingival Tissues from Healthy Individuals, Patients with Nifedipine Induced Gingival Overgrowth and Non Responders on Nifedipine

    PubMed Central

    Balaji, Anitha; Balaji, Thodur Madapusi

    2015-01-01

    Context The Renin Angiotensin system has been implicated in the pathogenesis of Drug Induced Gingival Overgrowth (DIGO), a fibrotic condition, caused by Phenytoin, Nifedipine and Cyclosporine. Aim This study quantified Angiotensin II levels in gingival tissue samples obtained from healthy individuals, patients on Nifedipine manifesting/not manifesting drug induced gingival overgrowth. Materials and Methods Gingival tissue samples were obtained from healthy individuals (n=24), patients on nifidipine manifesting gingival overgrowth (n= 18) and patients on nifidipine not manifesting gingival overgrowth (n=8). Angiotensin II levels were estimated in the samples using a commercially available ELISA kit. Results Angiotensin II levels were significantly elevated in patients on Nifedipine manifesting gingival overgrowth compared to the other 2 groups (p<0.01). Conclusion The results of the study give an insight into the role played by Angiotensin II in the pathogenesis of drug induced gingival overgrowth. PMID:26436057

  3. 21 CFR 872.1500 - Gingival fluid measurer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Gingival fluid measurer. 872.1500 Section 872.1500...) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1500 Gingival fluid measurer. (a) Identification. A gingival fluid measurer is a gauge device intended to measure the amount of fluid in the...

  4. 21 CFR 872.1500 - Gingival fluid measurer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gingival fluid measurer. 872.1500 Section 872.1500...) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1500 Gingival fluid measurer. (a) Identification. A gingival fluid measurer is a gauge device intended to measure the amount of fluid in the...

  5. 21 CFR 872.1500 - Gingival fluid measurer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Gingival fluid measurer. 872.1500 Section 872.1500...) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1500 Gingival fluid measurer. (a) Identification. A gingival fluid measurer is a gauge device intended to measure the amount of fluid in the...

  6. 21 CFR 872.1500 - Gingival fluid measurer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Gingival fluid measurer. 872.1500 Section 872.1500...) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1500 Gingival fluid measurer. (a) Identification. A gingival fluid measurer is a gauge device intended to measure the amount of fluid in the...

  7. [Necrotizing fasciitis of the head and neck].

    PubMed

    Gajda, Mieczysław; Holzhausen, Hans-Jürgen; Gudziol, Silke; Hauptmann, Steffen; Bloching, Marc

    2005-01-01

    Necrotizing fasciitis (NF) is a potentially lethal soft tissue infection characterized by cutaneous necrosis, suppurative fasciitis, vascular thrombosis and extreme systemic toxicity. It is a rare entity in the head and neck region, but occur most frequently in patients with diabetes and chronic alcoholism. Mostly involved are immunodeficient patients with banal infections of the upper aerodigestive tract, small traumas, but also after surgical procedures. Necrotizing fasciitis is an infection caused by aerobic or anaerobic microorganisms. A strong complication is a streptococcus-associated-toxic shock-syndrome which should be prevented because it is often associated with letal outcome. Septicemia and systemic toxic effects may lead to death within as short a time as 2 to 4 days. Necrotizing fasciitis is often misdiagnosed or the diagnosis is delayed with a mortality rate of approximately 30-70%. Once identified, treatment consists of antimicrobial therapy and surgical debridement followed at a later date with reconstructive surgery. We present a fatal case of craniofacial necrotizing fasciitis (NF) in a 63-year-old diabetic and chronic alcoholic man and discuss it's pathophysiology, clinical manifestations and the best therapeutic choice for this disease. A review of the literature with the clinical presentations, bacteriology diagnosis and treatment was presented.

  8. Necrotizing granulomatous inflammation of the liver.

    PubMed

    Chou, Chung Kuao; Chou, Shih-Cheng

    2016-09-01

    A 73-year-old patient with necrotizing granulomatous inflammation of the liver is presented. The computed tomography demonstrated 2 hypodense tumors with progressive enhancement in the liver. They became nearly isodense to the normal hepatic parenchyma on the delayed phase. PMID:27594940

  9. [Necrotizing fasciitis of the head and neck].

    PubMed

    Gajda, Mieczysław; Holzhausen, Hans-Jürgen; Gudziol, Silke; Hauptmann, Steffen; Bloching, Marc

    2005-01-01

    Necrotizing fasciitis (NF) is a potentially lethal soft tissue infection characterized by cutaneous necrosis, suppurative fasciitis, vascular thrombosis and extreme systemic toxicity. It is a rare entity in the head and neck region, but occur most frequently in patients with diabetes and chronic alcoholism. Mostly involved are immunodeficient patients with banal infections of the upper aerodigestive tract, small traumas, but also after surgical procedures. Necrotizing fasciitis is an infection caused by aerobic or anaerobic microorganisms. A strong complication is a streptococcus-associated-toxic shock-syndrome which should be prevented because it is often associated with letal outcome. Septicemia and systemic toxic effects may lead to death within as short a time as 2 to 4 days. Necrotizing fasciitis is often misdiagnosed or the diagnosis is delayed with a mortality rate of approximately 30-70%. Once identified, treatment consists of antimicrobial therapy and surgical debridement followed at a later date with reconstructive surgery. We present a fatal case of craniofacial necrotizing fasciitis (NF) in a 63-year-old diabetic and chronic alcoholic man and discuss it's pathophysiology, clinical manifestations and the best therapeutic choice for this disease. A review of the literature with the clinical presentations, bacteriology diagnosis and treatment was presented. PMID:16521446

  10. [Necrotizing sialometaplasia of the nasal cavity].

    PubMed

    Deubel, M; Meister, F; Podvinec, M; Stamm, B

    1994-11-01

    In the present paper we report two cases of "necrotizing sialometaplasia" in uncommon locations. The relevant literature is reviewed. Necrotizing sialometaplasia is self-limiting and is characterized by necrosis and squamous pseudohypertrophy. Typically occurring in the minor salivary glands of the oral mucosa, our cases appear to be the sixth and seventh cases of involvement of the nasal cavity reported in the literature. Owing to the similarity of histological findings, the term "sialometaplasia" is also used for this disorder. This rare disease is a benign process but may be misdiagnosed as mucoepidermoid or squamous cell carcinoma. Therefore, the possibility of this disease in the nose should again be presented. Both of our cases show that with a histological examination considering defined morphological findings, the diagnosis of necrotizing sialometaplasia can be verified and a diagnosis of a carcinoma can be excluded. Especially with regard to radical and possibly unnecessary invasive therapeutic procedures we emphasize the importance of considering "necrotizing sialometaplasia" as part of the differential diagnosis of nasal lesions.

  11. Necrotizing sialometaplasia affecting the minor labial glands.

    PubMed

    Matilla, A; Flores, T; Nogales, F F; Galera, H

    1979-02-01

    A case of necrotizing sialometaplasia of the lower lip, a previously unreported location for this lesion, is presented. In the past, other cases of this benign process occuring in this site may have been confused with squamous-cell or mucoepidermoid carcinoma. In order to arrive at the correct diagnosis, an ample biopsy of the lesion is mandatory.

  12. Multiple myeloma presenting as gingival hyperplasia.

    PubMed

    Jain, Sanjeev; Kaur, Harjit; Kansal, Gaurav; Gupta, Parul

    2013-05-01

    Multiple myeloma is a malignant neoplasm that is characterized by a monoclonal proliferation of plasma cells. Oral and maxillofacial manifestations as an initial sign or symptom of multiple myeloma are rare. A 58-year-old male patient presented with generalized gingival enlargement for last 6 months. Based on clinical presentation, a diagnosis of gingival hyperplasia was made. After Phase I therapy, excisional biopsy was taken in anterior mandibular region and excised tissue was sent for histopathological examination. The histopathology report revealed a lining of stratified squamous epithelium with foci of ulceration. The subepithelial zone showed infiltration by sheets of mainly binucleate and multinucleate plasma cells, few cells being less differentiated. Rounded cytoplasmic inclusion bodies were identified in many of these cells. After a series of clinical investigations, a case of "multiple myeloma" was diagnosed. Patient presenting with generalized gingival hyperplasia should be worked up for systemic disease like multiple myeloma.

  13. [Face necrotizing fasciitis following spinocellular epithelioma excision].

    PubMed

    Gindre, S; Dellamonica, J; Couadau, E; Carles, M; Vandenbos, F; Delgiudice, P; Grimaud, D; Ichai, C

    2005-06-01

    Necrotizing fasciitis is a bacterial dermo-hypodermitis with superficial aponevrosis necrosis due to Streptococcus pyogenes. Head and neck region are some rare localization of this infection especially after surgery. We report herein a case of a face necrotizing fasciitis following minor face surgery. A 86 year-old Caucasian male without any antecedents, nor treatment, has been operated for a fronthead spinocellular epithelioma under local anesthesia. Twelve hours later, a severe pain localized to the face occurred, with sleeplessness, followed up with a face orbitary oedema and fever. Twenty-four hours later, an intravenous antibiotherapy was therefore started and surgical treatment was performed as soon as the diagnosis of necrotizing fasciitis was considered. An important inflammatory oedema was noticed, associated to a large necrotic softening of the face, the eyelid and the neck sub-cutaneous tissues. Then, the patient has been transferred in intensive care unit because multi-organ failure clinical and biological signs occurred. Pre-operatory bacteriological samples culture identified Streptococcus pyogenes. Repeated surgical explorations and debridement (excision, cleaning, draining and bandages recovery) were performed daily as needed until all the necrotic tissue was all eradicated. The antibiotherapy was prescribed to totalised 15 days. Our report underlines the importance of an early recognition of the diagnosis of soft tissue infection, because early surgical treatment has a better prognosis and antibiotic treatment alone is inefficient for the recovery. Alert is delivered by the local signs quickly followed up by skin changes. Anti-inflammatory therapy must be avoid in case of any soft tissue infection sign: they may increase the lesions, hide alarm signs and delay surgical treatment.

  14. [Face necrotizing fasciitis following spinocellular epithelioma excision].

    PubMed

    Gindre, S; Dellamonica, J; Couadau, E; Carles, M; Vandenbos, F; Delgiudice, P; Grimaud, D; Ichai, C

    2005-06-01

    Necrotizing fasciitis is a bacterial dermo-hypodermitis with superficial aponevrosis necrosis due to Streptococcus pyogenes. Head and neck region are some rare localization of this infection especially after surgery. We report herein a case of a face necrotizing fasciitis following minor face surgery. A 86 year-old Caucasian male without any antecedents, nor treatment, has been operated for a fronthead spinocellular epithelioma under local anesthesia. Twelve hours later, a severe pain localized to the face occurred, with sleeplessness, followed up with a face orbitary oedema and fever. Twenty-four hours later, an intravenous antibiotherapy was therefore started and surgical treatment was performed as soon as the diagnosis of necrotizing fasciitis was considered. An important inflammatory oedema was noticed, associated to a large necrotic softening of the face, the eyelid and the neck sub-cutaneous tissues. Then, the patient has been transferred in intensive care unit because multi-organ failure clinical and biological signs occurred. Pre-operatory bacteriological samples culture identified Streptococcus pyogenes. Repeated surgical explorations and debridement (excision, cleaning, draining and bandages recovery) were performed daily as needed until all the necrotic tissue was all eradicated. The antibiotherapy was prescribed to totalised 15 days. Our report underlines the importance of an early recognition of the diagnosis of soft tissue infection, because early surgical treatment has a better prognosis and antibiotic treatment alone is inefficient for the recovery. Alert is delivered by the local signs quickly followed up by skin changes. Anti-inflammatory therapy must be avoid in case of any soft tissue infection sign: they may increase the lesions, hide alarm signs and delay surgical treatment. PMID:15963844

  15. Topical Tacrolimus and Periodontal Therapy in the Management of a Case of Oral Chronic GVHD Characterized by Specific Gingival Localization

    PubMed Central

    Conrotto, Davide; Broccoletti, Roberto; Carcieri, Paola; Giaccone, Luisa; Arduino, Paolo G.

    2014-01-01

    Background. Chronic graft versus host disease (cGVHD) is a complication following bone marrow transplantation. The oral lesions are difficult to control with a systemic pharmacological therapy. Case Description. A 63-year-old female patient, who underwent an allogeniec transplantation for acute myeloid leukemia, developed a chronic oral and cutaneous GVHD. The patient was treated with topical tacrolimus 0.1%, twice daily for two months, and underwent a protocol of oral hygiene characterized by 3 appointments of scaling, root planning, and daily oral hygiene instructions. The patient showed marked resolution of gingival lesions and a significant improvement of related pain and gingival inflammatory indexes. Clinical Implications. This case report suggests that treatment with topical tacrolimus and professional oral hygiene may be helpful in the management of chronic oral GVHD with severe gingival involvement. PMID:24639902

  16. Topical tacrolimus and periodontal therapy in the management of a case of oral chronic GVHD characterized by specific gingival localization.

    PubMed

    Conrotto, Davide; Broccoletti, Roberto; Carcieri, Paola; Giaccone, Luisa; Arduino, Paolo G

    2014-01-01

    Background. Chronic graft versus host disease (cGVHD) is a complication following bone marrow transplantation. The oral lesions are difficult to control with a systemic pharmacological therapy. Case Description. A 63-year-old female patient, who underwent an allogeniec transplantation for acute myeloid leukemia, developed a chronic oral and cutaneous GVHD. The patient was treated with topical tacrolimus 0.1%, twice daily for two months, and underwent a protocol of oral hygiene characterized by 3 appointments of scaling, root planning, and daily oral hygiene instructions. The patient showed marked resolution of gingival lesions and a significant improvement of related pain and gingival inflammatory indexes. Clinical Implications. This case report suggests that treatment with topical tacrolimus and professional oral hygiene may be helpful in the management of chronic oral GVHD with severe gingival involvement.

  17. Gingival fibroblasts resist apoptosis in response to oxidative stress in a model of periodontal diseases

    PubMed Central

    Cheng, R; Choudhury, D; Liu, C; Billet, S; Hu, T; Bhowmick, NA

    2015-01-01

    Periodontal diseases are classified as inflammation affecting the supporting tissue of teeth, which eventually leads to tooth loss. Mild reversible gingivitis and severe irreversible periodontitis are the most common periodontal diseases. Periodontal pathogens initiate the diseases. The bacterial toxin, lipopolysaccharide (LPS), triggers the inflammatory response and leads to oxidative stress. However, the progress of oxidative stress in periodontal diseases is unknown. The purpose of this study is to examine oxidative stress and cell damage in gingivitis and periodontitis. Our results showed that LPS increases reactive oxygen species (ROS) accumulation in gingival fibroblast (GF). However, oxidative stress resulting from excessive ROS did not influence DNA damage and cell apoptosis within 24 h. The mechanism may be related to the increased expression of DNA repair genes, Ogg1, Neil1 and Rad50. Detection of apoptosis-related proteins also showed anti-apoptotic effects and pro-apoptotic effects were balanced. The earliest damage appeared in DNA when increased γH2AX, an early biomarker for DNA damage, was detected in the LPS group after 48 h. Later, when recurrent inflammation persisted, 8-OHdG, a biomarker for oxidative stress was much higher in periodontitis model compared to the control in vivo. Staining of 8-OHdG in human periodontitis specimens confirmed the results. Furthermore, TUNEL staining of apoptotic cells indicated that the periodontitis model induced more cell apoptosis in gingival tissue. This suggested GF could resist early and acute inflammation (gingivitis), which was regarded as reversible, but recurrent and chronic inflammation (periodontitis) led to permanent cell damage and death. PMID:27551475

  18. Efficacy of two gingival retraction systems on lateral gingival displacement: A prospective clinical study

    PubMed Central

    Anupam, Purwar; Namratha, N.; Vibha, Shetty; Anandakrishna, G.N.; Shally, Khanna; Singh, Amit

    2013-01-01

    Purpose Gingival management is a substantive procedure in fixed dental prosthesis treatment. Various new retraction cord systems are available and used. This study aimed to compare the efficacy of a new retraction cord (Stay-Put, Coltene Whaledent AG) and a conventional retraction cord (Ultrapak, Ultradent Products Inc., South Jordan, Utah) on lateral gingival displacement in continuation with the treatment protocol of the subjects fixed dental prosthesis for various partial edentulous conditions requiring fixed dental prosthesis. Method Thirty subjects were selected who needed bilateral fixed dental restoration. In selected subjects both gingival retraction cords were placed bilaterally buccolingually by simple randomization method. After removing the cords, impressions were made and undamaged definitive casts were retrieved. The abutment teeth were sectioned buccolingually at the buccal ridge followed by decimal measurement of the width (in millimeter) of the retracted gingival sulcus, under a traveling microscope. Results Data was analyzed using SPSS version. Paired "t" test was used to compare the difference between the displaced gingival width in two retraction group (p > 0.05). Conclusion Although mean gingival retraction in Stay-Put system (0.528 ± 0.12 mm) was higher as compared to that in Ultrapak (0.487 ± 0.10 mm), the difference between the two systems (0.041 ± 0.11) was not significant statistically (p = 0.057). PMID:25737887

  19. The relation of gingival thickness to dynamics of gingival margin position pre- and post-surgically

    PubMed Central

    Vandana, Kharidhi Laxman; Gupta, Ira

    2016-01-01

    Background: To evaluate the gingival margin position (GMP) before and after open flap debridement in different gingival thickness (GT). Materials and Methods: Twenty-seven healthy patients with moderate to advanced adult periodontitis were included in a randomized control clinical trial. A calibrated UNC-15 periodontal probe, an occlusal onlay stent was used for clinical measurements recorded at baseline, 3 month, 6 month, and 16 month. The changes in the GMP were studied at midbuccal (Mi-B), mesiobuccal (MB), and distobuccal sites. GT was measured presurgically, transgingivally at Mi-B and interdental sites, divided into 2 groups: Group 1 (thin) and Group 2 (thick). Results: In GT of ≤1 mm group, the statistically significant apical shift of GMP led to gingival recession at all study sites in the early postsurgical period of 1 and 3 months. During 6 and 16 months, the apical shift of GMP coincided with the Chernihiv Airport at Mi-B site (6 months), MB site (16 months). The gingival recession was obvious at Mi-B sites (16 months). In the GT of >1 mm, the statistically significant apical shift of GMP did not cause gingival recession at any sites throughout postsurgical (1, 3, 6, and 16 months) period. Conclusion: Thin gingiva showed apical shift of GMP leading to gingival recession as compared to thick gingiva postsurgically. PMID:27143829

  20. Association between gingivitis and anterior gingival enlargement in subjects undergoing fixed orthodontic treatment

    PubMed Central

    Zanatta, Fabricio Batistin; Ardenghi, Thiago Machado; Antoniazzi, Raquel Pippi; Pinto, Tatiana Militz Perrone; Rösing, Cassiano Kuchenbecker

    2014-01-01

    Objective The aim of this study was to investigate the association among gingival enlargement (GE), periodontal conditions and socio-demographic characteristics in subjects undergoing fixed orthodontic treatment. Methods A sample of 330 patients undergoing fixed orthodontic treatment for at least 6 months were examined by a single calibrated examiner for plaque and gingival indexes, probing pocket depth, clinical attachment loss and gingival enlargement. Socio-economic background, orthodontic treatment duration and use of dental floss were assessed by oral interviews. Associations were assessed by means of unadjusted and adjusted Poisson's regression models. Results The presence of gingival bleeding (RR 1.01; 95% CI 1.00-1.01) and excess resin around brackets (RR 1.02; 95% CI 1.02-1.03) were associated with an increase in GE. No associations were found between socio-demographic characteristics and GE. Conclusion Proximal anterior gingival bleeding and excess resin around brackets are associated with higher levels of anterior gingival enlargement in subjects under orthodontic treatment. PMID:25162567

  1. Pre-transplant gingival hyperplasia predicts severe cyclosporin-induced gingival overgrowth in renal transplant patients.

    PubMed

    Varga, E; Lennon, M A; Mair, L H

    1998-03-01

    The relationship between the pre-transplant periodontal status and the development of post-transplant gingival overgrowth was investigated in a longitudinal study. The periodontal condition of 35 patients was examined on 2 occasions while they were on the transplant waiting list and then at 4-6, 10-12, 16 and 20 weeks post-transplant. At each visit the plaque index, the bleeding index and a pocket index (CPITN) were measured. Dental impressions were taken of the pre- and post-transplant gingival condition and used to make stone models which were used to score the gingival overgrowth index (GOI). The patients divided into 3 distinct groups having severe (n=13), mild (n=16) or no post-transplant gingival overgrowth (n=6). Only 1 of the patients had taken cyclosporin prior to inclusion into the study. All the patients who developed severe overgrowth had evidence of gingival hyperplasia before the transplant. There was no difference in the serum cyclosporin levels between the three groups (chi2<2.28, p>0.319). Furthermore, there was no statistical difference for any of the periodontal indices. This study indicates that the hyperplastic gingival inflammatory response of some individuals appears to be potentiated by cyclosporin resulting in severe post-transplant overgrowth. In other patients the same reaction may allow the fibroblastic activity to occur to an extent where it produces a mild clinically apparent overgrowth.

  2. Aloe vera: It's effect on gingivitis

    PubMed Central

    Ajmera, Neha; Chatterjee, Anirban; Goyal, Vikas

    2013-01-01

    Objective: Aloe vera is the oldest medicinal plant that has maintained its popularity over the course of time. It is widely known for its medicinal uses in wound healing, as an analgesic, and for its anti-inflammatory properties. Aim: The aim of this study is to evaluate the anti-inflammatory property of aloe vera mouthwash on plaque-induced gingivitis. Materials and Methods: Forty-five patients who were diagnosed with plaque-induced gingivitis were included in the study. They were divided into three groups with fifteen patients in each group. Group 1 was asked to rinse with 10 ml of aloe vera mouthwash twice daily for three months. Group 2 were treated with scaling only. Group 3 patients were asked to rinse with aloe vera mouthwash and scaling was done. The clinical changes were evaluated with Loe and Silness gingival index (1963) and Muhlemann and Son's Sulcus bleeding index (1971) at baseline, after one month and three months, respectively. Results: The data obtained was compared statistically. The paired ‘t’ test was done for intragroup comparison and one-way analysis of variance with a post hoc Tukey test was used for intergroup comparison. The data was obtained at the baseline, end of first month, and end of the third month. The result suggested reduction in gingival inflammation in all the three groups, but it was more in the aloe vera mouthwash and scaling group. Hence, it was concluded that aloe vera had a significant anti-inflammatory property. Thus, it can be used as an adjunct to mechanical therapy for treating plaque-induced gingivitis. PMID:24174720

  3. Contact lens-associated nocardial necrotizing scleritis.

    PubMed

    Rush, Ryan B

    2013-08-01

    A 52 year-old, contact lens-wearing man presented with progressive right eye pain and redness for one month. He had been evaluated and treated for necrotizing scleritis by multiple eye care specialists prior to presentation. He underwent a complete systemic work-up for both autoimmune and infectious causes of scleritis, including a culture. The culture revealed heavy growth of Nocardia asteroides complexes. The patient was treated with topical amikacin and oral Bactrim. Following several weeks of antibiotic treatment, the patient's infection resolved completely, and his visual acuity returned to baseline status. Nocardia is a rare but potentially devastating cause of necrotizing scleritis that may affect contact lens wearers without an associated keratitis. Prompt recognition and early treatment with appropriate antimicrobial agents are critical to achieve a favorable outcome. PMID:23908577

  4. [Necrotizing enterocolitis. Pathogenesis and iatrogenic factors].

    PubMed

    Obladen, M

    1986-08-01

    Following clinical observations, measurements of osmolarity of liquid drugs, and determination of blood loss due to sampling in very low birthweight infants, the following hypothesis on iatrogenic factors contributing to the pathogenesis of necrotizing enterocolitis is proposed: Due to diagnostic blood sampling during intensive care, premature infants may become severely anemic. Therefore their intestinal perfusion is reduced, causing hypoxia and hypoperfusion in the submucosa. Especially in infants with oral feeding and hyperosmolar medication, mechanical factors, hyperosmolarity and infection can affect the mucosa from the luminal side. Simultaneous hypoperfusion and hyperosmolar load may contribute to the pathogenesis of necrotizing enterocolitis. This hypothesis, which needs experimental verification, explains the different incidence of the disease in different hospitals.

  5. Necrotizing Fasciitis: An Emergency Medicine Simulation Scenario

    PubMed Central

    Galust, Henrik; Oliverio, Matthew H; Giorgio, Daniel J; Espinal, Alexis M

    2016-01-01

    Necrotizing fasciitis (NF) is a rare and rapidly progressing life-threatening infectious process. By progressing through a simulation involving a patient with NF and participating in a post-scenario debriefing, learners will gain the necessary skills and knowledge to properly diagnose and manage patients with NF. Learners are taught to initiate appropriate and timely treatment and to advocate on behalf of their patient after inappropriate pushback from consultants to improve outcomes. PMID:27733963

  6. Identifying statin-associated autoimmune necrotizing myopathy.

    PubMed

    Albayda, Jemima; Christopher-Stine, Lisa

    2014-12-01

    Statins up-regulate expression of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), the rate-limiting enzyme in cholesterol synthesis and the major target of autoantibodies in statin-associated immune-mediated necrotizing myopathy. As muscle cells regenerate, they express high levels of HMGCR, which may sustain the immune response even after statin therapy is stopped. Awareness of this entity will help physicians who prescribe statins to take action to limit the associated morbidity.

  7. Neonatal necrotizing enterocolitis: a focus on.

    PubMed

    Pellegrini, M; Lagrasta, N; Garcìa Garcìa, C; Campos Serna, J; Zicari, E; Marzocca, G

    2002-01-01

    Necrotizing enterocolitis (NEC) is a multifactorial worldwide problem, representing the most frequent gastrointestinal emergency in neonates. Extremely common in preterm infants, it is also registered in fullterm low birth weight neonates. Despite extensive research, its etiopathogenesis is not completely understood and this neonatal disease remains associated with high morbidity and mortality rates. This review proposes an interdisciplinary focus on recent developments in NEC etiopathogenesis, diagnosis and management. PMID:12608653

  8. Necrotizing sialometaplasia (adenometaplasia) of the trachea.

    PubMed

    Romagosa, V; Bella, M R; Truchero, C; Moya, J

    1992-09-01

    Necrotizing sialometaplasia is a benign condition first described in minor salivary glands of the soft palate with morphological changes which can be misinterpreted as squamous-cell carcinoma. Similar lesions have been subsequently reported in other locations including major salivary glands, lip, breast and skin (the term syringometaplasia has been applied for the latter). We report three cases of such a process involving submucosal glands in the trachea following prolonged translaryngeal intubation.

  9. Necrotizing sialometaplasia. A condition simulating malignancy.

    PubMed

    Raugi, G J; Kessler, S

    1979-03-01

    Necrotizing sialometaplasia occurred in a 55-year-old woman. The ulcerated lesion on the hard palate was treated conservatively and resolved spontaneously in about three months. The histology of the lesion consisted of coagulative necrosis of the salivary gland lobules and prominent squamous metaplasia within adjacent viable lobules. Since this benign lesion has frequently been mistaken for mucoepidermoid carcinoma or squamous cell carcinoma, recognition of it may spare the patient a radical surgical procedure.

  10. Necrotizing sialometaplasia: literature review and case reports.

    PubMed

    Imbery, T A; Edwards, P A

    1996-07-01

    The authors describe necrotizing sialometaplasia, a benign inflammatory lesion primarily involving the minor salivary glands of the hard palate. The lesion presents itself as a deep-seated palatal ulcer with clinical and histologic features mimicking those of a malignant neoplasm. The lesion is believed to be the result of vascular ischemia initiated by trauma. An incisional biopsy is required to confirm the diagnosis, and the lesion heals by secondary intention within four to 10 weeks.

  11. [Necrotizing sialometaplasia. Report of a case].

    PubMed

    Rapisarda, F; Ficarra, G

    1999-06-01

    Necrotizing sialometaplasia is a benign lesion of the minor and major salivary glands. It occurs with a palatal swelling which rapidly becomes a deep ulcer. Histopathological aspects include ulceration of the surface epithelium, squamous metaplasia and acinar necrosis. In general no treatment is necessary and the lesion heals spontaneously in 4-10 weeks. This condition must be distinguished from more serious diseases such as squamous cell carcinoma and mucoepidermoid carcinoma.

  12. [Descendending necrotizing mediastinitis single center experience].

    PubMed

    Kovacić, Ivan; Kovacić, Marijan

    2014-01-01

    The descending necrotizing mediastinitis is a rare but life-threatening inflammation, and occurs as a complication of deep inflammation of the neck. The mortality rate is still high by 40% despite the use of a variety of potent antimicrobial drugs. We describe 7 patients with the descending necrotizing mediastinitis treated in our hospital during the last 12 years. The primary site of infection in 5 patients were tonsils and pharynx, and in the other two patients odontogenic inflammation of the lower molars. Most of the patients belonged to the risk groups (diabetes mellitus, alcoholism), the average age of 60.4 years. After the diagnosis with computed tomography (CT), we surgically intervened in all patients. Deep neck infections are treated with aggressive surgical cervicotomy and high quality mediastinal drainage was performed with transcervical approach in all patients. Perioperative tracheotomy (n=3) was performed for the upper airway edema and postoperative tracheostomy for extended intubation (n = 1).Only in one case, we subsequently conducted a secondary surgical procedure, lateral thoracotomy because of pleural decortication. All patients were successfully cured with an average length of hospitalization was 24.6 days. For successful treatment of the descending necrotizing mediastinitis diagnosis must be set as early as possible and with the use of computed tomography scanning. Treatment requires the simultaneous application of potent antimicrobial drugs, aggressive surgical debridement of the neck and high-quality drainage of the mediastinum, which can be achieved through the transcervical approach.

  13. A rare case of necrotic thymoma*

    PubMed Central

    DE PALMA, A.; PAGLIARULO, V.; LORUSSO, M.; VERARDO, L.; DI GENNARO, F.; GENUALDO, M.; QUERCIA, R.; MONTRONE, T.; GENTILE, A.; LOIZZI, M.

    2014-01-01

    Summary The Authors report the case of a patient who underwent resection of a huge anterior mediastinal mass, revealing to be a necrotic thymoma. The patient had been previously submitted to surgical biopsies of the mass yielding non-diagnostic results due to extensive necrosis. A sternotomy was then performed to resect the mediastinal mass originating from the thymus, en-bloc with the mediastinal fat and the apparently infiltrated lung. Histopathology showed a possible cyst/thymoma in massive necrosis, not further definable; revision by a specialized experienced pathologist (J. Rosai) confirmed total mass necrosis and no lung infiltration, thus orientating diagnosis towards a necrotic thymoma and excluding a lymphoblastic lymphoma, with similar histopathological features but more frequent in children or characterized by neoplastic infiltration of surrounding lung. Total body computed tomography (CT) scan and fluorodeoxyglucose positron emission tomography (18F-FDG-PET)/CT, show neither local recurrence, nor distant metastases two years after surgery. In case of anterior mediastinal mass with difficult histopathological diagnosis due to massive necrosis, the hypothesis of a necrotic thymoma should be considered. After radical removal prognosis is generally favourable and no adjuvant treatment is required. PMID:24690340

  14. Genetics Home Reference: acute necrotizing encephalopathy type 1

    MedlinePlus

    ... interacts with a protein complex known as the nuclear pore. The nuclear pore is a channel that allows transport of ... transport of proteins and other molecules through the nuclear pore and helps modify proteins coming into or ...

  15. Necrotizing sialometaplasia of the palate. Ulcerative or necrotizing stage of leukokeratosis nicotina palati?

    PubMed

    Philipsen, H P; Petersen, J K; Simonsen, B H

    1976-12-01

    A typical case of the recently described tumor-suspect lesion, necrotizing sialometaplasia (NS) of the palate, in a 54-year old Caucasian male is presented. Results of complete blood- and urinanalysis including serum electrophoresis and labial salivary gland biopsy strongly pointed at a local etiologic factor. Previous statements that the disease represents a new entity are questioned. The present authors favor the idea that NS is the necrotizing (ulcerative) or terminal stage of leukokeratosis nicotina palati (nicotinic stomatitis). It is of particular importance that this lesion is not diagnosed as a malignancy, as it heals spontaneously and uneventfully.

  16. Distribution of smile line, gingival angle and tooth shape among the Saudi Arabian subpopulation and their association with gingival biotype

    PubMed Central

    AlQahtani, Nabeeh A.; Haralur, Satheesh B.; AlMaqbol, Mohammad; AlMufarrij, Ali Jubran; Al Dera, Ahmed Ali; Al-Qarni, Mohammed

    2016-01-01

    Objectives: To determine the occurrence of smile line and maxillary tooth shape in the Saudi Arabian subpopulation, and to estimate the association between these parameters with gingival biotype. Materials and Methods: On the fulfillment of selection criteria, total 315 patients belong to Saudi Arabian ethnic group were randomly selected. Two frontal photographs of the patients were acquired. The tooth morphology, gingival angle, and smile line classification were determined with ImageJ image analyzing software. The gingival biotype was assessed by probe transparency method. The obtained data were analyzed with SPSS 19 (IBM Corporation, New York, USA) software to determine the frequency and association between other parameters and gingival biotype. Results: Among the clinical parameters evaluated, the tapering tooth morphology (56.8%), thick gingival biotype (53%), and average smile line (57.5%) was more prevalent. The statistically significant association was found between thick gingival biotype and the square tooth, high smile line. The high gingival angle was associated with thin gingival biotype. Conclusions: The study results indicate the existence of an association between tooth shape, smile line, and gingival angle with gingival biotype. PMID:27195228

  17. Correlation analysis for clinical and gingival crevicular fluid parameters at anatomically related gingival sites.

    PubMed

    Lamster, I B; Oshrain, R L; Celenti, R; Levine, K; Fine, J B

    1991-04-01

    This study was designed to evaluate the relationship of certain clinical and biochemical measures of periodontal pathology at anatomically related gingival sites. The maxillary first molar--second bicuspid region was studied in patients with gingivitis and periodontitis. The mesiobuccal site on the first molar was compared to the mesiopalatal and direct buccal sites on the molar and the distobuccal site on the second bicuspid. Probing depth, attachment level, gingival index, gingival crevicular fluid (GCF) volume, and GCF levels of the lysosomal enzyme B-glucuronidase (BG), the cytoplasmic enzyme lactate dehydrogenase, IgG and the protease-inhibitor alpha-2-macroglobulin were studied. For the 3 anatomical pairs that were analyzed, the correlation coefficients for the GCF constituents were generally higher than the correlations for the clinical parameters. The mean correlations for the GCF constituents were higher for the periodontitis patients as compared to the gingivitis patients. For the periodontitis patients, BG activity was correlated at adjacent proximal sites, approached significance at adjacent papillary sites, but was not significantly correlated at adjacent facial-proximal sites. This data suggests that sampling of BG activity from a mesiobuccal site provides information about the anterior papillary unit. In contrast, IgG in GCF collected from the mesiobuccal site on the first molar was significantly correlated with the total IgG in the 3 other sites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1713224

  18. Treatment of gingival recession using free gingival graft with fibrin fibronectin sealing system: A novel approach

    PubMed Central

    Srinivas, B. V. V.; Rupa, N.; Halini Kumari, K. V.; Rajender, A.; Reddy, M. Narendra

    2015-01-01

    Periodontal plastic surgery is the branch of periodontology that is focused mainly on the correction or elimination of mucogingival problems associated with lack of attached gingiva, a shallow vestibule and aberrant frenum. Various mucogingival surgical procedures are used to halt the progression of the gingival recession and to correct poor esthetic appearance. Free gingival autograft is one of the most common techniques used for a gingival recession in areas of inadequate attached gingiva in the mandibular anterior region. Fibrin sealants are human plasma derivatives that mimic the final stages of blood coagulation, forming a fibrin clot. Fibrin Sealants enhances the overall outcome of surgical intervention because of their hemostatic, adhesive, and healing properties. These properties of fibrin sealants may reduce operating time, prevent complications, and enhance the overall outcome of many surgical interventions. Hence, this case report aims to investigate the clinical effectiveness of free gingival graft along with the commercially available fibrin-fibronectin sealing system (Tissucol®) in the treatment of Miller's class II gingival recession. PMID:26538956

  19. Idiopathic gingival hyperplasia and orthodontic treatment: a case report.

    PubMed

    Clocheret, K; Dekeyser, C; Carels, C; Willems, G

    2003-03-01

    There are many reasons for gingival hyperplasia. Mostly, proper oral hygiene is sufficient to achieve normal healthy gingiva. In some situations, however, gingival hyperplasia is drug-induced or can be a manifestation of a genetic disorder. In the latter, it may exist as an isolated abnormality or as part of a syndrome. If orthodontic treatment is needed in patients with gingival hyperplasia, both orthodontic and periodontal aspects need to be considered. Extreme hereditary gingival fibromatosis was periodontally treated, by removal of all gingival excess using flaps and gingivectomies. After a follow-up period, the orthodontic treatment started with fixed appliances. Monthly periodontal check-ups (scaling and polishing) were scheduled to control the gingival inflammation. After the orthodontic treatment, permanent retention was applied, once more followed by a complete gingivectomy in both maxilla and mandible. One of the most important keys to successful treatment of hyperplasia patients is the cooperation between the periodontist and the orthodontist.

  20. Calcium channel blocker-induced gingival enlargement.

    PubMed

    Livada, R; Shiloah, J

    2014-01-01

    Despite the popularity and wide acceptance of the calcium channel blockers (CCBs) by the medical community, their oral impact is rarely recognized or discussed. CCBs, as a group, have been frequently implicated as an etiologic factor for a common oral condition seen among patients seeking dental care: drug-induced gingival enlargement or overgrowth. This enlargement can be localized or generalized, and can range from mild to extremely severe, affecting patient's appearance and function. Treatment options for these patients include cessation of the offending drug and substitution with another class of antihypertensive medication to prevent recurrence of the lesions. In addition, depending on the severity of the gingival overgrowth, nonsurgical and surgical periodontal therapy may be required. The overall objective of this article is to review the etiology and known risk factors of these lesions, their clinical manifestations and periodontal management.

  1. Familial gingival fibromatosis: A rare case report

    PubMed Central

    Sharma, Shweta; Goyal, Dhawal; Shah, Gaurav; Ray, Amit

    2012-01-01

    Hereditary gingival fibromatosis is a rare condition that can occur as an isolated disease or as part of a syndrome or chromosomal abnormality. In severe cases, the gingival enlargement may cover the crowns of teeth and cause severe functional and aesthetic concerns. Here, we present a case of an 8-year-old girl with severe enlargement of gums in maxilla and mandible. Both deciduous and permanent teeth were not erupted in the oral cavity at all. Mutation in the Son-of-Sevenless (SOS-1) gene has been associated with the disease. The diagnosis was made based on clinical examination and family history. Surgical removal of the hyperplastic tissue was performed under general anesthesia. PMID:22629070

  2. Characterization of dental anatomy and gingival biotype in Asian populations.

    PubMed

    Lee, Stacey A; Kim, Alexis C; Prusa, Louis A; Kao, Richard T

    2013-01-01

    Gingival and dental characteristics are risk factors for periodontal problems. With short or fused roots, a decreased periodontium results in some attachment loss, compromising periodontal stability. Similarly, with an increased incidence of thin gingival biotype, inflammatory and traumatic insults may result in gingival recession. Anecdotally, Asian dentitions have been described as having short roots with "thin gingiva". This cross-sectional study will utilize clinical data and radiographic interpretation to ascertain whether this clinical impression is valid.

  3. Amlodipine-induced Gingival Hyperplasia - A Case Report and Review.

    PubMed

    Madi, M; Shetty, S R; Babu, S G; Achalli, S

    2015-06-01

    Anticonvulsants, antihypertensive calcium channel blockers and immunosuppressants are the three main classes of drugs known to cause drug-induced gingival hypertrophy or hyperplasia. Among the calcium channel blockers, nifedipine administration has most frequently been associated with medication-related gingival hyperplasia. The incidence with amlodipine, which has a mode of action pharmacodynamically comparable to nifedipine, has rarely been reported. Here, we present a rare case of amlodipine-induced gingival hyperplasia in a hypertensive patient.

  4. Non syndromic gingival fibromatosis in a mild mental retardation child

    PubMed Central

    Duddu, Mahesh K.; Muppa, Radhika; Reddy, G. S. Prasad; Reddy, P. Veerendra Nath

    2012-01-01

    Gingival fibromatosis is a benign oral condition characterized by enlargement of gingival tissues. It usually develops as an isolated disorder but can be one of the features of a syndrome. This case report is of a 5-year-old male with severe gingival hyperplasia and mild mental retardation which was complicated by open bite, abnormal occlusion, open lip posture, and disabilities associated with mastication and speech. Full mouth gingivectomy in single sitting under general anesthesia was done with electrocautery. PMID:23230365

  5. Salivary Biomarkers Associated With Gingivitis and Response to Therapy

    PubMed Central

    Syndergaard, Ben; Al-Sabbagh, Mohanad; Kryscio, Richard J.; Xi, Jing; Ding, Xiuhua; Ebersole, Jeffrey L.; Miller, Craig S.

    2015-01-01

    Background Salivary biomarkers are potentially important for determining the presence, risk, and progression of periodontal disease. However, clinical translation of biomarker technology from lab to chairside requires studies that identify biomarkers associated with the transitional phase between health and periodontal disease (i.e., gingivitis). Methods Eighty participants (40 with gingivitis, 40 healthy) provided saliva at baseline and 7 to 30 days later. An additional sample was collected from gingivitis participants 10 to 30 days after dental prophylaxis. Clinical parameters of gingival disease were recorded at baseline and the final visit. Salivary concentrations of interleukin (IL)-1β, IL-6, matrix metalloproteinase (MMP)-8, macrophage inflammatory protein (MIP)-1α, and prostaglandin E2 (PGE2) were measured. Results Clinical features of health and gingivitis were stable at both baseline visits. Participants with gingivitis demonstrated significantly higher bleeding on probing (BOP), plaque index (PI), and gingival index (GI) (P ≤ 0.002) and a significant drop in BOP, PI, and GI post-treatment (P ≤ 0.001). Concentrations of MIP-1α and PGE2 were significantly higher (2.8 times) in the gingivitis group than the healthy group (P ≤ 0.02). After dental prophylaxis, mean biomarker concentrations did not decrease significantly from baseline in the gingivitis group, although concentrations of IL-1β, IL-6, and MMP-8 approached healthy levels, whereas MIP-1α and PGE2 concentrations remained significantly higher than in the healthy group (P ≤ 0.04). Odds ratio analyses showed that PGE2 concentrations, alone and in combination with MIP-1α, readily discriminated gingivitis from health. Conclusions Salivary PGE2 and MIP-1α discriminate gingivitis from health, and patients with gingivitis who return to clinical health continue to produce inflammatory mediators for weeks after dental prophylaxis. PMID:24502627

  6. Gingival Tissue Transcriptomes Identify Distinct Periodontitis Phenotypes

    PubMed Central

    Kebschull, M.; Demmer, R.T.; Grün, B.; Guarnieri, P.; Pavlidis, P.; Papapanou, P.N.

    2014-01-01

    The currently recognized principal forms of periodontitis—chronic and aggressive—lack an unequivocal, pathobiology-based foundation. We explored whether gingival tissue transcriptomes can serve as the basis for an alternative classification of periodontitis. We used cross-sectional whole-genome gene expression data from 241 gingival tissue biopsies obtained from sites with periodontal pathology in 120 systemically healthy nonsmokers with periodontitis, with available data on clinical periodontal status, subgingival microbial profiles, and serum IgG antibodies to periodontal microbiota. Adjusted model-based clustering of transcriptomic data using finite mixtures generated two distinct clusters of patients that did not align with the current classification of chronic and aggressive periodontitis. Differential expression profiles primarily related to cell proliferation in cluster 1 and to lymphocyte activation and unfolded protein responses in cluster 2. Patients in the two clusters did not differ with respect to age but presented with distinct phenotypes (statistically significantly different whole-mouth clinical measures of extent/severity, subgingival microbial burden by several species, and selected serum antibody responses). Patients in cluster 2 showed more extensive/severe disease and were more often male. The findings suggest that distinct gene expression signatures in pathologic gingival tissues translate into phenotypic differences and can provide a basis for a novel classification. PMID:24646639

  7. Natural course of acute pancreatitis.

    PubMed

    Beger, H G; Rau, B; Mayer, J; Pralle, U

    1997-02-01

    Acute pancreatitis comprises, in terms of clinical, pathologic, biochemical, and bacteriologic data, four entities. Interstitial edematous pancreatitis and necrotizing pancreatitis are the most frequent clinical manifestations; pancreatic pseudocyst and pancreatic abscess are late complications after necrotizing pancreatitis, developing after 3 to 5 weeks. Determinants of the natural course of acute pancreatitis are pancreatic parenchymal necrosis, extrapancreatic retroperitoneal fatty tissue necrosis, biologically active compounds in pancreatic ascites, and infection of necrosis. Early in the course of acute pancreatitis multiple organ failure is the consequence of various inflammatory mediators that are released from the inflammatory process and from activated leukocytes attracted by pancreatic injury. During the late course, starting the second week, local and systemic septic complications are dominant. Around 80% of deaths in acute pancreatitis are caused by septic complications. The infection of pancreatic necrosis occurs in 8% to 12% of acute pancreatitis and in 30% to 40% of patients with necrotizing pancreatitis. Bacteriologic analysis of intraoperative smears and aspirates reveals predominantly gram-negative germs deriving from the intestine, most frequently Escherichia coli. It has been confirmed that after necrotizing pancreatitis a considerable large group of patients suffer long-lasting exocrine and endocrine insufficiency.

  8. DESCENDING NECROTIZING MEDIASTINITIS SECONDARY TO RETROPHARYNGEAL ABSCESS.

    PubMed

    Kovacić, Marijan; Kovacić, Ivan; Dželalija, Boris

    2015-12-01

    Descending necrotizing mediastinitis secondary to a nontraumatic retropharyngeal abscess is very rare. This form of mediastinitis in the era of potent antibiotics often ends up with lethal outcome. It usually occurs in immunocompromised patients and requires intensive multidisciplinary treatment approach. We report a case of nontraumatic retropharyngeal abscess complicated by descending necrotizing mediastinitis in a 70-year-old man with insulin dependent diabetes mellitus. The patient was admitted to our hospital after clinical and radiological diagnosis of retropharyngeal abscess. During treatment for retropharyngeal abscess with antibiotic therapy and transoral incision, the patient showed mild clinical improvement but his condition suddenly aggravated on day 4 of hospital stay. He had high fever, chest pain with tachypnea, tachycardia, hypotension, and showed signs of occasional disorientation. Emergency computed tomography (CT) scan of the neck and thorax showed inflammation in the retropharyngeal space, as well as thickening of the upper posterior mediastinum fascia with the presence of air. Emergency surgery including cervicotomy and drainage of the retropharyngeal space and posterior mediastinum was performed. The patient promptly recovered with improvement of the clinical status and laboratory findings. After 16 days of treatment he was discharged from the hospital in good condition. Descending necrotizing mediastinitis can be a serious and life threatening complication of deep neck infection if the diagnosis is not quickly established. Besides inevitable application of antimicrobial drugs, good drainage of the mediastinum is necessary. We believe that transcervical approach can achieve high-quality drainage of the upper mediastinum, especially if it is done timely as in this case. Its efficacy can be verified by intensive monitoring of the patient clinical condition, by CT scan of the thorax, and by laboratory tests. In the case of inefficacy of this type

  9. DESCENDING NECROTIZING MEDIASTINITIS SECONDARY TO RETROPHARYNGEAL ABSCESS.

    PubMed

    Kovacić, Marijan; Kovacić, Ivan; Dželalija, Boris

    2015-12-01

    Descending necrotizing mediastinitis secondary to a nontraumatic retropharyngeal abscess is very rare. This form of mediastinitis in the era of potent antibiotics often ends up with lethal outcome. It usually occurs in immunocompromised patients and requires intensive multidisciplinary treatment approach. We report a case of nontraumatic retropharyngeal abscess complicated by descending necrotizing mediastinitis in a 70-year-old man with insulin dependent diabetes mellitus. The patient was admitted to our hospital after clinical and radiological diagnosis of retropharyngeal abscess. During treatment for retropharyngeal abscess with antibiotic therapy and transoral incision, the patient showed mild clinical improvement but his condition suddenly aggravated on day 4 of hospital stay. He had high fever, chest pain with tachypnea, tachycardia, hypotension, and showed signs of occasional disorientation. Emergency computed tomography (CT) scan of the neck and thorax showed inflammation in the retropharyngeal space, as well as thickening of the upper posterior mediastinum fascia with the presence of air. Emergency surgery including cervicotomy and drainage of the retropharyngeal space and posterior mediastinum was performed. The patient promptly recovered with improvement of the clinical status and laboratory findings. After 16 days of treatment he was discharged from the hospital in good condition. Descending necrotizing mediastinitis can be a serious and life threatening complication of deep neck infection if the diagnosis is not quickly established. Besides inevitable application of antimicrobial drugs, good drainage of the mediastinum is necessary. We believe that transcervical approach can achieve high-quality drainage of the upper mediastinum, especially if it is done timely as in this case. Its efficacy can be verified by intensive monitoring of the patient clinical condition, by CT scan of the thorax, and by laboratory tests. In the case of inefficacy of this type

  10. [Necrotizing enterocolitis in the preterm infant: etiopathogenic considerations].

    PubMed

    Pellegrini, Michele; Lagrasta, Nancy; Campos Serna, Javier; Garcìa Garcìa, Covadonga; Marzocca, Giuseppe

    2004-01-01

    Necrotizing enterocolitis (NE) represents the most frequent gastrointestinal emergency encountered in neonatal intensive care units. This necrotic-inflammatory bowel disease affects primarily premature patients and it is recorded as an important cause of neonatal morbidity and mortality. The NE aetiology seems to be multifactorial: prematurity, enteral feeding, hypoxia and micro-organisms toxicity are registered as the most important risk factors, able to trigger the phlogistic and necrotic way at the basis of necrotizing enterocolitis. Despite the NE first report was in the past century, the correct pathogenic sequence of this neonatal disease is still hypothetical. PMID:15303550

  11. Amlodipine-induced gingival hyperplasia in a Great Dane.

    PubMed

    Pariser, Marlene S; Berdoulay, Paul

    2011-01-01

    A 3 yr old, 70 kg (154 lbs) female spayed Great Dane developed gingival hyperplasia after treatment of systemic hypertension with amlodipine 7.5 mg q 12 hr for 16 mo. Physical examination was unremarkable except for systemic hypertension and severe gingival hyperplasia. Amlodipine was replaced with hydralazine (0.72 mg/kg [0.32 mg/lb]). Nine months later, gingival hyperplasia was nearly resolved and hypertension was well controlled. Calcium channel blockers such as amlodipine are a rare cause of gingival hyperplasia in the canine patient. Recognition of this side effect is important because a full recovery can be achieved when the offending agent is removed.

  12. Carpal tunnel release complicated by necrotizing fasciitis.

    PubMed

    Greco, R J; Curtsinger, L J

    1993-06-01

    We report a 31-year-old diabetic woman who underwent carpal tunnel release for median nerve compression followed by a laparoscopic tubal ligation. The procedure was complicated by a severe postoperative necrotizing fasciitis infection of the carpal tunnel release incision. This has not been previously reported. The wound was poorly responsive to antibiotic therapy and serial wound debridements. Control of the woman's infection required total excision of the palmar skin and fascia. Complicating factors in this case included the woman's long history of insulin-dependent diabetes and a concomitant clean-contaminated procedure.

  13. Necrotizing Soft Tissue Infections: Surgeon's Prospective

    PubMed Central

    Mishra, Shashi Prakash; Gupta, Sanjeev Kumar

    2013-01-01

    Necrotizing soft tissue infections (NSTIs) are fulminant infections of any layer of the soft tissue compartment associated with widespread necrosis and systemic toxicity. Delay in diagnosing and treating these infections increases the risk of mortality. Early and aggressive surgical debridement with support for the failing organs significantly improves the survival. Although there are different forms of NSTIs like Fournier's gangrene or clostridial myonecrosis, the most important fact is that they share common pathophysiology and principles of treatment. The current paper summarizes the pathophysiology, clinical features, the diagnostic workup required and the treatment principles to manage these cases. PMID:24455410

  14. The surgical management of necrotizing enterocolitis.

    PubMed

    Kastenberg, Zachary J; Sylvester, Karl G

    2013-03-01

    Necrotizing enterocolitis (NEC), a common cause of neonatal morbidity and mortality, is strongly associated with prematurity and typically occurs following initiation of enteral feeds. Mild NEC is adequately treated by cessation of enteral feeding, empiric antibiotics, and supportive care. Approximately 50% of affected infants will develop progressive intestinal necrosis requiring urgent operation. Several surgical techniques have been described, but there is no clear survival benefit for any single operative approach. While debate continues regarding the optimal surgical management for infants with severe NEC, future progress will likely depend on the development of improved diagnostic tools and preventive therapies. PMID:23415269

  15. Necrotizing sialometaplasia involving the nasal cavity.

    PubMed

    Maisel, R H; Johnston, W H; Anderson, H A; Cantrell, R W

    1977-03-01

    Necrotizing sialometaplasia is a disease process which affects minor salivary glands. It may clinically and microscopically resemble squamous cell or mucoepidermoid carcinoma but is histologically benign. Thirteen patients with this process occurring on the hard palate have been reported in the past two years. We describe two cases in the nasal cavity and propose that compromise of the blood supply contributed to the occurrence of these lesions. This apparently benign lesion may represent nonspecific reaction of salivary and mucous glands to ischemic injury and must be distinguished from carcinoma.

  16. Growth of Necrotic Cores in Vulnerable Plaque

    NASA Astrophysics Data System (ADS)

    Fok, Pak-Wing

    2011-03-01

    Plaques are fatty deposits that grow mainly in arteries and develop as a result of a chronic inflammatory response. Plaques are called vulnerable when they are prone to mechanical rupture. Vulnerable Plaques (VPs) are characterized by lipid-rich, necrotic cores that are heavily infiltrated with macrophages. The rupture of VPs releases thrombogenic agents into the bloodstream, usually resulting in myocardial infarctions. We propose a quantitative model to predict the development of a plaque's necrotic core. By solving coupled reaction-diffusion equations for macrophages and dead cells, we explore the joint effects of hypoxic cell death and chemo-attraction to Ox-LDL, a molecule that is strongly linked to atherosclerosis. Our model predicts cores that have approximately the right size and shape. Normal mode analysis and subsequent calculation of the smallest eigenvalues allow us to compute the times required for the system to reach its steady state. This study allows us to make quantitative predictions for how quickly vulnerable plaques develop and how their growth depends on system parameters such as chemotactic coefficients and cell death rates.

  17. Necrotic enteritis predisposing factors in broiler chickens.

    PubMed

    Moore, Robert J

    2016-06-01

    Necrotic enteritis in chickens develops as a result of infection with pathogenic strains of Clostridium perfringens and the presence of predisposing factors. Predisposing factors include elements that directly change the physical properties of the gut, either damaging the epithelial surface, inducing mucus production, or changing gut transit times; factors that disrupt the gut microbiota; and factors that alter the immune status of birds. In the past research into necrotic enteritis predisposing factors was directed by the simple hypothesis that low-level colonization of C. perfringens commonly occurred within the gut of healthy chickens and the predisposing factors lead to a proliferation of those bacteria to produce disease. More recently, with an increasing understanding of the major virulence factors of C. perfringens and the application of molecular techniques to define different clades of C. perfringens strains, it has become clear that the C. perfringens isolates commonly found in healthy chickens are generally not strains that have the potential to cause disease. Therefore, we need to re-evaluate hypotheses regarding the development of disease, the origin of disease causing isolates of C. perfringens, and the importance of interactions with other C. perfringens strains and with predisposing factors. Many predisposing factors that affect the physical and immunological characteristics of the gastrointestinal tract may also change the resident microbiota. Research directed towards defining the relative importance of each of these different actions of predisposing factors will improve the understanding of disease pathogenesis and may allow refinement of experiment disease models. PMID:26926926

  18. Necrotic enteritis predisposing factors in broiler chickens.

    PubMed

    Moore, Robert J

    2016-06-01

    Necrotic enteritis in chickens develops as a result of infection with pathogenic strains of Clostridium perfringens and the presence of predisposing factors. Predisposing factors include elements that directly change the physical properties of the gut, either damaging the epithelial surface, inducing mucus production, or changing gut transit times; factors that disrupt the gut microbiota; and factors that alter the immune status of birds. In the past research into necrotic enteritis predisposing factors was directed by the simple hypothesis that low-level colonization of C. perfringens commonly occurred within the gut of healthy chickens and the predisposing factors lead to a proliferation of those bacteria to produce disease. More recently, with an increasing understanding of the major virulence factors of C. perfringens and the application of molecular techniques to define different clades of C. perfringens strains, it has become clear that the C. perfringens isolates commonly found in healthy chickens are generally not strains that have the potential to cause disease. Therefore, we need to re-evaluate hypotheses regarding the development of disease, the origin of disease causing isolates of C. perfringens, and the importance of interactions with other C. perfringens strains and with predisposing factors. Many predisposing factors that affect the physical and immunological characteristics of the gastrointestinal tract may also change the resident microbiota. Research directed towards defining the relative importance of each of these different actions of predisposing factors will improve the understanding of disease pathogenesis and may allow refinement of experiment disease models.

  19. Necrotizing Autoimmune Myopathy: A Unique Subset of Idiopathic Inflammatory Myopathy.

    PubMed

    Carroll, Matthew B; Newkirk, Michelle R; Sumner, Nathan S

    2016-10-01

    Necrotizing autoimmune myopathy (NAM) is a recently recognized entity within the spectrum of idiopathic inflammatory myopathies. Diagnosis critically rests on histopathologic demonstration of macrophage predominant myocyte destruction, with few to no lymphocytes. We report our experience with identifying and treating this subset of inflammatory myositis, highlighting the importance of muscle biopsy in diagnosis, association with statin use and malignancy, and challenges of therapy.We present 3 cases that presented to 2 hospitals within our academic system in calendar year 2014 with acute/subacute onset of profound proximal muscle weakness and markedly elevated creatine kinase levels. All patients had been exposed to statins for varying periods. While each electromyogram (EMG) study showed changes with a diffuse inflammatory myopathy, it was not until muscle biopsy was performed when histopathologic features consistent with NAM solidified the diagnosis in all 3 cases. While high-dose glucocorticoids helped provide some degree of improvement in symptoms, none of our cases returned to their preillness baseline independent functioning. Additional immunosuppressive therapy was considered in each case but limited because of comorbidities.These cases demonstrate the importance of pursuing muscle biopsy in all patients with proximal muscle weakness and markedly elevated creatine kinase levels. While symptoms appear consistent with polymyositis, only through muscle biopsy can the diagnosis of NAM be made. Statins have been implicated in NAM, acting through an antibody-dependent mechanism. Combination immunosuppressive therapy has been advocated, but our patient's comorbidities precluded safe use of medications beyond glucocorticoids. PMID:27660937

  20. How are necrotic cells recognized by their predators?

    PubMed

    Li, Zao; Zhou, Zheng

    2016-01-01

    Necrosis is a type of cell death often caused by cell injury and is linked to human diseases including neuron degeneration, stroke, and cancer. Cells undergoing necrosis are engulfed and degraded by engulfing cells, their predators. The mechanisms by which necrotic cells are recognized and removed remain elusive. Here we comment on our recent findings that reveal new molecular mechanisms of necrotic-cell recognition. Through studying the C. elegans touch neurons undergoing excitotoxic necrosis, we identified a receptor/ligand pair that enables engulfing cells to recognize necrotic neurons. The phagocytic receptor CED-1 is activated through interaction with its ligand phosphatidylserine (PS), exposed on the surface of necrotic cells. Furthermore, against the common belief that necrotic cells have ruptured plasma membrane, we found that necrotic C. elegans touch neurons actively present PS on their outer surfaces while maintaining plasma membrane integrity. We further identified 2 mechanisms governing the presentation of PS, one of which is shared with cells undergoing apoptosis, a "cell suicide" event, whereas the other is unique to necrotic neurons. The influx of Ca(2+), a key necrosis-triggering factor, is implicated in activating a neuronal PS-scramblase for PS exposure. We propose that the mechanisms controlling PS-exposure and necrotic-cell recognition by engulfing cells are likely conserved from worms to humans. PMID:27073733

  1. Case 11: large, infected, necrotic mixed-aetiology leg ulcer.

    PubMed

    Price, Juliet; Boulton, Zoe

    2016-03-01

    This painful and malodorous ulcer was covered with 40% necrotic tissue. Combined use of octenilin Wound gel and Wound Irrigation Solution gently debrided the necrotic tissue, and helped reduce the pain and malodour. Within 6 weeks, the wound was covered with granulation tissue. PMID:26949855

  2. Case 9: heavily exuding, malodorous, necrotic pressure ulcer.

    PubMed

    Simon, Deborah

    2016-03-01

    In this case, the necrotic tissue was so hard it was not possible to categorise the ulcer. Octenilin products were able to debride the necrotic tissue, so that the wound depth could be determined. After 4 weeks, the wound was covered with granulation tissue, improving the patient's quality of life.

  3. Carbohydrate maldigestion induces necrotizing enterocolitis in preterm pigs

    PubMed Central

    Thymann, Thomas; Møller, Hanne K.; Stoll, Barbara; Støy, Ann Cathrine F.; Buddington, Randal K.; Bering, Stine B.; Jensen, Bent B.; Olutoye, Oluyinka O.; Siggers, Richard H.; Mølbak, Lars; Sangild, Per T.

    2009-01-01

    Necrotizing enterocolitis (NEC) remains the most severe gastrointestinal disorder in preterm infants. It is associated with the initiation of enteral nutrition and may be related to immature carbohydrate digestive capacity. We tested the hypothesis that a formula containing maltodextrin vs. a formula containing lactose as the principal source of carbohydrate would predispose preterm pigs to a higher NEC incidence. Cesarean-derived preterm pigs were given total parenteral nutrition for 48 h followed by total enteral nutrition with a lactose-based (n = 11) or maltodextrin-based (n = 11) formula for 36 h. A higher incidence (91% vs. 27%) and severity (score of 3.3 vs. 1.8) of NEC were observed in the maltodextrin than in the lactose group. This higher incidence of NEC in the maltodextrin group was associated with significantly lower activities of lactase, maltase, and aminopeptidase; reduced villus height; transiently reduced in vivo aldohexose uptake; and reduced ex vivo aldohexose uptake capacity in the middle region of the small intestine. Bacterial diversity was low for both diets, but alterations in bacterial composition and luminal concentrations of short-chain fatty acids were observed in the maltodextrin group. In a second study, we quantified net portal absorption of aldohexoses (glucose and galactose) during acute jejunal infusion of a maltodextrin- or a lactose-based formula (n = 8) into preterm pigs. We found lower net portal aldohexose absorption (4% vs. 42%) and greater intestinal recovery of undigested carbohydrate (68% vs. 27%) in pigs acutely perfused with the maltodextrin-based formula than those perfused with the lactose-based formula. The higher digestibility of the lactose than the maltodextrin in the formulas can be attributed to a 5- to 20-fold higher hydrolytic activity of tissue-specific lactase than maltases. We conclude that carbohydrate maldigestion is sufficient to increase the incidence and severity of NEC in preterm pigs. PMID:19808655

  4. Three-dimensional statistical model for gingival contour reconstruction.

    PubMed

    Wu, Ting; Liao, Wenhe; Dai, Ning

    2012-04-01

    Optimal gingival contours around restored teeth and implants are of critical importance for restorative success and esthetics. This paper describes a novel computer-aided methodology for building a 3-D statistical model of gingival contours from a 3-D scan dental dataset and reconstructing missing gingival contours in partially edentulous patients. The gingival boundaries were first obtained from the 3-D dental model through a discrete curvature analysis and shortest path searching algorithm. Based on the gingival shape differential characteristics, the boundaries were demarcated to construct the gingival contour of each individual tooth. Through B-spline curve approximation to each gingival contour, the control points of the B-spline curves are used as the shape vector for training the model. Statistical analysis results demonstrate that the method can give a simple but compact model that effectively capture the most important variations in arch width and shape as well as gingival morphology and position. Within this statistical model, the morphologically plausible missing contours can be inferred based on a nonlinear optimization fitting from the global similarity transformation, the model shape deformation and a Mahalanobis prior. The reconstruction performance is evaluated through large simulated experimental data and a real patient case, which demonstrates the effectiveness of this approach.

  5. 21 CFR 872.1500 - Gingival fluid measurer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Gingival fluid measurer. 872.1500 Section 872.1500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Diagnostic Devices § 872.1500 Gingival fluid measurer. (a)...

  6. Mucopolysaccharidosis type VI in a juvenile miniature schnauzer dog with concurrent hypertriglyceridemia, necrotizing pancreatitis, and diabetic ketoacidosis

    PubMed Central

    Pérez, Mayrim L.; Kridel, Heather A.; Gallagher, Alex; Sheppard, Barbara J.; Reese, Shona; Kondo, Hirotaka; Alleman, Rick; Giger, Urs

    2015-01-01

    A 7-month-old, neutered male miniature schnauzer dog with a history of cryptorchidism and umbilical hernia was referred for diabetic ketoacidosis. Clinical evaluation revealed stunted growth, skeletal abnormalities, hypertriglyceridemia, diabetic ketoacidosis, and acute necrotizing pancreatitis. Further testing was diagnostic for mucopolysaccharidosis type VI causing the stunted growth and skeletal deformities, but no connection between mucopolysaccharidosis type VI, hypertriglyceridemia, and pancreatic diseases was found. PMID:25750448

  7. Severe gingival overgrowth associated with cyclosporine therapy.

    PubMed

    Rostock, M H; Fry, H R; Turner, J E

    1986-05-01

    A case of severe gingival overgrowth secondary to cyclosporine therapy in a 19-year-old black male who received a liver allograft transplant is reported. Clinical examination revealed a severely overgrown and inflamed gingiva. Surgical excision of the excess tissue was accomplished under general anesthesia. Healing occurred uneventfully, with acceptable contours; however, some regrowth was evident as early as 2 months. Spontaneous repositioning of the teeth was also seen postoperatively. Examination of the excised tissues revealed alternating areas of dense collagen and myxomatous change. An inflammatory infiltrate primarily of plasma cells was present. There was no evidence of an increased number of fibroblasts in the specimens examined.

  8. Necrotizing enterocolitis in premature infants and newborns.

    PubMed

    Mϋller, M J; Paul, T; Seeliger, S

    2016-09-16

    Necrotizing enterocolitis (NEC) is the most common acquired disease of the gastrointestinal tract (GIT) in premature infants and newborns. It is defined as an ulcerative inflammation of the intestinal wall. The clinical signs of incipient NEC are often very discrete, and range from localized intestinal symptoms to generalized signs of sepsis. NEC is classified depending on its severity into disease states according to the modified Bell's Classification. Treatment of NEC ranges, depending on its severity, from a conservative therapeutic approach to surgery with resection of the affected parts of the intestine. Mortality is considerably high in extremely small preterm infants reaching up to 42% of the affected children. Measures such as breastfeeding or alternatively nutrition with pasteurized human donor milk from a milk bank, administration of probiotics, avoidance of histamine type II receptor antagonists, and restrictive antibiotic treatment should be considered early on for prevention of NEC. PMID:27589549

  9. Cutaneous necrotizing vasculitis. Relation to systemic disease.

    PubMed

    Lotti, T M; Comacchi, C; Ghersetich, I

    1999-01-01

    Cutaneous necrotizing vasculitis (CNV) is a complex multisystem disease generally involving the skin and mucous membranes, often accompanied by renal, gastrointestinal, pericardial, neurological, and articular signs and symptoms. CNV may be idiopatical or occur in association with a drug, infection, or underlying disease. CNV has been shown in patients with chronic infections (viral, bacterial, protozoa, helminthic), serum sickness, a variety of collagen vascular diseases (systemic lupus erythematous, Sjögren's syndrome, rheumatoid arthritis, Behçet's disease) hyperglobulinemic states, cryoglobulinemia, bowel bypass syndrome, ulcerative colitis, cystic fibrosis, primary biliary cirrhosis and HIV infection. Association with malignancies is not frequent. Lymphoproliferative disorders (Hodgkin's disease, mycosis fungoides, lymphosarcoma, adult T-cell leukemia, multiple mieloma) and solid tumors (lung cancer, colon carcinoma, renal, prostate, head and neck cancer and breast cancer) may be associated with CNV. Whenever possible, treatment is directed at the elimination of the cause. In other cases after adequate laboratory screening local and systemic therapy are recommended. PMID:10599332

  10. Cervical Necrotizing Fasciitis Caused by Dental Infection

    PubMed Central

    Song, Chi-Woong; Yoon, Hyun-Joong; Jung, Da-Woon; Lee, Sang-Hwa

    2014-01-01

    Necrotizing fasciitis (NF) is defined as rapidly progressive necrosis of subcutaneous fat and fascia. Although NF of the face is rare, its mortality rate is nearly 30%. It usually originates from dental infection and can lead to involvement of the neck, mediastinum, and chest wall. Complications resulting from pre-existing systemic diseases can increase the mortality rate. Known complication factors for NF include diabetes, malnutrition, advanced age, peripheral vascular disease, renal failure, and obesity. Here, we report a case of NF originating from dental infection in an 88-year-old woman already diagnosed with hypertension, thoracic aortic aneurysm, and renal diseases. Such conditions limited adequate surgical and antibiotic treatment. However, interdisciplinary treatment involving multiple departments was implemented with good results. PMID:27489813

  11. Epizootic necrotic enteritis in wild geese.

    PubMed

    Wobeser, G; Rainnie, D J

    1987-07-01

    Outbreaks of a disease characterized by severe necrotic enteritis occurred among Canada geese (Branta canadensis), lesser snow geese (Anser caerulescens), Ross' geese (A. rossi), and white-fronted geese (A. albifrons) on lakes in Saskatchewan and Manitoba during the autumn of 1983, 1984 and 1985. Ducks using the lakes were apparently not affected. Lesions in the geese closely resembled those described in enteritides in other species associated with the proliferation of Clostridium perfringens in the small intestine. Clostridium perfringens was present in large numbers in the affected areas of the intestine of the geese; other pathogens were not identified. It is hypothesized that an abrupt change in diet as geese begin to feed on grain disrupts the intestinal microflora, allowing C. perfringens to proliferate in the upper small intestine. Toxins produced by the bacteria then cause mucosal necrosis. Protease-inhibitory substances in some grains might also have a role in the disease. PMID:3625893

  12. Necrotizing granulomatous inflammation of the glans penis.

    PubMed

    Christodoulidou, Michelle; Bunker, Christopher B; Trevisan, Giorgia; Muneer, Asif

    2016-01-01

    We describe the case of a 73-year-old man who presented with a 10-month history of an ulcerating lesion on the glans penis. Initially this was thought to be an invasive squamous cell carcinoma but a biopsy showed histological features consistent with necrotizing granulomatous inflammation. Extensive serological, immunological and microbiological tests only showed a positive antinuclear and perinuclear antineutrophil cytoplasmic antibodies indicating a possible autoimmune aetiology but an underlying systemic cause was not identified. Treatment with oral corticosteroids limited the inflammatory process but due to the gross destruction of the glans penis, he still required a glansectomy and split-skin graft reconstruction from which he recovered well. Although this patient ultimately required surgery for this rare presentation, this case highlights the differential diagnosis of penile ulceration (that transcends neoplasia) and the importance of performing and interpreting penile biopsies before undertaking potentially mutilating definitive surgery. PMID:27558192

  13. Effect of Periodontal Surgery on Osteoprotegerin Levels in Gingival Crevicular Fluid, Saliva, and Gingival Tissues of Chronic Periodontitis Patients

    PubMed Central

    Hassan, Sandy H. S.; El-Refai, Mahmoud I.; Ghallab, Noha A.; Kasem, Rehab Fawzy; Shaker, Olfat G.

    2015-01-01

    Objectives. This study was undertaken to investigate the OPG profiles in gingival crevicular fluid (GCF), saliva, and gingival tissues of chronic periodontitis (CP) patients in response to open flap debridement (OFD). Subjects and Methods. The study included 30 subjects divided into 2 groups: 20 CP patients and 10 periodontally healthy subjects. Plaque index, gingival index, pocket depth, and clinical attachment level measurements were recorded for all subjects. GCF, salivary, and gingival samples were collected from all 30 subjects at baseline and 3 and 6 month after OFD from the 20 CP patients. GCF and salivary OPG levels were assessed by ELISA assay, while OPG expression in gingival tissues was examined by immunohistochemistry. Results. GCF, salivary and gingival OPG profiles were significantly higher in control subjects compared to CP patients at baseline (P < 0.001). Within CP group, OPG levels in GCF, saliva, and gingival samples showed a significant increase at 3 and 6 months after OFD (P < 0.001) compared to baseline. Although OPG values increased significantly in gingival samples and insignificantly in saliva after 3 months compared to 6 months, yet GCF levels were significantly decreased. Conclusions. OPG might be considered as a diagnostic and prognostic biomarker of periodontal bone destruction. This trial is registered with NCT02160613. PMID:25814780

  14. Evaluation of Toothpaste Containing Aqueous Saffron Stigma Extract on Gingival Indices in Patients with Marginal Generalized Plaque-Induced Gingivitis

    PubMed Central

    Forouzanfar, Ali; Mokhtari, Majid Reza; Kamalinezhad, Mohammad; Babayian, Mohammad; Tavakoli-Kakhki, Mandana; Lotfalizadeh, Mohammad Hasan

    2016-01-01

    Background: Gingivitis is an inflammatory disease involving the gums. Saffron contains various forms of flavonoids, glycosides, and anthocyanin compounds that are proven to have anti-inflammatory and antioxidant effects. This study evaluates the anti-inflammatory effects of Saffron stigma on gingival indices in patients with marginal generalized plaque-induced gingivitis. Methods: For this study, we used toothpaste containing aqueous extract of Saffron stigma. Twenty-two patients with generalized marginal gingivitis were selected. Patients were randomly divided into two equal groups of test and placebo. In each group the pocket depth index (PD), gingival index (GI), plaque index (PI) and bleeding of probing index (BOP) were measured before and one month after use. Independent t-test, Mann–Whitney test and Wilcoxon test were used for statistical analysis (P<0.05). Results: The comparison between gingival indices before and one month after toothpaste usage showed a significant decrease in some measured indices at the end of the study. Saffron stigma treated group had a significant difference in reducing GI and BOP indices in comparison with the placebo group (P<0.05). However, the difference for PD and PI indices was not statistically significant (P>0.05). Conclusion: In this study, it was found that using aqueous extract of Saffron stigma flower containing toothpaste might have a positive effect on some gingival indices in patients with gingivitis. PMID:27516664

  15. Acute Pancreatitis

    PubMed Central

    Geokas, Michael C.

    1972-01-01

    For many decades two types of acute pancreatitis have been recognized: the edematous or interstitial and the hemorrhagic or necrotic. In most cases acute pancreatitis is associated with alcoholism or biliary tract disease. Elevated serum or urinary α-amylase is the most important finding in diagnosis. The presence of methemalbumin in serum and in peritoneal or pleural fluid supports the diagnosis of the hemorrhagic form of the disease in patients with a history and enzyme studies suggestive of pancreatitis. There is no characteristic clinical picture in acute pancreatitis, and its complications are legion. Pancreatic pseudocyst is probably the most common and pancreatic abscess is the most serious complication. The pathogenetic principle is autodigestion, but the precise sequence of biochemical events is unclear, especially the mode of trypsinogen activation and the role of lysosomal hydrolases. A host of metabolic derangements have been identified in acute pancreatitis, involving lipid, glucose, calcium and magnesium metabolism and changes of the blood clotting mechanism, to name but a few. Medical treatment includes intestinal decompression, analgesics, correction of hypovolemia and other supportive and protective measures. Surgical exploration is advisable in selected cases, when the diagnosis is in doubt, and is considered imperative in the presence of certain complications, especially pancreatic abscess. PMID:4559467

  16. [Characteristics of domestically produced siloxane elastomer for making elastic gingival prosthetic device].

    PubMed

    Riakhovskiĭ, A N; Poiurovskaia, I Ia; Kirillova, E V

    2006-01-01

    Gingival prosthetics effectively eliminates esthetic and phonetic disturbances in cases of pronounced gingival recession. Technology for making elastic gingival prosthetic devices of domestically produced siloxane elastomer composition with microwave siloxane vulcanization is described as well as the technique for making combined gingival prosthetics of siloxane composition and colorless plastic. PMID:16482030

  17. Foreign body gingivitis: An iatrogenic disease

    SciTech Connect

    Daley, T.D.; Wysocki, G.P. )

    1990-06-01

    Gingival biopsy specimens from eight patients exhibiting a localized, erythematous, or mixed erythematous/leukoplakic gingivitis that was refractory to conventional periodontal therapy were examined histologically and by energy-dispersive X-ray microanalysis. Histologic examination revealed variable numbers of small, usually subtle, sometimes equivocal, and occasionally obvious foci of granulomatous inflammation. Special stains for fungi and acid-fast bacilli were consistently negative. In all cases, the granulomatous foci contained particles of foreign material that were often inconspicuous and easily overlooked during routine histologic examination. Energy-dispersive X-ray microanalysis of these foreign particles disclosed Ca, Al, Si, Ti, and P in most lesions. However, other elements such as Zr, V, Ag, and Ni were found only in specific biopsy specimens. By comparing the elemental analyses, clinical features, and history of the lesions, strong evidence for an iatrogenic source of the foreign material was found in one case, and good evidence in five cases. In the remaining two patients, the source of the foreign particles remains unresolved.

  18. Gingival Diseases in Childhood – A Review

    PubMed Central

    Ilango, Paavai; Subbareddy, Venkat; Katamreddy, Vineela; Parthasarthy, Harinath

    2014-01-01

    Children and adolescents are subject to a wide variety of gingival infections. Epidemiological studies indicate that gingivitis of varying severity is nearly a universal finding in children and adolescents. The shorter life span of the primary dentition may be the reason why in general little attention is given to periodontitis in children. Since early diagnosis is important for successful treatment, it is imperative that children receive a periodontal examination as part of their routine dental visit. Furthermore destructive periodontal disease occurs in children with certain systemic diseases. Indeed the presence of severe periodontitis may be an early sign of systemic disease. A general medical evaluation to determine if systemic diseases are present should be considered in children who exhibit severe periodontitis, especially if the disease appears resistant to therapy. Though periodontal health awareness and therapy are increasing day by day in our country compared to earlier days, it is much restricted to adults rather than children. Oral cavity examination in children is much oriented in hard tissue evaluation than soft tissue health. Hence, this article enlightens about the prevalence of various soft tissue diseases and importance of long term overall oral health maintenance in childhood. PMID:25478471

  19. Untypical amlodipine-induced gingival hyperplasia.

    PubMed

    Pavlic, Verica; Zubovic, Nina; Ilic, Sanja; Adamovic, Tijana

    2015-01-01

    Amlodipine is a third generation dihydropyridine calcium channel blocker that is frequently used in therapy of hypertension. Among many side effects, amlodipine has been found associated with gingival overgrowth (GO) which usually occurs within the first three months of starting therapy at a dose of 10 mg/day. However, there are very few reports on amlodipine-induced gingival overgrowth (AIGO) at a lower dose (5 mg/day) and only after short term administration. A 64-year-old male patient with hypertension, who received amlodipine (5 mg/day) for four years, sought medical attention at the Department of Periodontology and Oral Medicine, Institute of Dentistry, Banja Luka, Bosnia and Herzegovina. The patient complained of masticatory problems due to extensive maxillary GO along with pain, bleeding, and foul odor. The clinical and the histological evidences were consistent with AIGO. The first line treatment consisted of the amlodipine substitution (amlodipine was replaced with enalapril, 5 mg/day) and the scaling and root planning/SRP. At one-month follow-up, drug replacement and SRP resulted in some reduction of the inflammation and significant reduction of symptoms. Further, gingivectomy/gingivoplasty helped overcome the effect of these drugs. The possibility of AIGO should be considered for a lower dose, as well as a late presentation.

  20. Gingival diseases in childhood - a review.

    PubMed

    Pari, Arul; Ilango, Paavai; Subbareddy, Venkat; Katamreddy, Vineela; Parthasarthy, Harinath

    2014-10-01

    Children and adolescents are subject to a wide variety of gingival infections. Epidemiological studies indicate that gingivitis of varying severity is nearly a universal finding in children and adolescents. The shorter life span of the primary dentition may be the reason why in general little attention is given to periodontitis in children. Since early diagnosis is important for successful treatment, it is imperative that children receive a periodontal examination as part of their routine dental visit. Furthermore destructive periodontal disease occurs in children with certain systemic diseases. Indeed the presence of severe periodontitis may be an early sign of systemic disease. A general medical evaluation to determine if systemic diseases are present should be considered in children who exhibit severe periodontitis, especially if the disease appears resistant to therapy. Though periodontal health awareness and therapy are increasing day by day in our country compared to earlier days, it is much restricted to adults rather than children. Oral cavity examination in children is much oriented in hard tissue evaluation than soft tissue health. Hence, this article enlightens about the prevalence of various soft tissue diseases and importance of long term overall oral health maintenance in childhood. PMID:25478471

  1. Idiopathic gingival enlargement associated with generalized aggressive periodontitis in a 19-year-old female

    PubMed Central

    Shetty, Arvind; Gupta, Neha; Shetty, Devanand; Kadakia, Rukshit

    2014-01-01

    Gingival enlargement, one of the manifestations of gingival and periodontal disease, is also known as gingival overgrowth. Idiopathic gingival enlargement is a rare gingival overgrowth, which is of an undetermined cause. This unknown etiology has now been linked to specific genes and idiopathic gingival enlargement is at times referred to as hereditary gingival enlargement. This condition is a benign, slow growing proliferation of gingival tissues. Aggressive periodontitis is the rapid form of periodontal disease which is characterized by extensive periodontal tissue destruction, increased host-susceptibility toward periodontal disease progress and a genetic predilection toward disease occurrence. We present a rare case of idiopathic gingival fibromatosis associated with generalized aggressive periodontitis in a young female. The patient presented with classic clinical and radiographic presentation associated with gingival enlargement and aggressive periodontitis. The diagnosis was then confirmed by histopathological and neutrophil functions tests. PMID:24872638

  2. Necrotizing fasciitis of the nose complicated with cavernous sinus thrombosis.

    PubMed

    Swaminath, D; Narayanan, R; Orellana-Barrios, M A; Temple, B

    2014-01-01

    Necrotizing fasciitis is a rapidly progressive life threatening bacterial infection of the skin, the subcutaneous tissue, and the fascia. We present a case of necrotizing fasciitis involving the nose complicated by cavernous sinus thrombosis. Few cases of septic cavernous sinus thrombosis have been reported to be caused by cellulitis of the face but necrotizing fasciitis of the nose is rare. It is very important to recognize the early signs of cavernous thrombosis. Treatment for septic cavernous sinus thrombosis is controversial but early use of empirical antibiotics is imperative. PMID:24876978

  3. Polymicrobial abdominal wall necrotizing fasciitis after cesarean section.

    PubMed

    DeMuro, Jp; Hanna, Af; Chalas, E; Cunha, Ba

    2012-09-01

    We report a case of a previously healthy woman after an uneventful caesarean section who developed polymicrobial necrotizing fasciitis. She was given a non-steroidal anti-inflamatory drug (NSAID) after her delivery. Her post-delivery course was complicated by septic shock, and required multiple debridements before abdominal reconstruction. This case describes the increased risk of necrotizing fasciitis with NSAID use. Unusual were the organisms causing the polymicrobial necrotizing fasciitis: Staphylococcus aureus, Enterobacter agglomerans, Acinetobacter baumannii, and two strains of Enterobacter cloacae.

  4. The use of maggots in head and neck necrotizing fasciitis.

    PubMed

    Dunn, Christopher; Raghavan, Ullas; Pfleiderer, A G

    2002-01-01

    Historically maggots have been used to clean necrotic war wounds. With the ready availability of sterile maggots, they are being used increasingly in surgical practice. Although maggots have most frequently been employed in the management of necrotic wounds and ulcers involving the lower limb, we have identified a particularly useful application in the head and neck and describe a case in which maggots played a significant part in the successful treatment of a florid necrotizing cervical fasciitis in a patient, who was unfit for repeated surgical debridement.

  5. Chronic gingivitis: the prevalence of periodontopathogens and therapy efficiency.

    PubMed

    Igic, M; Kesic, L; Lekovic, V; Apostolovic, M; Mihailovic, D; Kostadinovic, L; Milasin, J

    2012-08-01

    The purpose of this study was to determine the level of gingival inflammation and the prevalence of periodontopathogenic microorganisms in adolescents with chronic gingivitis, as well as to compare the effectiveness of two approaches in gingivitis treatment-basic therapy alone and basic therapy + adjunctive low-level laser therapy (LLLT). After periodontal evaluation, the content of gingival pockets of 140 adolescents with gingivitis was analyzed by multiplex PCR for the presence of P. gingivalis, A. actinomycetemcomitans, T. forsythensis and P. intermedia. Subsequent to bacteria detection, the examinees were divided into two groups with homogenous clinical and microbiological characteristics. Group A was subjected to basic gingivitis therapy, and group B underwent basic therapy along with adjunctive LLLT. A statistically significant difference between the values of plaque-index (PI) and sulcus bleeding index (SBI) before and after therapy was confirmed in both groups (p<0.001), though more pronounced in group B. Following therapy, the incidence of periodontopathogenic microorganisms decreased considerably. The best result was obtained in P. gingivalis eradication by combined therapy (p=0.003). The presence of periodontopathogens in adolescents with gingivitis should be regarded as a sign for dentists to foster more effective oral health programs. LLLT appears to be beneficial as adjuvant to basic therapy.

  6. Lymphocyte subpopulation in healthy and diseased gingival tissue

    PubMed Central

    Amunulla, Aniz; Venkatesan, Remya; Ramakrishnan, Hemalatha; Arun, K. V.; Sudarshan, Subitha; Talwar, Avaneendra

    2008-01-01

    In this study, infiltrating lymphocytes subpopulation in gingival sections of healthy, inflamed, and periodontitis lesions was investigated. A set of cluster of differentiation (CD) antigen specific monoclonal/polyclonal antibodies to detect different cell types within the tissues was used. These included anti-CD3 (pan T-cell), anti-CD45RO (memory T-cell), anti-CD20 (B-cell), and kappa light chain (plasma cells). Biopsies of gingival tissue were obtained from 17 patients who had clinically healthy gingiva, from 18 patients with gingivitis, and 17 patients with periodontitis. A significantly greater proportion of T-cells (P < 0.00) was observed in healthy gingival and gingivitis tissue samples compared to periodontitis tissue samples. In addition, a greater proportion of B-cells was observed in periodontitis lesions than in the gingival lesions (P < 0.00). The memory T-cells and the kappa light-chain plasma cells were present in both healthy and diseased tissues, suggestive of previous activation by periodontal pathogenic microorganisms. In conclusion, these differences in the relative proportions of B- and T-cells may reflect a difference in the immunopathology of periodontitis and gingivitis lesions. PMID:20142944

  7. Contribution of nitrergic nerve in canine gingival reactive hyperemia

    PubMed Central

    Shimada, Shigeru; Todoki, Kazuo; Omori, Yoichi; Toyama, Toshizo; Matsuo, Masato; Wada-Takahashi, Satoko; Takahashi, Shun-suke; Lee, Masaichi-Chang-il

    2015-01-01

    Reactive hyperemia reflects a compensatory vasodilation response of the local vasculature in ischemic tissue. The purpose of this study is to clarify the mechanism of regulation of this response in gingival circulation by using pharmacological analysis of reactive hyperemia and histochemical analysis of gingival tissue. Application of pressure to the gingiva was used to create temporary ischemia, and gingival blood flow was measured after pressure release. Reactive hyperemia increased in proportion to the duration of pressure. Systemic hemodynamics remained unaffected by the stimulus; therefore, the gingival reactive hyperemia reflected a local adjustment in circulation. Gingival reactive hyperemia was significantly suppressed by nitric oxide (NO) synthase inhibitors, especially the neural NO synthase-selective antagonist 7-nitroindazole, but not by anticholinergic drugs, β-blockers, or antihistaminergic drugs. Moreover, immunohistochemical staining for neural NO synthase and histochemical staining for NADPH diaphorase activity were both positive in the gingival perivascular region. These histochemical and pharmacological analyses show that reactive hyperemia following pressure release is mediated by NO-induced vasodilation. Furthermore, histochemical analysis strongly suggests that NO originates from nitrergic nerves. Therefore, NO may play an important role in the neural regulation of local circulation in gingival tissue ischemia. PMID:25759514

  8. Gingival pigmentation index proposal of a new index with a brief review of current indices

    PubMed Central

    Peeran, Syed Wali; Ramalingam, Karthikeyan; Peeran, Syed Ali; Altaher, Omar Basheer; Alsaid, Fatma Mojtaba; Mugrabi, Marei Hamed

    2014-01-01

    Cosmetic expectations have increased with time and current trends speak volumes about gingival esthetics and smile designing. Gingival pigmentation especially on the labial aspect of anterior teeth has become an important component of general esthetics. Various physiologic and pathologic factors cause gingival pigmentation. The existing indices do not deal with the etiology, extent and severity of gingival pigmentation. Hence, we propose a new classification and index for gingival pigmentation to assess the treatment needs for the patient. PMID:24966785

  9. Gingival fibromatosis with multiple unusual findings: report of a rare case

    PubMed Central

    He, Long; Ping, Fei-Yun

    2012-01-01

    Gingival fibromatosis is a rare disease, especially its syndromic form. Here, we review the literatures on gingival fibromatosis and briefly summarize some characters on clinical, etiological, genetic and histopathological aspects. We also present a rare case of gingival fibromatosis with multiple unusual findings in a 21-year-old man. And we differentiate it from some well-known syndromes including gingival fibromatosis. Maybe it implies a new syndrome within the spectrum of those including gingival fibromatosis. PMID:22955199

  10. Prevalence of gingival enlargement in Karnataka school going children

    PubMed Central

    Krishna, K Bala; Raju, P Krishnam; Chitturi, Radha Raani; Smitha, G; Vijai, S; Srinivas, B V V

    2014-01-01

    Background: Periodontal diseases affect more people all over the world than dental caries. Increase in size of gingiva is known as gingival hyperplasia or gingival enlargement. Gingival swelling is almost universally the result of Fluid accumulation within the tissues. Enlargement and even aesthetically disfiguring over growth of the gingival tissue, is also a common finding of leukemia, scurvy and subjects undergoing the hormonal changes of puberty, pregnancy, menopause and drugs. Materials & Methods: A sample size of 1500 was taken. All children who were between the chronological age of 5-12 years from selected schools were included in the study.Three age groups were selected for the study, Group I: 5-7yrs, Group II: 7-9 yrs, Group III 9-12yrs. Each group comprised of 500 students. The examination of gingival enlargement was made according to Gingival Enlargement Index. The oral hygiene status of the child was examined using Oral Hygiene Index-Simplified. Results: The prevalence of Gingival Enlargement increased with the increase of age. Though the Prevalence of GE in female children (15.1%) was more than male children (13.4%), it was not statistically significant. Female children (1.6%) had a higher prevalence of epilepsy than male children (0.29%) in this present study. Conclusion: The prevalence of gingival enlargement was predominantly inflammatory, showing that the oral hygiene status of the oral Children in Karnataka was far from satisfactory. Further studies need to be undertaken regarding the prevalence if GE in School going children. How to cite the article: Krishna KB, Raju PK, Chitturi RR, Smitha G, Vijai S, Srinivas BV. Prevalence of gingival enlargement in Karnataka school going children. J Int Oral Health 2014;6(1):106-10. PMID:24653613

  11. Predictors of Monomicrobial Necrotizing Soft Tissue Infections

    PubMed Central

    Guidry, Christopher A.; Horn, Christopher B.; Gilsdorf, Daniel; Davies, Stephen W.; Dietch, Zachary C.; Sawyer, Robert G.

    2015-01-01

    Abstract Background: Broad-spectrum antibiotic therapy is critical in the management of necrotizing soft tissue infections (NSTI) in the emergency setting. Clindamycin often is included empirically to cover monomicrobial gram-positive pathogens but probably is of little value for polymicrobial infections and is associated with significant side effects, including the induction of Clostridium difficile colitis. However, there have been no studies predicting monomicrobial infections prior to obtaining cultures. The purpose of this study was to identify independent predictors of monomicrobial NSTI where the use of clindamycin would be most beneficial. We hypothesized that monomicrobial infections are characterized by involvement of the upper extremities and fewer co-morbid diseases. Methods: We reviewed all cases of potential NSTI occurring between 1996 and 2013 in a single tertiary-care center. The infection was diagnosed by the finding of rapidly progressing necrotic fascia during debridement with positive cultures of tissue. Univariable analysis was performed using the Student t-, Wilcoxon rank sum, χ2, and Fisher exact tests as appropriate. Multivariable logistic regression was used to identify independent variables associated with outcomes. Results: A group of 151 patients with confirmed NSTI with complete data was used. Of the monomicrobial infections, 61.8% were caused by Group A streptococci, 20.1% by Staphylococcus aureus, and 12.7% by Escherichia coli. Of the polymicrobial infections, E. coli was involved 13.7% of the time, followed by Candida spp. at 12.9%, and Bacteroides fragilis at 11.3%. On univariable analysis, immunosuppression, upper extremity infection, and elevated serum sodium concentration were associated with monomicrobial infection, whereas morbid obesity and a perineal infection site were associated with polymicrobial infection. On multivariable analysis, the strongest predictor of monomicrobial infection was immunosuppression (odds ratio [OR

  12. Plasma cell gingivitis with severe alveolar bone loss.

    PubMed

    Kumar, Vivek; Tripathi, Amitandra Kumar; Saimbi, Charanjit Singh; Sinha, Jolly

    2015-01-16

    Plasma cell gingivitis is a rare benign condition of the gingiva characterised by sharply demarcated erythaematous and oedematous gingiva often extending up to the muco gingival junction. It is considered a hypersensitive reaction. It presents clinically as a diffuse, erythaematous and papillary lesion of the gingiva, which frequently bleeds, with minimal trauma. This paper presents a case of a 42-year-old man who was diagnosed with plasma cell gingivitis, based on the presence of plasma cells in histological sections, and severe alveolar bone loss at the affected site, which was managed by surgical intervention.

  13. Surgical management of gingival recession: A clinical update

    PubMed Central

    Alghamdi, Hamdan; Babay, Nadir; Sukumaran, Anil

    2009-01-01

    Gingival recession is defined as the apical migration of the junctional epithelium with exposure of root surfaces. It is a common condition seen in both dentally aware populations and those with limited access to dental care. The etiology of the condition is multifactorial but is commonly associated with underlying alveolar morphology, tooth brushing, mechanical trauma and periodontal disease. Given the high rate of gingival recession defects among the general population, it is imperative that dental practitioners have an understanding of the etiology, complications and the management of the condition. The following review describes the surgical techniques to treat gingival recession. PMID:23960465

  14. [Cyclosporine-induced gingival hyperplasia: report of one case].

    PubMed

    Bahamondes, Carlos; Godoy, Jorge

    2007-03-01

    Gingival enlargement can be an adverse effect of cyclosporine A and nifedipine use. It has a high relapse rate if the drugs are not discontinued. There is a genetic predisposition to the development of this condition and dental biofilm can also play a role. We report a 64 years old male who received a renal allograft and was treated with cyclosporine and nifedipine. He required six surgical interventions for generalized gingival enlargement. After the sixth relapse, the patient was subjected to a periodontal treatment to eliminate the dental biofilm, which decreased the rate of recurrence of gingival enlargement. PMID:17505584

  15. [Cyclosporine-induced gingival hyperplasia: report of one case].

    PubMed

    Bahamondes, Carlos; Godoy, Jorge

    2007-03-01

    Gingival enlargement can be an adverse effect of cyclosporine A and nifedipine use. It has a high relapse rate if the drugs are not discontinued. There is a genetic predisposition to the development of this condition and dental biofilm can also play a role. We report a 64 years old male who received a renal allograft and was treated with cyclosporine and nifedipine. He required six surgical interventions for generalized gingival enlargement. After the sixth relapse, the patient was subjected to a periodontal treatment to eliminate the dental biofilm, which decreased the rate of recurrence of gingival enlargement.

  16. [Orthodontic treatment and gingival hyperplasia: a case report].

    PubMed

    Bellamine, M; Ousehal, L; Kissa, J

    2012-06-01

    Gingival hyperplasia is a relatively frequent pathologic condition during orthodontic treatment. Oral hygiene can be easily altered in such cases because of additive and irritative effects of orthodontics appliances. So, adequate control of the gingival inflammation is required. The present case reports on a 13-year-old boy who developed, during orthodontic treatment, a gingival hypertrophy that was successfully treated with periodontal surgery consisting on an apically positioned flap procedure. For this purpose, multidisciplinary approach involving orthodontist and periodontist was crucial in the perspective of optimal clinical issues.

  17. [Behaviour of gingival elastic constituents in periodontal disease].

    PubMed

    Bonnaure-Mallet, M; Apiou, J; Chambon, Y

    1991-01-01

    Disorganization of gingival elastic constituents, including oxytalan fibers, elaunin fibers, and mature elastic fibers, is a feature of periodontal disease. In early stages where inflammation is moderate, this disorganization involves only oxytalan fibers. As the disease progresses, fragmentation and lamination of elaunin fibers and mature elastic fibers is seen. In cyclosporin A-induced gingival hyperplasia, there is a substantial increase in the amount of elastic fibers as compared with healthy gingiva. In gingival fragments from edentulous elderly individuals the elastic constituents form dense granules.

  18. Idiopathic gingival fibromatosis with asymmetrical presentation and electrosurgical management

    PubMed Central

    Pol, Dilip Ganpat; Lobo, Tanya Marguerite; Pol, Samruddhi Dilip

    2016-01-01

    Idiopathic gingival fibromatosis is a rare genetically heterogeneous condition characterized by recurrent gingival enlargement without any identifiable cause. We report a case of 14-year-old female patient affected with sporadic, nonsyndromic, progressive gingival enlargement. It manifested more severely on the right side of the mouth with history of recurrence after prior conventional surgical excision. Electrosurgical resection of the enlargement was done, and overall patient management had a successful outcome along with achieving preservation of teeth with poor prognosis in the 2 years follow-up. PMID:27041849

  19. Measurement of Reduced Gingival Melanosis after Smoking Cessation: A Novel Analysis of Gingival Pigmentation Using Clinical Oral Photographs

    PubMed Central

    Kato, Tomotaka; Takiuchi, Hiroya; Sugiyama, Seiichi; Makino, Michiko; Noguchi, Satoshi; Katayama-Ono, Tomoko; Hanioka, Takashi; Naito, Toru

    2016-01-01

    Background: Due to moisture and the anatomical complexity of the oral mucosa, it is difficult to measure the extent of gingival melanosis in an optical manner. Therefore, we developed a new quantitative method using clinical oral photographs and compared the extent of gingival melanosis before and after smoking cessation. Methods: A new analysis method, which we named the gingival melanosis record (GMR), is a quantitative analysis method using clinical oral photographs. We obtained 659 clinical photographs from 263 patients from 16 general dental offices in Japan. Standardized measuring sites were automatically spotted on the screen, and the presence of gingival melanosis was determined at the measuring sites. We assessed the validity of the GMR with the previously reported Hedin’s classification using Spearman’s rank correlation and intraclass correlation coefficients. Results: The GMR showed a significant association with Hedin’s classification (p < 0.01, correlation coefficient = 0.94). The GMR also showed excellent reproducibility of the substantial repeated agreement intraclass correlation coefficients (ICC) (1,1) and ICC (2,1), p > 0.61). The longitudinal loss of gingival melanosis was confirmed by a change in the GMR among patients who successfully achieved smoking cessation for a mean of 4.5 years. Conclusion: The GMR is an effective method to assess gingival melanosis. The loss of gingival melanosis after smoking cessation can be objectively confirmed with the use of the GMR. PMID:27322294

  20. Systemic necrotizing vasculitides in severe alpha1-antitrypsin deficiency.

    PubMed

    Mazodier, P; Elzouki, A N; Segelmark, M; Eriksson, S

    1996-08-01

    We describe the clinical presentation and outcome in a series of eight patients with systemic necrotizing vasculitis and severe alpha1-antitrypsin (AAT) deficiency followed up at three Swedish hospitals during 1968-92. We also review six other cases reported in the literature during the same period. Diagnosis of severe AAT deficiency was based on the presence of the PiZZ phenotype, or low plasma total trypsin inhibitory capacity, or a low plasma AAT concentration (10-40% of the normal mean value) and presence of the PiSZ or PiFZ phenotype. The diagnosis of systemic vasculitis was biopsy-verified in all eight patients. Pretreatment laboratory findings, treatment protocol, and outcome were reviewed in each of the 14 patients. Of the eight patients in the Swedish series, six had systemic vasculitis of the microscopic polyangiitis form, one had Wegener's granulomatosis, and another had Henoch-Schönlein purpura. In the series as a whole (n = 14), median age at diagnosis was 48 years (range 44-84), the median number of affected organs was eight, and all 14 patients had skin involvement, and either renal or joint involvement (in most cases both); 71% (10/14) had emphysema; 57% (8/14) had hepatic abnormalities (two having cirrhosis, two fibrosis, and one multiple aneurysms in hepatic arteries); one patient who presented with acute ulcerative colitis developed manifest vasculitic syndrome three years later; and 64% (9/14) died, the major cause of death being renal failure. This syndrome, characterized by multiple organ involvement and fatal outcome, has been underdiagnosed. Physicians should be alert to the presence of the PiZ AAT deficiency gene in patients with systemic vasculitis, especially when the course is progressive or when the patient also has emphysema or cirrhosis. Awareness of those features may aid prompt recognition and enable early treatment.

  1. Metabolomic determinants of necrotizing enterocolitis in preterm piglets

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Studies in premature infants and animals show that carbohydrate malabsorption and gut microbiota colonisation are key elements for triggering necrotizing enterocolitis (NEC). Our aim was to determine how dietary carbohydrate composition affects the metabolomic profile and whether unique metabolite s...

  2. Descending necrotizing mediastinitis associated with Lactobacillus plantarum

    PubMed Central

    2013-01-01

    Background Descending necrotizing mediastinitis (DNM), a severe infection with a high fatality rate, develops in mediastinal spaces due mainly to deep cervical abscesses. The majority of causative microbes of DNM are Streptococci and oral anaerobes. DNM associated with Lactobacillus-infection is rather rare. Case presentation A 69-year-old male with an unremarkable past medical history was referred to our hospital for surgical resection of advanced laryngeal cancer. Full examination revealed a neck abscess and DNM with a background of untreated diabetes mellitus. Initially, he was treated with meropenem. However, Lactobacillus plantarum was isolated from surgical drainage of a mediastinal abscess. Despite using antibiotics capable of eradicating all isolates with susceptibilities not differing significantly from those of the neck and mediastinal abscesses, we attributed DNM to the L. plantarum detected only in the mediastinal abscess. After DNM treatment, he underwent total pharyngolaryngectomy with bilateral neck dissection followed by reconstruction using free jejunum. He was discharged fully recovered. Conclusion We concluded that L. plantarum as the sole cause of the mediastinal abscess in the present case cannot be ruled out. As the number of immunocompromised patients increases, we should be cautious regarding this “familiar” microbe. PMID:23987907

  3. Necrotizing Urethritis due to Aerococcus urinae.

    PubMed

    Babaeer, Abdulrahman A; Nader, Claudia; Iacoviello, Vito; Tomera, Kevin

    2015-01-01

    A 49-year-old male presented to the emergency with hematuria and pain in the shaft of the penis for one day. The patient was found to be in a state of shock. The shaft of the penis and the scrotum were swollen and tender. No skin necrosis was observed and no crepitus was palpable. Serum white count (WBC) was 29.5 × 10(3)/μL. A CT scan showed gas in the corpus spongiosum. Antibiotics were started with IV metronidazole, vancomycin, and piperacillin/tazobactam. Metronidazole was then replaced by clindamycin. Exploration was performed but no necrotic tissue was identified. Cystourethroscopy revealed dusky looking urethra. A suprapubic tube and a urethral catheter were placed in the bladder. WBC trended down to 13.9 × 10(3)/μL on the fourth postoperative day. Urine culture grew Aerococcus urinae and blood cultures grew Alpha Hemolytic Streptococcus. On the sixth day, the patient was feeling worse and WBC increased. MRI revealed absent blood flow to the corpus spongiosum. Urethroscopy revealed necrosis of the urethra. Urethrectomy was performed via perineal approach. The patient immediately improved. The patient was discharged on the sixth postoperative day to continue ampicillin/sulbactam IV every 6 hours for a total of 4 weeks from the day of urethrectomy. PMID:26171271

  4. Necrotizing Urethritis due to Aerococcus urinae

    PubMed Central

    Babaeer, Abdulrahman A.; Nader, Claudia; Iacoviello, Vito; Tomera, Kevin

    2015-01-01

    A 49-year-old male presented to the emergency with hematuria and pain in the shaft of the penis for one day. The patient was found to be in a state of shock. The shaft of the penis and the scrotum were swollen and tender. No skin necrosis was observed and no crepitus was palpable. Serum white count (WBC) was 29.5 × 103/μL. A CT scan showed gas in the corpus spongiosum. Antibiotics were started with IV metronidazole, vancomycin, and piperacillin/tazobactam. Metronidazole was then replaced by clindamycin. Exploration was performed but no necrotic tissue was identified. Cystourethroscopy revealed dusky looking urethra. A suprapubic tube and a urethral catheter were placed in the bladder. WBC trended down to 13.9 × 103/μL on the fourth postoperative day. Urine culture grew Aerococcus urinae and blood cultures grew Alpha Hemolytic Streptococcus. On the sixth day, the patient was feeling worse and WBC increased. MRI revealed absent blood flow to the corpus spongiosum. Urethroscopy revealed necrosis of the urethra. Urethrectomy was performed via perineal approach. The patient immediately improved. The patient was discharged on the sixth postoperative day to continue ampicillin/sulbactam IV every 6 hours for a total of 4 weeks from the day of urethrectomy. PMID:26171271

  5. Severe gingival enlargement associated with aggressive periodontitis.

    PubMed

    Padmanabhan, Shyam; Dwarakanath, C D

    2013-01-01

    Enlargement of the gingiva can be due to various causes. Most prevalent are the inflammatory type and drug-induced type of gingival hyperplasia. However, sever enlargement associated with an aggressive type of periodontitis is an infrequent finding. Reported here is a case of a female patient aged 18 years who presented with severe enlargement of the maxillary and mandibular gingiva. Examination revealed enlargement extending up to the incisal edge of all the teeth and also an associated generalized loss of attachment with radiographic evidence of reduced bone height resembling an aggressive type of periodontitis. There were no associated systemic signs and symptoms or any family history except that there was generalized vitiligo of the skin and oral mucous membrane. The case was treated by gross electrosection of the gingiva.

  6. Severe gingival enlargement associated with aggressive periodontitis

    PubMed Central

    Padmanabhan, Shyam; Dwarakanath, C. D.

    2013-01-01

    Enlargement of the gingiva can be due to various causes. Most prevalent are the inflammatory type and drug-induced type of gingival hyperplasia. However, sever enlargement associated with an aggressive type of periodontitis is an infrequent finding. Reported here is a case of a female patient aged 18 years who presented with severe enlargement of the maxillary and mandibular gingiva. Examination revealed enlargement extending up to the incisal edge of all the teeth and also an associated generalized loss of attachment with radiographic evidence of reduced bone height resembling an aggressive type of periodontitis. There were no associated systemic signs and symptoms or any family history except that there was generalized vitiligo of the skin and oral mucous membrane. The case was treated by gross electrosection of the gingiva. PMID:23633785

  7. Necrotic enteritis in broilers: an updated review on the pathogenesis.

    PubMed

    Timbermont, L; Haesebrouck, F; Ducatelle, R; Van Immerseel, F

    2011-08-01

    Clostridium perfringens-induced necrotic enteritis and related subclinical disease have become economically significant problems for the broiler industry. Fortunately, scientific interest in this topic has grown: new C. perfringens virulence factors have been discovered and new insight gained about the pathogenesis of necrotic enteritis. It has been shown that alpha toxin, for a long time thought to be the key virulence factor, is not essential for the development of the disease. Moreover, it is now clearly established that only certain C. perfringens strains are capable of inducing necrotic enteritis under specific conditions that predispose to the disease and they constitute only a minority in the intestinal tract of healthy chickens. A novel pore-forming toxin, NetB, has been identified in these virulent avian C. perfringens strains. Using a gene knockout mutant, it has been shown that NetB is a critical virulence factor in the pathogenesis of necrotic enteritis in broilers. In addition to toxin production, other factors have been described that contribute to the ability of certain C. perfringens strains to cause necrotic enteritis in broilers. It has been suggested that proteolytic enzymes play an important role in the initial stages of necrotic enteritis since the villi are first affected at the level of the basement membrane and the lateral domain of the enterocytes. In field outbreaks of necrotic enteritis, a single clone of C. perfringens is dominant in intestines of all affected birds, as opposed to the mixture of different C. perfringens strains that can be isolated from healthy bird intestines. It has been proposed that bacteriocin production is responsible for the dominance of a single strain in necrotic enteritis cases. Furthermore, it has been shown that virulent strains are more able to adhere to extracellular matrix molecules than non-virulent strains. The current knowledge on the pathogenesis of the disease has been summarized in this short review.

  8. Gingival Squamous Cell Carcinoma: a Case Report

    PubMed Central

    Cabral, Luiz Antonio Guimarães; de Carvalho, Luis Felipe das Chagas e Silva; Salgado, José Antônio Pereira; Brandão, Adriana Aigotti Haberbeck

    2010-01-01

    ABSTRACT Background Squamous cell carcinoma is a malignant epithelial neoplasm characterized by variable clinical manifestations. When located in the gingiva, this neoplasm may mimic common inflammatory lesions. The aim of this study was to report a case of atypical squamous cell carcinoma, in which the patient had no risk factors for the development of this neoplasm. Methods A 61 year old Caucasian female was seen with a 3 month history of a rapidly growing, painful nodule in the gingiva adjacent to tooth #11. Clinical examination revealed a proliferative lesion in the vestibular marginal gingiva of teeth #11 and #12, presenting with purulent exudation. Thus, in view of the clinical symptoms and differential diagnosis of an infectious granulomatous process and malignant neoplasm, an incisional biopsy was obtained from the lesion. Results The diagnosis of squamous cell carcinoma was made and fourteen days after incisional biopsy, healing was found to be unsatisfactory. The patient was referred for treatment consisting of surgical excision of the tumour. A removable partial denture was fabricated for rehabilitation, one month after surgery of the maxilla; the patient was submitted to dissection of the regional lymph nodes and radiotherapy for an additional 3 months. Three years after the end of treatment, the patient continues to be followed-up and does not show any sign of recurrence. Conclusions Gingival squamous cell carcinoma is a condition which chance of cure is higher when carcinomatous lesions are diagnosed and treated early. In this instance dentists play an important role in early detection of gingival squamous cell carcinoma. PMID:24421976

  9. The effect of oral physiotherapy on dilantin gingival hyperplasia.

    PubMed

    King, D A; Hawes, R R; Bibby, B G

    1976-01-01

    Gingival hyperplasia was studied in 13 boys with epilepsy living in a state hospital. Boys were selected on the basis of having gingival hyperplasia, having all teeth between cuspids (upper and lower), having no occlusal abnormality and being cooperative. After gingivectomy, regrowth of gingiva was compared around lateral incisors on one side of the mouth having operator-assisted oral hygiene with that around lateral incisors on the other side of the mouth without operator-assisted oral hygiene. Regrowth of tissue was documented by precise photogrammetry. Oral hygiene, gingival inflammation and crevicular fluid were monitored. Less inflammation, less crevicular fluid and less regrowth of gingival tissues occurred around teeth subjected to good oral hygiene. Precise periodic photographic documentation of the clinical status of patients during studies such as this is considered very valuable.

  10. Diagnosis and treatment of a hereditary gingival fibromatosis case.

    PubMed

    Zhou, Min; Xu, Li; Meng, Huan Xin

    2011-01-01

    Hereditary gingival fibromatosis (HGF) is a rare condition characterised by severe gingival hyperplasia, which could result in serious aesthetic and emotional problems and functional impairment. Here the present authors report a case of a 28-year-old female patient with generalised severe gingival enlargement covering almost all of the teeth and diagnosed as HGF. Her family history was of significance, since her father and 3-year-old daughter suffered from the same symptoms. Many studies have agreed that surgical removal should be used in the treatment of HGF, and gingivectomy is the most common method. This study tried both external and internal bevel incisions. The results suggest that the former is better for shaping gingival contour, if the attached gingiva is adequate. Correct physiological contour of the marginal gingiva, good oral hygiene and periodic recall can decrease recurrence risk. Post-surgical follow-up after 26 months demonstrated no recurrence and the patient was satisfied with her appearance.

  11. [Adjusting gingival tissues morphology after dental implantation with fibrin use].

    PubMed

    Maĭborodin, I V; Kolesnikov, I S; Sheplev, B V; Ragimova, T M; Kovyntsev, A N; Kovyntsev, D N; Shevela, A I

    2009-01-01

    In gingival tissues of 62 patients after dental implantation of traditional type and with the use of thrombocyte rich fibrin preparation (TRFP) microcirculation and leucocytal infiltration were studied. It was disclosed that in all terms after titanium screw dental implant setting lymphostasis and leucocytal infiltration were seen as signs of active inflammatory process in gingival tissues. 3 months later after implants setting with the use of TRFP the lymphatic vessels status was normalized, the degree of leucocytal infiltration was reduced; when implantation was made without use of fibrin technologies in gingival tissues more leucocytes were found and lymphatic bed components were remained dilated. Besides fibrin preparation use in the process of dental implantation promoted quicker and stronger implant fixation, but granulomatous inflammatory process could develop and amount of eosinophils in gingival tissues could also increased. PMID:19365340

  12. Chronic desquamative gingivitis in siblings: A report of two cases

    PubMed Central

    Vijayakar, Harshad N.; Shah, Pratik P.; Desai, Ankit B.; Ghonasgi, Sugandha R.; Gawankar, Ravindra J.

    2014-01-01

    Desquamative gingivitis is a gingival response associated with a variety of clinical conditions and characterized by intense erythema, desquamation and ulceration of free and attached gingiva. A variety of diseases such as lichen planus, pemphigus, pemphigoid, dermatitis herpetiformis, linear IgA disease, lupus erythematosus, erythema multiformae manifest clinically as desquamative gingivitis. Of all the disease entities, Lichen Planus is a relatively common disorder affecting the skin and mucous membrane. Very often it has oral manifestations. These lesions of oral lichen planus (OLP) have myriad but distinct morphology. As they mimic other mucocutaneous disorders with regard to clinical appearance, many lesions of oral lichen planus go undiagnosed or are wrongly diagnosed. Reported here are two cases of desquamative gingivitis. One of these was diagnosed as erosive lichen planus based on the symptoms, clinical findings, histologic, and immunofluorescent examination. Further management was done in consultation with a dermatologist. PMID:25024556

  13. "United Pedicle Flap" for management of multiple gingival recessions.

    PubMed

    Chopra, Aditi; Sivaraman, Karthik; Bhat, Subraya Giliyar

    2016-01-01

    Numerous surgical procedures have evolved and are being modified with time to treat gingival recession by manipulating gingival or mucosal tissues in various ways. However, the decision to choose the most appropriate technique for a given recession site still remains a challenging task for clinicians. Mucogingival deformities such as shallow vestibule, frenal pull, or inadequate attached gingiva complicate the decision and limit the treatment options to an invasive procedure involving soft tissue grafts. The situation is further comprised if there is a nonavailability of adequate donor tissue and patients' unwillingness for procedures involving a second surgical site. In such situations, the recession either remains untreated or has poor treatment outcomes. This case report presents a modified pedicle graft technique for treatment of multiple gingival recessions with shallow vestibule and inadequate attached gingiva. The technique is a promising therapeutic alternative to invasive surgical procedures such as soft tissue grafts for treatment of multiple gingival recessions. PMID:27563212

  14. Periodontal plastic surgical technique for gingival fenestration closure.

    PubMed

    Peacock, M E; Mott, D A; Cuenin, M F; Hokett, S D; Fowler, E B

    2001-01-01

    Gingival fenestration is an opening through oral keratinized tissue, usually unattached, that is observed in thin gingiva with usually thick subgingival calculus deposits. This lesion is seen infrequently but may be more common than has been reported; lack of symptoms may inhibit patient awareness. Because surgical correction usually is not required, there are very few reports in the literature concerning this lesion. The following report describes a case of gingival fenestration and surgical treatment with a connective tissue/periosteal graft. PMID:12016683

  15. Hereditary Nonsyndromic Gingival Fibromatosis: Report of Family Case Series

    PubMed Central

    Peeran, Syed Wali; Ramalingam, Karthikeyan; Peeran, Syed Ali; Mugrabi, Marei Hamed; Abdulla, Khaled Awidat

    2013-01-01

    Hereditary gingival fibromatosis (HGF) is a rare, benign disorder with slowly progressive enlargement of maxillary and mandibular gingiva. Herewith, we report the first case series of HGF presenting among mother and all of her 3 children. Their complaints included unaesthetic appearance due to gingival growth, malocclusion, and difficulty in mastication. Conventional gingivectomy with oral hygiene measures and regular followup is the treatment of choice for such presentation. PMID:24191204

  16. Sarcoidosis presenting as isolated gingival enlargement: a rare case entity.

    PubMed

    Tripathi, Pragya; Aggarwal, Jaihans; Chopra, Deepak; Bagga, Sukhchain; Sethi, Kanika

    2014-11-01

    Sarcoidosis is a non-caseating granulomatous disease . It is a multiorgan inflammatory disorder of unknown etiology. Conditions affecting skin or other organs frequently involve oral cavity and rarely manifest as gingival disease. Here we are reporting a rare case in which gingival hyperplasia was the initial symptom which finally led to the diagnosis of sarcoidosis. Oral mucous membrane needs to be examined carefully as it may constitute in presenting first sign of systemic sarcoidosis.

  17. An unusual necrotic myositis by Clostridium perfringens in a German Shepherd dog: A clinical report, bacteriological and molecular identification.

    PubMed

    Salari Sedigh, Hamideh; Rajabioun, Masoud; Razmyar, Jamshid; Kazemi Mehrjerdi, Hossein

    2015-01-01

    Clostridial myositis, considered to be rare in pet animals, is an acutely fatal toxaemic condition. Some species of clostridia are responsible for necrotic myositis. A 2-year-old male German shepherd dog was admitted with non-weight bearing lameness and massive swelling of the left hind limb. Clostridium perfringens type A with alpha toxin was diagnosed as a pathogenic agent. Based on the history, the bacteria were introduced inside the tissue via contaminated needle following intramuscular injection. Urgent medical therapy followed by surgical intervention was performed. The dog was discharged completely healthy after hospitalization for four weeks. The objective of this report was to describe necrotic myositis in a dog with an emphasis on clinical signs and treatment as well as bacteriological and molecular identification of the micro-organism. Because of the fatal entity of the disease, prompt diagnosis as well as proper and urgent treatment is very important for successful therapy. PMID:26973773

  18. An unusual necrotic myositis by Clostridium perfringens in a German Shepherd dog: A clinical report, bacteriological and molecular identification

    PubMed Central

    Salari Sedigh, Hamideh; Rajabioun, Masoud; Razmyar, Jamshid; Kazemi Mehrjerdi, Hossein

    2015-01-01

    Clostridial myositis, considered to be rare in pet animals, is an acutely fatal toxaemic condition. Some species of clostridia are responsible for necrotic myositis. A 2-year-old male German shepherd dog was admitted with non-weight bearing lameness and massive swelling of the left hind limb. Clostridium perfringens type A with alpha toxin was diagnosed as a pathogenic agent. Based on the history, the bacteria were introduced inside the tissue via contaminated needle following intramuscular injection. Urgent medical therapy followed by surgical intervention was performed. The dog was discharged completely healthy after hospitalization for four weeks. The objective of this report was to describe necrotic myositis in a dog with an emphasis on clinical signs and treatment as well as bacteriological and molecular identification of the micro-organism. Because of the fatal entity of the disease, prompt diagnosis as well as proper and urgent treatment is very important for successful therapy. PMID:26973773

  19. Predictive modeling of gingivitis severity and susceptibility via oral microbiota.

    PubMed

    Huang, Shi; Li, Rui; Zeng, Xiaowei; He, Tao; Zhao, Helen; Chang, Alice; Bo, Cunpei; Chen, Jie; Yang, Fang; Knight, Rob; Liu, Jiquan; Davis, Catherine; Xu, Jian

    2014-09-01

    Predictive modeling of human disease based on the microbiota holds great potential yet remains challenging. Here, 50 adults underwent controlled transitions from naturally occurring gingivitis, to healthy gingivae (baseline), and to experimental gingivitis (EG). In diseased plaque microbiota, 27 bacterial genera changed in relative abundance and functional genes including 33 flagellar biosynthesis-related groups were enriched. Plaque microbiota structure exhibited a continuous gradient along the first principal component, reflecting transition from healthy to diseased states, which correlated with Mazza Gingival Index. We identified two host types with distinct gingivitis sensitivity. Our proposed microbial indices of gingivitis classified host types with 74% reliability, and, when tested on another 41-member cohort, distinguished healthy from diseased individuals with 95% accuracy. Furthermore, the state of the microbiota in naturally occurring gingivitis predicted the microbiota state and severity of subsequent EG (but not the state of the microbiota during the healthy baseline period). Because the effect of disease is greater than interpersonal variation in plaque, in contrast to the gut, plaque microbiota may provide advantages in predictive modeling of oral diseases.

  20. Microbiota-based Signature of Gingivitis Treatments: A Randomized Study

    PubMed Central

    Huang, Shi; Li, Zhen; He, Tao; Bo, Cunpei; Chang, Jinlan; Li, Lin; He, Yanyan; Liu, Jiquan; Charbonneau, Duane; Li, Rui; Xu, Jian

    2016-01-01

    Plaque-induced gingivitis can be alleviated by various treatment regimens. To probe the impacts of various anti-gingivitis treatments on plaque microflora, here a double blinded, randomized controlled trial of 91 adults with moderate gingivitis was designed with two anti-gingivitis regimens: the brush-alone treatment and the brush-plus-rinse treatment. In the later group, more reduction in both Plaque Index (TMQHI) and Gingival Index (mean MGI) at Day 3, Day 11 and Day 27 was evident, and more dramatic changes were found between baseline and other time points for both supragingival plaque microbiota structure and salivary metabonomic profiles. A comparison of plaque microbiota changes was also performed between these two treatments and a third dataset where 50 subjects received regimen of dental scaling. Only Actinobaculum, TM7 and Leptotrichia were consistently reduced by all the three treatments, whereas the different microbial signatures of the three treatments during gingivitis relieve indicate distinct mechanisms of action. Our study suggests that microbiota based signatures can serve as a valuable approach for understanding and potentially comparing the modes of action for clinical treatments and oral-care products in the future. PMID:27094556

  1. [Clinical evaluation of gingival tissue restored with stainless steel crown].

    PubMed

    Chao, D D; Tsai, T P; Chen, T C

    1992-12-01

    The use of stainless steel crown for the restoration of primary molars is widely accepted in pediatric dentistry. There has been a concern regarding their effect on the health of the gingival tissue. It is a possibility that the preformed crown may be a contributing cause of gingivitis. This study evaluated one hundred and thirty-seven crowns in forty-five patients who had received pedodontic treatment at Chang Gung Memorial Hospital. The results indicated that the majority of stainless steel crowns had one or more defects, with crown crimping being the most common error. According to what the paired t-test showed, non-ideal crowns indicated that the gingival index was significantly higher than the entire mouth and control teeth. However the supragingival plaque accumulation of these teeth was significant lower than the entire mouth and control teeth. There was only a moderate positive correlation between supragingival plaque and gingivitis. The operator is necessary to adapt the stainless steel crown margin as closely as possible to the tooth and to avoid the mechanical defect of a crown. It minimizes the irritation of gingival tissue and diminishes the bacterial adherence of subgingival plaque, therefore preserving the health of gingival tissue.

  2. Predictive modeling of gingivitis severity and susceptibility via oral microbiota.

    PubMed

    Huang, Shi; Li, Rui; Zeng, Xiaowei; He, Tao; Zhao, Helen; Chang, Alice; Bo, Cunpei; Chen, Jie; Yang, Fang; Knight, Rob; Liu, Jiquan; Davis, Catherine; Xu, Jian

    2014-09-01

    Predictive modeling of human disease based on the microbiota holds great potential yet remains challenging. Here, 50 adults underwent controlled transitions from naturally occurring gingivitis, to healthy gingivae (baseline), and to experimental gingivitis (EG). In diseased plaque microbiota, 27 bacterial genera changed in relative abundance and functional genes including 33 flagellar biosynthesis-related groups were enriched. Plaque microbiota structure exhibited a continuous gradient along the first principal component, reflecting transition from healthy to diseased states, which correlated with Mazza Gingival Index. We identified two host types with distinct gingivitis sensitivity. Our proposed microbial indices of gingivitis classified host types with 74% reliability, and, when tested on another 41-member cohort, distinguished healthy from diseased individuals with 95% accuracy. Furthermore, the state of the microbiota in naturally occurring gingivitis predicted the microbiota state and severity of subsequent EG (but not the state of the microbiota during the healthy baseline period). Because the effect of disease is greater than interpersonal variation in plaque, in contrast to the gut, plaque microbiota may provide advantages in predictive modeling of oral diseases. PMID:24646694

  3. Gingival enlargements: Differential diagnosis and review of literature

    PubMed Central

    Agrawal, Amit Arvind

    2015-01-01

    Gingival enlargement is one of the frequent features of gingival diseases. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. They can be categorized based on their etiopathogenesis, location, size, extent, etc. Based on the existing knowledge and clinical experience, a differential diagnosis can be formulated. Subsequently, after detailed investigation, clinician makes a final diagnosis or diagnosis of exclusion. A perfect diagnosis is critically important, since the management of these lesions and prevention of their recurrence is completely dependent on it. Furthermore, in some cases where gingival enlargement could be the primary sign of potentially lethal systemic diseases, a correct diagnosis of these enlargements could prove life saving for the patient or at least initiate early treatment and improve the quality of life. The purpose of this review article is to highlight significant findings of different types of gingival enlargement which would help clinician to differentiate between them. A detailed decision tree is also designed for the practitioners, which will help them arrive at a diagnosis in a systematic manner. There still could be some lesions which may present in an unusual manner and make the diagnosis challenging. By knowing the existence of common and rare presentations of gingival enlargement, one can keep a broad view when formulating a differential diagnosis of localized (isolated, discrete, regional) or generalized gingival enlargement. PMID:26380825

  4. Microbiota-based Signature of Gingivitis Treatments: A Randomized Study.

    PubMed

    Huang, Shi; Li, Zhen; He, Tao; Bo, Cunpei; Chang, Jinlan; Li, Lin; He, Yanyan; Liu, Jiquan; Charbonneau, Duane; Li, Rui; Xu, Jian

    2016-01-01

    Plaque-induced gingivitis can be alleviated by various treatment regimens. To probe the impacts of various anti-gingivitis treatments on plaque microflora, here a double blinded, randomized controlled trial of 91 adults with moderate gingivitis was designed with two anti-gingivitis regimens: the brush-alone treatment and the brush-plus-rinse treatment. In the later group, more reduction in both Plaque Index (TMQHI) and Gingival Index (mean MGI) at Day 3, Day 11 and Day 27 was evident, and more dramatic changes were found between baseline and other time points for both supragingival plaque microbiota structure and salivary metabonomic profiles. A comparison of plaque microbiota changes was also performed between these two treatments and a third dataset where 50 subjects received regimen of dental scaling. Only Actinobaculum, TM7 and Leptotrichia were consistently reduced by all the three treatments, whereas the different microbial signatures of the three treatments during gingivitis relieve indicate distinct mechanisms of action. Our study suggests that microbiota based signatures can serve as a valuable approach for understanding and potentially comparing the modes of action for clinical treatments and oral-care products in the future. PMID:27094556

  5. Molecular and Clinical Aspects of Drug-induced Gingival Overgrowth

    PubMed Central

    Kantarci, A.

    2015-01-01

    Drug-induced gingival overgrowth is a tissue-specific condition and is estimated to affect approximately one million North Americans. Lesions occur principally as side-effects from phenytoin, nifedipine, or ciclosporin therapy in approximately half of the people who take these agents. Due to new indications for these drugs, their use continues to grow. Here, we review the molecular and cellular characteristics of human gingival overgrowth lesions and highlight how they differ considerably as a function of the causative drug. Analyses of molecular signaling pathways in cultured human gingival fibroblasts have provided evidence for their unique aspects compared with fibroblasts from the lung and kidney. These findings provide insights into both the basis for tissue specificity and into possible therapeutic opportunities which are reviewed here. Although ciclosporin-induced gingival overgrowth lesions exhibit principally the presence of inflammation and little fibrosis, nifedipine- and especially phenytoin-induced lesions are highly fibrotic. The increased expression of markers of gingival fibrosis, particularly CCN2 [also known as connective tissue growth factor (CTGF)], markers of epithelial to mesenchymal transition, and more recently periostin and members of the lysyl oxidase family of enzymes have been documented in phenytoin or nifedipine lesions. Some oral fibrotic conditions such as leukoplakia and oral submucous fibrosis, after subsequent additional genetic damage, can develop into oral cancer. Since many pathways are shared, the study of gingival fibrosis and comparisons with characteristics and molecular drivers of oral cancer would likely enhance understandings and functional roles of molecular drivers of these oral pathologies. PMID:25680368

  6. [Unilateral idiopathic gingival fibromatosis--a case report].

    PubMed

    Łazarz-Bartyzel, Katarzyna; Gawron, Katarzyna; Darczuk, Dagmara; Chomyszyn-Gajewska, Maria

    2016-01-01

    Gingival fibromatosis is a painless gingival overgrowth. It may result in difficulties with proper dental hygiene keeping, mastication and occlusion. Herein, a case of a 10-year-old patient was described. The patient reported to the Department of Periodontology and Oral Medicine of the Jagiellonian University Medical College in Krakow due to the problems with permanent teeth eruption (23-26), chewing and dental hygiene maintaining. Based on medical history, clinical examination, diagnostic tests and histopathological study of gingival tissue biopsies the patient was diagnosed with unilateral idiopathic gingival fibromatosis. After oral cavity hygienization, patient un- derwent dental surgery procedures by gingivectomy and gingivoplasty. The follow-up examination 2 and 6 months post operation showed un- eventful healing, proper tooth eruption, improved oral hygiene and chewing function. Twelve months post surgery no recurrence was noted. Due to the etiological diversity of gingival lesions occurring as an overgrowth, accurate medical history, clinical examination, laboratory tests and histopathological study are needed. Accurate diagnos- tics is crucial mainly to exclude he- matological and oncological diseases. Gingivectomy being the "gold method" of gingival fibromatosis treatment was effective and sufficient to cure the case presented in this article. PMID:27526431

  7. Gingival enlargements: Differential diagnosis and review of literature.

    PubMed

    Agrawal, Amit Arvind

    2015-09-16

    Gingival enlargement is one of the frequent features of gingival diseases. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. They can be categorized based on their etiopathogenesis, location, size, extent, etc. Based on the existing knowledge and clinical experience, a differential diagnosis can be formulated. Subsequently, after detailed investigation, clinician makes a final diagnosis or diagnosis of exclusion. A perfect diagnosis is critically important, since the management of these lesions and prevention of their recurrence is completely dependent on it. Furthermore, in some cases where gingival enlargement could be the primary sign of potentially lethal systemic diseases, a correct diagnosis of these enlargements could prove life saving for the patient or at least initiate early treatment and improve the quality of life. The purpose of this review article is to highlight significant findings of different types of gingival enlargement which would help clinician to differentiate between them. A detailed decision tree is also designed for the practitioners, which will help them arrive at a diagnosis in a systematic manner. There still could be some lesions which may present in an unusual manner and make the diagnosis challenging. By knowing the existence of common and rare presentations of gingival enlargement, one can keep a broad view when formulating a differential diagnosis of localized (isolated, discrete, regional) or generalized gingival enlargement.

  8. Unique database study linking gingival inflammation and smoking in carcinogenesis.

    PubMed

    Söder, Birgitta; Andersson, Leif C; Meurman, Jukka H; Söder, Per-Östen

    2015-02-01

    We investigated statistical association between gingival inflammation and cancer in a group of patients followed up for 26 years with the hypothesis that gingival inflammation affects carcinogenesis. Altogether, 1676 30- to 40-year-old subjects from Stockholm were clinically examined in 1985. In 2011, we compared the baseline oral examination and follow-up data with cancer diagnoses sourced from the Swedish national hospital register databases. Of 1676 individuals, 89 (55 women, 34 men) had got cancer by the year 2011. Women were found to be at higher risk for cancer than men. Smoking (expressed in pack-years) had been more prevalent in the cancer group than in those with no cancer diagnosis. Gingival index, marker of gingival inflammation, was higher in the cancer group than in subjects with no cancer. There were no significant differences between the groups regarding age, education, dental plaque and calculus index scores, or in the number of missing teeth. In multiple logistic regression analysis with cancer as the dependent variable and several independent variables, pack-years of smoking appeared to be a principal independent predictor with odds ratio (OR) 1.32 while gingival inflammation showed OR 1.29. Hence, our present findings showed that together with smoking, gingival inflammation indeed associated with the incidence of cancer in this cohort. PMID:25533098

  9. Intestinal alkaline phosphatase to treat necrotizing enterocolitis

    PubMed Central

    Biesterveld, Ben E.; Koehler, Shannon M.; Heinzerling, Nathan P.; Rentea, Rebecca M.; Fredrich, Katherine; Welak, Scott R.; Gourlay, David M.

    2015-01-01

    Background Intestinal alkaline phosphatase (IAP) activity is decreased in necrotizing enterocolitis (NEC), and IAP supplementation prevents NEC development. It is not known if IAP given after NEC onset can reverse the course of the disease. We hypothesized that enteral IAP given after NEC induction would not reverse intestinal injury. Materials and methods NEC was induced in Sprague–Dawley pups by delivery preterm followed by formula feedings with lipopolysaccharide (LPS) and hypoxia exposure and continued up to 4 d. IAP was added to feeds on day 2 until being sacrificed on day 4. NEC severity was scored based on hematoxylin and eosin-stained terminal ileum sections, and AP activity was measured using a colorimetric assay. IAP and interleukin-6 expression were measured using real time polymerase chain reaction. Results NEC pups' alkaline phosphatase (AP) activity was decreased to 0.18 U/mg compared with controls of 0.57 U/mg (P < 0.01). Discontinuation of LPS and hypoxia after 2 d increased AP activity to 0.36 U/mg (P < 0.01). IAP supplementation in matched groups did not impact total AP activity or expression. Discontinuing LPS and hypoxia after NEC onset improved intestinal injury scores to 1.14 compared with continued stressors, score 2.25 (P < 0.01). IAP supplementation decreased interleukin-6 expression two-fold (P < 0.05), though did not reverse NEC intestinal damage (P = 0.5). Conclusions This is the first work to demonstrate that removing the source of NEC improves intestinal damage and increases AP activity. When used as a rescue treatment, IAP decreased intestinal inflammation though did not impact injury making it likely that IAP is best used preventatively to those neonates at risk. PMID:25840489

  10. [Lymphotropic therapy for acute purulent odontogenic jaw periostitis].

    PubMed

    Maĭborodin, I V; Lĭubarskiĭ, M S; Loĭko, E R; Sheplev, B V

    2003-01-01

    The structure of the gingival mucosa was studied by optic microscopy in patients with acute purulent odontogenic maxillary periostitis treated traditionally and receiving lymphotropic therapy. Lymphotropic administration of the antibiotic during 2 days resulted in less pronounced dilatation of the interstitial spaces and lymph vessels adjacent to the molars and higher counts of lymphocytes, monocytes, and macrophages. This indicated high efficiency of lymphotropic therapy of acute purulent maxillary periostitis for molars. Microcirculation parameters and tissue leukocyte cytogram in gingival mucosal tissue adjacent to the canines and premolars differed negligibly in patients treated by different methods.

  11. Changes in Gingival Crevicular Fluid Inflammatory Mediator Levels during the Induction and Resolution of Experimental Gingivitis in Humans

    PubMed Central

    Offenbacher, Steven; Barros, Silvana; Mendoza, L; Mauriello, S; Preisser, J; Moss, K; de Jager, Marko; Aspiras, Marcelo

    2010-01-01

    Aim The goal of this study is to characterize the changes in 33 biomarkers within the gingival crevicular fluid during the 3-week induction and 4-week resolution of stent-induced, biofilm overgrowth mediated, experimental gingivitis in humans. Methods Experimental gingivitis was induced in 25 subjects for 21 days followed by treatment with a sonic powered toothbrush for 28 days. Clinical indices and gingival crevicular fluids were collected weekly during induction and biweekly during resolution. Samples were analyzed using a bead-based multiplexing analysis for the simultaneous measurements of 33 biomarkers within each sample including cytokines, matrix-metalloproteinases and adipokines. Prostaglandin-E2 was measured by enzyme-linked immunoadsorbant assay. Statistical testing using general linear models with structured covariance matrices were performed to compare stent to contralateral (non-stent) changes in clinical signs and in biomarker levels over time. Results Gingivitis induction was associated with a significant 2.6-fold increase in interleukin 1-beta, a 3.1 fold increase in interleukin 1-alpha, and a significant decrease in multiple chemokines as well as matrixmetalloproteinases −1, −3 and 13. All changes in clinical signs and mediators rebounded to baseline in response to treatmentin the resolution phase. Conclusions Stent-induced gingivitis is associated with marked, but reversible increases in interleukins 1-alpha and 1-beta with suppression of multiple chemokines as well as selected matrixmetalloproteinases. PMID:20447255

  12. Multiple functions of gingival and mucoperiosteal fibroblasts in oral wound healing and repair.

    PubMed

    Chiquet, Matthias; Katsaros, Christos; Kletsas, Dimitris

    2015-06-01

    Fibroblasts are cells of mesenchymal origin. They are responsible for the production of most extracellular matrix in connective tissues and are essential for wound healing and repair. In recent years, it has become clear that fibroblasts from different tissues have various distinct traits. Moreover, wounds in the oral cavity heal under very special environmental conditions compared with skin wounds. Here, we reviewed the current literature on the various interconnected functions of gingival and mucoperiosteal fibroblasts during the repair of oral wounds. The MEDLINE database was searched with the following terms: (gingival OR mucoperiosteal) AND fibroblast AND (wound healing OR repair). The data gathered were used to compare oral fibroblasts with fibroblasts from other tissues in terms of their regulation and function during wound healing. Specifically, we sought answers to the following questions: (i) what is the role of oral fibroblasts in the inflammatory response in acute wounds; (ii) how do growth factors control the function of oral fibroblasts during wound healing; (iii) how do oral fibroblasts produce, remodel and interact with extracellular matrix in healing wounds; (iv) how do oral fibroblasts respond to mechanical stress; and (v) how does aging affect the fetal-like responses and functions of oral fibroblasts? The current state of research indicates that oral fibroblasts possess unique characteristics and tightly controlled specific functions in wound healing and repair. This information is essential for developing new strategies to control the intraoral wound-healing processes of the individual patient.

  13. Necrotizing Fasciitis of the Abdominal Wall Caused by Serratia Marcescens.

    PubMed

    Lakhani, Naheed A; Narsinghani, Umesh; Kumar, Ritu

    2015-04-15

    In this article, we present the first case of necrotizing fasciitis affecting the abdominal wall caused by Serratia marcescens and share results of a focused review of S. marcescens induced necrotizing fasciitis. Our patient underwent aorto-femoral bypass grafting for advanced peripheral vascular disease and presented 3 weeks postoperatively with pain, erythema and discharge from the incision site in the left lower abdominal wall and underwent multiple debridement of the affected area. Pathology of debrided tissue indicated extensive necrosis involving the adipose tissue, fascia and skeletal muscle. Wound cultures were positive for Serratia marcescens. She was successfully treated with antibiotics and multiple surgical debridements. Since necrotizing fasciitis is a medical and surgical emergency, it is critical to examine infectivity trends, clinical characteristics in its causative spectrum. Using PubMed we found 17 published cases of necrotizing fasciitis caused by Serratia marcescens, and then analyzed patterns among those cases. Serratia marcescens is prominent in the community and hospital settings, and information on infection presentations, risk factors, characteristics, treatment, course, and complications as provided through this study can help identify cases earlier and mitigate poor outcomes. Patients with positive blood cultures and those patients where surgical intervention was not provided or delayed had a higher mortality. Surgical intervention is a definite way to establish the diagnosis of necrotizing infection and differentiate it from other entities.

  14. A necrotic cell death model in a protist.

    PubMed

    Laporte, C; Kosta, A; Klein, G; Aubry, L; Lam, D; Tresse, E; Luciani, M F; Golstein, P

    2007-02-01

    While necrotic cell death is attracting considerable interest, its molecular bases are still poorly understood. Investigations in simple biological models, taken for instance outside the animal kingdom, may benefit from less interference from other cell death mechanisms and from better experimental accessibility, while providing phylogenetic information. Can necrotic cell death occur outside the animal kingdom? In the protist Dictyostelium, developmental stimuli induced in an autophagy mutant a stereotyped sequence of events characteristic of necrotic cell death. This sequence included swift mitochondrial uncoupling with mitochondrial 2',7'-dichlorofluorescein diacetate fluorescence, ATP depletion and increased oxygen consumption. This was followed by perinuclear clustering of dilated mitochondria. Rapid plasma membrane rupture then occurred, which was evidenced by time-lapse videos and quantified by FACS. Of additional interest, developmental stimuli and classical mitochondrial uncouplers triggered a similar sequence of events, and exogenous glucose delayed plasma membrane rupture in a nonglycolytic manner. The occurrence of necrotic cell death in the protist Dictyostelium (1) provides a very favorable model for further study of this type of cell death, and (2) strongly suggests that the mechanism underlying necrotic cell death was present in an ancestor common to the Amoebozoa protists and to animals and has been conserved in evolution.

  15. Black esophagus (acute esophageal necrosis) after spinal anesthesia.

    PubMed

    Román Fernández, A; López Álvarez, A; Fossati Puertas, S; Areán González, I; Varela García, O; Viaño López, P M

    2014-01-01

    Acute esophagic necrosis or black esophagus is an uncommon clinical entity that owes its name to the endoscopic view of the necrotic esophageal mucosa. It is always related with a critical medical condition and usually has an ischemic etiology. We report the first case of acute esophageal necrosis after a spinal anesthetic for partial hip joint arthroplasty. We discuss the underlying pathophysiological mechanisms.

  16. Medical treatment of acute pancreatitis.

    PubMed

    Mayerle, Julia; Simon, Peter; Lerch, Markus M

    2004-12-01

    Eighty percent of all cases of acute pancreatitis are linked etiologically to gallstone disease or caused by immoderate alcohol consumption. No specific causal treatment for acute pancreatitis exists. Early prognostic factors that indicate severe disease are three or more signs on organ failure scores according to Ranson, Imrie, or Acute Physiology and Chronic Health Evaluation (APACHE) 11, extrapancreatic complications of the disease, or the detection of pancreatic necrosis on CT scans. Elevated CRP levels above 130 mg/L can also predict a severe course of acute pancreatitis. The essential medical treatment for acute pancreatitis is the correction of hypovolemia. Moreover, relief of often severe visceral pain is a high priority. Prophylactic antibiotics should be restricted to patients with necrotizing pancreatitis, infected necrosis, or other infectious complications. Enteral nutrition has no adverse effect compared with parenteral nutrition during the course of acute pancreatitis, and is probably beneficial in regard to outcome.

  17. Unusual Presentation of Necrotic Erythema Nodosum Leprosum on Scalp: A Case Report.

    PubMed

    Barman, K D; Madan, A; Garg, V K; Goel, K; Khurana, N

    2015-01-01

    Lepra reactions are acute episodes occurring during the disease process of leprosy and are of 2 types: type 1 or reversal reaction and type 2 reaction or erythema odosumleprosum (ENL). In the episodes of lepra reaction several parts are affected including face and extremities like oral cavity. In the present case report we reported a rare case of lepromatous leprosy with necrotic ENL involving scalp apart from the usual sites. A 58 year old married male presented to us with complaints of spontaneous onset, recurrent eruption of multiple reddish raised painful lesions. Biopsy from the infiltrated skin over the back showed atrophic epidermis, free Grenz zone, diffuse and periadnexal macrophage granulomas with predominant mononuclear infiltrate, appandageal atrophy, fibrosis around the neural structures and leukocytoclastic vasculitis. Fites stain showed strong positivity for M. leprae. His routine blood investigations showed anemia (Hb = 7.8 gm%), neutrophil leukocytosis (TLC = 17,600, DLC = P66L28M4E2) and raised ESR (80 mm in the first hour). These bullous and necrotic lesions in leprosy may be a manifestation of severe type II reactions in patients with very high bacillary load. PMID:26591847

  18. Necrotizing fasciitis and death following an insect bite.

    PubMed

    Fernando, Dinesh Malcolm G; Kaluarachchi, Chandishni I; Ratnatunga, Champa N

    2013-09-01

    A healthy man who presented to hospital with painful swelling of the left arm following a history of insect (tick) bite developed shock and died within 48 hours. The postmortem examination revealed swelling and desquamation of skin and erythema on the left arm extending below the elbow. The subcutaneous tissue was necrotic with healthy underlying muscles. Group A β-hemolytic streptococcus was isolated from postmortem swabs of the infected tissue. Histopathologic changes were consistent with necrotizing fasciitis.Secondary bacterial infection is an important possible complication following insect bite, and a high degree of suspicion with aggressive early treatment is required in cases of necrotizing fasciitis to prevent fatalities. Both clinicians and pathologists need to be aware of this rare, rapidly fatal condition that may follow an insect bite.

  19. Necrotizing sialometaplasia masquerading as residual cancer of the lip.

    PubMed

    Granick, M S; Solomon, M P; Benedetto, A V; Hannegan, M W; Sohn, M

    1988-08-01

    Necrotizing sialometaplasia is a benign disorder that histologically can mimic carcinoma. It is thought to develop as a result of ischemia or adjacent tissue injury. A patient is described who underwent a Mohs' micrographical fresh-tissue excision of one-third of the upper lip for basal cell carcinoma. By the time she was ready for reconstruction, a marked eczematous reaction developed to a polymyxin neomycin preparation (Neosporin ointment) at the wound edges. Reexcision of the wound margins before a flap reconstruction revealed necrotizing sialometaplasia on histopathological examination. This incidental finding fortunately was not mistaken for residual tumor. To prevent over-diagnosis and over-treatment of presumed malignancies, an awareness of necrotizing sialometaplasia is essential for all surgeons operating on mucosal surfaces in the head and neck.

  20. Effect of pre-experimental maintenance care duration on the development of gingivitis in a partial mouth experimental gingivitis model.

    PubMed

    Van der Weijden, G A; Timmerman, M F; Danser, M M; Nijboer, A; Saxton, C A; Van der Velden, U

    1994-05-01

    The present study was designed to evaluate if different periods of supervised oral hygiene prior to the experimental gingivitis trial have an effect on the amount of inflammation which develops in the 'toothshield' model. Two groups were compared. One group (Group A) was supervised over a 5-month period before experimental gingivitis. Six months later Group A participated in a second trial, this time receiving only a 1-month pretrial. A second group (Group B) which served as a control was supervised over a pre-trial period of 1-month prior to the start of the experimental gingivitis phase. During the pre-trial period all subjects undertook a regime of vigorous oral hygiene which included polishing of the test quadrant in the upper jaw and supervised subgingival brushing, interdental taping or the use of toothpicks. The presence of plaque and bleeding were assessed. Following the pre-trial period all plaque control measures in the experimental area were prevented during oral hygiene periods by the temporary placement of soft, loosely fitting vinyl toothshield guard. During this period they accumulated plaque rapidly and developed a generalized gingivitis. The results of this study indicate that, irrespective of the length of the pretrial period, subjects by group develop a comparable mean level of plaque and gingival bleeding. However, the extent to which gingivitis develops differs among individuals and was for a number of subjects not consistent. Therefore, in designing an experimental gingivitis trial care should be taken to include a sufficient number of subjects to account for individual variation.

  1. Relationship of Gingival Pigmentation with Passive Smoking in Women

    PubMed Central

    Moravej-Salehi, Elahe; Moravej-Salehi, Elham

    2015-01-01

    Background: Oral mucosal pigmentation is among the most common findings in smokers, affecting smile esthetics. Passive smoking significantly compromises the health of non-smoker individuals particularly women. The purpose of this study was to assess the relationship of passive smoking with oral pigmentation in non-smoker women. Materials and Methods: This historical-cohort study was conducted on a case group of 50 married women who were unemployed, not pregnant, non-smoker, had no systemic condition causing cutaneous or mucosal pigmentation, were not taking any medication causing cutaneous or mucosal pigmentation and had a heavy smoker husband. The control group comprised of 50 matched females with no smoker member in the family. Both groups were clinically examined for presence of gingival pigmentation and the results were analyzed using chi-square and logistic regression tests. Results: Gingival pigmentation was found in 27 (54%) passive smokers and 14 (28%) controls (P=0.01). The odds ratio (OR) of gingival pigmentation in women exposed to secondhand smoke of their husbands (adjusted for education and having a smoker parent at childhood) was 3 (95% confidence interval; CI: 1.26 – 7.09). House floor area was correlated with gingival pigmentation in female passive smokers (P=0.025). Conclusion: This study was the first to describe the relationship between secondhand smoke and gingival pigmentation in women and this effect was magnified in smaller houses. PMID:26528364

  2. The Effectiveness of Propolis on Gingivitis: A Randomized Controlled Trial

    PubMed Central

    Paulino, Niraldo; Nör, Jacques E.; Moreira, Alexandre

    2014-01-01

    Abstract Background: A randomized, double-blind, controlled clinical trial was conducted to evaluate the effectiveness of a propolis rinse on induced gingivitis by using the co-twin study design. Methods: Twenty-one twin pairs (n=42) were enrolled in a gingivitis study with oral hygiene promotion (14 days) and gingivitis induction (21 days). During the gingivitis induction phase, one member of the twin pair was randomly assigned to a 2% typified propolis rinse, and the other was assigned a color-matched 0.05% sodium fluoride plus 0.05% cetylpyridinium chloride rinse (positive control). Patients rinsed twice daily with 20 mL for 30 seconds for 21 days. Gingivitis was measured on days −14 (baseline), 0 (after hygiene phase), and 21 (after no-hygiene phase) by using the Papillary Bleeding Score (PBS) and by standard digital imaging of the gum tissues (G-parameter). Results: The 38 persons who completed the study (age 13–22 years) were well balanced according to PBS at baseline and G-parameter after the initial hygiene phase. After 21 days without oral hygiene, the propolis rinse and positive control rinse groups did not differ significantly for average PBS measurements or G-parameter. Conclusions: Use of a 2% typified propolis rinse was equivalent to a positive control rinse during a 21-day no-hygiene period. PMID:25380344

  3. Defective Wound-healing in Aging Gingival Tissue

    PubMed Central

    Cáceres, M.; Oyarzun, A.; Smith, P.C.

    2014-01-01

    Aging may negatively affect gingival wound-healing. However, little is known about the mechanisms underlying this phenomenon. The present study examined the cellular responses associated with gingival wound-healing in aging. Primary cultures of human gingival fibroblasts were obtained from healthy young and aged donors for the analysis of cell proliferation, cell invasion, myofibroblastic differentiation, and collagen gel remodeling. Serum from young and old rats was used to stimulate cell migration. Gingival repair was evaluated in Sprague-Dawley rats of different ages. Data were analyzed by the Mann-Whitney and Kruskal-Wallis tests, with a p value of .05. Fibroblasts from aged donors showed a significant decrease in cell proliferation, migration, Rac activation, and collagen remodeling when compared with young fibroblasts. Serum from young rats induced higher cell migration when compared with serum from old rats. After TGF-beta1 stimulation, both young and old fibroblasts demonstrated increased levels of alpha-SMA. However, alpha-SMA was incorporated into actin stress fibers in young but not in old fibroblasts. After 7 days of repair, a significant delay in gingival wound-healing was observed in old rats. The present study suggests that cell migration, myofibroblastic differentiation, collagen gel remodeling, and proliferation are decreased in aged fibroblasts. In addition, altered cell migration in wound-healing may be attributable not only to cellular defects but also to changes in serum factors associated with the senescence process. PMID:24776985

  4. Comparative clinical efficacy evaluation of three gingival displacement systems

    PubMed Central

    Shrivastava, Kirti Jajoo; Bhoyar, Anjali; Agarwal, Surendra; Shrivastava, Saurabh; Parlani, Swapnil; Murthy, Varsha

    2015-01-01

    Aim: We compared the clinical efficacy of three gingival displacement systems to accurately record intra-crevicular margins of tooth preparation. Materials and Methods: One mechanical (magic foam cord) and two chemico-mechanical (expasyl paste and retraction cord impregnated with 15% aluminum chloride) gingival displacement systems were used. This study was conducted on the maxillary central incisors of 20 patients (20-60 years old) requiring full coverage restoration. All the three gingival displacement systems were tested in three sessions at an interval of 14 days in same order. The casts were sectioned and viewed under an optical microscope, followed by quantitative measurements of the width of the pre and postretracted sulci. Results: All the three displacement systems produced highly significant horizontal gingival displacement. Retraction cord soaked in 15% aluminum chloride produced maximum displacement (0.74 mm), followed by expasyl paste (0.48 mm) whereas magic foam cord produced the least displacement (0.41 mm). Conclusions: Gingival displacement shown by each displacement system was found to be more than the accepted value necessary for elastomeric impression accuracy (0.2 mm) to record intra-crevicular margins of tooth preparation. PMID:26604620

  5. Presence of Porphyromonas gingivalis in gingival squamous cell carcinoma

    PubMed Central

    Katz, Joseph; Onate, Mairelys D; Pauley, Kaleb M; Bhattacharyya, Indraneel; Cha, Seunghee

    2011-01-01

    Periodontal disease has been recently linked to a variety of systemic conditions such as diabetes, cardiovascular disease, preterm delivery, and oral cancer. The most common bacteria associated with periodontal disease, Porphyromonas gingivalis (P. gingivalis) has not yet been studied in the malignant gingival tissues. The objective of this study was to investigate the presence of P. gingivalis in specimens from squamous cell carcinoma patients. We have performed immunohistochemical staining to investigate the presence of P. gingivalis and Streptococcus gordonii (S. gordonii), a non invasive oral bacteria, in paraffin embedded samples of gingival squamous cell carcinoma (n=10) and normal gingiva (n=5). Staining for P. gingivalis revealed the presence of the bacteria in normal gingival tissues and gingival carcinoma, with higher levels (more than 33%, P<0.05) detected in the carcinoma samples. The staining intensity was also significantly enhanced in the malignant tissue by 2 folds (P<0.023) compared to specimens stained for the non-invasive S. gordonii. P. gingivalis is abundantly present in malignant oral epithelium suggesting a potential association of the bacteria with gingival squamous cell carcinoma. PMID:22010579

  6. Craniocervical necrotizing fasciitis of odontogenic origin with mediastinal extension.

    PubMed

    Edwards, John D; Sadeghi, Nader; Najam, Farzad; Margolis, Mark

    2004-08-01

    We review an interesting case of craniocervical necrotizing fasciitis with thoracic extension in an immunocompetent 44-year-old man. The patient underwent aggressive medical and surgical management during a long hospitalization. Multiple surgical debridements, including transcervical mediastinal debridement, and eventually a thoracotomy for mediastinal abscess were required. The patient eventually recovered, and 3 months later he showed no sign of complications or recurrence. Craniocervical necrotizing fasciitis is a fulminant soft-tissue infection, usually of odontogenic origin, that requires prompt identification and treatment to ensure survival. Broad-spectrum intravenous antibiotics, aggressive surgical debridement and wound care, hyperbaric oxygen, and good intensive care are the mainstays of treatment.

  7. Necrotizing sialometaplasia: literature review and presentation of five cases.

    PubMed

    Grillon, G L; Lally, E T

    1981-10-01

    Necrotizing sialometaplasia is a benign, ulcerative, inflammatory process of the minor salivary glands, primarily found in the hard palate. It is often mistaken clinically and histologically for a malignant tumor (that is, mucoepidermoid or squamous cell carcinoma). The lesion heals spontaneously in six to 12 weeks. It occurs primarily in persons between the ages of 40 and 60 and has been reported more frequently in men than women. In necrotizing sialometaplasia the squamous metaplasia and tissue necrosis is confined to the existing ductal and lobular pattern of the salivary glands, a unique characteristic that aids in diagnosis. Five additional cases are presented.

  8. A Clinical Evaluation of Gingival Overgrowth in Children on Antiepileptic Drug Therapy

    PubMed Central

    Chopra, Saroj; Thomas, Abi M; Pandian, Jeyraj

    2016-01-01

    Introduction Gingival overgrowth, a well-known side effect of chronic phenytoin therapy has also been known to be caused by other anti epileptic drugs (AED’s). Various factors like plaque, gingival inflammation, and periodontal health have been postulated to effect gingival overgrowth. Aim To identify the AED having an effect on gingival overgrowth and to study the factors affecting it. Materials and Methods Three groups of 30 children each on monotherapy of phenytoin, sodium valproate, and carbamazepine were longitudinally followed for six months. Their oral and epileptic health status was assessed and were monitored for change in plaque levels, gingival inflammation, probing depth and the status of gingival overgrowth at baseline, at the end of 3 months and finally at the end of 6 months. The data was recorded and statistically analysed. Results Phenytoin caused gingival overgrowth in a significant number of children (53.6%) within 3 months. Sodium valproate also led to gingival overgrowth, but not upto statistically significant levels. Patients on carbamazepine did not show any signs of gingival overgrowth. Gingival overgrowth is seen more on buccal side, in the anterior segment and in the lower arch. No correlation could be found between, either plaque level, or gingival inflammation with gingival overgrowth. Probing depth could be positively correlated with gingival overgrowth. Conclusion Phenytoin is the drug, which can be chiefly implicated for causing gingival overgrowth. Sodium valproate carries the potential for gingival overgrowth, although only up to clinically insignificant levels in 6 months. Carbamazepine can be considered a safe drug in children in relation to gingival overgrowth. PMID:26894172

  9. Primary intraoral granulocytic sarcoma: A rare case presenting as generalized gingival enlargement

    PubMed Central

    Dineshkumar, Thayalan; Suresh, Vemuri; Ramya, Ramadas; Rajkumar, Krishnan

    2016-01-01

    Granulocytic sarcoma (GS) is an extremely rare condition involving infiltration of myeloblasts or immature myeloid cells in an extramedullary site. It is also known as chloroma, myeloid sarcoma or extramedullary myeloid tumor. It usually occurs concomitantly with acute myelogenous leukemia or with the onset of blastic phase of chronic myelogenous leukemia. On rare occasions, it evolves even before the onset of leukemias, and when it precedes leukemias without any overt signs, it is referred to as the primary type. Although GSs can involve any body part, localization in the oral cavity is extremely rare. The recognition of this rare primary entity is important because early aggressive chemotherapy can cause regression of the tumor and improve survival. Here, we report a rare case of GS in a nonleukemic 62-year-old female who presented with generalized gingival enlargement involving both maxilla and mandible. PMID:27721621

  10. [Adsorption therapy for acute suppurative periostitis of the jaw].

    PubMed

    Maĭborodin, I V; Liubarskiĭ, M S; Loĭko, E R

    2002-01-01

    Capillaries and tissue leukocyte cytograms in soft gingival tissues were examined by optic microscopy in patients with acute purulent periostitis of the jaws treated by different methods. Disorders in the lymph outflow from gingival tissues were detected, which were due to dilatation of the lymph vessels and interstitial spaces in the mucosal lamina propria and stasis with leukocyte aggregation and purulent clots in the lumina of many lymph vessels. Less pronounced dilatation of interstitial spaces and lymph vessels, higher counts of lymphocytes, monocytes, and macrophages in the tissues of the gingival mucosa lamina propria, observed 2 days after the beginning of adsorption therapy of the subperiosteal abscess cavity, indicate that this therapy is more effective in acute purulent periostitis than traditional treatment.

  11. Descending Necrotizing Mediastinitis Treated with Tooth Extractions following Mediastinal and Cervical Drainage

    PubMed Central

    Fukuchi, Minoru; Suzuki, Okihide; Nasu, Daisuke; Koizumi, Kazue; Muta, Yu; Imaizumi, Hideko; Ishiguro, Toru; Kumagai, Youichi; Ishibashi, Keiichiro; Mochiki, Erito; Ishida, Hideyuki

    2015-01-01

    Descending necrotizing mediastinitis (DNM) is a rare condition in which oropharyngeal infection spreads to the mediastinum via the cervical fascia. Delayed diagnosis and surgery result in a high mortality rate among patients with DNM. We present a case of DNM resulting from odontogenic infection treated successfully with tooth extraction following mediastinal and cervical drainage. A 43-year-old, previously healthy Japanese man was admitted to our hospital for treatment of acute mediastinitis. Computed tomography revealed gas collection around the mid-thoracic esophagus and bilateral pleural effusion. We performed mediastinal drainage via right thoracotomy. Cervicotomy was performed on postoperative day 14 to drain a residual cervical abscess. The patient required the extraction of ten teeth over three procedures to address primary odontogenic infection before his fever resolved on postoperative day 40. Prompt diagnosis, aggressive drainage and removal of the source of infection can improve survival among patients with this life-threatening disease. PMID:26600767

  12. Necrotizing vasculitis of the skin and uterine cervix associated with minocycline therapy for acne vulgaris.

    PubMed

    Schrodt, B J; Kulp-Shorten, C L; Callen, J P

    1999-05-01

    In recent years, minocycline has become a commonly used agent for the treatment of acne vulgaris and rosacea. With this increased use have come reports of severe and in some cases life-threatening toxicity, often occurring in otherwise healthy young women after prolonged courses of minocycline. These adverse reactions include hepatotoxicity, drug-induced lupus erythematosus, eosinophilic pneumonitis, and hypersensitivity syndrome. We describe a 35-year-old woman who had necrotizing vasculitis of the skin and uterine cervix after 2 years of minocycline therapy for acne vulgaris. Skin and cervical biopsies revealed acute inflammation involving through-and-through necrosis of vessel walls with thrombosis, focal fibrinoid change, and a perivascular lymphohistiocytic infiltrate. The disease fully resolved within 3 months of discontinuance of the minocycline therapy. Patients should be informed of these rare but potentially serious adverse effects before the initiation of minocycline therapy. Early recognition of these complications can result in complete resolution.

  13. Acute Esophageal Necrosis: An Update

    PubMed Central

    Inayat, Faisal; Hurairah, Abu; Virk, Hafeez Ul Hassan

    2016-01-01

    Acute esophageal necrosis (AEN) or “black esophagus” is a rare clinical entity with an unclear etiology. It is diagnosed at upper gastrointestinal endoscopy with the presence of strikingly black necrotic esophagus. The treatment is primarily medical, but the prognosis is generally poor due to advanced age and comorbid illnesses in patients who develop AEN. Herein, we discussed the implications of poor glycemic control in regards with AEN and undertook a literature review of this rare diagnosis. PMID:27583242

  14. Acute Esophageal Necrosis: An Update.

    PubMed

    Inayat, Faisal; Hurairah, Abu; Virk, Hafeez Ul Hassan

    2016-07-01

    Acute esophageal necrosis (AEN) or "black esophagus" is a rare clinical entity with an unclear etiology. It is diagnosed at upper gastrointestinal endoscopy with the presence of strikingly black necrotic esophagus. The treatment is primarily medical, but the prognosis is generally poor due to advanced age and comorbid illnesses in patients who develop AEN. Herein, we discussed the implications of poor glycemic control in regards with AEN and undertook a literature review of this rare diagnosis. PMID:27583242

  15. Prevention of Phenytoin-Induced Gingival Overgrowth by Lovastatin in Mice

    PubMed Central

    Assaggaf, Mohammad A.; Kantarci, Alpdogan; Sume, Siddika S.; Trackman, Philip C.

    2016-01-01

    Drug-induced gingival overgrowth is caused by the antiseizure medication phenytoin, calcium channel blockers, and ciclosporin. Characteristics of these drug-induced gingival overgrowth lesions differ. We evaluate the ability of a mouse model to mimic human phenytoin-induced gingival overgrowth and assess the ability of a drug to prevent its development. Lovastatin was chosen based on previous analyses of tissue-specific regulation of CCN2 production in human gingival fibroblasts and the known roles of CCN2 in promoting fibrosis and epithelial to mesenchymal transition. Data indicate that anterior gingival tissue overgrowth occurred in phenytoin-treated mice based on gross tissue observations and histomorphometry of tissue sections. Molecular markers of epithelial plasticity and fibrosis were regulated by phenytoin in gingival epithelial tissues and in connective tissues similar to that seen in humans. Lovastatin attenuated epithelial gingival tissue growth in phenytoin-treated mice and altered the expressions of markers for epithelial to mesenchymal transition. Data indicate that phenytoin-induced gingival overgrowth in mice mimics molecular aspects of human gingival overgrowth and that lovastatin normalizes the tissue morphology and the expression of the molecular markers studied. Data are consistent with characterization of phenytoin-induced human gingival overgrowth in vivo and in vitro characteristics of cultured human gingival epithelial and connective tissue cells. Findings suggest that statins may serve to prevent or attenuate phenytoin-induced human gingival overgrowth, although specific human studies are required. PMID:25843680

  16. Repair of a Gingival Fenestration Using an Acellular Dermal Matrix Allograft.

    PubMed

    Breault, Lawrence G; Brentson, Raquel C; Fowler, Edward B; Bisch, Frederick C

    2016-01-01

    A case report illustrating the successful treatment of a gingival fenestration with an acellular dermal matrix (ADM) allograft. After 2½ months of healing, the ADM was completely integrated into the soft tissues of the mandibular anterior gingiva with complete resolution of the gingival fenestration, resulting in excellent gingival esthetics. PMID:26874103

  17. An update on crown lengthening. Part 1: Gingival tissue excess.

    PubMed

    Kalsi, Harpoonam Jeet; Hussain, Zahra; Darbar, Ulpee

    2015-03-01

    This is the first article in a two-part series which aims to provide an overview of the different techniques used to increase clinical crown height. In the first paper, the focus will be on the management of patients who present with gingival tissue excess. The different aetiologies are discussed and illustrated with clinical cases, following which a range of procedures that may be employed in the management of these patients are presented. With an increasingly ageing population, more patients are taking regular medications prescribed from their general medical practitioner, and so having a working knowledge of the specific drugs that may cause gingival enlargement is essential. Clinical Relevance: When patients with gingival tissue excess present in primary or secondary care, a clinician must have a good knowledge of the possible causes of the condition, as well as an idea of how the patient may be managed.

  18. Gingival hyperplasia being the first sign of Wegener's granulomatosis.

    PubMed

    Aravena, Víctor; Beltrán, Víctor; Cantín, Mario; Fuentes, Ramón

    2014-01-01

    Wegener's granulomatosis (GW) is a multisystemic granulomatous vasculitis that predominantly affects the airways and the kidneys, but may affect any organ. Otorhinolaryngological manifestations may be gingival swelling, oral ulcer or septal perforations that can cause saddle nose deformities, rhinitis, sinusitis and hearing loss. We report a case of WG that was first diagnosed on oral gingival mucosa. A 54-year old woman was referred to a specialized dentist because of consistent irritative buccal gingival hyperplasia that did not react to conservative and microbial treatment. The lesion was biopsied and the diagnosis was suggestive for WG. Patient was further referred to the Unit of Rheumatology and the diagnose of WG was confirmed and treated. This case emphasizes the importance to recognize the oral manifestation of WG to get proper medication as soon as possible and avoid serious systemic tissue damage.

  19. A new classification system for gingival and palatal recession.

    PubMed

    Kumar, Ashish; Masamatti, Sujata Surendra

    2013-03-01

    Various classifications have been proposed to classify gingival recession. Miller's classification of gingival recession is most widely followed. With a wide array of cases in daily clinical practice, it is often difficult to classify numerous gingival recession cases according to defined criteria of the present classification systems. To propose a new classification system that gives a comprehensive depiction of recession defect that can be used to include cases that cannot be classified according to present classifications. A separate classification system for palatal recessions (PR) is also proposed. This article outlines the limitations of present classification systems and also the inability to classify PR. A new comprehensive classification system is proposed to classify recession on the basis of the position of interdental papilla and buccal/lingual/palatal recessions. PMID:23869122

  20. The Autosomal Recessive Inheritance of Hereditary Gingival Fibromatosis

    PubMed Central

    Nair, Vineet; Mukherjee, Malancha; Ghosh, Sujoy; Dey, Subrata Kumar

    2013-01-01

    Hereditary gingival fibromatosis (HGF) is a rare condition which is marked by enlargement of gingival tissue that covers teeth to various extents leading to aesthetic disfigurement. This study presents a case of a 28-year-old female patient and 18-year-old male who belong to the same family suffering from HGF with chief complaint of overgrowing swelling gingiva. The presence of enlarged gingiva with the same eruption was found in their other family members with no concomitant drug or medical history, and the occurrence of HGF has been found in one generation of this family which may indicate the autosomal recessive inheritance pattern of HGF. Hereditary gingival fibromatosis is an idiopathic condition as its etiology is unknown and it was found to recur in some cases even after surgical treatment. Both patients underwent thorough oral prophylaxis and later surgical therapy to correct the deformity. PMID:24416600

  1. Binding, uptake, and release of nicotine by human gingival fibroblasts

    SciTech Connect

    Hanes, P.J.; Schuster, G.S.; Lubas, S. )

    1991-02-01

    Previous studies of the effects of nicotine on fibroblasts have reported an altered morphology and attachment of fibroblasts to substrates and disturbances in protein synthesis and secretion. This altered functional and attachment response may be associated with changes in the cell membrane resulting from binding of the nicotine, or to disturbances in cell metabolism as a result of high intracellular levels of nicotine. The purpose of the present study, therefore, was to (1) determine whether gingival fibroblasts bound nicotine and if any binding observed was specific or non-specific in nature; (2) determine whether gingival fibroblasts internalized nicotine, and if so, at what rate; (3) determine whether gingival fibroblasts also released nicotine back into the extracellular environment; and (4) if gingival fibroblasts release nicotine intact or as a metabolite. Cultures of gingival fibroblasts were prepared from gingival connective tissue biopsies. Binding was evaluated at 4{degree}C using a mixture of {sup 3}H-nicotine and unlabeled nicotine. Specific binding was calculated as the difference between {sup 3}H-nicotine bound in the presence and absence of unlabeled nicotine. The cells bound 1.44 (+/- 0.42) pmols/10(6) cells in the presence of unlabeled nicotine and 1.66 (+/- 0.55) pmols/10(6) cells in the absence of unlabeled nicotine. The difference was not significant. Uptake of nicotine was measured at 37{degree}C after treating cells with {sup 3}H-nicotine for time periods up to 4 hours. Uptake in pmols/10(6) cells was 4.90 (+/- 0.34) at 15 minutes, 8.30 (+/- 0.75) at 30 minutes, 12.28 (+/- 2.62) at 1 hour and 26.31 (+/- 1.15) at 4 hours.

  2. Prevalence of gingival biotype and its relationship to clinical parameters

    PubMed Central

    Shah, Rucha; Sowmya, N. K.; Mehta, D. S.

    2015-01-01

    Introduction: The dimensions of gingiva and different parts of the masticatory mucosa have a profound impact in periodontics as it governs the way; the gingival tissue reacts to various physical, chemical, or bacterial insults. The purpose of the following study was to assess the gingival thickness (GT) and correlate it to gender, presence of recession, and width of keratinized gingiva (WKG) in a subset of the Indian population. Methods: A total of 400 subjects in the age range of 20–35 years (200 males and 200 females) were included in the study. Clinical parameters such as probing depth, recession depth, WKG, and GT were recorded for all the patients. Results: The prevalence of thin biotype was 43.25%, and that of thick gingival biotype was 56.75%. The mean GT of central incisor, lateral incisor, and canine in Group I was 1.11 ± 0.17, 1.01 ± 0.16, and 0.82 ± 0.17 mm, respectively. No significant association was observed between the gender and the presence of gingival recession to GT. The mean WKG of central incisor, lateral incisor, and canine in Group I was 4.38 ± 1.18, 5.18 ± 1.25, 4.16 ± 1.16 mm, respectively. A positive correlation exists between WKG and the GT (P < 0.05). Conclusion: It was concluded that the prevalence of thick and thin gingival biotype is 56.75% versus 43.25%, respectively, and there is no significant relationship between age, gender, and the presence of recession to gingival biotype. A positive correlation exists between WKG and the GT. PMID:26604569

  3. Desquamative gingivitis: what's behind it? A case report.

    PubMed

    Parwani, Simran R; Parwani, Rajkumar N

    2014-01-01

    Desquamative gingivitis (DG) is a clinical term used to describe red, painful, glazed, friable gingiva. It may be a manifestation of a mucocutaneous condition, such as lichen planus or other vesiculobulous disorders. Dentists must be aware of this rare clinical entity in order to distinguish DG from the far more common plaque-induced gingivitis. This case is unique in that it involves oral lichen planus and chronic DG, which may be secondary to plaque or a manifestation of the oral lichen planus. Intraoral examination and biopsy reports revealed features of chronic DG and oral reticular lichen planus.

  4. [Parodontocid efficiency in complex treatment and prevention of gingivitis].

    PubMed

    Makeeva, I M; Turkina, A Iu; Poliakova, M A; Babina, K S

    2013-01-01

    Antiplaque/antigingivitis effect of an alcohol-free mouthrinse Parodontocid were evaluated by randomized parallel group clinical trial. Sixty patients with gingivitis were clinically examined to determine PHP, RMNPI and PMA indexes. After professional dental prophylaxis, subjects were randomly assigned in two groups to 10 days oral hygiene program. Group 1 patients used only toothbrush and prophylactic toothpaste while in group 2 persons used Parodontocid in conjunction with normal brushing and flossing.Parodontocid significantly reduced plaque and gingivitis compared to negative control. PMID:24429785

  5. Plasma-cell gingivitis. Report of a case.

    PubMed

    Lubow, R M; Cooley, R L; Hartman, K S; McDaniel, R K

    1984-04-01

    A well-documented case of plasma-cell gingivitis is presented. When viewed in a total perspective, the clinical examination, history of usage of a popular mint , laboratory data and histologic examination provide support for this diagnosis. This patient did not exhibit any evidence of glossitis or cheilitis as is often reported in the literature; however, a positive history to psoriasis was noted. The occurrence of plasma-cell gingivitis in a patient with documented psoriasis provides some interesting speculation regarding the etiologic picture of this condition. PMID:6585542

  6. [A case of gingival myiasis caused by Wohlfahrtia magnifica].

    PubMed

    Çetın Özdemır, Eda; Ekşi, Fahriye; Şenyurt, Süleyman Ziya; Üstün, Kemal; Karaoğlan, İlkay; Ercıyas, Kamile

    2014-07-01

    Myiasis is an infestation of living or dead tissue of humans and animals by diptera larvae. Gingival myiasis is a rare pathology and is mainly associated with poor oral hygiene, alcoholism, senility, suppurative lesions, mouth breathing, mental retardation and hemiplegia. Myiasis is most common during summer since the fly population increases during this season. Mostly it occurs in farmers and people who live in tropical climates. Gingival myiasis in humans in Turkey is limited to only a few cases. According to our literature research, this is the first case of gingival myiasis produced by larvae of Wohlfahrtia magnifica in a Turkish adult. According to our best knowledge, it is also the first gingival myiasis case that one of the causative larva had grown to the adult stage in Turkey. A 43 years old male patient who perceived the presence of live maggots in his mouth was referred to our clinic. Clinical findings of gingival myiasis were observed. The patient had no history of systemic disease but oral hygiene was poor. Clinical and radiographic examination indicated that he had chronic periodontitis. Before the dental treatment seven larvae and during the scalling five larvae were elevated from the gingival sulcus. The body of the larvae composed of 12 segments and they were 8-10 mm in length. One of the larvae which was sent to the microbiology laboratory were placed into sheep liver to resume life and the other larvae were placed into 70% alcohol solution. After 9-10 days, the larva which was placed in the liver became pupa. Approximately 15 days later, the pupa became an adult fly. The larvae were identified as the second stage larvae of Wohlfahrtia magnifica. Treatment consisted of removal of the maggots from the gingival sulcus, followed by scaling and oral hygiene instruction. Non-surgical periodontal treatment was applied and the patient was followed-up for 3 months. After non-surgical periodontal treatment, patient didn't accept the flap operation. The

  7. Global developmental delay with sodium valproate-induced gingival hyperplasia.

    PubMed

    Patil, Ravi B; Urs, Pallavi; Kiran, Shital; Bargale, Seema Dinesh

    2014-01-01

    Global developmental delay (GDD) refers to a disturbance in an individual child across one or more developmental domains, which include motor, cognition, daily activities, speech and language. The present case discusses a 5-year-old child with GDD associated with infantile spasms treated with sodium valproate. Delay in the widespread acquisition of skills, epilepsy and poor oral hygiene with gingival enlargement was the main concern to seek medical aid. This case is special as the child was suffering from GDD associated with sodium valproate-induced gingival enlargement.

  8. [Method and procedures in bacteriological study of necrotic teeth].

    PubMed

    Rodríguez-Ponce, A; López Campos, A; López Paz, J; Pazos Sierra, R

    1991-01-01

    Research was conducted of 160 radicular canals with necrotic pulp. Results of different bacteriological analyses are presented. Culture analyses in aerobic and anaerobic media, resulted in the isolation of Staphylococcus Epidermidis, Streptococcus Viridans and Corynebacterium sp in the group studied, as the most frequent bacteria. There was no evidence of a specific germ linked with the pulp necrosis.

  9. Tomato necrotic streak virus, a novel subgroup 2 ilarvirus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A novel plant virus has been identified infecting fresh market tomato plants in south and southeast Florida. The virus causes necrosis of tomato leaves, petioles and stems, and necrotic rings or spots on tomato fruits. Symptomatic tomato plant tissue was used to mechanically inoculate tomato plant...

  10. IVIG-mediated protection against necrotizing pneumonia caused by MRSA.

    PubMed

    Diep, Binh An; Le, Vien T M; Badiou, Cedric; Le, Hoan N; Pinheiro, Marcos Gabriel; Duong, Au H; Wang, Xing; Dip, Etyene Castro; Aguiar-Alves, Fábio; Basuino, Li; Marbach, Helene; Mai, Thuy T; Sarda, Marie N; Kajikawa, Osamu; Matute-Bello, Gustavo; Tkaczyk, Christine; Rasigade, Jean-Philippe; Sellman, Bret R; Chambers, Henry F; Lina, Gerard

    2016-09-21

    New therapeutic approaches are urgently needed to improve survival outcomes for patients with necrotizing pneumonia caused by Staphylococcus aureus One such approach is adjunctive treatment with intravenous immunoglobulin (IVIG), but clinical practice guidelines offer conflicting recommendations. In a preclinical rabbit model, prophylaxis with IVIG conferred protection against necrotizing pneumonia caused by five different epidemic strains of community-associated methicillin-resistant S. aureus (MRSA) as well as a widespread strain of hospital-associated MRSA. Treatment with IVIG, either alone or in combination with vancomycin or linezolid, improved survival outcomes in this rabbit model. Two specific IVIG antibodies that neutralized the toxic effects of α-hemolysin (Hla) and Panton-Valentine leukocidin (PVL) conferred protection against necrotizing pneumonia in the rabbit model. This mechanism of action of IVIG was uncovered by analyzing loss-of-function mutant bacterial strains containing deletions in 17 genes encoding staphylococcal exotoxins, which revealed only Hla and PVL as having an impact on necrotizing pneumonia. These results demonstrate the potential clinical utility of IVIG in the treatment of severe pneumonia induced by S. aureus. PMID:27655850

  11. An update on sequence diversity of Impatiens necrotic spot virus

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Impatiens necrotic spot virus (INSV; genus Tospovirus, family Bunyaviridae) is an economically important viral pathogen for a wide range of plants, including greenhouse ornamental and vegetable crops. In many cases, symptoms induced by INSV are similar, though not identical, to those induced by Toma...

  12. Identification of cultivable microorganisms from primary teeth with necrotic pulps.

    PubMed

    Ledezma-Rasillo, Gildardo; Flores-Reyes, Hector; Gonzalez-Amaro, Ana M; Garrocho-Rangel, Arturo; Ruiz-Rodriguez, M del Socorro; Pozos-Guillen, Amaury J

    2010-01-01

    The objective of this study was to identify cultivable microorganisms from primary teeth with necrotic pulps. This experimental study included 21 patients of both sexes between 4 and 7 years of age with necrotic pulps in primary teeth. Twenty-one maxillary and mandibular molars containing at least 1 necrotic canal, an abscess or sinus tract, one or more radiolucent areas in the furcation or periapical region, teeth having at least two thirds of root length, and carious lesions directly exposed to the oral environment were included. After antisepsis of the oral cavity, anesthesia of the affected tooth, and isolation and disinfection of the operative field, 3 sterile absorbent paper points were sequentially placed for 30 seconds for the collection of samples. The samples were immediately processed in an anaerobic chamber, and all isolated microorganisms were identified. Anaerobic species (anaerobic facultative and moderate anaerobes) were isolated in all root canals; 68.4% of root canal samples studied showed a polymicrobial nature. Most of the isolate consisted of Bifidobacterium Spp2 and Streptococcus intermedius. Other less frequently encountered species were Actinomyces israelii, Bifidobacterium spp 1, Clostridium spp, and Candida albicans. Results indicate the existence of combinations of bacterial species in root canal infections of the primary dentition with necrotic pulps, anaerobic bacteria predominating.

  13. Focal transmural necrotic tracheitis in commercial meat turkeys.

    PubMed

    Sentíes-Cué, Gabriel; Crespo, Rocio; Chin, R P

    2003-01-01

    This report describes an unusual presentation of severe focal necrotic tracheitis in a flock of 8-wk-old commercial turkeys. The flock was kept on a range that is located near a cotton field. The cotton field had been chemically defoliated 2 wk before the birds were submitted for necropsy. At necropsy, most of the birds had a 1-cm, yellow-white constricture in the upper third of the trachea at which the lumen was partially occluded by necrotic tissue. Microscopically, there was severe, transmural necrosis with an accumulation of inflammatory exudate in the tracheal lumen and numerous bacteria within the necrotic debris, mucosa, and lamina propria. Mixed bacteria were isolated from the trachea. No viruses were detected. Neither abnormal heavy metal concentrations in the liver nor paraquat in the respiratory tract were detected. The exact cause of this severe, necrotic tracheitis was not determined. Based on the clinical history and laboratory findings, it was concluded that a combination of a toxic irritant, possibly an aerosolized cotton defoliant, and bacterial infections were likely the cause of this lesion. PMID:12713185

  14. Necrotizing fasciitis – a diagnostic dilemma: two case reports

    PubMed Central

    2014-01-01

    Introduction Necrotizing soft tissue infections can affect various tissue planes. Although predisposing etiologies are many, they mostly center on impaired immunity occurring directly or indirectly and loss of integrity of protective barriers which predispose to infection. The nonspecific presentation may delay diagnosis and favor high mortality. Case presentation Two case vignettes are presented. The first patient, a 44-year-old healthy South Asian man with a history of repeated minor traumatic injury presented to a primary health care center with a swollen left lower limb. He was treated with antibiotics with an initial diagnosis of cellulitis. Because he deteriorated rapidly and additionally developed intestinal obstruction, he was transferred to our hospital which is a tertiary health care center for further evaluation and management. Prompt clinical diagnosis of necrotizing soft tissue infection was made and confirmed on magnetic resonance imaging as necrotizing fasciitis. Urgent debridement was done, but the already spread infection resulted in rapid clinical deterioration with resultant mortality. The second patient was a 35-year-old South Asian woman with systemic lupus erythematous receiving immunosuppressive therapy who developed left lower limb pain and fever. Medical attention was sought late as she came to the hospital after 4 days. Her condition deteriorated rapidly as she developed septic shock and died within 2 days. Conclusions Necrotizing fasciitis can be fatal when not recognized and without early intervention. Clinicians and surgeons alike should have a greater level of suspicion and appreciation for this uncommon yet lethal infection. PMID:24965382

  15. Focal transmural necrotic tracheitis in commercial meat turkeys.

    PubMed

    Sentíes-Cué, Gabriel; Crespo, Rocio; Chin, R P

    2003-01-01

    This report describes an unusual presentation of severe focal necrotic tracheitis in a flock of 8-wk-old commercial turkeys. The flock was kept on a range that is located near a cotton field. The cotton field had been chemically defoliated 2 wk before the birds were submitted for necropsy. At necropsy, most of the birds had a 1-cm, yellow-white constricture in the upper third of the trachea at which the lumen was partially occluded by necrotic tissue. Microscopically, there was severe, transmural necrosis with an accumulation of inflammatory exudate in the tracheal lumen and numerous bacteria within the necrotic debris, mucosa, and lamina propria. Mixed bacteria were isolated from the trachea. No viruses were detected. Neither abnormal heavy metal concentrations in the liver nor paraquat in the respiratory tract were detected. The exact cause of this severe, necrotic tracheitis was not determined. Based on the clinical history and laboratory findings, it was concluded that a combination of a toxic irritant, possibly an aerosolized cotton defoliant, and bacterial infections were likely the cause of this lesion.

  16. [Method and procedures in bacteriological study of necrotic teeth].

    PubMed

    Rodríguez-Ponce, A; López Campos, A; López Paz, J; Pazos Sierra, R

    1991-01-01

    Research was conducted of 160 radicular canals with necrotic pulp. Results of different bacteriological analyses are presented. Culture analyses in aerobic and anaerobic media, resulted in the isolation of Staphylococcus Epidermidis, Streptococcus Viridans and Corynebacterium sp in the group studied, as the most frequent bacteria. There was no evidence of a specific germ linked with the pulp necrosis. PMID:1659855

  17. Carbohydrate maldigestion induces necrotizing enterocolitis in preterm pigs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Necrotizing enterocolitis (NEC) remains the most severe gastrointestinal disorder in preterm infants. It is associated with the initiation of enteral nutrition and may be related to immature carbohydrate digestive capacity. We tested the hypothesis that a formula containing maltodextrin vs. lactose ...

  18. Temporary feed restriction partially protects broilers from necrotic enteritis.

    PubMed

    Tsiouris, V; Georgopoulou, I; Batzios, Chr; Pappaioannou, N; Ducatelle, R; Fortomaris, P

    2014-01-01

    The objective of this study was to investigate the effect of feed restriction on the intestinal ecosystem and on the pathogenesis of experimental necrotic enteritis in broiler chicks. To induce subclinical necrotic enteritis, an experimental challenge model using a specific diet formulation, Gumboro vaccination, oral inoculation of broilers with a 10-fold dose of attenuated anticoccidial vaccine and multiple oral inoculations with a specific strain of Clostridium perfringens was adopted. Two hundred and forty 1-day-old Cobb 500 broilers were randomly allocated to four groups: feed restricted, challenged, both feed restricted and challenged, and negative control. At 21, 22, 23 and 24 days of age, the intestines, gizzard and liver were collected from 15 birds in each group and scored for gross lesions. The intestinal digesta was collected for pH and viscosity determination. One caecum from each bird was taken for microbiological analysis. The application of feed restriction in birds challenged with C. perfringens reduced the necrotic enteritis lesion score significantly (P ≤ 0.05) and feed restriction significantly reduced (P ≤ 0.05) pH in the small intestine, the viscosity of the jejunum digesta as well as the C. perfringens counts in the caeca compared with the controls. In conclusion, feed restriction of broilers has a positive effect on the intestinal ecosystem and a significant protective effect against necrotic enteritis in the subclinical experimental model.

  19. [Necrotizing sialometaplasia--diagnostic difficulties--literature review].

    PubMed

    Jamróz-Wilkońskaa, Lidia; Chomyszyn-Gajewska, Maria; Wilkoński, Wojciech

    2014-01-01

    Necrotizing sialometaplasia is a benign, self-limiting inflammatory process, which concerns small salivary glands. This kind of lesion is very rare, with difficulties in clinical and histopathological diagnosis. Ulceration is the dominating symptom, which may suggest that it is a malignancy. Lesions usually heal spontaneously.

  20. The effect of waxed and unwaxed dental floss on gingival health. Part I. Plaque removal and gingival response.

    PubMed

    Lamberts, D M; Wunderlich, R C; Caffesse, R G

    1982-06-01

    The purpose of this study was to determine the effectiveness of waxed and unwaxed floss in plaque removal and on gingival health when used in a home oral hygiene program. Eighty patients, having previously received periodontal therapy, were divided into four similar groups, according to the S-OHI. Each group represented four different types of dental floss being tested: Butler waxed, Butler unwaxed, Johnson and Johnson waxed, and Johnson and Johnson unwaxed. After receiving a thorough prophylaxis, each patient received oral hygiene instruction with a video tape, and was given a toothbrush and a quantity of test floss. At 0, 28 and 56 day intervals, The patients were scored for plaque and gingivitis. The data were then analyzed statistically using analysis of variance. It was found that there was no statistical difference among the four different types of tested floss as far as their plaque removal ability or prevention of gingivitis is concerned.

  1. Incidence of verapamil-induced gingival hyperplasia in a dental population.

    PubMed

    Miller, C S; Damm, D D

    1992-05-01

    The records of 5,000 dental patients were reviewed for history of verapamil use between 1987 and 1990. Twenty-four dentate patients who received verapamil for more than 1 year were identified. Of these, gingival hyperplasia occurred in 1 patient (4.1%) that was limited to the mandibular attached gingiva. Onset of gingival overgrowth was associated with drug dosage, bacterial accumulation, and gingival inflammation. Histologically, the findings resembled that seen in hyperplasia induced by phenytoin, cyclosporin, and other calcium channel blockers. Our data suggest that gingival hyperplasia caused by verapamil occurs less frequently than nifedipine-induced gingival hyperplasia.

  2. Zoledronic acid suppresses transforming growth factor-β-induced fibrogenesis by human gingival fibroblasts

    PubMed Central

    KOMATSU, YUKO; IBI, MIHO; CHOSA, NAOYUKI; KYAKUMOTO, SEIKO; KAMO, MASAHARU; SHIBATA, TOSHIYUKI; SUGIYAMA, YOSHIKI; ISHISAKI, AKIRA

    2016-01-01

    Bisphosphonates (BPs) are analogues of pyro-phosphate that are known to prevent bone resorption by inhibiting osteoclast activity. Nitrogen-containing BPs, such as zoledronic acid (ZA), are widely used in the treatment of osteoporosis and bone metastasis. However, despite having benefits, ZA has been reported to induce BP-related osteonecrosis of the jaw (BRONJ) in cancer patients. The molecular pathological mechanisms responsible for the development of BRONJ, including necrotic bone exposure after tooth extraction, remain to be elucidated. In this study, we examined the effects of ZA on the transforming growth factor-β (TGF-β)-induced myofibroblast (MF) differentiation of human gingival fibroblasts (hGFs) and the migratory activity of hGFs, which are important for wound closure by fibrous tissue formation. The ZA maximum concentration in serum (Cmax) was found to be approximately 1.47 µM, which clinically, is found after the intravenous administration of 4 mg ZA, and ZA at this dose is considered appropriate for the treatment of cancer bone metastasis or bone diseases, such as Erdheim-Chester disease. At Cmax, ZA significantly suppressed i) the TGF-β-induced promotion of cell viability, ii) the TGF-β-induced expression of MF markers such as α-smooth muscle actin (α-SMA) and type I collagen, iii) the TGF-β-induced migratory activity of hGFs and iv) the expression level of TGF-β type I receptor on the surfaces of hGFs, as well as the TGF-β-induced phosphorylation of Smad2/3. Thus, ZA suppresses TGF-β-induced fibrous tissue formation by hGFs, possibly through the inhibition of Smad-dependent signal transduction. Our findings partly elucidate the molecular mechanisms underlying BRONJ and may prove to be beneficial to the identification of drug targets for the treatment of this symptom at the molecular level. PMID:27176567

  3. A review of factors influencing the incidence and severity of plaque-induced gingivitis.

    PubMed

    Trombelli, L; Farina, R

    2013-06-01

    An individual variation in the gingival inflammatory response to the dental biofilm has been demonstrated. This variability can be observed between individuals with neither quantitative nor qualitative differences in plaque accumulation. The reported significant differences in gingival inflammatory response under quantitatively and/or qualitatively almost identical bacterial challenge suggest that the gingival response to plaque accumulation may be an individual trait, possibly genetic in origin. The most recent classification of periodontal diseases acknowledges that the clinical expression of plaque-induced gingival inflammation can be substantially modified by systemic factors, either inherent to the host or related to environmental influences. The aim of the present literature review is to describe (i) the factors influencing the development of plaque-induced gingivitis as well as (ii) those metabolic, environmental and systemic factors which have a direct impact on the etiopathogenetic pathway of plaque-induced gingivitis, thus altering the nature or course of the gingival inflammatory response to dental biofilm.

  4. Lasers in esthetic treatment of gingival melanin hyperpigmentation: a review article.

    PubMed

    Bakhshi, Mahin; Rahmani, Somayeh; Rahmani, Ali

    2015-11-01

    The health and suitability of mouth components play an important role towards defining facial attractiveness. An important component of the oral cavity is the color of the gingival tissue. Gingival melanin hyperpigmentation is caused by several reasons and affects people across ethnicity, race, age, and both gender. Lasers are presently being used for gingival melanin depigmentation. In this article, we reviewed studies on laser parameters, duration of gingival healing, pain perception during and after the operation, scores used for the evaluation of gingival melanin hyperpigmentation, follow-up period, treatment results, and recurrence reports. We conclude that laser ablation for gingival depigmentation is one of the most pleasant, reliable, acceptable, and impressive techniques available for treating gingival melanin hyperpigmentation.

  5. Effect of Phenytoin and Age on Gingival Fibroblast Enzymes

    PubMed Central

    Vahabi, Surena; Nazemisalman, Bahareh; Vahid Golpaigani, Mojtaba; Ahmadi, Anahid

    2014-01-01

    Objective: The alteration of cytokine balance is stated to exert greater influence on gingival overgrowth compared to the direct effect of the drug on the regulation of extracellular matrix metabolism. The current study evaluated the effect of phenytoin on the regulation of collagen, lysyl oxidase and elastin in gingival fibroblasts. Materials and Methods: Normal human gingival fibroblasts (HGFs) were obtained from 4 healthy children and 4 adults. Samples were cultured with phenytoin. MTT test was used to evaluate the proliferation and ELISA was performed to determine the level of IL1β and PGE2 production by HGFs. Total RNA of gingival fibroblasts was extracted and RT-PCR was performed on samples. Mann-Whitney U test was used to analyze the data with an alpha error level less than 0.05. Results: There was a significant difference in the expression of elastin between the controls and treated samples in both adult and pediatric groups and also in the lysyl oxidase expression of adult controls and treated adults. No significant difference was found between collagen expression in adults. Conclusion: The significant difference in elastin and lysyl oxidase expression between adult and pediatric samples indicates the significant effect of age on their production. PMID:25628662

  6. Enamel-renal-gingival syndrome and FAM20A mutations.

    PubMed

    Kantaputra, Piranit Nik; Kaewgahya, Massupa; Khemaleelakul, Udomrat; Dejkhamron, Prapai; Sutthimethakorn, Suchitra; Thongboonkerd, Visith; Iamaroon, Anak

    2014-01-01

    The enamel-renal syndrome of amelogenesis imperfecta (AI) and nephrocalcinosis, and the amelogenesis imperfecta-gingival fibromatosis syndrome have both been associated with mutations in FAM20A. We report on two unrelated Thai patients with three novel and one previously reported mutations in FAM20A with findings suggesting both disorders, including hypoplastic AI, gingival fibromatosis, unerupted teeth, aggressive periodontitis, and nephrocalcinosis/nephrolithiasis. Additional findings consisted of a supernumerary premolar, localized aggressive periodontitis, thin alveolar bone, vitamin D deficiency-associated hyperparathyroidism, and heterotopic calcification in other tissues, including lungs, dental pulp, gingiva, dental follicles, and periodontal tissues, and early cessation of limited menstruation. Greater promotory activity of urine on calcium oxalate crystal growth compared to controls may help to explain the pathogenesis, and suggest that FAM20A mutations can contribute to nephrocalcinosis/nephrolithiasis. Our findings expand the phenotypic spectrum of FAM20A mutations. Since both of our patients and a large number of previously reported cases had all the important features of both syndromes, including AI, renal anomalies, and gingival fibromatosis, we are convinced that these two disorders actually are the same entity. The name of enamel-renal-gingival syndrome is suggested. PMID:24259279

  7. Ambras Syndrome with Gingival Hyperplasia: A Rare Entity.

    PubMed

    Reddy Kundoor, Vinay Kumar; Maloth, Kotya Naik; Kesidi, Sunitha; Moni, Thakur

    2016-01-01

    Ambras syndrome is a rare and special form of congenital hypertrichosis, characterized by dysmorphic facial features and familial pattern of inheritance. It is rarely associated with gingival hyperplasia. We report such a rare entity in a 38-year-old female patient with a history of consanguinity and positive family history. PMID:27601862

  8. Electrodeposition of pronectin for titanium to augment gingival epithelium adhesion.

    PubMed

    Kawabata, Shingo; Asano, Kazunari; Miyazawa, Atsuko; Satoh, Tazuko; Tabata, Yasuhiko

    2013-05-01

    This paper is one trial of surface modification of titanium with pronectin F+ (PN) of an artificial protein to enhance gingival adhesion. Titanium plates were electrodeposited in the PN solution to prepare PN-electrodeposited titanium plates. When PN detachment from the PN-electrodeposited titanium plates was investigated, no detachment was observed, in contrast to the case of titanium plates simply coated with PN. A cell culture experiment demonstrated that electrodeposited PN had an inherent ability to enhance the initial attachment of gingival epithelial cells. The PN-electrodeposited titanium plates were implanted between the gingival epithelium and the underlying bone tissue of rabbits to evaluate epithelial growth on the plates and their gingival adhesion. Non-treated and PN-coated titanium plates were used as controls. PN electrodeposition enhanced epithelial growth and adhesion of titanium plates to a significantly great extent compared with PN-coated plates. These findings demonstrate that PN electrodeposition is a promising method to enhance epithelium adhesion onto a titanium surface.

  9. Ambras Syndrome with Gingival Hyperplasia: A Rare Entity

    PubMed Central

    Reddy Kundoor, Vinay Kumar; Maloth, Kotya Naik; Kesidi, Sunitha; Moni, Thakur

    2016-01-01

    Ambras syndrome is a rare and special form of congenital hypertrichosis, characterized by dysmorphic facial features and familial pattern of inheritance. It is rarely associated with gingival hyperplasia. We report such a rare entity in a 38-year-old female patient with a history of consanguinity and positive family history.

  10. Management of Cyclosporine and Nifedipine-Induced Gingival Hyperplasia

    PubMed Central

    Dilber, Erhan; Aral, Kübra; Sarica, Yagmur; Sivrikoz, Oya Nermin

    2015-01-01

    Gingival enlargements modified by medications are becoming more common because of the increased use of inducing drugs, and may create speech, mastication, tooth eruption, periodontal, and aesthetic problems. We hereby present a case of a 54-year-old man with 12-month history of generalized gingival enlargement in the keratinized gingiva was referred to our clinic. The patient had a history of kidney transplant and was under medication of cyclosporine and nifedipine. After medical consultation, cyclosporine was changed to tacrolimus and nifedipine was changed to captopril. Gingivectomy was performed using a diode laser, and scaling and root planning were performed. At five months postoperative, the gingival enlargements relapsed and diode laser-assisted surgery was repeated. The patient was followed-up on second postoperatively at 18 months and no relapse was seen. Diode laser-assisted gingivectomy was found to be useful for coagulation during surgery and decreased postoperative bleeding. Recurrence risk of cyclosporine and nifedipine-induced gingival overgrowth is high, thus, there is a great need for prolonged care of patients following treatment and prosthetic restoration. PMID:26812935

  11. Management of Cyclosporine and Nifedipine-Induced Gingival Hyperplasia.

    PubMed

    Aral, Cüneyt Asim; Dilber, Erhan; Aral, Kübra; Sarica, Yagmur; Sivrikoz, Oya Nermin

    2015-12-01

    Gingival enlargements modified by medications are becoming more common because of the increased use of inducing drugs, and may create speech, mastication, tooth eruption, periodontal, and aesthetic problems. We hereby present a case of a 54-year-old man with 12-month history of generalized gingival enlargement in the keratinized gingiva was referred to our clinic. The patient had a history of kidney transplant and was under medication of cyclosporine and nifedipine. After medical consultation, cyclosporine was changed to tacrolimus and nifedipine was changed to captopril. Gingivectomy was performed using a diode laser, and scaling and root planning were performed. At five months postoperative, the gingival enlargements relapsed and diode laser-assisted surgery was repeated. The patient was followed-up on second postoperatively at 18 months and no relapse was seen. Diode laser-assisted gingivectomy was found to be useful for coagulation during surgery and decreased postoperative bleeding. Recurrence risk of cyclosporine and nifedipine-induced gingival overgrowth is high, thus, there is a great need for prolonged care of patients following treatment and prosthetic restoration.

  12. Ambras Syndrome with Gingival Hyperplasia: A Rare Entity.

    PubMed

    Reddy Kundoor, Vinay Kumar; Maloth, Kotya Naik; Kesidi, Sunitha; Moni, Thakur

    2016-01-01

    Ambras syndrome is a rare and special form of congenital hypertrichosis, characterized by dysmorphic facial features and familial pattern of inheritance. It is rarely associated with gingival hyperplasia. We report such a rare entity in a 38-year-old female patient with a history of consanguinity and positive family history.

  13. Enamel-renal-gingival syndrome and FAM20A mutations.

    PubMed

    Kantaputra, Piranit Nik; Kaewgahya, Massupa; Khemaleelakul, Udomrat; Dejkhamron, Prapai; Sutthimethakorn, Suchitra; Thongboonkerd, Visith; Iamaroon, Anak

    2014-01-01

    The enamel-renal syndrome of amelogenesis imperfecta (AI) and nephrocalcinosis, and the amelogenesis imperfecta-gingival fibromatosis syndrome have both been associated with mutations in FAM20A. We report on two unrelated Thai patients with three novel and one previously reported mutations in FAM20A with findings suggesting both disorders, including hypoplastic AI, gingival fibromatosis, unerupted teeth, aggressive periodontitis, and nephrocalcinosis/nephrolithiasis. Additional findings consisted of a supernumerary premolar, localized aggressive periodontitis, thin alveolar bone, vitamin D deficiency-associated hyperparathyroidism, and heterotopic calcification in other tissues, including lungs, dental pulp, gingiva, dental follicles, and periodontal tissues, and early cessation of limited menstruation. Greater promotory activity of urine on calcium oxalate crystal growth compared to controls may help to explain the pathogenesis, and suggest that FAM20A mutations can contribute to nephrocalcinosis/nephrolithiasis. Our findings expand the phenotypic spectrum of FAM20A mutations. Since both of our patients and a large number of previously reported cases had all the important features of both syndromes, including AI, renal anomalies, and gingival fibromatosis, we are convinced that these two disorders actually are the same entity. The name of enamel-renal-gingival syndrome is suggested.

  14. Ambras Syndrome with Gingival Hyperplasia: A Rare Entity

    PubMed Central

    Reddy Kundoor, Vinay Kumar; Maloth, Kotya Naik; Kesidi, Sunitha; Moni, Thakur

    2016-01-01

    Ambras syndrome is a rare and special form of congenital hypertrichosis, characterized by dysmorphic facial features and familial pattern of inheritance. It is rarely associated with gingival hyperplasia. We report such a rare entity in a 38-year-old female patient with a history of consanguinity and positive family history. PMID:27601862

  15. Giant gingival pseudoepitheliomatous hyperplasia in lung squamous cell carcinoma.

    PubMed

    Xiang, Guolin; Long, Xing; Han, Qianchao; Tian, Lihua

    2012-07-01

    We here describe a case of giant primary gingival pseudoepitheliomatous hyperplasia in a 53-year-old Chinese male patient with lung squamous cell carcinoma (SCC). The pathogenesis of the lesion and the deferential diagnosis from invasive SCC are also discussed. To our knowledge, such a hugeous primary pseudoepitheliomatous hyperplasia of the gingiva accompanied with lung SCC is unusual.

  16. The effectiveness of dental floss in reducing gingival inflammation.

    PubMed

    Finkelstein, P; Grossman, E

    1979-03-01

    Unwaxed and waxed dental floss were clinically evaluated for effectiveness in reducing gingival inflammation. Two different scoring methods were employed. Both types of floss, when administered by a dental hygienist, were very effective, but no significant differences between them could be found. Both scoring methods led to the same conclusions, but one was more sensitive and provided more detailed information.

  17. Evaluation of gingival vascularisation using laser Doppler flowmetry

    NASA Astrophysics Data System (ADS)

    Vitez, B.; Todea, C.; Velescu, A.; Şipoş, C.

    2016-03-01

    Aim: The present study aims to assess the level of vascularisation of the lower frontal gingiva of smoker patients, in comparison with non-smokers by using Laser Doppler Flowmetry (LDF), in order to determine the changes in gingival microcirculation. Material & methods: 16 volunteers were included in this study and separated into 2 equal groups: non-smoker subjects in Group I and smoker subjects in Group II. All patients were submitted to a visual examination and professional cleaning The gingival bloodflow of each patient was recorded in 5 zones using LDF, resulting in a total of 80 recordings. LDF was done with the Moor Instruments Ltd. "moorLAB" Laser Doppler. All data were collected as graphs, raw values and statistically analyzed. Results: After strict analysis results show that Group II presents a steady level of gingival microcirculation with even patterns in the graph, while Group I shows many signs of damage to it`s microvascular system through many irregularities in the microcirculation level and graph patterns. Conclusion: The results suggest that prolonged smoking has a definitive effect on the gingival vascularisation making it a key factor in periodontal pathology.

  18. Prevalence of Gingival Biotypes among Young Dentate North Indian Population: A Biometric Approach

    PubMed Central

    Rao, Polsani L; Bhoria, Mohaneesh

    2016-01-01

    ABSTRACT Aim: To evaluate the prevalence of various gingival biotypes and to corroborate gingival thickness and gingival biotypes across tooth type, site, and gender. Materials and methods: A cross-sectional study was conducted across systemically healthy subjects. A systematic clinical evaluation for gingival biotypes and gingival thicknesses was recorded by modified Iwanson’s gauge, to the nearest 0.1 mm, probing the gingival sulcus at the midfacial aspect of maxillary and mandibular central incisors and first molars. All measurements were made across a total of 920 sites in 115 subjects (69 female and 46 male) based on gingival transparency and were statistically analyzed. Results: A significant agreement on the reproducibility of the measurements was noted. The median overall gingival thickness was recorded at 0.75 mm with interquantile difference of 0.39 mm. The thin biotype variant showed across the ranges of 0.3 to 0.6 mm of gingival thicknesses and thick biotype variant across the ranges of 1.0 to 1.2 mm, with more prevalence in anterior and posterior site respectively. Moreover, for gingi-val thickness of 0.7 mm, the probe visibility showed tendency toward both thin/thick biotype variant in both anterior and posterior segments. The disposition of male participants toward thick biotype and female participants toward the thin biotype variant has been noted. Conclusion: Within the limitations of the current study, our data support the traditional hypothesis of two main gingival biotypes as distinguishable by gingival transparency. In addition, we provide evidence of existence of intermediate biotypes with respect to gingival thickness. These findings can be utilized as objective guidelines for determination of biotype and can be implicated in many dental operative procedures. How to cite this article: Rathee M, Rao PL, Bhoria M. Prevalence of Gingival Biotypes among Young Dentate North Indian Population: A Biometric Approach. Int J Clin Pediatr Dent 2016

  19. Necrotizing sialometaplasia in the mouth floor secondary to reconstructive surgery for tongue carcinoma.

    PubMed

    Matsumoto, T; Kuwabara, N; Shiotsu, H; Fukuda, Y; Yanai, A; Ichikawa, G

    1991-09-01

    Necrotizing sialometaplasia is a benign inflammatory process, which histologically can mimic squamous cell carcinoma. A 63-year-old man underwent left hemiglossectomy involving transplantation of a myocutaneous flap for squamous cell carcinoma of the tongue. One month after the operation, necrotizing sialometaplasia occurred in the minor salivary gland tissue of the mouth floor, compressed by the necrotic flap. This case is very unusual because of the occurrence of necrotizing sialometaplasia in the floor of the mouth. The etiology of the lesion was considered to be ischemia secondary to compression by the necrotic myocutaneous flap.

  20. The effect of triclosan on mediators of gingival inflammation.

    PubMed

    Gaffar, A; Scherl, D; Afflitto, J; Coleman, E J

    1995-06-01

    Triclosan (2,4,4',-trichloro-2'-hydroxydiphenylether) is a well-known and widely used nonionic antibacterial agent which has recently been introduced in toothpastes and mouthrinses. The efficacy of triclosan-containing toothpaste and mouthrinse to reduce both plaque and gingivitis in long-term clinical trials has been well documented. Until recently, it was generally assumed that triclosan's effect on gingival inflammation was due to its antimicrobial and anti-plaque effect. It has now become apparent that triclosan may have a direct anti-inflammatory effect on the gingival tissues. Several in vitro studies were conducted to evaluate the effect of triclosan on 4 primary enzymes of the pathways of arachidonic acid metabolism, cyclo-oxygenase 1, cyclo-oxygenase 2, 5-lipoxygenase and 15-lipoxygenase. These pathways lead to the production of known mediators of inflammation such as the prostaglandins, leukotrienes and lipoxins. Triclosan inhibited both cyclooxygenase 1 and cyclo-oxygenase 2 with IC-50 values of 43 microM and 227 microM, respectively. Triclosan also inhibited 5-lipoxygenase with an IC-50 of 43 microM. The 15-lipoxygenase was similarly inhibited by triclosan with an IC-50 of 61 microM. Hence, triclosan has the ability to inhibit both the cyclo-oxygenase and lipoxygenase pathways of arachidonic acid metabolism with similar efficacy. In cell culture experiments, it was found that triclosan inhibited IL-1 beta induced prostaglandin E2 production by human gingival fibroblasts in a concentration dependent manner, and at relatively low concentrations. These data, taken together, indicate that triclosan can inhibit formation of several important mediators of gingival inflammation.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Subgingival bacterial colonization profiles correlate with gingival tissue gene expression

    PubMed Central

    2009-01-01

    Background Periodontitis is a chronic inflammatory disease caused by the microbiota of the periodontal pocket. We investigated the association between subgingival bacterial profiles and gene expression patterns in gingival tissues of patients with periodontitis. A total of 120 patients undergoing periodontal surgery contributed with a minimum of two interproximal gingival papillae (range 2-4) from a maxillary posterior region. Prior to tissue harvesting, subgingival plaque samples were collected from the mesial and distal aspects of each tissue sample. Gingival tissue RNA was extracted, reverse-transcribed, labeled, and hybridized with whole-genome microarrays (310 in total). Plaque samples were analyzed using checkerboard DNA-DNA hybridizations with respect to 11 bacterial species. Random effects linear regression models considered bacterial levels as exposure and expression profiles as outcome variables. Gene Ontology analyses summarized the expression patterns into biologically relevant categories. Results Wide inter-species variation was noted in the number of differentially expressed gingival tissue genes according to subgingival bacterial levels: Using a Bonferroni correction (p < 9.15 × 10-7), 9,392 probe sets were differentially associated with levels of Tannerella forsythia, 8,537 with Porphyromonas gingivalis, 6,460 with Aggregatibacter actinomycetemcomitans, 506 with Eikenella corrodens and only 8 with Actinomyces naeslundii. Cluster analysis identified commonalities and differences among tissue gene expression patterns differentially regulated according to bacterial levels. Conclusion Our findings suggest that the microbial content of the periodontal pocket is a determinant of gene expression in the gingival tissues and provide new insights into the differential ability of periodontal species to elicit a local host response. PMID:19835625

  2. Human Memory B Cells in Healthy Gingiva, Gingivitis, and Periodontitis.

    PubMed

    Mahanonda, Rangsini; Champaiboon, Chantrakorn; Subbalekha, Keskanya; Sa-Ard-Iam, Noppadol; Rattanathammatada, Warattaya; Thawanaphong, Saranya; Rerkyen, Pimprapa; Yoshimura, Fuminobu; Nagano, Keiji; Lang, Niklaus P; Pichyangkul, Sathit

    2016-08-01

    The presence of inflammatory infiltrates with B cells, specifically plasma cells, is the hallmark of periodontitis lesions. The composition of these infiltrates in various stages of homeostasis and disease development is not well documented. Human tissue biopsies from sites with gingival health (n = 29), gingivitis (n = 8), and periodontitis (n = 21) as well as gingival tissue after treated periodontitis (n = 6) were obtained and analyzed for their composition of B cell subsets. Ag specificity, Ig secretion, and expression of receptor activator of NF-κB ligand and granzyme B were performed. Although most of the B cell subsets in healthy gingiva and gingivitis tissues were CD19(+)CD27(+)CD38(-) memory B cells, the major B cell component in periodontitis was CD19(+)CD27(+)CD38(+)CD138(+)HLA-DR(low) plasma cells, not plasmablasts. Plasma cell aggregates were observed at the base of the periodontal pocket and scattered throughout the gingiva, especially apically toward the advancing front of the lesion. High expression of CXCL12, a proliferation-inducing ligand, B cell-activating factor, IL-10, IL-6, and IL-21 molecules involved in local B cell responses was detected in both gingivitis and periodontitis tissues. Periodontitis tissue plasma cells mainly secreted IgG specific to periodontal pathogens and also expressed receptor activator of NF-κB ligand, a bone resorption cytokine. Memory B cells resided in the connective tissue subjacent to the junctional epithelium in healthy gingiva. This suggested a role of memory B cells in maintaining periodontal homeostasis. PMID:27335500

  3. Comparative evaluation of the amount of gingival displacement produced by three different gingival retraction systems: An in vivo study

    PubMed Central

    Chaudhari, Jignesh; Prajapati, Paranjay; Patel, Jayanti; Sethuraman, Rajesh; Naveen, Y.G

    2015-01-01

    Statement of Problem: Tetrahydrozoline has been introduced as new gingival retraction agent but its clinical efficacy with widely used conventional retraction agents has not been tested. Purpose: The study was designed to clinically evaluate efficacy of newer retraction agent tetrahydrozoline with two widely used retraction systems i.e., Expasyl retraction system and medicated retraction cords on basis of amount of gingival retraction. Materials and Methods: 30 subjects were selected according to inclusion and exclusion criteria. Maxillary Impressions were made with irreversible hydrocolloid for all subjects. Tray material was used for making the special tray. Latin Block Design was Used in the Study to avoid tissue fatigue. Retraction was done with aluminium chloride; Tetrahydrozoline and Expasyl according to Latin block design. Impressions were poured with die stone. Casts were retrieved and sections were made with die cutter. 3 mm thin slices were obtained. Each slice was used to measure the amount of retraction under stereomicroscope under 20x and images were transferred to image analyser. Results: The amount of gingival retraction obtained by using aluminium chloride as gingival retraction agent was maximum (148238.33 μm2) compared to tetrahydrozoline (140737.87 μm2) and Expasyl (67784.90 μm2). PMID:26097353

  4. Red clover necrotic mosaic virus: Biophysics and Biotechnology

    NASA Astrophysics Data System (ADS)

    Lockney, Dustin M.

    Red clover necrotic mosaic virus (RCNMV) is a highly robust (Tm=60 °C), 36 nm icosahedral plant virus. The capsid of RCNMV is assembled from 180 chemically equivalent coat proteins (CPs). The CPs arrange in a T=3 symmetry, in 1 of 3 conformations forming the asymmetric subunit (ASU). There are two Ca(II) binding sites per CP; the removal of divalent cations causes the CP subunits of the ASU to rotate away from each other forming a ˜13 A channel. These channels lead to the highly organized bipartite genome of RCNMV and can be closed by adding back Ca(II). Titrimetric analysis and tryptophan fluorescence was used to determine the affinity of RCNMV for Ca(II) to be ˜Kd < 300 nM. It has been shown that doxorubicin (Dox) can be infused into the capsid at a mole ratio of ˜1000:1, Dox-to-virus, and unlike other nanoparticles, there is no detectable leakage. The high loading of Dox is most likely due to intercalation into the genome and significant intercalation or exposure to denaturants was observed to cause loss of capsid stability. To better understand the limitations of cargo loading, Dox and other intercalating molecules (rhodamine 800, ethidium bromide, and propidium iodide) were assayed to determine optimum infusion conditions. Dox was observed to have a propensity to aggregate. In order to manage the Dox aggregation, the infusion buffer was changed from 50 mM Tris-HCl/50 mM NaOAc/50 mM EDTA or 200 mM EDTA at pH 8.0 to 5 mM HEPES/5 mM Na4EDTA/10 mM NaCl pH 7.8. The Dox:RCNMV infusion mole ratio was also lowered from 5000:1 to 500:1 and the incubation temperature was changed from 4 °C to 22 °C for <12 hours, opposed to 24 hours. To impart targeting functionality to RCNMV, biomimetic peptides were conjugated to either the surface capsid lysines or cysteines using standard bioconjugation methods. For all of the biomimetic peptides screened, sulfosuccinimidyl 4-(N-maleimidomethyl) cyclohexane-1-carboxylate (sulfo-SMCC) was used to orthogonally attach the

  5. Minimally Invasive Treatment of Acute Intrahepatic Fluid Collections With Acute Biliary Pancreatitis

    PubMed Central

    Ambrosi, Antonio; Fersini, Alberto; Tartaglia, Nicola; Valentino, Tiziano Pio

    2009-01-01

    Background: Peripancreatic fluid collection suggests the anatomical-clinical scenario of necrotizing acute pancreatitis. However, intrahepatic fluid collection is a rare occurrence with fewer than 30 cases being reported in the medical literature. We describe 2 cases of intrahepatic fluid collection in 2 patients with acute biliary pancreatitis and discuss the therapeutic possibilities. Case Reports: The first case report is that of a 68-year-old female with a diagnosis of acute biliary pancreatitis with several necrotizing fluid collections and a large infected intrahepatic collection in the left lobe. The patient was successfully treated by percutaneous US/CT guided drainage. The second case report is that of a 72-year-old female with a diagnosis of acute biliary pancreatitis with several peripancreatic fluid collections and a voluminous intrahepatic fluid collection in the left lobe that caused epigastric pain. This patient was also successfully treated with percutaneous US/CT guided drainage. Conclusion: Intrahepatic fluid collection in the course of acute biliary pancreatitis is a rare occurrence. The therapeutic approach is the same as that for pancreatic and peripancreatic fluid collections. In case of infection, the patient undergoes percutaneous US/CT guided drainage. This therapeutic procedure can be added to the therapeutic program for necrotizing acute biliary pancreatitis together with ERCP/ES and videolaparocholecystectomy (VLC). PMID:19660231

  6. [Pathogenesis of acute encephalitis and acute encephalopathy].

    PubMed

    Shiomi, Masashi

    2011-03-01

    Many aspects of the pathogenesis of acute encephalitis and acute encephalopathy have been clarified in this decade, although many unknown mechanisms remain to be elucidated. According to progress of MRI and neuroimmunological analysis and the observation of clinical findings, many new syndromes were found, which enhanced our understanding of acute encephalitis and acute encephalopathy. The pathogenesis of encephalitis is divided into infection and immune mediated mechanisms. The antibodies to neuronal surface antigens(NSA) such as NMDA receptors, leucin-rich glioma inactivated 1 (LGI1) and aquaporin 4 were demonstrated in specific encephalitis, limbic encephalitis and neuromyelitis optica. Anti-NSA antibody encephalitis should be treated by immunotherapy such as corticosteroid and plasmapheresis. Acute encephalitis with refractory repetitive partial seizures (AERRPS) is a devastating postinfectious disease in children and adults, although the pathogenesis of AERRPS is poorly understood. Influenza associated encephalopathy(IAE) is characterized by it's high incidence in Japanese children between 1 year and 5 years of age, its onset in the first or the second day of illness and its high mortality (15-30%) and morbidity (25-40%). We proposed the classification of IAE with poor prognosis from the neuroradiological findings. Four types of encephalopathy seem to be differentiated from each other, acute necrotizing encephalopathy (ANE) type, hemorrhagic shock and encephalopathy syndrome (HSES) type, acute brain swelling (ABS) type, febrile convulsive status epilepticus (FCSE) type. The notable radiological features are thalamic lesions in ANE, diffuse cerebral cortical cytotoxic edema in HSES, reversible cerebral swelling in ABS which sometimes reaches lethal brain herniation, and in FCSE type, dendritic high signal in subcortical white matter by DWI ("bright tree appearance") appears simultaneously with the later onset of repetitive focal seizure. These four types are

  7. Treatment of Necrotic Calcified Tooth Using Intentional Replantation Procedure

    PubMed Central

    Arvin, Armita; Darvish, Alireza; Aflaki, Sareh

    2014-01-01

    Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM) cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible. PMID:24716000

  8. Treatment of necrotic calcified tooth using intentional replantation procedure.

    PubMed

    Moradi Majd, Nima; Arvin, Armita; Darvish, Alireza; Aflaki, Sareh; Homayouni, Hamed

    2014-01-01

    Introduction. If the teeth are impacted by a chronic irritant, the pulp space possibly will undergo calcific changes that may impede access opening during root canal treatment. In such cases that conventional endodontic treatment is impossible or impractical, intentional replantation may be considered as a last solution to preserve the tooth. Methods. After failing to perform conventional root canal therapy for a necrotic calcified right mandibular second premolar, the tooth was gently extracted. The root apex was resected and the root end cavity was prepared and filled with calcium enriched mixture (CEM) cement. Then, the extracted tooth was replanted in its original position. Results. After a year the tooth was asymptomatic, and the size of periapical radiolucency was remarkably reduced and no clinical sign of ankylosis was observed. Conclusion. Intentional replantation of the necrotic calcified teeth could be considered as an alternative to teeth extraction, especially for the single-rooted teeth and when nonsurgical and surgical endodontic procedures seem impossible.

  9. Transfusion-associated Necrotizing Enterocolitis (TANEC): Evidence and Uncertainty

    PubMed Central

    Gephart, Sheila M.

    2012-01-01

    Transfusion-associated Necrotizing Enterocolitis (TANEC) has been described as necrotizing enterocolitis (NEC) that arises within 48 hours of a blood transfusion. [1, 2] TANEC is concerning to clinicians and has been shown to be associated with 25–35% of NEC in recent studies. Evidence related to TANEC is limited to observational, retrospective studies. Infants who develop TANEC tend to be smaller, born at earlier gestation, more severely ill and develop NEC after 30 days of age. Evidence in two studies support holding feedings during transfusion to protect the preterm gut from the cascade of events that lead to NEC but higher quality research, including prospective randomized controlled trials, is needed to evaluate the effect of feeding on TANEC. PMID:22864004

  10. A mesenteric hernia complicated with a triple necrotic volvulus.

    PubMed

    Tassinari, Davide; Santoro, Stefano; Bernardi, Filippo; Lima, Mario

    2012-09-24

    A 6-year-old girl was admitted to the paediatric emergency department with colicky abdominal pain. She had a significant medical history, with four previous admissions due to recurrent abdominal pain in the past year. On examination the abdomen was soft, there was no rebound tenderness and Rovsing's sign was negative. Her blood tests revealed a raised white cells count, although her C reactive protein was within the normal range. Abdominal x-ray revealed small bowel obstruction. During her assessment the patient rapidly deteriorated and seemed to go into shock. Her clinical state in addition to the radiological findings meant that she was taken to theatre for surgical exploration. This showed a triple volvulus with necrotic bowel loops that had herniated through a mesenteric defect. The necrotic bowel was subsequently resected.

  11. A case of Apophysomyces trapeziformis necrotizing soft tissue infection.

    PubMed

    Echaiz, Jose F; Burnham, Carey-Ann D; Bailey, Thomas C

    2013-12-01

    Mucormycosis is a rare and devastating disease. Apophysomyces trapeziformis is an environmental mold that was recently implicated in several cases of cutaneous and soft tissue mucormycosis in victims of a tornado in Joplin, Missouri. Here, we report a case of Apophysomyces trapeziformis necrotizing soft tissue infection in a resident of Joplin 10 months after the disaster and without preceding trauma. Aspects of histological and microbiological diagnosis are also reviewed. PMID:23891642

  12. Ahmed glaucoma valve surgery for necrotizing scleritis with secondary glaucoma.

    PubMed

    Ranjan, Abhishek; Rao, Aparna

    2014-04-01

    To report the challenges in management in a case of scleritis with extensive staphylomas with secondary glaucoma. A 35-year-old one eyed female, a known case of scleromalacia perforans, presented with raised intraocular pressure on maximum medical treatment. She underwent successful Ahmed glaucoma valve surgery with exposure of the implant following a repeat episode of necrotizing scleritis after 3 months. Management of eyes with scleritis and secondary glaucoma can be challenging with unexpected complications and postoperative course.

  13. Necrotizing hepatitis in a domestic pigeon (Columba livia).

    PubMed

    Himmel, L; O'Connor, M; Premanandan, C

    2014-11-01

    An adult male domestic pigeon (Columba livia) was presented for necropsy following natural death after a period of chronic weight loss and severe intestinal ascariasis. Histopathologic examination of the liver found moderate to marked, multifocal necrotizing hepatitis with large, basophilic intranuclear inclusion bodies. Transmission electron microscopy of affected hepatocytes demonstrated numerous intra- and perinuclear icosahedral virions arranged in a lattice structure, consistent with adenoviral infection.

  14. Necrotizing sialometaplasia involving the mucous glands of the nasal cavity.

    PubMed

    Johnston, W H

    1977-09-01

    Necrotizing sialometaplasia was found in maxillary sinus mucous glands of an 83 year old woman who had undergone a radical maxillectomy for basal cell carcinoma 10 days earlier. Previously recognized as an ulcerating lesion involving salivary glands in the oral cavity, this benign reactive process may also occur in the mucous glands of the nasal cavity and sinuses and can simulate squamous cell or mucoepidermoid carcinoma. Ischemia appears to be pathogenetic.

  15. An Immature Myeloid/Myeloid-Suppressor Cell Response Associated with Necrotizing Inflammation Mediates Lethal Pulmonary Tularemia.

    PubMed

    Periasamy, Sivakumar; Avram, Dorina; McCabe, Amanda; MacNamara, Katherine C; Sellati, Timothy J; Harton, Jonathan A

    2016-03-01

    Inhalation of Francisella tularensis (Ft) causes acute and fatal pneumonia. The lung cytokine milieu favors exponential Ft replication, but the mechanisms underlying acute pathogenesis and death remain unknown. Evaluation of the sequential and systemic host immune response in pulmonary tularemia reveals that in contrast to overwhelming bacterial burden or cytokine production, an overt innate cellular response to Ft drives tissue pathology and host mortality. Lethal infection with Ft elicits medullary and extra-medullary myelopoiesis supporting recruitment of large numbers of immature myeloid cells and MDSC to the lungs. These cells fail to mature and die, leading to subsequent necrotic lung damage, loss of pulmonary function, and host death that is partially dependent upon immature Ly6G+ cells. Acceleration of this process may account for the rapid lethality seen with Ft SchuS4. In contrast, during sub-lethal infection with Ft LVS the pulmonary cellular response is characterized by a predominance of mature neutrophils and monocytes required for protection, suggesting a required threshold for lethal bacterial infection. Further, eliciting a mature phagocyte response provides transient, but dramatic, innate protection against Ft SchuS4. This study reveals that the nature of the myeloid cell response may be the primary determinant of host mortality versus survival following Francisella infection. PMID:27015566

  16. An Immature Myeloid/Myeloid-Suppressor Cell Response Associated with Necrotizing Inflammation Mediates Lethal Pulmonary Tularemia.

    PubMed

    Periasamy, Sivakumar; Avram, Dorina; McCabe, Amanda; MacNamara, Katherine C; Sellati, Timothy J; Harton, Jonathan A

    2016-03-01

    Inhalation of Francisella tularensis (Ft) causes acute and fatal pneumonia. The lung cytokine milieu favors exponential Ft replication, but the mechanisms underlying acute pathogenesis and death remain unknown. Evaluation of the sequential and systemic host immune response in pulmonary tularemia reveals that in contrast to overwhelming bacterial burden or cytokine production, an overt innate cellular response to Ft drives tissue pathology and host mortality. Lethal infection with Ft elicits medullary and extra-medullary myelopoiesis supporting recruitment of large numbers of immature myeloid cells and MDSC to the lungs. These cells fail to mature and die, leading to subsequent necrotic lung damage, loss of pulmonary function, and host death that is partially dependent upon immature Ly6G+ cells. Acceleration of this process may account for the rapid lethality seen with Ft SchuS4. In contrast, during sub-lethal infection with Ft LVS the pulmonary cellular response is characterized by a predominance of mature neutrophils and monocytes required for protection, suggesting a required threshold for lethal bacterial infection. Further, eliciting a mature phagocyte response provides transient, but dramatic, innate protection against Ft SchuS4. This study reveals that the nature of the myeloid cell response may be the primary determinant of host mortality versus survival following Francisella infection.

  17. An Immature Myeloid/Myeloid-Suppressor Cell Response Associated with Necrotizing Inflammation Mediates Lethal Pulmonary Tularemia

    PubMed Central

    Periasamy, Sivakumar; Avram, Dorina; McCabe, Amanda; MacNamara, Katherine C.; Sellati, Timothy J.; Harton, Jonathan A.

    2016-01-01

    Inhalation of Francisella tularensis (Ft) causes acute and fatal pneumonia. The lung cytokine milieu favors exponential Ft replication, but the mechanisms underlying acute pathogenesis and death remain unknown. Evaluation of the sequential and systemic host immune response in pulmonary tularemia reveals that in contrast to overwhelming bacterial burden or cytokine production, an overt innate cellular response to Ft drives tissue pathology and host mortality. Lethal infection with Ft elicits medullary and extra-medullary myelopoiesis supporting recruitment of large numbers of immature myeloid cells and MDSC to the lungs. These cells fail to mature and die, leading to subsequent necrotic lung damage, loss of pulmonary function, and host death that is partially dependent upon immature Ly6G+ cells. Acceleration of this process may account for the rapid lethality seen with Ft SchuS4. In contrast, during sub-lethal infection with Ft LVS the pulmonary cellular response is characterized by a predominance of mature neutrophils and monocytes required for protection, suggesting a required threshold for lethal bacterial infection. Further, eliciting a mature phagocyte response provides transient, but dramatic, innate protection against Ft SchuS4. This study reveals that the nature of the myeloid cell response may be the primary determinant of host mortality versus survival following Francisella infection. PMID:27015566

  18. Imaging lexicon for acute pancreatitis: 2012 Atlanta Classification revisited.

    PubMed

    Sureka, Binit; Bansal, Kalpana; Patidar, Yashwant; Arora, Ankur

    2016-02-01

    The original 1992 Atlanta Classification System for acute pancreatitis was revised in 2012 by the Atlanta Working Group, assisted by various national and international societies, through web-based consensus. This revised classification identifies two phases of acute pancreatitis: early and late. Acute pancreatitis can be either oedematous interstitial pancreatitis or necrotizing pancreatitis. Severity of the disease is categorized into three levels: mild, moderately severe and severe, depending upon organ failure and local/systemic complications. According to the type of pancreatitis, collections are further divided into acute peripancreatic fluid collection, pseudocyst, acute necrotic collection, and walled-off necrosis. Insight into the revised terminology is essential for accurate communication of imaging findings. In this review article, we will summarize the updated nomenclature and illustrate corresponding imaging findings using examples.

  19. NetB and necrotic enteritis: the hole movable story.

    PubMed

    Rood, Julian I; Keyburn, Anthony L; Moore, Robert J

    2016-06-01

    Clostridium perfringens is the primary causative agent of avian necrotic enteritis. Our understanding of the pathogenesis of this economically important disease has been enhanced by the discovery of C. perfringens NetB toxin, which belongs to the α-haemolysin family of β-pore-forming toxins. In a chicken disease model, the analysis of an isogenic set of strains comprising the wild type, a netB mutant, and its complemented derivative, fulfilled molecular Koch's postulates and revealed that NetB was essential for disease. These results were consistent with epidemiological surveys, which generally found that there was a higher prevalence of netB carriage in C. perfringens isolates from diseased poultry compared to healthy birds. The netB gene has been shown to be located on large conjugative plasmids that are closely related to other toxin plasmids from C. perfringens, which has potential implications for the epidemiology of necrotic enteritis infections. The crystal structures of both monomeric NetB and the heptameric NetB pore have been determined, the latter revealed a central pore diameter of approximately 26 Å. Finally, it has been shown that vaccine preparations that include NetB can protect chickens against disease and a series of single amino acid substitution derivatives of NetB that have potential value for vaccine formulations have been isolated and analysed. It is likely that NetB will be an important antigen to include in an effective, commercially viable, necrotic enteritis vaccine. PMID:27009522

  20. Necrotic Enteritis in Chickens Associated with Clostridium sordellii.

    PubMed

    Rimoldi, Guillermo; Uzal, Francisco; Chin, R P; Palombo, Enzo A; Awad, Milena; Lyras, Dena; Shivaprasad, H L

    2015-09-01

    Three outbreaks of necrotic enteritis-like disease associated with Clostridium sordelii were diagnosed in commercial broiler chicken flocks with 18,000 to 31,000 birds between 18 and 26 days old. Clinical signs in the affected flocks included high mortality up to 2% a day, depression, and diarrhea. The main gross changes included segmental dilation of the small intestine with watery contents, gas, mucoid exudate, and roughened and uneven mucosa, occasionally covered with a pseudomembrane. Microscopic lesions in the small intestine were characterized by extensive areas of coagulative necrosis of the villi, fibrinous exudate in the lumen, and high numbers of large, Gram-positive rods, occasionally containing subterminal spores, seen in the necrotic tissue and lumen. These rods were identified as C. sordellii by immunohistochemistry. Clostridium sordellii was isolated in an almost pure culture from the intestine of affected birds. A retrospective study of commercial broiler chicken and turkey submissions to the California Animal Health and Food Safety Laboratory System revealed that C. sordellii had been isolated from intestinal lesions in outbreaks of necrotic enteritis-like disease in 8 of 39 cases, 5 times together with Clostridium perfringens and 3 times alone. The latter three cases are reported here.

  1. Bacteriological analysis of necrotic pulp and fistulae in primary teeth

    PubMed Central

    FABRIS, Antônio Scalco; NAKANO, Viviane; AVILA-CAMPOS, Mario Júlio

    2014-01-01

    Objectives Primary teeth work as guides for the eruption of permanent dentition, contribute for the development of the jaws, chewing process, preparing food for digestion, and nutrient assimilation. Treatment of pulp necrosis in primary teeth is complex due to anatomical and physiological characteristics and high number of bacterial species present in endodontic infections. The bacterial presence alone or in association in necrotic pulp and fistula samples from primary teeth of boys and girls was evaluated. Material and Methods Necrotic pulp (103) and fistula (7) samples from deciduous teeth with deep caries of 110 children were evaluated. Bacterial morphotypes and species from all clinical samples were determined. Results A predominance of gram-positive cocci (81.8%) and gram-negative coccobacilli (49.1%) was observed. In 88 out of 103 pulp samples, a high prevalence of Enterococcus spp. (50%), Porphyromonas gingivalis (49%), Fusobacterium nucleatum (25%) and Prevotella nigrescens (11.4%) was observed. Porphyromonas gingivalis was detected in three out of seven fistula samples, Enterococcus spp. in two out of seven samples, and F. nucleatum, P. nigrescens and D. pneumosintes in one out of seven samples. Conclusions Our results show that Enterococcus spp. and P. gingivalis were prevalent in necrotic pulp from deciduous teeth in boys from 2 to 5 years old, and that care of the oral cavity of children up to five years of age is important. PMID:24676582

  2. Phenytoin, folic acid and gingival enlargement: Breaking myths

    PubMed Central

    Nayyar, Abhishek Singh; Khan, Mubeen; Vijayalakshmi, K. R.; Suman, B.; Subhas, G. T.; Nataraju, B.; Anitha, M.

    2014-01-01

    Background: Epilepsy is described as a chronic neurological disorder characterized by recurrent seizures of cerebral origin, presenting with episodes of sensory, motor or autonomic phenomenon with or, without loss of consciousness. A recent meta-analysis of published and unpublished studies puts an overall prevalence rate of epilepsy in India at 5.59 per 1,000 populations. There have been studies that report clinical benefits of the use of folic acid as an adjuvant to the anti-epileptic therapy in the prevention of anti-epileptic drug induced gingival enlargement. However, studies conducted in the past have also reported precipitation of epileptic attacks in patients on folic acid adjuvant therapy due to fall in sera levels of phenytoin due to drug interactions. The study was planned to investigate the association of phenytoin induced gingival enlargement and sera levels of folic acid in epileptic patients on phenytoin therapy so as to justify the use of folic acid as a routine adjuvant to the usual anti-epileptic therapy to prevent this inevitable adverse effect without destabilizing the ongoing regimen leading to the precipitation of seizures in an otherwise stable patient (breakthrough seizures). Materials and Methods: A total of 100 patients between the ages 18 and 50 years were clinically diagnosed with epilepsy prior to the start of phenytoin therapy were included based on selection criteria and written informed consents were obtained. Assessment of serum folic acid levels and gingival enlargement was performed prior to the start of and after 1 year of phenytoin therapy. Statistical Analysis Used: The statistical analysis was carried out using t-test and the baseline serum folate levels and the serum folate levels obtained after 1 year of phenytoin therapy were correlated with the respective grades of gingival enlargement using Pearson's coefficient formula. Results: The results of the study confirmed a significant association between low serum folate levels

  3. Necrotizing fasciitis: epidemiology and clinical predictors for amputation

    PubMed Central

    Khamnuan, Patcharin; Chongruksut, Wilaiwan; Jearwattanakanok, Kijja; Patumanond, Jayanton; Tantraworasin, Apichat

    2015-01-01

    Background Necrotizing fasciitis, a relatively uncommon infection involving the skin, subcutaneous tissue, and fascia, is a rapidly progressive soft tissue infection and a medical and surgical urgency. Delayed debridement, with subsequent huge soft tissue loss is associated with loss of limb and infection and is the most common cause of mortality. The purpose of this work is to describe the epidemiology of necrotizing fasciitis and to identify the clinical characteristics that may be used to predict amputation in routine clinical practice. Methods Retrospective cohort study data were collected from three general hospitals located in the Chiang Rai, Kamphaeng Phet, and Phayao provinces in northern Thailand. Epidemiologic data for all patients with a surgically confirmed diagnosis of necrotizing fasciitis between 2009 and 2012 were collected. Medical records and reviews were retrieved from inpatient records, laboratory reports, and registers. Clinical predictors for amputation were analyzed by multivariable risk regression. Results A total of 1,507 patients with a diagnosis of necrotizing fasciitis were classified as being with amputation (n=127, 8.4%) and without amputation (n=1,380, 91.6%). The most common causative Gram-positive and Gram-negative pathogens were Streptococcus pyogenes (33.3% in the amputation group and 40.8% in the non-amputation group) and Escherichia coli (25% in the amputation group and 17.1% in the non-amputation group). Predictive factors for amputation included gangrene (risk ratio [RR] 4.77, 95% confidence interval [CI] 2.70–8.44), diabetes mellitus (RR 3.08, 95% CI 1.98–4.78), skin necrosis (RR 2.83, 95% CI 2.52–3.18), soft tissue swelling (RR 1.76, 95% CI 1.24–2.49), and serum creatinine values ≥1.6 mg/dL on admission (RR 1.71, 95% CI 1.38–2.12). All data were analyzed using the multivariable risk regression generalized linear model. Conclusion The most causative pathogens were S. pyogenes and E. coli. Clinical predictors for

  4. Severity of necrotizing enterocolitis: influence on outcome at 2 years of age.

    PubMed

    Walsh, M C; Kliegman, R M; Hack, M

    1989-11-01

    The long-term outcome of very low birth weight (VLBW) infants with necrotizing enterocolitis has been reported to be similar to that of other VLBW infants. To examine the influence of disease severity on outcome, the growth and neurodevelopment of survivors of necrotizing enterocolitis were evaluated when the babies were 20 months' corrected age. Between 1975 and 1983, 1506 VLBW infants were admitted to the hospital, and necrotizing enterocolitis developed in 84 (5.6%). Forty infants (48%) survived to be 20 months' corrected age, and complete follow-up data were available for 36. Survivors were classified by modified Bell's criteria into four groups by increasing severity of disease; 13 had mild necrotizing enterocolitis (stage IIA, IIB), and 23 had severe necrotizing enterocolitis (stage IIIA, IIIB). The 36 survivors were compared with 766 surviving VLBW infants without necrotizing enterocolitis. There were no perinatal or socioeconomic differences between groups. Compared with infants with stage II necrotizing enterocolitis at 20 months, infants with stage III necrotizing enterocolitis had a higher rate of subnormal body weight (39% vs 15%) and subnormal head circumference (30% vs 0%). Thirty-three percent of necrotizing enterocolitis survivors had significant neurodevelopmental impairment; the majority of impaired infants (10 of 12) were survivors of stage III necrotizing enterocolitis. These findings highlight the importance of continued evaluations for medical and neurodevelopmental sequelae.

  5. Treatment and two-year follow-up of a patient with hereditary gingival fibromatosis

    PubMed Central

    Bansal, Abhinav; Narang, Sumit; Sowmya, K.; Sehgal, Nidhi

    2011-01-01

    Hereditary gingival fibromatosis is a rare disorder characterized by various degrees of attached gingival overgrowth. Gingival fibromatosis usually develops as an isolated disorder but can be one feature of a syndrome. A case of a 17-year-old female who presented with a generalized severe gingival overgrowth, involving the maxillary and mandibular arches and covering almost the whole dentition. Excess gingival tissue was removed by conventional gingivectomy under local anesthesia. The postoperative course was uneventful and the patient's appearance improved considerably. Good esthetic result was achieved without recurrence of the gingival overgrowth. After treatment, regular recall visits are necessary in order to evaluate oral hygiene, and the stability of the periodontal treatment. PMID:22368369

  6. Lip repositioning surgery for correction of excessive gingival display

    PubMed Central

    Muthukumar, Santhanakrishnan; Natarajan, Shanmuganathan; Madhankumar, Seenivasan; Sampathkumar, Jayakrishnakumar

    2015-01-01

    Esthetic demands have considerably increased over the years in routine clinical practice. A pleasant smile can give supreme confidence to an individuals personality. However, a perfect smile is dictated by a perfect balance of the white (teeth) and pink (gingival) display. This balance can be managed different treatment modalities, which is based on proper diagnosis. This case report demonstrates a successful management of gummy smile with a lip-repositioning procedure in a patient with an incompetent upper lip. This was accomplished by removing a partial thickness strip of mucosa from the maxillary buccal vestibule and suturing the lip mucosa to the mucogingival line. This resulted in a narrower vestibule and restricted muscle pull, thereby resulting incompetent lips and reduced gingival display during smiling. PMID:26538972

  7. Aesthetic Depigmentation of Gingival Smoker's Melanosis Using Carbon Dioxide Lasers

    PubMed Central

    Monteiro, Luis Silva; Costa, José Adriano; da Câmara, Marco Infante; Albuquerque, Rui; Martins, Marco; Pacheco, José Júlio; Salazar, Filomena; Figueira, Fernando

    2015-01-01

    Melanic pigmentation results from melanin produced by the melanocytes present in the basal layer of the oral epithelium. One of the most common causes of oral pigmentation is smoker melanosis, a condition associated with the melanocyte stimulation caused by cigarette smoke. This paper aims to illustrate the use of a carbon dioxide laser in the removal of the gingival melanic pigmentation for aesthetic reasons in a 27-year-old female patient with history of a smoking habit. The carbon dioxide laser vaporisation was performed on the gingival mucosa with effective and quick results and without any complications or significant symptoms after the treatment. We conclude that a carbon dioxide laser could be a useful, effective, and safe instrument to treat the aesthetic complications caused by oral smoker melanosis. PMID:25954535

  8. Pink esthetics in periodontics - Gingival depigmentation: A case series.

    PubMed

    Thangavelu, Arthiie; Elavarasu, Sugumari; Jayapalan, Piranitha

    2012-08-01

    Smile expresses a feeling of joy, success, sensuality, affection, and courtesy, and reveals self-confidence and kindness. The harmony of the smile is determined not only by the shape, the position, and the color of the teeth, but also by the gingival tissues. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of "black gums" are common, particularly in patients having a very high smile line. Thus, perio-esthetic treatment modalities strive to achieve a harmonious inter-relationship of the pink with white, which is imperative of all treatment procedures. For depigmentation of gingival, different treatment modalities have been reported, such as bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery, and laser. In the present case series, scraping, electrosurgery, and diode laser have been tried for depigmentation, which are simple, effective, and yield good results, along with good patient satisfaction.

  9. Pink esthetics in periodontics – Gingival depigmentation: A case series

    PubMed Central

    Thangavelu, Arthiie; Elavarasu, Sugumari; Jayapalan, Piranitha

    2012-01-01

    Smile expresses a feeling of joy, success, sensuality, affection, and courtesy, and reveals self-confidence and kindness. The harmony of the smile is determined not only by the shape, the position, and the color of the teeth, but also by the gingival tissues. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of “black gums” are common, particularly in patients having a very high smile line. Thus, perio-esthetic treatment modalities strive to achieve a harmonious inter-relationship of the pink with white, which is imperative of all treatment procedures. For depigmentation of gingival, different treatment modalities have been reported, such as bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery, and laser. In the present case series, scraping, electrosurgery, and diode laser have been tried for depigmentation, which are simple, effective, and yield good results, along with good patient satisfaction. PMID:23066249

  10. Hydrogen peroxide-induced apoptosis in human gingival fibroblasts

    PubMed Central

    Gutiérrez-Venegas, Gloria; Guadarrama-Solís, Adriana; Muñoz-Seca, Carmen; Arreguín-Cano, Juan Antonio

    2015-01-01

    In the process of bleaching vital, discolored teeth, low concentrations of hydrogen peroxide (H2O2) are effective alternatives to heat-activated 30% H2O2. However, interest has been expressed in the assessment of pathological effects of long-term exposure to bleaching agents such as irritation and ulceration of the gingival or other soft tissues. The aim of the present study was to determine the effect of hydrogen peroxide on apoptosis in human gingival fibroblasts (HGF). Cytochrome c, Bcl-2, Bax, Bid and caspase-3 protein expression were detected by Western blotting. HGF cell apoptosis induced by H2O2 was both dose and time dependent. The addition of H2O2 resulted in the release of cytochrome c to the cytosol, and an increase of Caspase-3 cleavage. Data suggest that oxidative stress-induced apoptosis in HGF is intrinsic pathway involved the release of apoptotic signal from mitochondria. PMID:26884825

  11. Lip repositioning surgery for correction of excessive gingival display.

    PubMed

    Muthukumar, Santhanakrishnan; Natarajan, Shanmuganathan; Madhankumar, Seenivasan; Sampathkumar, Jayakrishnakumar

    2015-08-01

    Esthetic demands have considerably increased over the years in routine clinical practice. A pleasant smile can give supreme confidence to an individuals personality. However, a perfect smile is dictated by a perfect balance of the white (teeth) and pink (gingival) display. This balance can be managed different treatment modalities, which is based on proper diagnosis. This case report demonstrates a successful management of gummy smile with a lip-repositioning procedure in a patient with an incompetent upper lip. This was accomplished by removing a partial thickness strip of mucosa from the maxillary buccal vestibule and suturing the lip mucosa to the mucogingival line. This resulted in a narrower vestibule and restricted muscle pull, thereby resulting incompetent lips and reduced gingival display during smiling. PMID:26538972

  12. Oral gingival myiasis: A rare case report and literature review

    PubMed Central

    Sharma, Dheeraj; Kumar, Sandeep; Parashar, Pranav; Naphade, Vihang Vinod

    2015-01-01

    Myiasis is a universal term for extreme infection by the parasitic fly larvae that feed on their host living/dead tissue. Gingival myiasis is a rare disease in the humans associated with poor oral hygiene, suppurative oral lesions, alcoholism, and senility, among other conditions. We present a case of gingival myiasis in the maxillary anterior region on the palatal surface in a 21-year-old mentally challenged male with moderate periodontitis and neurologic deficit. The diagnosis was made on the presence of larvae in the lesion. Treatment done was a manual removal of the larvae, one by one, with the help of the clinical forceps, surgical debridement of the oral wound, and subsequent management of the periodontal disease. PMID:26681864

  13. Gene polymorphism in amlodipine induced gingival hyperplasia: a case report.

    PubMed

    Charles, Nsc; Ramesh, V; Babu, Kennedy Spk; Premalatha, B

    2012-10-01

    The management of cardiovascular disorders poses a dilemma for the medical fraternity. Calcium channel blockers are one of the most commonly used drugs for the management of this disorder, and it is also a well known fact that they are one of the most common group of drugs responsible for causing gingival over growth as one of their adverse effects. Amlodipine is a new generation hypertensive, which has found wide acceptance and usage due to its duration of action. Even with all its benefits as a potent hypertensive, its effect on gingival tissues is what causes concern to the patient and dental surgeon equally. The objective of this article is to create awareness regarding the adverse oral effects of amlodipine, its underlying mechanism of action in bringing about this adverse reaction, along with providing a brief review of the pharmacologic profile of this drug. PMID:23493253

  14. Hereditary gingival hyperplasia associated with amelogenesis imperfecta: a case report.

    PubMed

    Nibali, Luigi; Brett, Peter M; Donos, Nikos; Griffiths, Gareth S

    2012-06-01

    Hereditary gingival fibromatosis (HGF) and amelogenesis imperfecta (AI) are two rare oral conditions with genetic etiologies. The case of a 17-year-old boy affected by HGF, AI, anterior open bite, and pyramidal impaction of the maxillary molars is reported. Internal bevel gingivectomies were carried out to reduce gingival overgrowth. Clinical examination of the family revealed the presence of HGF and AI in his 12-year-old sister (both in milder forms) and of HGF in his older half brother. Genetic sequencing analyses were performed to detect any of the known mutations leading to HGF and AI. Histologic analysis revealed the presence of fibroepithelial hyperplasia, consistent with a diagnosis of GF. Sequencing genetic analysis failed to identify any of the common mutations leading to HGF (SOS-1) or AI (enamelin and amelogenin genes). This phenotype, similar to what has been described in other families, may represent a new syndrome caused by an as-yet unknown genotype.

  15. Gene polymorphism in amlodipine induced gingival hyperplasia: a case report.

    PubMed

    Charles, Nsc; Ramesh, V; Babu, Kennedy Spk; Premalatha, B

    2012-10-01

    The management of cardiovascular disorders poses a dilemma for the medical fraternity. Calcium channel blockers are one of the most commonly used drugs for the management of this disorder, and it is also a well known fact that they are one of the most common group of drugs responsible for causing gingival over growth as one of their adverse effects. Amlodipine is a new generation hypertensive, which has found wide acceptance and usage due to its duration of action. Even with all its benefits as a potent hypertensive, its effect on gingival tissues is what causes concern to the patient and dental surgeon equally. The objective of this article is to create awareness regarding the adverse oral effects of amlodipine, its underlying mechanism of action in bringing about this adverse reaction, along with providing a brief review of the pharmacologic profile of this drug.

  16. Oral gingival myiasis: A rare case report and literature review.

    PubMed

    Sharma, Dheeraj; Kumar, Sandeep; Parashar, Pranav; Naphade, Vihang Vinod

    2015-01-01

    Myiasis is a universal term for extreme infection by the parasitic fly larvae that feed on their host living/dead tissue. Gingival myiasis is a rare disease in the humans associated with poor oral hygiene, suppurative oral lesions, alcoholism, and senility, among other conditions. We present a case of gingival myiasis in the maxillary anterior region on the palatal surface in a 21-year-old mentally challenged male with moderate periodontitis and neurologic deficit. The diagnosis was made on the presence of larvae in the lesion. Treatment done was a manual removal of the larvae, one by one, with the help of the clinical forceps, surgical debridement of the oral wound, and subsequent management of the periodontal disease. PMID:26681864

  17. Gingival necrosis due to the ill-fitting denture

    PubMed Central

    Boras, Vucicevic

    2014-01-01

    We present a case of an 80-year-old male who was referred to the Department of Oral Medicine, School of Dental Medicine University of Zagreb, Croatia due to gingival ulcer which was present for eight days. Clinical examination has revealed exposed bone on the toothless alveolar ridge in the lower molar region on the right side of 0.8 cm in diameter. Otherwise, the patient was taking doxazosin due to urinary problems and ipatropium bromide due to respiratory problems. The patient wore a 6-year-old partial lower denture. He was initially treated with periodontal bandage (Resopack, HagenWerken, Germany) for the first three days and was instructed not to wear the denture; however, no benefit could be seen. Therefore, we added a local corticosteroid (betamethasone) and am oral antiseptic (chlorhexidine digluconate) applied three times a day. After 3 weeks the lesion healed. A list of possible causative factors regarding gingival ulcers is included.

  18. A comparison of gingival inflammation related to retraction cords.

    PubMed

    de Gennaro, G G; Landesman, H M; Calhoun, J E; Martinoff, J T

    1982-04-01

    Potassium aluminum sulfate, aluminum chloride, and 8% racemic epinephrine did not demonstrate practical differences, although potassium aluminum sulfate produced fewer inflammatory changes than the other agents. 2. It appears that factors other than the chemical agent (e.g., physiologic differences in patients) may play a role in the amount of gingival inflammation induced. 3. Additional studies using a larger sample size and an untreated control site should be undertaken.

  19. Surgical Management of Implant-Associated Gingival Fenestrations.

    PubMed

    Livada, Rania; Bland, Paul S; Shiloah, Jacob

    2016-03-01

    Soft tissue fenestrations are extremely rare in the natural dentition and have only recently been reported on dental implants. Although the pathogenesis of their formation is not completely understood, several predisposing risk factors have been identified, some of which may affect dental implants as well. This article presents a thorough review of the literature pertaining to gingival fenestration. It also describes the surgical management of lesions developed approximately six years following osseointegration of two dental implants. PMID:27209719

  20. The effect of anti-plaque agents on gingivitis.

    PubMed

    Spivakovsky, Silvia; Keenan, Analia

    2016-06-01

    Data sourcesAn electronic search was conducted on PubMed Central. References of retrieved papers and previously published systematic reviews were hand searched.Study selectionRandomised controlled trials (RCTs) with at least six months follow-up evaluating the use of test products used in mouthrinses, toothpastes or gels as adjuncts to mechanical oral hygiene (including toothbrushing) were considered.Data extraction and synthesisTwo trained and calibrated reviewers independently assessed the studies for eligibility, with any disagreement being resolved by discussion. Two reviewers under the supervision of a third reviewer extracted data. Risk of bias was evaluated using the Cochrane risk of bias tool and the CONSORT statement. Outcomes were summarised as means and standard deviation (SD) or standard error (SE), the results were pooled and analysed using weighted mean differences (WMD), and heterogeneity among the studies was calculated.ResultsEighty-seven articles with 133 comparisons were included in the review. A majority of the studies (75) were considered to be at high risk of bias, eight at unclear risk and four at low risk. Fifteen different categories of active agent were used in toothpastes and ten in mouthwashes. The additional effects of the tested products were statistically significant for the Loe & Silness gingival index (46 studies), WMD -0.217, the modified gingival index (23 studies) - 0.415, gingivitis severity index (26 studies) - 14.939% or bleeding index (23 studies) - 7.626% with significant heterogeneity. For plaque, additional effects were found for Turesky (66 studies) WMD - 0.0475, Silness & Loe (26 studies) - 0.109 and for plaque severity (12 studies) - 23.4% indices, with significant heterogeneity.ConclusionsWithin the limitations of the present study, formulations with specific agents for chemical plaque control provide statistically significant improvements in terms of gingival, bleeding and plaque indices. PMID:27339238

  1. Improving gingival smile by means of guided bone regeneration principles

    PubMed Central

    Ferreira, Carlos Eduardo de Almeida; Brandão, Roberto Carlos Bodart; Martinelli, Carolina Borges; Pignaton, Túlio Bonna

    2016-01-01

    ABSTRACT Objective: This study evaluated the effectiveness of guided bone regeneration (GBR) carried out with xenogenic bone substitute (Bio-OssTM) and collagen resorbable membrane (Bio-GideTM) to improve gingival smile (GS) in patients with excessive vertical maxillary growth (EVMG). Methods: Twelve healthy women aged between 20 and 49 years old (mean age of 26 years), with 5 mm or more of gingival exposure during fully posed smile (FPS) due to EVMG, were included. Baseline digital photographs were taken with standardized head position at rest and FPS. In eight out of 12 cases, crown lengthening procedure was indicated and the initial incision was made 2 to 4 mm from the gingival margin. In four cases, with no indication for crown lengthening procedure, a sulcular incision was performed. GBR was performed in all cases, using micro screws and/or titanium mesh associated with Bio-OssTM and Bio-GideTM. After 10 days, sutures were removed. Recall appointments were scheduled at 1, 6, and 12 months when standardized photographs were again taken. ImageToolTM software was used to measure the gingival exposure (GE) during FPS from the standardized close-up smile photographs at baseline and 12 months. Results: GE mean at baseline was 275.44 mm2. After 12 months, patients who undergone exclusively GBR procedure, presented GE reduction of 40.7%, ∆ = 112.01 mm2 (statistically significant, p = 0.12), and patients who had crown lengthening associated with the graft had a reduction of 60%, ∆ = 167.01 mm2. Conclusion: Our results using GBR to improve GS in cases of EVMG showed an exceptionally high patient acceptance and satisfaction. One-year follow-up confirmed stable results. PMID:27409660

  2. Palmoplantar keratoderma with progressive gingivitis and recurrent pyodermas.

    PubMed

    Moss, Tyler A; Spillane, Anne P; Almquist, Sam F; McCleskey, Patrick E; Wisco, Oliver J

    2014-04-01

    Papillon-Lefèvre syndrome (PLS) is a rare inherited palmoplantar keratoderma (PPK) that is associated with progressive gingivitis and recurrent pyodermas. We present a case exhibiting classic features of this autosomal-recessive condition and review the current understanding of its pathophysiology, diagnosis, and treatment. Additionally, a review of pertinent transgredient PPKs is undertaken, with key and distinguishing features of each syndrome highlighted.

  3. [A gingival hyperplasia in a patient suffering from neurofibromatosis].

    PubMed

    Nolte, J W; Baart, J A; van der Waal, I

    2012-04-01

    A 30-year-old woman suffering from neurofibromatosis type 1 was referred by her dentist to the department of oral and maxillofacial surgery of a university medical centre for excision of a gingival hyperplasia in the mandibular frontal region. The hyperplasia was a neurofibroma, which was surgically removed, as were 2 neurofibromas of the tongue, a postauricular neurofibroma and 2 neurofibromas of the feet.

  4. Gingival depigmentation: A split mouth comparative study between scalpel and cryosurgery

    PubMed Central

    Patil, Kaustubh P; Joshi, Vaibhav; Waghmode, Vijay; Kanakdande, Vinayak

    2015-01-01

    Gingival hyperpigmentation is a major esthetic concern for many people. Although it is not a medical problem, many people complain of dark gums as unesthetic. Gingival depigmentation is a periodontal plastic surgical procedure, whereby the hyperpigmentation is removed or reduced by various techniques. For depigmentation of gingival, different treatment modalities have been reported, such as scalpel, cryosurgery, electrosurgery, lasers, etc., this article compares the management of three cases with scalpel and cryosurgery and also highlights the relevance of cryosurgery. PMID:25821386

  5. Amlodipine-induced gingival hyperplasia in chronic renal failure: a case report.

    PubMed

    Aldemir, N M; Begenik, H; Emre, H; Erdur, F M; Soyoral, Y

    2012-12-01

    Amlodipine is a dihydropyridine calcium channel blocker that is used in the management of both hypertension and angina. Amlodipine induced side effects are headache, dizziness, edema, flushing, palpitations, and rarely gingival hyperplasia. The exact reason of amlodipine-induced gingival hyperplasia is not known. We presented a case with chronic renal failure (CRF) that developed gingival hyperplasia due to amlodipine use, which improved after ceasing the drug.

  6. Amlodipine-induced Gingival Hyperplasia – A Case Report and Review

    PubMed Central

    Madi, M; Shetty, SR; Babu, SG; Achalli, S

    2015-01-01

    ABSTRACT Anticonvulsants, antihypertensive calcium channel blockers and immunosuppressants are the three main classes of drugs known to cause drug-induced gingival hypertrophy or hyperplasia. Among the calcium channel blockers, nifedipine administration has most frequently been associated with medication-related gingival hyperplasia. The incidence with amlodipine, which has a mode of action pharmacodynamically comparable to nifedipine, has rarely been reported. Here, we present a rare case of amlodipine-induced gingival hyperplasia in a hypertensive patient. PMID:26426184

  7. Are gingival and periodontal conditions related to salivary gland flow rates in healthy individuals?

    PubMed

    Crow, H C; Ship, J A

    1995-11-01

    Some have suggested that gingival and periodontal health is related to salivary gland function; however, there are few data to support this hypothesis. The purpose of this study was to determine if correlations existed between major salivary gland flow rates and gingival and periodontal conditions in people of different ages. The results suggest that there is no consistent relationship between major salivary gland flow rates and gingival and periodontal conditions in healthy people. PMID:7499648

  8. A Novel Pore-Forming Toxin in Type A Clostridium perfringens Is Associated with Both Fatal Canine Hemorrhagic Gastroenteritis and Fatal Foal Necrotizing Enterocolitis

    PubMed Central

    Nowell, Victoria J.; Nicholson, Vivian M.; Oliphant, Kaitlyn; Prescott, John F.

    2015-01-01

    A role for type A Clostridium perfringens in acute hemorrhagic and necrotizing gastroenteritis in dogs and in necrotizing enterocolitis of neonatal foals has long been suspected but incompletely characterized. The supernatants of an isolate made from a dog and from a foal that died from these diseases were both found to be highly cytotoxic for an equine ovarian (EO) cell line. Partial genome sequencing of the canine isolate revealed three novel putative toxin genes encoding proteins related to the pore-forming Leukocidin/Hemolysin Superfamily; these were designated netE, netF, and netG. netE and netF were located on one large conjugative plasmid, and netG was located with a cpe enterotoxin gene on a second large conjugative plasmid. Mutation and complementation showed that only netF was associated with the cytotoxicity. Although netE and netG were not associated with cytotoxicity, immunoblotting with specific antisera showed these proteins to be expressed in vitro. There was a highly significant association between the presence of netF with type A strains isolated from cases of canine acute hemorrhagic gastroenteritis and foal necrotizing enterocolitis. netE and netF were found in all cytotoxic isolates, as was cpe, but netG was less consistently present. Pulsed-field gel electrophoresis showed that netF-positive isolates belonged to a clonal population; some canine and equine netF-positive isolates were genetically indistinguishable. Equine antisera to recombinant Net proteins showed that only antiserum to rNetF had high supernatant cytotoxin neutralizing activity. The identifica-tion of this novel necrotizing toxin is an important advance in understanding the virulence of type A C. perfringens in specific enteric disease of animals. PMID:25853427

  9. Local cause of gingival overgrowth. Clinical and histological study.

    PubMed

    Drăghici, Emma Cristina; CrăiŢoiu, Ştefania; MercuŢ, Veronica; Scrieciu, Monica; Popescu, Sanda Mihaela; Diaconu, Oana Andreea; Oprea, Bogdan; Pascu, Roxana Maria; CrăiŢoiu, Monica Mihaela

    2016-01-01

    The overgrowth, depending on its extension, has multiple effects on the stomatognathic apparatus: functional disorders (impaired speech), difficulty in chewing and aesthetic problems but can cause significant psychological problems. We proposed this study, motivated by the relative increased frequency of the gum outgrowth, its multifactorial etiopathogeny, but especially from the point of view of the specialist practitioner, by the problems that this pathology raises not only for the functionality of the stomatognathic apparatus but also for the facial esthetics, and especially for future therapeutic attitudes needed to solve the existing pathology at this level. We conducted a clinical study and a histological one. For the clinical study, we selected 74 patients who experienced different degrees of gingival outgrowing associated with fillings, dental caries, fixed prostheses, mobile prostheses, orthodontic apparatus. Thirty gingival fragments from patients with gingival outgrowing were processed by paraffin-embedding histological technique and stained with Hematoxylin-Eosin. The morphological results obtained provide the necessary support for understanding the possibility of developing a therapeutic strategy to prevent or minimize the gum outgrowth by administering antibiotic and anti-inflammatory medications associated with medications, which shall cause the apoptosis of the fibroblasts. PMID:27516015

  10. Factors associated with gingival inflammation among adults with systemic sclerosis

    PubMed Central

    Yuen, Hon K.; Weng, Yanqiu; Reed, Susan G.; Summerlin, Lisa M.; Silver, Richard M.

    2013-01-01

    OBJECTIVE To identify factors associated with increased gingival inflammation in adults with systemic sclerosis (SSc, scleroderma). METHODS In this cross-sectional study, forty-eight adults with SSc received assessment of gingival inflammation using Löe and Silness gingival index (LSGI), measurement of oral aperture, and evaluation of manual dexterity to perform oral hygiene using the Toothbrushing Ability Test, as well as completion of an oral health-related questionnaire. RESULTS Three explanatory variables in the final multiple predictor models for the LSGI outcome were statistically significant -- manual dexterity to perform oral hygiene, flossing in the evening, and SSc subtype, with higher LSGI score among those with impaired manual dexterity, not flossing in the evening and diffuse form of SSc. In addition, posterior teeth had higher LSGI scores compared to that of the anterior teeth after adjusting for other variables CONCLUSIONS Results suggest that dental health professionals take manual dexterity into consideration when educating patients with SSc to improve their oral hygiene, and educate them on paying more attention on cleaning their posterior teeth and the importance of flossing in the evening -- especially those who only floss once a day or less often. PMID:23611650

  11. Genetic heterogeneity of gingival fibromatosis on chromosome 2p

    PubMed Central

    Shashi, V.; Pallos, D.; Pettenati, M.; Cortelli, J.; Fryns, J.; von Kap-Herr, C.; Hart, T.

    1999-01-01

    Gingival fibromatosis (GF) occurs in several genetic forms as a simple Mendelian trait, in malformation syndromes, and in some chromosomal disorders. Specific genes responsible for GF have not been identified. An autosomal dominant form of hereditary gingival fibromatosis (HGF, MIM 135300) was recently mapped to chromosome 2p21 in a large Brazilian family and there was an earlier report of GF in a boy with a cytogenetic duplication involving 2p13→p21. We thus hypothesised that a common gene locus may be responsible for GF in both the Brazilian family and the boy with the chromosome 2p duplication. We performed additional genetic linkage studies on the Brazilian family and molecular cytogenetic studies on the patient with the cytogenetic duplication to correlate more precisely the genetic interval of the HGF phenotype with the duplicated 2p interval. Additional linkage analysis of new family members resulted in refinement of the candidate region for HGF to an 8 Mb region. Molecular cytogenetic analysis of the 2p13→p21 duplication associated with GF showed that the duplicated region was proximal to the candidate interval for HGF. Thus, our results support the presence of two different gene loci on chromosome 2p that are involved in GF.


Keywords: gingival fibromatosis; chromosome duplication; chromosome 2 PMID:10507724

  12. Acute pancreatitis: clinical vs. CT findings

    SciTech Connect

    Hill, M.C.; Barkin, J.; Isikoff, M.B.; Silver stein, W.; Kalser, M.

    1982-08-01

    In a prospective study of 91 patients with acute pancreatitis, computed tomographic (CT) findings were correlated with the clinical type of acute pancreatitis. In acute edematous pancreatitis (63 patients; 16 with repeat CT), CT was normal (28%) or showed inflammation limited to the pancreas (61%). Phlegmonous changes were present in 11%, including one patient with focal pancreatic hemorrhage, indicating that clinically unsuspected hemorrhagic pancreatitis can occur. In acute necrotizing (hemorrhagic, suppurative) pancreatitis (nine patients; eight with repeat CT), no patient had a normal CT scan and 89% had phlegmonous changes. One patient had hemorrhagic pancreatitis and three had abscesses. In acute exacerbation of chronic pancreatitis (10 patients; three with repeat CT), there were pancreatic calcifications (70%), a focal mass (40%), and pancreatic ductal dilation (30%). On follow-up CT, the findings of acute pancreatitis did not always disappear with resolution of the clinical symptons. This was especialy true of phlegmonous pancreatitis, where the CT findings could persist for months.

  13. Adenosquamous carcinoma of the larynx associated with necrotizing sialometaplasia--a diagnostic challenge.

    PubMed

    Ravn, Tomaas; Trolle, Waldemar; Kiss, Katalin; Balle, Viggo Hulthin

    2009-12-01

    Necrotizing sialometaplasia is a benign, self-limiting, inflammatory process involving salivary glands, commonly associated with tissue ischemia. Clinically, necrotizing sialometaplasia is most often found in the hard palate as a deep ulcer with raised, indurated edges that can be indolent. This, as well as the histopathologic findings of necrotizing sialometaplasia, can be confused with those of a malignant neoplasm. We report a rare case of necrotizing sialometaplasia in the larynx, probably initiated by an underlying malignant process. We suggest an aggressive diagnostic approach, when necrotizing sialometaplasia involves the larynx and no recent exposure to radiation, surgery or trauma has been recorded. Necrotizing sialometaplasia of the larynx should be regarded as secondary to malignancy until proven otherwise.

  14. Necrotizing Sialometaplasia of the Hard Palate: A Rare Entity of Dilemma on Cytology, Confirmatory on Histopathology.

    PubMed

    Shetty, Archana; Chowdappa, Vijaya; Devasamudra, Chidananda R; Janardhan, Jayalakshmi Valligari

    2015-12-01

    Necrotizing sialometaplasia is a rare, benign reactive necrotizing lesion, involving sites where salivary gland tissue is usually present. The importance of this lesion is that it mimics malignancy clinically leading to treatments ranging from conservative excision to total maxillectomy. Cytologically and histologically also the lesion is often confused with neoplasms. We present a case of a lady with a hard palatal swelling, which was non - ulcerative unlike typical cases of necrotizing sialometaplsia. FNAC features made us strongly suspect a low grade mucoepidermiod carcinoma, following which the swelling was excised. Histopathology came to the rescue, on which the final diagnosis of necrotizing sialometaplasia of the hard palate was made. Necrotizing siaometaplasia is often misdiagnosed by the inexperienced cytologist, with histopathological examination being confirmatory. We also emphasize the fact that lesions like necrotizing sialometaplasia need a high degree of suspicion along with clinical co relation before subjecting the patient to unnecessary surgical procedures.

  15. Gingival Enlargement in a Case of Variant Jones Syndrome: a Case Report

    PubMed Central

    DA, Roopa; Singh, Shinkhala; Gupta, Ira; Gopal, Saumiya

    2016-01-01

    Gingival enlargement can be caused by a variety of etiological factors like inflammation, drugs, and systemic diseases or can be presented as a part of a syndrome. One such syndrome is Jones Syndrome, which is associated with gingival enlargement and progressive hearing loss. We present here a case of fifteen-year-old boy with gingival enlargement, hearing loss, and generalized alveolar bone loss and diagnosed as Jones syndrome. The diagnosis was made based on history, clinical, radiographic, and histopathological findings. Gingival enlargement was surgically managed using gingivectomy and no recurrence was observed. The patient showed remarkable esthetical and functional improvement. PMID:26966711

  16. Low dose amlodipine-induced gingival enlargement: A clinical case series

    PubMed Central

    Tripathi, Amitandra Kumar; Mukherjee, Sudarshana; Saimbi, Charanjit Singh; Kumar, Vivek

    2015-01-01

    Gingival enlargement sometimes has an adverse effect of certain systemic drugs such as the use of anticonvulsants, phenytoin, antihypertensive, calcium channel blockers and immunosuppressant, cyclosporine. Amlodipine, a relatively newer calcium channel blocker drugs, exhibit adverse effect of gingival enlargement in middle to older aged adults. There are very few reports of amlodipine-induced gingival enlargement at a lower dose (5 mg). In this article, three cases of amlodipine-induced gingival enlargement in the age range of 50-65 years old hypertensive patient with a lower dose of amlodipine (5 mg). PMID:25684923

  17. Assesment of gingival microcirculation in anterior teeth using laser Doppler flowmetry

    NASA Astrophysics Data System (ADS)

    Canjau, Silvana; Miron, Mariana I.; Todea, Carmen D.

    2016-03-01

    Introduction: Evaluating the health status of the gingival tissue represents an important objective in the daily practice. Inflammation changes the microcirculatory and micromorphological dynamics of human gingiva. Aim: The purpose of this study was to evaluate the microcirculation in subjects with moderate gingivitis and healthy gingiva by using laser Doppler flowmetry (LDF). Material and Methods: Recordings of the gingival microcirculation (GM) were taken from 20 healthy gingival sites and from 20 sites with moderate gingivitis. The gingival blood flows in the gingivitis group before treatment was significantly different from those in the healthy gingiva group. Signals were recorded with the aid of a laser Doppler MoorLab instrument VMS-LDF2 probe VP3 10 mm S/N 2482. Three consecutive determinations of the GM were registered for each site, as follows: before the initial therapy, at 24 hours after the initial therapy and then, 7 days after the initial therapy. The data were processed using the statistical analysis software SPSS v16.0.1. Results: The results of this preliminary study showed statistically significant differences among the GM values recorded before and after the initial therapy. Conclusions: LDF could be a useful, noninvasive, sensitive, reproducible, and harmless method for measuring gingival blood flow (gingival microcirculation) in humans.

  18. [Clinical experience with the treatment of gingival hyperplasia induced by calcium channel blocking agents].

    PubMed

    Keglevich, T; Benedek, E; Gera, I

    1999-12-01

    The prevalence of the nifedipine-induced gingival hyperplasia is ranging from 0.5-83% in the dental literature. The pathomechanism of the nifedipine-induced gingival hyperplasia is not clearly understood. Evaluating the dental history and the course of disease of 34 patients treated and followed up at the Department of Periodontology the following answers were raised: What sort of local and systemic factors are enhancing the recurrence of the gingival overgrowth and how this can be anticipated in patients on continuous Ca channel blocking medication. Eight out of the 34 patients participating in the clinical trial did not remember the onset of their gingival overgrowth. 10 cases developed three years and three cases after less then one year of the onset of the drug administrations. 27 out of the 34 cases required gingival surgery and seven showed good clinical improvement after the hygienic phase of the comprehensive periodontal treatment. 70% of the gingival hyperplasia cases presented no clinical sign of recurrence one year after the completion of the active phase of the treatment. A positive correlation was found between the oral hygiene and the recurrence rate of gingival overgrowth. Oral hygiene seems to play a decisive role in the development of gingival enlargement. The present findings and substantial evidences from the dental literature indicate that the gingival enlargement can be successfully controlled even under the continuous nifedipine administration by meticulous professional and individual oral hygiene.

  19. Recurrent idiopathic gingival fibromatosis with generalized aggressive periodontitis: A rare case report

    PubMed Central

    Jadhav, Ashwini Sudhakar; Marathe, Swati Pramodan

    2015-01-01

    Gingival fibromatosis is an enlargement of the gingival tissue, which may be localized or generalized, characterized by hypertrophy and proliferation of the connective tissue, predominantly Type I collagen, with occasional presence of an increased number of cells, supposedly fibroblasts. Gingival fibromatosis occurs more commonly as a side- effect of systemic drugs, such as phenytoin, cyclosporine, nifedipine, or due to hereditary factors. However, in some cases, it is idiopathic. We report one such case in 30 -year- old - female who presented with a complaint of swelling of gums since 2 months. This case appears to be of special interest because of the recurrent nature of gingival enlargement along with excessive osseous destruction. PMID:25810601

  20. Esthetic impact of gingival plastic surgery from the dentistry students’ perspective

    PubMed Central

    Ayyildiz, Erdem; Tan, Enes; Keklik, Hakan; Demirtag, Zulfikar; Celebi, Ahmet Arif; Pithon, Matheus Melo

    2016-01-01

    Objective: The aim of the this study was to evaluate the perception of smile esthetics and alterations in cases of gingival plastic surgery for correction of a gummy smile, by means of alterations in smile photograph among dentistry degree students. Materials and Methods: A frontal smile photograph of a 40-year-old woman having normal occlusion was used with diverse compositions of gingival exposure level and crown length of maxillary teeth. The eight photographs were evaluated by 216 dentistry students in five class groups (1st, 2nd, 3rd, 4th and 5th classes). Results: The results revealed that almost all of the class’ students perceived differences between images, additionally, the highest percentage of students that answered “no difference” was 12% at 1st class’ students. 1st and 2nd class’ students most liked photograph which is 2.5 mm gingival display and 3rd class students liked two different photographs which are 2.5 mm gingival display and 2 mm gingival display whereas 4th class students preferred two different photographs which are 1.5 mm gingival display and 1 mm gingival display, 5th class students preferred photograph which is 1.5 mm gingival display as the most. Conclusion: Esthetic perception of smile improve as a student passes to higher study classes in terms of gingival exposure. The harmonious display of gingiva exhibits an important effect in the smile esthetics rather than reduced or excessive display. PMID:27403061

  1. Gingival Fibromatosis with Distinctive Facies – A Three Generation Case Report

    PubMed Central

    Sidana, Sunil; Rajguru, Sneha; Padhye, Ashvini

    2015-01-01

    Hereditary gingival fibromatosis (HGF) is a rare disorder characterized by progressive and varying degrees of gingival overgrowth. Oral manifestations may vary from minimal involvement of only tuberosity area and the buccal gingiva around the lower molars to a generalized gingival enlargement. It can occur as an isolated disorder but can be one feature of a syndrome. Although the clinical and histopathological characteristics of HGF are well known and described, the pathogenic mechanism remains unknown. The goal of this article is to describe a family with three generations afflicted with a syndromic form of HGF known as gingival fibromatosis with distinctive facies, and discuss the diagnosis and treatment of the disease. PMID:26155576

  2. The effect of waxed and unwaxed dental floss on gingival health. Part II. Crevicular fluid flow and gingival bleeding.

    PubMed

    Wunderlich, R C; Lamberts, D M; Caffesse, R G

    1982-06-01

    Eighty patients, having received periodontal therapy previously, were divided into four groups, corresponding to one of four different types of dental floss being used. Seven to ten days after receiving a thorough prophylaxis, each patient had oral hygiene instruction by video tape, was given a toothbrush and a quantity of the test floss. At 0, 28 and 56 day intervals, the patients were scored for crevicular fluid flow and gingival bleeding. Data were analyzed statistically. Johnson and Johnson unwaxed dental floss was found to be slightly less effective in reducing gingival bleeding at the 56th day. It was also found that crevicular fluid flow was least with waxed floss use at the 56 day session. However, the range of variations was so minimal that no clinical significance could be ascribed to either finding. There were patients in each of the four floss groups with no fluid flow or bleeding during all three sessions.

  3. Revised Atlanta Classification for Acute Pancreatitis: A Pictorial Essay.

    PubMed

    Foster, Bryan R; Jensen, Kyle K; Bakis, Gene; Shaaban, Akram M; Coakley, Fergus V

    2016-01-01

    The 2012 revised Atlanta classification is an update of the original 1992 Atlanta classification, a standardized clinical and radiologic nomenclature for acute pancreatitis and associated complications based on research advances made over the past 2 decades. Acute pancreatitis is now divided into two distinct subtypes, necrotizing pancreatitis and interstitial edematous pancreatitis (IEP), based on the presence or absence of necrosis, respectively. The revised classification system also updates confusing and sometimes inaccurate terminology that was previously used to describe pancreatic and peripancreatic collections. As such, use of the terms acute pseudocyst and pancreatic abscess is now discouraged. Instead, four distinct collection subtypes are identified on the basis of the presence of pancreatic necrosis and time elapsed since the onset of pancreatitis. Acute peripancreatic fluid collections (APFCs) and pseudocysts occur in IEP and contain fluid only. Acute necrotic collections (ANCs) and walled-off necrosis (WON) occur only in patients with necrotizing pancreatitis and contain variable amounts of fluid and necrotic debris. APFCs and ANCs occur within 4 weeks of disease onset. After this time, APFCs or ANCs may either resolve or persist, developing a mature wall to become a pseudocyst or a WON, respectively. Any collection subtype may become infected and manifest as internal gas, though this occurs most commonly in necrotic collections. In this review, the authors present a practical image-rich guide to the revised Atlanta classification system, with the goal of fostering implementation of the revised system into radiology practice, thereby facilitating accurate communication among clinicians and reinforcing the radiologist's role as a key member of a multidisciplinary team in treating patients with acute pancreatitis. (©)RSNA, 2016.

  4. A Fatal Case of Necrotizing Fasciitis Caused by a Highly Virulent Escherichia coli Strain

    PubMed Central

    Vincent, André; Lin, Alex; Harel, Josée; Côté, Jean-Charles; Tremblay, Cécile

    2016-01-01

    Necrotizing fasciitis is a serious disease characterized by the necrosis of the subcutaneous tissues and fascia. E. coli as the etiologic agent of necrotizing fasciitis is a rare occurrence. A 66-year-old woman underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. She rapidly developed necrotizing fasciitis which led to her death 68 hours following surgery. An E. coli strain was isolated from blood and fascia cultures. DNA microarray revealed the presence of 20 virulence genes. PMID:27366162

  5. Immunoexpression of α2-integrin and Hsp47 in hereditary gingival fibromatosis and gingival fibromatosis-associated dental abnormalities

    PubMed Central

    de Oliveira-Santos, Carolina; Della-Coletta, Ricardo; Cristianismo-Costa, Daiane; Paranaíba, Lívia M.-R.; Martelli-Júnior, Hercílio

    2013-01-01

    Objective: The purpose of the present study was to investigate the expression of the α2-integrin subunit and heat shock protein 47 (Hsp47) in two families with isolated gingival fibromatosis (GF) form and one family with GF associated with dental abnormalities and normal gingiva (NG). Study Design: Immunohistochemistry was performed with antibodies against α2-integrin and Hsp47 in specimens from two unrelated families with hereditary gingival fibromatosis (Families 1 and 2) and from one family with a gingival fibromatosis-associated dental abnormality (Family 3); NG samples were used for comparison. The results were analysed statistically. Results: Immunoreactivity for α2-integrin and Hsp47 was observed in the nucleus of epithelial cells of both the basal and suprabasal layer and a more discreet signal was noted in connective tissue in all study samples. Hsp47 showed higher immunoreactivity in Family 2 compared with the other families (p≤0.05). Despite the markup α2-integrin was higher in Family 3 there was no statistically significant difference between the families studied (p≥0.05). Conclusions: Our results confirmed the heterogeneity of GF, such that similar patterns of expression of the condition may show differences in the expression of proteins such as Hsp47. Although no difference in α2-integrin expression was observed between GF and NG groups, future studies are necessary to determine the exact role of this protein in the various forms of GF and whether it contributes to GF pathogenesis. Key words:Gingival fibromatosis, integrin alpha2, heat shock protein Hsp47. PMID:23229240

  6. Necrotizing hepatitis in pet birds associated with Pseudomonas fluorescens.

    PubMed

    Jackson, M K; Phillips, S N

    1996-01-01

    Six pet birds, from a flock of 100 birds of various species, died within a 2-day period. Drinking water had recently been changed from potable water to irrigation water. Three birds submitted for necropsy had hepatic necrosis with numerous gram-negative rodshaped bacteria present in necrotic areas and Kuppfer cells. Pseudomonas fluorescens was isolated in pure culture from the livers of all three birds and from other organs. This is the first report of naturally occurring disease in which P. fluorescens was the sole etiologic agent identified. PMID:8790902

  7. Necrotizing lung infection caused by the protozoan Balantidium coli

    PubMed Central

    Sharma, Sat; Harding, Godfrey

    2003-01-01

    Balantidium coli, a ciliated protozoan, is well known to cause intestinal infection in humans. Extraintestinal spread to the peritoneal cavity and genitourinary tract has rarely been reported. There have also been a few cases of lung involvement from this parasite. A case of B coli causing a thick-walled right upper lobe cavity in an organic farmer who had contact with aerosolized pig manure is reported. Bronchoalveolar lavage fluid examined for ova and parasite revealed trophozoites of B coli in large numbers. Treatment with doxycycline hyclate led to marked improvement. Necrotizing lung infection caused by the protozoan B coli should be considered in individuals who report contact with pigs. PMID:18159451

  8. Update in Pathogenesis and Prospective in Treatment of Necrotizing Enterocolitis

    PubMed Central

    Terrin, Gianluca; Scipione, Antonella; De Curtis, Mario

    2014-01-01

    Necrotizing enterocolitis (NEC) is among the most common and devastating diseases in neonates and, despite the significant advances in neonatal clinical and basic science investigations, its etiology is largely understood, specific treatment strategies are lacking, and morbidity and mortality remain high. Improvements in the understanding of pathogenesis of NEC may have therapeutic consequences. Pharmacologic inhibition of toll-like receptor signaling, the use of novel nutritional strategies, and microflora modulation may represent novel promising approaches to the prevention and treatment of NEC. This review, starting from the recent acquisitions in the pathogenic mechanisms of NEC, focuses on current and possible therapeutic perspectives. PMID:25147804

  9. Detecting necrotic neurons with fluoro-jade stain.

    PubMed

    Krinke, G J; Classen, W; Vidotto, N; Suter, E; Würmlin, C H

    2001-10-01

    Fluoro-jade, a novel stain for detection of neuropathic lesions by fluorescence microscopy, was validated on the models of toxic neuropathy induced with 3-acetylpyridine (3-AP) or with acrylamide (ACR). Groups of male and female albino rats of Wistar strain were either exposed to a single administration of 80 mg/kg i.p. 3-AP followed 5 hours later by 300 mg/kg of nicotinamide i.p. and examined at days 3 and 15, or to 15 daily doses of 30 mg/kg p.o. ACR and examined at day 15. Following in-life behavioral observations and measurements, the rats were fixed by perfusion with formalin. Additional animals treated with same dose of 3-AP and nicotinamide were submitted to purposeful autolysis for 4 or 16 hours before immersion fixation with formalin on test day 3. In-life observations showed in 3-AP-treated animals signs of severe general toxicity, sensorimotor dysfunction and decreased motor activity starting shortly after the treatment and persisting throughout the observation period. ACR-treated rats started to develop abnormal gait on test day 8 and by day 15 developed reduced grip strength, increased landing footsplay and decreased motor activity. Fluoro-jade, applied to paraffin sections of the nervous system, detected selectively and sensitively the necrotic neurons in the brain, especially those in the inferior olivary nucleus of animals treated with 3-AP, at test day 3, as well as the necrotic Purkinje cells in the cerebellum of ACR-treated animals at test day 15. Chromatolytic neurons in the dorsal root ganglia of ACR-treated animals did not stain positively, indicating that this kind of reversible neuronal remodeling is not detectable using fluoro-jade. Necrotic neurons were still stained by fluoro-jade after 4 hour autolysis, but following 16 hour autolysis the results became false negative. There was no false positive fluorescence in fresh or autolytic tissues, except that emitted by red blood cells in unperfused specimens. The study confirmed the validity of

  10. Necrotizing lung infection caused by the protozoan Balantidium coli.

    PubMed

    Sharma, Sat; Harding, Godfrey

    2003-05-01

    Balantidium coli, a ciliated protozoan, is well known to cause intestinal infection in humans. Extraintestinal spread to the peritoneal cavity and genitourinary tract has rarely been reported. There have also been a few cases of lung involvement from this parasite. A case of B coli causing a thick-walled right upper lobe cavity in an organic farmer who had contact with aerosolized pig manure is reported. Bronchoalveolar lavage fluid examined for ova and parasite revealed trophozoites of B coli in large numbers. Treatment with doxycycline hyclate led to marked improvement. Necrotizing lung infection caused by the protozoan B coli should be considered in individuals who report contact with pigs. PMID:18159451

  11. Nuclear scanning in necrotizing progressive ''malignant'' external otitis

    SciTech Connect

    Parisier, S.C.; Lucente, F.E.; Som, P.M.; Hirschman, S.Z.; Arnold, L.M.; Roffman, J.D.

    1982-09-01

    The usefulness of radionuclear scanning in the treatment of 18 patients with necrotizing progressive ''malignant'' external otitis is discussed. A Tc 99-m bone scan, a valuable test since results are positive in early cases of osteomyelitis of the temporal bone and base of skull, showed increased uptake in all 18 patients. In 6 patients, Ga-67 citrate scans were obtained at the start of therapy and at 5-6 week intervals thereafter. The serial gallium scans were useful in evaluating the effectiveness of therapy since the uptake decrease with control of infection.

  12. Necrotizing sialometaplasia. A self-limited pseudotumoral palatal ulcer.

    PubMed

    Spark, R P; Duncan, D G

    1978-01-01

    Necrotizing sialometaplasia of the palate, an enigmatic pseudomalignant penetrating ulcer, is a benign lesion which heals spontaneously in three to ten weeks. Relative painlessness contributes to patient delay in seeking medical attention, and suggest that many cases are subclinical. Clinically, the patient age group and morbid gross appearance mimic malignant palatal tumors. Lack of awareness of this entity has led to the misdiagnosis of carcinoma in several previous cases. However, the histopathologic features of sialadenitis, focal lobular necrosis with mucosal ulceration and glandular squamous metaplasia, are distinctly benign. A typical case and literature review are presented.

  13. Trypanosoma cruzi Causes Paralyzing Systemic Necrotizing Vasculitis Driven by Pathogen-Specific Type I Immunity in Mice

    PubMed Central

    Roffê, Ester; Marino, Ana Paula M. P.; Weaver, Joseph; Wan, Wuzhou; de Araújo, Fernanda F.; Hoffman, Victoria; Santiago, Helton C.

    2016-01-01

    Infectious agents are often considered potential triggers of chronic inflammatory disease, including autoimmunity; however, direct evidence is usually lacking. Here we show that following control of acute infection of mice with the myotropic Colombiana strain of Trypanosoma cruzi, parasites persisted in tissue at low levels associated with development of systemic necrotizing vasculitis. Lesions occurred in many but not all organs and tissues, with skeletal muscle arteries being the most severely affected, and were associated with myositis, atrophy, paresis/paralysis, and death. Histopathology showed fibrinoid vascular necrosis, rare amastigote nests within skeletal muscle myocytes, and massive leukocyte infiltrates composed mainly of inflammatory monocytes, F4/80+ macrophages, and T. cruzi tetramer-specific CD8+ T lymphocytes capable of producing gamma interferon (IFN-γ) and tumor necrosis factor alpha (TNF-α) but not interleukin-17 (IL-17). T. cruzi-specific IgG was detected in sera from infected mice, but antibody deposits and neutrophilic inflammation were not features of the lesions. Thus, T. cruzi infection of mice may be a specific infectious trigger of paralyzing systemic necrotizing vasculitis most severely affecting skeletal muscle, driven by pathogen-specific type I immune responses. PMID:26857570

  14. Pauci-Immune Necrotizing and Crescentic Glomerulonephritis with Membranous Lupus Nephritis, Fifteen Years after Initial Diagnosis of Secondary Membranous Nephropathy

    PubMed Central

    Burkhart, Ryan; Shah, Nina; Abel, Michael; Oliver, James D.; Lewin, Matthew

    2015-01-01

    Renal involvement in systemic lupus erythematosus (SLE) is usually immune complex mediated and may have multiple different presentations. Pauci-immune necrotizing and crescentic glomerulonephritis (NCGN) refers to extensive glomerular inflammation with few or no immune deposits that may result in rapid decline in renal function. We report a case of a 79-year-old Hispanic male with a history of secondary membranous nephropathy (diagnosed by renal biopsy 15 years previously) who was admitted with acute kidney injury and active urinary sediment. P-ANCA titers and anti-myeloperoxidase antibodies were positive. The renal biopsy was diagnostic for NCGN superimposed on a secondary membranous nephropathy. A previous diagnosis of SLE based on American College of Rheumatology criteria was discovered via Veteran's Administration records review after the completion of treatment for pauci-immune NCGN. ANCAs are detected in 20–31% of patients with SLE. There may be an association between SLE and ANCA seropositivity. In patients with lupus nephritis and biopsy findings of necrotizing and crescentic glomerulonephritis, without significant immune complex deposition, ANCA testing should be performed. In patients with secondary membranous nephropathy SLE should be excluded. PMID:26558120

  15. Trypanosoma cruzi Causes Paralyzing Systemic Necrotizing Vasculitis Driven by Pathogen-Specific Type I Immunity in Mice.

    PubMed

    Roffê, Ester; Marino, Ana Paula M P; Weaver, Joseph; Wan, Wuzhou; de Araújo, Fernanda F; Hoffman, Victoria; Santiago, Helton C; Murphy, Philip M

    2016-04-01

    Infectious agents are often considered potential triggers of chronic inflammatory disease, including autoimmunity; however, direct evidence is usually lacking. Here we show that following control of acute infection of mice with the myotropic Colombiana strain of Trypanosoma cruzi, parasites persisted in tissue at low levels associated with development of systemic necrotizing vasculitis. Lesions occurred in many but not all organs and tissues, with skeletal muscle arteries being the most severely affected, and were associated with myositis, atrophy, paresis/paralysis, and death. Histopathology showed fibrinoid vascular necrosis, rare amastigote nests within skeletal muscle myocytes, and massive leukocyte infiltrates composed mainly of inflammatory monocytes, F4/80(+)macrophages, and T. cruzi tetramer-specific CD8(+) T lymphocytes capable of producing gamma interferon (IFN-γ) and tumor necrosis factor alpha (TNF-α) but not interleukin-17 (IL-17). T. cruzi-specific IgG was detected in sera from infected mice, but antibody deposits and neutrophilic inflammation were not features of the lesions. Thus,T. cruzi infection of mice may be a specific infectious trigger of paralyzing systemic necrotizing vasculitis most severely affecting skeletal muscle, driven by pathogen-specific type I immune responses. PMID:26857570

  16. Biofilm in group A streptococcal necrotizing soft tissue infections

    PubMed Central

    Siemens, Nikolai; Chakrakodi, Bhavya; Shambat, Srikanth Mairpady; Morgan, Marina; Bergsten, Helena; Skrede, Steinar; Madsen, Martin B.; Johansson, Linda; Juarez, Julius; Bosnjak, Lidija; Mörgelin, Matthias; Svensson, Mattias

    2016-01-01

    Necrotizing fasciitis caused by group A streptococcus (GAS) is a life-threatening, rapidly progressing infection. At present, biofilm is not recognized as a potential problem in GAS necrotizing soft tissue infections (NSTI), as it is typically linked to chronic infections or associated with foreign devices. Here, we present a case of a previously healthy male presenting with NSTI caused by GAS. The infection persisted over 24 days, and the surgeon documented the presence of a “thick layer biofilm” in the fascia. Subsequent analysis of NSTI patient tissue biopsies prospectively included in a multicenter study revealed multiple areas of biofilm in 32% of the patients studied. Biopsies associated with biofilm formation were characterized by massive bacterial load, a pronounced inflammatory response, and clinical signs of more severe tissue involvement. In vitro infections of a human skin tissue model with GAS NSTI isolates also revealed multilayered fibrous biofilm structures, which were found to be under the control of the global Nra gene regulator. The finding of GAS biofilm formation in NSTIs emphasizes the urgent need for biofilm to be considered as a potential complicating microbiological feature of GAS NSTI and, consequently, emphasizes reconsideration of antibiotic treatment protocols.

  17. Aspergillus fumigatus Endophthalmitis with Necrotizing Scleritis following Pars Plana Vitrectomy.

    PubMed

    Gruener, Anna M; Allen, Felicity; Stanford, Miles R; Graham, Elizabeth M

    2016-01-01

    We present a case of Aspergillus fumigatus endophthalmitis complicated by necrotizing scleritis in a 68-year-old man with diet-controlled diabetes, after retinal detachment repair. He was initially treated with systemic steroids for surgically induced necrotizing scleritis following routine pars plana vitrectomy. An additional diagnosis of endophthalmitis was made when the patient developed a hypopyon. Repeat vitreous culture isolated Aspergillus fumigatus. Symptoms improved following antifungal treatment leaving the patient with scleromalacia and an advanced postoperative cataract. Fungal scleritis and endophthalmitis are rare complications of intraocular surgery with sight-threatening consequences, and, as this case demonstrates, may even occur concomitantly. The overlapping features of both conditions can make differentiating one from the other difficult. A fungal aetiology should be considered in cases of postoperative scleritis and endophthalmitis that are protracted and refractory to standard therapy. Even in cases of early diagnosis and treatment, visual outcomes in Aspergillus endophthalmitis and scleritis are variable and often disappointing, not infrequently necessitating enucleation of a painful blind eye.

  18. Biofilm in group A streptococcal necrotizing soft tissue infections

    PubMed Central

    Siemens, Nikolai; Chakrakodi, Bhavya; Shambat, Srikanth Mairpady; Morgan, Marina; Bergsten, Helena; Skrede, Steinar; Madsen, Martin B.; Johansson, Linda; Juarez, Julius; Bosnjak, Lidija; Mörgelin, Matthias; Svensson, Mattias

    2016-01-01

    Necrotizing fasciitis caused by group A streptococcus (GAS) is a life-threatening, rapidly progressing infection. At present, biofilm is not recognized as a potential problem in GAS necrotizing soft tissue infections (NSTI), as it is typically linked to chronic infections or associated with foreign devices. Here, we present a case of a previously healthy male presenting with NSTI caused by GAS. The infection persisted over 24 days, and the surgeon documented the presence of a “thick layer biofilm” in the fascia. Subsequent analysis of NSTI patient tissue biopsies prospectively included in a multicenter study revealed multiple areas of biofilm in 32% of the patients studied. Biopsies associated with biofilm formation were characterized by massive bacterial load, a pronounced inflammatory response, and clinical signs of more severe tissue involvement. In vitro infections of a human skin tissue model with GAS NSTI isolates also revealed multilayered fibrous biofilm structures, which were found to be under the control of the global Nra gene regulator. The finding of GAS biofilm formation in NSTIs emphasizes the urgent need for biofilm to be considered as a potential complicating microbiological feature of GAS NSTI and, consequently, emphasizes reconsideration of antibiotic treatment protocols. PMID:27699220

  19. Regenerative endodontic treatment for necrotic immature permanent teeth.

    PubMed

    Chueh, Ling-Huey; Ho, Yi-Ching; Kuo, Tien-Chun; Lai, Wing-Hong; Chen, Yea-Huey Melody; Chiang, Chun-Pin

    2009-02-01

    This retrospective study included 23 necrotic immature permanent teeth treated for either short-term (treatment period <3 months) or long-term (treatment period >3 months) using conservative endodontic procedures with 2.5% NaOCl irrigations without instrumentation but with Ca(OH)(2) paste medication. For seven teeth treated short-term, the gutta-percha points were filled onto an artificial barrier of mineral trioxide aggregate (MTA). For 16 teeth treated long-term, the gutta-percha points, amalgam, or MTA were filled onto the Ca(OH)(2)-induced hard tissue barrier in the root canal. We found that all apical lesions showed complete regression in 3 to 21 (mean, 8) months after initial treatment. All necrotic immature permanent teeth achieved a nearly normal root development 10 to 29 (mean, 16) months after initial treatment. We conclude that immature permanent teeth with pulp necrosis and apical pathosis can still achieve continued root development after proper short-term or long-term regenerative endodontic treatment procedures. PMID:19166764

  20. Aspergillus fumigatus Endophthalmitis with Necrotizing Scleritis following Pars Plana Vitrectomy.

    PubMed

    Gruener, Anna M; Allen, Felicity; Stanford, Miles R; Graham, Elizabeth M

    2016-01-01

    We present a case of Aspergillus fumigatus endophthalmitis complicated by necrotizing scleritis in a 68-year-old man with diet-controlled diabetes, after retinal detachment repair. He was initially treated with systemic steroids for surgically induced necrotizing scleritis following routine pars plana vitrectomy. An additional diagnosis of endophthalmitis was made when the patient developed a hypopyon. Repeat vitreous culture isolated Aspergillus fumigatus. Symptoms improved following antifungal treatment leaving the patient with scleromalacia and an advanced postoperative cataract. Fungal scleritis and endophthalmitis are rare complications of intraocular surgery with sight-threatening consequences, and, as this case demonstrates, may even occur concomitantly. The overlapping features of both conditions can make differentiating one from the other difficult. A fungal aetiology should be considered in cases of postoperative scleritis and endophthalmitis that are protracted and refractory to standard therapy. Even in cases of early diagnosis and treatment, visual outcomes in Aspergillus endophthalmitis and scleritis are variable and often disappointing, not infrequently necessitating enucleation of a painful blind eye. PMID:27379189

  1. Computed tomography of necrotizing meningoencephalitis in 3 Yorkshire Terriers.

    PubMed

    Ducoté, J M; Johnson, K E; Dewey, C W; Walker, M A; Coates, J R; Berridge, B R

    1999-01-01

    A necrotizing meningoencephalitis of Yorkshire terriers has recently been reported in 6 dogs in Switzerland, 1 dog in Japan and 1 dog in the United States. The purpose of this report is to describe the computed tomographic (CT) findings in 3 dogs with this disease, and to correlate the CT abnormalities with the clinical and pathologic findings in each case. Three Yorkshire Terriers between 2 and 10 years old were evaluated. Physical and neurologic examinations, complete blood count (CBC), serum biochemistry profile, cerebrospinal fluid analysis, and CT scan were performed on all 3 dogs. Brainstem auditory evoked responses (BAER) were evaluated for 2 dogs. Two dogs were euthanized at the owners' request and necropsies were performed. Neurologic examination findings were consistent with a multifocal/diffuse encephalitis involving the cerebrum and brainstem in all 3 dogs. Complete blood count and biochemistry profiles were normal. Elevated protein concentration and a mononuclear pleocytosis were demonstrated in 2 of 3 dogs on cerebrospinal fluid evaluation. Multifocal, extensive areas of decreased opacity throughout the cerebral hemispheres, asymmetric ventriculomegaly, and lack of contrast enhancement were appreciated on CT images of all three dogs. No mass effect was seen. These findings correlated well with pathologic findings at necropsy, which included multiple malacic cavitations within the brain, representing areas of locally extensive necrosis. CT abnormalities in combination with signalment, clinical findings and cerebrospinal fluid analysis should facilitate a presumptive diagnosis of Yorkshire Terrier necrotizing meningoencephalitis.

  2. Intracellular Delivery of Synthetic dsRNA to Leukemic Cells Induces Apoptotic and Necrotic Cell Death.

    PubMed

    Mahmud, S M; Mek, K J; Idris, A

    2016-01-01

    The type of tumour cell death dictates the type of adaptive immune response mounted against the tumours. In haematological malignancies such as acute myeloid leukaemia (AML), immune evasion due to the poor immunogenicity of leukemic cells is a major hurdle in generating an effective immune response. Transfection of synthetic dsRNA, poly I:C, into leukemic cells to trigger tumour cell death and enhance immunogenicity of the tumour is a promising immunotherapeutic approach. However, the temporal cell death kinetics of poly I:C-electroporated AML cells has not been thoroughly investigated. Electroporation of U937 cells, a human AML cell line, with a high dose of poly I:C resulted in cytotoxicity as early as 1 h post-transfection. Flow cytometric analysis revealed the temporal switch from early apoptosis to late apoptosis/secondary necrosis in poly I:C-electroporated cells in which the nuclear morphology at later time points was consistent with necrotic cell death. Our brief findings demonstrated the temporal cell death kinetics of dsRNA-transfected leukemic cells. This finding is an important development in the field of dsRNA immunotherapy for leukaemia as understanding the type of cell death elicited by transfected dsRNA will dictate the type of immune response to be directed against leukemic cells. PMID:27187041

  3. Intravenous contrast medium aggravates the impairment of pancreatic microcirculation in necrotizing pancreatitis in the rat.

    PubMed Central

    Schmidt, J; Hotz, H G; Foitzik, T; Ryschich, E; Buhr, H J; Warshaw, A L; Herfarth, C; Klar, E

    1995-01-01

    BACKGROUND: Previous reports demonstrated that radiographic contrast medium, as used in contrast-enhanced computed tomography, increases acinar necrosis and mortality in experimental pancreatitis. The authors studied the possibility that these changes may be related to an additional impairment of pancreatic microcirculation. METHODS: Fifty Wistar rats had acute pancreatitis induced by intraductal glycodeoxycholic acid (10 mmol/L for 10 min) and intravenous cerulein (5 micrograms/kg/hr for 6 hrs). After rehydration (16 mL/kg), pancreatic capillary perfusion was quantified by means of intravital microscopy at baseline before intravenous infusion of contrast medium (n = 25) or saline (n = 25), and 30 and 60 minutes thereafter. In addition to total capillary flow, capillaries were categorized as high- or low-flow (> or < 1.6 nL/min). RESULTS: Pancreatic capillary flow did not change in either high- or low-flow capillaries after saline infusion. However, contrast medium infusion induced a significant decrease of total capillary flow (p < 0.001). Analysis according to the relative flow rate revealed that this was primarily because of a significant additional reduction of perfusion in low-flow capillaries (p < 0.0001). Furthermore, complete capillary stasis was observed in 15.9 +/- 3.4% after contrast medium as compared with 3.2 +/- 1.2% after saline infusion (p < 0.006). CONCLUSION: Radiographic contrast medium aggravates the impairment of pancreatic microcirculation in experimental necrotizing pancreatitis. PMID:7717779

  4. Bacterial DNA Content in the Intestinal Wall from Infants with Necrotizing Enterocolitis

    PubMed Central

    Bucher, Brian T.; McDuffie, Lucas A.; Shaikh, Nurmohammad; Tarr, Phillip I.; Warner, Barbara B.; Hamvas, Aaron; White, Francis V.; Erwin, Christopher R.; Warner, Brad W.

    2011-01-01

    PURPOSE The objectives of our study were to quantify mucosal bacterial DNA within specimens from neonates undergoing small bowel resection for necrotizing enterocolitis (NEC). METHODS We obtained clinical information and pathologic specimens from all infants diagnosed with NEC who underwent surgical treatment at our institution from 1999–2008. Bacterial and human DNA were isolated from paraffin-embedded surgical specimens and real-time PCR was used to amplify bacterial and human genes. Linear regression was used to quantify the amount of human and bacterial DNA in our specimens. RESULTS From a cohort of fifty infants, we identified twenty-three infants who underwent both surgical resection and subsequent intestinal reanastomosis. Thirteen (59%) of the neonates had Bell's Stage III NEC, and nine (41%) had Stage II. There was significantly more bacterial DNA in the resection specimens than in the reanastomosis specimens. This corresponds to a median (IQR) increase of 1.81 (1.11–4.69) fold bacterial DNA in the resection specimen compared to the reanastomosis specimen (p<0.05). CONCLUSION There is more bacterial DNA in infants with acute NEC compared with the same infants after the NEC had clinically resolved. These findings underscore the potential relevance of adherent or invasive bacteria across the bowel wall in the pathogenesis of NEC. PMID:21683193

  5. Hereditary hyperplastic gingivitis in North American farmed silver fox (Vulpes vulpes).

    PubMed

    Clark, Jo-Anna B J; Hudson, Robert C; Marshall, H Dawn

    2015-04-01

    Hereditary hyperplastic gingivitis is a progressive growth of gingival tissues in foxes resulting in dental encapsulation. It is an autosomal recessive condition displaying a gender-biased penetrance, with an association with superior fur quality. This disease has been primarily described in European farmed foxes. Here we document its emergence in Canada.

  6. Effectiveness of glucometer in screening diabetes mellitus using gingival crevicular blood

    PubMed Central

    Rajesh, Kashyap S.; Irshana, Rahmath; Arun Kumar, M. S.; Hegde, Shashikant

    2016-01-01

    Aim: Study was carried out to evaluate the efficacy of a glucometer for screening diabetes using gingival crevicular blood and to compare the blood glucose levels in the gingival crevicular blood sample and blood sample collected by finger puncture method using glucometers. Subjects and Methods: A total of 24 known diabetic patients who fulfilled the selection criteria were selected after obtaining their informed consent. Samples were collected from two sites, i.e., gingival crevice and fingertip which was measured using a self-monitoring device. Statistical Analysis Used: Karl Pearson correlation. Results: This study revealed the existence of a positive correlation between gingival crevicular blood and capillary blood glucose level (r = 0.826), and gingival blood glucose level estimates 68.2% of capillary blood glucose level. Hence, based on the observations of the study using gingival crevicular blood glucose level, capillary blood glucose level may be estimated based on the following regression equation. Capillary blood glucose = 84.66 + 0.77x gingival crevicular blood glucose level. Conclusions: The intraoral sampling technique is safer, convenient, and cost-effective for the dental practitioner as the sample can be obtained during the routine periodontal examination. It can be concluded that with the regression equation based on the gingival crevicular blood glucose level, capillary blood glucose can be estimated. PMID:27307664

  7. Cetylpyridinium chloride mouth rinses alleviate experimental gingivitis by inhibiting dental plaque maturation.

    PubMed

    Teng, Fei; He, Tao; Huang, Shi; Bo, Cun-Pei; Li, Zhen; Chang, Jin-Lan; Liu, Ji-Quan; Charbonneau, Duane; Xu, Jian; Li, Rui; Ling, Jun-Qi

    2016-09-29

    Oral rinses containing chemotherapeutic agents, such as cetylpyridinium chloride (CPC), can alleviate plaque-induced gingival infections, but how oral microbiota respond to these treatments in human population remains poorly understood. Via a double-blinded, randomised controlled trial of 91 subjects, the impact of CPC-containing oral rinses on supragingival plaque was investigated in experimental gingivitis, where the subjects, after a 21-day period of dental prophylaxis to achieve healthy gingivae, received either CPC rinses or water for 21 days. Within-subject temporal dynamics of plaque microbiota and symptoms of gingivitis were profiled via 16S ribosomal DNA gene pyrosequencing and assessment with the Mazza gingival index. Cetylpyridinium chloride conferred gingival benefits, as progression of gingival inflammation resulting from a lack of dental hygiene was significantly slower in the mouth rinse group than in the water group due to inhibition of 17 gingivitis-enriched bacterial genera. Tracking of plaque α and β diversity revealed that CPC treatment prevents acquisition of new taxa that would otherwise accumulate but maintains the original biodiversity of healthy plaques. Furthermore, CPC rinses reduced the size, local connectivity and microbiota-wide connectivity of the bacterial correlation network, particularly for nodes representing gingivitis-enriched taxa. The findings of this study provide mechanistic insights into the impact of oral rinses on the progression and maturation of dental plaque in the natural human population.

  8. Nifedipine-induced gingival hyperplasia: a clinical and in vitro study.

    PubMed

    Nishikawa, S; Tada, H; Hamasaki, A; Kasahara, S; Kido, J; Nagata, T; Ishida, H; Wakano, Y

    1991-01-01

    Two cases of gingival hyperplasia associated with long-term administration of nifedipine, a drug that dilates coronary arteries, are reported. The clinical and histopathological features of the gingival hyperplasia induced by nifedipine were similar to those induced by phenytoin, an anticonvulsant drug. In the present cases, gingival inflammation had developed before drug administration. In one case, extensive dental plaque control in addition to surgical removal of the overgrown gingival tissues resulted in satisfactory progress without the need to discontinue drug administration, suggesting that the preexisting gingival inflammation was involved in the development of this periodontal disease. In the other case, change from nifedipine to another drug resulted in spontaneous recovery, strongly suggesting that the drug had induced the gingival hyperplasia. Nifedipine had no direct effects in vitro on proliferation or collagen synthesis of gingival fibroblastic cells from one of the patients. Study of these two cases suggests that both local inflammatory factors and long-term administration of nifedipine were responsible for the gingival hyperplastic changes observed. PMID:2002429

  9. Cetylpyridinium chloride mouth rinses alleviate experimental gingivitis by inhibiting dental plaque maturation.

    PubMed

    Teng, Fei; He, Tao; Huang, Shi; Bo, Cun-Pei; Li, Zhen; Chang, Jin-Lan; Liu, Ji-Quan; Charbonneau, Duane; Xu, Jian; Li, Rui; Ling, Jun-Qi

    2016-01-01

    Oral rinses containing chemotherapeutic agents, such as cetylpyridinium chloride (CPC), can alleviate plaque-induced gingival infections, but how oral microbiota respond to these treatments in human population remains poorly understood. Via a double-blinded, randomised controlled trial of 91 subjects, the impact of CPC-containing oral rinses on supragingival plaque was investigated in experimental gingivitis, where the subjects, after a 21-day period of dental prophylaxis to achieve healthy gingivae, received either CPC rinses or water for 21 days. Within-subject temporal dynamics of plaque microbiota and symptoms of gingivitis were profiled via 16S ribosomal DNA gene pyrosequencing and assessment with the Mazza gingival index. Cetylpyridinium chloride conferred gingival benefits, as progression of gingival inflammation resulting from a lack of dental hygiene was significantly slower in the mouth rinse group than in the water group due to inhibition of 17 gingivitis-enriched bacterial genera. Tracking of plaque α and β diversity revealed that CPC treatment prevents acquisition of new taxa that would otherwise accumulate but maintains the original biodiversity of healthy plaques. Furthermore, CPC rinses reduced the size, local connectivity and microbiota-wide connectivity of the bacterial correlation network, particularly for nodes representing gingivitis-enriched taxa. The findings of this study provide mechanistic insights into the impact of oral rinses on the progression and maturation of dental plaque in the natural human population. PMID:27680288

  10. Nifedipine-induced gingival hyperplasia: a clinical and in vitro study.

    PubMed

    Nishikawa, S; Tada, H; Hamasaki, A; Kasahara, S; Kido, J; Nagata, T; Ishida, H; Wakano, Y

    1991-01-01

    Two cases of gingival hyperplasia associated with long-term administration of nifedipine, a drug that dilates coronary arteries, are reported. The clinical and histopathological features of the gingival hyperplasia induced by nifedipine were similar to those induced by phenytoin, an anticonvulsant drug. In the present cases, gingival inflammation had developed before drug administration. In one case, extensive dental plaque control in addition to surgical removal of the overgrown gingival tissues resulted in satisfactory progress without the need to discontinue drug administration, suggesting that the preexisting gingival inflammation was involved in the development of this periodontal disease. In the other case, change from nifedipine to another drug resulted in spontaneous recovery, strongly suggesting that the drug had induced the gingival hyperplasia. Nifedipine had no direct effects in vitro on proliferation or collagen synthesis of gingival fibroblastic cells from one of the patients. Study of these two cases suggests that both local inflammatory factors and long-term administration of nifedipine were responsible for the gingival hyperplastic changes observed.

  11. Effects of a Novel Dental Gel on Plaque and Gingivitis: A Comparative Study

    PubMed Central

    Dadkhah, M; Chung, NE; Ajdaharian, J; Wink, C; Klokkevold, P; Wilder-Smith, P

    2015-01-01

    Objectives The goal of this prospective, randomized, controlled, double-blinded study was to evaluate the effects of a novel dental gel on plaque and gingival health. The dental gel was designed to (1) break up and prevent re-accumulation of microbial biofilm, and (2) inhibit metal mediated inflammation. Materials and Methods Twenty-five subjects with moderate gingival inflammation (Löe and Silness Gingival Index ≥2) and pocket depths <4 were randomly assigned to brush twice daily for 21 days with the test or the control dental gel. On Days 0, 7, 14 and 21, plaque levels (Quigley-Hein, Turesky Modification Plaque Index), gingival inflammation (Löe and Silness Gingival Index) and gingival bleeding (modified Sulcus Bleeding Index) were determined by one blinded, investigator using a pressure sensitive probe. Results After 3 weeks, all 3 clinical indices were significantly improved in both groups (P<0.05) and significantly lower in the test group (P<0.05). Conclusion The novel dental gel formulation was provided effective plaque control and reduced gingival inflammation. Clinical Relevance A novel dentifrice formulation may be an effective tool for plaque removal and maintaining gingival health. PMID:26052472

  12. Effect of ozonated oil and chlorhexidine gel on plaque induced gingivitis: A randomized control clinical trial

    PubMed Central

    Indurkar, Maya Sanjeev; Verma, Renu

    2016-01-01

    Background: Several chemotherapeutic agents have been developed to prevent gingivitis and its progression into periodontitis. In this present study, the efficacy of ozonated oil and chlorhexidine gel was assessed and compared on plaque induced gingivitis. Aim: To evaluate the effect of ozonated oil on plaque induced gingivitis and to compare its efficacy with chlorhexidine gel. Materials and Methods: A total of 20 subjects, aged from 18 to 65 years, with plaque-induced gingivitis were selected from the outpatient Department of Periodontology, Government Dental College and Hospital, Aurangabad, for this study. They were divided randomly into the test or ozonated oil group (Group I) and the control or chlorhexidine gel group (Group II) with 10 subjects in each group. Subjects were randomly assigned to massage their gingiva thrice a day for 3 weeks with ozonated oil (test), and chlorhexidine gel (control). Plaque index and gingival index scores were recorded for the 20 subjects at baseline and after 3 weeks. Results: Ozonated oil (Group I) and chlorhexidine gel (Group II) groups showed statistically significant differences with respect to plaque index and gingival index, from the baseline to 3 weeks (P < 0.001 in both). But the difference between Group I and Group II, at the end of the study period, was not statistically significant with respect to the plaque index and gingival index. Conclusions: The ozonated oil and chlorhexidine gel, both can be used as an effective agent in maintaining and improving gingival health. PMID:27041835

  13. Idiopathic Gingival Hyperplasia: A Case Report with a 17-Year Followup

    PubMed Central

    Lai, Bien; Muenzer, Joseph; Roberts, Michael W.

    2011-01-01

    This is a case report of a patient with idiopathic gingival hyperplasia and an undiagnosed genetic disorder that demonstrated static encephalopathy, mental retardation, developmental delay, seizures, hypotonia, and severe gingival hypertrophy. The clinical dental management and attempts to obtain a genetic diagnosis are described. PMID:22567452

  14. Necrotizing Meningoencephalitis in a Captive Black and White Ruffed Lemur (Varecia variegata variegata) Caused by Acanthamoeba T4 Genotype.

    PubMed

    Gaide, N; Pelandakis, M; Robveille, C; Albaric, O; Jouvion, G; Souchon, M; Risler, A; Abadie, J

    2015-11-01

    A mature male, black and white ruffed lemur (Varecia variegata variegata) died in a zoological garden after a 4-day history of lethargy and non-responsive convulsions. Necropsy and histopathological examinations revealed acute necrotizing and haemorrhagic meningoencephalitis with intralesional amoebas confirmed by immunohistochemistry. Acanthamoeba T4 genotype was identified as the causative agent of the brain lesion, based on amplification and sequencing of 18S ribosomal RNA genes. The presence of free-living amoebas in water and mud from the lemur's environment was investigated by morphological and molecular analyses. The two predominant genera, representing 80% of isolated amoebas, were Naegleria spp. and Acanthamoeba spp. All Acanthamoeba isolates belonged to the T4 genotype. To the author's knowledge, this is the first report of a meningoencephalitis due to Acanthamoeba T4 genotype in Lemuridae with concurrent analysis of pathological tissues and environment.

  15. Necrotizing Meningoencephalitis in a Captive Black and White Ruffed Lemur (Varecia variegata variegata) Caused by Acanthamoeba T4 Genotype.

    PubMed

    Gaide, N; Pelandakis, M; Robveille, C; Albaric, O; Jouvion, G; Souchon, M; Risler, A; Abadie, J

    2015-11-01

    A mature male, black and white ruffed lemur (Varecia variegata variegata) died in a zoological garden after a 4-day history of lethargy and non-responsive convulsions. Necropsy and histopathological examinations revealed acute necrotizing and haemorrhagic meningoencephalitis with intralesional amoebas confirmed by immunohistochemistry. Acanthamoeba T4 genotype was identified as the causative agent of the brain lesion, based on amplification and sequencing of 18S ribosomal RNA genes. The presence of free-living amoebas in water and mud from the lemur's environment was investigated by morphological and molecular analyses. The two predominant genera, representing 80% of isolated amoebas, were Naegleria spp. and Acanthamoeba spp. All Acanthamoeba isolates belonged to the T4 genotype. To the author's knowledge, this is the first report of a meningoencephalitis due to Acanthamoeba T4 genotype in Lemuridae with concurrent analysis of pathological tissues and environment. PMID:26297109

  16. The Efficacy of Green Tea Chewing Gum on Gingival Inflammation

    PubMed Central

    Behfarnia, Parichehr; Aslani, Ahmad; Jamshidian, Foroogh; Noohi, Soheil

    2016-01-01

    Statement of the Problem According to previous studies, the components of green tea extracts can inhibit the growth of a wide range of gram-pos-itive and -negative bacterial species and might be useful in controlling oral infections. Purpose The aim of this study was to determine the effect of green tea chewing gum on the rate of plaque and gingival inflammation in subjects with gingivitis. Materials and Method In this double-blind randomize controlled clinical trial, 45 patients with generalized marginal gingivitis were selected and divided into two groups of green tea (23) and placebo (22) chewing gum. The patients chewed two gums for 15 minutes daily for three weeks. Sulcus bleeding index (SBI) and approximal plaque index (API) were studied at the baseline, 7 and 21 days later. Saliva sampling was conducted before and after 21 days for evaluation of IL-1β. The results were analyzed and compared by using repeated measures ANOVA, paired t test, and independent two-sample t test (α=0.05). Result The results showed that chewing gum significantly affected the SBI and API (p< 0.001). Paired t test showed that the two groups were significantly different regarding the mean changes of SBI and API at different periods of 1-7, 1-21, and 7-21 (p< 0.001). Concerning IL-1β, the repeated measures ANOVA revealed that the effect of chewing gum was significant (p<0.001). Moreover, paired t-test represented no significant difference between the mean changes of IL-1β within 1-21 day (p= 0.086). Conclusion The green tea chewing gum improved the SBI and API and effectively reduced the level of IL-1β. PMID:27284561

  17. MicroRNAs and Their Target Genes in Gingival Tissues

    PubMed Central

    Stoecklin-Wasmer, C.; Guarnieri, P.; Celenti, R.; Demmer, R.T.; Kebschull, M.; Papapanou, P.N.

    2012-01-01

    To gain insights into the in vivo function of miRNAs in the context of periodontitis, we examined the occurrence of miRNAs in healthy and diseased gingival tissues and validated their in silico-predicted targets through mRNA profiling using whole-genome microarrays in the same specimens. Eighty-six individuals with periodontitis contributed 198 gingival papillae: 158 ‘diseased’ (bleeding-on-probing, PD > 4 mm, and AL ≥ 3 mm) and 40 ‘healthy’ (no bleeding, PD ≤ 4 mm, and AL ≤ 2 mm). Expression of 1,205 miRNAs was assessed by microarrays, followed by selected confirmation by quantitative RT-PCR. Predicted miRNA targets were identified and tested for enrichment by Gene Set Enrichment Analysis (GSEA). Enriched gene sets were grouped in functional categories by DAVID and Ingenuity Pathway Analysis. One hundred fifty-nine miRNAs were significantly differentially expressed between healthy and diseased gingiva. Four miRNAs (hsa-miR-451, hsa-miR-223, hsa-miR-486-5p, hsa-miR-3917) were significantly overexpressed, and 7 (hsa-miR-1246, hsa-miR-1260, hsa-miR-141, hsa-miR-1260b, hsa-miR-203, hsa-miR-210, hsa-miR-205*) were underexpressed by > 2-fold in diseased vs. healthy gingiva. GSEA and additional filtering identified 60 enriched miRNA gene sets with target genes involved in immune/inflammatory responses and tissue homeostasis. This is the first study that concurrently examined miRNA and mRNA expression in gingival tissues and will inform mechanistic experimentation to dissect the role of miRNAs in periodontal tissue homeostasis and pathology. PMID:22879578

  18. The Impact of Amlodipine on Gingival Enlargement After Kidney Transplantation

    PubMed Central

    Rostami, Zohreh; Einollahi, Behzad; Einollahi, Mohammad Javad; lessan, Simin

    2012-01-01

    Abstract Background: Although cyclosporine (CsA) and calcium channel blockers (CCBs) parallel to each other may provoke gingival enlargement (GE), there are few considerations about combined effects of CsA and CCBs on gingival tissues. Objectives: This study aimed to determine prevalence of GE among renal transplant recipients and to compare its occurrence in patients who received only CsA and those who were on CsA and amlodipine. Patients and Methods: We conducted a prospective randomized case-control trial including 213 renal transplant recipients between February 2010 and August 2010. They were randomly divided into two groups including control group (on continuous treatment with CsA alone; n = 112) and trial group (treated with combined CsA and amlodipine; n = 101). Buccal, lingual, and inter-proximal membranes at last 12 anterior teeth were assessed for GE and packet depth (PD) using Gingival Index of McGaw and others, and Packet Index of Turesky–Gilmore–Glickman, respectively. Results: Marked GE was observed in 26 patients (25.7%) in trial group and only in 4 individuals (3.6%) in control group (P = 0.000). In logistic regression analysis, obese (OR = 3, P = 0.04), older (OR = 2.8, P = 0.03), and female (OR = 1.3, P = 0.03) recipients as well as who received high dose amlodipine (OR = 4.4, P = 0.000) were at risk for marked GE. Conclusions: There is a strong correlation between GE, in particular marked GE, and combination therapy with CsA and amlodipine in transplant patients compared to those treated by CsA alone. We suggest CsA dose reduction may restrain this adverse effect. PMID:23573487

  19. Trichoderma L-Lysine-α-Oxidase Producer Strain Culture Fluid Inhibits Impatiens Necrotic Spot Virus.

    PubMed

    Smirnova, I P; Shneider, Yu A; Karimova, E V

    2016-01-01

    A method for PCR diagnosis of impatiens necrotic spot virus is developed. Concentrated culture fluid with active L-lysine-α-oxidase (0.54 U/ml) from Trichoderma harzianum Rifai fungus producer strain F-180 inhibits vitally hazardous impatiens necrotic spot phytovirus. PMID:26742733

  20. Paediatric necrotizing fasciitis complicating third molar extraction: report of a case.

    PubMed

    Ricalde, P; Engroff, S L; Jansisyanont, P; Ord, R A

    2004-06-01

    Necrotizing fasciitis is an uncommon but well-described entity. In the paediatric population compromising risk factors are frequently absent. We describe the successful treatment of a case of cervicofacial necrotizing fasciitis in a healthy 14-year-old male following routine extraction of an uninfected wisdom tooth for orthodontic purposes. PMID:15145048

  1. Bilateral Necrotizing Fasciitis around the Hips Differentiated from Fournier Gangrene: A Case Report

    PubMed Central

    Yang, Bo Kyu; Yi, Seung Rim; Lee, Ye Hyun; Kim, Hyun See; Nam, Seok Woo; Ahn, Young Joon; Kim, Seong Wan; Yang, Sung Wook

    2014-01-01

    As an emergency encountered in orthopedic practice requiring prompt diagnosis and aggressive treatment, necrotizing fasciitis around the hip must be discriminated from Fournier gangrene. The current case report describes a patient who suffered from bilateral type I necrotizing fasciitis around the hips, which was alleviated by prompt surgical debridement and intensive postoperative care. PMID:27536594

  2. Effect of bismuth citrate, lactose, and organic acid on necrotic enteritis in broilers

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Clostridium perfringens – associated necrotic enteritis causes significant losses and increased morbidity in poultry. The objective of this study was to evaluate the effect of bismuth citrate and acidifiers on the development of necrotic enteritis in broilers. The first study was a dose response t...

  3. Trichoderma L-Lysine-α-Oxidase Producer Strain Culture Fluid Inhibits Impatiens Necrotic Spot Virus.

    PubMed

    Smirnova, I P; Shneider, Yu A; Karimova, E V

    2016-01-01

    A method for PCR diagnosis of impatiens necrotic spot virus is developed. Concentrated culture fluid with active L-lysine-α-oxidase (0.54 U/ml) from Trichoderma harzianum Rifai fungus producer strain F-180 inhibits vitally hazardous impatiens necrotic spot phytovirus.

  4. Necrotizing sialometaplasia: review of the literature and report of nonulcerative case.

    PubMed

    Birkholz, H; Minton, G A; Yuen, Y L

    1979-08-01

    A review of the literature and a report of a case of necrotizing sialometaplasia of the hard palate is presented. Because necrotizing sialometaplasia may be misdiagnosed as squamous cell carcinoma or mucoepidermoid carcinoma, it is important that the clinician and pathologist take the necessary precautions to prevent any further mutilative surgery for this benign disease entity.

  5. Gingival recession: its causes and types, and the importance of orthodontic treatment

    PubMed Central

    Jati, Ana Suzy; Furquim, Laurindo Zanco; Consolaro, Alberto

    2016-01-01

    abstract Gingival recession has direct causes and predisposing factors. Orthodontic treatment is able to prevent recession and even contribute to its treatment, with or without periodontal approach, depending on the type and severity of gingival tissue damage. There is no evidence on the fact that orthodontic treatment alone might induce gingival recession, although it might lead the affected teeth (usually mandibular incisors or maxillary canines) to be involved in situations that act as predisposing factors, allowing direct causes to act and, therefore, trigger recession, especially when the buccal bone plate is very thin or presents with dehiscence. Several aspects regarding the relationship between orthodontic treatment and gingival recession have been addressed, and so has the importance of the periosteum to the mechanism of gingival recession formation. Clinical as well as experimental trials on the subject would help to clarify this matter, of which understanding is not very deep in the related literature. PMID:27409650

  6. Idiopathic gingival fibromatosis rehabilitation: a case report with two-year followup.

    PubMed

    Jayachandran, Mahesh; Kapoor, Shalini; Mahesh, Rethi

    2013-01-01

    Gingival enlargements are quite common and may be either inflammatory, noninflammatory, or a combination of both. Gingival hyperplasia is a bizarre condition causing esthetic, functional, psychological, and masticatory disturbances of the oral cavity. Causes of gingival enlargement can be due to plaque accumulation, due to poor oral hygiene, inadequate nutrition, or systemic hormonal stimulation (Bakaeen and Scully, 1998). It can occur as an isolated disease or as part of a syndrome or chromosomal abnormality. A progressive fibrous enlargement of the gingiva is a facet of idiopathic fibrous hyperplasia of the gingiva (Carranza and Hogan, 2002; Gorlin et al., 1976). It is described variously as fibromatosis gingivae, gingivostomatitis, hereditary gingival fibromatosis, idiopathic fibromatosis, familial elephantiasis, and diffuse fibroma. We present a case of idiopathic gingival fibromatosis with its multidisciplinary approach of management.

  7. Evaluation of cleansing devices in the maintenance of interproximal gingival health.

    PubMed

    Vogel, R I; Sullivan, A J; Pascuzzi, J N; Deasy, M J

    1975-12-01

    This study consisted of 24 dental students, who 10 days prior to the start of the experimental period, were thoroughly scaled and given instructions in the use of a rubber tip stimulator, unwaxed dental floss, and a modified Bass brushing technique. On day 0, the subjects had reached a high level of interproximal gingival health as measured by intracrevicular exudate flow and löe's Gingival Index. Subjects were then randomly divided into 4 groups which were to brush; brush and floss; brush and rubber tip; and brush, floss and rubber tip. Evaluation was performed on days 0, 9, 15, and 33 using Löe's Gingival Index, Podchadley's Plaque Index, and gingival exudate flow. The results of this study indicate that interproximal gingival health can be maintained in motivated patients with initially healthy gingivae (for at least several weeks) with proper use of the modified Bass brushing technique alone.

  8. Clinical evaluation of three new gingival retraction systems: a research report.

    PubMed

    Gupta, Ankit; Prithviraj, D R; Gupta, Deepti; Shruti, D P

    2013-03-01

    The purpose of this study was to evaluate the clinical efficacy of 3 new gingival retraction systems; Stay-put, Magic foam cord and expasyl, on the basis of their relative ease of handling, time taken for placement, hemorrhage control and the amount of gingival retraction. Thirty subjects were selected requiring fixed prosthesis. The 3 gingival retraction systems were used on the prepared abutments randomly. The time taken for placement of each retraction system was recorded. The vertical gingival retraction was measured before and after retraction using flexible measuring strip with 0.5 mm grading. The horizontal retraction was measured on polyether impressions made before the retraction and after retraction. Based on the results, magic foam cord retraction system can be considered more effective gingival retraction system among the three retraction systems used in the study.

  9. Idiopathic Gingival Fibromatosis Rehabilitation: A Case Report with Two-Year Followup

    PubMed Central

    Jayachandran, Mahesh; Kapoor, Shalini; Mahesh, Rethi

    2013-01-01

    Gingival enlargements are quite common and may be either inflammatory, noninflammatory, or a combination of both. Gingival hyperplasia is a bizarre condition causing esthetic, functional, psychological, and masticatory disturbances of the oral cavity. Causes of gingival enlargement can be due to plaque accumulation, due to poor oral hygiene, inadequate nutrition, or systemic hormonal stimulation (Bakaeen and Scully, 1998). It can occur as an isolated disease or as part of a syndrome or chromosomal abnormality. A progressive fibrous enlargement of the gingiva is a facet of idiopathic fibrous hyperplasia of the gingiva (Carranza and Hogan, 2002; Gorlin et al., 1976). It is described variously as fibromatosis gingivae, gingivostomatitis, hereditary gingival fibromatosis, idiopathic fibromatosis, familial elephantiasis, and diffuse fibroma. We present a case of idiopathic gingival fibromatosis with its multidisciplinary approach of management. PMID:23606991

  10. Gingival recession: its causes and types, and the importance of orthodontic treatment.

    PubMed

    Jati, Ana Suzy; Furquim, Laurindo Zanco; Consolaro, Alberto

    2016-06-01

    Gingival recession has direct causes and predisposing factors. Orthodontic treatment is able to prevent recession and even contribute to its treatment, with or without periodontal approach, depending on the type and severity of gingival tissue damage. There is no evidence on the fact that orthodontic treatment alone might induce gingival recession, although it might lead the affected teeth (usually mandibular incisors or maxillary canines) to be involved in situations that act as predisposing factors, allowing direct causes to act and, therefore, trigger recession, especially when the buccal bone plate is very thin or presents with dehiscence. Several aspects regarding the relationship between orthodontic treatment and gingival recession have been addressed, and so has the importance of the periosteum to the mechanism of gingival recession formation. Clinical as well as experimental trials on the subject would help to clarify this matter, of which understanding is not very deep in the related literature. PMID:27409650

  11. Impact of the sonicare toothbrush on plaque and gingivitis.

    PubMed

    Kugel, Gerard; Boghosian, Alan A

    2002-07-01

    The sonicare toothbrush has been shown to be 40% more effective in removing plaque than a manual toothbrush, 82% better in removing plaque from interproximal areas, and to reverse gingivitis. In vitro studies have examined the ability of the sonicare toothbrush to remove plaque bacteria beyond the reach of the bristles. The sonicare toothbrush has also been shown to produce significantly less dentin wear in vitro than another leading power toothbrush. This article reviews both in vivo and in vitro studies that illustrate the efficacy of the sonicare toothbrush in improving oral health.

  12. Gingival status during prolonged fasting for weight loss.

    PubMed

    Squire, C F; Costley, J M

    1976-02-01

    Nineteen obese patients were observed during a prolonged period of fasting for weight loss. The period of fasting ranged from 15 to 71 days. The patients consumed a dose of certain vitamins and minerals with 2 liters of water per day. No effort was made to alter the patient at the beginning and termination of the fasting period. At the time of original recording the Plaque and Gingival Index correlated directly. As the fasting period lengthened, there was a decrease in the Plaque Index scores but the Ginival Index scores increased considerably. This is an opposite correlation to what one would expect in individuals maintained on an adequate diet. PMID:1062556

  13. Frequency of Entamoeba gingivalis in human gingival scrapings.

    PubMed

    Dao, A H; Robinson, D P; Wong, S W

    1983-09-01

    A survey was made of gingival scrapings stained by the Papanicolaou method to assess the occurrence of Entamoeba gingivalis, a nonpathogenic-oral amoeba. Positive findings were recorded in 59% of 113 dental patients, and 32% of 96 healthy controls. These figures showed no significant changes during the last 20 years when compared with data published in 1960 and 1963. The existence of E. gingivalis and its rare appearance in the sputum should be known to cytologists because of the morphologic resemblance to Entamoeba histolytica, a pathogenic amoeba. Morphologic features are described to differentiate E. gingivalis from similar structures found in sputum. PMID:6881102

  14. Clinical and bacteriological study of the effect of Nd:YAG laser in gingivitis therapy

    NASA Astrophysics Data System (ADS)

    Colojoara, Carmen; Mavrantoni, Androniki; Miron, Mariana I.

    2000-06-01

    The relationship between dental plaque and gingivitis was verified. Nonspecific gingivitis is an inflammatory process, frequently caused by enzymes and toxins liberate by bacteria form dental plaque. Loose plaque has come under a great deal of investigation because of its role in attachment loss. The current methods used in the treatment of non specific gingivitis encompass the use of antibiotics and conventional surgical techniques. Treating gingivitis with laser energy may further reduce the gingival inflammation and decrease the wound healing time. The lack of correlation between the quantity of dental plaque and the intensity of gingivitis determined us to study the effect of Nd:YAG pulsed laser in reduction of gingival inflammation and wound healing. The aim of this work is to evaluate clinically the anti- inflammatory and wound healing effect of pulsed Nd:YAG laser and to compare the appearance and the levels of the bacteria in the supergingival and subgingival plaque in adolescents with tooth crowding after Nd:YAG laser. The experimental procedure consisted of a clinical and bacteriological study which was undertaken in 20 patients presenting moderate gingivitis. A group of 10 patients was the subject of a bacteriological study and the other group of 10 was used for clinical and histological examination. For each group the clinical criteria of evaluation were: the gingival index, papillary bleeding index, spontaneous aches. Each patient was tested before and after laser exposure or conventional therapy for bacteriological analyses. The results prove that early gingivitis exposure to laser registers a decrease of bacterial colony number and absence of loss of attachment as compared to the application of the conventional treatment. Clinical study has shown that the combination of scaling and root planning with laser therapy is enough to provide improvement in clinical indices and reduction in the number of bacterial colonies.

  15. Prevalence of herpesviruses in gingivitis and chronic periodontitis: relationship to clinical parameters and effect of treatment

    PubMed Central

    Shah, Rucha; Mehta, Dhoom Singh

    2016-01-01

    Background: Assess the prevalence of herpesviruses in healthy subjects, gingivitis, and chronic periodontitis patients, to assess the relationship between the prevalence of herpesviruses and periodontal clinical parameters, and to evaluate the effect of phase-I therapy on the level of viral detection. Materials and Methods: Hundred patients consisting of 20 healthy subjects, 40 gingivitis, and 40 chronic periodontitis were included in the study. Clinical parameters recorded included plaque index, gingival index, sulcus bleeding index, probing depth, and clinical attachment level. The gingivitis and chronic periodontitis patients received phase-I periodontal therapy including oral hygiene instructions, full mouth scaling for gingivitis patients and scaling and root planing for chronic periodontitis patients. Gingival crevicular fluid (GCF) was collected, and the presence of herpes simplex virus-1 (HSV-1), HSV-2, cytomegalovirus, and Epstein–Barr virus (EBV) was analyzed using polymerase chain reaction (PCR). Recording of periodontal parameters as well as GCF collection was performed at baseline and 6 weeks postphase-I therapy. Results: At baseline, the levels of HSV-1 and EBV detection were lower in healthy controls as compared to gingivitis (P < 0.05) and chronic periodontitis cases (P < 0.001). Phase-I therapy led to reduction in the amount of HSV-1 and EBV in gingivitis patients (P < 0.05) and for HSV-1, human cytomegalovirus and EBV in chronic periodontitis patients (P < 0.05) in comparison to baseline. The prevalence of EBV in chronic periodontitis patients was positively associated with increased gingival index, probing depth and loss of clinical attachment (P < 0.05). Conclusions: Higher prevalence of HSV-1 and EBV viruses in GCF of gingivitis and chronic periodontitis suggests a strong association between these viruses and periodontal diseases and periodontal therapy can lead to a reduction in herpesviruses at infected sites. PMID:27563201

  16. Fatal hemorrhagic-necrotizing pancreatitis associated with pancreatic and hepatic lipidosis in an obese Asian palm civet (Paradoxurus hermaphroditus)

    PubMed Central

    Laura, Bongiovanni; Nicola, Di Girolamo; Alessandro, Montani; Leonardo, Della Salda; Paolo, Selleri

    2014-01-01

    Asian palm civets (Paradoxurus hermaphroditus), or toddy cats, belong to the family Viverridae. Little is known about the pathology of these animals and few articles have been published, mainly concerning their important role as wild reservoir hosts for severe infectious diseases of domestic animals and human beings. A 4-year-old, female Asian palm civet was found dead by the owner. At necropsy, large amount of adipose tissue was found in the subcutis and in the peritoneal cavity. Most of the pancreas appeared red, translucent. Hepatomegaly, discoloration of the liver were evident, with multifocal areas of degeneration, characterized by white nodular lesions. Histologically, the pancreas showed severe interstitial and perilobular necrosis and extensive haemorrhages, with separation of the interstitium, mild reactive inflammation at the periphery of the pancreatic lobules. Liver showed multifocal foci of vacuolar degeneration, lipidic accumulation, sometimes associated to hepatocyte necrosis. A diagnosis of acute severe hemorrhagic-necrotizing pancreatitis (or acute pancreatic necrosis) associated with pancreatic and hepatic lipidosis was made. To the best of our knowledge, this represents the first case report of acute lethal pancreatitis in an Asian palm civet. Although the exact cause of the disease remains undetermined, a hypothesis of the cause and pathogenesis is discussed, pointing out dietary indiscretion and consequent overweight as possible important risk factors. PMID:25183148

  17. Fatal hemorrhagic-necrotizing pancreatitis associated with pancreatic and hepatic lipidosis in an obese Asian palm civet (Paradoxurus hermaphroditus).

    PubMed

    Laura, Bongiovanni; Nicola, Di Girolamo; Alessandro, Montani; Leonardo, Della Salda; Paolo, Selleri

    2014-05-01

    Asian palm civets (Paradoxurus hermaphroditus), or toddy cats, belong to the family Viverridae. Little is known about the pathology of these animals and few articles have been published, mainly concerning their important role as wild reservoir hosts for severe infectious diseases of domestic animals and human beings. A 4-year-old, female Asian palm civet was found dead by the owner. At necropsy, large amount of adipose tissue was found in the subcutis and in the peritoneal cavity. Most of the pancreas appeared red, translucent. Hepatomegaly, discoloration of the liver were evident, with multifocal areas of degeneration, characterized by white nodular lesions. Histologically, the pancreas showed severe interstitial and perilobular necrosis and extensive haemorrhages, with separation of the interstitium, mild reactive inflammation at the periphery of the pancreatic lobules. Liver showed multifocal foci of vacuolar degeneration, lipidic accumulation, sometimes associated to hepatocyte necrosis. A diagnosis of acute severe hemorrhagic-necrotizing pancreatitis (or acute pancreatic necrosis) associated with pancreatic and hepatic lipidosis was made. To the best of our knowledge, this represents the first case report of acute lethal pancreatitis in an Asian palm civet. Although the exact cause of the disease remains undetermined, a hypothesis of the cause and pathogenesis is discussed, pointing out dietary indiscretion and consequent overweight as possible important risk factors.

  18. The Tuberculosis Necrotizing Toxin kills macrophages by hydrolyzing NAD

    PubMed Central

    Sun, Jim; Siroy, Axel; Lokareddy, Ravi K.; Speer, Alexander; Doornbos, Kathryn S.; Cingolani, Gino; Niederweis, Michael

    2015-01-01

    Mycobacterium tuberculosis (Mtb) induces necrosis of infected cells to evade immune responses. Recently, we found that Mtb utilizes the protein CpnT to kill human macrophages by secreting its C-terminal domain, named tuberculosis necrotizing toxin (TNT) that induces necrosis by an unknown mechanism. Here we show that TNT gains access to the cytosol of Mtb-infected macrophages, where it hydrolyzes the essential co-enzyme nicotinamide adenine dinucleotide (NAD+). Expression or injection of a non-catalytic TNT mutant showed no cytotoxicity in macrophages or zebrafish zygotes, respectively, demonstrating that the NAD+-glycohydrolase activity is required for TNT-induced cell death. To prevent self-poisoning, Mtb produces an immunity factor for TNT (IFT) that binds TNT and inhibits its activity. The crystal structure of the TNT-IFT complex revealed a novel NAD+-glycohydrolase fold of TNT, which constitutes the founding member of a toxin family wide-spread in pathogenic microorganisms. PMID:26237511

  19. A decreased incidence of necrotizing enterocolitis after prenatal glucocorticoid therapy.

    PubMed

    Bauer, C R; Morrison, J C; Poole, W K; Korones, S B; Boehm, J J; Rigatto, H; Zachman, R D

    1984-05-01

    In a large multicentered, collaborative randomized and blinded trial utilizing antenatal corticosteroids, the goals included determining the effectiveness of these agents in accelerating lung maturation, as well as monitoring any short-term or long-term adverse effects of this treatment on the parturient, fetus, and/or infant. More than 100 specific items, pertaining to diagnoses, complications, and outcomes were recorded for the 696 mothers enrolled in the study and their 745 infants. A significantly decreased incidence of necrotizing enterocolitis (P = .002) was found in the infants treated with steroids. The possibility of accelerated intestinal maturation induced by antenatal maternal steroid therapy exists. This treatment regimen is particularly attractive as adverse aspects of steroid therapy at the dosage utilized have not been demonstrated. PMID:6371696

  20. Necrotizing enterocolitis--150 years of fruitless search for the cause.

    PubMed

    Obladen, Michael

    2009-01-01

    Necrotizing enterocolitis (NEC) is not a new disease but one that has been reported since special care units began to house preterm infants. It was observed in foundling hospitals in Paris [Billard, 1828] and Vienna [Bednar, 1850] and, as it occurred in clusters, was regarded as a nosocomial infection in the infant hospitals of Zurich [Willi, 1944] and Berlin [Ylppo, 1931]. Clinical and patho-anatomic characterization was achieved by Schmidt and Quaiser in 1952. The unproven hypothesis of mesenteric hypoperfusion as a major etiological factor arose from animal models and analogous perforating disorders in term infants. Despite similarities between NEC and clostridial infections, few studies employed anaerobic culture techniques. The pathogenesis remains unclear and its distinction from related disorders uncertain. It is unlikely that strategies to prevent NEC will be successful unless the disease is better understood.

  1. Necrotizing fasciitis of the head and neck: a case report

    PubMed Central

    2015-01-01

    Necrotizing fasciitis (NF) is an infection that spreads along the fascial planes, causing subcutaneous tissue death characterized by rapid progression, systemic toxicity, and even death. NF often appears as a red, hot, painful, and swollen wound with an ill-defined border. As the infective process continues, local pain is replaced by numbness or analgesia. As the disease process continues, the skin initially becomes pale, then mottled and purple, and finally, gangrenous. The ability of NF to move rapidly along fascial planes and cause tissue necrosis is secondary to its polymicrobial composition and the synergistic effect of the enzymes produced by the bacteria. Treatment involves securing the airway, broad-spectrum antimicrobial therapy, intensive care support, and prompt surgical debridement, repeated as needed. Reducing mortality rests on early diagnosis and prompt aggressive treatment. PMID:25922821

  2. Propolis-induced descending necrotizing mediastinitis and aspiration pneumonia.

    PubMed

    Wu, Jeng-Yuan; Hsu, Nan-Yung

    2013-04-01

    Propolis is a resinous substance collected by bees as a sealant for their hives. It is also used in traditional medicine as an antioxidant and antiinflammatory agent to treat ulcers, superficial burns, and microbial diseases. In this report, a 40-year-old woman who took liquid propolis for relief of her common cold experienced severe sore throat, dysphagia, and easy choking followed by fever and chills. Descending necrotizing mediastinitis and concomitant aspiration pneumonia were evident on the image studies. We performed video-assisted thoracoscopic surgery to achieve immediate and adequate drainage, and the patient resumed normal deglutition 2 months later. Early diagnosis and prompt video-assisted thoracoscopic surgery intervention are paramount to manage this life-threatening situation.

  3. Necrotizing fasciitis secondary to enterocutaneous fistula: three case reports.

    PubMed

    Gu, Guo-Li; Wang, Lin; Wei, Xue-Ming; Li, Ming; Zhang, Jie

    2014-06-28

    Necrotizing fasciitis (NF) is an uncommon, rapidly progressive, and potentially fatal infection of the superficial fascia and subcutaneous tissue. NF caused by an enterocutaneous fistula has special clinical characters compared with other types of NF. NF caused by enterocutaneous fistula may have more rapid progress and more severe consequences because of multiple germs infection and corrosion by digestive juices. We treated three cases of NF caused by postoperative enterocutaneous fistula since Jan 2007. We followed empirically the principle of eliminating anaerobic conditions of infection, bypassing or draining digestive juice from the fistula and changing dressings with moist exposed burn therapy impregnated with zinc/silver acetate. These three cases were eventually cured by debridement, antibiotics and wound management. PMID:24976737

  4. Necrotizing sialometaplasia of the parotid gland in a dog.

    PubMed

    Kim, Ha-Young; Woo, Gye-Hyeong; Bae, You-Chan; Park, Yeon-Hee; Joo, Yi-Seok

    2010-11-01

    Necrotizing sialometaplasia (NS) is a self-limiting, benign, ischemic, inflammatory disease that is most often described in the submandibular glands of dogs, with clinical and histologic features that resemble malignancy. Unilateral swelling of the parotid salivary gland in a 7-year-old Cocker Spaniel dog was diagnosed as NS. The dog also had otitis externa on the same side as the parotid gland lesions. The main histologic features were included lobular necrosis of salivary tissue; fibrinoid necrosis of some arteries; marked squamous metaplasia of duct and/or acinar epithelium, with intercellular bridge formation; preservation of salivary lobular morphology; and variable inflammation and fibrosis. Etiologic factors for NS in both humans and animals remain obscure.

  5. Necrotizing sialometaplasia obscuring an underlying malignancy: report of a case.

    PubMed

    Poulson, T C; Greer, R O; Ryser, R W

    1986-07-01

    Necrotizing sialometaplasia poses many diagnostic problems, both clinically and microscopically. Caution had most frequently been urged for distinguishing between malignancy and NS, so as to avoid mutilating surgical treatment resulting from the misdiagnosis of a lesion that is benign and self-limiting. This case has been presented to alert the practitioner to the possibility that NS may obscure an underlying malignant disease process, possibly resulting in delays in referral or treatment. The exceedingly rapid growth of this mesenchymal neoplasm may have caused obstruction of the blood supply to the overlying mucosa and submucosa, thereby producing the ischemic alterations observed in the first biopsy specimens. Some of the difficulties encountered in the detection and diagnosis of neoplasms arising in the parapharyngeal space were discussed, and some previously published suggestions to aid in these efforts were reiterated.

  6. CrossLaps and beta-glucuronidase in peri-implant and gingival crevicular fluid.

    PubMed

    Schubert, U; Kleber, B M; Strietzel, F P; Dörfling, P

    2001-01-01

    Collagen degradation products of the carboxyterminal region possibly reflect bone and attachment loss. In the present study, the Serum CrossLaps One-Step enzyme-linked immunosorbent assay was used to determine a specific part of the carboxyterminal region of type I collagen, the CrossLaps. Samples of peri-implant and gingival crevicular fluid of 111 implants and 53 teeth from 47 partially or completely edentulous patients were examined in reference to levels of CrossLaps and beta-glucuronidase (beta G), an established marker of periodontal disease. Clinical probing pocket depth (PPD), bleeding on probing (BOP), plaque accumulation, mobility, radiographic bone loss, and the occurrence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia were assessed. The mean values were: for PPD at implants 3.76 +/- 1.41 mm, at teeth 3.44 +/- 0.88 mm; for beta G at implants 0.364 +/- 0.392 pU/min, at teeth 0.314 +/- 0.209 pU/min; for CrossLaps at implants 0.069 +/- 0.059 pmol/min, at teeth 0.082 +/- 0.053 pmol/min. Bleeding on probing was significantly higher on implants than on teeth (McNemar test, P = .004). No significant difference of beta G levels was found between teeth and implants (Wilcoxon test). A negative correlation was found between beta G levels and CrossLaps levels at teeth (Pearson-rank correlation, P = .002). On implants, no significant correlation of these 2 parameters was seen, but significant correlations were found between sulcus fluid flow rate and PPD (P = .012), beta G levels and bone loss (P < 0.0005), and CrossLaps levels and PPD (P = .011). CrossLaps can be detected in both gingival and peri-implant crevicular fluid. While rising levels of beta G may indicate acute peri-implantitis, CrossLaps may not, but could play a role as a marker of ongoing attachment loss.

  7. Desquamative gingivitis - A clinical sign in mucous membrane pemphigoid: Report of a case and review of literature

    PubMed Central

    Hasan, Shamimul

    2014-01-01

    Gingival desquamation is a clinical sign in which the gingiva appears reddish, glazed and friable with destruction of the epithelium. Gingival desquamation may be the result of various disease processes in gingiva. Mucous membrane pemphigoid (MMP), oral lichen planus and pemphigus vulgaris accounts for the major causes of gingival desquamation. MMP is a rare, chronic autoimmune blistering disorder characterized by subepithelial bullae. The condition frequently involves mucous membranes, with rare skin involvement. Oral cavity is mostly affected and desquamative gingivitis is the most common manifestation. Hereby, we present an interesting case of MMP manifesting as desquamative gingivitis, along with a brief review of the literature. PMID:24741281

  8. Current Concepts in the Management of Necrotizing Fasciitis

    PubMed Central

    Misiakos, Evangelos P.; Bagias, George; Patapis, Paul; Sotiropoulos, Dimitrios; Kanavidis, Prodromos; Machairas, Anastasios

    2014-01-01

    Necrotizing fasciitis (NF) is a severe, rare, potentially lethal soft tissue infection that develops in the scrotum and perineum, the abdominal wall, or the extremities. The infection progresses rapidly, and septic shock may ensue; hence, the mortality rate is high (median mortality 32.2%). Prognosis becomes poorer in the presence of co-morbidities, such as diabetes mellitus, immunosuppression, chronic alcohol disease, chronic renal failure, and liver cirrhosis. NF is classified into four types, depending on microbiological findings. Most cases are polymicrobial, classed as type I. The clinical status of the patient varies from erythema, swelling, and tenderness in the early stage to skin ischemia with blisters and bullae in the advanced stage of infection. In its fulminant form, the patient is critically ill with signs and symptoms of severe septic shock and multiple organ dysfunction. The clinical condition is the most important clue for diagnosis. However, in equivocal cases, the diagnosis and severity of the infection can be secured with laboratory-based scoring systems, such as the laboratory risk indicator for necrotizing fasciitis score or Fournier’s gangrene severity index score, especially in regard to Fournier’s gangrene. Computed tomography or ultrasonography can be helpful, but definitive diagnosis is attained by exploratory surgery at the infected sites. Management of the infection begins with broad-spectrum antibiotics, but early and aggressive drainage and meticulous debridement constitute the mainstay of treatment. Postoperative management of the surgical wound is also important for the patient’s survival, along with proper nutrition. The vacuum-assisted closure system has proved to be helpful in wound management, with its combined benefits of continuous cleansing of the wound and the formation of granulation tissue. PMID:25593960

  9. [Complex treatment of generalized gingivitis with mineral therapy].

    PubMed

    Leonova, L E; Pavlova, G A; Omarova, L V; Barannikov, V G; Kirichenko, L V; Varankina, S A

    2015-01-01

    A comprehensive examination and treatment of 49 students aged 20-25 years diagnosed chronic generalized catarrhal gingivitis (CGCG) were held. Depending on the methods of treatment were created into two groups of observation. The main group comprised 24 patients who along with dental sanitation and treatment of gingivitis took the course of salt treatment for 17 days, as opposed to control group. Hygienic researches and mineralthcrapy were held in a special room (23.6 m2). equipped with sylvite blocks with a total reaction surface 5 m2, salt filters with air ducts filled with wooden plates with mineral fragments. The study of the effectiveness of a comprehensive treatment of young patients with CGCG allowsto gel an information of the positive impact of salt therapyon the clinical condition of marginal periodontal tissues and indeces of oral cavity local immunity. The main curative factorsforming the internal environment of silvinite structures are multicomponent highly dispersed salt aerosol with a defined particle size and aeroionization. Natural salts complex consisting of chlorides of potassium, sodium and magnesium has an anti-inflammatory and immuno-modulating effects.

  10. Gingival wound healing: an essential response disturbed by aging?

    PubMed

    Smith, P C; Cáceres, M; Martínez, C; Oyarzún, A; Martínez, J

    2015-03-01

    Gingival wound healing comprises a series of sequential responses that allow the closure of breaches in the masticatory mucosa. This process is of critical importance to prevent the invasion of microbes or other agents into tissues, avoiding the establishment of a chronic infection. Wound healing may also play an important role during cell and tissue reaction to long-term injury, as it may occur during inflammatory responses and cancer. Recent experimental data have shown that gingival wound healing is severely affected by the aging process. These defects may alter distinct phases of the wound-healing process, including epithelial migration, granulation tissue formation, and tissue remodeling. The cellular and molecular defects that may explain these deficiencies include several biological responses such as an increased inflammatory response, altered integrin signaling, reduced growth factor activity, decreased cell proliferation, diminished angiogenesis, reduced collagen synthesis, augmented collagen remodeling, and deterioration of the proliferative and differentiation potential of stem cells. In this review, we explore the cellular and molecular basis of these defects and their possible clinical implications.

  11. Retractions of the gingival margins evaluated by holographic methods

    NASA Astrophysics Data System (ADS)

    Sinescu, Cosmin; Negrutiu, Meda Lavinia; Manole, Marius; de Sabata, Aldo; Rusu, Laura-Cristina; Stratul, Stefan; Dudea, Diana; Dughir, Ciprian; Duma, Virgil-Florin

    2015-05-01

    The periodontal disease is one of the most common pathological states of the teeth and gums system. The issue is that its evaluation is a subjective one, i.e. it is based on the skills of the dental medical doctor. As for any clinical condition, a quantitative evaluation and monitoring in time of the retraction of the gingival margins is desired. This phenomenon was evaluated in this study with a holographic method by using a He-Ne laser with a power of 13 mW. The holographic system we have utilized - adapted for dentistry applications - is described. Several patients were considered in a comparative study of their state of health - regarding their oral cavity. The impressions of the maxillary dental arch were taken from a patient during his/her first visit and after a period of six months. The hologram of the first model was superposed on the model cast after the second visit. The retractions of the gingival margins could be thus evaluated three-dimensionally in every point of interest. An evaluation of the retraction has thus been made. Conclusions can thus be drawn for the clinical evaluation of the health of the teeth and gums system of each patient.

  12. [Complex treatment of generalized gingivitis with mineral therapy].

    PubMed

    Leonova, L E; Pavlova, G A; Omarova, L V; Barannikov, V G; Kirichenko, L V; Varankina, S A

    2015-01-01

    A comprehensive examination and treatment of 49 students aged 20-25 years diagnosed chronic generalized catarrhal gingivitis (CGCG) were held. Depending on the methods of treatment were created into two groups of observation. The main group comprised 24 patients who along with dental sanitation and treatment of gingivitis took the course of salt treatment for 17 days, as opposed to control group. Hygienic researches and mineralthcrapy were held in a special room (23.6 m2). equipped with sylvite blocks with a total reaction surface 5 m2, salt filters with air ducts filled with wooden plates with mineral fragments. The study of the effectiveness of a comprehensive treatment of young patients with CGCG allowsto gel an information of the positive impact of salt therapyon the clinical condition of marginal periodontal tissues and indeces of oral cavity local immunity. The main curative factorsforming the internal environment of silvinite structures are multicomponent highly dispersed salt aerosol with a defined particle size and aeroionization. Natural salts complex consisting of chlorides of potassium, sodium and magnesium has an anti-inflammatory and immuno-modulating effects. PMID:26145468

  13. Desquamative gingivitis as only presenting sign of mucous membrane pemphigoid.

    PubMed

    Vijayan, Veena; Paul, Ajish; Babu, Kennedy; Madhan, Balasubramanian

    2016-01-01

    Desquamative gingivitis (DG) is a clinical condition in which the gingiva appears reddish, glazed, and friable with loss of superficial epithelium. DG is considered a clinical manifestation of many gingival diseases and hence not identified as a diagnosis itself. Mucous membrane pemphigoid (MMP) is an autoimmune vesiculobullous disorder of mucous membrane characterized by subepithelial bullae formation. MMP can affect the mucous membranes of oral cavity, conjunctiva, nasopharynx, larynx, esophagus, genitourinary tract, and anus and vary in its severity. The most commonly affected sites are oral cavity and conjunctiva. Since DG may be the early sign or only presenting sign of these conditions, most of the times, dental surgeon plays a key role in the diagnosis and prevention of the systemic complications of these diseases. We report a case of a 41-year-old male patient presented with DG. Histopathological examination revealed subepithelial clefting suggestive of MMP. The patient was treated with topical application of triamcinolone acetonide 0.1% 3-4 times a day for 1 month. PMID:27563211

  14. Desquamative gingivitis as only presenting sign of mucous membrane pemphigoid

    PubMed Central

    Vijayan, Veena; Paul, Ajish; Babu, Kennedy; Madhan, Balasubramanian

    2016-01-01

    Desquamative gingivitis (DG) is a clinical condition in which the gingiva appears reddish, glazed, and friable with loss of superficial epithelium. DG is considered a clinical manifestation of many gingival diseases and hence not identified as a diagnosis itself. Mucous membrane pemphigoid (MMP) is an autoimmune vesiculobullous disorder of mucous membrane characterized by subepithelial bullae formation. MMP can affect the mucous membranes of oral cavity, conjunctiva, nasopharynx, larynx, esophagus, genitourinary tract, and anus and vary in its severity. The most commonly affected sites are oral cavity and conjunctiva. Since DG may be the early sign or only presenting sign of these conditions, most of the times, dental surgeon plays a key role in the diagnosis and prevention of the systemic complications of these diseases. We report a case of a 41-year-old male patient presented with DG. Histopathological examination revealed subepithelial clefting suggestive of MMP. The patient was treated with topical application of triamcinolone acetonide 0.1% 3–4 times a day for 1 month. PMID:27563211

  15. Gingival squamous cell carcinoma mimicking as a desquamative lesion

    PubMed Central

    Keshava, Abbayya; Gugwad, Sushma; Baad, Rajendra; Patel, Rufi

    2016-01-01

    Oral squamous cell carcinoma (SCC) is the most frequently encountered neoplasm in the oral cavity, which accounts for more than 90% of all cancers. Except for carcinoma of the lip vermilion, the most common sites of oral SCC are the tongue and floor of mouth, followed at a lower frequency by the soft palate, gingiva, and buccal mucosa. Clinically, it may be misdiagnosed because of its variable appearances. This case report presents a case of well-differentiated SCC of gingiva. A 48-year-old male patient reported to the Department of Periodontology, School of Dental Sciences, Karad, with a 1-year history of burning sensation and painful lesion on the gingiva from 35 to 37 (mandibular) regions. On clinical examination, desquamated gingival lesion was seen with no purulent exudation. Clinical characteristics and differential diagnosis indicated the lesion for an excisional biopsy. Histopathological examination confirmed the lesion to be a well-differentiated SCC. The patient was referred for the treatment consisting of surgical excision of the lesion. Since an early diagnosis and treatment was possible in this case, it resulted in a good prognosis. In these instances, dentist plays an important role in early detection of gingival SCC. PMID:27041843

  16. CEMP1 Induces Transformation in Human Gingival Fibroblasts

    PubMed Central

    Bermúdez, Mercedes; Imaz-Rosshandler, Ivan; Rangel-Escareño, Claudia; Zeichner-David, Margarita; Arzate, Higinio; Mercado-Celis, Gabriela E.

    2015-01-01

    Cementum Protein 1 (CEMP1) is a key regulator of cementogenesis. CEMP1 promotes cell attachment, differentiation, deposition rate, composition, and morphology of hydroxyapatite crystals formed by human cementoblastic cells. Its expression is restricted to cementoblasts and progenitor cell subpopulations present in the periodontal ligament. CEMP1 transfection into non-osteogenic cells such as adult human gingival fibroblasts results in differentiation of these cells into a “mineralizing” cell phenotype. Other studies have shown evidence that CEMP1 could have a therapeutic potential for the treatment of bone defects and regeneration of other mineralized tissues. To better understand CEMP1’s biological effects in vitro we investigated the consequences of its expression in human gingival fibroblasts (HGF) growing in non-mineralizing media by comparing gene expression profiles. We identified several mRNAs whose expression is modified by CEMP1 induction in HGF cells. Enrichment analysis showed that several of these newly expressed genes are involved in oncogenesis. Our results suggest that CEMP1 causes the transformation of HGF and NIH3T3 cells. CEMP1 is overexpressed in cancer cell lines. We also determined that the region spanning the CEMP1 locus is commonly amplified in a variety of cancers, and finally we found significant overexpression of CEMP1 in leukemia, cervix, breast, prostate and lung cancer. Our findings suggest that CEMP1 exerts modulation of a number of cellular genes, cellular development, cellular growth, cell death, and cell cycle, and molecules associated with cancer. PMID:26011628

  17. [Procalcitonin. A new marker for acute phase reaction in acute pancreatitis].

    PubMed

    Bertsch, T; Richter, A; Hofheinz, H; Böhm, C; Hartel, M; Aufenanger, J

    1997-01-01

    Procalcitonin is a protein which is found in elevated concentrations in the blood circulation during systemic bacterial, fungal or protozoal infection. In contrast to classical acute-phase proteins like C-reactive protein or interleukin-6, it is not elevated after operative trauma. In this paper we present current opinions on the assumed induction mechanisms of the protein by cytokines and endotoxin. Furthermore, the clinical value for early detection of systemic infections in abdominal and transplantation surgery is demonstrated by examples from the literature. Our investigation shows that eight patients with necrotizing pancreatitis had a PCT mean value of 6.9 ng/ml on the day of admission. Seven patients with edematous pancreatitis had only a PCT mean value of 0.69 ng/ml. Despite these differences in the mean values, a significant difference between the normal value and the mean value of the group with necrotizing pancreatitis or edematous pancreatitis was not observed due to the wide range of PCT levels in the group of patients with necrotizing pancreatitis. The fact that only a few of the patients had a superinfected necrosis with systemic evasion of bacterias or their toxins may be the reason for this wide range. We suggest that a discrimination between superinfected necrotizing or sterile pancreatitis and edematous pancreatitis by PCT could be possible but more extensive studies with microbiological examination of the necrotic material are required to recognize the subgroups and to establish the real diagnostic efficiency of PCT in clinical practice, especially in the prediction of the outcome of acute pancreatitis.

  18. Effects of herbal and non-herbal toothpastes on plaque and gingivitis: A clinical comparative study

    PubMed Central

    Tatikonda, Aravind; Debnath, Surangama; Chauhan, Vivek Singh; Chaurasia, Vishwajit Rampratap; Taranath, M; Sharma, Akanksha Manmohan

    2014-01-01

    Background: Presence of plaque may be the culprit for dental caries, gingivitis, periodontal problems, and halitosis. Many mechanical aids are practiced worldwide to remove or control plaque, including tooth brushes, dental floss, mouth rinses, and dentifrices. The objective of this clinical study was to investigate the effectiveness of herbal toothpaste (Dabur Red) in controlling plaque and gingivitis, as compared to conventional (non-herbal) dentifrice (Pepsodent). Materials and Methods: In this study, 30 subjects aged 35–43 years with established gingivitis and at least 20 natural teeth, and having a probing depth <3 mm were investigated. After the washout period, plaque and gingival index (PI and GI, respectively) scores were assessed at days 0 and 30. Differences between groups were compared with Mann–Whitney U test and the mean scores of PI and GI by Wilcoxon test. Statistical difference between the weights of dentifrices tubes on days 0 and 30 was evaluated by Student's t-test. Results: At the end of 30 days of the study, there was statistically significant difference between both the groups for plaque and gingival scores. Conclusion: After 30 days of trial, both test and control groups showed effective reduction of plaque and gingivitis, which was statistically significant. No adverse reactions to dentifrices products were observed during the trial. It was concluded that herbal dentifrice was as effective as non-herbal dentifrices in the control of plaque and gingivitis. PMID:25558453

  19. The Clinical Effectiveness of Post-Brushing Rinsing in Reducing Plaque and Gingivitis: A Systematic Review

    PubMed Central

    Patthi, Basavaraj; Singla, Ashish; Gupta, Ritu; Jankiram, Chandrasheker; Kumar, Jishnu Krishna; Vashishtha, Vaibhav; Malhi, Ravneet

    2016-01-01

    Introduction Dental plaque is the major etiological factor associated with the development of gingivitis. Hence, maintenance of oral hygiene is very essential. Aim To systematically review the literature on the effects of a post toothbrushing rinsing on plaque and parameters of gingival inflammation. Materials and Methods A literature review was performed in PubMed Central and Cochrane library, embase, google scholar were searched up to February 2015 to identify appropriate studies. The primary outcome measure was plaque and gingival inflammation reduction. Results Out of the total 56 titles appeared, 08articles fulfilled the criteria and were selected for the review. One article which was hand searched and one article which was through e-mail was included. A statistically significant reduction in overall plaque and gingivitis was noted when different mouth rinses were compared to the control (p<0.05). It was seen that chlorhexidine is the best antiplaque and antigingivitis agent but due to its side effects after continuous use, was not indicated for long term use. Probiotic was superior to chlorhexidine in terms of reduction of gingival inflammation. Conclusion There are relatively few studies evaluating the association between post toothbrushing rinsing and gingivitis. A clear effect was observed, indicating that different mouthrinses (chlorhexidine, probiotic, herbal, essential oil mouthrinse) when used as an adjunct to mechanical means of oral hygiene, provides an additional benefit with regard to plaque and gingivitis reduction as compared to a placebo or control. PMID:27437376

  20. Alport syndrome: significance of gingival biopsy in the initial diagnosis and periodontal evaluation after renal transplantation.

    PubMed

    Toygar, Hilal Uslu; Toygar, Okan; Guzeldemir, Esra; Cilasun, Ulkem; Nacar, Ahmet; Bal, Nebil

    2009-01-01

    Alport Syndrome (AS) is an important hereditary disorder affecting the glomerular basement membrane. Diagnosis of AS is based on the presence of hematuric nephropathy, renal failure, hearing loss, ocular abnormalities and changes in the glomerular basement membrane of the lamina densa. The aims of this case report were to show the changes in the gingival tissues in a patient with AS under therapy with cyclosporin-A after renal transplantation and to discuss the possible role of type IV collagen in gingival basal lamina as an alternative approach for the diagnosis of AS. A 20-year-old male patient with AS underwent periodontal therapy including a series of gingivectomy surgeries. Gingival samples obtained during the second surgery were examined histopathologically and by transmission electron microscopy for further pathological examination. Gingivectomy procedures have been performed every 6 months over the last 4 years. The excessive and fibrous gingival enlargements resulted in migration of the anterior teeth, but no alveolar bone loss occurred. This is the first report to demonstrate the possible changes in the gingival tissues caused by AS. It is suggested that gingival biopsy can be an initial diagnostic tool instead of renal or skin biopsies. Proper dental and periodontal care and regular visits to the dentist could provide limited gingival hyperplasia to patients with AS.