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Dermoid cyst of the floor of the mouth.

Dermoid cysts of the floor of the mouth are rare lesions thought to be caused by entrapment of germinal epithelium during the closure of the mandibular and hyoid branchial arches. They usually present as a nonpainful swelling. This type of lesion occurs more frequently in patients between 15 and 35 years, but can be seen in all age ranges. Histologically, all dermoids are lined by epidermis. The contents of the cyst lining determine the histological categories of the cyst: epidermoid, if epidermis is lining the cyst; dermoid, if skin annexes exist; or teratoid, if there are tissues derivated from the three germinal layers. Anatomical classification is useful for surgical approach choice, intra- or extraorally. This report presents a case of a dermoid cyst of the floor of the mouth in a 12-year-old patient, and a review of all steps necessary for its diagnosis and treatment was made.

Child↗

Guidelines in head and neck oncology compliance and consequences of deviations from the standard protocol for tongue and floor of mouth squamous carcinoma.

OBJECTIVES: To investigate the extent of violation of a regional guideline for the treatment of patients with carcinoma of the tongue/floor of mouth (ICD0 C02, C04). Different aspects of protocol violation (i.e. undertreatment or overtreatment) and consequences for treatment outcome were evaluated. DESIGN: Retrospective analysis of data from medical records. SETTING: The Department of Maxillofacial and Oral Surgery and the Department of Otorhinolaryngology and Head and Neck Surgery of the University Medical Centre Utrecht. PARTICIPANTS: A total of 217 patients treated between 1991 and 2001 for a stage II and stage III carcinoma of the tongue/floor of mouth. MAIN OUTCOME MEASURES: Protocol violation, tumour recurrence. RESULTS: The overall adherence to the guideline was 55%. In the non-adherence group of patients, 21% were overtreated, 71% were undertreated, and 8% were both overtreated and undertreated. There was no statistically significant difference in tumour recurrence between the two groups for stage II (P=0.68) or stage III (P=0.97) disease, or between undertreatment and overtreatment of patients with stage II (P=0.47) or stage III (P=0.90) disease. CONCLUSIONS: Although protocol violation occurs in as many as 45% of patients, this does not result in a worse tumour recurrence. Neither overtreatment nor undertreatment appears to affect the overall tumour recurrence.

Female↗

Alteration in directional specificity of interdental dimension discrimination with the degree of mouth opening.

The interdental dimension discrimination (IDD) ability was tested at seven different degrees of mouth opening: 40 mm, 30 mm, 20 mm and 10 mm openings for the dentate subjects, and 10 mm opening, intercuspal position (ICP) and the ICP minus 5 mm for the edentulous subjects. The subjects were asked to discriminate between pairs of sticks held alternately between the upper and lower incisors. The IDD ability, evaluated in terms of the 50% difference limen (DL), did not differ significantly between any two of the tests conducted at seven different openings, although the number of misjudgments of the dentate subjects tended to increase with the degree of mouth opening. On the other hand, the directional specificity of the IDD, which is a tendency to overestimate the dimension of the first stick of each pair, developed almost linearly with a decrease in the opening degree. These findings indicate that the behaviour of the receptors concerned varies with the intermaxillary distance. Some edentulous subjects could not perceive the presence of a small test stick at the overclosed position (ICP -5 mm), but vibration applied to the mandible enabled the subjects to detect the stick at the same opening. These results support the assumption that the muscle spindles of the jaw-closing muscles are the receptors responsible for the IDD.

Adult↗

Disturbed lower denture stability due to lipoma in the floor of the mouth.

An unusual case of lipoma arising in the floor of the mouth of a 70-year-old man is presented. The unusual appearance suggests that the tumour be included as a rare possibility in the differential diagnosis of swellings in the floor of the mouth that can also adversely affect lower denture stability.

Aged↗

The oral gram-negative anaerobic microflora in young children: longitudinal changes from edentulous to dentate mouth.

Eruption of primary teeth has a great influence on the oral environment by providing suitable niches for bacterial colonization. The composition of oral gram-negative anaerobic microflora was investigated in 21 young children (mean age 32 months) with primary dentition. The bacterial findings of samples were compared with those of the same children collected at their edentulous infant period (mean age 3 months). During the primary period, 2 samples were collected from each child: a sample with dental floss from gingival margin of 2 teeth and stimulated saliva pooled with a mucosal swab sample. Both samples were cultured aerobically and anaerobically using nonselective and selective media. Prevotella melaninogenica, nonpigmented Prevotella spp., Fusobacterium nucleatum group and Capnocytophaga spp. were found in all children at the older age, whereas they occurred in edentulous mouth in 76%, 62%, 67% and 19%, respectively. The occurrence of Prevotella loescheii increased from 14% to 90%, Prevotella intermedia from 10% to 67%, Leptotrichia spp. from 24 to 71%, Campylobacter (Wolinella) spp. from 5 to 43% and Eikenella corrodens from 5 to 57%. Only the occurrence of Bacteroides gracilis and Veillonella spp. remained at about the same level. Species not isolated from the edentulous mouth, such as Prevotella denticola, Fusobacterium spp. other than the F. nucleatum group and Selenomonas spp. were now detected in 71%, 71% and 43% of the children. The stability of the colonizing P. melaninogenica strain(s) in the oral cavity was determined by using ribotyping; 1-2 isolates per child from the edentulous infant period of 9 children and 3-15 isolates per child from their primary dentition period were analyzed.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Typing Techniques↗

Burning mouth in a Finnish adult population.

Burning mouth syndrome is an oral pain disorder with a prevalence of 5-18% in patient materials. The aim of this study was to determine the prevalence of Burning mouth syndrome in a representative sample of the general adult population. Altogether 431 subjects (237 females, 194 males) participated in the study. Subjects were questioned about the experience of prolonged burning sensation; the site, severity, pattern, duration and possible associations of the onset of the burning sensation, and a thorough clinical examination was performed. In all, 15% of the subjects had experienced prolonged oral burning but a half of them had some clinically observable oral mucosal lesion or oral candidosis. The prevalence of the complaint was significantly higher in females than in males.

Adult↗

Contact allergy to denture materials in the burning mouth syndrome.

Several factors may be responsible for stomatitis in general and the burning mouth syndrome in particular. The results of patch testing are reported in 4 patients with burning mouth symptoms thought to be due to sensitization to denture material. 2 patients reacted to substances in Luxene dentures, but the allergens were not identified. In a 3rd patient, sensitization was found to monomeric methyl methacrylate. The other patient gave positive patch tests to epoxy resin (and bisphenol A), probably present in glue used for repair of dental plates. To obtain a complete diagnosis in cases of suspected contact stomatitis due to allergens in dentures, a reliable standard test series is required.

Aged↗

Coexistence of lymphoepithelial and epidermoid cysts on the floor of the mouth: report of a case.

Lymphoepithelial and epidermoid cysts in the oral cavity are uncommon. The coexistence of lymphoepithelial and epidermoid cysts in the oral cavity is extremely rare. Only one case of lymphoepithelial cyst associated with two epidermoid cysts on the floor of the mouth has been reported in the literature and the present report describes a second case where a lymphoepithelial cyst coexisted with an epidermoid cyst on the floor of the mouth. It is likely an accidental trauma that was accompanied by inflammation produced the development of implantation-keratinizing epidermoid and lymphoepithelial cysts.

Adult↗

Ectopic tonsillar tissue in the mucosa of the floor of the mouth simulating a benign tumour. Case report.

Ectopic tonsillar tissue in the mucosa of the floor of the mouth is rare. A case of a 38-year-old man with ectopic tonsillar tissue in the mucosa of the floor of the mouth is described. The lesion was manifested as a small, painless tumour. There was difficulty in establishing a clinical diagnosis, but it was thought to be a benign tumour and was removed and then examined histopathologically to confirm the diagnosis.

Adult↗

INFLUENCE OF TISSUE CULTURE PASSAGE ON VIRULENCE OF FOOT-AND-MOUTH DISEASE VIRUS FOR MOTHER MICE.

Campbell, Charles H. (Plum Island Animal Disease Laboratory, Greenport, N.Y.). Influence of tissue culture passage on virulence of foot-and-mouth disease virus for mother mice. J. Bacteriol. 86:593-597. 1963.-Foot-and-mouth disease virus serially passaged in bovine cell cultures was more lethal for mother mice than the parent virus from infected steers. In tests with virus from several pools of bovine tongue tissue, only 0 to 20% of the mice died. Serial passage of such virus in primary calf-kidney cell cultures progressively increased the lethality of the virus. By the eighth passage, after which no further appreciable increase was observed, the mortality was 60%. As the lethal capability of this virus population increased, the average time required for it to produce death decreased.

Animals↗

CT of the oropharynx, tongue base, and floor of the mouth: normal anatomy and range of variations, and applications in staging carcinoma.

CT scans of 35 patients were obtained during rapid drip infusion of contrast material to determine the range of normal variation in the structures of the oropharynx and the floor of the mouth. Superficial structures such as the tonsillar pillars and lingual and faucial tonsils vary so much in appearance that they are not useful indicators in the detection of subtle lesions; in fact, they are potential sources of "pseudomasses." Asymmetric obliteration of the parapharyngeal space is useful for the detection of subtle lesions of the upper tonsillar fossae; however, confident diagnosis in regard to the lower oropharynx depends on visualization of a mass lesion or loss of the more constant planes in the floor of the mouth and the tongue base. CT findings added unique and valuable information in eight of 12 cases of carcinoma, confirmed the clinical impression of the extent of the lesion in four cases, and were potentially misleading in one case. CT is a valuable adjunct to the detection and staging of an oropharyngeal malignancy.

Diagnostic Errors↗

Viral lesions of the mouth in HIV-infected patients.

Viral lesions of the mouth in patients with HIV infection are common and these diseases any be a marker for HIV and disease progression. We review the spectrum of oral viral manifestations and discuss treatment modalities. The most common Epstein-Barr virus (EBV)-induced disorder in HIV-infected patients is oral hairy leukoplakia. EBV-related oral B-cell and T-cell lymphoma in AIDS patients has been described repeatedly. Herpes virus type 1 and rarely type 2 may lead to painful and resistant oral ulcers, and systemic treatment with acyclovir, valaciclovir or famciclovir is indicated. In acyclovir-resistant cases foscarnet is the treatment of choice. In recent years it has been documented that Kaposi's sarcoma, which often affects oral mucosa, is probably induced by herpesvirus type 8. Cytomegalovirus was found in 53% of cases with herpesviridae-induced mucosal ulcers as the only ulcerogenic viral agent in AIDS patients. In severe cytomegalovirus infection treatment with ganciclovir is helpful. Viral warts induced by different HPV may occur in the mouth. Several physical treatment modalities are possible in the oral mucosa. In AIDS patients mollusca contagiosa may occur as large and atypical lesions in the face and lips and rarely in the oral cavity. Cryotherapy is a bloodless treatment in such patients.

2-Aminopurine↗

Lymphatics of the floor of the mouth and periosteum: anatomic studies with possible clinical correlations.

An anatomic study is made to determine the role of the periosteum in the lymphatic drainage of the floor of the mouth in the dog. Microsurgical techniques are used to cannulate and perfuse a lymphatic vessel. Pathways are dissected to the proximity of the mandible, where a full-thickness mucoperiosteal flap is elevated. It is found that the floor-of-the-mouth lymphatics drained through the periosteum prior to entering the cervical lymphatic chain.

Animals↗

Epidermoid carcinoma of the floor of the mouth: surgical therapy vs combined therapy vs radiation therapy.

A retrospective analysis of 103 selected patients with floor-of-mouth epidermoid carcinoma compared the effectiveness of surgical therapy alone vs planned preoperative radiation combined therapy vs irradiation therapy. All three treatment methods appeared equally effective in irradicating stage I and II disease. Stage III floor-of-mouth epidermoid carcinoma was similarly controlled by either surgical therapy or combined therapy. Irradiation therapy alone was markedly inferior in treatment of stage III disease. Stage IV disease was poorly handled by any of the treatment methods. Histologic factors, tumor characteristics, tumor spread, nodal status, and staging did not appear in the majority of cases to significantly influence treatment selection or survival or both.

Adult↗

The use of antimicrobials in the mouth.

The use of antimicrobials in the mouth, particularly in the form of antiseptic mouth-washes, is widely practised. The purposes for which such treatment is used are very diverse and reports are widely scattered throughout the literature. It is the purpose of this review to bring together diverse literature references and to present a short but comprehensive survey of the subject.

Anti-Infective Agents, Local↗

The molecular epidemiology of foot-and-mouth disease virus serotypes A and O from 1998 to 2004 in Turkey.

BACKGROUND: Foot-and-Mouth Disease (FMD) causes significant economic losses in Turkish livestock. We have analysed the genetic diversity of the 1D sequences, encoding the hypervariable surface protein VP1, of Turkish isolates of serotype A and O collected from 1998 to 2004 in order to obtain epidemiological and immunological information. RESULTS: The 1D coding region of 33 serotype O and 20 serotype A isolates, obtained from outbreaks of FMD between 1998 and 2004, was sequenced. For serotype A, we confirmed the occurrence of the two subtypes IRN99 and IRN96. These subtypes are most divergent within the region encoding the immuno-dominant GH-loop. Also a close relationship to Foot-and-Mouth Disease virus (FMDV) serotype A isolates obtained from outbreaks in Iraq and Iran were detected and a clustering of isolates collected during the same period of time were found. The analysis of the deduced amino-acid sequences of these subtypes revealed evidence of positive selection in one site and one deletion, both within the GH-loop region. By inferring the ancestral history of the positively selected codon, two potential precursors were found. Furthermore, the structural alignment of IRN99 and IRN96 revealed differences between the tertiary structures of these subtypes. The similarity plot of the serotype O isolates suggested a more homogeneous group than the serotype A isolates. However, phylogenetic analysis revealed two major groups, each further divided in subgroups, of which some only consisted of Turkish isolates. Positively selected sites and structural differences of the Turkish isolates analysed, were not found. CONCLUSION: The sequence and structural analysis of the IRN99 strains is indicative of positive selection suggesting an immunological advantage compared to IRN96. However, results of antigenic comparison reported elsewhere do not substantiate such a conclusion. There is evidence that IRN99 was introduced to Turkey, in all probability from Iran. Since, a member of the IRN96 lineage was included as a component of the FMDV vaccine produced since 2000, the outbreaks caused by IRN96 strains in 2004 could be due to incomplete vaccine coverage. The Turkish type O strains, all with a VP1 structure similar to the O1/Manisa/69 vaccine, appear in several sublineages. Whether these sublineages reflect multiple samplings from a limited number of outbreaks, or if they reflect cross-boundary introductions is not clear.

Amino Acid Sequence↗

True lateral dermoid cyst of the floor of the mouth.

Congenital dermoid cysts of the floor of the mouth are relatively rare but when they occur, they do so inevitably in the midline. We present a case of a true lateral dermoid cyst of this region without any intra-oral extension. We discuss the anatomical and histological classification of dermoid cysts within the floor of the mouth.

Adult↗