Investigation of foreign materials in gingival lesions: a clinicopathologic, energy-dispersive microanalysis of the lesions and in vitro confirmation of pro-inflammatory effects of the foreign materials

A Retrospective Histological Study on Palatal and Gingival Mucosa Changes during a Rapid Palatal Expansion Procedure

The most common inflammatory reactions in the oral mucosa are found at the gingival level. The treatment of these inflammations requires, first of all, the removal of the causative factor; often, this maneuver is sufficient. The aim of this retrospective study was to evaluate clinical and histopathological changes that occur in terms of gingival and palatal mucosa enlargement during palatal expansion treatment and their evolution during treatment. Twenty-five (n = 25) research participants, aged between thirteen and twenty-six years old, were examined in this retrospective study. At the end of the treatment, fragments of tissue from the affected level were obtained via incisional biopsy and sent to the histopathology laboratory for a specialized examination. The changes identified were specific to mechanical traumatic injuries, thus excluding hyperplasia from other etiologies (infectious, tumoral, or non-mechanical traumatic). The examined fragments showed hyperplasia. The histopathological examination revealed the mechanical character of the lesion, strengthening the causal relationship between the insertion of the expander and the occurrence of hyperplasia of the palatal mucosa. The type of palatal expander influenced the degree of inflammation, with the severity of hyperplasia being more pronounced in the case of mini-implant-anchored rapid palatal expander (MARPE) usage than in the case of tooth-borne rapid palatal expander (RPE) usage. The analysis of the distance between the expander and the palatal mucosa did not provide conclusive results; the incidence and severity of the reaction were variable in patients with the same distance between the expander and the palatal or gingival mucosa.

Interactions between silica and titanium nanoparticles and oral and gastrointestinal epithelia: Consequences for inflammatory diseases and cancer

Engineered nanoparticles (NPs) composed of elements such as silica and titanium, smaller than 100 nm in diameter and their aggregates, are found in consumer products such as cosmetics, food, antimicrobials and drug delivery systems, and oral health products such as toothpaste and dental materials. They may also interact accidently with epithelial tissues in the intestines and oral cavity, where they can aggregate into larger particles and induce inflammation through pathways such as inflammasome activation. Persistent inflammation can lead to precancerous lesions. Both the particles and lesions are difficult to detect in biopsies, especially in clinical settings that screen large numbers of patients. As diagnosis of early stages of disease can be lifesaving, there is growing interest in better understanding interactions between NPs and epithelium and developing rapid imaging techniques that could detect foreign particles and markers of inflammation in epithelial tissues. NPs can be labelled with fluorescence or radioactive isotopes, but it is challenging to detect unlabeled NPs with conventional imaging techniques. Different current imaging techniques such as synchrotron radiation X-ray fluorescence spectroscopy are discussed here. Improvements in imaging techniques, coupled with the use of machine learning tools, are needed before diagnosis of particles in biopsies by automated imaging could move usefully into the clinic.

Plasma Cell Gingivitis and Its Mimics

Plasma cell gingivitis (PCG) is an inflammatory condition that affects the gingival mucosa of the oral cavity. It is characterized by polyclonal dense plasma cell infiltrate in the connective tissue. Lesions do not respond to prophylactic treatment. Etiology is most likely hypersensitivity to certain antigens (eg, toothpastes, oral rinses, chewing gums, spices). Differential diagnosis of PCG includes reactive, granulomatous, and neoplastic lesions. The diagnostic workup is based on patient's history and the clinicopathologic correlation to rule out mimics of PCG. Dermatologic patch test may be indicated in chronic conditions to identify the allergen.