Malignant schwannoma of the gingiva.

A case of malignant schwannoma on the buccal-attached gingiva in the right mandible is described. There was no evidence of multiple neurofibromatosis and the tumor was totally excised. Numerous closely-packed spindle-shaped cells showing marked mitotic activity were seen. The recognizable pattern of neurilemmoma could be observed focally in a small area of the tumor. At two years follow-up, the patient has remained symptom-free with no signs of metastasis.

Oral pathology in children. Frequency, distribution and clinical significance.

A statistical study of 1289 biopsies of children 0-15 years old, received at the Pathology Department, Dental Faculty, Buenos Aires University is presented. This number, represents 6.8% of the 18,966 biopsies received from 1960 to 1985. The histologic diagnosis were grouped into the following categories: 1) cysts, 2) tumour-like lesions, 3) inflammatory lesions, 4) neoplasms, 5) neck and head non-oral lesions, 6) dental anomalies and pulp diseases, 7) unclassified diagnosis. Cysts were the most frequent lesion (25.4%). 75% were localized in the jaws and 25% in soft tissue. Bone tumour-like lesions (20.1%) were less frequent than the soft tissue tumour-like lesions (79.9%). Inflammatory lesions and neoplasms in children, account for 15.7% and 10.2% of the lesions respectively. Eighty four percent of the neoplasms were benign and 16% were malignant. Odontogenic tumours constituted 49.6% of all the neoplasms studied. These results indicate the need to be constantly aware of the possible presence of these clinical and radiographic lesions to allow for early diagnosis and adequate treatment.

Verrucous carcinoma, hyperplasia and leukoplakia of the oral mucosa: a clinico-histopathological and histometric study.

Thirteen cases of verrucous leucoplakia (VL), 3 of verrucous hyperplasia (VH) and 19 of verrucous carcinoma (VC) were evaluated by means of 4 clinical features, 12 microscopic parameters and 6 epithelial histometric measurements. No significant clinical differences were detected, but histologic data showed that orthokeratinization was more frequent in VL and VH, while parakeratinization proved more common in VC. Sharp epithelial projections predominated in all three lesion types, though lymphoplasmatic infiltration and Russell bodies were more frequent in VH. Histometrically, there were statistical differences between VL or VH vs VC in three parameters, namely connective tissue-epithelial interface (Ice), epithelial height (He) and connective tissue-epithelial interface plus verrucous epithelial surface (Ice + Sve). To conclude, in this series, VH failed to exhibit significant clinical or histologic differences vs VL or VC, but histometric analysis was able to detect epithelial differences between both premalignant lesions and VC.

Comparative study of keratocysts, associated and non-associated with nevoid basal cell carcinoma syndrome.

Keratocysts of the solitary type were histologically and histometrically compared with those associated with the nevoid basal cell carcinoma syndrome (NBS). It was observed that parakeratinization, intramural epithelial remnants and satellite cysts were a more frequent finding among NBS keratocysts than among solitary keratocysts. Conversely, it was also found that the total nuclear density was greater in non-associated cysts and that the total number of nuclei, the number of basal nuclei and the epithelial height values were also higher in solitary keratocysts. NBS-keratocysts and solitary keratocysts are considered to be two morphologically distinct populations of the same entity.

Silver accumulations in periapical granulomas: report of five cases using the scanning electron microscope, the electron microprobe, and other complementary methods.

A series of cytologic imprints obtained from periapical granulomas were studied with the conventional light microscope, the scanning electron microscope, and the electron microprobe to analyze the chemical composition of several black deposits that were randomly observed near or in the cytoplasm of macrophages and multinucleated giant cells. These granulomas had been removed from endodontically treated human teeth in which the root canals had been obturated with silver cones and Grossman's sealer 3 to 5 years previously. To investigate whether corrosion had occurred on the silver cones, the cones were also examined with the scanning electron microscope and the electron microprobe. Our observations revealed that all the examined silver cones showed different degrees of corrosion on their surfaces, whereas different concentrations of silver, sulfur, and chlorine were detected at the same sites in the cytologic imprints. However, it is impossible to determine from this study whether the presence of corrosive by-products in the periapical tissues is responsible for the development of a pathologic reaction at these sites.

Tissue response to a glass ionomer used as an endodontic cement. A preliminary study in dogs.

A glass ionomer and a standard zinc phosphate were compared with respect to their biocompatibility as endodontic cements. The tissue response was assessed by implantation of both materials in dog tibias. In general, the glass ionomer appeared to provoke a slightly lesser inflammatory response than the zinc phosphate, but this was significant only at the 10- and 30-day observations. At the end of 90 days the tissue response to the tested materials appeared to be similar and the inflammatory picture tended to be resolved with progressive new bone formation. These findings suggest that the tested glass ionomer might adequately replace the zinc phosphate cement as a luting material for endodontic implant stabilizers.

Ameloblastoma in childhood.

Clinical, radiologic, and histologic studies were performed in eight cases of ameloblastoma in patients younger than 16 years of age. The mean age of the patients was 10.8 years, equal numbers of males and females were affected, and the most common location was the lower molar and ramus areas. Radiologically, a monocystic osteolytic image was observed in all cases. Histologically, two forms of growth were observed: an intramural, infiltrating, plexiform or follicular type, and a polypoid type, prolapsing toward the lumen of a cystic cavity. The ameloblastomas recurred in three cases a year after surgery.

[Oral manifestations in AIDS or HIV infection. Bibliographic update]. / Manifestaciones bucales en el SIDA o en la infeccion por VIH.

AIDS is a systemic infection that in many steps of its evolution presents various oral lesions and clinical conditions. This fact raises a problem for the dentist who are working on heterogeneous populations of healthy and infected people as well as on AIDS patients: to receive a continuous update about the disease. Apart from the risks of exposure inherent to his personal relation with HIV-infected or AIDS patients, the dentist is one of the health careworkers who must and ought recognize the oral signs of the disease when they appear in the mouth. For this reason this paper describes recent data on oral findings in AIDS: fungal, viral and bacterial infections, neoplasms and other manifestations of unknown or rare etiology. The most precocious clinical or pathological characteristics of these oral diseases suggesting HIV-infection or its results, are also stressed when described. Some doubts are possessed here about the meaning of outstanding oral AIDS lesions as "hairy leukoplakia". On the other way diagnostic methods which can help to recognize this lesion are also commented.

[Histomorphometry of dentigerous cysts in children, associated or not with formocresol]. / Histomorfometria de quistes dentigeros en ninos, asociados o no con formocresol.

Literature reports appeared in the last years suggested that some type of dentigerous cyst (DC) in children would initiate by teh action of other factors than developmental and at different stages of dental sac growth. Periodontitis and pulp therapy with formocresol (FC) have been suggested as aeteological factors, both promoting DC in children by irritation of the underlaying dental sacs of premolar. The purpose of this study is to analyse the pathological changes in DC of patients aged 0 to 15 years, and to compare the findings according to the anatomical site of DC and the existence of previous FC therapy. Morphological changes observed in the epithelium and the connective wall did not show clear differences between both groups of DC. The histometric measurements of epithelial changes did not show significant statistical differences of various parameters in the DC walls. These facts would not support the hypotesis of DC initiation from FC effects.

Desmoplastic and non-desmoplastic ameloblastoma: a comparative clinicopathological analysis.

OBJECTIVES: The aim of this study was to review a large series of ameloblastomas, accessioned during a period of 35 years in a single Oral Pathology Diagnostic Center, for the incidence of desmoplastic ameloblastoma (DA) and in order to analyze the clinical features of this unusual variant. MATERIALS AND METHODS: All cases diagnosed as ameloblastoma were reviewed and 14 were rediagnosed as DA. These cases were analyzed in terms of gender, patient age, location, clinical diagnosis, radiographic features and recurrence following treatment. Data from DA and non-desmoplastic ameloblastoma (NDA) were compared. RESULTS: The incidence of DA in this series was 8.8%. The mean age of NDA and DA were 39.1 and 38.8 years respectively, and a higher female prevalence was observed in the latter. The mandible was the most affected bone in both groups of tumors, but with a different regional distribution. Most NDA arose in the angle and ramus of the mandible, but the premolar/molar region was the preferential location for DA. The most common radiographic feature in DA was the osteolytic type, either monolocular or multilocular. Most of these cases were clinically diagnosed as ameloblastoma. According to follow-up data available, 21.4% of DA and 10.1% of NDA recurred. CONCLUSIONS: The results of this study do not support the hypothesis that DA should be a separate clinicopathological entity. It seems most likely that DA is another histologic variant of ameloblastoma.

Myxoma in childhood: an analysis of 10 cases.

PURPOSE: The object of this study was to present a series of myxoma in children and to evaluate possible differences between young and adults patients. MATERIALS AND METHODS: All tumors of patients under 16 years of age (10 cases), were separated from the 80 myxomas found in the Oral Pathology Laboratory, Faculty of Odontology, Buenos Aires University, and were analyzed in terms of clinical data, radiographic image, histopathology, treatment, and evolution. RESULTS: Myxoma in childhood represented 12.5% of the 80 cases in our series. The mean age was 11.6 years. Six patients were boys and four were girls. Both jaws were affected equally, predominantly in the premolar-molar region. Eighty percent of the tumors were larger than 2 cm. Only one case was clinically diagnosed as myxoma. Radiologically the most frequent image was unilocular with cortical expansion and tooth displacement. Histologically seven cases were diagnosed as myxoma and three as fibromyxoma. Treatment involved surgical resection in most cases. Two patients showed recurrence within the first year after surgery. CONCLUSIONS: The frequency of myxoma in childhood may be higher than that of other aggressive odontogenic tumors, although some literature refers to this tumor as very uncommon in children. Clinically this tumor may not always be taken into account in the differential diagnosis of intraosseous radiolucencies in young patients. The histologic appearance is similar in young and adult patients, but myxoma in children may be larger. It was not possible to correlate the histologic type of myxoma and the age of the patients.

The formocresol technique in young permanent teeth. A histopathologic study.

Twenty-six extractions were performed at random among seventy-six young, permanent teeth, treated by the formocresol technique, between 5 and 20 months after treatment: twenty-one with penetrating caries (nine vital and twelve nonvital) and five healthy. As a control group, thirteen permanent teeth with penetrating caries were removed: seven vital and six nonvital. The histopathologic analysis compared pretreatment and posttreatment radiographic examinations. In the control cases, there was almost always inflammation and/or necrosis in the entire root canal. In the experimental cases, fibrosis and osteodentin predominated in the apical third, diminishing gradually near the cervical third. Inflammation and necrosis, very low in the apical third, increased similarly near the cervical third. This response seems to be a stage in a process of evolution in biologic scar healing. The complete cure must require a greater lapse of time than that of this experiment--around 10 to 12 months.

Myxoma of the mandible with unusual radiographic appearance.

Myxoma of the jaws is a fairly frequent bone tumor classified as a benign odontogenic neoplasm. The radiographic picture varies according to its evolution and, it many cases, diagnosis is not easy. A new case with an unusual radiographic appearance is reported. On occlusal radiographic examination the tumor showed multiple spicules of bone with a classic "sun-ray" effect. Only two similar cases were found in the literature. Oral and maxillofacial surgeons should be aware of this unusual presentation so that a misdiagnosis of malignant bone tumor is not made.

Immunocytochemical detection of carcinoembryonic antigen in salivary gland tumors.

The immunoperoxidase method was applied for carcinoembryonic antigen (CEA) detection in biopsy specimens of salivary gland tumors. 9 out of 10 adenoidcystic carcinomas revealed a strong and abundant reaction in tumoral glands. 10 other specimens of pleomorphic adenomas showed weak staining in the areas of epithelial proliferation. Normal glands adjacent to the tumor mass revealed a weak but constant reaction on the luminal border. As in other types of gland tumor, the quantitative estimation of CEA production by salivary gland tumors may be useful in the monitoring of recurrencies.

[Frequency and distribution of oral lesions in elderly patients]. / Frecuencia y distribución de las lesiones orales en pacientes de la tercera edad.

In this study the relative frequency of oral lesions was evaluated in a group of 526 patients, 55 years old or elder. Clinical and pathological data were obtained from 244 patients who attended to a clinic of Medical and Social Assistance Program (PAMI) ad from 282 cases registered in the files of the Surgical Pathology Laboratory F.O.U.B.A. (LAP) since 1984 to 1986. The mean age of the groups was 63 years old. The most frequency lesions were the pseudotumors (44.6%) in LAP and (17.2%) in PAMI; premalignant lesions were (20.5%) in LAP, while in PAMI (2.4%). The cysts in LAP found (15.6%) in PAMI were (2.4%). The groups of PAMI showed (90%) of Candidiasis. Traumatic ulcer (30.7%) and afthae (28.8%). In LAP were (4.6%) the traumatic ulcer. The malignant tumors the most frequency was carcinoma espinocelular (8.16%) LAP and (6.56%) PAMI. It was remarkable that stomatodine as represented in PAMI (72.2%) and Candidiasis were (90%). Candidiasis were 90% of the specific inflammations. Results suggest that oral mobility in elderly patients correlates with the findings in this type of social assisted groups. The figures of the importance of methodical collaboration of Stomatologists and Oral Pathologists for differential diagnosis.

Focal epithelial hyperplasia. Report of five new cases from Argentina.

Five cases of focal epithelial hyperplasia in Argentina from 1968 to 1974 are reported. There was an age range from 11 to 27 years, with an average of 18 years. Three of the patients were born in Jujuy in the northwest corner of the country. Two of these cases were observed in an epidemiologic study carried out among 8,895 20-year-old Argentine men from different areas.