Ramon syndrome (MIM 266270) is an extremely rare genetic syndrome, characterized by gingival fibromatosis, cherubism-like lesions, epilepsy, intellectual disability, hypertrichosis, short stature, juvenile rheumatoid arthritis, and ocular abnormalities. Hereditary or non-syndromic gingival fibromatosis (HGF) is also rare and considered to represent a heterogeneous group of disorders characterized by benign, slowly progressive, non-inflammatory gingival overgrowth. To date, two genes, ELMO2 and TBC1D2B, have been linked to Ramon syndrome. The objective of this study was to further investigate the genetic variants associated with Ramon syndrome as well as HGF. Clinical, radiographic, histological, and immunohistochemical examinations were performed on affected individuals. Exome sequencing identified rare variants in TBC1D2B in both conditions: a novel homozygous variant (c.1879_1880del, p.Glu627LysfsTer61) in a Thai patient with Ramon syndrome and a rare heterozygous variant (c.2471A>G, p.Tyr824Cys) in a Cambodian family with HGF. A novel variant (c.892C>T, p.Arg298Cys) in KREMEN2 was also identified in the individuals with HGF. With support from mutant protein modeling, our data suggest that TBC1D2B variants contribute to both Ramon syndrome and HGF, although variants in additional genes might also contribute to the pathogenesis of HGF.

BACKGROUND: Myeloid sarcoma (MS), also referred to as granulocytic sarcoma or chloroma, is a rare type of extramedullary malignant tumor. MS comprises primitive granulocytic precursor cells that play a key role in the early stages of white blood cell development. Notably, the occurrence of this tumor in the gingiva is rare.
METHODS: The present study reported the case of MS with gingival swelling in the maxillary region, with aleukemic presentation in a 32-year-old male patient. Following two courses of chemotherapy, computed tomography of the region demonstrated complete clearance of the tumor. At the 12-month follow-up appointment, the patient was in a stable condition with the absence of progression. The etiology, clinical features, diagnosis, and relevant treatment of MS are discussed in the present study.
CONCLUSIONS: Diagnosis of MS may be confirmed following histological and immunohistochemical examinations.

Plasma cell granuloma is extremely rare in the oral cavity. This paper reports a case of plasma cell granuloma in the oral cavity and reviews the literature. In this case, the plasma cell granuloma occurred in the gingiva, which was bright red and granular. The lesion was resected and diagnosed as gingival plasma cell granuloma by clinical pathological examination. Four months follow-up after operation surgery showed no signs of recurrence. Although gingival plasma cell granuloma is rare, it is easily confused with related diseases and should be identified and followed up closely.
浆细胞肉芽肿在口腔内罕见，本文报道1例位于口腔内的浆细胞肉芽肿并进行文献复习。本例浆细胞肉芽肿发生于牙龈，呈多发性，牙龈鲜红呈颗粒状。病损行切除术，经临床病理检查确诊为牙龈浆细胞肉芽肿。术后4个月复查，无复发迹象。牙龈浆细胞肉芽肿虽然少见，但易与相关疾病混淆，应与相关疾病鉴别，并密切随访。.

OBJECTIVE: Psychological stress can be a common risk factor for the development of oral and systemic disease; therefore, analysis of a pathophysiologic mechanisms that may explain this association may be significant in planning preventive strategies. The aim of this study was to investigate the association amongst academic stress, periodontal health, and salivary cortisol and nitrite and nitrate levels in a sample of university students.
METHODS: Participants (N = 14) were classified into 2 groups according to their exposure to academic stress due to periods of university exams (n = 6 and n = 8, respectively). All participants were subjected evlauted for their behavioural, psychological, and anthropometric parameters, as well as an oral health examination. A real-time polymerase chain reaction analysis in samples of saliva and plaque was used to detect Prevotella intermedia and Veillonella dispar as well as the total bacterial count. Nitrite/nitrate ratio (NR ratio) and cortisol in saliva were evaluated by enzyme-linked immunosorbent assay.
RESULTS: Full Mouth Bleeding Score, Full Mouth Plaque Score, and Gingival Index were significantly higher in the group exposed to academic stress. Nitrite was directly related to the presence of V dispar (coefficient, 0.13; P = .00; CI, 0.07 to 0.19) and inversely related to total bacterial count (coefficient, -0.07; P = .012; CI, -0.13 to 0.02). NR ratio was directly related to V dispar (coefficient, 4.35; P = .010; 95% CI, 1.35 to 7.36) and inversely related to total bacterial count (coefficient, -4.05; P = .018; 95% CI, -7.32 to 0.86).
CONCLUSIONS: These results confirm the importance of stress on periodontal health and salivary nitrite concentration and highlight a potential differential role of specific bacteria on nitrite concentration in saliva.

UNASSIGNED: Various similarities have been observed between gingival crevicular fluid (GCF) and peri-implant sulcular fluid (PISF). This has resulted in research that has evaluated similar biological fluid markers that are similar to those present within the gingival sulcus. These biomarkers have high sensitivity and are a reliable biological tool when compared to clinical and/or radiographic examination and aid in diagnosis as well as monitoring the progression of periodontal disease surrounding teeth as well as the implants.
UNASSIGNED: The study aimed to compare the effectiveness of periostin in peri-implant sulcular and gingival crevicular fluids.
UNASSIGNED: This experimental prospective in vitro analysis was done following clearance by the institutional ethical committee. A total of 100 patients were selected. They were categorized into two groups: (I) Group A patients had peri-implant disease (n = 50), whereas (II) Group B patients had periodontitis (n = 50). Clinical loss of attachment score was noted in six sites around natural teeth and four sites around the implants. Presterilized filter paper strips were inserted within the sulcus/pocket till pressure was felt for 60 s. Periostin concentration levels in GCF and PISF samples were measured by the enzyme-linked immunosorbent assay technique. Statistical analysis of data collected was performed using Shapiro-Wilk statistical tool for normally distributed numerical data.
UNASSIGNED: Mean ± standard deviation concentration of periostin in gingival crevicular fluid from periodontitis cases was recorded as 20.15 ± 2.76 ng/30sn, whereas in PISF was 19.23 ± 1.89 ng/30sn. On statistical analysis, no statistically significant differences were seen after comparing the concentration of periostin in periodontitis as well as peri-implantitis groups (P > 0.05).
UNASSIGNED: The present study analyzed periostin levels in gingival crevicular fluid obtained from patients diagnosed with periodontitis and sulcular fluid obtained from the sulcus around implants. Early biological markers or indicators of inflammation should be studied to determine the prognosis of treatment apart from the clinical assessment for the patient\'s benefit.
Résumé Contexte: Diverses similitudes ont été observées entre le fluide sulculaire gingival (GCF) et le fluide sulculaire péri-implantaire (PISF). Ce a abouti à des recherches qui ont évalué des marqueurs fluides biologiques similaires à ceux présents dans le sillon gingival. Ces les biomarqueurs ont une sensibilité élevée et sont un outil biologique fiable par rapport à l\'examen clinique et/ou radiographique et aident à diagnostic ainsi que le suivi de la progression de la maladie parodontale entourant les dents ainsi que les implants. Objectif: L\'étude visait à comparent l\'efficacité de la périostine dans les fluides péri-implantaires sulculaires et gingivaux. Matériels et Méthodes: Ce test expérimental une analyse prospective in vitro a été effectuée après autorisation par le comité d\'éthique de l\'établissement. Au total, 100 patients ont été sélectionnés. Ils étaient classés en deux groupes: (I) les patients du groupe A avaient une maladie péri-implantaire (n = 50), alors que (II) les patients du groupe B avaient une parodontite (n = 50). Le score clinique de perte d\'attache a été noté dans six sites autour des dents naturelles et quatre sites autour des implants. Bandes de papier filtre préstérilisées ont été insérés dans le sulcus/poche jusqu\'à ce que la pression soit ressentie pendant 60 s. Les niveaux de concentration de périostine dans les échantillons GCF et PISF ont été mesurés par la technique de dosage immuno-enzymatique. L\'analyse statistique des données recueillies a été effectuée à l\'aide de la méthode statistique de Shapiro-Wilk. outil pour les données numériques distribuées normalement. Résultats: concentration moyenne ± écart-type de périostine dans le liquide gingival les cas de parodontite ont été enregistrés à 20,15 ± 2,76 ng/30sn, alors que dans le PISF, ils étaient de 19,23 ± 1,89 ng/30sn. Sur l\'analyse statistique, pas statistiquement des différences significatives ont été observées après avoir comparé la concentration de périostine dans les groupes parodontite et péri-implantite (P > 0,05). Conclusion: La présente étude a analysé les niveaux de périostine dans le liquide créviculaire gingival obtenu chez des patients diagnostiqués avec une parodontite et fluide sulculaire obtenu à partir du sulcus autour des implants. Les marqueurs ou indicateurs biologiques précoces de l\'inflammation doivent être étudiés pour déterminer le pronostic du traitement en dehors de l\'évaluation clinique au bénéfice du patient. Mots-clés: Créviculaire, liquide, gingival, péri-implantaire, parodontite, périostine, pronostic, sulculaire.

OBJECTIVE: This article presents technical guidelines for perio-restorative esthetic crown lengthening, along with a discussion of the biologic rationale. A classification system is proposed to assist in treatment planning and sequencing the surgical and restorative phases.
METHODS: When esthetic crown lengthening is performed as an adjunct to restorative therapy, the surgical approach must be determined by the anticipated position of the restorative margins. The removal of sufficient bone to achieve the desired clinical crown length and preserve the supracrestal gingival tissue dimensions is facilitated by the use of a surgical guide fabricated according to the design of the restorations. A staged approach allows sequencing the provisional restoration to minimize unesthetic sequelae during the healing period. Inadequate bone resection and/or alteration of the soft tissue dimensions results in delayed healing, leading to coronal gingival rebound and biologic width impingement.
CONCLUSIONS: The identification and preservation of appropriate restorative and biologic landmarks is essential for success in pre-prosthetic esthetic crown lengthening treatment. A staged approach improves the esthetic management during the postsurgical healing and maturation period.
CONCLUSIONS: A restorative driven classification system for sequencing and staging adjunctive esthetic crown lengthening procedures is presented. Technical guidelines to enhance gingival margin predictability are suggested, accompanied by relevant evidence. In addition, wound healing timelines following gingival and osseous resection are provided.

Equine sarcoids are common skin tumors that are thought to be caused by cross-species infection by bovine papillomaviruses (BPV). A 16-year-old horse developed a 1cm diameter mandibular gingival mass opposite the right second premolar tooth (406) and a 2cm diameter mass close to the commissure of the lips on the same side of the mouth. The right cheek was diffusely thickened. Histology of the smaller mass revealed a proliferation of mesenchymal cells covered by hyperplastic epithelium that formed thick rete pegs. BPV2 DNA was amplified from the mass. Although the mass had been incompletely excised, there was no recurrence after 5 months. The histological features and detection of BPV2 DNA is consistent with a diagnosis of equine sarcoid. Sarcoids have not previously been reported in the oral cavity of horses. It is hypothesized that trauma to the mouth may have been important for sarcoid development. Additionally, different BPV types may have variable ability to infect the gingiva. While rare, sarcoids are a differential for an oral mass in a horse.

Mesenchymal stem cells (MSCs) can be isolated from numerous tissues and have the potential for self-renewal and multidirectional differentiation. Evidence is accumulating which suggests that MSCs are also present in the gingival tissue. This study aimed to evaluate the feasibility of collecting, purifying, and amplifying gingival-derived MSCs (GMSCs) from canine gingiva and to obtain GMSC-derived exosomes (GMSC-exo). GMSCs were isolated and cultured; furthermore, cellular immunofluorescence demonstrated that GMSCs possess characteristic MSC markers, and in vitro differentiation was induced, indicating that GMSCs can differentiate into multiple lineages. GMSC-exo was successfully extracted from GMSCs supernatant and found that they exhibit the typical characteristics of exosomes as analyzed by transmission electron microscopy, nanoflow analysis, and western blotting. GMSC-exo promoted the proliferation and migration of Madin-Darby canine kidney cells. It was concluded that canine gingiva is a good source of MSCs. Additionally, GMSC-exo is a potentially promising cell-free therapeutic tool for the treatment of canine gingival diseases.

To-date, there is no evidence comparing the long-term efficacy of powered and manual toothbrushes in adolescents undergoing fixed appliance treatment. The trial compared the efficacy of manual versus powered toothbrush in controlling plaque and gingival health in patients undergoing fixed treatment in respect of both the short- and long-term.
This was a randomized, parallel, controlled single-blind clinical trial, undertaken in a hospital setting, for which the consolidated standards of reporting trials guidelines were followed.
Ninety-two adolescent participants planned to undergo fixed appliance therapy, were randomly assigned to either a manual or powered toothbrush, with allocation concealment. The outcome measures were plaque and gingival indices and bleeding on probing, assessed at baseline (prior to fixed appliance), one-, six- and 12-months.
The final sample included 84 participants, aged 12-18 (M=14.1, SD=1.93) years, with 40 (47%) were using a manual and 44 (52%) a powered toothbrush. The intervention (powered vs. manual toothbrush) itself appeared insignificant with regards to the gingival index (GI) (95%CI -0.1 - 0.03; P=0.26), plaque index (PI) (95%CI -0.13 - 0.14; P=0.93) and bleeding on probing (BoP) (95%CI -0.03 - 0.03; P=0.98) at any of the time points assessed. However, periodontal health indicators and plaque control significantly worsened (p<0.01), over the 12-month follow-up period, following placement of the fixed appliances placement.
Whilst no differences were found between manual and powered toothbrushes in controlling plaque and gingival health, in participants undergoing fixed orthodontic treatment, both were suboptimal and highlighted the need for greater patient support and monitoring.
https://doi.org/10.1186/ISRCTN74268923 Trial funding: Colgate-Palmolive (USA).

A 5-month-old intact male domestic shorthair cat presenting for routine vaccinations was diagnosed with congenital hypothyroidism. His primary presenting symptom was incomplete dentition with delayed dental eruption. Congenital hypothyroidism was confirmed by baseline thyroxine (T4), free T4, and thyroid-stimulating hormone testing. The cat was treated with oral thyroid hormone supplementation and 16 weeks after initiation of therapy the cat was clinically normal with age-appropriate dentition. No surgical intervention was necessary to achieve normal dental eruption.