Oral Surgery Oral Medicine Oral Pathology

Published by Elsevier
Online ISSN: 0030-4220
Publications
Article
Because of their chronic nature treatment of oral vesiculoerosive diseases remains a challenge to the oral medicine specialist. Even though oral vesiculoerosive diseases respond well to systemic steroids, adverse side effects sometimes limit their use. Potent topical steroids are becoming increasingly useful to treat these chronic conditions with good control. The purpose of this double-blind clinical trial was to compare clobetasol propionate and fluocinonide ointment in orabase as treatments for controlling oral vesiculoerosive diseases. Sixty patients were asked to participate (43 women and 17 men). Data are reported for 55 patients. Each patient was seen at baseline and at days 7, 14, 21, and 28. Variables evaluated were pain, erythema, atrophy, and size of lesion. Overall, both medications had a beneficial effect in the control of symptoms and signs of oral vesiculoerosive diseases with minimal side effects. Clobetasol propionate was better than fluocinonide as measured by more rapid control of pain (within 7 days). Candidiasis was observed in 13 patients at the end of treatment (most of them carriers of Candida). Therefore normal carriers should be identified and treatment with antifungal therapy instituted before the patient begins using topical steroids.
 
Article
A double-blind study evaluated the ability of 0.12% chlorhexidine rinse to decrease the incidence of localized alveolar osteitis after the removal of mandibular third molar teeth. One hundred sixty extraction sites in 80 patients were evaluated. A statistically significant decrease in the incidence of dry socket was seen in patients using the chlorhexidine rinse with no significant adverse reactions. Thus a 0.12% chlorhexidine rinse is shown to be an effective means of decreasing alveolar osteitis that may follow removal of third molar teeth.
 
Article
The antibacterial effect of 0.5 percent sodium hypochlorite solution as root canal irrigant was studied in fifteen single-rooted teeth. Each tooth was treated at five appointments, and the presence of bacteria in the root canal was studied on each occasion. No antibacterial intracanal dressings were used between the appointments. When 0.5 percent hypochlorite was used no bacteria could be recovered from twelve of fifteen root canals at the fifth appointment. This should be compared with eight of fifteen root canals when saline solution was used as irrigant. These results suggest that 0.5 percent sodium hypochlorite solution is more effective than saline solution as a root canal irrigant.
 
Article
In this clinical study at the University of Texas M. D. Anderson Cancer Center, unstimulated and stimulated salivary flow rates were obtained from 47 patients with head and neck cancer who had received mantle, unilateral facial, or bilateral facial field radiotherapy from 0.5 to 25 years earlier. The magnitude of salivary flow rate reduction compared with a healthy control group was primarily related to the radiation dosage and the amount of salivary gland tissue included in the irradiated fields. Flow rates were lower for women in all groups, but these differences were not statistically significant.
 
Article
The effects of removal of the submandibular gland (sialoadenectomy) and administration of human urinary epidermal growth factor on the 9,10-dimethyl-1,2-benzanthracene-induced tumor formation were investigated with the use of a hamster cheek pouch model. Syrian hamsters were treated with 0.5% 9,10-dimethyl-1,2-benzanthracene for 6 weeks. Thereafter hamsters in group 1 underwent a sham operation and those in groups 2 and 3 underwent a sialoadenectomy. Subsequently, hamsters in groups 1 and 2 were given 0.9% sodium chloride and group 3 received the human urinary epidermal growth factor at a dose of 0.25 mg/kg body weight subcutaneously three times a week for 8 weeks. Sixteen weeks after the start of the experiment, the mean number of tumors that were less than 3-mm in diameter in groups 1 and 3 was significantly greater than that in group 2 (p < 0.05). The overall incidence and mean number of all carcinomas irrespective of size showed no differences among the experimental groups. These results indicate that epidermal growth factor synthesized in the submandibular gland may enhance the induction of cheek pouch tumor.
 
Article
A survey of 1,447 Nigerian patients with fractures of the facial skeleton is presented. The frequency and etiology of the fractures are described. Patients mainly affected were in the third decade of life. The male:female ratio is strikingly high, and the site distributions of the fractures are recorded and compared with those of other series. The cause of delay in reporting for treatment is examined, and the subsequent sequalae are outlined. Life-endangering injuries occurred in association with facial fractures. The necessity for teamwork between surgical specialists is emphasized. All fractures were treated by simple methods of fixation.
 
Article
Previous studies have shown magnetic resonance imaging to be potentially teratogenic for eye development. An investigation was undertaken to ascertain the effects of 1.5 Tesla magnetic resonance imaging fields on crown-rump length and craniofacial perimeter, two less sensitive teratologic end points of the C57BL/6J mouse. A sham control and two experimental groups of dams (N = 12, 11, 12) placed in different magnet locations were exposed to magnetic resonance imaging fields under clinically realistic conditions. A T-2 weighted spin-echo technique of 36-minutes duration was used on each dam. Crown-rump length was chosen because it is a standard measure of embryotoxicity. Craniofacial perimeter was evaluated because of its relationship to the anterior neural plate, the same region in the developing embryo that gives rise to the eyes. Magnetic resonance imaging fields were found to produce crown-rump and craniofacial perimeter measures smaller than control animals (p < 0.05) when exposed at the isocenter (p = 0.038 and 0.008 respectively). Groups exposed to magnetic resonance imaging fields at the magnet entrance showed p values of 0.004 and 0.053 respectively. The results confirmed magnetic resonance imaging teratogenicity in the C57BL/6J mouse and demonstrates the need for further experimental investigation to ascertain the clinical safety of magnetic resonance imaging for humans.
 
Article
Etiology, predisposing factors, clinical features, and prophylactic measures for hemorrhage after oral surgery are discussed on the basis of a review of the literature and an evaluation of 103 cases. In the material studied, in which the largest number of patients were from 16 to 30 years of age, there were strikingly more male patients than female patients. A predominant site of bleeding was the lower third molar region; after periodontal surgery, however, hemorrhages from maxillary regions were more frequent than those of mandibular origin. A statistically significant high frequency of earlier postsurgical bleeding episodes suggests that certain oral surgery patients do have a tendency to postoperative hemorrhage without displaying hematologic values characteristic of any known hemorrhagic diathesis. In the remaining cases, the bleeding was believed to be of local origin, a high frequency of occurrence of mucosal lacerations calling for special attention. Therapeutically, the techniques described yielded a stable hemostasis in at least 84 per cent of the cases.
 
Article
A series of 105 cases of melanotic macule of the oral mucosa is analyzed, both clinically and histologically. In most patients the melanotic macule was a solitary lesion, and the most common location was the vermilion border, followed by the gingiva. Histologically, the melanotic macule is characterized by increased pigmentation in either the basal-cell layer, the lamina propria (mainly within melanophages), or in both locations. It is suggested that the term melanotic macule be reserved for lesions in which there is a definite clinicopathologic correlation between a clinically pigmented macule and the aforementioned histologic features and that the term focal melanosis be used only as a histologic designation when these features appear in clinically nonpigmented pathologic conditions.
 
Article
Review and analysis of data of seventy-five cases from the literature, together with an additional thirty-two new cases, revealed that nevi of the oral mucosa are not rare and may be more common than previously thought. Nevi of the intramucosal type are the most common, followed by the common blue nevus. Compound nevi are uncommon, and junctional nevi are very rare. The data are analyzed as to the location, presence of clinical pigmentation, configuration, size, and duration of the nevi, as well as the patient's age, sex, and race. Oral nevi (especially those that are clinically nonpigmented) are often misdiagnosed, indicating that they are far more common than they would seem from the reported cases. The potential for oral nevi to undergo malignant transformation is unclear because of the paucity of cases and limited follow-up. Nevertheless, we recommend that all oral pigmented nevi be removed.
 
Article
The dense bone island is an asymptomatic radiopacity of unknown origin and is known under many synonyms when it occurs in the jaw. This article discusses 113 dense bone islands in 107 patients with a review of the literature and comparison with previous reports. The average age of the patient at discovery was 36 years with a women to men ratio of 2:1. The mandible was involved in 109 of the 113 DBIs, with only 4 in the maxilla. The most common site affected was the mandibular first molar region, the premolar region was the second most common site affected. Resorption occurred in 11 (9.7%) cases, the first permanent molar was the most commonly affected.
 
Article
A study has been carried out in order to examine the correlation between the clinical diagnosis of the affected dental pulp and its corresponding histologic appearance. One hundred nine affected pulps from permanent teeth were extirpated after their clinical state was assessed. They were evaluated histologically, and the results were compared. Absolute correlation was found in 49.5 per cent of the cases, while 46.7 per cent showed only a partial correlation.
 
Article
Forty male hamsters were divided into three groups. Group 1 (16 animals) received topical applications with a 0.5% solution of DMBA in liquid paraffin on the right buccal pouch for 16 weeks. Group 2 (16 animals) received DMBA for 16 weeks, plus the retinoid RO-109359 three times during the 17th week in doses of 200 mg/kg. Group 3 (8 animals) remained untreated for 16 weeks and, during the 17th week, received the retinoid as in group 2. After administration of the retinoid, a marked regression in the size of the carcinomas of the right pouch in group 2 animals was observed clinically. Histologically, these tumors consisted mostly of large necrotic areas and showed an excessive keratin loss. Although the hypervitaminosis A symptoms could not be avoided, the findings suggest that high doses have a therapeutic effect on hamster buccal pouch carcinomas.
 
Article
Diffuse sclerosing osteomyelitis of the mandible is a disease that is characterized by a protracted course of recurrent pain, swelling of the cheek, and trismus. The cause of the lesion has been obscure for a long period of time. Recent research, however, pointed out that this disease is likely to be caused by overuse of the jaw musculature (chronic tendoperiostitis) and can be treated accordingly. The protracted course of the disease and the difficulty of treatment with an eventual positive outcome are illustrated by a case report of a 65-year-old man with an 11-year history of diffuse sclerosing osteomyelitis (chronic tendoperiostitis) of the mandible.
 
Article
The following case report describes the development of a lingual mandibular bone cavity in a child. Previous cases of these cystlike mandibular defects have been, to the best of my knowledge, all observed in adults. Some of the literature and the different etiologies are reviewed. In this case report the first examination showed normal bone pattern in the mandible, and it was then possible to follow the development of the mandibular bone cavity for about 5 years. During this period the defect expanded until it reached what seems to be a mature stage. The radiographic technique used included lateral, occlusal, and posteroanterior projections.
 
Article
Eleven HIV-positive patients with chronic oral candidiasis were supplemented with 60 to 120 mg of beta-carotene daily for 3 to 7 months. Lymphocyte profiles were evaluated at intervals to help assess immune competence. Although there was a modest increase in some lymphocyte values at 2 months, there was a significant decrease in numbers of CD4 and CD8 cells and CD4 percentage of lymphocytes after 6 months of beta-carotene supplementation. Serum triglyceride and liver enzyme levels were not affected by the beta-carotene supplementation. No improvement was observed in the control of the oral candidiasis. Under the conditions of the study, there was no indication that daily beta-carotene supplements enhanced immune competence or was of benefit in managing oral candidiasis.
 
Article
A series of 110 oral papillomas is reviewed in order to ascertain incidence pertinent to age, sex, site, and recurrence. The tumors are found to occur most often in adults with an average age of 38 years. The tongue is the most frequent location, and females are affected slightly more often than males. Dyskeratosis is used as a barometer of premalignant change in the histologic evaluation of the lesions and is found to be conspicuously absent in all cases. These lesions seldom recur if properly excised.
 
Article
As other studies have suggested, the odontogenic adenomatoid tumor is predominately a tumor of young persons under the age of 20 years.There is a marked female preference (7:4), as well as a marked maxillary preference (4.5:2.5).Fully 76 per cent of these lesions occur in the anterior regions of the jaws, and 74 per cent are associated with an unerupted tooth—most commonly a cuspid (68 per cent).It has been shown that the odontogenic adenomatoid tumor has, on occasion, an inductive effect upon the connective tissue and cannot continue to be considered a pure epithelial tumor.A significant number of cases with long-term follow-up has been presented which, in our opinion, offers sufficient support for the widely held concept that the odontogenic adenomatoid tumor is a benign lesion that does not recur after conservative removal.
 
Article
A review of the world literature has revealed 113 cases of the calcifying epithelial odontogenic tumor. The clinical, radiographic, and histopathologic features are analyzed. Various treatments that have been carried out are related to the frequency of recurrence. The theories of histogenesis are discussed and an attempt is made to explain the nature and origin of the amyloid-like substance.
 
Article
In Japan 114 cases of osteosarcoma of the maxillofacial region have been reported during the past 60 years. The average age at the onset of the disease in this region was about one or two decades later than that of osteosarcoma of other regions. Females were affected more frequently (59.6%) than males (40.4%). The mandible was more frequently affected (58.8%) than the maxilla (41.2%). Swelling was the conspicuous symptom for osteosarcoma of the maxillofacial region. Most patients received surgical treatment with or without radiation and chemotherapy; however, the prognosis is poor, regardless of the type of treatment.
 
Article
A review of 1,120 cases of histiocytosis X yielded 114 cases with oral involvement. Seventy-eight percent of the oral lesions in this series were categorized as monostotic or polyostotic eosinophilic granuloma. The great majority of cases occurred in males, with 40 percent of the lesions having developed before the patient had reached the age of 10 years. The mandible was involved in 73 percent of the cases, and the posterior jaw region was the predominant site. Extraoral involvement occurred in 70 percent, with the most common sites being the skull and lower extremity. The preferred treatment for oral lesions was surgical curettage, and the prognosis was generally very favorable, as evidenced by the over-all recurrence rate of 16 percent.
 
Article
A clinical examination of 115 cases of oral lichen planus has been presented. The observation period varied from 1 month to 10 years, with an average of2½ years. Six clinical types of lesion in oral lichen planus were recognized: (1) reticular, (2) papular, (3) plaque, (4) atrophic, (5) ulcerative or erosive, and (6) bullous lesions.Skin lesions were present in fifty-one cases (44 per cent). In the present study twenty-six patients (23 per cent) showed spontaneous healing during the observation period. The reticular type of lesion had a favorable course, while the ulcerative pattern showed no sign of healing in the observation period. Dental factors aggravating the oral lesions were seen in nine cases (8 per cent). No case of malignant change was found.
 
Article
The histopathologic features of 116 ameloblastomas were reviewed with special reference to the incidence of the recently described desmoplastic variant. The series included 110 intraosseous lesions and 6 extraosseous ameloblastomas. Ninety-six (88%) of the intraosseous tumors were found in the mandible, and 61% involved the molar-ascending ramus area. Fourteen examples of the desmoplastic variant were identified, representing 13% of the intraosseous tumors. The lesions showed distinctive histologic features characterized by an extensive collagenized stroma containing small islands of tumor epithelium with scant tendency to form cystic structures. This histologic variant has a marked tendency to involve the anterior portions of the jaws with 7 of the 14 examples being located in the maxilla. These desmoplastic lesions also showed unusual radiographic findings, often more suggestive of a benign fibro-osseous lesion than of ameloblastoma.
 
Article
In order to determine whether 13-cis-retinoic acid, an analog of vitamin A, has antitumor activity in an oral cancer model system, the following study was undertaken. Fifty-three adult hamsters were divided into four groups. Group 1 was tested with a 0.5 percent solution of 9,10-dimethyl-1,2-benzanthracene (DMBA) in heavy mineral oil, which was painted on the right buccal pouch three times per week for 12 weeks. Group 2 received DMBA plus 13-cis-retinoic acid (RA) incorporated into gelatinized beadlets and mixed with a powdered commercial diet (dosage, 300 mg per kilogram of diet). Group 3 received only RA; Group 4 received a placebo. The animals were killed at 6, 12, and 18 weeks and tissues were studied clinically and histologically in a routine manner. Results show that all groups receiving DMBA developed epidermoid carcinomas. However, there were several other changes. In the RA-treated animals, particularly those treated with DMBA, there was an ingrowth of surface epithelium with development of ductal structures in the buccal pouch. There were changes in surface epithelium, and there were dense aggregates of lymphoid tissue with development of exophytic nodules suggestive of lymphoma. Animals fed RA showed a relative weight loss. The findings suggest that there was a hypervitaminosis A state yielding prominent epithelial metaplastic changes but not affecting the progression or production of carcinoma.
 
Article
An extremely rare case of numerous oral hairs in a 13-year-old boy with alopecia areata is presented. The hairs growing from gingival pockets were black in color, similar to the hair on the patient's scalp. Microscopic examination of hairs from the oral cavity and those from the scalp showed differences in their structure.
 
Article
Sixty-four male and female Syrian hamsters, 3 months of age and weighing 90 to 120 grams, were divided into four equal experimental groups. In animals of Groups 1 and 2 the left buccal pouch was painted three times weekly with a 0.5% solution of DMBA in heavy mineral oil. Group 2 animals also received 10 mg. of 13-cis-retinoic acid in peanut oil administered orally twice a week by pipette. Carcinogen retinoid were administered on alternate days. Group 3 animals served as controls, receiving only 13-cis-retinoic acid. Group 4 animals served as untreated controls. Four animals in each group (two males and two females) were killed at 10, 12, 14, and 16 weeks. The Group 2 animals, which received 13-cis-retinoic acid, exhibited a significant delay in DMBA carcinogenesis of buccal pouch mucosa, as studied both grossly and histologically. Both groups eventually demonstrated well-differentiated epidermoid carcinomas, but the tumors were smaller in the DMBA-retinoid animals.
 
Article
Salivary duct carcinoma is an uncommon and relatively unknown clinically aggressive adenocarcinoma of salivary origin that histologically demonstrates a remarkable resemblance to invasive carcinoma of the breast. We report the clinicopathologic features of 13 cases that were also examined by image analysis for DNA ploidy. The results were then analyzed collectively with the less than 100 cases of salivary duct carcinoma reported in the English-language literature to define the characteristics of this unusual neoplasm. The 12 men and one woman averaged 68 years of age (range, 49 to 90 years). All tumors arose in the parotid (10 cases) or submandibular glands (three cases). Nine tumors were aneuploid, three diploid, and one was indeterminate because of insufficient tissue. Follow-up (median, 24 months) was available in 12 cases: three patients died of disease, six were alive without disease, and three died of other causes. Combining our cases with those in the literature, a total of 104 cases, confirms that salivary duct carcinoma is a highly malignant neoplasm with distinctive clinical and pathologic features. It arises almost exclusively in the major salivary glands (96% of cases), is three times more common in men, and usually occurs in patients over 50 years of age (range, 22 to 91 years). One-third of patients experience local recurrences, 59% develop positive regional lymph nodes, 46% have systemic metastases (lungs and bones), and 65% die of their disease, usually within 4 years of diagnosis. Determination of tumor ploidy has no prognostic significance. The presence of distant metastasis was the only clinicopathologic feature that was statistically associated with prognosis (p = 0.02); all patients with systemic metastasis died of disease.
 
Article
A case of a mesiodens in the vault of the palate of a skull estimated to be approximately 13,000 years old is presented. The currently cited theories of tooth eruption were considered, and it was concluded that only the newly formulated BVT (blood vessel thrust) theory of tooth eruption can account for the migration of this mesiodens into that position.
 
Article
We retrospectively analyzed direct immunofluorescence (DIF) findings from 130 cases of oral mucosal disease. The diagnosis of each case was based on history, clinical features, histopathology, and clinical follow-up. To avoid circular reasoning, we did not use the DIF results in forming the diagnoses. Our results indicate that the presence of characteristic fluorescent patterns produced by several DIF reagents can establish the diagnosis of the oral lesions of pemphigus and pemphigoid and strongly indicate the diagnoses of lichen planus and lupus erythematosus. The absence of these fluorescent patterns can help to rule out these conditions, thereby strengthening the diagnoses of other oral mucosal diseases. The results of DIF are sufficiently distinguishing to be routinely helpful as diagnostic criteria for chronic ulcerative diseases of the oral mucosa.
 
Article
Clinical characteristics and treatment responses were studied in 130 patients with burning mouth syndrome (BMS). Most patients were postmenopausal women, and the tongue was the most frequently afflicted site. Although 39% of the patients complained of dry mouth, no causative factors were evident. Therefore BMS is assumed to be a functional disorder. This was at least partially confirmed because the most effective management was in response to mood-altering drugs. From our data BMS appears to be a chronic condition with variations in symptoms among patients and without a predictable endpoint.
 
Article
A study of blood loss measurements for the determination of blood loss during full-mouth extraction and alveoloplasty under general anesthesia in a group of twenty-one patients has been presented. A control group of seven patients was also studied. I131 serum albumin was utilized in carrying out the procedure. The blood loss ranged from 148 c.c. to 912 c.c., with a mean of 536.5 c.c. Classification of these operations by the results places them among the major surgical procedures. The average difference in the control group was within ±2 per cent.
 
Article
Dental management of persons with epidermolysis bullosa remains challenging because of the severe hard and soft tissue manifestations of these diseases. This study reviews the dental treatment of 14 cases requiring 24 general anesthetics. Twenty-three of the cases were managed with oral tracheal intubation to accomplish full-mouth dental rehabilitation. Dental therapy consisted of preventive, restorative, and surgical procedures, with extractions and stainless steel crowns being the most common treatment modalities. There were no serious postoperative complications, and no airway problems were experienced. Although extensive intraoral mucosal blistering did occur in several cases, postoperative healing progressed normally. Soft tissue trauma may be lessened through the use of small suction tips, flat tissue retractors, and extensive lubrication of all tissues requiring manipulation. This study provides further evidence that even the most severely affected patients with epidermolysis bullosa can receive comprehensive dental treatment directed at maintaining a functional dentition.
 
Article
A case of periapical osteofibrosis in a young person is presented, with emphasis on the importance of the radiologic features in the recognition of the condition.
 
Article
14C-Formocresol and 14C-glutaraldehyde were placed in the root canals of freshly extracted human teeth. The outward diffusion of labeled aldehydes was then measured and autoradiograms of cross-sections taken. No diffusion of glutaraldehyde was detectable within 72 hours, whereas there was a rapidly increasing outflow of formocresol during the same period. In a separate group normal root canal treatment was completed until 2 mm. short of the roentgenologic apex with glutaraldehyde as an irrigant. The walls of the root canals of some of the specimens were examined with electron microscopy and the outflow of 14C-formocresol which was later placed in some specimens was counted. The use of glutaraldehyde as an irrigant resulted in closure of the apical third of the root canal as indicated by the absence of 14C-formocresol diffusion.
 
Article
The distribution of [14C] leucine and 85Sr labeled tracer microspheres from rat incisor pulp canals was investigated in an effort to establish the potential for passage of substances from within the root canal to the systemic circulation. Following introduction of the tracer materials into the pulp canals, the radioactivity in the lungs, spleen, kidney, liver, heart, blood, skeletal muscle, adrenal glands, salivary glands, and submandibular lymph nodes was determined. At all of the time intervals studied the incorporation of [14C] leucine into the adrenal gland was significantly greater than the [14C] leucine incorporation into the other organs. High levels of 85Sr labeled microspheres were detected in the ipsilateral submandibular glands and submandibular lymph nodes and in the lungs.
 
Article
In surgical relief of impacted third molars, forty-seven bilaterally and fifty-six unilaterally affected patients were treated. Solutions of hyaluronidase and saline were compared to determine effects in reduction of trismus, pain, and swelling. Patients given hyaluronidase recovered from trismus in about one half the time required by controls.
 
Article
Pigmented nevi are uncommon oral lesions. This study adds data on 36 new cases. The most common type of nevus was the intramucosal type (20 cases), followed by the common blue nevus (11 cases). Only three cases were of the compound type and only two were of the junctional type. The hard palate was the most frequent location for the blue nevus, whereas the buccal mucosa was the most frequent site for the intramucosal nevus. One nevus (intramucosal type) was located on the tongue, and to our knowledge, this is the first reported example of pigmented nevus at this site. The individual data on the 36 cases are presented and compared with a previous study on oral nevi from the University of California at San Francisco. The previously unpublished clinical details on the 32 nevi from the previous study are also presented.
 
Article
Review and analysis of data on 191 cases of oral pigmented nevi from the literature and from two studies at the University of California, San Francisco, revealed that nevi of the intramucosal type are the most common, followed by the common blue nevus. Compound and junctional nevi are rare, and combined nevi are the rarest. The data on location, presence of clinical pigmentation, configuration, size, and duration of the nevi, as well as on the patient's age, sex, and race, are analyzed. Blue nevi were found mostly on the hard palate, whereas intramucosal nevi occurred on the buccal mucosa, on the gingiva, and on the lips as well as on the palate. Nonpigmented nevi were especially common (22%) in the intramucosal group. Most oral nevi are raised, which can be of help in the differential diagnosis. Oral nevi are small, most being between 0.1 and 0.6 cm at the largest dimension. Because the malignant potential of oral nevi is still uncertain and because preexisting macular pigmentation is present in about one third of all patients with oral melanoma, it is advisable to accurately diagnose all oral pigmented lesions, many of which will require microscopic examination.
 
Article
A gross morphologic anomaly affecting both the primary and secondary teeth of unknown cause is presented. A 5-year-old American Indian child exhibited macrodontia, extreme shovel-shaping, agenesis, three-rooted deciduous molars, dens invaginatus, and other less striking dental features. This case represents the earliest example of a variant of the Ekman-Westborg-Julin syndrome reported in the New World.
 
Article
DNA was extracted from fresh frozen tissues of eight patients with primary oral squamous carcinoma. Samples of normal oral mucosa were available in seven cases and metastatic tumor in two cases. The samples were probed for human papillomavirus types 16 and 18 by Southern hybridization. In one case of squamous carcinoma of the floor of the mouth, human papillomavirus type 16 was identified in the primary tumor and a lymph node metastasis, but it was not detectable in normal oral mucosa from this patient. Human papillomavirus DNA was not detected in any other sample of primary tumor, metastasis, or normal oral mucosa. Restriction enzyme digests of the human papillomavirus positive primary tumor and its metastasis revealed that the viral DNA was identical to the prototype human papillomavirus type 16 and present at 50 to 100 copies per cell in an episomal state with no evidence of integration into the host DNA. Compared to the human papillomavirus DNA in the primary tumor, the viral DNA in the metastasis was of the same type, in the same physical state, and at the approximately the same copy number. The consistent maintenance of human papillomavirus DNA in metastases from human papillomavirus positive primary tumors supports the hypothesis that human papillomaviruses are cofactors in the pathogenesis of some carcinomas.
 
Top-cited authors
Crispian Scully
  • University College London
Francina Lozada Nur
  • University of California, San Francisco
Joel B Epstein
  • Cedars-Sinai Medical Center
Ross Henry Tallents
  • University of Rochester
Doss Mcdavid
  • University of Texas Health Science Center at San Antonio