Epipalatus: a rare intraoral teratoma

A wide range of discrete head and neck tumors are developmental, including those termed choristoma, hamartoma, dermoid cysts, teratoid tumors, and true teratomas. In classifying various teratomas, consideration is given to the embryonal layers represented within the substance of the tumor and to their level of organizational complexity. By definition, a hamartoma is a tissue mass, present at or near the time of birth, that is benign and native to the site of origin. Growth capacity of a hamartomatous process parallels that of the host organism. A choristoma, on the other hand, is a mass of tissue that is foreign to the site of discovery and is thought to result from growth to displaced primordial tissue that is histologically normal for that tissue.     

Ossifying fibroma of the mandible and maxilla: review of 18 cases

A clinical, radiographic, histologic and follow up study of 18 cases of ossifying fibroma involving the mandible and maxilla was performed. Differences in behavior and management according to age, location, radiographic appearance and histopathology were not evident. A wide range of microscopic findings within and between cases was evident, while the radiographic finding consisting of sharp delineation was consistent in all cases. The presence or absence of cementum or cementum-like material and various types of formed elements was likewise of little clinical significance. Finally, a potential source of the neoplastic cell from the periodontal apparatus may help explain the range of histologic findings.     

Aphthous ulcers

Aphthous ulcers are one of the most common oral diseases worldwide. Their clinical presentation is characterized by multiple, recurrent, small, round, or ovoid ulcers with circumscribed margins and erythematous haloes present in different sizes. Oral lesions similar to aphthous ulcers may be present in several systemic diseases. This article will summarize the differential diagnosis of aphthous ulceration, with emphasis on a practical guide for the management of recurrent aphthous ulceration, including topical and systemic therapy.     

Osteopetrosis: a case report including gross and microscopic findings in the mandible at autopsy

A case of juvenile osteopetrosis in a 10-year-old girl, including the skeletal, hematologic, and neurologic features, is described. Ankylosis of cementum to bone was evident in histologic sections, providing a possible explanation for the delayed or impaired eruption of teeth. A summary of the literature on the pathogenesis of osteopetrosis is presented.     

Halitosis

Halitosis (oral malodor, bad breath) is a condition affecting millions of Americans and is a major concern to the general public. In healthy individuals complaining of bad breath, the mouth is the main source of their oral malodor, more specifically the posterior dorsum of the tongue. Halitosis may also indicate an underlying medical condition that necessitates treatment. In a patient with oral malodor for whom an underlying systemic problem has been ruled out, improved oral hygiene, removal of tongue plaque, and, if necessary, antibacterial mouth rinses are advised.     

Impact of underreporting on the management of occupational bloodborne exposures in a dental teaching environment

The objectives of this study were to determine the rates of bloodborne exposures experienced by junior and senior dental students at a large dental teaching institution during 2001-02 and the percentages of these bloodborne exposures that were reported by the students to their designated counselors. Two hundred and four third- and fourth-year students voluntarily and anonymously filled out a questionnaire on the numbers of bloodborne exposures they had experienced and reported. Sixty-seven (32.8 percent) reported experiencing 109 occupational exposures (OEs) to blood or other potentially infectious materials. This corresponds to an OE rate of 80 +/- 7.7 exposures/100 person-years, far in excess of the highest recorded student rate (7.18 +/- 0.52) in a previous study. Twenty-six students (39 percent) reported two or more exposures each. Only 19 percent of exposures were reported to the school counselor, with 35 percent reported by third-year students and only 14.5 percent by fourth-year students. Thus the large differential in reported exposure rates between third- and fourth-year students found in our earlier study might have been an artifact of the sharply different reporting rates of these two groups. These results suggest an urgent need to reexamine the reliability of the present reporting system for such OEs. Also this study indicates that the gender differences in OE rates reported in our earlier study were due primarily to differential reporting by male and female students, not differences in their underlying OE rates.     

Thirty years of the human immunodeficiency virus epidemic and beyond

After more than 30 years of battling a global epidemic, the prospect of eliminating human immunodeficiency virus （HIV） as the most challenging infectious disease of the modern era is within our reach. Major scientific discoveries about the virus responsible for this immunodeficiency disease state, including its pathogenesis, transmission patterns and clinical course, have led to the development of potent antiretroviral drugs that offer great hopes in HIV treatment and prevention. Although these agents and many others still in development and testing are capable of effectively suppressing viral replication and survival, the medical management of HIV infection at the individual and the population levels remains challenging. Timely initiation of antiretroviral drugs, adherence to the appropriate therapeutic regimens, effective use of these agents in the pre and post-exposure prophylaxis contexts, treatment of comorbid conditions and addressin~ social and nsvcholo2ical factors involved in the care of individuals continue to be important considerations.     

Oral white patches in a national sample of medical HIV patients in the era of HAART

OBJECTIVES: Several types of HIV-related oral mucosal conditions have been reported to occur during the course of HIV disease progression. Of these, few may be manifested as 'white' lesions and many are noticeable to the patient. This paper examines the relationships between social, behavioral and medical aspects of HIV infection and reporting an occurrence of oral white patches (OWP) by HIV-infected patients. METHODS: The subjects are participants in all three interviews in the HIV Cost and Services Utilization Study (HCSUS). The subjects were selected using a three-stage probability sampling design. The multivariate analysis is based on 2109 subjects with nonmissing binary outcome variable for all three waves representing a national sample of 214 000 individuals. The multivariate model was fitted using generalized estimating equations (GEE) by implementing the XTGEE command in STATA. RESULTS: We estimate that 75 000 persons (35%) reported at least one incident of OWP, of these 14 000 reported having OWP during all three interviews, and that the rate of reporting declined over the three HCSUS waves. The multivariate analysis showed seven variables that were significant predictors of at least one report of OWP. CONCLUSIONS: Compared with persons on HAART therapy, patients on other regimens or taking no antiviral medications were 23-46% more likely to report an incident of OWP. Compared with whites, African Americans were 32% less likely to report OWP, while current smokers were 62% more likely than nonsmokers. Being diagnosed with AIDS and having CD4 counts less than 500 significantly increased the likelihood of reporting OWP.     

Social aspects of HIV and their relationship to craniofacial problems: workshop 4C

The oral research community needs an understanding of the social causes, consequences, and costs of disease in relation to oral health. This workshop concluded that HIV infection constitutes a special dental need requiring specific arrangements to facilitate oral care for infected persons. Oral manifestations of HIV infection affect everyday life, but more evidence is needed on the effects of interventions to alleviate these impacts. Other oral health habits add to the burden of HIV/AIDS-associated oral diseases and compete with them for resources. These problems are most acute where the prevalence of HIV is high and resources are scarce. Effective health promotion is therefore important in these areas. Without data on the utility of oral health care in developing countries, practical approaches are guided by societal and multidisciplinary principles. There are also important ethical considerations.