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1.
Gerodontology ; 31(2): 145-8, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24797619

ABSTRACT

OBJECTIVE: To present a case of reactive osteocartilaginous metaplasia (ROCM) in the anterior edentulous mandibular ridge. BACKGROUND: The ROCM secondary to chronic mechanical denture trauma is rare and appears as a focal sometimes painful mass on or near the crest of the edentulous alveolar ridge in long-term denture wearers. The literature review disclosed 24 cases involving more commonly the posterior portion of the mandible. MATERIALS AND METHODS: An 80-year-old female was referred for the evaluation of a painful, submucosal nodule extending into the vestibular mucosa of the anterior edentulous mandibular region. Microscopically, cartilaginous regions exhibiting sparse hyperchromatic or binucleated chondrocytes transitioned into areas of ossification. RESULTS: The diagnosis was ROCM. The presence of osteocartilaginous tissue displaying bizarre histopathological features can create a diagnostic dilemma. CONCLUSION: Complete conservative surgical excision of this lesion has a very good prognosis. Surgical augmentation of the sharp edentulous mandibular ridges might be needed to avoid continuous irritation and possible recurrence.


Subject(s)
Denture, Complete, Lower/adverse effects , Hyaline Cartilage/pathology , Mandible/pathology , Aged, 80 and over , Chondrocytes/pathology , Diagnosis, Differential , Female , Humans , Jaw, Edentulous/pathology , Metaplasia , Osteoblasts/pathology
2.
J Craniofac Surg ; 22(2): 721-4, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21415644

ABSTRACT

An odontogenic keratocyst that eroded into the sinus through the maxillary bone and occupied it, showed replacement of the sinus respiratory epithelium by lesional epithelium, and was associated with fungal rhinosinusitis is presented. A review of the literature disclosed that epithelial replacement has been described in 2 previous case reports, although there is no report on the coexistence of odontogenic keratocyst with fungal rhinosinusitis.


Subject(s)
Maxillary Sinus , Odontogenic Cysts/diagnosis , Odontogenic Cysts/surgery , Paranasal Sinus Diseases/diagnosis , Paranasal Sinus Diseases/surgery , Adult , Diagnosis, Differential , Humans , Male , Tomography, X-Ray Computed
3.
Article in English | MEDLINE | ID: mdl-20060342

ABSTRACT

OBJECTIVE: Parathyroid hormone-related peptide (PTHrP) binds to the parathyroid hormone receptor type 1 (PTHR1), which results in the activation of pathways in osteoblasts that promote osteoclastogenesis through the RANK/RANKL system. RANK/RANKL expression has been shown in central giant cell granuloma of the jaws but PTHrP/PTHR1 has not. MSX1 protein is a classical transcription regulator which promotes cell proliferation and inhibits cell differentiation by inhibiting master genes in tissues such as bone and muscle. It has been implicated in the pathogenesis of cherubism, and its expression has been reported in a single central giant cell granuloma (CGCG) case. We aimed, therefore, to study the expression of those proteins by the different cellular populations of central and peripheral giant cell granulomas (PGCGs) of the jaws. STUDY DESIGN: Twenty cases of CGCG and 20 cases of PGCG of the jaws were retrospectively examined by immunohistochemistry for the percentage of positively staining cells to antibodies for PTHrP, PTHR1, and MSX1, using a semiquantitative method. RESULTS: In both CGCG and PGCG of the jaws, PTHrP and PTHR1 were abundantly expressed by type I multinucleated giant cells (MGC) and mononucleated stromal cells (MSC) with vesicular nuclei, whereas type II MGC and MSC with pyknotic nuclei expressed those proteins to a lesser extent. In both CGCG and PGCG of the jaws, MSX1 was abundantly expressed by type I MGC and MSC but type II MGC did not express it. A statistically significant difference (P < .05) was observed between CGCG and PGCG in the expression of PTHrP in type II MGC and MSC with pyknotic nuclei and in the expression of PTHR1 in type II MGC. CONCLUSIONS: We suggest that in CGCG and PGCG of the jaws, PTHrP-positive immature osteoblasts activate PTHR1-positive mature osteoblasts to produce RANKL which interacts with RANK on the PTHrP/PTHR1-positive osteoclast-precursor cells found in abundance in the stroma of giant cell lesions and induces osteoclastogenesis through the classic pathway. Cells of the jawbones, the periodontal ligament, or the dental follicle, originating from the neural crest, may be involved in the pathogenesis of giant cell lesions of the jaws. Further study is required for these suggestions to be proved.


Subject(s)
Granuloma, Giant Cell/metabolism , MSX1 Transcription Factor/metabolism , Mandibular Diseases/metabolism , Maxillary Diseases/metabolism , Parathyroid Hormone-Related Protein/metabolism , Receptor, Parathyroid Hormone, Type 1/metabolism , Adult , Chi-Square Distribution , Female , Giant Cells/cytology , Giant Cells/metabolism , Giant Cells/pathology , Granuloma, Giant Cell/pathology , Humans , Immunohistochemistry , Male , Mandibular Diseases/pathology , Maxillary Diseases/pathology , Middle Aged
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