bluuebunny/crossref_metadata_2025 huggingface dataset:
The in vitro post‐antifungal effect of nystatin on Candida species of oral origin
Authors: Ellepola A. N. B. , Samaranayake L. P.
Published: August 2010

The post‐antifungal effect (PAFE) is defined as the suppression of growth that persists following limited exposure of yeasts to antimycotics and subsequent removal of the drug. Although limited data are available on the PAFE of nystatin on oral isolates of C. albicans, there is no information on non‐albicans Candida species. As nystatin is the commonest antifungal agent prescribed in dentistry, the main aim of this investigation was to measure the PAFE of oral isolates of Candida belonging to six different species (five isolates each of C. albicans, C. tropicalis, C. krusei, C. parapsilosis, C. glabrata and C. guilliermondii) following limited exposure (1 h) to nystatin. The yeasts were examined for the presence of the PAFE after 1 h exposure to the minimum inhibitory concentration (MIC) of nystatin. The PAFE was determined as the difference in time (h) required for the growth of the drug‐free control and the drug‐exposed test cultures to increase to the 0.05 absorbance level following removal of the antifungal agent. The mean duration of nystatin‐elicited PAFE was lowest for C. albicans (6.85 h) and greatest for C. parapsilosis (15.17 h), while C. krusei (11.58 h), C. tropicalis (12.73 h), C. glabrata (8.51 h), and C. guilliermondii (8.68 h) elicited intermediate values. These findings clarify another intriguing possibility for the persistent, chronic recurrence of oral C. albicans infections despite apparently adequate antifungal drug regimens. The significant variations in nystatin‐induced PAFE amongst non‐albicans species may also have clinical implications, in terms of nystatin regimens used in the management of these fungal infections.
Expression of E‐cadherin and α‐catenin in epithelial odontogenic tumours: an immunohistochemical study
Authors: Kumamoto Hiroyuki , Ooya Kiyoshi
Published: August 2010

To clarify the possible role of cell adhesion in epithelial odontogenic tumors, expression of E‐cadherin and α‐catenin was examined by an immunohistochemical method. These molecules showed pericellular distribution in epithelial cells of the tooth germ and its derived tumors. In ameloblastomas, E‐cadherin and α‐catenin were expressed strongly in central polyhedral cells and slightly in peripheral columnar cells. These features resembled those of epithelial components in the tooth germ tissues, retaining cytodifferentiation of odontogenic epithelium. Expression of the molecules in the variants of ameloblastomas showed loss in the keratinizing areas and reduction in the granular cell clusters, suggesting terminal differentiation of the tumor cells. Calcifying epithelial odontogenic tumors and a clear cell odontogenic tumor preserved E‐cadherin and α‐catenin expression without a specific feature for histogenesis or cytodifferentiation. One case of two malignant ameloblastomas showed prominent reduction in expression of E‐cad‐herin and α‐catenin.
Paediatric AIDS ‐ related linear gingival erythema: a form of erythematous candidiasis?
Authors: Velegraki Aristea , Nicolatou Ourania , Theodoridou Maria , Mostrou Glykeria , Legakis Nicholas J.
Published: August 2010

Three verticall HIV‐infected children showed, in addition to oral candidiasis, HIV‐gingivitis, which healed on antimycotic treatment. The intense linear gingival erythema of a fourth child was also clinically evaluated as a possible form of erythematous oral candidiasis. Direct microscopic examiniation of material from the gingival lesions of the latter disclosed yeast cells and hyphae. Subsequent culture, biochemical and serologicla tests identified the yeast as Candida dubliniensis. As the patient was on long‐term prophylaxis with fluconazole, ketoconazole was administered and led to a good clinical response. This is the first report implicating this new Candida species as a pathogen in linear gingival erythema in a HIV‐positive individual. The case reports presented provide evidence that linear gingival erythema may be of candidal origin. Further clinical and laboratory observations are required to establish whether this condition constitutes a variant of erythematous candidiasis associated with paediatric HIV infection.
Oral ulcers in AIDS patients frequently associated with cytomegalovirus (CMV) and Epstein‐Barr virus (EBV) infections
Authors: Syrjänen S. , Leimola‐Virtanen R. , Schmidt‐Westhausen A. , Reichart P. A.
Published: August 2010

Oral ulcers are common in AIDS patients, with a wide spectrum of underlying causes, including different viruses. In the present study, the presence of cytomegalovirus (CMV), Epstein‐Barr virus (EBV) and human herpesvirus‐8 (HHV‐8) DNA was analysed in 21 biopsies from oral ulcers of 17 male homosexual AIDS patients. The methods used were in situ hybridization (ISH) and the polymerase chain reaction (PCR) with subsequent non‐radioactive Southern blot hybridization to confirm the specificity of PCR products. With ISH, 4 biopsies were CMV DNA‐positive and 11 contained EBV‐DNA. Using PCR, an additional 4 CMV‐and 7 EBV‐positive samples were detected, and HHV‐8 DNA was present in three oral ulcers. Six of the patients (35%) had oral ulcers co‐infected by two or three viruses. The overall figures for patients with the detectable EBV‐, CMV‐, and HHV‐8 DNA were 82% (14/17), 35% (6/17) and 18% (3/17), respectively. This is the first study to show the frequent presence of EBV‐DNA in oral ulcers of AIDS patients. Because ISH‐positivity signifies active virus replication, these results implicate an etiological role of EBV in AIDS‐associated oral ulcers. The causal role of HHV‐8 has to be considered as well, because this virus was detected in three such ulcers, which were not associated with Kaposi's sarcoma. To conclude, three common members of the herpesvirus family (CMV, EBV, HHV‐8) were detected in all but three ulcers in AIDS patients, warranting the inclusion of these viral analyses in the diagnosis of ulcerative lesions of the oral mucosa in all immunosuppressed individuals.
Oral lichen planus: an immunohistochemical study of heat shock proteins (HSPs) and cytokeratins (CKs) and a unifying hypothesis of pathogenesis
Authors: Chaiyarit Ponlatham , Kafrawy Abdel H. , Miles Dale A. , Zunt Susan L. , Van Dis Margot L. , Gregory Richard L.
Published: August 2010

The expression of heat shock proteins HSP60 and HSP70 and cytokeratins CK1/10 and CK7/18 were compared in epithelium of oral lichen planus (OLP) lesions and oral fibromas using an avidin‐biotin‐peroxidase complex (ABC) immunohistochemical method. An immunostaining intensity distribution (IID) index was developed to assess staining intensity and the proportion of positively stained cells in different layers of the epithelium. The expression of HSP60 in the basal layer was significantly higher in OLP than in fibromas. No difference in HSP70 expression was evident between OLP and fibromas. The expression of CK1/10 in the epithelial basal and suprabasal layers was significantly higher in OLP than in fibromas. There was no demonstrable staining for CK7/18 in either OLP or fibromas. A significant correlation was evident between the expression of HSP60 and CK1/10 in the basal epithelial cells in OLP. The findings support a role for HSP60 in the pathogenesis of OLP. A unifying hypothesis of the pathogenesis of OLP, involving two sequential immune reactions, is proposed.
Immunohistochemical analysis of cell cycle‐associated proteins p16, pRb, p53, p27 and Ki‐67 in oral cancer and precancer with special reference to verrucous carcinomas
Authors: Saito Tadashi , Nakajima Takashi , Mogi Kenji
Published: August 2010

Alterations in cell proliferative activity are a common phenomenon in oral carcinogenesis. In this study, the expression of the cell cycle‐associated proteins p16, pRb, p53, p27 and Ki‐67 were examined by immunohistochemistry in precancerous and cancerous oral lesions, including verrucous carcinomas (VCs). Generally, expression of pRb, p53 and Ki‐67 increased according to the cell proliferative activity or tumor progression, but p27 expression showed an inverse relationship. Comparing squamous cell carcinomas (SCCs) with VCs, there was a great difference in expression levels of p27, Ki‐67 and p53, which seemed to reflect the different cell proliferative activities of these two tumors. Expression of p16 was low in both dysplasia and SCCs, whereas p16 expression was high in VCs. The high immunohistochemical expression for both p16 and pRb in VC is quite different compared with SCC, which may indicate a possible relationship between VC and human papillomavirus (HPV) infection.
Congenital unilateral fusion of the maxilla and mandible
Authors: Haddad I. K. , Shamo'on H. , Salah S.
Published: August 2010

We present an uncommon severe first branchial arch congenital malformation, in which complete unilateral bony fusion between the maxillary and mandibular processes was found in a newborn exposed to carbamazepine medication all through pregnancy. This condition interferes with oral feeding, intubation, growth and development. In a review of previously reported cases it was found that this anomaly was commonly associated with other abnormalities. The etiology of this malformation was uncertain in our case, as carbamazepine was not proven to be the definite cause.
Potentially malignant and malignant lesions of the lip. Role of silver staining nucleolar organizer regions, proliferating cell nuclear antigen, p53, and c‐myc in differentiation and prognosis
Authors: de Rosa IIrai , Staibano Stefania , Muzio Lorenzo Lo , Delfino Mario , Lucariello Antonio , Coppola Armando , de Rosa Gaetano , Scully Crispian
Published: August 2010

The cellular changes leading to carcinoma of the lip are still not completely understood. This study was carried out on 44 malignant and potentially malignant lesions of the lower lip [30 squamous cell carcinomas (SCC), 7 actinic cheilitis, 3 leukoplakias, and 4 nodal metastases from lower lip SCC]. Silver‐stained nucleolar organizer regions (AgNORs) and the immunohistochemical expression of proliferating cell nuclear antigen (PCNA), p53, and c‐myc were evaluated on formalin‐fixed, paraffin‐embedded sections. The results indicate that the size and numbers of AgNORs and the percentage of PCNA‐positive cells are sensitive parameters for discriminating between potentially malignant lesions and SCC, and for the prognostic sub‐typing of lower lip SCC. Futhermore, while p53 positivity was found more freqently in high‐grade carcinomas, p53‐positive cellular clones were also found in some potentially malignant lesions, a finding probably related to ultraviolet‐related cellular damage. These p53‐positive lesions could be considered at higher risk of progression to malignancy than the p53‐negative ones, althoug there is no evidence for this as yet. c‐myc positivity was found only in some high‐grade carcinomas and metastases, and appeared correlated with the later phases of lip carcinogenesis. The combined evaluation of the proliferation status, together with the changes in p53 and c‐myc oncoproteins, might constitute useful markers for the prognostic evaluation of potentially malignant, as well as malignant, lesions of the lip.
A clinicopathologic study of 196 intraoral minor salivary gland tumours
Authors: Lopes Márcio Ajudarte , Kowalski Luis Paulo , Cunha Santos Gilda , de Almeida Oslei Paes
Published: August 2010

We present a retrospective study of 196 patients with intraoral minor salivary gland tumours, 128 malignant and 68 benign, diagnosed from 1954 to 1993 in the A.C. Camargo Hospital, São Paulo, Brazil. Sixty‐five percent of the cases occurred in the palate, followed by tongue (9.7%) and retromolar area (6.1%). Pleomorphic adenoma was the most common benign tumour, and mucoepidermoid carcinoma was predominant among the malignant tumours. Surgery was the main treatment method and postoperative radiotherapy and radiotherapy alone were used in 40 and 15 patients, respectively. Local recurrence was observed in two patients with pleomorphic adenoma and in eight patients with malignant tumours. Regional lymph node metastases occurred in four cases and distant metastases in five. Forty‐six of 47 patients with benigh tumours who were followed up from 1 to 7 years were alive without disease. Twenty‐four of 79 patients with malignant tumours who were followed up for at least 5 years died due to the tumour and 47 were alive without disease.
Immunohistochemical and ultrastructural study of a papillary cystadenocarcinoma arising from the sublingual gland
Authors: Kobayashi Ieyoshi , Kiyoshima Tamotsu , Ozeki Satoru , Shima Kaori , Shigemura Noriatsu , Matsuo Kou , Sakai Hidetaka
Published: August 2010

Immunohistochemical and ultrastructural findings in a rare case of papillary cystadenocarcinoma arising from the left sublingual gland of a 55‐year‐old Japanese man are reported. Histologically, the tumor tissue was found to be composed of various‐sized cystic cavities in which papillary epithelial projections with thin fibrovascular cores were observed. The papillary projections consisted of a single layer to several layers of high columnar epithelial cells. Invasion to the surrounding fibrous tissue and into the lymphatics was observed, thus suggesting an aggressive potential in the present case. The possibility of the involvement of myoepithelial cells could be excluded based on the immunohistochemical and ultrastructural findings. The immunohistochemical and ultrastructural findings also suggested that this type of salivary gland tumor, at least the present case, may arise from striated or excretory ducts. There was positive immunostaining for tumor markers CA19‐9 and CA125. However, the biological role of these carbohydrate antigens in salivary gland tumors is unclear at present. Further investigations are, therefore, called for to solve this issue.
Primary Sjögren's syndrome (pSS): subjective symptoms and salivary findings
Authors: Pedersen Anne Marie , Reibel Jesper , Nauntofte Birgitte
Published: August 2010

We studied the relationship between dry mouth, general health and objective findings in 16 patients having primary Sjogren's syndrome (pSS) according to the 1993 European classification criteria as well as in healthy controls. Serum autoantibody to SSA/SSB (AB) was correlated to unstimulated whole saliva flow (UWS) and labial salivary gland focus score (FS). All patients had dry mouth symptoms and UWS ≦ 0.10 ml/min, but patients with UWS < 0.05 ml/min and AB had more complaints of oral and ocular dryness. These patients also tended to have more exocrine and non‐exocrine manifestations, and oral dryness had a greater impact on their self‐reported general health than in patients with UWS ≧ 0.05 ml/min. Accordingly, we consider rating of oral dryness by visual analogue scales or categorised questionnaires to be valuable for the evaluation of oral involvement in pSS.
Odontogenic ghost cell carcinoma: report of four new cases and review of the literature
Authors: Lu Yong , Mock David , Takata Takashi , Jordan Richard C. K.
Published: August 2010

Only 12 odontogenic ghost cell carcinomas (OGCC) have been reported in the English language literature to date. This article reports four additional cases of this rare odontogenic tumour and examines them in relation to those previously described. Judging from the number of published cases, the OGCC is more prevalent in Asians than other racial groups, occurs more often in the maxilla than the mandible, and is slightly more common in males than females. Histologically, elements of a benign calcifying odontogenic cyst (COC) can be identified in all the malignant variants, either separated or admixed with the malignant epithelial component. The latter can consist of either small basaloid cells or large epithelial cells. Despite the differing histological presentations, the biological behavior of the tumour is unpredictable, with some cases characterized by relatively indolent growth and others by a locally aggressive and potentially fatal course. The tumour apparently arises most often from malignant transformation of a preexisting benign COC, although it may also develop from other odontogenic tumours.
Antioxidant status of oral mucosal tissue and plama levels in smokers and non‐smokers
Authors: Cowan C. G. , Calwell E. I. L. , Young I. S. , McKillop D. J. , Lamey P.‐J.
Published: August 2010

The antioxidant status of an individual is thought to be important in the development of potentially malignant oral lesions (PMOL) and oral squamous cell carcinoma (OSCC). To date, little detailed information on mucosal antioxidant status is available in a United Kingdom population and neither has the relationship between smoking and mucosal antioxidant status been established. Furthermore, it has been implied that serum levels of antioxidants and tissue levels in the oral mucosa should be equivalent, but that is unproven. To address these deficiencies in our knowledge we studied 60 individuals, all of whom had an oral mucosal biopsy and simultaneous vanous blood sampling. Antioxidant levels were measured using high performance liquid chromatogaphy. Smokers (n=19) were found to have significantly lower levels of plasma β‐carotene (P<0.05) and significantly lower levels of tissue α‐carotene (P<0.05) than non‐smokers (n=41). Tissue α‐carotene correlated with plasma levels, but this was not the case with α‐tocopherol, retinol, lycopene or β‐carotene. This is the first data on oral mucosal antioxidant levels and provides baseline data from which to study patients with potentially malignant oral lesions and oral squamous cell carcinoma.
Local tumor recurrence or emergence of a new primary lesion? A molecular analysis
Authors: Zhang L. , Epstein J. , Band P. , Berean K. , Hay J. , Cheng X. , Rosin M. P.
Published: August 2010

The distinction between a new primary oral tumor and recurrence may bear significant prognostic implications. Currently, this differentiation relies mainly on tumor location: when both lesions are at or near the same site, the new one is regarded as a recurrence; when the two are at different sites, the second lesion is regarded as a new primary. Recent investigations using molecular analysis have demonstrated that some oral squamous cell carcinomas (SCC) arising from different sites show the same clonogenical changes. In this case report, we studied the clonality of three SCC (one primary, two apparent recurrences) from the right lateral tongue of a young, non‐smoking woman by using microsatellite analysis for loss of heterozygosity. The results showed that while the first two tumors were clonogenically similar, the third tumor was clonogenically different and was consistent with the development of a new primary. This result indicates that location of tumors alone is not always reliable in determining whether a new tumor is a recurrence or a new primary lesion.
PCNA/AgNOR and Ki‐67/ AgNOR double staining in oral squamous cell carcinoma
Authors: Costa Antonio de Lisboa Lopes , de Araújo Ney Soares , Jr Décio dos Santos Pinto , de Araújo Vera Cavalcanti
Published: August 2010

Costa ALL, Araujo NS, Pinto Jr DS, Araujo VC: PCNA/AgNOR and Ki‐67/ AgNOR double staining in oral squamous cell carcinoma. J Oral Pathol Med 1999; 28: 438–41. © Munksgaard, 1999.

This study was performed on oral squamous cell carcinomas (OSCC) in order to investigate the relation between the number of interphase silver‐stained nucleolar organizer regions (AgNORs) and the immunolabeling of proliferation‐associated markers, using antibodies to Ki‐67 and proliferating cell nuclear antigen (PCNA). Fifteen consecutive cases of oral squamous cell carcinoma were used and a double staining technique was performed in order to quantify the number of NORs in PCNA‐positive and ‐negative cells as well as in Ki‐67‐positive and ‐negative cells. Our results showed a higher mean number of AgNORs in PCNA‐and Ki‐67‐positive cells than in PCNA‐ and Ki‐67‐negative cells. We concluded that there is an association between cell proliferation and AgNOR score in OSCC.
Biosynthesis of glycosaminoglycans and aggrecan by tumor cells in salivary pleomorphic adenoma: ultrastructural evidence
Authors: Zhao Ming , Takata Takashi , Kudo Yasusei , Sato Sunao , Ogawa Ikuko , Wakida Kazuyoshi , Uchida Takashi , Nikai Hiromasa
Published: August 2010

Zhao M, Takata T, Kudo Y, Sato S, Ogawa I, Wakida K, Uchida T, Nikai H: Biosynthesis of glycosaminoglycans and aggrecan by tumor cells in salivary pleomorphic adenoma: ultrastructural evidence. J Oral Pathol Med 1999; 28: 442–50. © Munksgaard, 1999.

The present study attempted to discover the sites of synthesis of various glycosaminoglycans (GAGs) and aggrecan in salivary pleomorphic adenoma (PA) with the use of a highly sensitive and specific post‐embedding immunogold‐silver staining technique at the ultrastructural level. Silver particles representing various GAGs and aggrecan were found to accumulate frequently in the intercellular spaces of non‐luminal cells in the epithelial clusters and were dispersed in the myxoid matrix of the mesenchyme‐like areas. Furthermore, the non‐luminal epithelial cells were demonstrated to contain immunopositive intracytoplasmic vesicles and vacuoles, some of which were of Golgi complex origin. In contrast, intracellular silver particles for hyaluronic acid were mostly attached to the inner surface of the cell membrane. These observations agree well with the current theories of the biosynthesis of GAGs and proteoglycans and provide direct evidence for the production of various GAGs and aggrecan by tumor epithelial cells of PA. Such findings support the ideas that in PA a loss of epithelium occurs by stromali‐zation following epithelial secretion of extracellular matrix substances and transformation of epithelium to mesenchyme represents the basic principle of the tissue heterogeneity in this tumor.
Crystalloid architecture of a sialolith in a minor salivary gland
Authors: Riesco J. M. , Juanes J. A. , Diaz‐Gonzalez M. P. , Blanco E. J. , Riesco‐Lopez J. M. , Vazquez R.
Published: August 2010

Riesco JM, Juanes JA, Díaz‐González MP, Blanco EJ, Riesco‐Löpez JM, Vázquez R: Crystalloid architecture of a sialolith in a minor salivary gland. J Oral Pathol Med 1999; 28: 451–5. © Munksgaard, 1999.

A sialolith from a minor salivary gland of the mucosa of the upper lip was studied morphologically and analytically. Under stereoscopic microscopic visualisation, no core or any concentric laminar structure was found in the sialolith and it had a transparent glassy appearance. Scanning electron microscopy revealed differences between the internal structure of the sialolith and its external structure. No microbes were observed but some mineralized inclusion bodies were seen. X‐ray diffraction indicated the absence of inorganic crystals in the sialolith, while energy dispersive x‐ray microanalysis revealed a high content of S followed by Ca, Si and Na and little and scarce P on the fracture surface, with S, Na, Ca and P being distributed throughout the external coating of the sialolith. The results suggest that the sialolith was young and consisted of a crystalloid body with an incipient coating undergoing calcification.
The effect of tobacco smoking and of betel chewing with tobacco on the buccal mucosa: a cytomorphometric analysis
Authors: Ramaesh T. , Mendis B. R. R. N. , Ratnatunga N. , Thattil R. O.
Published: August 2010

The effect of tobacco use on the buccal mucosa has been assessed by cytomor‐phometry. Cell and nuclear diameters (CD, ND) of exfoliated oral squames were measured in tobacco smokers (S), betel chewers with tobacco (C) and those with a combined habit (S + C). Non‐users (NU) served as controls. The mean CD values in S, C, S + C and NU were: 50.8 (± 0.47), 49.39 (± 0.48), 49.12 (±0.47) and 51.87 (± 0.76) urn, and the mean ND values were: 8.83 (± 0.07), 8.61 (± 0.08), 8.72 (± 0.10) and 8.33 (± 0.09) um, respectively. The least significant difference procedure (LSD at P= 0.05) showed a significant reduction for CD in C and S + C and an increase for ND in all three habit groups, compared to the controls. This study shows that the use of tobacco influences the cytomorphology of the normal buccal mucosa. Betel chewing with tobacco influences the ND and CD, while smoking influences only the ND.
Telomerase activity and in situ telomerase RNA expression in oral carcinogenesis
Authors: Chang Lien‐Yu , Lin Shu‐Chun , Chang Che‐Shoa , Wong Yong‐Kie , Hu Yueh‐Chiang , Chang Kuo‐Wei
Published: August 2010

To investigate the role of telomerase in oral carcinogenesis, we assayed telomerase activity in various oral tissues by a modified telomeric repeat amplification protocol (TRAP) analysis. Also, using digoxigenin‐labeled probes, we measured the in situ expression of human telomerase RNA component (hTR) in paired oral squamous cell carcinomas (OSCC) and adjacent non‐cancerous matched tissue (NCMT). We detected telomerase activity in three OSCC cell lines, but not in primary oral keratinocytes. In patient samples, most OSCC (36/42, 86%) and oral premalignant lesions (8/12, 67%) possessed telomerase activity. In addition, 6 of 27 (22%) NCMT contained weak telomerase activity. In situ hybridization showed that hTR was expressed in almost all OSCC (23/27, 85%) as well as in the majority of NCMT (20/25, 80%). In most cases, accumulation of hTR was observed both in the nucleus and cytoplasm of epithelial cells. A correlation between hTR expression and more advanced tumor grade was observed. The appearance of telomerase activation and hTR expression during oral carcinogenesis was different. This study indicates that the activation of telomerase is an early and frequent event in OSCC.
Glycaemic disorders in denture stomatitis
Authors: Vitkov Ljubomir , Weitgasser Raimund , Lugstein Alois , Noack Michael J. , Fuchs Karl , Krautgartner Wolf Dietrich
Published: August 2010

The prevalence of glycaemic disorders was investigated in native Upper‐Austrians with Candida‐associated denture stomatitis. All patients with previously unknown diabetes mellitus were subjected to an oral glucose tolerance test (OGTT) and as a result diabetes was diagnosed in 13% of the patients over 50 years of age. Thirty‐five percent of all inspected patients over 50 years of age with denture stomatitis had type 2 diabetes mellitus and 36% had impaired glucose tolerance (IGT). The correlation between Candida‐associated denture stomatitis and diabetes mellitus indicates a means for the early diagnosis of diabetes. Hyperglycaemia could not be a predisposition to denture stomatitis, since all patients with denture stomatitis in the age‐bracket 26–50 years were without diabetes and only very few of the older patients with diabetes were obese. The correlation between Candida‐associated denture stomatitis and type 2 diabetes mellitus could be traced back to a reduced resistance to Candida that preceded the diabetes.
Maxillofacial osteonecrosis in a patient with multiple “idiopathic” facial pains
Authors: Adams William R. , Spolnik Kenneth J. , Bouquot Jerry E.
Published: August 2010

Previous investigations have identified focal areas of alveolar bone tenderness, increased mucosal temperature, abnormal anesthetic response, radiographic abnormality, increased radioisotope uptake on bone scans, and abnormal marrow within the quadrant of pain in patients with chronic, idiopathic facial pain. The present case reports a 53‐year‐old man with multiple debilitating, “idiopathic” chronic facial pains, including trigeminal neuralgia and atypical facial neuralgia. At necropsy he was found to have numerous separate and distinct areas of ischemic osteonecrosis on the side affected by the pains, one immediately beneath the major trigger point for the lancinating pain of the trigeminal neuralgia. This disease, called NICO (neuralgia‐inducing cavitational osteonecrosis) when the jaws are involved, is a variation of the osteonecrosis that occurs in other bones, especially the femur. The underlying problem is vascular insufficiency, with intramedullary hypertension and multiple intraosseous infarctions occurring over time. The present case report illustrates the extreme difficulties involved in the diagnosis and treatment of this disease.
A study of 342 oral keratotic white lesions induced by qat chewing among 2500 Yemeni
Authors: Ali Aiman A. , Al‐Sharabi Ali K. , Aguirre José M. , Nahas R.
Published: August 2010

Background:  Qat chewing is a common habit in Yemen. Various studies demonstrated clear effects of this habit on the systemic organs of the human body. The lack of studies, however, on the effects of this habit on oral mucosa was the major motive of this study.

Methods:  This cross‐sectional study was made on 2500 Yemeni citizens (mean age 27 years, 1818 males and 682 females). Clinical protocol was made for all cases with a full intraoral examination. A new grading system was applied for each case with oral white lesion.

Results:  Of our sample, 1528 cases (61.12%) were qat chewers; of them, 342 cases (22.4%) had oral keratotic white lesions at the site of qat chewing, while only 6 (0.6%) non‐chewer cases had white lesions in their oral cavity (P < 0.000000, Odds ratio = 46.43, RR = 36.26). According to our grading system; 14, 5.9 and 2.4% were grade I, II and III.

Conclusions:  We conclude that qat chewing can provoke the development of oral keratotic white lesions at the site of chewing. The prevalence of these lesions and its severity increase as duration and frequency increase.
Tenascin and fibronectin expression in odontogenic cysts
Authors: De Oliveira Marcílio Dias Chaves , De Miranda João Luiz , De Amorim Rivadávio Fernandes Batista , De Souza Lélia Batista , De Almeida Freitas Roseana
Published: August 2010

Background: Odontogenic cysts (OCs) present distinct evolution and clinical behavior. This study was performed in order to investigate if some components of the extracellular matrix (ECM) may drive these differences.

Methods: Thirty OCs were selected: 10 radicular cysts (RCs), 10 dentigerous cysts (DCs), 10 non‐syndrome odontogenic keratocysts (OKCs) and they were immunohistochemically analyzed to verify the expression pattern of tenascin and fibronectin.

Results: Tenascin immunostaining was mainly intense as a thick band deep to the epithelial‐mesenchymal interface in both RCs and OKCs. The intense tenascin immunoexpression observed in the RCs was usually associated with inflammation. An intense fibronectin reactivity was observed in the basement membrane region and at the cystic wall of OKCs.

Conclusions: Our results demonstrate differences between the expression of ECM proteins in the OCs studied. The higher tenascin and fibronectin expression in the capsule of OKCs suggests marked instability in the cystic structure and may contribute to its aggressive behavior.
Clinicopathological characteristics of tongue piercing: an experimental study
Authors: López Jornet P. , Vicente Ortega V. , Yáñez Gascón J. , Cozar Hidalgo A. , Pérez Lajarín L. , García Ballesta C. , Alcaraz Baños M.
Published: August 2010

Background:  This study attempts to remedy the situation that no morphological studies exit of tongue piercing.

Methods:  The tongues of eight Beagles were pierced with titanium implants. The animals were then divided into four groups: 1 week, 2 weeks, 1 month and 3 months for clinical‐photographic and histopathological studies.

Results:  Group I: clinically, erythema at both orifices and, microscopically, granulation tissue covering the surface of the canal and infiltrates of polynuclear neutrophils. Group II: persistence of erythema and of the granulation tissue, with the edges of the epithelium showing signs of regeneration. Group III: granulation tissue alternating with fibrosis; epithelium covering the sides of the canal. Group IV: fibrosis substituting the granulation tissue and almost complete re‐epithelialization of the canal. All groups, except group I, numerous foreign body‐type granulomas.

Conclusions:  Tongue piercing provokes fibrous reparation with almost total re‐epithelialization of the perforated zone and foreign body‐like granulomatous inflammation.
Cementoblastoma related to a primary tooth: a case report
Authors: Vieira Anya Pimentel Gomes Fernandes , Meneses Jose Maria Sampaio , Maia Renato Luiz
Published: August 2010

Cementoblastomas are benign lesions of the odontogenic ectomesenchyme that rarely occur related to the primary dentition, especially on the left side of the mandible. This study describes a case of a true cementoblastoma related to the left second primary mandibular molar in a 7‐year‐old child (the largest one seen in the left side of the mandible). Additionally, the radiographic and histologic findings of the lesion are described in details.
Three siblings with juvenile hyaline fibromatosis
Authors: Uslu H. , Bal N. , Guzeldemir E. , Pektas Z. O.
Published: August 2010

Juvenile hyaline fibromatosis (JHF) is an extremely rare hereditary genetic disease of autosomal recessive transmission that is characterized by large cutaneous tumors commonly involving the scalp, papulonodular skin lesions, flexural joint contractures, gingival hyperplasia, and osteolytic bone lesions. JHF is usually diagnosed in young infants and in children younger than 5 years, and the lesions characteristic of this disorder consist of fibrous tissue and homogenous amorphous eosinophilic hyaline material. We report the case of a 9‐year‐old girl with severe gingival hyperplasia, nasal enlargement, mild osteoporosis, and multiple papulonodular skin lesions. Her two brothers (7 and 13 years of age, respectively) were also diagnosed as having JHF. In the patient described in this report, the maintenance of oral hygiene after gingivectomy enabled the continued resolution of gingival hyperplasia, although skin lesions recurred and nasal overgrowth persisted.
Neck mass with marked squamous metaplasia: a diagnostic pitfall in aspiration cytology
Authors: Su Cheng‐Chuan , Chou Chien‐Wen , Yiu Ching‐Yi
Published: August 2010

Fine‐needle aspiration cytology (FNAC) is a highly accurate tool for the diagnosis of pleomorphic adenomas; however, this common salivary gland neoplasm can be diagnostically challenging, causing pitfalls in cytodiagnosis. A 50‐year‐old woman suffered from a painless, slowly‐growing mass in the right posterior upper neck for 5 months. FNAC from this mass revealed many discohesive parakeratotic cells and keratin flakes, and a few stromal elements. Under the impression of metastatic well‐differentiated squamous cell carcinoma, the tumor mass was totally excised. Histology confirmed a pleomorphic adenoma with marked squamous metaplasia and frequent keratin pearl formations without the evidence of malignancy. Pleomorphic adenoma occasionally reveals focal squamous metaplastic changes, when extensive, it may be misdiagnosed as metastatic well‐differentiated squamous cell carcinoma in FNAC, particularly in the neck region.
Extension of Pindborg tumor to the maxillary sinus: a case report
Authors: Mohtasham Nooshin , Habibi Ataollah , Jafarzadeh Hamid , Amirchaghmaghi Maryam
Published: August 2010

The calcifying epithelial odontogenic tumor is a benign epithelial odontogenic lesion that accounts for less than 1% of all odontogenic tumors. It is most frequently seen in the posterior areas of the mandible. Extension of this lesion to the maxillary sinus is extremely rare. In this paper, we report the fourth of such cases which has been reported, up to now. This tumor was encased between the right maxillary lateral and canine roots with extension to the maxillary sinus. Histologically, the tumor is composed of sheets of epithelial cells with eosinophilic or clear cytoplasm, intercellular bridges, nuclear pleomorphism, but no mitotic figures, amorphous eosinophilic and calcified materials were seen within the sheets of epithelial cells.
Management of potentially malignant disorders: evidence and critique
Authors: Lodi Giovanni , Porter Stephen
Published: August 2010

At a workshop coordinated by the WHO Collaborating Centre of Oral Cancer and Precancer in the United Kingdom, issues related to management of patients affected by oral leukoplakia were discussed by an expert group. The consensus views of the working group are presented here. Although removal of a lesion still seems to be the predominant method of treatment by the majority of relevant health care professionals, no randomized controlled trials have been undertaken to test the hypothesis that excision either by scalpel or laser greatly influences the potential for later malignant transformation within the oral mucosa of an affected individual. Results of observational studies indicate that, although surgery may have a beneficial effect, this is not likely to reduce the risk of later recurrence nor malignant transformation at the same or another site. Medical measures that lessen the size, extent or histopathological features of dysplasia within leukoplakia likewise presently do not seem to be of particular promise, as relapse or later malignant transformation can occur, and there is a risk of adverse effects, particularly with systemic agents (which themselves may be contra‐indicated in some individuals). While the risk of malignant transformation, and the development of further potentially malignant disease may theoretically be reduced by cessation of risk activities, such as tobacco usage and alcohol consumption, there remain no good studies that demonstrate that such measures significantly reduce such events.
Influence of altered occlusal plane on rabbit temporomandibular joint cartilage
Authors: Yoshikawa Sakiko , Nodai Etsuo , Habu Manabu , Furuta Norihiko , Fukuda Jinichi , Yamaguchi Kazunori
Published: August 2010

Background:  There is limited knowledge relating to the influence of mechanical stress on the temporomandibular joint (TMJ) and the degree of damage this stress can induce in the case of an altered occlusal plane on the extracellular matrix cartilage and chondrocytes. The aim of this study was to examine the histopathological influence of an altered occlusal plane on rabbit TMJ cartilage.

Methods:  Fifteen male Japanese white rabbits were used in this study. In 12 cases, the upper right and lower left teeth were ground to their cervical level so that the occlusal plane was tilted right side up. Their temporomandibular joints (TMJs) harvested at 3 days, 1, 2 and 4 weeks were analyzed immunocytochemically and immunohistochemically. The terminal deoxynucleotidyl transferase‐mediated deoxyuridine triphosphate biotin nick endlabeling (TUNEL) method was used for immunocytochemical study to detect DNA fragmentation in chondrocytes. An immunohistochemical study was also performed to evaluate the metabolism of type 2 collagen in the extracellular matrix in the TMJ cartilage.

Results:  The number of apoptotic cells increased in all experimental animals. More apoptotic cells were observed in the articular eminences than in the condyles. The type 2 collagen‐positive area in the condyles was reduced at the beginning but recovered within 4 weeks, and remained small throughout this experimental period in the articular eminences.

Conclusions:  These findings suggest that histopathological changes occurred in response to alteration of the occlusal plane. The influence decreased as the occlusal plane recovered in the condyles, but the immunocytochemical and immunohistochemical influence continued in the articular eminences.
Natural history of potentially malignant oral lesions and conditions: an overview of the literature
Authors: Napier Séamus S. , Speight Paul M.
Published: August 2010

At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Pre‐cancer in the UK issues related to potentially malignant disorders of the oral cavity were discussed by an expert group. The consensus views of the Working Group are presented in a series of papers. In this report we review the literature on the epidemiology and natural history of potentially malignant disorders (PMD), detailing those characteristics of the patients and lesions thought to be associated with future development of oral squamous cell carcinoma (OSCC). Older patients, particularly females are more at risk than younger patients; the duration of PMD may be important. Those who have never used tobacco seem at greater risk than smokers. OSCC is more likely with PMD on the lateral and ventral tongue, floor of mouth and retromolar/soft palate complex than with those elsewhere. The vast majority of PMD in which OSCC develop are non‐homogenous although 5% of homogenous PMD will develop carcinoma. Large lesions covering several intraoral subsites also appear more at risk.
Oral epithelial dysplasia classification systems: predictive value, utility, weaknesses and scope for improvement
Authors: Warnakulasuriya S. , Reibel J. , Bouquot J. , Dabelsteen E.
Published: August 2010

At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Precancer in the United Kingdom issues related to potentially malignant disorders of the oral cavity were discussed by an expert group. The consensus views of the Working Group are presented in a series of papers. In this report, we review the oral epithelial dysplasia classification systems. The three classification schemes [oral epithelial dysplasia scoring system, squamous intraepithelial neoplasia and Ljubljana classification] were presented and the Working Group recommended epithelial dysplasia grading for routine use. Although most oral pathologists possibly recognize and accept the criteria for grading epithelial dysplasia, firstly based on architectural features and then of cytology, there is great variability in their interpretation of the presence, degree and significance of the individual criteria. Several studies have shown great interexaminer and intraexaminer variability in the assessment of the presence or absence and the grade of oral epithelial dysplasia. The Working Group considered the two class classification (no/questionable/ mild – low risk; moderate or severe – implying high risk) and was of the view that reducing the number of choices from 3 to 2 may increase the likelihood of agreement between pathologists. The utility of this need to be tested in future studies. The variables that are likely to affect oral epithelial dysplasia scoring were discussed and are outlined here; these need to be researched in longitudinal studies to explore the biological significance of a low‐risk or high‐risk dysplasia.
Perivascular myoid tumors of the oral region: a clinicopathologic re‐evaluation of 35 cases
Authors: Ide F. , Mishima K. , Yamada H. , Saito I. , Horie N. , Shimoyama T. , Kusama K.
Published: August 2010

Background:  Myopericytoma (MPC) is a generic denomination to describe tumors showing differentiation toward perivascular myoid cells /myopericytes. It has been suggested that MPC forms a morphologic continuum with glomus tumor (GT), solitary myofibroma (SMF), and angioleiomyoma (ALM). This proposed relationship has not yet been assessed in the oral region.

Methods:  We reviewed our 28‐year experience with 35 oral tumors, originally diagnosed as ALM (n = 28), SMF (n = 4), GT (n = 2), and MPC (n = 1) to analyze their overlapping microscopic features, with the assistance of immunohistochemistry.

Results:  Myopericytoma showed a wide range of growth patterns; concentric perivascular whorls, hemangiopericytomatous areas, glomangiopericytoma (GPC)‐type vessels and leiomyomatous foci. Intravascular growth was also seen. Among 28 cases studied, three ALM were reclassified as MPC (n = 2) and SMF (n = 1), based on the present diagnostic criteria. Additional MPC‐type components, at varying degrees, were similarly found in four ALM and three SMF, at least focally. One GT featured intravascular whorls of spindle cells. These four interrelated groups of tumors had in common GPC‐type vasculature and intraluminal cellular proliferation was nearly ubiquitously present. Diffuse immunoreactivity for α‐smooth muscle actin and less staining intensity of muscle‐specific actin were observed in all tumors. Only ALM displayed desmin positivity of variable extent. Neither case tested expressed CD34.

Conclusions:  Our data matches with the recent results in extraoral sites that MPC, GT, SMF, and ALM exhibit histologic and immunohistochemical overlap with each other. A common perivascular myoid differentiation between these tumor types is further reinforced by the present oral series.
Isolated gingival relapse of acute lymphoblastic leukemia after transplantation
Authors: Au Wing Y. , Wong Kai Y. , Leung Rock Y. Y. , Tong Antonio C. K.
Published: August 2010

A patient with a history of precursor B‐cell leukemia presented with an isolated ulcerating gum lesion 8 years after allogeneic stem cell transplantation with severe graft versus host disease. A biopsy revealed an undifferentiated malignant hemic lesion. Examinations of the peripheral blood and marrow were normal. Molecular studies confirmed clonal relationship between the gum lesion with the original marrow disease, despite the anatomical, histological and chronological separations.
High interstitial fluid pressure in rat tongue cancer is related to increased lymph vessel area, tumor size, invasiveness and decreased body weight
Authors: Raju Bina , Haug Sivakami Rethnam , Ibrahim Salah Osman , Heyeraas Karin Johanne
Published: August 2010

Background:  Interstitial fluid pressure (IFP) in most tumors is high, and this high pressure has been correlated with poor prognosis. Measurements of IFP in normal tongue and in tongue cancer are lacking. Recent research suggests the existence of a relationship between increased peritumoral lymph vessels (PTLV) and survival, and a correlation of increased lymphatic vessel density with an unfavorable prognosis has been reported.

Materials and methods:  In the present study, tongue squamous cell carcinoma (SCC) was induced by adding the carcinogen 4‐nitroquinoline oxide in drinking water for 19 weeks. The IFP was measured by micropuncture and immunohistochemistry was used to visualize lymph vessels.

Results:  In normal tongue, IFP averaged 3.1 ± 0.3 mmHg. The IFP, both in the tumor (29.1 ± 2.9 mmHg) and 0.5 cm anterior to it (15.4 ± 2.1 mmHg) was consistently increased (P < 0.005) with values ranging from 10 to 40 mmHg. The highest IFP values were measured in rats with large tumors (P < 0.05) and low body weight (P < 0.001), suggesting that IFP increases with cancer progression. Lymphatic vessel area (%), as determined with the lymphatic specific marker LYVE‐1 antibody, was significantly increased in the peritumoral area when compared to intratumoral and control mucosa (P < 0.05). There was a significant positive correlation between IFP, PTLV area, tumor size and invasiveness.

Conclusions:  Our data show that IFP is increased in tongue cancer. Corresponding changes in PTLV area, invasiveness, tumor area and IFP suggest that the increased pressure is caused by defective lymph drainage and solid stress generated by tumor cells growing in a low compliant environment.