Ameloblastoma, calcifying epithelial odontogenic tumor, and glandular odontogenic cyst show a distinctive immunophenotype with some myoepithelial antigen expression

Background:  Odontogenic neoplasms have some morphologic overlap with salivary gland neoplasms, many of which show myoepithelial differentiation. In the 1980s, an ultrastructural study identified a population of myoepithelial-like cells in calcifying epithelial odontogenic tumor. Myoepithelial derived tumors have since been shown to have distinct immunohistochemical profiles.
Methods:  We examined a series of odontogenic neoplasms, including 11 ameloblastomas, four calcifying epithelial odontogenic tumors, five glandular odontogenic cysts (GOCs), and five keratocystic odontogenic tumors with a panel of myoepithelial-associated immunohistochemical stains. We also assessed representative control examples of oral mucosa, odontogenic rests, and dentigerous cysts.
Results:  All of the neoplastic and non-neoplastic oral epithelium-derived entities share a p63-positive, high molecular weight cytokeratin (CK5/6)-positive immunophenotype. Calponin reactivity was at least focally present in two of four calcifying epithelial odontogenic tumors, three of five GOCs, and 10 of 11 ameloblastomas; the sole completely non-reactive ameloblastoma represents a lung metastasis. One case of calcifying epithelial odontogenic tumor was focally positive for glial fibrillary acidic protein. However, other more definitive markers of myoepithelial differentiation, including S-100 and smooth muscle actin, were negative. Two of three calcifying epithelial odontogenic tumors and five of five GOCs were also positive for a low molecular weight cytokeratin (CK7).
Conclusions:  Ameloblastomas, GOCs, and calcifying epithelial odontogenic tumors show a distinctive immunophenotype which overlaps with that of myoepithelial-derived salivary gland neoplasms but does not provide definitive support for myoepithelial differentiation.     

Patterns of dental service use among homeless people using a targeted service

Objective: The objective of this study was to describe the patterns of dental service use among homeless people using a targeted dental service from 1992 to 2001.
Method: A case-note review of a selection of patients ( n  = 204) was undertaken using a pre-designed data abstraction form.
Results: For those presenting at their first contact, 40 percent ( n  = 68) expressed need in relation to oral pain and disease/tissue damage, and 28 percent ( n  = 33) in relation to dental checking and oral prophylaxis. Most homeless people had normative need for dental treatment (93 percent: n  = 153). The dental service was delivered using a mix of outreach and fixed site clinics, with 75 percent ( n  = 153) of all first contacts made at outreach clinics. The targeted service was moderately successful at getting people to attend the fixed site service for continuing care, with 51 percent ( n  = 87) attending for subsequent visits. Location of first contact with the targeted dental service did not predict subsequent attendance. Those who did attend for further care tended to have normative needs for periodontal disease and dental decay and have their presenting complaint met. Only 23 percent ( n  = 46) of people completed a treatment plan, over a mean of 8.2 (standard deviation ± 9.4) visits. No factors appeared to predict completion of treatment.
Conclusions: While the small sample limits the findings in this study, it is hypothesized that the presence of the dental service promoted uptake of dental care. Flexible attendance tended to result in multiple visits and delayed outcomes, which themselves could have acted as barriers to care.     

Hutchinson-Gilford progeria syndrome: oral and craniofacial phenotypes

Objective:  Hutchinson-Gilford progeria syndrome (HGPS) is a rare early-onset accelerated senescence syndrome. In HGPS, a recently identified de novo dominant mutation of the lamin A gene ( LMNA ) produces abnormal lamin A, resulting in compromised nuclear membrane integrity. Clinical features include sclerotic skin, cardiovascular and bone abnormalities, and marked growth retardation. Craniofacial features include 'bird-like' facies, alopecia, craniofacial disproportion, and dental crowding. Our prospective study describes dental, oral soft tissue, and craniofacial bone features in HGPS.
Methods:  Fifteen patients with confirmed p.G608G LMNA mutation (1–17 years, seven males, eight females) received comprehensive oral evaluations. Anomalies of oral soft tissue, gnathic bones, and dentition were identified.
Results:  Radiographic findings included hypodontia ( n  = 7), dysmorphic teeth ( n  = 5), steep mandibular angles ( n  = 11), and thin basal bone ( n  = 11). Soft tissue findings included ogival palatal arch ( n  = 8), median sagittal palatal fissure ( n  = 7), and ankyloglossia ( n  = 7). Calculated dental ages (9 months to 11 years 2 months) were significantly lower than chronological ages (1 year 6 months to 17 years 8 months) ( P  = 0.002). Eleven children manifested a shorter mandibular body, anterior/posterior cranial base and ramus, but a larger gonial angle, compared to age/gender/race norms.
Conclusion:  Novel oral-craniofacial phenotypes and quantification of previously reported features are presented. Our findings expand the HGPS phenotype and provide additional insight into the complex pathogenesis of HGPS.     

Immune-expression of HSP27 and IL-10 in recurrent aphthous ulceration

Background:  Recently, abnormal cellular immune response has been considered responsible for the oral lesion in the recurrent aphthous ulceration (RAU). For reasons not yet defined, antigens of the oral microbiota would trigger abnormal Th1 immune response against epithelial cells. On the other hand, studies have demonstrated that heat shock proteins (HSP) can block the production of proinflammatory cytokine through inhibition of NF-κB and mitogen-activated protein kinase pathways or activate anti-inflammatory cytokines and therefore control the magnitude of the immune response. HSP27 has been considered a powerful inductor of IL-10, a major inhibitor of Th1 response.
Methods:  Using immunohistochemistry, we studied the expression and location of HSP27 and IL-10 in ulcerated lesions clinically diagnosed as RAU ( n  = 27) and to compare it with that of oral clinically normal mucosa (CT; n  = 6) and of other inflammatory chronic diseases such as oral fibrous inflammatory hyperplasia (FIH; n  = 18), Crohn's disease (CD; n  = 10) and ulcerative colitis (UC; n  = 9).
Results:  A lower proportion of HSP27-positive epithelial cells in RAU and CD were observed when compared with CT and FIH ( P  < 0.001**; P  = 0.013**). A lower proportion of IL-10-positive interstitial cells in RAU was observed when compared with FIH, UC, CT and CD ( P  < 0.001**; P  < 0.001**; P  < 0.001**; P  = 0.034*).
Conclusion:  Altogether the data suggest that a reduced cellular expression of HSP27 and IL-10 in RAU might be related with the aetiopathogenesis of the ulcerated oral lesions.     

Expression of phosphorylated Akt in oral carcinogenesis and its induction by nicotine and alkaline stimulation

Background:  In Taiwan, it is well documented that cigarette smoking and areca nut chewing contribute to the risk of oral squamous cell carcinoma (OSCC). The role of phosphorylated Akt (p-Akt) in oral carcinogenesis induced by nicotine and alkaline environments was investigated.
Method:  Immunohistochemistry (IHC) was used to detect p-Akt expression in cancerous ( n  = 30) precancerous ( n  = 30), and normal mucosa tissues ( n  = 10). Western blotting was used to detect time-dependent induction of p-Akt by 100 μM nicotine in normal human bronchial epithelial cell (NHBE), normal human oral keratinocytes (NHOK), immortalized human epithelial cells (HaCaT) and OEC-M1 cells, dose-dependent induction of p-Akt in OEC-M1 and HaCaT cells and pH effect of p-Akt in OEC-M1. The unpaired t -test and the Fisher's exact test were used to analyze the p-Akt immunoreactivity in various groups and its association with clinicopathological parameters.
Results:  Higher p-Akt expression in cancerous group than in normal mucosa ( P  = 0.0002) and precancerous ( P  = 0.0049) groups was observed. A time-dependent increase in p-Akt in the NHBE, NHOK, HaCaT and OEC-M1 cell lines was observed with 100 μM nicotine treatment. The dose-dependent increase in p-Akt by nicotine treatment in HaCaT and OEC-M1 cells was obviously observed. Higher p-Akt expression in more alkaline environment (pH 8.0) was observed than at pH 7.4 in OEC-M1 cells.
Conclusion:  A potential role for increased p-Akt may relate to the dose and time of nicotine use. The potential role of an alkaline environment to enhance nicotine-related oral carcinogenesis may exist.     

Oral Langerhans cell histiocytosis in Malaysian children: a 40-year experience

Background.  Oral Langerhans cell histiocytosis is generally seen in children.
Objective.  To determine the clinicopathological features of oral LCH in Malaysian paediatric patients.
Methods.  A retrospective study was carried out to determine the clinicopathological features of Langerhans cell histiocytosis (LCH), Letterer–Siwe disease, Hand–Schuller–Christian disease, eosinophilic granuloma, and histiocytosis X occurring in the oral cavity in children, diagnosed histologically in the main oral histopathology laboratory in Malaysia from 1967 to 2007.
Result.  There were 17 cases (eight girls and nine boys) with age ranging from 1 to 7 years. There were ten Malays, four Chinese, two Indians, and one of other ethnicity. Thirteen cases presented as gingival swellings with six of these cases accompanied with mobility of the teeth. Nine cases involved the mandible, two in the maxilla, and two cases in both the maxilla and mandible. The radiographic findings were mentioned only in nine cases with presence of bony erosion or destruction of the jaw bones. Four cases had punched-out radiolucencies of the skull. The patients also had other systemic signs and symptoms: skin lesions ( n  = 5), hepatosplenomegaly ( n  = 2), prolonged fever ( n  = 2), diabetes insipidus ( n  = 1), and exophthalmos ( n  = 1). Two cases were known cases of systemic LCH.
Conclusion.  The histopathologic features of LCH are easily recognized; however, with the development of immunostaining, the use of CD1a helps in confirming the diagnosis.     

Evaluation of myofibroblasts in oral epithelial dysplasia and squamous cell carcinoma

Background:  Carcinogenesis is accompanied by a number of changes in the adjacent stroma including the appearance of myofibroblasts. The purpose of this study was to evaluate and compare the presence of myofibroblasts in normal mucosa, oral epithelial dysplasia, and different grades of oral squamous cell carcinoma.
Methods:  The study sample consisted of three groups, including 40 oral squamous cell carcinomas, 15 dysplasias, and 15 sections of normal oral epithelium. Vimentin, desmin, and alpha-smooth muscle actin were used to identify myofibroblasts.
Results:  The percentage and intensity of alpha-smooth muscle actin were examined, and positive immunostaining was observed in the myofibroblasts of all squamous cell carcinomas; however these cells did not stain in the dysplasias or normal epithelium specimens. The presence of myofibroblasts was significantly higher in oral squamous cell carcinomas compared to both, dysplasias and normal mucosa cases ( P  < 0.001). A significant difference was not observed between the different grades of oral squamous cell carcinoma ( P  = 0.2).
Conclusions:  These findings show the presence of myofibroblasts in the stroma of oral squamous cell carcinoma but not dysplasia and normal mucosa, suggesting further investigation to clarify the role of myofibroblasts in the carcinogenesis of this tumor.     

Expression of CXCR4 in oral squamous cell carcinoma: correlations with clinicopathology and pivotal role of proliferation

J Oral Pathol Med (2010) 39 : 63–68
Background:  The chemokine SDF-1 and its receptor CXCR4 play active role in the metastasis and proliferation of several malignancies.
Methods:  In this study, we used an immunohistochemical technique in 91 specimens of oral squamous cell carcinoma (SCC), and flow cytometry technique in oral SCC cell line, and then evaluated the role of proliferation of CXCR4 using MTT assay in oral SCC cell line.
Results:  The expression of CXCR4 in 91 specimens of oral SCC was 62.6% and in oral SCC cell line was 68.6%. There was a significant association between the expression of CXCR4 and lymph node metastasis ( P  = 0.012), tumor size ( P  = 0.01), UICC stage ( P  = 0.016), tumor histology grade ( P  < 0.001). SDF-1 stimulated proliferation of oral SCC cell and CXCR4 neutralization by monoclonal antibodies decreased proliferation.
Conclusions:  Our results suggest that CXCR4 might be a novel biomarker to evaluate the biological behavior of oral SCC. CXCR4 inhibitors or antagonists might be potential anticancer agents to suppress tumor proliferation.     

In vitro susceptibility of the Streptococcus milleri group to antimicrobial peptides

Aim  To determine the susceptibility of strains of the Streptococcus milleri group (SMG) to commercially available antimicrobial peptides.
Methodology  Thirty strains of SMG from a range of sources were assessed for their susceptibility to 10 antimicrobial peptides of either human, animal or insect origin, using a double layer diffusion assay.
Results  The majority of the test strains were sensitive to the amidated peptides, mastoparan (100%; n  = 30), magainin 2 amide (95%; n  = 21) and indolicin (91%; n  = 23). Some strains were susceptible to cecropin B (30%; n  = 30) and histatin (10%; n  = 30), whilst no activity was observed for the defensins HNP-1 and HNP-2, histatin 8, cecropin P1 and magainin 2.
Conclusions  The majority of strains were resistant to the human derived peptides. The ability to resist such peptides may be a factor in the colonisation of the oral cavity and the survival and initiation of infection in the pulp and root canal environment. Interestingly, the present study indicated that amidated and alpha helical peptides exhibit antimicrobial activity against SMG. Structural modification of these peptides may allow a targeted approach for the development of these substances as preventative or therapeutic agents.     

Role of TP53 in the progression of pre-malignant and malignant oral mucosal lesions. A follow-up study of 144 patients

Background:  Prediction of progression from pre-malignant oral mucosal lesions to malignancy, or recurrence of an existing oral squamous cell carcinoma (OSCC), is an important clinical problem in oral medicine.
Methods:  This study presents a follow-up of a study published in 2002. Samples from 54 patients with OSCC, 45 with oral lichen planus (OLP) and 45 with hyperkeratosis (clinically leukoplakia), diagnosed between 1987 and 1996, were analysed for TP53 protein expression and TP53 mutation. Follow-up was 11–17 years for OSCC (mean 13.3), 12–22 years for OLP (mean 15.9) and 12–17 years for hyperkeratosis (mean 14.5).
Results:  Of the 54 OSCC patients, 28 experienced recurrent disease, 21 died of OSCC, 22 died of other causes. Of the 14 OSCC patients with mutated TP53 ( n  = 11), the cancer recurred in eight (57%) and in 20/39 (51%) without mutation. Expression of TP53 protein was significantly associated with reduced overall survival. Among OLP patients, nine were TP53- mutated out of 31 tested. One TP53- mutated OLP patient developed OSCC in a different site. Of the hyperkeratosis patients, three were mutated of 22 tested. One hyperkeratosis patient (non-mutated) developed OSCC in the same site.
Conclusion:  TP53 mutations can exist in benign oral mucosal lesions for many years without progression to malignancy. No association was found between TP53 protein expression or TP53 mutation and recurrence of OSCC or disease-related survival. Overall survival was reduced in patients with positive TP53 protein expression.     

Demonstration of ethanol-induced protein adducts in oral leukoplakia (pre-cancer) and cancer

Background:  Excessive alcohol consumption is a common cause for upper gastrointestinal tract cancers. However, the primary mechanisms of alcohol-induced carcinogenesis have remained poorly defined.
Method:  We examined the generation and subcellular distribution of protein adducts with acetaldehyde (AA), the first metabolite of ethanol, and end products of lipid peroxidation, malondialdehyde (MDA) and 4-hydroxynonenal (HNE), from oral biopsy specimens obtained from 36 subjects (11 British, 25 Japanese) reporting alcohol misuse. All patients had been diagnosed with oral pre-cancer (leukoplakia, n  = 7) or squamous cell carcinoma (SCC; n  = 29). Automated immunostaining for AA, MDA and HNE adducts was performed using monospecific antibodies.
Results:  Positive staining for AA, MDA and HNE adducts was observed in the dysplastic or malignant epithelial cells, HNE being relatively the most abundant adduct species. The subgroup of Japanese patients had higher levels of AA and MDA, although not HNE, than the British sample. When the material was divided to those with SCC or leukoplakia, MDA adducts but not the other antigens were more prominent in the former group. Significant correlations were found between the different adducts (AA vs. MDA, r  = 0.68, P  < 0.001; AA vs. HNE, r  = 0.47, P  < 0.01 and MDA vs. HNE, r  = 0.59, P  < 0.001). In addition, cytochrome P450 2E1 staining was found in these samples, correlating with both AA and MDA adducts.
Conclusion:  The data indicates that AA- and lipid peroxidation-derived adducts are formed in oral tissues of alcohol misusers with oral leukoplakia and cancer. The findings also support a pathogenic role of AA and excessive oxidative stress in carcinogenesis.     

Reduction of syndecan-1 expression during lip carcinogenesis

Background:  Actinic cheilitis (AC) is an oral pre-cancerous lesion that sometimes develops into lip squamous cell carcinoma (SCC). Syndecan-1, a transmembrane heparan sulfate proteoglycan, modulates cell-proliferation, adhesion, migration and angiogenesis. Malignant epithelial cells often down-regulate their own syndecan-1 production, and are capable of inducing aberrant syndecan-1 expression in stromal cells. The aim of this study was to evaluate the variations in syndecan-1 expression during lip carcinogenesis, in normal lip (NL), AC and well-differentiated lip SCC.
Methods:  Biopsies of NL vermillion ( n  = 19), AC ( n  = 23) and lip SCC ( n  = 24) were stained immunohistochemically for syndecan-1.
Results:  Syndecan-1 expression was significantly reduced in AC and lip SCC as compared to NL ( P  < 0.05), with a significant reduction in lip SCC as compared to AC ( P  < 0.0001). In lip SCC lesions, syndecan-1 expression at the epithelium overlying the tumor was increased when compared to the tumor itself ( P  < 0.03), but was significantly reduced as compared to AC and NL ( P  < 0.001).
Conclusion:  The results showed that epithelial syndecan-1 expression is reduced as lip carcinogenesis progresses (NL>AC>lip SCC), suggesting that syndecan-1 could be a useful marker of malignant transformation in the lip.     

A composite index for determining the impact of oral ulcer activity in Behcet's disease and recurrent aphthous stomatitis

Background:  Although number, frequency and healing time of oral ulcers and pain are generally used for clinical practice and studies in Behcet's disease (BD) and recurrent aphthous stomatitis (RAS), no standardized activity index is currently present to monitor clinical manifestations associated with oral ulcers. The aim of this study was to develop a standardized composite index (CI) to assess oral ulcer activity in BD and RAS.
Methods:  In this cross-sectional study, 121 patients with BD and 45 patients with RAS were included. Sixty-five percentage of BD and 68.9% of RAS patients were in active stage during the previous 3 months. The developed CI included the presence of oral ulcers, ulcer-related pain and functional status and was evaluated in patients with both active and inactive disease for content validity.
Results:  Composite index score was observed to be higher in active patients with RAS (6.94 ± 2.19) compared with active BD patients (6.01 ± 2.04) ( P  = 0.04). The number of oral ulcers and healing time of oral ulcers were significantly higher in RAS compared with BD ( P  = 0.018, P  = 0.001 respectively). CI score correlated with the number of oral ulcers in both BD and RAS ( P  = 0.000, P  = 0.002 respectively). CI score was '0' for inactive patients without oral ulcer in BD and RAS.
Conclusions:  The presented CI as an oral ulcer activity index seems to be a reliable and suitable tool for evaluating the clinical impact and disease-specific problems in BD and RAS.     

The analysis of characteristics of elderly people with high VSC level

Objective:  The purpose of this study was to examine the characteristics of elderly subjects who had objectionable levels of volatile sulfur compound (VSC).
Subjects and method:  In 2002, a total of 115 85-year-old persons in Japan were subjected to oral examinations, tongue coat collections, measurements of VSCs levels inside the mouth using a portable gas chromatography (Oral Chroma^TM, Abilit, Japan), and assessments of quality of life (QOL) using an SF-36 questionnaire.
Results:  Sixty-six of the subjects were edentulous and 49 were dentulous. They were divided into two groups by VSC levels, those with oral malodor (both H₂S > 112 ppb and CH₃SH > 26 ppb; subjects with oral malodor, OM group; n  = 7) and those without ( n  = 108). Our results showed that tongue coat deposit amounts and proportion of dentulous subjects were significantly higher in the OM group. Further, in an analysis of QOL, the SF-36 scores for vitality, social functioning and mental health were significantly higher in OM.
Conclusion:  We found that elderly subjects with oral malodor tended to be dentulous and had large deposits of tongue coating. However, oral malodor in the OM group subjects did not appear to cause a disadvantage in their social lives.     

Fatty acid synthase expression in squamous cell carcinoma of the tongue: clinicopathological findings

Background:  Overexpression of fatty acid synthase (FAS), the cytosolic enzyme responsible for the conversion of dietary carbohydrates to fatty acids, has been reported in several human malignancies and pointed as a potential prognostic marker for some tumors. This study investigated whether FAS immunohistochemical expression is correlated with the clinicopathological characteristics of oral squamous cell carcinoma (OSCC).
Materials and methods:  The clinical features of 102 patients with OSCC of the tongue treated in a single institution were obtained from the medical records and all histopathological diagnoses were reviewed. The expression of FAS was determined by the standard immunoperoxidase technique in formalin-fixed and paraffin-embedded specimens and correlated with the clinicopathological characteristics of the tumors.
Results:  Eighty-one cases (79.41%) were positive for FAS. Microscopic characteristics such as histological grade ( P  < 0.05), lymphatic permeation ( P  < 0.001), perineural infiltration ( P  < 0.05), and nodal metastasis ( P  < 0.02) were associated with FAS status. A significantly lower survival probability for patients with advanced clinical stage (log-rank test, P  < 0.001), lymph nodes metastasis (log-rank test, P  < 0.001), presence of vascular permeation (log-rank test, P  = 0.05), and perineural invasion (log-rank test, P  = 0.01) was observed in the studied samples.
Conclusion:  The expression of FAS in OSCC of the tongue is associated with the microscopic characteristics that determine disease progression and prognosis.     

Comparison of biomaterial implants in the dental socket: histological analysis in dogs

Background: Bone graft procedures have been used commonly in buco-maxillo-facial surgery. For this reason, many researchers have evaluated the bone substitutes.
Purpose: The present study evaluated soft and hard tissue reactions to two different hydroxyapatites HAs (synthetic HA and natural HA) and bioactive glass implanted into the sockets immediately after extraction.
Materials and Methods: First and third upper and lower premolars, on both sides, were extracted from six female dogs. The alveolar sockets were randomly assigned to four groups: Group 1 – control (unfilled), Group 2 – filled with synthetic hydroxyapatite, Group 3 – filled with bovine bone mineral (natural HA), and Group 4 – filled with bioactive glass. The animals were euthanized at 4 weeks ( n  = 2), 8 weeks ( n  = 2), and 28 weeks ( n  = 2) after extraction. The mandible and maxilla of each animal were removed for histological analysis to determine soft tissue reactions, newly formed bone, bone characteristics, and presence or absence of implanted materials.
Results: Most particles of synthetic hydroxyapatite had bone formation on their surface, although some particles showed a layer of fibrous connective tissue. The bovine bone mineral group exhibited particles partially replaced with bone formation. The bioactive glass group showed particles with a thin layer of calcified tissue, but was absent in some specimens, suggesting complete resorption.
Conclusion: All biomaterials had similar behavior. Bovine bone mineral, compared to synthetic hydroxyapatite and bioactive glass, showed a larger number of particles covered with osseous tissue. All biomaterials interfered with the socket repair process.     

Oral manifestations of HIV infection in adult patients from the province of Sancti Spiritus, Cuba

Background:  Studies on the prevalence of HIV-related oral lesions (HIV-OL) have shown great variations among different countries. The aim of this study was to describe the prevalence of HIV-OL in adults infected with HIV in the province of Sancti Spiritus, Cuba, and to determine the factors associated with the presence of HIV-OL.
Methods:  A cross-sectional observational study was performed between November 2006 and August 2007 at the Hospital General Universitario 'Camilo Cienfuegos', Sancti Spiritus. One hundred and fifty-four HIV-infected patients were included. Patients were examined and interviewed by a periodontal specialist. Diagnosis of HIV-OL was based on clinical criteria. Demographical, clinical and laboratory data were obtained. Independent association of each factor with HIV-OL was assessed by logistic regression modelling.
Results:  The prevalence of HIV-OL was 40.9%. The commonest manifestation was oral hairy leucoplakia ( n  = 19; 12.3%); oral candidiasis ( n  = 17; 11%); herpes simplex virus infection ( n  = 11; 7.4%); and aphthous ulcer ( n  = 9; 5.8%). Principal factors associated with the presence of HIV-OL were CD4⁺ lymphocytes <500 cells/mm³ (OR: 2.06; 95% CI: 1.019–4.195) and smoking (OR: 2.03 CI: 1.037–3.982).
Conclusion:  This study described the prevalence of HIV-OL in 154 HIV-infected patients which represent about 80% of those known to be infected in the province of Sancti Spiritus. The prevalence of HIV-OL was lower than those reported from developing countries. Oral hairy leucoplakia and oral candidiasis were the most prevalent HIV-OL. Smoking and CD4⁺ cells count <500 cells/mm³ were the two factors independently associated with the presence of HIV-OL.     

Prognostic factors for keratocystic odontogenic tumor (odontogenic keratocyst): analysis of clinico-pathologic and immunohistochemical findings in cysts treated by enucleation

Background:  The purpose of this study was to determine prognostic factors for the recurrence of keratocystic odontogenic tumors (KCOTs) following simple enucleation by examining clinico-pathologic and immunohistochemical findings.
Methods:  Following enucleation, the frequency of recurrence among 32 subjects diagnosed with KCOT was analyzed for tumor site, radiographic and histologic features, and immunopositivity for Ki-67 and p53.
Results:  Keratocystic odontogenic tumors in four out of 32 subjects (12.5%) recurred during the follow-up period (median: 33 months, range: 7–114 months). Three out of four subjects (75.0%) among recurrent group showed high expression of Ki-67 (LI >10%) in basal layer and four (4/28; 14.3%) among non-recurrence group ( P  = 0.025). Expression of p53 among non-recurrent group was observed in 11 subjects (11/28; 39.3%), and in three subjects (3/4; 75.0%) among the recurrent group ( P  = 0.295). Hazard risk for the recurrence of KCOT was 4.02 (95% CI 1.42–18.14) for high Ki-67 expression in the basal layer by the Cox proportional hazard model ( P   =  0.009). In our study, none of the other clinico-pathologic variables were associated with the recurrence of KCOT.
Conclusion:  The results suggested that the evaluation of Ki-67 expression in KCOT at the time of pathological diagnosis might be helpful for consideration of appropriate adjunctive surgical procedures to avoid a recurrence and may serve as a prognostic marker.     

Oxidant/antioxidant status in recurrent aphthous stomatitis

Objective:  Recurrent aphthous stomatitis (RAS) is a common oral mucosal disorder characterized by recurrent, painful oral aphthae, and oxidative stress presumably contributes to its pathogenesis. The study was performed to evaluate the involvement of oxidant toxicity in this disorder.
Methods:  Patients with RAS ( n  = 26) and age- and sex-matched healthy control subjects ( n  = 20) were included in this study. Following an overnight fast, blood specimens were obtained. Plasma malondialdehyde concentrations and erythrocytes glutathione peroxidase activities were determined. Also, plasma vitamin E and selenium levels were detected. Mann–Whitney U -test was performed for statistical evaluation.
Results:  Oxidative stress was confirmed by the significant elevation in plasma malondialdehyde levels and by the significant decrease in glutathione peroxidase activities, vitamin E and selenium levels ( P  < 0.001).
Conclusions:  Our results indicated that lipid peroxidation and the inadequacy of the defense system seem to play a crucial role in the pathogenesis of recurrent aphthous stomatitis.