The aim of present study was to assess the thickness of masticatory mucosa on the hard palate and tuberosity as a potential donor site for mucogingival surgery. Thickness measurement was performed in 30 dental college students who are periodontally healthy, with a recently developed, ultrasonic device(SDM). The mean age of study subjects was 23.7(range 21-29) years old and the subjects were composed of 18 males and 12 females. Eighteen standard measurement points were defined on the hard palate, located on 3 lines which ran at different distances parallel to the gingival margin. Six positions were designated on each of these 3 lines between the level of the canine and the second molar. On the tuberosity, 6 standard measurement points were defined, located on 2 lines running parallel to the gingival margin at different distances. Data were analyzed to determine differences in gender, between different positions, and between lines, by an analysis of variance. The results showed that the mucosa of the tuberosity was significantly thicker than that of the hard palate region. Gender did not influence the thickness of masticatory mucosa, either on the hard palate or the tuberosity. On the hard palate, mucosa thickness increased as the distance from the marginal gingiva increased. The mucosa over the palatal root of the maxillary first molar was significantly thinner than that at all other positions on the hard palate. Measurement error at palate was 0.25mm, at tuberosity 0.51mm. No difference in the thickness of masticatory mucosa on palate and tuberosity was found between men and women. On the hard palate, soft tissue thickness progressively increased in sites further from the gingival margin. Therefore, we may harvest more thicker graft on the tuberosity that has more masticatory mucosa thickness than hard palate, however the width may not be sufficient for using.
In order to determine how oral mucosal change relates to inducing factors of burning mouth syndrome, the difference in pain perception scale and keratinization rate between burning mouth syndrome patients and normal subjects were investigated. Twenty patients (13 female, 7 male, mean age: 59 years), presenting in the Department of Oral Medicine, Chonnam National University Hospital were participated in this study. All subjects had been complaining of constant oral burning pain for more than a year, none took any strong analgesics, and none had oral mucosal lesions. Twenty volunteers (11 females, 9 males, mean age: 25 years) were also participated in this study as a control group. The control subjects had never had any symptoms of oral burning pain. A thermal stimulation using a Nd-YAG laser and cytological smear were carried out to anterodorsal part of tongue, tip of tongue, the left buccal mucosa, the lower lip mucosa and the chief complaint site. Stimulation of the dorsum of left hand was also carried out to contrast the mucosal area of burning mouth syndrome subjects and the control subjects. The laser output power could be adjusted from 0.75W to 4W. The pain perception scale of the burning mouth syndrome subjects were lower than in control subjects in the chief complaint area, the anterodorsal part of tongue and the buccal mucosa(p<0.01). The keratinization rate of burning mouth syndrome subjects, however, was higher keratinization rate than in normal subjects in the same area and lower lip mucosa(p<0.001). From above results, the anterodorsal part of tongue is the most appropriate site to use diagnostic laser stimulation. The higher level of keratinization and the lower level of thermal pain perception of the burning mouth syndrome subjects are explained as a protective mechanism against xerostomia and burning sensations. The application of Nd-YAG laser stimuli and cytological smear to oral mucosal surface could therefore be usefully employed as appropriate and standardized diagnostic tools for chronic orofacial pain subjects.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.35
no.1
/
pp.45-48
/
2009
Verrucous carcinoma is a distinctive form of low-grade squamous cell carcinoma. The tumor has an exophytic, cauliflower-like appearance, and usually occurs in males and tends to affect individuals over 60 years of age. It typically involves the oral cavity, larynx, esophagus and skin. Most intraoral cases involve the mandibular vestibule, the buccal mucosa and the hard palate. The cause is unknown, but most verrucous carcinomas arise from the oral mucosa in people who chronically use chewing tobacco or snuff. The treatment of oral verrucous carcinoma remains controversial. Whenever possible, surgically total excision and skin or mucosal grafting is recommended. After total excision of huge verrucous carcinoma,instead of dermal or mucosal grafting, we used artificial dermis silicone membrane. We had a good result without recurrence and present this case.
The present investigation was carried out to identify salivary components of mucosal pellicle and to explore the difference of mucosal pellicle components according to the location of oral mucosa. By using antisera and immunoblotting, high-(MG1) and low-(MG2) molecular-mass salivary mucins, amylase, IgA, proline-rich proteins(PRPs) were detected in mucosal pellicle in vivo. In addition, the data indicated that mucins, IgA and proline-rich proteins could be cleaved into lower-molecular-mass products, whereas the IgA, proline-rich proteins could also be cross-linked into higher-molecular-mass complexes. Mucosal pellicles from buccal, labial and palatal mucosa showed similar pattern in immunoblotting experiments using anti-MG2 and anti-PRPs antisera. The data from this study suggest that during mucosal pellicle formation multiple components of saliva adsorb to oral mucosal epithelial cell surfaces, and selected components can be proteolytically cleaved into smaller fragments and/or cross-linked into higher-molecular products.
Journal of The Korean Society of Integrative Medicine
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v.5
no.4
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pp.103-112
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2017
Purpose : This study was conducted to improve cognitive oral healthcare care by analyzing the correlation between oral health behavior and oral health status Korean adolescents. The subjects were 65,528 youths in 798 schools monitored in the Twelfth Korea Youth Risk Behavior Web-based Survey in 2016. Methods : The general characteristics consisted of 9 items including sex, grade, and academic performance. The academic performance and economic status were restructured into "upper, middle, lower". Subjective health perception and subjective oral health perception were reorganized as "health", "normal", "no health". The sub-areas of oral health behavior include five times of daily brushing during the day yesterday. The number of brushing times was "0", "1-2", "3", "more than 4" After lunch at school, brushing was restructured as "always," "sometimes," "not." The oral health status subscale consisted of 6 items including tooth breakage and toothache at the time of eating. Result : Tooth fracture(43.7 %), pain in mastication(43.7 %), tooth tingling(47.4 %), gum pain and bleeding(45 %), pain in buccal mucosa(43.8 %) and halitosis(46.6 %) were rare in adolescent having healthy oral health status cognitively(P<.001). Nosymptom adolescents without dental sealant showed low tooth fracture(0.64 times), pain in mastication(0.67 times), tooth tingling(0.59 times), gum pain and bleeding(0.84 times), pain in buccal mucosa(0.76 times), and halitosis(0.90 times). Nosymptom adolescents without scaling showed low tooth fracture(0.88 times), pain in mastication(1.03 times), tooth tingling(0.82 times), gum pain and bleeding(0.64 times), pain in buccal mucosa(0.70 times) and halitosis(0.82 times). Conclusion : This study revealed that oral health status is correlated with oral health behavior. Development of educational media and program, and aggressive promotion required to establish oral health Korean adolescent.
Kim, Jong-Ryoul;Park, Bong-Wook;Byun, June-Ho;Kim, Yong-Deok;Shin, Sang-Hoon;Kim, Uk-Kyu;Chung, In-Kyo
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.31
no.2
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pp.170-177
/
2005
The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients' age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one's clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey's syndrome after parotidectomy. We examined Frey's syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.
Pachyonychia congenita is a very rare group of an autosomal dominant genodermatosis caused by heterozygous mutations in the keratin genes. The clinical findings affect nail and toenails, soles, and oral mucosa, etc. The main symptoms include nail and toenail dystrophy, hyperkeratosis of hands and feet, follicular hyperkeratosis, oral leukokeratosis. Many therapeutic modalities have been used to treat skin lesion, including surgical and mechanical procedures, chemical agents, medications. Oral lesions but not usually require treatment, if the patient's discomfort occurs, symptomatic therapy is performed. In the patients accompanied by oral and skin lesions, clinician have to observe specific manifestations with dystrophy of the fingernails and toenails, plantar hyperkeratosis, oral leukokeratosis and tissue biopsy is required for diagnosis confirmed.
The sublingual locus has recently received great attention as a delivery site for various immunotherapies, including those that induce allergen-specific tolerance, and for vaccines that generate protective immunity. To further understand the immune functions of the human sublingual mucosa, we characterized the distribution of various immunocytes therein by immunohistochemistry. We identified professional antigen presenting cells (APCs), including Langerhans cells (LCs) and macrophages. $CD1a^+$ and $langerin^+$ LCs were further found to be distributed in the basal and supra-basal layers of the epithelium, and macrophages were identified in the lamina propria. HLA-$DR^+$ cells were observed in both the epithelium and the lamina propria, which mirrors the tissue distribution of LCs and macrophages within these tissues. $CD3^+$, $CD4^+$, and $CD8^+$ T cells were found to be distributed along the basal layer of the epithelium and also in the lamina propria. Although B cells, plasma cells, and $Foxp3^+$ regulatory T cells (Tregs) were only occasionally observed in the human sublingual mucosa in the absence of inflammation, they did show enrichment at inflammatory sites. Hence, we have further elucidated the immune cell component distribution in human sublingual mucosa.
Di Gianfilippo, Riccardo;Valente, Nicola Alberto;Toti, Paolo;Wang, Hom-Lay;Barone, Antonio
Journal of Periodontal and Implant Science
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v.50
no.4
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pp.209-225
/
2020
Purpose: Marginal bone loss (MBL) is an important clinical issue in implant therapy. One feature that has been cited as a contributing factor to this bone loss is peri-implant mucosal thickness. Therefore, in this report, we conducted a systematic review of the literature comparing bone remodeling around implants placed in areas with thick (≥2-mm) vs. thin (<2-mm) mucosa. Methods: A PICO question was defined. Manual and electronic searches were performed of the MEDLINE/PubMed and Cochrane Oral Health Group databases. The inclusion criteria were prospective studies that documented soft tissue thickness with direct intraoperative measurements and that included at least 1 year of follow-up. When possible, a meta-analysis was performed for both the overall and subgroup analyses. Results: Thirteen papers fulfilled the inclusion criteria. A meta-analysis of 7 randomized clinical trials was conducted. Significantly less bone loss was found around implants with thick mucosa than around those with thin mucosa (difference, -0.53 mm; P<0.0001). Subgroups were analyzed regarding the apico-coronal positioning, the use of platform-matched vs. platform-switched (PS) connections, and the use of cement-retained vs. screw-retained prostheses. In these analyses, thick mucosa was found to be associated with significantly less MBL than thin mucosa (P<0.0001). Among non-matching (PS) connections and screw-retained prostheses, bone levels were not affected by mucosal thickness. Conclusions: Soft tissue thickness was found to be correlated with MBL except in cases of PS connections used on implants with thin tissues and screw-retained prostheses. Mucosal thickness did not affect implant survival or the occurrence of biological or aesthetic complications.
This study was undertaken to compare and investigate the wound healing process following Nd:YAG laser wounds and scalpel incisions of the rat tongue dorsal mucosa. Laser wounds were made parallel on the right side of tongue dorsum and scalpel incisions were made on the left side with 5mm length, respectively Visual inspection and immunohistochemistry with CD44 antibody after immediately, 6 hours, 1 day, 2, 4, 7, 11, 21 days after surgery were carried out. The results were as follows : 1. There was macroscopically no treat difference between laser wounds and scalpel incisions. 2. Laser wounds appeared as dry, bloodless and irregular grooves with carbonization and whitening of superficial tissues compared to sharp, straight and bleeding incisions using scalpel. 3. In the epithelium of rat tongue mucosa, CD44 expression in healing laser wounds and scalpel incisions were similar. 4. In the lamina propria and muscle layer, CD44 expression in healing laser wounds gradually increased earlier and decreased faster than scalpel incisions. Conclusively, it is suggested that pulsed Nd:YAG laser has more beneficial effect on the healing of wounded oral mucosa than scalpel in knew of CD44 expression.
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