Biomedical subjects
Publications and source records attributed to C Scully.
This second of two articles reviews the many uncommon and rare oral lesions that have arisen in persons infected with human immunodeficiency virus (HIV). The various drug-related oral disorders of HIV disease are also considered.
Viruses have been implicated in the etiology of several chronic disorders of the oral mucosa. Most of these associations have been with DNA viruses, particularly certain herpesviruses, which are associated, for example, with some cases of erythema multiforme and with hairy leukoplakia. Papillomaviruses are associated with various papillomatous lesions, focal epithelial hyperplasia, and possibly with some carcinomas. Viruses may possibly be associated with recurrent aphthae, Behçet's syndrome, and some dermatoses. The literature concerning these possible associations is reviewed. However, much more research needs to be done before the full story of viral associations with oral mucosal disorders can be written.
The clinical findings of patients with oral Kaposi's sarcoma are reviewed. These oral findings commonly included candidiasis, hairy leukoplakia, gingivitis associated with human immunodeficiency virus (HIV), periodontitis, and other symptoms, including xerostomia. The other common symptoms of HIV disease that may be of importance in leading to a diagnosis are reviewed in this patient group. Treatment by local radiotherapy or by intralesional vinblastine of these oral Kaposi's sarcomas resulted in successful palliation, with more than 50% regression of the lesions in 80% of the patients treated.
Gingivitis in the preschool child is uncommon and is usually associated with underlying systemic disease such as leukemias, neutropenias, and other immunologic defects. This report describes gingival hyperplasia in a preschool child with aplastic anemia and highlights the need to exclude systemic disease in children with periodontal disease.
Paracoccidioidomycosis (South American blastomycosis) is an uncommon, progressive systemic mycosis, potentially fatal if untreated. It is virtually restricted to persons spending time in Latin America. Reports of oral lesions are extremely rare in the English-language literature. Three adults with oral lesions as the first sign of paracoccidioidomycosis are described; this appears to be the largest series in the dental literature. The oral lesions had a characteristic appearance with a granular purpuric surface. The upper gingiva was a typical site, but lesions were also seen in the palate, tongue, and buccal mucosa. Two of the patients proved to have detectable pulmonary involvement. Long-term systemic ketoconazole therapy produced resolution of oral lesions in all cases.
This paper examines the evidence for an aetiological role for viruses in the development of oral carcinoma. Several viruses have been sought in oral cancer and evidence found for some, particularly herpes simplex and human papillomavirus. However, the evidence also suggests that these viruses are ubiquitous agents and a number of criteria must be met before these potentially oncogenic agents can reliably be implicated in human carcinogenesis. In contrast, there is no evidence that viruses such as adenovirus, Epstein-Barr virus, and retroviruses play any role in oral carcinogenesis.
Acute pericoronitis is a common oral infection characterised by a predominance of anaerobic micro-organisms such as peptococci, peptostreptococci, bacteroides and fusobacteria, and also spirochaetes. Penicillins such as amoxycillin, and metronidazole are effective antimicrobials in the treatment of acute pericoronitis. This study presents the views of a group of British Oral and Maxillofacial Surgeons as to the causative microbial agents and the antimicrobial management of acute pericoronitis.
Reports were studied of all incidents of injury and accidents involving outpatients or visitors to Bristol Dental Hospital between 1980 and 1988 inclusive. Seventy-two incidents were reported, two-thirds of which occurred during or just after dental treatment, and usually involved oral soft tissues or teeth. Few accidents that occurred at this time could be attributed to faulty equipment. One-third of accidents occurred outside the treatment area, the resultant injuries were usually minor, although one injury was considered serious enough to warrant legal action to be taken against the Health Authority. Hence, it is important that the provisions of the Health and Safety at Work etc. Act (1974) are implemented in all parts of a dental practice to avoid injury to patients.
Explore the source record for details and available documents.
This study examined the characteristics of keratinocytes from 4-nitroquinoline N-oxide-treated rat oral epithelium that formed well differentiated carcinomas or spindle cell tumours when transplanted s.c. to athymic mice. Small polygonal-type cells in early culture passage gave rise to xenografts that were well differentiated carcinomas with keratin positivity and a differential reactivity with two anti-vimentin antibodies (positive Vim Dako, negative Vim 3B4). Progressive culture of the polygonal cells resulted in cells of a more stellate-like morphology which, when transplanted, formed spindle cell tumours that were keratin negative and vimentin positive (Vim Dako and Vim 3B4). The staining pattern of the xenografts was similar to that of the cultured cell derivatives. By contrast to normal oral keratinocytes which were stimulated by epidermal growth factor (EGF), the parental and xenograft-derived cells were markedly less responsive and at times refractory to EGF. Low affinity EGF receptors characterized normal keratinocytes whilst parental and xenograft-derived cells from well differentiated carcinomas and spindle cell tumours expressed diminished numbers of low and high affinity and high affinity EGF receptors respectively. Normal keratinocytes and parental tumour cells were inhibited by transforming growth factor (TGF-beta) whereas xenograft-derived cell lines from both well differentiated carcinomas and spindle cell tumours were refractory to TGF-beta. TGF-beta receptors were predominantly of high affinity although xenograft-derived cells, particularly from spindle cell tumours, expressed increased numbers of receptors which were of lower affinity. The results indicate that spindle cell tumours are a variant of well differentiated carcinomas and express an aberrant pattern of differentiation. Resistance to EGF-induced stimulation and TGF-beta-induced inhibition appears not to be an integral part of the tumour phenotype but the pattern of EGF and TGF-beta receptor expression closely follows the degree of tumour differentiation.
Explore the source record for details and available documents.
During the last decade, many studies in Europe and North America have evaluated oral conditions and dental needs in the elderly. Similar information does not exist in Brazil. The aim of this study was to determine the prevalence of oral health and disease in elderly persons living in an institution in the city of Piracicaba, State of São Paulo, Brazil. Of 350 elderly persons, 134 males and 136 females were interviewed and clinically examined. Less than one half had healthy mouths. 58.9% of the examined individuals showed one or more lesions in the oral mucosa, the most frequent being denture-induced stomatitis (20.0%). Fibrous hyperplasias (11.8%) and angular cheilitis (9.3%) were fairly common. Gender, use and degree of hygiene of the denture were factors statistically significantly contributing to prevalence of denture stomatitis. Precancerous lesions such as leukoplakia (3.0%), actinic cheilitis (2.6%) were uncommon but three cases of squamous carcinoma (1.1%) were revealed. This study emphasizes the need for regular oral examinations of the elderly by personnel trained in oral diagnosis.
The aims of the study were to examine the knowledge of occupational hazards from blood-borne viruses, and practices related to cross-infection control in Brazil, by a survey of 947 Brazilian dental practitioners at a National Dental Congress in January 1990. Over 80% were aware that hepatitis B virus can be present in the oral cavity and constitutes an occupational hazard but their perceptions as to the hazards from other agents were at variance with the published evidence. Over 75% were aware of the existence of vaccines against hepatitis B virus but less than 60% appreciated the possible long-term hepatic sequelae of hepatitis B virus infection and, less than 40% were aware of the oncogenic potential. Less than 10% had been immunized against hepatitis B and only a further 30% intended to be vaccinated. Autoclaves were used by less than 10%: most appeared to use chemical means for disinfection of dental instruments. These results indicate the urgent need for a campaign to improve infection control procedures in Brazilian dental practice.
Epstein syndrome is a rare dominantly inherited disorder in which the main features are nephritis, deafness and macrothrombocytopathic thrombocytopenia. A case with oral haemorrhage and purpuric lesions is reported. This appears to be the first report of this syndrome in the dental literature.
This study examined the expression of major histocompatibility complex (MHC) antigens in the KB human carcinoma cell line. MHC class I antigens (HLA-ABC and beta 2microglobulin) were constitutively expressed but not significantly enhanced by interferon-gamma (IFN-gamma). By contrast, MHC class II antigens were absent or expressed minimally on unstimulated KB cells, but DR and DP were significantly stimulated in a non-coordinated pattern (HLA-DR greater than -DP greater than -DQ) by IFN-gamma.
Hereditary gingival fibromatosis is frequently an isolated condition of little consequence apart from a cosmetic problem and occasional associations with hypertrichosis and/or epilepsy. There are, however, several uncommon or rare eponymous syndromes described in which gingival fibromatosis can be a feature: these include the Zimmermann-Laband, Murray-Puretic-Drescher, Rutherfurd, Cowden and Cross syndromes. This paper describes two siblings with features of the rare Zimmermann-Laband syndrome and discusses the major aspects of this and other eponymous syndromes that may be associated with hereditary gingival fibromatosis.
DNA was extracted from an odontogenic keratocyst and assayed for the presence of human papilloma virus (HPV) type 16 DNA sequences using high stringency Southern blot hybridization. HPV type 16 homologous DNA sequences were detected at a copy number of 50-100 genome copies per diploid cell. The oral HPV DNA was not identical to the prototype HPV 16 when cleaved with the restriction enzyme Pst-I, since it appeared to lack the Pst-I C fragment (L2/L1 ORFs) and contained "off-sized" high molecular weight fragments suggestive of integration events into the host cell chromosome.
The knowledge of occupational hazards from blood-borne viruses, and practices related to cross-infection control were studied in Jordanian dental students. A survey in July 1990 showed that over 90% were aware of the existence of vaccines against hepatitis B virus and most appreciated the possible long-term hepatic sequelae of hepatitis B virus infection. Nearly 50% had already been immunized against hepatitis B and a further 4% intended to be vaccinated. Autoclaves were used by more than 80% for the sterilization of dental instruments.