Histological evaluation of teeth with hyperplastic pulpitis caused by trauma or caries: case reports.

AIM: The purpose of this histological study was to examine teeth with hyperplastic pulpitis caused by trauma or caries. SUMMARY: The pulp tissue of one young permanent incisor with a complicated crown-root fracture and a hyperplastic pulpitis, which had been contaminated with oral microflora for 40 days, and pulp polyps from four permanent first molars whose crowns were destroyed by extensive caries were prepared for standard histological examination. Histologically, normal pulp tissue organization was observed in the tooth with a complicated crown-root fracture in the cervical radicular region. Irregular calcification was seen in the coronal and radicular portion of the pulp in the four carious teeth with pulp polyps. Radicular pulp tissue in the middle and apical third of root canals beneath irregular calcification showed intensive fibrosis but was free from inflammatory cells. KEY LEARNING POINTS: Hyperplastic pulpitis is a type of irreversible chronic open pulpitis. Young permanent teeth with hyperplastic pulpitis caused by trauma or caries have a great inherent defensive capacity to heal.

Primary osteosarcoma of the sphenoid bone with multiple recurrences: a case report and review of the literature.

In this paper a patient with primary osteosarcoma of the sphenoid bone, which recurred twice following surgery and was managed with re-excision, irradiation and chemotherapy is presented due to its extremely rare presentation and atypical course. The relevant literature is also reviewed.

An important procedure in ossiculoplasty: autoclaving the ossicles.

Autoclaving of the ossicles prior to ossiculoplasty is a very important procedure in surgery of cholesteatomatous chronic otitis media. Autoclaving allows the reuse of the ossicles removed from patients with cholesteatomatous chronic otitis media as an autograft. It also allows utilization of the malleus, incus and stapes taken from cadavers or of the uneroded malleus and incus removed from patients undergoing non-functional middle ear surgery chosen carefully with detailed history and laboratory analysis. The powerful disinfecting effect of the sterilising procedures of the homografts inactivates prion proteins which cause degenerative encephalopathies. In various studies, it has been concluded that autoclaving does not alter the matrix of the bone which is responsiable for its biophysical properties, whereas it removes all viable cells within the bone and dentures the soft tissue attached to the surface of the ossicle. We have also found confirming histological results in our two previous studies published in 1999 and 2001. It is usually recommended that soft tissue on the surface of the ossicles is removed before autoclaving. It is also sufficient to autoclave the ossicles at 134 degrees C, and at 2.5 atmosphere pressure for 5 minutes in a flash autoclave. The autoclaving time of the homograft ossicles must be longer, for 20 minutes. Following the autoclaving, these homograft ossicles should be kept at pH 5.6 for 3 days, then use a solution of 0.5% formaldehyde at pH 7 and 4 degrees C for 21 days and it should be washed with physiologic saline solution three times for 7 minutes before use. Depending on the results obtained from our planned comparative experimental study, there will be no need for additional formaldehyde fixation procedure after autoclaving and the autoclaved ossicles will be used immediately without preservation in formaldehyde solution for 24 days.

Fibrocartilaginous dysplasia: a variant of fibrous dysplasia.

Eight cases of fibrous dysplasia having enchondroma-like areas (fibrocartilaginous dysplasia) are reported. Four patients were male, four were female. The patients' ages ranged from 8 to 18 years (mean = 11.3 years). In seven cases, the lesions were located at the proximal femur while one was at the tibial diaphysis. Histologically, large, well-defined, sharply demarcated islands of hyaline cartilage tissue were seen within the typical fibro-osseous stroma of fibrous dysplasia. Some of the cartilage islands showed growth plate-like enchondral ossification at the periphery. Cartilage islands were mostly low in cellularity but infrequently, hypercellular areas were detected. Prolonged growth plate columns or developmental cartilage nests are considered in the origin of the cartilaginous component. In the differential diagnosis from benign and malignant chondroid tumours, the lack of atypia in the surrounding fibrous stroma is important.

Can homograft ossicles still be used in ossiculoplasty?

The use of ossicular homografts has been legally forbidden in many countries for the last five years. In Turkey, imported ossicular biomaterials are very expensive. Malleus and incus homografts were mostly obtained during non-functional ear microsurgery on selected patients using a detailed history and special preoperative tests to avoid the risk of virus contamination. In order to determine the method for the procedure, the ossicles were first investigated histologically. The histological studies have shown, that there are no differences in the organic osseus matrix, the collagen fibres and the lamellar structure formed by these fibres in all groups of ossicles. According to the classical method, we preferred autoclaving at 135 degrees C temperature for 20 minutes after immersing the ossicles in 4% formol solution at pH 5.6 for 3 days. These ossicles were kept in 0.5% formol solution at pH 7 refrigerated at 4 degrees C. Until 1995, allograft ossicles, treated with formaldehyde solution without sterilization in the autoclave were our choice. For the last 4 years, we have been using sterilization with the autoclave especially to inactivate the prions. If the ossicles of the patient are over-eroded, ossicular allografts, which can be obtained without any cost are still a choice of treatment in our country. In the surgery of cholesteatomacous chronic otitis media, the malleus and incus which were in contact with the cholesteatoma, could be used like an autograft in ossiculoplasties, after autoclaving.

Odontoameloblastoma: report of a case.

Ameloblastic odontoma is a mixed odontogenic tumor, which is characterized as being extremely rare, displaying aggressive clinical behavior, resembling a mixed radiopaque and radiolucent radiographic appearance and containing both ameloblastoma and a composite odontoma. An eleven-year-old boy complaining of the edentulous area at the anterior maxilla, was seen at the Department of Oral Surgery of Ege University Dental Faculty. The lesion presented a radiopaque and radiolucent features on panoramic radiogram. Locally operated lesion was diagnosed as ameloblastic odontoma, because it contains islands of ameloblastoma with calcified dental structures as odontoma. The patient was followed-up for 7 years and no recurrence was seen. This case is presented because of its rarity, early detection in an edentulous area of a child, and the successful choice of treatment.

Recurrence of an atrial myxoma.

A 22-year-old man had an operation 14 years ago for removal of a left atrial myxoma. He was admitted to our hospital because of acute femoral arterial embolism. Echocardiographic examination revealed a mobile pedunculated echodense atrial mass attached to the atrial septum. At operation, the left atrium was found to be occupied with a gelatinous pale mass attached by a stalk to the atrial septum. The tumour was extirpated along with a part of atrial septum, which was assumed to be involved in the tumour. The atrial septal defect created was closed with patch. Histopathological examination of excised material revealed typical features of a myxoma.

Accessory scrotum: report of a case.

Perineal ectopic (accessory) scrotum is an uncommon anomaly. We could trace only 5 such cases reported in the literature (8, 10, 11). A case of accessory scrotum and glandular hypospadias has been presented and discussed.

Congenital desmoplastic fibroma of the cranium.

A case of congenital desmoplastic fibroma of the right parietal area between the two skull tables is presented.

Orbito-cranial teratoma. A case report.

A case of congenital orbito-cranial teratoma is presented. Histological examination of this extremely rare tumour revealed unusual tissue elements derived from all three germinal layers.

Histological and biochemical studies on cartilage from osteoarthrotic femoral heads with special reference to surface characteristics.

A study has been made of cartilage from osteoarthrotic femoral heads in an attempt to relate histological to biochemical and metabolic changes. Cartilage showing different surface characteristics and originating from different areas of the femoral head has been studied. Depending on its surface characteristic and location, the osteoarthrotic cartilage ranged in composition and sulphate metabolism from practically normal to glycosaminoglycan depleted and metabolically depressed. There was no indication of elevation in the sulphate incorporation in the osteoarthrotic cartilage.