Biomedical subjects
Publications and source records attributed to D Dayan.
Metastases of chondrosarcoma to the oral mucosa are very rare. The present case describes such a metastasis to the maxillary gingiva which mimics a benign reactive exophytic lesion. The literature concerning this matter is reviewed. The differential diagnosis and pathogenesis of such lesions are discussed.
A case is presented where a 4-year-old girl was injured in an automobile accident. The dental injury, intrusive luxation of the maxillary deciduous incisors, seemed unimportant at the time, since the child was in critical condition. The situation was first evaluated 5 years later, when the child was referred for treatment of an apical periodontitis originating from the right central incisor. The present case reflects several important aspects that were overlooked at the time of injury: the potential of intruded luxated deciduous teeth to cause developmental anomalies to the permanent dentition; the necessity of a longer follow-up period to detect such anomalies; and the need to develop effective treatment methods.
Mineralized products were analyzed in a series of 62 cases of peripheral giant cell granuloma of the gingiva or alveolar ridge of man. Histologic sections were examined by routine light microscopy and under polarized light to assess the extent and composition of mineralized tissues in these lesions. In 35% of the cases, mineralized tissue was identified in the form of woven and/or lamellar bone and dystrophic calcification. The most common type was the woven bone which appeared alone or in combination with lamellar bone in 82% of the lesions containing mineralized material. Unlike peripheral ossifying fibroma, no cementum-like material was identified in peripheral giant cell granuloma.
Polarization colors of various purified collagens were studied in fibers of similar thickness. Three different soluble collagens of type I, insoluble collagen type I, lathyritic collagen type I, two p-N-collagens type I, pepsin extract collagen type II, two soluble collagens type III, p-N-collagen type III, and soluble collagen type V were submitted to a routine histopathologic procedure of fixation, preparation of 5-microns-thick sections, staining with Picrosirius red and examination under crossed polars. Polarization colors were determined for thin fibers (0.8 micron or less) an thick fibers, (1.6-2.4 microns). Most thin fibers of collagens and p-N-collagens showed green to yellowish-green polarization colors with no marked differences between the various samples. Thick fibers of all p-N-collagens, lathyritic and normal 0.15 M NaCl-soluble collagens showed green to greenish-yellow polarization colors, while in all other collagens, polarization colors of longer wavelengths (from yellowish-orange to red) were observed. These data suggested that fiber thickness was not the only factor involved in determining the polarization colors of Picrosirius red-stained collagens. Tightly packed and presumably, better aligned collagen molecules showed polarization colors of longer wavelengths. Thus, packing of collagen molecules and not only fiber thickness plays a role in the pattern of polarization colors of Picrosirius red-stained collagens.
Two types of multinucleated giant cells were observed in periapical granulomas--the foreign body type and the Touton type. In the Touton type, the nuclei were near the center of the cell, surrounded by foamy cytoplasm. Both types of giant cells reacted positively to lysozyme, alpha 1-antitrypsin and alpha 1-antichymotrypsin, indicating their histiocytic origin.
Myofibroblasts are found in various pathologic conditions including lesions containing giant cells, such as central giant cell granuloma and the giant cell tumor of tendon sheath (nodular tendosynovitis). In the present study, myofibroblasts were found in peripheral giant cell granuloma (PGCG) using the TP-Levanol fast cyanine 5RN histochemical procedure and electron microscopy. A number of myofibroblasts displayed intracellular collagen fibrils. The presence of myofibroblasts supports the reactive nature of PGCG.
Ancient neurilemmoma is a rare lesion of the oral cavity. The present article describes an additional case and discusses some difficulties in its histological diagnosis. The final diagnosis is based on both light and electron microscopy morphology. Immunohistochemical studies are, at present, only of supportive value.
Adherence of microorganisms to the surfaces of the host is believed to be an initial and essential step in the production of infection. The objective of the present study was to compare the adherence in vitro of 17 isolates of various Candida species to acrylic surfaces. The results showed that all 17 Candida strains adhered to acryl. Generally, all Candida albicans strains were more adherent than the other strains of Candida species that were tested. Marked differences in the adherence ability of strains belonging to the same species were noted. Future studies to search for possible association between adherence of Candida strains to acryl and pathogenesis of denture stomatitis are planned.
In a study of 80 perioral muscle specimens, lipid pigment (Lipofuscin) granules were present in 68.5% of the cases. The pigmented granules, which were stored at the nuclear poles, were PAS positive, stained black or brown with the Masson-Fontana procedure, black with Sudan black and strong purple-pink with Ziehl-Neelsen staining; yellow autofluorescence was emitted in ultraviolet light. The morphology, histochemical reactions and autofluorescence of the pigmented granules were characteristics of the endogenous lipid pigment--lipofuscin. Statistical analyses indicated a direct correlation between increase in quantity and distribution of the pigment and increase in age (p less than 0.0001), in both males and females. Accumulation of the pigment in the perioral muscles with aging was found to be similar to that in the myocardium and tongue muscles.
A case of a cholesterol granuloma of the mandible, which manifested as a solitary radiolucent lesion in an edentulous area, is presented. There is a lack of accurate data regarding its nomenclature and pathogenesis. In this report, the literature is reviewed, the nomenclature is clarified and the pathogenesis discussed.
A case with a firm asymptomatic nodule of 1 cm diameter on the gingiva between the left upper cuspid and first bicuspid is presented. Radiographic examination did not reveal any pathology of the bone in that region. Histologic examination revealed a cyst wall lined by squamous stratified epithelium, characteristic to the lining of an odontogenic keratocyst. It is suggested that the term peripheral odontogenic keratocyst be used for the diagnosis of this lesion.
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Migratory stomatitis is a unique oral condition with several descriptive names. The diagnosis is based on the clinical appearance and the history of the lesions. The etiology of this entity is still open to debate. A review of the literature and a clinical description of a study group consisting of seven additional cases, in which long-term follow-up was done, are presented. Migratory stomatitis is suggested as the most suitable term to describe accurately the nature and the behavior of this condition.
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A case of peripheral calcifying odontogenic cyst is presented. The nature of the lesion as a neoplasm is discussed including review of the literature. The terminology proposed for this lesion is "dentinogenic ghost cell tumor."
A rare case of central odontogenic fibroma - a simple type according to Gardner's classification - is presented. Clinical manifestations and treatment are described. The aetiology and histopathological differential diagnosis are discussed.
A case of peripheral ameloblastoma on the gingiva of a 50-year-old male is presented. The clinical and histological picture of the lesion is described. The etiology and the dilemma in the differential diagnosis of this peripheral odontogenic tumor is discussed.
The peripheral ossifying fibroma (POF), a benign gingival overgrowth, occurs mainly in the anterior portion of the maxilla in young adults. The size of the lesion is usually less than 1.5 cm. A unique case of POF in the posterior mandible of a 70-year-old female is presented. The lesion was 6 cm in the largest diameter. It is apparent that POF can become a sizeable tumor unless it is surgically excised in an early stage.