The presence of insulin immunoreactivity in extra-pancreatic tissues and fluids suggests multiple sites of insulin production. Immunoreactive insulin occurs in human saliva and concentrations increase after oral glucose ingestion. The goal of these experiments was to determine whether the presence of immunoreactive insulin in this extra-pancreatic site is independent of pancreatic production or merely represents the accumulation of circulating pancreatic insulin. The mean +/- SEM concentration of extracted salivary immunoreactive insulin in five normal volunteers increased during an oral glucose tolerance test from basal values of 36 +/- 3.0 to 291 +/- 40 pmol/l; however, the peak occurred 45-90 min later than in serum. On this basis, it was not possible to distinguish between the stimulation (by increased blood glucose concentrations) of insulin synthesis in the saliva glands from the accumulation of blood insulin. Therefore, we studied a group of five volunteers during intravenous infusion of insulin (1 and 10 mU X kg-1 X min-1, sequentially) and glucose (euglycaemic clamp). Under these conditions, salivary immunoreactive insulin concentrations increased significantly from 254 +/- 100 to 1919 +/- 437 pmol/l (p less than 0.05), while simultaneous mean plasma C-peptide concentrations were unchanged. Thus, the concentration of salivary immunoreactive insulin was clearly related to the amount of insulin in the blood and not to the plasma glucose concentration. Physico-chemical and immunological characterization of salivary immunoreactive insulin by dilution in radioimmunoassay, gel filtration and polyacrylamide disc gel electrophoresis demonstrated that the majority of it was indistinguishable from insulin standards.(ABSTRACT TRUNCATED AT 250 WORDS)

Background A main drawback of bone block graft surgery is the resorption occurring in early stages of healing. To our knowledge, there are no studies comparing outcomes of freeze‐dried bone allograft (FDBA) blocks with different architecture. Purpose The aim of this work was to investigate different factors that can affect graft resorption and to compare the resorption rates of two different types of allogeneic blocks, corticocancellous and cancellous. Materials and Methods A randomized clinical trial was designed. Twenty‐eight patients referred for onlay bone augmentation prior to implant placement were included in the study. Preoperative computerized tomography (CT) was taken for all patients. Patients received FDBA blocks of either cancellous or corticocancellous bone obtained from the iliac crest. After a 4‐month follow‐up, postoperative CT was taken. Then, another surgery was performed, with the purpose to place dental implants. The aforementioned groups were compared for bone resorption and implant outcome using analysis of covariance (ANCOVA) and repeated ANOVA measures, respectively. Demographic data, trabecular bone density, and graft sites were also analyzed. Results A total of 93 implants were placed in the augmented bone sites over 28 patients. A 100% survival rate was achieved during a mean follow‐up period of 24 months in both groups. Higher bone resorption rate was found with cancellous bone grafts (29.2% ± 2.6) compared with corticocancellous grafts (19.3% ± 2.3). Moreover, higher resorption rates in patients with lower bone density (<185 Hounsfield Units) (31.7% ± 3.1) and smokers (26.39% ± 2.3) were observed when compared with patients with higher bone density (>185 Hounsfield Units) (16.8% ± 2.1) and nonsmokers (22.1% ± 2.3), respectively. Conclusion Within the limitations of this study, these findings indicate that both corticocancellous and cancellous FDBA grafts constitute a clinical acceptable alternative for bone reconstruction, although cancellous grafts present higher resorption rates. Moreover, host factors such as patient's low bone density and smoking habits may also increase graft resorption rates.

This report deals with a case of AIDS‐related Burkitt's lymphoma in which some of the earliest findings were dental and periodontal in nature. The patient presented initially with painless and extremely loose teeth accompanied by progressive paresthesia of the lower jaw. Unique radiographie findings included extensive periodontal ligament space widening and bulbous, granuloma‐like lesions about the apices of the teeth. These findings were associated with progressive tumor infiltration of the mandible and do not appear to be related to other reports of aggressive Periodontitis associated with impaired immunologic functions in AIDS patients. [Journal of Periodontology 1989;60:723–727)

A 35-year-old woman was referred to the Department of Oral Medicine and Orofacial Surgery after several recurrences of an ossifying fibroma (OF) that affected the free and attached gingiva of the maxillary right central incisor. Surgery was performed with a complete excision of the lesion together with the surrounding healthy tissue up to the bone. To guide the healing of the anterior esthetic framework and the excised tissues, a porcine collagen matrix as an alternative to connective tissue graft was used. After an 18-month follow-up, the lesion had not recurred and keratinized gingiva had formed around the area.

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