Non-antimicrobial properties of tetracyclines - dental and medical implications

The tetracyclines are a group of broad-spectrum antimicrobial agents. The first of these compounds, chlortetracycline was isolated from Streptomyces aureofaciens by Benjamin Duggar and introduced into the market in 1948. In 1952, tetracycline was derived semisynthetically from chlortetracycline by removal of its chlorine atom by catalytic hydrogenation. Methacycline, doxycycline and minocycline are all semi-synthetic derivatives. The tetracyclines are closely congeneric derivatives of the polycyclic napthacenecarboxamide. The tetracyclines possess a wide range of antimicrobial activity against gram-positive and gram-negative bacteria. In vitro, these drugs are primarily bacteriostatic. Tetracyclines have been used extensively as antimicrobial agents for the treatment of various types of periodontal diseases until light was shed on their equally important non-antimicrobial properties by Golub. The tetracyclines and their non-antimicrobial, chemically modified analogues have properties that appear to modulate host response by inhibiting the activity of the matrix metalloproteinases that cause collagen destruction. They also inhibit osteoclast function, stimulate osteoblastic bone formation, and regulate angiogenesis.

Intraoral botryomycosis masquerading as a pyogenic granuloma.

Bacterial pseudomycosis also known as Botryomycosis is a rare, indolent infection that has been described in patients with immunodeficiency and tissue with decreased healing ability. It affects the visceral organs and infection in the head and neck has been described as affecting the tongue and jaw bones. Histologically, the disease is characterized by the presence of 'Bollinger granules', surrounded by neutrophils in a fibrocellular stroma. A case of gingival Botryomycosis is presented which was diagnosed as a routine pyogenic granuloma in a healthy male.

Primary intraosseous carcinoma of the jaws originating in odontogenic cysts.

Primary intraosseous carcinoma (PIOC) of the jaws is a rare lesion and majority of them arise from the epithelial lining of pre-existing odontogenic cysts (OCS). In a case of 20 year old male, PIOC presented a painless swelling extending from left posterior side of the mandible to across the midline with a duration of three months. X-rays revealed a cystic Unilocular radiolucency with well demarcated margin. Aspiration revealed the characteristics of cystic fluid. Histological examination of the biopsy specimen following marsupialisation showed SCA arising in cystic lining. In another case of 24 year old female, PIOC presented a painless swelling on the right side of the mandible with a hollow cavity seen intraorally in the region of the first molar, exfoliated itself in one month. X-rays revealed a cystic radiolucency but with irregular margin centrally. Histologic examination of a biopsy specimen from the lining of the cavity showed SCA originating in cystic lining. In both cases habit of tobacco was absent.

Childhood thrombocytopenic purpura--review and a case report.

Childhood idiopathic thrombocytopenic purpura is a rare condition seen in children. A case of a 10 year old female child is reported. Bleeding from the gingiva and petechiae on the tongue were observed. The blood picture was normocytic normochromic with neutrophilia and thrombocytopenia. Bone marrow study was suggestive of marrow changes in idiopathic thrombocytopenic purpura. Dental extractions were postponed. Recognition of the disease by the dental profession is stressed.

Fragile 'X' syndrome. A case study.

Fragile 'X' syndrome also known as the Martin-Bell syndrome or the marker 'X' syndrome is an 'X'-linked disorder with connective tissue dysplasia and varying degree of mental retardation. A case of this syndrome with characteristic Martin-Bell phenotype is presented. Oral features as yet unmentioned are added.

Mucormycosis. A case report.

Mucormycosis is a rare fungal infection which involves the orofacial region. Depending upon the severity and extent of the spread it may involve the upper respiratory, ocular and intracranial regions. A case of mucormycosis in a 45-year-old male patient presenting as a diffuse swelling of the right side of the face, the right eye and extensive palatal ulceration has been reported and the literature reviewed.