Oral leiomyomatous hamartoma: presentation of 3 cases and review of the literature.

Oral leiomyomatous hamartoma (OLH) is a rare lesion, with only 40 cases reported in the literature. It typically presents early in life as a nodule on the anterior maxillary alveolar tissues or the tongue. Its growth potential is limited, with few cases reaching dimensions >2.0 cm, and its microscopic composition includes an intact surface mucosa with an underlying fibrovascular stroma possessing an unencapsulated proliferation of smooth muscle fascicles. Excision is considered the definitive treatment. Here we describe the clinical, microscopic, histochemical, and immunohistochemical features and management of 3 cases of OLH and review the literature. The findings we present here can assist in performing differential diagnosis, particularly in discriminating between OLH and similar yet non-hamartomatous processes and in selecting appropriate management.

Point-of-care oral cytology tool for the screening and assessment of potentially malignant oral lesions.

BACKGROUND: The effective detection and monitoring of potentially malignant oral lesions (PMOL) are critical to identifying early-stage cancer and improving outcomes. In the current study, the authors described cytopathology tools, including machine learning algorithms, clinical algorithms, and test reports developed to assist pathologists and clinicians with PMOL evaluation. METHODS: Data were acquired from a multisite clinical validation study of 999 subjects with PMOLs and oral squamous cell carcinoma (OSCC) using a cytology-on-a-chip approach. A machine learning model was trained to recognize and quantify the distributions of 4 cell phenotypes. A least absolute shrinkage and selection operator (lasso) logistic regression model was trained to distinguish PMOLs and cancer across a spectrum of histopathologic diagnoses ranging from benign, to increasing grades of oral epithelial dysplasia (OED), to OSCC using demographics, lesion characteristics, and cell phenotypes. Cytopathology software was developed to assist pathologists in reviewing brush cytology test results, including high-content cell analyses, data visualization tools, and results reporting. RESULTS: Cell phenotypes were determined accurately through an automated cytological assay and machine learning approach (99.3% accuracy). Significant differences in cell phenotype distributions across diagnostic categories were found in 3 phenotypes (type 1 ["mature squamous"], type 2 ["small round"], and type 3 ["leukocytes"]). The clinical algorithms resulted in acceptable performance characteristics (area under the curve of 0.81 for benign vs mild dysplasia and 0.95 for benign vs malignancy). CONCLUSIONS: These new cytopathology tools represent a practical solution for rapid PMOL assessment, with the potential to facilitate screening and longitudinal monitoring in primary, secondary, and tertiary clinical care settings.

Generation of intra-oral-like images from cone beam computed tomography volumes for dental forensic image comparison.

UNLABELLED: Identification of unknown individuals using dental comparison is well established in the forensic setting. The identification technique can be time and resource consuming if many individuals need to be identified at once. Medical CT (MDCT) for dental profiling has had limited success, mostly due to artifact from metal-containing dental restorations and implants. DESCRIPTION: The authors describe a CBCT reformatting technique that creates images, which closely approximate conventional dental images. METHOD: Using a i-CAT Platinum CBCT unit and standard issue i-CAT Vision software, a protocol is developed to reproducibly and reliably reformat CBCT volumes. The reformatted images are presented with conventional digital images from the same anatomic area for comparison. CONCLUSION: The authors conclude that images derived from CBCT volumes following this protocol are similar enough to conventional dental radiographs to allow for dental forensic comparison/identification and that CBCT offers a superior option over MDCT for this purpose.

Isolation of Staphylococcus aureus from environmental surfaces in an academic dental clinic.

BACKGROUND: Staphylococcus aureus is an important health care-associated pathogen that often is resistant to antibiotics. The authors conducted a pilot study to determine if abiotic surfaces in a dental clinic were contaminated frequently. METHODS: The authors sampled surfaces with swabs that they then used to inoculate selective and differential media. CHRO-Magar Staph aureus (DRG International, Mountainside, N.J.) was the most effective. They used phenotypic and genotypic tests to identify presumptive S. aureus colonies. They determined the sensitivity of S. aureus isolates to five antibiotics, including oxacillin, according to the Kirby-Bauer method. RESULTS: The authors recovered S. aureus from 20 of 429 surfaces (4.7 percent). Most isolates were resistant to penicillin but none were resistant to the other antibiotics. No isolate carried the mecA gene encoding resistance to methicillin. The authors considered one site to be highly contaminated (> 200 colony-forming units [CFUs]), but all other sites that tested positive yielded fewer than 5 CFUs. CONCLUSIONS: Abiotic surfaces in the authors' dental clinic were not a reservoir for methicillin-resistant S. aureus. The authors identified and eliminated one nonclinical site of potential methicillin-sensitive S. aureus cross-contamination. CLINICAL IMPLICATIONS: Periodic sampling of surfaces for S. aureus may be a useful adjunct to standard infection control practices in dental health care settings.