Oncogenes, tumor suppressors and viruses in oral squamous carcinoma.

The pathogenesis of oral squamous cell carcinoma involves recognised carcinogens in tobacco and/or alcohol but other factors, including viruses, may also have a role. This paper reviews the gene changes revealed in oral carcinoma, the evidence implicating viruses, and mechanisms whereby viruses may affect gene function.

Erythema multiforme involving gingiva.

Erythema multiforme is a vesiculobullous condition that may affect skin and/or mucosa. Oral lesions are characterized by hemorrhagic crusting of the lips and ulceration mainly of the non-keratinized mucosa. This paper describes a patient who presented with gingival lesions as well as the more typical oral signs of erythema multiforme.

Tissue markers of potentially malignant human oral epithelial lesions.

Tissue markers of potential malignancy have been sought for many years. Cell surface markers, particularly blood group and histocompatibility antigens, have shown great promise and several squamous carcinoma antigens have been identified--but not fully studied in potentially malignant lesions. Growth factors and receptors also need further study.

Epstein's syndrome. Implications for oral surgery.

Epstein's syndrome is a rare inherited disorder that appears principally as nephritis and deafness with thrombocytopathic thrombocytopenia producing a bleeding tendency. Management of the disorder for oral surgical procedures is discussed and highlighted by a case report.

Oral presentation of lymphoma: case report of T-cell lymphoma masquerading as oral Crohn's disease, and review of the literature.

A 15-year-old male with labial swelling, mouth ulcers and mucosal tags is reported. While the features were clinically consistent with oral Crohn's disease the patient proved to have a fatal T-cell lymphocytic lymphoma.

Human herpes simplex-1 and papillomavirus type 16 homologous DNA sequences in normal, potentially malignant and malignant oral mucosa.

We have tested a range of normal, potentially malignant and malignant oral mucosal biopsies tissues by Southern blot hybridisation analysis for the simultaneous presence of HSV-1 and HPV type 16 DNA sequences, both of which have been implicated as risk factors in oral carcinogenesis. The results show that: (1) 2/4 patients with lichen planus, 2/4 patients with non-specific keratosis, 1/8 patients with oral carcinoma and 3/5 biopsy specimens of normal oral mucosa contained DNA sequences homologous to the HSV-1, Bam HI-G fragment. (2) HPV-16 homologous DNA sequences were detected in 3/4 patients with lichen planus, 4/4 non-specific keratosis, 4/8 oral carcinomas and in 3/5 biopsy specimens of normal oral mucosa.

Are viruses associated with aphthae and oral vesiculo-erosive disorders?

Oral and maxillofacial surgeons in District General Hospitals in UK often carry the major workload of patients with chronic oral ulcerative conditions. Although the immunopathogenic basis of many of these is being unravelled, the aetiology is often unclear, though a role for viruses is increasingly suspected. This paper reviews the current evidence.

The de Lange syndrome in association with a bleeding tendency: oral surgical implications.

A patient with de Lange syndrome who also had a variant of von Willebrand's disease is reported. The problems with dental surgery, particularly with respect to difficulty of extraction and bleeding tendency, are discussed.

Orofacial manifestations in primary immunodeficiencies: common variable immunodeficiencies.

The orofacial manifestations of 15 patients with Common Variable Immunodeficiencies (CVID) are reported. Aphthous-like ulceration, pseudomembranous candidosis and/or enamel hypoplasia were observed in 11 patients. Four patients had no orofacial lesions.

Oral cancer: new insights into pathogenesis.

Understanding the pathogenesis of cancer may well lead to improved diagnostic tests, preventive treatment and management. This paper reviews the gene changes, the evidence implicating viruses in the aetiology of oral cancer, and the mechanisms whereby viruses may affect gene function and thereby contribute to carcinogenesis.

Orofacial manifestations in primary immunodeficiencies involving IgA deficiency.

The orofacial manifestations of 39 patients with primary IgA deficiency are reported. Aphthous-like oral ulceration was observed in 61% while candidosis and recurrent herpes labialis were each present in 25%. Only 4 (9%) patients had no orofacial lesions.

Complications of dental surgery in persons with HIV disease.

Post tooth extraction infective complications have occasionally been described in HIV-infected persons. However, there is little objective data as to the frequency of this and the need for antibiotic prophylaxis. Similarly the frequency of postextraction bleeding in patients infected with HIV, who may have thrombocytopenia, is unknown.

Gingival and other oral manifestations in tuberous sclerosis: a case report.

Tuberous sclerosis is a rare congenital disorder characterized by cutaneous angiofibromas, mental retardation, seizure disorders, and a variety of other, less common systemic anomalies. The present report details the features and periodontal management of a patient with gingival fibromata secondary to tuberous sclerosis.

Viral infections affecting periodontal health.

A wide spectrum of viruses can give rise to oral and periodontal manifestations. This article reviews viral infections of clinical importance to the periodontologist and confirms the important role of the periodontologist in the recognition and treatment of common viral infections of the mouth.

Pigmented purpuric stomatitis.

The pigmented purpuric dermatoses are a group of disorders in which there is chronic capillaritis, with pigmented purpuric lesions predominantly on the lower limbs. We report a case with chronic oral lesions that had histologic features most in keeping with the purpuric lichenoid dermatitis of Gougerot and Blum syndrome.

The ranking of facial attractiveness.

A method of assessing facial attractiveness is described in which facial photographs were ranked by adults in order from the most to the least attractive. The rankings of a group of normal 10-year-old children were compared to those given to a group of similarly aged patients with repaired clefts. Most previous methods have grouped patients into categories, but this tends to obscure individual differences in facial attractiveness: patients with small differences in appearance are generally placed in the same group.

Necrosis of the tongue in a patient with intestinal infarction.

A patient with a rare combination of bilateral lingual necrosis and intestinal infarction, caused by giant cell arteritis, is described and the literature reviewed.

Pulse oximetry during minor oral surgery with and without intravenous sedation.

This study investigated the levels of oxygen saturation and pulse rates of patients undergoing minor oral surgery under local analgesia, with (20 patients) or without (20 patients) intravenous sedation with midazolam. The results indicated that a statistically significant fall in arterial blood oxygenation of 1% to 2%, as measured by pulse oximetry, followed midazolam administration; however, this was physiologically insignificant. Both groups showed a similar postoperative small fall in oxygen saturation.

Comparison of oral squamous cell carcinoma in younger and older patients in India.

This study examines the demographic, aetiological and clinico-pathological features of 37 patients with oral squamous cell carcinoma (SCC) who were less than 35 years old and a comparable number of patients who were greater than 60 years old. The study was undertaken at the Regional Cancer Centre, Trivandrum, India, between 1988 and 1990. In patients younger than 35 years old, oral SCC occurred more commonly in females, was apparent in all social classes and was associated with fewer aetiological factors.

Progressive abrogation of TGF-beta 1 and EGF growth control is associated with tumour progression in ras-transfected human keratinocytes.

This study examined the response of human keratinocytes in different stages of transformation to exogenous TGF-beta 1 and EGF as well as their receptor and growth-factor expression. Cells of the spontaneously immortalized HaCaT cell line and c-Ha-ras transfected clones (I-6, I-7, II-3, II-4) exhibited different tumorigenic potentials when transplanted to athymic mice. HaCaT- and I-6 cells were non-tumorigenic, I-7 cells formed persisting epidermal cysts (benign tumours) and II-3 and II-4 cells developed into invasive squamous-cell carcinomas.

Cardiopulmonary resuscitation skills of dental personnel.

This study assessed the cardiopulmonary resuscitation (CPR) skills of 25 dental personnel. Theory was tested by multiple choice questionnaire (MCQ) and practical skills assessed using a recording Resusci-Anne manikin. The assessment was based upon the recommendations of the Resuscitation Council of the UK.