The prolonged bisphosphonate (BP) uptakes are frequently resulted in BP-related osteonecrosis of jaws (BRONJ). The previous study reported that the BP-involved bones were stained blue by Masson trichrome and showed weak birefringence compared to the normal bone1). Using the representative twenty cases of BRONJ osteomyelitis the present study examined the ultrastructure of BP-involved bone by scanning electron microscope (SEM) using decalcified bone microsections. As the BP-involved bones showed different features from adjacent normal bone by blue staining in Masson trichrome method and by rare birefringence under polarizing microscope, the ultrastructure of BP-involved bone matrixes were distinguishable histologically in comparison with normal bone. The normal bone showed the tight attachment of interdigitating dendritic bone matrixes, producing many Haversian canaliculi, while the BP-involved bone showed the compact alignment of granular bone matrixes, resulted in the abortive Haversian canaliculi. The osteocytes in the lacunar spaces of BP-involved bone became shrunken and necrotic, and the BP-involved bone showed many tunnel-like spaces produced by direct chemical resorptions and proteolytic degradation of bone matrixes. Taken together, it was conspicuous that the BP-involved bones were abnormal in their stainability of Masson trichrome, birefringence under polarizing microscope, and ultrastructure under SEM. These findings of BP-involved bone may have an implication for the pathogenetic roles of BRONJ, and can be applicable for the differential diagnosis of BRONJ from other osseous lesions.
The purpose of this study is evaluating about the survival rate and causes of failed implants. In this study, the 371 implants was evaluated for the survival rate and failing factors of implant. The survival rate was 96.5%. The failure rate was 3.5%. The average life time of implants was 50 months. The average age of patients treated was 49 years old. In total 371 cases, 13 cases failed implants were removed. The causes of failing implants were poor oral hygiene, excessive occlusal loading, smoking, and etc. The leading causes of failed implants were improper oral hygiene and excessive occlusal loading. In conclusion, I suggest that the periodic plaque control and occlusal force management can improve the survival rate of implants.
Exostosis is a phenomenon of exophytic growth of compact bone, and the oral exostosis, so called a torus is usually found in the lingual or labial areas of mandible and maxilla, and the hard palatal area. It is not a pathological nor tumoral formation but a localized bony protuberance relevant to developmental and environmental origins. However, the pathogenesis of exostosis has not been clearly elucidated so far. In the present study total 51 cases of oral exostosis were examined by radiological, histological, and immunohistochemical methods to observe the osteogenetic potential existed in the sclerosed bony tissue of exostosis. Particularly, the unilateral mandibular exostoses occurred in the vicinity of mandibular primary growth centers which were more prominent than the contralateral ones in the radiological observation. Histologically the peripheral area of exostosis was composed of lamellated bone and covered with periosteal tissue which showed sparse osteoblastic activity, while the central area of exostosis was composed of thickened and anastomosed trabecular bones with small amount of marrow connective tissue. The latter stained blue in Masson trichrome method, while the former stained red. The immunohistochemical reactions of BMP-2, bFGF, CMG2, and TGF-β1 were clearly positive in the central trabecular bones, while almost negative in the peripheral cortical bones of exostosis. These findings may indicate that the central area of exostosis is less mineralized than the peripheral area of exostosis, and the former expresses different osteogenetic proteins to produce bony tissue contrary to the latter. Therefore, it is suggested that the strong osteogenetic potential in the central area of exostosis be relevant to the growth potential of mandibular and maxillary primary growth centers and play an important role for the latent expansile growth of exostosis in adult life.
Toxic heavy metals like mercury and cadmium are known to involve in altering the salivary flow so that can be appeared sialorrhea or ptyalism, the condition of increased salivary flow, or xerostomia (“dry mouth”), the condition related to inhibited or decreased salivary flow. Although many people were exposed to these heavy metal in work environment, dental clinics, the mechanism is rarely discussed in the clinical literature. The present study is to carried out analysis of AQP5 expression that play a key role in saliva fluid secretion and cell membrane water permeability on mercury- or cadmium-exposed mice submandibular gland. To investigate AQP 5 expression, immunohistochemical study and western blot assay were carried out on mercury- or cadmium-exposed mice. Additionally, RT-PCR, real- time PCR with specific primers were carried out. Cadmium or mercury exposure led ductal extension, ductal cell increase, and blood vessel increase in mouse submandibular gland. The mRNA and protein expression of AQP5 were increased in time dependent manners on cadmium or mercury exposed mouse. Also, AQP5 were translocated from basolateral membrane to apical membrane of acini cell. In conclusion, toxic heavy metal such as mercury and cadmium appear to alter the AQP5 expression and distribute to apical membrane of ductal cell and lead to alter salivary secretion.
Sialolith is a common disease of salivary glands characterized by the development of salivary stones, resulting in the salivary ductal obstruction. The chief complaints of patients with sialoliths are pain and swelling of the involved gland during meals. Most sialoliths are found in the submandibular gland of middle-aged patients. The size of the salivary stones can vary, but most of them are less than 10mm in size, giant sialoliths(larger than 15mm) are very rare. In this case, we report a 68-years old female patient who had removal of a giant sialolith located in left proximal Wharton’s duct by less invasive intraoral surgical technique successfully. We also review related literature.
We present a case of lipogranuloma of the chin in a 17-year-old man. The lesion was revealed as lipogranuloma in radiological and histopathological findings and did not recur after being surgically removed. Lipogranuloma is a granulomatous inflammation with marked sclerosing response to the fatty tissue caused by foreign material injection. Despite lipogranuloma was reported as a complication arising from injection of oil-based substances into soft tissues for the purpose of cosmetic therapy, patient in this case had no history of foreign material injection. We expect that patient had a history of traumatic injury on his right chin that he doesn’t remember. Definitive treatment of lipogranuloma is surgical excision and usually involves secondary reconstruction. Regarding the physical and psychological complications of this practice, prevention is required the most but once occurred accurate history taking and biopsy is important to diagnosis