bromochloroacetic-acid and Mouth--Edentulous

Topics: Gingiva; Humans; Keratins; Mouth Mucosa; Mouth, Edentulous

This work aimed to investigate the effectiveness and predictability of different treatment modalities for gain of keratinized tissue (KT) in fully edentulous jaws prior to dental implant placement: apically positioned flap (APF), APF plus xenogeneic collagen matrix (XCM), and APF plus free gingival graft (FGG).. In fully edentulous patients with insufficient zones of KT at the prospective implant positions, four treatment modalities were performed in the lower jaw: APF, XCM, FGG, and an untreated control group (control). APF and XCM were applied in the first molar positions, FGG and control in the canine positions. Assessed outcomes up to 3 months post-surgery included changes in width of KT (over a 3-month period), histomorphometric analysis of harvested soft-tissue biopsies (at 3 months postoperatively), and patient-reported outcomes measures (PROMs).. For the primary outcome, changes in KT width demonstrated an increase of 1.93 ± 1.6 mm (APF), whereas XCM and FGG showed an increase of 4.63 ± 1.25 mm and 3.64 ± 2.01, respectively. Histomorphometric analyses revealed a thickness of the epithelium ranging between 375 ± 122 μm (APF), 410 ± 116 μm (XCM), 336 ± 122 μm (FGG), and 413 ± 109 μm (control). All biopsies showed a regular muco-periosteal structure with a keratinized epithelium of comparable thickness in all groups.. All three methods were suitable to increase the width of KT, although APF alone rendered roughly 50% less gain compared to XCM and FGG.. The use of XCM in conjunction with an APF represents a valuable treatment option for the gain of keratinized tissue in edentulous sites.

Topics: Aged; Aged, 80 and over; Biopsy; Connective Tissue; Dental Implants; Female; Gingivoplasty; Humans; Keratins; Male; Middle Aged; Mouth, Edentulous; Patient Reported Outcome Measures; Pilot Projects; Surgical Flaps; Vestibuloplasty

A 30-year-old man presented with lesions on his oral mucosa and soles. There were no similar complaints in his family members. The dermatological examination revealed follicular hyperkeratosis on his trunk and upper extremities and flesh-colored, firm cystic lesions on his axillae. He had focal, painful, hyperkeratotic areas sited particularly on both his soles and palms. In addition to these, leukokeratosis and ulcerative areas on buccal, labial mucosa, tongue, and at corners of the mouth, and complete loss of teeth was observed. The proximal layering was revealed on all of his nails. The laboratory investigations produced normal results except the deficiency of immunoglobulin A. The psychiatric examination revealed mild mental retardation. Keratin gene (KRT6a, KRT6b, KRT16, and KRT17) mutations for pachyonychia congenita were negative. He got removable dental prosthesis because of inadequate alimentation. Squamous cell cancer developed on lower lip mucosa during follow-up. We present an individual who had different nail dystrophy, epidermal cysts, mental retardation, blepharitis, complete loss of teeth, and negative keratin gene mutations for pachyonychia congenita and developed squamous cell cancer on the oral leukokeratosis lesions. We think that the present case may be an unusual new type of pachyonychia congenita.

Topics: Adult; Carcinoma, Squamous Cell; Epidermal Cyst; Humans; Intellectual Disability; Keratins; Keratosis; Leukoplakia, Oral; Lip Neoplasms; Male; Mouth, Edentulous; Oral Ulcer; Pachyonychia Congenita; Syndrome

To investigate whether there is a difference in the density of Merkel cells between the gingiva of dentate and edentate subjects.. One hundred and two blocks of human mandibular (n=55) and maxillary (n=47) gingiva from 69 white skinned individuals (44 males, 25 females, mean age 70.1 years, range 42--92 years) were analysed. Twenty-six individuals had teeth remaining in at least one jaw (mean age of dentate 64.5 years, edentate 72.1 years), of which 15 were dentate in both jaws. Overall, 24/55 mandibles and 17/47 maxillae were dentate. Five micrometer sections were stained with a monoclonal antibody to cytokeratin 20 (CK 20) using standard immunoperoxidase or immunoalkaline phosphatase methods. Positive cells were counted in 20 consecutive high power fields using the x 40 objective in three sections from each biopsy, and the results analysed for differences related to age, sex, site and presence of teeth.. CK 20-positive Merkel cells were present either singly or in clusters in the basal epithelial layers, particularly at the tips of rete ridges. Numbers of gingival Merkel cells were significantly higher (p<0.005, Mann-Whitney) in edentate (cells per field mean, median, standard deviation, respectively: 1.39, 0.64, and 1.85) when compared to dentate (0.67, 0.20, and 1.21) specimens. The differences were not statistically significant for any other variable.. The data raise the possibility that reduced perception following loss of teeth may be compensated for by an increase in the local Merkel cell population.

Topics: Adult; Aged; Aged, 80 and over; Cell Count; Epithelial Cells; Female; Gingiva; Humans; Immunohistochemistry; Keratin-20; Keratins; Male; Merkel Cells; Middle Aged; Mouth, Edentulous; Tooth Loss

Topics: Adult; Alveoloplasty; Denture, Complete; Humans; Keratins; Mouth Mucosa; Mouth, Edentulous; Oral Surgical Procedures, Preprosthetic; Tooth Extraction

The reduction in the epithelial thickness under dentures did not reach the level of significance. The significant reduction in the epithelial morphology indicating a flatter basement membrane would suggest that the epithelium undergoes an adaptive change as a result of surface loading to produce a more uniform epithelium. The degree of keratinization was less and the stratum corneum was thinner in the epithelium under dentures. The complete dentures in these studies seemed to reduce the quantity and quality of the keratin layer. This study has shown that the presence of a denture produced a more regular epithelium with few rete ridges, and a thinner, less highly keratinized stratum corneum.

Topics: Adolescent; Adult; Age Factors; Aged; Connective Tissue; Denture, Complete; Epithelium; Humans; Keratins; Male; Middle Aged; Mouth Mucosa; Mouth, Edentulous; Smoking; Time Factors

The denture-bearing mucosa of aged maxillary and mandibular ridges show morphologic changes that are irreversible. These changes limit the extensibility and the rebound capacity of the denture-bearing area.

Topics: Adolescent; Aged; Aging; Alveolar Process; Arteriosclerosis; Collagen; Connective Tissue; Female; Humans; Keratins; Male; Mouth Mucosa; Mouth, Edentulous; Osteoporosis

Thirty human mucogingival specimens were evaluated histologically and histochemically to determine whether a difference exists in the mucogingival junction of dentulous and edentulous areas of the maxilla and mandible. No significant differences were observed between the two areas. The presence of an intermediate zone is described, which may have clinical implications in some surgical procedures.

Topics: Adult; Aged; Elastic Tissue; Epithelium; Female; Gingiva; Glycogen; Humans; Keratins; Male; Middle Aged; Mouth Mucosa; Mouth, Edentulous; Tooth

The histologic tissue changes of the residual alveolar ridges were studied in five edentulous patients ranging from 55 to 80 years of age. The material studied was obtained from cadavers. The following observations were made: (1) The epithelium was hornified. Acanthosis was found in all specimens. (2) In four of the specimens, the collagen fibers covering the residual bone crest showed a hyalinized area. (3) Mucoid collagen degeneration was seen in all specimens. (4) The most striking finding, common to all specimens, was the epithelial remnants. Resting and proliferating types were identified. (5) Chronic inflammation was found in all specimens. (6) Both osteoid and necrotic bone types were observed. (7) An outstanding characteristic of the residual alveolar ridge was the reinforcement of the internal structure of the bone by endosteal apposition.

Topics: Aged; Alveolar Process; Collagen; Connective Tissue; Epithelium; Humans; Hyalin; Keratins; Male; Middle Aged; Mouth, Edentulous

Topics: Cytodiagnosis; Female; Humans; Keratins; Male; Massage; Middle Aged; Mouth, Edentulous; Toothbrushing