Various bone matrix proteins are produced during the process of osteogenesis. Many previous studies suggested that the topography of an implant surface might affect the expression of osteoblast-mediated cytokines. However, these earlier studies were performed using in vitro cell culture. This study investigated the influence of the surface topography of a titanium implant placed under the periosteum on the gene expression of bone morphogenic markers in rat. Six custom-made implants with a rough upper surface and 6 custom-made implants with a smooth machined upper surface were placed subcrestally with the upper surface facing up in the femurs of 6 adult male rats. Five rats were sacrificed 7 days after the implant placement, and the periosteum above the embedded implant was obtained and analyzed by quantitative real-time RT-PCR for the target genes: alkaline phosphatase (ALP), bone sialoprotein (BSP) and osteocalcin (OCN). The other rat was sacrificed at day 7, and both implants and the surrounding tissue were embedded in paraffin. For light microscopic observations, paraffin sections were stained with toluidine blue. Gene expression of ALP , BSP and OCN at the rough surface implant was significantly higher than that at the smooth machined surface implant. At day 7, both types of implant were covered with soft tissue, but a lower number of cells stained with toluidine blue was observed on the machined surface compared with on the rough surface. It is considered that rough surfaces may stimulate osteoblasts, and that ALP activity is increased indirectly. Furthermore, the two other markers were also increased by the rough surface in vivo, and different distributions of cellular and extracellular components on the upper surface of the implants were observed at day 7. These results suggest that a rough surface implant under the periosteum promotes higher gene expression of ALP, BSP and OCN in rat.
Abstract:We report a case of necrotizing sialometaplasia arising as bilateral ulcers in the palate of a 20-year-old Japanese female patient. Based on histopathological and immunohistochemical findings, we discuss how to distinguish the condition from neoplastic lesions such as squamous cell carcinoma or mucoepidermoid carcinoma. Histopathologically, the ulcer bed of granulation tissue contained hyperplastic capillary vessels, inflammatory cell infiltrates, necrotizing and degenerating palatal glands, and squamous metaplasia of ducts and acini leaving lobular structures of the mucous gland. Immunohistochemically, the epithelial islands were positive for pancytokeratin (CK), CK7 and S-100 protein, partially positive for α-smooth muscle actin, and not positive for periodic acid-Schiff reaction. We diagnosed the lesion as a necrotizing sialometaplasia. It healed spontaneously without treatment, and there was no recurrence.
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