Squamous odontogenic proliferation with probable origin from the rests of Malassez (early squamous odontogenic tumor?).

A case is presented documenting an apparent nonreactive squamous odontogenic proliferation of the rests of Malassez. The nonreactive nature of the tumor is discussed along with the possible association between this lesion and the recently reported squamous odontogenic tumor.

Plasma-cell gingivitis. Report of a case.

A well-documented case of plasma-cell gingivitis is presented. When viewed in a total perspective, the clinical examination, history of usage of a popular mint , laboratory data and histologic examination provide support for this diagnosis. This patient did not exhibit any evidence of glossitis or cheilitis as is often reported in the literature; however, a positive history to psoriasis was noted. The occurrence of plasma-cell gingivitis in a patient with documented psoriasis provides some interesting speculation regarding the etiologic picture of this condition.

Traumatic bone cyst, aneurysmal bone cyst, and central giant cell granuloma--pathogenetically related lesions?

Three central bone lesions, a traumatic bone cyst, an aneurysmal bone cyst, and a central giant cell granuloma are reported. Comparisons of the clinical, radiographic, and histological features were made. Although these lesions are recognized as separate and distinct pathological entities, a common pathogenesis is suggested by similarities in certain features. Diagnostic aids are suggested to assist in a differential diagnosis.

Subepithelial nerve plexus (with ganglion cells) associated with taste buds.

OBJECTIVE: The purpose of this investigation was to confirm the presence of subepithelial nerve plexuses associated with taste buds in the human tongue and to study the histomorphologic features of each plexus. STUDY DESIGN: Through use of a light microscope, several hundred microslides representing biopsies of the human tongue were reviewed so that the histomorphologic character of subepithelial nerve plexuses could be detected and studied. Tissue sections were stained with hematoxylin-erythrosin, Bodian, and Masson's trichrome, as well as with immunohistochemical stains for neuron-specific enolase and S-100 protein. RESULTS: Twelve examples of the subepithelial nerve plexus, many with mature ganglion cells, were selected for microscopic evaluation. The plexuses were quite small, ranging from 1 to 3 millimeters in diameter. With one exception, each plexus was an incidental finding in a biopsy of a definitive soft tissue lesion, such as fibroma, papilloma, granular cell tumor, lymphoepithelial cyst, lingual tonsil, or foliate papilla. Ganglion cells, 1 to 5 in number and confirmed by neuron-specific enolase and S-100 protein, were observed in 9 of the cases. CONCLUSIONS: The subepithelial (subgemmal) nerve plexus is a tortuous neural proliferation associated with the taste buds of the human tongue, with ganglion cells and intergemmal/intragemmal branches. When hyperplastic, it should be recognized as such and not diagnosed as a neoplastic process--eg, a ganglioneuroma, neurofibroma, syndrome-associated neuroma, or traumatic neuroma.

Intraoral leukoplakia, abrasion, periodontal breakdown, and tooth loss in a snuff dipper.

Dentists should be aware that snuff dipping or chewing is increasing in southern states and perhaps in other sections of the United States. These habits can lead to clinical leukoplakia, gingival recession, tooth abrasion, and periodontal bone destruction. The possibility also exists that a malignant transformation of leukoplakia can develop in persons who use snuff and other forms of tobacco.

Particle size and composition of composite dusts.

Inhalation of respirable crystalline silica dusts (sized between 0.5 and 5.0 micrograms) causes silicosis. Crystalline silica fillers are used in some composites and fine dusts/aerosols generated during high-speed finishing of these materials may be regularly inhaled by clinical dental personnel. Due to the widespread use of composites, the potential of these dusts/aerosols for causing silicosis warrants concern. Six composites were polymerized, then abraded with diamond and carbide finishing burs to produce dusts in a manner simulating the clinical finishing of esthetic veneers. Dusts were collected on 0.8 micron filters using an air sampling pump. Six hundred particles of each dust sample were counted and measured using a light microscope. The respirable fraction of dust particles ranged between 57.2 and 85.7%. The diamond bur created more respirable particles than the carbide bur for each composite tested. The elemental composition of particles of each composite was determined by energy dispersive x-ray analysis. Silicon was detected in amounts ranging from 71-100%. Based on the composition and particle size distribution only, dusts generated during simulated finishing of composite resins containing quartz filler have the potential for causing silicosis in dental personnel.

Lingual malignancies. Improving early detection and diagnosis.

Malignancies affecting the tongue are usually in an advanced stage when they are first diagnosed. To recognize these lesions at the earliest possible time and to arrive at an accurate differential diagnosis, the clinician needs an awareness of the clinical features, location, and behavior of the malignant neoplasms that can occur in the lingual mucosa. Routine performance of a careful visual and tactile examination of the tongue, especially in patients identified as being at high risk, improves the chances for early and accurate diagnosis.

The smokeless tobacco 'time bomb'.

All healthcare professionals need to become aware of the extent and seriousness of smokeless tobacco use. In this article, the authors briefly review the current status of smokeless tobacco and describe its usage patterns and practices, pharmacologic (addictive) aspects, and associated health problems. They also suggest ways that primary care physicians can discover or prevent smokeless tobacco use in their patients.

Bilateral symmetrical lymphangiomas of the gingiva.

A case of bilateral superficial lymphangiomas occurring in the maxillary and mandibular gingivae of a young female patient is reported. The distribution and location of the lesions indicate that they are developmental anomalies, probably arising from residua of neonatal lymphangiomas. A review of the literature revealed only one previously reported case.

Extraradicular communicating dens invaginatus.

The morphologic occurrence of dens invaginatus often results in pathologic involvement of the pulp and associated periodontal tissues. Treatment must include endodontic therapy to reduce the organic and infectious content of the pulp and invaginated tract. Concervative therapy, however, is frequently insufficient to eliminate the irritant force to a level that is biologically acceptable to the host. Therefore, surgical intervention has been considered by most authors to be the most acceptable approach for correction of the deformity and associated alveolar defects. Both cases reviewed here represent the dens invaginatus type of malformations that have primary zones of irritation within the anomalous tract. A report similar to our Case 2 appeared in the literature 2 weeks after initial therapy of the nonpupally involved lateral incisor. These cases are published to document the occurrence of these forms of dens invaginatus and their associated periradicular pathosis, to recommend treatment, and to note the apparent favorable response to the involved tissues.

Reparative lesion of the tongue.

An ulcerative lesion of unknown etiology occurred on the dorsum of the tongue in a 6-month-old infant. Following surgical excision, microscopic examination revealed a benign reparative process with degeneration and regeneration of striated muscle.

Multiple progressive eosinophilic granuloma of the jaws.

A case of eosinophilic granuloma occurring in the jaws is reported, and the clinical and microscopic features of this entity are discussed. In this case, the lesions were progressive and ultimately involved large areas of the mandible and a small area in the maxilla. Early manifestations of the disorder were believed to be inflammatory, and consequently there was a significant delay in treatment. Curettage of the mandibular lesions followed by low-dose radiation therapy has apparently been effective. Twenty-four months after treatment, there is no evidence of soft tissue involvement or recurrent lesions in bone.

Oral cancer education in dental schools: survey of Texas dental students.

BACKGROUND: Senior dental students at the three Texas dental schools were surveyed about their attitudes and perceptions of their knowledge and skills in areas related to prevention, detection, and diagnosis of oral cancer, and the management of oral sequelae of cancer therapy methods. A 16-item survey was distributed to a total of 251 fourth-year dental students. A total of 198 completed surveys were returned, for a response rate of 79%. RESULTS: Just over half of the students had observed a biopsy of oral tissue or read a biopsy report, but only about one fourth had actually performed the procedure. Respondents who had observed or performed a biopsy or who had read a biopsy report were significantly more likely to report that they were comfortable with their competence in performing a biopsy. Although only about half (57%) reported that tobacco-use cessation programs had been discussed in their training and only 14% had received actual training, a much larger percentage intended to provide cessation materials or training in their practices. Likewise, only a fourth had been instructed in prescribing nicotine replacement therapy, but almost two-thirds planned to do so in their practices. Most respondents felt they were comfortable with their skills in counseling patients about oral cancer risk factors, and most felt they would be able to recognize a malignant lesion. Almost all had been taught full head and neck examination technique, and most (84%) were comfortable with their skills in performing such an examination. Smaller percentages reported instruction in the management of the oral sequelae of chemotherapy and radiation therapy. CONCLUSIONS: Future practitioners are more comfortable with skills that have been practiced in training. These data suggest that an increased emphasis on certain aspects of cancer education within the dental curriculum would result in a more confident, competent practitioner.

Intraoral spindle cell lipoma: case report with correlated light and electron microscopy.

A nontender submucosal nodule in the anterior floor of the mouth of a 33-year-old woman was removed surgically. Light and electron microscopic studies revealed features of a spindle cell lipoma, i.e., a well-circumscribed, unencapsulated mass composed of a mixture of univacuolated lipocytes and fibroblast-like spindle cells within a mucinous and collagenous stroma. To our knowledge this is the first reported case of a spindle cell lipoma in the oral cavity.