Oral medicine (stomatology) across the globe: birth, growth, and future.

Oral medicine (stomatology) is a recognized and increasingly important dental specialty in many parts of the world that recognizes and fosters the interplay between medical health and oral health. Its dental activities rely greatly on the underlying biology of disease and evidence-based outcomes. However, full recognition of the importance of oral medicine to patient care, research, and education is not yet totally universally acknowledged.

Oral herpes simplex virus infection in pregnancy: what are the concerns?

Although epidemiologic data and the potentially serious effects of transmission of genital herpes from mother to infant during birth have been widely reported, published reports on oral herpes disease in pregnancy remain scarce and no clear management guidelines exist. Thus, questions remain about acquisition, transmission and outcome of infection, especially with respect to acute gingivostomatitis in pregnancy. In response to these questions, we summarize previous reports on herpes simplex virus 1 (HSV-1) oral disease in pregnancy and, briefly, present 2 cases of primary gingivostomatitis in the first trimester of pregnancy, resulting in a favourable outcome for both mother and infant.

The multi-step process of human skin carcinogenesis: a role for p53, cyclin D1, hTERT, p16, and TSP-1.

As proposed by Hanahan and Weinberg (2000. Cell 100, 57-70) carcinogenesis requires crucial events such as (i) genomic instability, (ii) cell cycle deregulation, (iii) induction of a telomere length maintenance mechanism, and (iv) an angiogenic switch. By comparing the expression of p53, cyclin D1, p16, hTERT, and TSP-1 in spontaneously regressing keratoacanthoma (KA) as a paradigm of early neoplasia, with malignant invasive cutaneous squamous cell carcinoma (SCC) as a paradigm of advanced tumour development, we are now able to assign the changes in the expression of these proteins to specific stages and allocate them to defined roles in the multi-step process of skin carcinogenesis.

Extensive papillomatosis of the palate exhibiting epithelial dysplasia and HPV 16 gene expression in a renal transplant recipient.

We report a unique case of extensive papillomatosis of the palate in a renal transplant recipient. The condition resembled inflammatory papillary hyperplasia; it exhibited severe epithelial dysplasia and concurred with generalized gingival hyperplasia. We document and discuss the probable multifactorial etiology of the lesions, including evidence for human papillomavirus (HPV) type 16 expression, as detected by in situ reverse transcription polymerase chain reaction.

The diagnosis and management of oral herpes simplex infection.

Acute herpetic gingivostomatitis and recurrent herpes labialis are the most common manifestations of infection with herpes simplex virus type 1 (HSV-1). In primary and recrudescent HSV-associated disease, the symptoms may range from subclinical to debilitating and life-threatening, depending on the host's immune responses or competence level. In this paper, the typical and atypical manifestations, and the current diagnostic and treatment options for localized, non-complicated oro-labial HSV infection are reviewed, with attention to cumulative evidence for the efficacy and safety of systemic antiviral agents.

Gain of 11q/cyclin D1 overexpression is an essential early step in skin cancer development and causes abnormal tissue organization and differentiation.

Non-melanoma skin cancers, in particular keratoacanthomas (KAs) and squamous cell carcinomas (SCCs), have become highly frequent tumor types especially in immune-suppressed transplant patients. Nevertheless, little is known about essential genetic changes. As a paradigm of 'early' changes, that is, changes still compatible with tumor regression, we studied KAs by comparative genomic hybridization and show that gain of chromosome 11q is not only one of the most frequent aberration (8/18), but in four tumors also the only aberration.

Are nicotine replacement strategies to facilitate smoking cessation safe?

Professional obligations to curb the prevalence of cigarette smoking reflect the importance of this preventable risk factor for innumerable diseases. These include chronic obstructive pulmonary disease and oral, lung and other cancers, although the morbidity and mortality rates for cerebrovascular disease (e.g.

Evidence for a role of mitogen-activated protein kinases in proliferating and differentiating odontogenic epithelia of inflammatory and developmental cysts.

Objective: The activation of intracellular signaling cascades involving serine/threonine kinases ERK1/2 has been variably reported either to stimulate or inhibit epithelial cell differentiation in response to extracellular signals. The purpose of our study was to determine the distribution of the signaling molecule ERK1 and its activated form pERK1/2 in the epithelial components of developmental and inflammatory odontogenic cysts in relation to parameters of differentiation and proliferation.

Study Design: Thirty samples of dental follicles, dentigerous cysts, and radicular cysts were immunostained with antibodies to ERK1, pERK1/2, and proliferating cell nuclear antigen (a marker for proliferation).

Treatment and long-term follow-up of a patient with hereditary gingival fibromatosis: a case report.

This report addresses the complex nature of oral diagnosis, treatment and long-term case management in the hereditary form of recurrent gingival fibromatosis. Case management is discussed in relation to a 13-year-old girl who presented with recurrent, progressive gingival enlargement requiring consecutive periodontal and orthodontic treatment. The initial course of treatment included 4-quadrant gingivectomy with reverse bevel incisions, followed by orthodontics.

Phenotypic comparison of periodontal ligament cells in vivo and in vitro.

The mammalian periodontal ligament contains heterogeneous populations of connective tissue cells, the precise function of which is poorly understood. Despite close proximity to bone and the application of high amplitude physical forces, cells in the periodontal ligament (PL) are capable of expressing regulatory factors that maintain PL width during adult life. The study of PL homeostasis and PL cell differentiation requires culture and phenotypic methods for precise characterization of PL cell populations, in particular those cells with an inherently osteogenic program.

Herpesvirus-induced diseases: oral manifestations and current treatment options.

The dentist is often the first health professional to be contracted by patients who develop acute orofacial symptoms of viral conditions such as shingles (varicella zoster) or herpetic gingivostomatitis. The diagnosis, treatment, and management of virally induced oral diseases is a challenge inasmuch as their presentation is atypical and may be complicated by immunosuppression. However, an increasing body of knowledge regarding the manifestations of viral infections in immunocompromised patients and the advances achieved in antiviral drug therapy during the past several years should make the task less daunting for the dentist.

Oral bowenoid lesions: differential diagnosis and pathogenetic insights.

Objective: To determine if oral lesions exhibiting bowenoid features reflect the diverse microscopic appearance and biologic behaviour of Bowen's disease and bowenoid papulosis of the skin and genitalia.

Study Design: Seven cases of oral bowenoid lesions (6 with follow-up data) were assessed for differences in histologic features, human papillomavirus (HPV) viral status, and selected immunohistochemically detectable cell cycling proteins (p53, WAF-1, Cyclin D1, Bcl-2) and were correlated with available follow-up data.

Results: Two histologic subsets were identified.

Differentiation and the cytomorphology of salivary gland tumors with specific reference to oncocytic metaplasia.

Objective: The different cell types and many growth patterns found in salivary gland tumors provide ample reason for the diagnostic problems caused by these tumors. To improve criteria for differential diagnosis, the potential range of cytologic features possible in salivary gland tumor cells must be better appreciated.

Study Design: From our respective pathology archives, normal salivary tissue and salivary gland tumours--other than Warthin's tumor and oncocytoma--with oncocytic differentiation were identified and studied by means of light and electron microscopy.

Detection of Helicobacter pylori in oral aphthous ulcers.

A causative role for Helicobacter pylori (H. pylori) in the pathogenesis of oral mucosal ulcerations has been suggested previously. We have adopted the polymerase chain reaction (PCR) as a rapid and sensitive means to detect H.

Human papilloma virus type 16 E6 gene expression in oral exophytic epithelial lesions as detected by in situ rtPCR.

Objective: We adopted an in situ reverse transcriptase polymerase chain reaction method of detecting and determining the frequency of early (E6) gene expression of human papilloma virus type 16 at the individual cell level in a sample of oral exophytic lesions with various degrees of epithelial hyperplasia and dysplasia in immunosuppressed and immunocompetent patients.

Study Design: The significance of differences between the study groups was determined by Mantel-Haenszel chi-square analysis and calculation of odds ratios, accounting for immunosuppression and degree of dysplasia, respectively.

Results: Grouped together, the lesions of dysplasia (mild to severe) and squamous cell carcinoma were found to be 16 times more likely to express human papilloma virus E6 mRNA than the benign lesions (P = .

Demonstration of c-erbB-2 oncogene overexpression in salivary gland neoplasms by in situ hybridization.

The level of c-erbB-2 cellular mRNA in 18 salivary gland tumours and in 7 normal salivary glands was determined by in situ hybridization using [35S] labelled RNA probes. Computer assisted quantitation of the autoradiographic signal indicated a significantly higher c-erbB-2 expression in the tumour group (22.64 grains per cell +/- 3.

Analysis of c-erbB-2 amplification in salivary gland tumours by differential polymerase chain reaction.

DNA samples extracted from 22 normal salivary glands, 38 salivary pleomorphic adenomas and 20 other salivary gland neoplasms were screened for amplification of the c-erbB-2 oncogene by a differential polymerase chain reaction (PCR). The samples were PCR amplified with primers specific for the c-erbB-2 oncogene and for a reference gene (interferon-gamma). A breast carcinoma cell line SKBR-3 known to contain c-erbB-2 amplification was used as positive control.

c-fos oncogene underexpression in salivary gland tumors as measured by in situ hybridization.

Tissue from 35 salivary gland tumors and 14 normal salivary glands was analyzed by in situ hybridization and computer-assisted morphometry for the expression of the c-fos oncogene. The normal salivary gland tissues were found to express c-fos focally, mainly in the acinar secretory cells. The majority of the cells in the normal tissues showed a high level of expression (47.

c-fos oncogene expression in dexamethasone stimulated osteogenic cells in chick embryo periosteal cultures.

Although the complex effects of glucocorticoids on bone cells have been studied extensively in vitro, little is known about the molecular mechanisms of glucocorticoid responses in osteogenic cells. As c-fos and its protein product are believed to play a key role in intracellular signal transduction, and since their role in regulation of bone formation is well-recognized, we studied the effect of the glucocorticoid analogue dexamethasone (DEX) on the expression of c-fos oncogene in the chick periosteal osteogenesis (CPO) model. C-fos mRNA expression was determined by in situ hybridization at various time points after 10(-7) M DEX treatment.

Inducibility of neoplastic transformation by Fujinami sarcoma virus in an in vitro chick embryo model for osteosarcoma: (i) effect of differentiation and (ii) investigation for in vivo growth potential in athymic mice.

We have described previously a novel in vitro model for the study of osteosarcoma. In this system, chick periosteal explants (CEP) transformed by the P140gag-fps oncoprotein of Fujinami avian sarcoma virus (FSV) exhibit biochemical and histological manifestations characteristic of osteosarcoma. In the present study, a hypothesis suggesting that more differentiated bone cells may resist FSV-induced oncogene changes was tested.

EBV and HSV infections in a patient who had undergone bone marrow transplantation: oral manifestations and diagnosis by in situ nucleic acid hybridization.

The course of infections with herpes simplex virus and Epstein-Barr virus in an immunosuppressed patient who had undergone bone marrow transplantation and had tested seronegative for human immunodeficiency virus is described. The clinical oral manifestations were unusual, as they included hairy leukoplakia-like lesions and extensive mucosal ulceration. Histologic examination disclosed unique features consisting of both lichenoid and viral cytopathic changes.

The regulatory effect of phosphates on bone metabolism in vitro.

One of the most important indicators in vitro of the bone-cell phenotype is the synthesis of mineralized bone-like tissue. This has been achieved by supplementing isolated bone-cell and tissue cultures with organic phosphates, in particular, beta-glycerophosphate. To analyze the effects of beta-glycerophosphate on bone-cell metabolism and osteogenesis in vitro, both biochemical analyses and computer-assisted morphometry were used.

Site-specific regulation of osteogenesis: maintenance of discrete levels of phenotypic expression in vitro.

Intrinsic differences in bone formation rate, cell numbers, and the percentages of cells expressing alkaline phosphatase activity were studied in explants of chick calvaria periosteum cultured for 4 days and 6 days. Proliferation, differentiation, and bone production were examined in radioautographs of plastic sections and by using whole-culture biochemical assays of protein and alkaline phosphatase. Ectocranial explants at both 4 days and 6 days exhibited more alkaline phosphatase-positive cells and significantly more bone formation than endocranial cultures.

Dexamethasone effects on induction of neoplastic transformation by Fujinami sarcoma virus in an in vitro chick embryo periosteal model for osteosarcoma.

Recently we have developed a model in vitro system for the study of factors regulating the histogenesis of osteosarcoma. In this system, Fujinami sarcoma virus (FSV) induces osteosarcomatous changes such as increased cell proliferation and altered patterns of bone and nonmineralized matrix (osteoid) formation. Such changes can be quantitated at the individual cell level, by computer-assisted morphometry.

Neoplastic transformation of osteogenic cells: quantitative morphometric analysis of an in vitro model for osteosarcoma.

Previously we have reported the development of a model in vitro system for the study of osteosarcoma. In this system, when chick periosteal explants are infected with Fujinami sarcoma virus (FSV), osteosarcoma-like tissue is formed. In the present study, a series of histopathologic parameters of neoplastic transformation and osteogenesis were quantitated, at a single cell level, by computer-assisted morphometry.