Central calcifying epithelial odontogenic tumour in the posterior maxilla: a case report.

The calcifying epithelial odontogenic tumour (CEOT), or Pindborg tumour, is a rare, benign odontogenic tumour. CEOT is usually asymptomatic and an incidental radiological finding, often presenting as a mandibular radiolucency with flecks of calcific material. We report an unusual case of CEOT in the left posterior maxilla of a 46-year-old male that was associated with an unerupted tooth. The tumour in this case caused non-specific sinus symptoms and appeared radiographically similar to an odontoma or ossifying fibroma due to its dense calcific contents. Diagnosis was confirmed histologically following surgical removal of the lesion, which showed classic CEOT histomorphology. We report this case to highlight the unusual clinico-radiologic presentation and illustrate the diagnostic difficulties that can occur with radiolucent and/or radiopaque lesions in the jaws.

The patient with recurrent oral ulceration.

This paper discusses the range of recurrent oral ulceration which affects the oral mucosa. Types of ulceration covered in this paper include traumatic, infective, aphthous, ulceration related to the oral dermatoses, drug-induced, ulceration as a manifestation of systemic disease and ulceration indicating malignancy. Aspects of the aetiology, diagnosis and management of common oral recurrent ulcerative conditions are reviewed from a clinical perspective as an aid to practising dentists.

Juvenile mandibular chronic osteomyelitis: a distinct clinical entity.

Sclerosing osteomyelitis of the mandible is an uncommon disease of unknown aetiology. A series of eight female children (6 to 12 years old) with a distinct mandibular inflammatory disease were studied. Each presented with pain and a recurrent soft tissue swelling overlying a predominantly unilateral mandibular enlargement. On imaging, this deformity demonstrated a mixture of patchy sclerosis and radiolucency. A raised erythrocyte sedimentation rate was the only consistent serological finding. Treatment varied from symptomatic control with non-steroidal anti-inflammatory medication, to surgical management that included decortication and contouring and, in one case, resection with reconstruction. A potential protocol for treatment of this disease is given. The early age of onset of the disease process and the uniformity of the features distinguish this condition from other groups of disorders that, previously, have been collectively designated as chronic diffuse sclerosing osteomyelitis. It is proposed that this inflammatory disease of mandibular bone, in the paediatric patient, should be regarded as a separate clinical entity: 'juvenile mandibular chronic osteomyelitis'.

Solitary fibrous tumour of the oral cavity: report of two cases.

The solitary fibrous tumour is an uncommon, benign neoplasm of adults involving the pleura. It is now recognised to occur in extrapleural sites. Only a limited number of cases have been reported in the oral cavity. This paper reports two further cases, which presented as clinically benign masses in the palate and buccal mucosa respectively.

Epstein-Barr virus receptors but not viral DNA are present in normal and malignant oral epithelium.

The presence and distribution of Epstein-Barr Virus receptors (EBVR's) on a range of normal (n = 18), dysplastic (n = 10) and malignant (n = 20) oral mucosa were studied by immunocytochemical methods using the monoclonal antibodies (MAb's) HB5 and B2. EBVR's were demonstrated as membrane staining of the spinous layers of normal non- and parakeratinized epithelium, indicating that EBVR's are differentiation-linked. This distribution was retained in dysplastic epithelium. Tissue from oral squamous cell carcinomas (SCC's) showed variable reactivity of only a few cells scattered randomly within the samples. Furthermore, a sensitive in situ hybridization (ISH) technique was used to determine if Epstein-Barr virus (EBV) was present in normal (n = 15) and oral squamous cell carcinoma tissue (n = 20). No EBV DNA was demonstrated within either normal or malignant epithelium, suggesting that the virus does not persist in normal oral stratified squamous epithelium nor is there any evidence for a role in oral carcinogenesis.

Progressive bulbar palsy: a case report of a type of motor neuron disease presenting with oral symptoms.

A case is presented of a patient with progressive bulbar palsy, a form of motor neuron disease, which is a progressive degenerative disorder of the motor nuclei in the medulla producing atrophy and fasciculations of the musculature of the tongue, dysarthria, dysphagia, and excessive accumulation of secretions. The patient may initially seek dental consultation. Clinicians should be aware of the signs and symptoms of this inexorably fatal disease so that an early neurologic referral is made and the appropriate symptomatic therapies instituted.

Oral pulse granuloma: clinical and histopathological features. A review of 62 cases.

Clinical and histopathological features of 62 cases of oral pulse granuloma were reviewed and compared to the cases previously described in the literature. Oral pulse granuloma is a histopathological diagnosis for a localized lesion resulting from the implantation of food particles of plant origin. It often occurs in the posterior regions of an edentulous mandible in association with a full lower denture but it may also be found in periapical areas of grossly decayed teeth or retained roots and teeth with a history of endodontic therapy, where the root canal has been left open at some stage, associated with impacted lower third molar teeth with a history of pericoronitis, in post-extraction tissue reactions or as part of a cyst wall where there has been a communication with the oral cavity. The essential histopathological features consist of a connective tissue stroma containing variable numbers of inflammatory cells and foreign-body giant cells associated with hyaline rings and ovoid fibrillary or amorphous hyaline masses. Treatment is by local curettage or excision.

Hemifacial atrophy and temporomandibular joint pain-dysfunction syndrome.

A case is described of a patient with progressive HA who presented because of left TMJ pain, jaw locking and ipsilateral masticatory muscle spasm. Several reports exist in the literature of masticatory muscle spasm associated with HA. A diagnosis of TMJPDS was made and an occlusal splint was provided which produced resolution of the TMJ pain and jaw locking and significantly reduced the masticatory muscle spasms.

The pathogenesis of oral pulse granuloma: an animal model.

Oral pulse granuloma is one of the terms used to describe oral inflammatory lesions characterized microscopically by the presence of giant cells and hyaline rings. The various names proposed for these lesions reflect the lack of agreement regarding their pathogenesis. One theory advanced claims that the process represents a foreign-body granulomatous reaction to implanted vegetable particles, more specifically those of pulses/legumes. In this study an animal model was developed where homogenized cooked legumes were implanted into the orofacial region of rats. Animals were killed at varying intervals ranging from one day to six months and the tissues associated with the implanted material were removed and processed for light microscopy. The experimentally produced lesions had many features similar to those found in humans, the similarities becoming more pronounced with time. The results indicate that the cellulose moiety of food particles of plant origin accidentally implanted into human tissues may cause the granulomatous reaction known as oral pulse granuloma.