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Biomedical subjects

G Perfetti

Publications and source records attributed to G Perfetti.

16 recordsLinked to original sources

Extraoral extraction: a very rare surgical approach to tooth impaction. A case report.

Extraoral route of access is usually not considered in surgical extraction of teeth because of technical difficulties and above all because of scar resulting from surgical skin wound healing. Some specific conditions, however, should suggest the use of this kind of access. A case of an impacted transmigrated right mandibular canine in an 18-year-old girl is reported. A CT examination has been carried out to evaluate the anatomy of the impacted toot as well as its relationship with the neighbouring structures. Extraoral surgical technique is then detaily described: skin incision, muscular dissection, ostectomy, tooth extraction and suture. Esthetical result was also reevaluated after 10 years. Advantages and drawbacks of intraoral and extraoral routes of access to mandibular tooth impaction are discussed and all anatomic and topographic factors related to the present impacted canine are examined. In conclusion, it is possible to confirm that extraoral access is indicated when a tooth is superficially impacted, in the molar-premolar region, toward the lingual aspect and near the lower border of the mandible.

Adolescent↗

Florid cemento-osseous dysplasia. Report of a case in a white woman with both mandibular and maxillary involvement.

Florid cemento-osseous dysplasia (FLCOD) is a rare pathological entity whose classification is not yet completely defined although its non-neoplastic clinical and histologic behaviour is very clear. FLCOD is a self-limiting lesion scarcely delimited from the surrounding healthy tissue and whose surgical treatment therefore is not elective, unless inflammatory signs are present. A case of a white woman with both mandibular and maxillary involvement is presented; she was referred to us for partial impaction of her lower 3(rd) molars. Standard radiographic and CT images are examined and the patient management is discussed.

Adult↗

Unusual surgical approach in a bilateral case of mandibular buccal infected cyst.

In the new edition of WHO's "Histological typing of odontogenic tumors", the mandibular infected buccal cyst, that is associated with the lower first or second permanent molars, is considered a paradental cyst as well as the inflammatory collateral cyst, which is usually related to the lower third molar. The lesion occurs on the buccal and lateral aspects of the roots of mandibular molars with vital pulp, at the eruption time, in children aged between 6 and 10 years. The inflammation is always present in these cysts and may have an important role in their pathogenesis because it stimulates hyperplasia and cystic change of the reduced enamel epithelium or the epithelial cell rests of Malassez. The authors report the case of a 7-year-old girl, in whom both first mandibular molars were affected by an infected buccal cyst. A different surgical approach was performed with marsupialization on the left side and cystectomy on the right side. The case reported here seems to be interesting because it is the second well documented case of bilateral mandibular infected cyst associated with unerupted molars and because the adopted treatment differs from the therapeutical approach suggested in the literature. A 6-year follow-up demonstrates a correct dental and bone evolution on both mandibular molar sides.

Child↗

Lingual displacement of an entire lower third molar. Report of a case with suggestions for prevention and management.

Perfect knowledge of regional anatomy is the main factor in the prevention of tooth displacement during lower third molar extraction. Some technical expedients should be used to avoid the occurrence of this accident and to manage it if it anyway happens. The patient was seen just 2 days after his left lower third molar was lingually displaced during surgical extraction. Two mucoperiosteal flaps were made under general anaesthesia, one on each side of the mandible, to obtain good exposure of the previous bone access and to retrieve the tooth. No further complications occurred. Lower third molar extraction becomes complicated if tooth displacement happens. Predisposing factors of this accident are analyzed and the rules to minimize the risk of its occurrence and to simplify the retrieval of the displaced tooth are discussed.

Adult↗

Expression of hMSH2 and hMLH1 proteins of the human DNA mismatch repair system in ameloblastoma.

The human DNA mismatch repair (hMMR) system plays an important role in reducing mutation and maintaining genomic stability. The MMR system in human cells is composed of at least six genes (hMSH2, hMLH1, hMSH3, hPMS1, hPMS2 and GTBP/hMSH6). In particular, hMSH2 and hMLH1 are expressed in human cells that are undergoing rapid renewal; their reduced expression has been reported in several tumors. We examined the protein expression pattern of hMSH2 and hMLH1 by immunohistochemistry in 25 ameloblastomas. All ameloblastomas expressed hMSH2 and hMLH1 proteins in the outer layer of epithelial cells. The localization of the staining was exclusively nuclear. These data suggest that the development and progression of these tumors do not depend on a defect in the hMMR system.

Ameloblastoma↗

Microbiological and clinical effects of a 1% chlorhexidine-gel in untreated periodontal pockets from adult periodontitis patients.

The aim of this study was to report the microbiological and clinical effects of repeated subgingival administration of a 1% Chlorhexidine-gel in periodontal pockets from 10 patients with adult periodontitis. Results showed that the experimental treatment significantly improved clinical parameters (Plaque Index, Gingival Bleeding Index, and Pocket Probing Depth). Direct subgingival administration of Chlorhexidine-gel also produced a remarkable modification in the proportions of putative periodontopathic microorganisms, such as Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Veillonella parvula, Fusobacterium nucleatum, and Peptostreptococcus micros, in subgingival bacterial plaque from periodontitis patients.

Actinobacillus↗

[Bcl-2, p53, Ki-67 and apoptotic index in cancerous and precancerous lesions of the oral mucosa].

BACKGROUND: In this study an immunohistochemical analysis of both normal and pathological tissues was made to investigate the expression of some factors involved in genic regulation mechanisms of apoptosis. METHODS: In normal mucosa, in leukoplakia, in mild and severe dysplasia and in high, mild and low grade cancer a bcl-2, p53, and Ki 67 evaluation was made using immunostaining techniques; also an evaluation of apoptotic index was carried out. Seventy-two biopsies were made in 12 patients with normal mucosa, 12 affected by leukoplakia, 12 by dysplasia (6 mild, 6 severe), 12 by low grade, 12 by mild grade and 12 by high grade cancer. > t RESULTS: The immunohistochemical analysis pointed out that there was weak bcl-2 expression in normal mucosa and in preneoplastic lesions and less more in severe dysplasia while bcl-2 was discreetly detectable in oral tumors. P53 was not detectable in normal mucosa and weakly expressed in preneoplastic lesions, presenting a peak in severe dysplasia. These results showed an interesting inverse relation between bcl-2 and p53 expression in severe dysplasia. Ki 67 expression results to be weak in normal mucosa, in preneoplastic lesions and in mild dysplasia, while it reaches the maximum level in severe dysplasia and in tumors. CONCLUSIONS: In all the samples the apoptotic index expression showed the same features of the Ki 67 protein. These results were achieved through statistically analysis carried out with the U Mann Whitney test.

Apoptosis↗

Complex odontoma as a periapical and interradicular radiopacity in a primary molar.

Only rarely is a mature complex odontoma seen in a periapical location and in association with a primary tooth. Complex odontomas usually present as a radiopacity with a radiolucent rim. The differential diagnosis must include mature fibro-osseous lesions (e.g. cementoblastoma). Complex odontomas can be differentiated from fibro-osseous lesions because they usually present a nonhomogeneous radiopacity and almost always will present as solitary lesions. For complex odontomas located in the periapical region, the differential diagnosis must include idiopathic periapical osteosclerosis. In this case, the presence of the radiolucent rim and the presence of denser, sharper radiopacities produced by enamel distinguish the odontoma.

Adult↗

[Parotid tumors: a diagnostic and therapeutic protocol in 81 surgical cases].

AIM: In the last five years we cured 81 patients divided in two groups: the first was managed inordinately, the second according to a diagnostic and therapeutic protocol. METHODS: The first 23 patients were differently evaluated, before surgery, by means of traditional sialography, US, CT, CT sialography, MR, larger bore needles and FNAB. Neoplasm enucleations, atipic resections, superficial and total conservative parotidectomies were performed. The following 58 patients were evaluated and cured according to a diagnostic and therapeutic protocol. RESULTS: Diagnostic and therapeutic time were shortened, patients endurance improved and cost lowered. DISCUSSION: We think that many diagnostic procedures are useless and delay operation that, if possible, must be performed according to principles of radical extirpation.

Adenoma, Pleomorphic↗

Cyclic Amp phosphodiesterase activity in normal and inflamed human dental pulp.

Cyclic AMP phosphodiesterase (cAMP PDE) seems to be important in pulp tissues. High levels of cAMP PDE have been demonstrated to be in dental pulp cells. In the present study cAMP PDE activity was analyzed in normal healthy human dental pulps, in reversible pulpitis and in irreversible pulpitis. Enzymatic cAMP PDE control values for normal healthy pulps were 12.14 +/- 3.74 nmols/mg of proteins. In reversible pulpitis the cAMP PDE activity increased almost 2.5 times. In irreversible pulpitis specimens the values increased 4.5 times compared with normal healthy pulps activity. The differences between the groups (control vs. reversible pulpitis and vs. irreversible pulpitis) were statistically significant. These results could point to a role of cAMP PDE in the initial pulp response after injury.

3',5'-Cyclic-AMP Phosphodiesterases↗