Biomedical subjects

P A Reichart

Publications and source records attributed to P A Reichart.

At least 19 recordsLinked to original sources

PubMed2005

[Occurrence of epithelium in the soft tissues associated with routine surgical removal of 150 mandibular third molars].

BACKGROUND: The aim of the study was to classify epithelial structures (ES) and to determine the prevalence of cysts associated with mandibular third molars (M(3)). MATERIAL AND METHOD: Sections of HE-stained soft tissue specimens and panoramic radiographs of 150 consecutive patients undergoing surgical removal of M(3) were evaluated. ES were classified as islands and/or strands of odontogenic epithelium (OE), reduced enamel epithelium (REE), stratified cyst epithelium (SCE), oral mucosa (OM), and pocket epithelium (PE). The diagnostic criteria were defined as a pericoronal translucency >2.5 mm and SCE for dentigerous cysts (DC) and a distal translucency >2.5 mm, SCE, and inflammation for inflammatory paradental cysts (IPC). RESULTS: Median age was 24.4 years: 23.0 years for 86 (57.3%) female patients and 25.7 years for 64 (42.7%) male patients (p=0.017). ES were found in 95.3%, classified as OE in 53.3%, REE in 34.7%, SCE in 28%, OM in 30.7%, and PE in 10.7%. Both REE and SCE were found in 6%. The total number of cases with REE and/or SCE was 56.7%. Median age of cases with SCE was 28.7 years compared to 20.7 years in cases with REE (p<0.001). Pericoronal translucencies were found in four M(3), of which three were associated with SCE. Distal translucencies were found in 47 M(3), of which 15 were associated with SCE and inflammation. The prevalence was 2% for DC and 10% for IPC. CONCLUSIONS: A differentiated application of histological and radiological criteria enables the prevalence of cystic lesions to be more accurately determined than does the use of one criterion alone.

Adolescent↗

PubMed2005

[Assessment of severity of oral lichen planus using a new clinical index].

AIM: The goal of this study was to develop a clinical index to assess therapy of oral lichen planus (OLP) to be used in comparing the efficacy of two topical glucocorticoids. The clinical severity of non-gingival and gingival lichen planus and their severity from the patients' view were evaluated. DESCRIPTION OF THE INDEX: A clinical index for assessing the severity of oral lichen planus is described with which the clinical forms as well as all the varying combinations of forms can be addressed separately. The clinical classification of OLP into six variants according to Andreasen [1] is the basis of the index. The index provides information about the severity of the disease in single regions and in the patient as a whole. The index is subdivided into a basic index as well as supplementary indices, which are optional. The clinical forms and size of OLP are recorded using the basic index, while various form-specific features such as the intensity of whitish pattern or mucosal erythema can be assessed additionally using the supplementary indices. Non-gingival and gingival lichen planus are assigned with their own indices. An index of subjective symptoms consisting of a visual analogue scale and verbal scales is available for describing patient discomfort. There is also a short form of the index (study-region index/one-region index), whereby only a single selected region is assessed. CONCLUSION: The index presented here is available as a new method of assessing OLP severity, offering both basic and advanced information for use especially in scientific studies of oral lichen planus.

Clinical Trials as Topic↗

PubMed2005

[Bisphosphonates and osteonecrosis of the jaw].

BACKGROUND: Since 2003, reports have been published on necrosis of the jaw bones possibly being associated with the administration of bisphosphonates. Bisphosphonates are highly active inhibitors of osteoclasts which have been used prophylactically or symptomatically in the treatment of plasmocytoma, bone metastasis of malignant disease, tumor-associated hypercalcaemia and in the treatment of osteoporosis. Due to the importance of this side effect of bisphosphonates, we report six cases. CASE REPORTS: Six patients (two women and four men) with a median age of 69 years (range 55-37) were diagnosed with osteonecrosis of the maxilla and/or mandible. These osteonecroses did not react adequately to local treatment and systemic therapy with antibiotics. Four patients suffered from plasmocytoma and two patients had a history of metastasising breast cancer. Besides cytostatic chemotherapies, all patients received bisphosphonates over an extended period. DISCUSSION: Bisphosphonates are considered an important standard in the treatment of plasmocytoma and bone metastasis due to malignancies. Since 2003, several reports have been published describing patients in whom therapy resistant osteonecrosis of jaw bones occurred either after dental extractions or spontaneously. Until then, unknown side effects of bisphosphonate therapy had been suspected. Since patients with malignant diseases receive cytostatic therapy and a range of other drugs, including bisphosphonates, enhancement of the side effects may be presumed. CONCLUSIONS: The probable association of the therapeutic use of bisphosphonates and the occurence of jaw bone necrosis has to be studied in further investigations. Patients receiving bisphosphonates should be followed-up regularly to avoid the occurrence of extended osteonecrotic lesions, which should be diagnosed early and treated adequately.

Adult↗

PubMed2005

Incidence of oral, pharyngeal, and laryngeal squamous cell carcinomas among 1515 patients after liver transplantation.

The purpose of this study was to evaluate the incidence and basic characteristics of oral, pharyngeal, and laryngeal squamous cell carcinomas (OPLC) in a single-centre series of liver transplantations (LT). The medical records of 1515 LT cases with a median follow-up of 6 years were analysed retrospectively for incident cases of OPLC. Incidence rates for the oral cavity and pharynx (ICD-9: 141-149), and larynx (ICD-9: 161) were assessed separately. OPLC cases and non-cases were evaluated with regard to end-stage alcoholic liver disease (ALD) as LT indication, smoking, and immunosuppression. The cumulative incidence of 13 cases with OPLC was 0.86% in total (n=1515). For 11 cases of OPLC in 307 patients with LT for ALD, it was 3.58%. The estimates for the annual incidence of OPLC (ICD-9: 141-149) were 121.79 for females and 111.65 for males (/100.000 patient-years). For OPLC (ICD-9: 161), the estimate was 37.21 for males, respectively (no female cases). ALD (84.6%) and pre-LT smoking (92.3%) were significantly overrepresented in OPLC cases (p<0.001). Age and gender distribution were comparable to non-cases. The 5-year survival rate after OPLC was 41.5%. OPLC were demonstrated as a late-onset complication of LT with poor prognosis. The impact of pre-, post-LT smoking, and, in particular, ALD as a confounder of OPLC deserves further investigation.

Adult↗

PubMed2005

Oral Candida species and betel quid-associated oral lesions in Padaung women of Northern Thailand.

Purpose of the present investigation was to study the association between the betel quid chewing (BQC) habits, the oral yeast flora and oral lesions in female Padaung of northern Thailand. Oral swabs were taken from the tongue and palate of 50 Padaung women with and 50 control individuals without BQC habit. The spectrum of oral Candida species in both groups was determined microbiologically. In addition, oral mucosal lesions were registered in both groups. Mean age of BQ chewers was 35.4 years, of non-chewers was 19.2 years. Candida parapsilosis was the most common Candida spp. isolated both in BQ chewers (46%) and non-chewers (44%). Candida albicans was revealed in 24% of BQ chewers and 18% of non-chewers. There was no significant difference in carriage of Candida spp. isolated between both groups. Forty-four per cent of BQ chewers revealed betel chewers mucosa, 10% showed leukoedema. Isolated populations such as the Padaung may reveal different patterns of candidal flora, in this case a predominance of Candida parapsilosis.

Adolescent↗

PubMed2004

[Shammah-associated oral leukoplakia-like lesions].

CASE REPORT: Shammah is a chewing tobacco, commonly used in Northern Africa. Leukoplakia-like lesions and oral cancer may be induced. In a 73-year-old male patient from Algeria leukoplakia-like lesions were observed in the anterior mandibular vestibulum and lower lip. The patient has been using shammah for 39 years. During the day three portions of shammah wrapped in a piece of paper tissue are prepared and rest in situ for 4-5 h. Due to its high alkalinity, shammah induces lesions resembling a burn. FINDINGS: Clinically, a white homogeneous lesion was seen in the vestibulum and mucosa of the lower lip. The white lesions could not be wiped off. Gingival recessions were seen in the lower front teeth. Root surfaces showed black-brown discoloration. A brush biopsy did not reveal epithelial atypia. The oral cavity showed signs of denture stomatitis and erythematous candidiasis. Microbiologically, Candida albicans was demonstrated. CONCLUSION: Due to the possibility of oral cancer in association with this habit, leukoplakia-like lesions have to be followed up diligently. Since chewing tobacco is a rare habit in Germany, changes as observed in the present case report may only rarely be observed. Due to migration it seems likely that in the future oral habits may be observed which are atypical for Western Europe. This phenomenon has also been addressed as transcultural dentistry.

Algeria↗

PubMed2004

Regional odontodysplasia: a review of the literature and report of four cases.

Regional odontodysplasia (RO) is a rare dental anomaly involving both dentitions, mostly teeth of one quadrant. The characteristic findings are discolored soft teeth accompanied by gingivitis, swelling or abscess. Enamel and dentin are hypomineralised and hypoplastic, so that the 'ghost teeth' appear shadowy in radiographs with wide pulp chambers. The etiology is unknown. Epidemiological data is rare; 138 cases of RO have been published to date and reports on ultrastructure are few. An analysis of published cases of RO in the international literature is presented. The sex ratio of females to males was 1.7:1. The age at the time of diagnosis ranged between 4 and 23 years. The maxilla was more often affected (maxilla to mandible ratio 1.6:1). In 67 patients the deciduous and permanent dentitions were affected (47.1%). In 129 cases, affected teeth lay side by side. Missing tooth development was observed in 10.7%. Failure of tooth eruption of RO teeth occurred in 39.7%. In addition, four cases with RO which were collected over a period of more than 25 years are presented. Ultrastructural findings of one specimen are demonstrated.

Child↗

PubMed2004

Abscess formation after lip augmentation with silicone: case report.

This paper describes the development of an abscess after injection of an alloplastic preparation (silicone) for enhancement of the lower lip. The 56-year-old woman presented with a painful swelling of her lower lip which was incised. Pus drained from the incision. A biopsy was taken. Histology revealed homogeneous foreign body inclusions (silicone) with fibrosis, chronic inflammation and multinuclear giant cells. Healing was uneventful with little deformation of the lower lip. Since the number of persons seeking aesthetic lip augmentation is increasing, oral surgeons and dentists should be familiar with adverse effects to filling agents.

Abscess↗

PubMed2004

The inflammatory paradental cyst: a critical review of 342 cases from a literature survey, including 17 new cases from the author's files.

BACKGROUND: A total of 325 cases of inflammatory paradental cysts (IPCs) and 17 own cases were reviewed. Although known since 1930, the IPC is still unrecognized by many clinicians. The IPCs show a relative frequency of 0.9-4.7%. The majority of cysts occur distally or distobuccally to vital, permanent mandibular molars with a history of pericoronitis (IPC/3rd mandibular molar alone accounts for 64.9%). Radiologically, the cyst appears as a well-defined, semilunar unilocular radiolucency. MATERIALS AND METHODS: Cases of inflammatory paradental cysts and related lesions were retrieved from a worldwide literature survey. In addition, 17 new cases from the files of the authors have been added. RESULTS: The mean ages for patients with IPC/1st, 2nd and 3rd mandibular molars are 8.7, 17.4 and 27.6 years, respectively. The male:female ratio was 1 : 0.9 for IPC/1st and 2nd mandibular molars, and 1 : 0.4 for 3rd mandibular molar. CONCLUSION: Reduced enamel epithelium, cell rests of Malassez and remnants of the dental lamina stimulated by inflammation are thought to play a role in the pathogenesis of IPC. Histological features are indistinguishable from those of the inflammatory, periapical (radicular) cyst.

Adolescent↗

PubMed2004

Oral candidosis and associated Candida species in HIV-infected Cambodians exposed to antimycotics.

Although human immundeficiency virus (HIV) infection is endemic in Southeast Asia, data on oral mycotic flora in this disease in Asians are sparse. The aim of this study was to determine the prevalence of Candida species in HIV-infected Cambodians with oral candidosis, unexposed (group 1) and exposed to antimycotics (group 2) and a healthy population (group 3). In 161 HIV patients with oral candidosis (group 1: 121 pts; group 2: 40 pts) and in 81 controls (group 3) swab samples of tongue and palate were obtained. Oral candidosis was detected in 100 and 70% of groups 1 and 2 respectively. Candida spp. were isolated from 91 and 100% of groups 1 and 2, respectively, and from 79% of controls. Candida albicans was the most common, with non-albicans species such as C. tropicalis and C. krusei being notable. Our data indicate that variants of oral candidal infections in HIV disease are similar to those seen in the pre-HAART era. The particularly high rate of C. krusei isolation in all groups is noteworthy.

AIDS-Related Opportunistic Infections↗

PubMed2003

[Oral precancerous conditions--an overview].

Precancerous conditions are defined as a generalized state associated with a significantly increased risk of cancer. For the oral and perioral region, sideropenic dysphagia, oral lichen planus (OLP), oral submucous fibrosis (OSF), syphilis, discoid lupus erythematosus, xeroderma pigmentosum as well as epidermolysis bullosa play a role as precancerous conditions. The number of published cases of oral or perioral malignant transformation for some of these diseases is small. In addition, carcinomas of the tongue and the oral cavity associated with syphilis are of historical interest, although publications in the 1990s still reported positive serology of syphilis and carcinomas of the tongue. OLP is still controversially discussed as to its premalignant nature. Transformation rates have been reported between 0% and 5.6%. Recent prospective studies have revealed that possibly oral lichenoid reactions (OLR) are more likely to form the basis of malignant transformation as compared to the classic OLP. The differentiation between OLP and OLR is difficult both from clinical and histopathological aspects. The second most important precancerous condition is oral submucous fibrosis, which is caused by betel quid chewing. OSF is most prevalent in South and Southeast Asia. The transformation rate is as high as 7.6% making OSF one of the most important precancerous conditions of the oral region.

Carcinoma, Squamous Cell↗

PubMed2003

Dental treatment prior to stem cell transplantation and its influence on the posttransplantation outcome.

Patients who receive allogeneic stem cell transplantation (SCT) for hematological malignancies are at increased risk of developing oral complications. To reduce morbidity pretransplantation dental evaluation and treatment of all sources of potential infection have become standard of care for these patients. This study examined the effect of dental foci on the posttransplantation (post-SCT) outcome in two groups of patients who underwent allogeneic or autologous SCT: those who had no dental foci or completed dental treatment preoperatively (n=36) and those who underwent SCT without dental interventions (n=22). Statistical analysis showed no significant correlations between dental foci and infections, mucositis, and survival rate post-SCT. We therefore do not recommend a radical dental treatment pre-SCT.

Adult↗

PubMed2003

[Proliferative verrucous leukoplakia. Report of five cases].

BACKGROUND: Proliferative verrucous leukoplakia (PVL) is a rare variant of oral leukoplakia (OL) with a high tendency for malignant transformation. PVL starts as a flat hyperkeratosis. During the course of the disease verrucous lesions develop. AIM OF THE STUDY, MATERIAL AND METHODS: Due to the scarcity of reports on PVL five cases of PVL are presented. Clinical and histopathological findings in five female patients with PVL were evaluated retrospectively. RESULTS: The clinical appearance of PVL was characteristic as compared to criteria described in the literature. The average period of observation in these cases was short (1.7 years). There were 3.6 different localizations observed per patient. The buccal mucosa, gingiva, and edentulous alveolar ridge were most often affected. One patient had already developed squamous cell carcinoma prior to referral. The others developed malignancies during follow-up. Recurrences and secondary malignancies could not be avoided using different therapeutic modalities. Two patients died from PVL. The characteristic spectrum of histopathological findings in PVL was observed. Homogeneous flat leukoplakias are characterized by acanthosis, hyperkeratosis, and often parakeratosis. Epithelial dysplasia is not seen. The proliferative verrucous stage of the disease is characterized by papillomatous epithelial growths with signs of slight epithelial dysplasia and subepithelial infiltration with immunocompetent cells. Stages of transformation may result in verrucous carcinoma or squamous cell carcinoma. CONCLUSIONS: PVL is associated with a very high rate of malignant transformations. These, as well as recurrences, cannot be avoided with present-day therapies. In order to define the biological profile of PVL more clearly, multicenter studies are necessary to reveal possible etiologic factors and concepts for therapy.

Aged↗

PubMed2003

[Inflammatory paradental cyst. Report of 6 cases].

BACKGROUND: The inflammatory paradental cyst has been described as an entity in the WHO classification of odontogenic tumors and cysts (1992). It is mainly located at mandibular molars, in particular third molars of the lower jaw. Radiologically, involved molars show a circumscribed, mostly half-moon shaped translucency distal or distobuccal to the involved tooth. Patients frequently report episodes of infection (pericoronitis). The histological findings are identical to those of inflammatory radicular cysts. The inflammatory paradental cyst has been described infrequently in the international literature. There are no reports available in German. AIM OF THE STUDY AND CASES: The aim of the present study was to present six of our own cases of inflammatory paradental cysts. Five men and one woman with an average age of 29.5 years were affected. In two cases paradental cysts occurred bilaterally. Three patients reported recurrent previous infections (pericoronitis). Radiologically, the typical translucency with clear demarcation distal to the third molars was observed. All of the third molars were vertically retained. Histologically, the inflammatory paradental cysts showed features identical to those of radicular cysts. The inflammatory paradental cyst is a clear indication for osteotomy of lower wisdom teeth. Postoperative complications or recurrences of the inflammatory paradental cysts have not been described. DISCUSSION: A correct clinical, radiological, and histopathological diagnosis of paradental cysts is mandatory, and more reports are needed in order to compile more information about relative frequency and pathogenesis of this cyst variant.

Adult↗

PubMed2003

[Revision of the 1992 edition of the WHO histological typing of odontogenic tumors. A suggestion].

The WHO classification of odontogenic tumors (1992, OT) was revised. The following main changes were proposed: (1) OT are not only "related to" odontogenic tissues but are derived from these; (2) the stroma of the epithelial tumor group (1.1.1) is of a fibrous nature and does not contain any ectomesenchymal component; (3) subtypes of ameloblastomas have to be differentiated (intra-, extraosseous, desmoplastic, unicystic); (4) eponyms are no longer used in the revised classification; (5) the AOT is reclassified as an epithelial OT; (6) a neoplastic and non-neoplastic line of the ameloblastic fibroma and ameloblastic fibrodentinoma is proposed; (7) the calcifying ghost cell odontogenic tumor is included in the classification; (8) the simple and the WHO type of odontogenic fibroma are included in the classification; (9) the classification of malignant OT is adapted from Eversole (1999) with a few changes. In particular, ameloblastic carcinoma is differentiated from malignant ( metastasizing) ameloblastoma; (10) the term carcinoma in intraosseous (peripheral) ameloblastoma is introduced. Also, the malignant epithelial odontogenic ghost cell tumor is termed calcifying ghost cell odontogenic carcinoma; (11) the clear cell odontogenic tumor is termed clear cell odontogenic carcinoma; (12) the so-called pseudocysts are termed "cavities" (aneurysmal bone cavity, simple bone cavity, lingual and buccal mandibular bone cavity, focal marrow-containing jaw cavity).

Ameloblastoma↗

PubMed2003

Oral manifestations in HIV-infected individuals from Thailand and Cambodia.

Oral manifestations were studied in 87 HIV-positive Thai adults (study 1), 45 HIV-positive children (study 2) and 101 HIV-positive (study 3). In study 1, 48% of patients had oral lesions; 23% had one and 13.8% two oral manifestations. Oral pseudomembranous candidiasis was found in 10.3%, erythematous candidiasis in 6.9%, and hairy leukoplakia (HL) in 11.5% of the patients. In study 2, 24.4% of children revealed one, 17.8% two and 6.6% three oral lesions; erythematous candidiasis was seen in 17.8%, and HL in 6.7% of the children. Fifteen patients (33.3%) received antiretroviral therapy. In study 3, pseudomembranous candidiasis was found in 52.5%, HL in 35.6% and necrotizing gingivo-periodontitis in 27.7%. Only 10% of patients were without oral lesions. The present three studies among HIV-infected Thai and Cambodians indicated a high prevalence of oral lesions, particularly variants of oral candidiasis such as pseudomembranous and erythematous candidiasis. Also, oral HL was a common finding, more so in patients with AIDS-associated diseases as represented by patients of study 3. Oral candidiasis and oral HL also seem to be quite prevalent in pediatric HIV-infected patients. In the absence of parameters indicating the degree of immunosuppression (CD4(+) cell counts and viral load) these oral lesions may be considered strong indicators of HIV-associated immunodeficiency.

AIDS-Related Opportunistic Infections↗

PubMed2003

Verruciform xanthoma--biological profile of 282 oral lesions based on a literature survey with nine new cases from Japan.

The biological profile of oral verruciform xanthoma (VX) is presented based on a world-wide literature survey of 282 cases. From 1979 onwards, extraoral cases have also been reported. This rare, harmless lesion with a sessile or pedunculated base is a red/pink, papillary/granular/verrucous mucosal growth, occurring in females (mean age, 54.9 yrs) and males (mean age, 44.2 yrs) in a female:male ratio of 1:1.1. The most common location is by far the gingival margin and other areas of the masticatory oral mucosa. Comparison between 173 non-Japanese and 109 Japanese patients with oral VX showed few discrepancies in epidemiological data, indicating only few significant ethnic differences between the two cohorts. Histomorphologically, the epithelium covering the lesion can be divided into three groups: (A) a verrucous, (B) a papillary and (C) a flat pattern. The hallmark of all VX, irrespective of the lesion being intra- or extraoral is, however, the presence of vacuolated, foam or xanthoma cells which ultimately replace the connective tissue between the epithelial ridges. The xanthoma cells have been shown to be cells of the monocyte/macrophage lineage. The present concept of the etiology and pathogenesis of VX, including the possible viral (HPV) association is revised, based on both intra- and some extraoral cases, and it is concluded that it is still far from being clarified.

Adolescent↗

PubMed2003

Decline of oropharyngeal cancer in Chiangmai province, Thailand, between 1988 and 1999.

A decline of oropharyngeal cancer has already been predicted for Thailand since the early 1960s. To substantiate these predictions it was the purpose of this study to examine trends in the incidence of oropharyngeal cancer in the province of Chiangmai, (1988-1999). Data on cancer incidence were extracted from the annual reports of the Cancer Registry, Cancer Unit, Faculty of Medicine, Chiangmai University, Thailand (1992-1999) and an IARC report on cancer in Thailand (1988-1991). The age-standardized annual incidence per 100000 of oral cancer in males dropped from 3.6 (1988-1991) to 1.2 in 1999 (P for trend 0.0002) and in females from 2.6 (1988-1991) to 1.1 in 1999 (P for trend 0.007). Similar trends in males and females for cancer of the tongue, oropharynx and hypopharynx were seen. The age-standardized annual incidence for cancer of the lip, salivary gland and nasopharyngeal carcinoma remained unchanged. Changes of traditional oral habits such as betel quid chewing and smoking of traditional cigars seem to have resulted in a marked decrease of oral cancer in both men and women in the recent past.

Age Distribution↗