Self-assessment of the forensic value of dental records.

One of the most important aspects of a person's dental record may well prove to be it's potential value should the forensic dental identification of their remains become necessary. The better the quality of the antemortem dental records, the easier and faster the identification of the remains will be. The forensic dentist must be able to select identifying features by decoding the deceased's antemortem dental records. A study was conducted on two groups of dentists who were asked to self-assess the forensic dental value of the dental records maintained in their own practices. The three most frequently recorded identifying dental features, other than caries and restorations, were the presence of diastemas, displaced or rotated teeth, and dental anomalies. Surveyed dentists imbedded identifying information into the removable prosthetic devices fabricated for their patients an average of only 64% of the time. Only 56% of the two groups combined felt that their dental chartings and written records would be extremely useful in dental identifications. It is concluded that the quality of antemortem dental records available for comparison to postmortem remains varies from inadequate to extremely useful. Practicing dentists can become valuable members of the dental identification process by developing and maintaining standards of record keeping which would be valuable in restoring their patients' identity.

Palatal canalicular adenoma: report of 12 cases and review of the literature.

Canalicular adenoma is the second most common type of adenoma of the oral region and arises almost exclusively in the upper lip. Other locations include the buccal mucosa, the palate, and the parotid gland. We report 12 cases of canalicular adenoma that arose in the palates of nine women and three men between the ages of 42 and 76 years. The tumor presented as a nonulcerated (eight patients) or ulcerated (four patients) lesion, usually at the junction of the hard and soft palates. Two tumors were misdiagnosed: one as adenoid cystic carcinoma and the other as low-grade adenocarcinoma. Both patients had had partial maxillectomy; the patient diagnosed with adenoid cystic carcinoma also received radiotherapy. One patient reported having had an adenoma removed from the palate 10 years previous to presentation; thus, the tumor was classified as a recurrence. Evidence of tumor metastasis was absent in all cases during the follow-up period, which ranged from 1 to 25 years. Eleven patients are alive and disease free; one died of other causes. Canalicular adenoma does not commonly occur in the palate. This tumor has an excellent prognosis after conservative surgical treatment in all locations. Pathologists should be aware of the occurrence of this neoplasm in the palatal region and of its histopathology so they can distinguish it from malignant tumors of the salivary gland.

Central odontogenic fibroma, WHO type. A report of three cases with an unusual associated giant cell reaction.

Three cases of central odontogenic fibroma, WHO type, that exhibited a prominent giant cell granuloma-like histopathologic component are described in this report. All three lesions occurred in women, and all were located in the mandibular premolar-molar region. One lesion recurred after conservative excision, and the recurrence displayed the two histologically distinct tissues of the original lesion. The authors think that this pathologic process does not represent a "collision lesion" but, instead, is a unique presentation of a central odontogenic fibroma, WHO type.

Use of orthopantomographs in forensic identification.

Radiographs of the head region were used for identification of 17 victims during an 11-year period in the Department of Forensic Medicine, University of Turku, Finland. Examinations resulted in positive identification of 10 victims. Proof of identity of four people was based on exclusion identifications. In one case, comparable information supporting the identity was achieved. Due to insufficient ante- and postmortem material, two individuals remained unidentified by radiological methods. The use of orthopantomography in identification is recommended because it enables visualization of the structures of the jaws and related areas on a single radiograph.

Primary osteosarcoma of the parotid gland.

Four cases of primary osteosarcoma of the parotid gland, where these tumors rarely occur, are presented. This neoplasm may arise after radiation therapy, but the majority arise de novo. As a group, extraosseous osteogenic sarcomas are aggressive and lethal. Patients with these tumors have an average 5-year survival rate of 15.6%. Of the four patients reported on two died within 6 months to 3 years, one has lung metastases, and one has been lost to follow-up.

Traumatic bone cyst, aneurysmal bone cyst, and central giant cell granuloma--pathogenetically related lesions?

Three central bone lesions, a traumatic bone cyst, an aneurysmal bone cyst, and a central giant cell granuloma are reported. Comparisons of the clinical, radiographic, and histological features were made. Although these lesions are recognized as separate and distinct pathological entities, a common pathogenesis is suggested by similarities in certain features. Diagnostic aids are suggested to assist in a differential diagnosis.

Localized primary amyloid tumor of the parotid gland.

We report a case of primary amyloid tumor (amyloidoma) of the left parotid gland. To the best of our knowledge this is the first case of this tumor in a parotid gland to be reported in the English literature. Congo red staining with prior potassium permanganate incubation confirmed the localized primary type of amyloid. Immunocytochemical studies demonstrated staining for immunoglobulin A, lambda and kappa light chains within the amyloid deposits and in the cytoplasm of the lymphocytes, and plasma cell aggregates. Ultrastructural examination showed characteristic findings of straight, nonbranching fibrils, measuring 80 to 100 A in length, that were diagnostic of amyloid. The patient had no symptoms and no clinical or laboratory evidence of systemic amyloidosis or multiple myeloma at a 1-year follow-up examination.