Complete spontaneous regression of congenital epulis in a baby by 8 months of age.

BACKGROUND: This paper describes the case of a 7-day-old girl who was referred to a paediatric dentistry clinic because of the presence of a pedunculated mass protruding from the front of her mouth. CASE REPORT: The mass was attached to the maxillary alveolus to the right of the midline, and was clinically diagnosed as a congenital epulis. The baby had no airway obstruction and was able to feed well. A conservative treatment was proposed, with monthly follow-up appointments to monitor the lesion. CONCLUSION: After 8 months, the lesion had completely regressed, meaning that the girl did not have to be exposed to unnecessary surgical procedures in her first few days of life. The eruption of the upper anterior teeth was not affected.

[Case report of prosthetic treatment for defected jaw with enucleation of the right maxillary sinus tumor].

PATIENT: The patient is a 71-year-old woman who had undergone a gingivectomy due to a gingival carcinoma of right maxillary sinus and a denture was made for the defected jaw. DISCUSSION: During three years and six months, |3 serves as the guidance tooth had suffered from various symptoms, from the detachment of the neighboring tooth to the use of an OP anchor followed by a partial fracture of the cuspid root. However, |3 has not been removed in accordance to the patient's request. In addition, a relining provided indirectly to the denture, it is still maintained and used for mastication, pronunciation and swallowing functions without difficulty. CONCLUSION: This is a case that a denture was made for the defected jaw. However, it is important ot take measures in the future, as the remaining tooth is not expected to be preserved for long.

Overexpression of Aurora-A potentiates HRAS-mediated oncogenic transformation and is implicated in oral carcinogenesis.

Aurora kinases are known to play a key role in maintaining mitotic fidelity, and overexpression of aurora kinases has been noted in various tumors. Overexpression of aurora kinase activity is thought to promote cancer development through a loss of centrosome or chromosome number integrity. Here we observed augmentation of G12V-mutated HRAS-induced neoplastic transformation in BALB/c 3T3 A31-1-1 cells transfected with Aurora-A. Aurora-A-short hairpin RNA (shRNA) experiments showed that the expression level of Aurora-A determines susceptibility to transformation. Aurora-A gene amplification was noted in human patients with tongue or gingival squamous carcinoma (4/11). Amplification was observed even in pathologically normal epithelial tissue taken at sites distant from the tumors in two patients with tongue cancer. However, overexpression of Aurora-A mRNA was observed only within the tumors of all patients examined (11/11). Our data indicate that Aurora-A gene amplification and overexpression play a role in human carcinogenesis, largely due to the effect of Aurora-A on oncogenic cell growth, rather than a loss of maintenance of centrosomal or chromosomal integrity.

[The influence of intermittent hemodialysis (HD) on bispectral index (scale) (BIS) and serum propofol concentration under postoperative intravenous sedation].

We experienced a case of postoperative intravenous sedation with propofol during intermittent hemodialysis (HD), and investigated the correlation between the clinical sedation level based on bispectral index scale (BIS) together with Ramsay score, and the serum concentration of propofol. One adult oral cancer patient (carcinoma of the lower gingiva) with end-stage renal dysfunction needing HD was selected for this study. The day after operation, HD was commenced under intravenous sedation with propofol. Clinical sedation level was assessed using BIS and Ramsay score, and serum propofol concentrations were determined in arterial blood samples. Serum concentrations were measured every 15 times until 51 hours after operation. The initial dose of propofol was set at 3.5 mg x kg(-1) x h(-1) on the basis of clinical symptoms. According to BIS and Ramsay score, sedation level decreased lineally for 1 hour after commencement of HD. In contrast, serum propofol concentration incresed from 1.71 microg x ml(-1) to 2.21 microg x ml(-1). Total serum concentration of propofol was enhanced during HD because of dialytic dehydration, but, according to BIS and Ramsay scores, the possibility was suggested that the fraction of albmin-unbound propofol with pharmacological activities was eliminated or absorbed by membrane during HD.

Expression of E-cadherin, alpha-catenin, and beta-catenin in the process of lymph node metastasis in oral squamous cell carcinoma.

Regional lymph node metastasis is a very important prognostic indicator. In the metastatic process, reduction in cell to cell adhesion including E-cadherin-catenin cell adhesion complex is an essential step. We investigated immunohistochemical expression of E-cadherin, alpha-catenin and beta-catenin in 159 tissue samples from patients with oral squamous cell carcinoma and examined the correlation between their expressions and the presence of regional lymph node metastasis. Significantly greater reduction in expression levels of E-cadherin, alpha-catenin and beta-catenin was found in the metastatic group (n=64) compared to the nonmetastatic group (n=95) (P=0.007, 0.001, 0.001, respectively). However, there was no significant correlation between their expressions and the features of the regional metastasis, the number of metastatic lymph nodes or the presence of extracapsular metastasis. These data suggest that evaluation of the immunohistochemical expression of E-cadherin, alpha-catenin and beta-catenin is extremely valuable for the diagnosis of metastatic occurrence.

Jaw bone remodeling at the invasion front of gingival squamous cell carcinomas.

BACKGROUND: It is still unknown how jaw bone remodeling occurs at actual invasion sites of oral squamous cell carcinomas. Since there is no other human carcinomas which make a direct invasion of the bone, gingival carcinomas are valuable examples. METHODS: Twelve surgical specimens of gingival squamous cell carcinoma were examined histopathologically and immunohistochemically for remodeling of bone and its surrounding tissue. RESULTS: Three types of bone interfaces with carcinomatous invasion were distinguished. These included areas with bone resorption, smooth bone surface and new bone formation. In the bone-resorption area, numerous osteoclasts were located along the bone surface, which was surrounded by myxoid stroma. The myxoid stroma was characterized by immunopositivity for heparan sulfate proteoglycan (HSPG), abundant vascularity and macrophagic infiltration. In the bone-formation area, rows of osteoblasts were aligned on the bone surface. The stroma around osteoblasts was also HSPG-immunopositive, poor in vascularity but rich in activated fibroblasts. In the smooth-bone area, the stroma showed an organizing phase of granulation tissue with slender fibroblasts and mature collagen fibers but with less vascularity and inflammatory infiltrates. CONCLUSION: The results indicate that the stromal architecture, especially in terms of its inflammatory cellular, vascular and matrix compositions, is strictly regulated in the timing and site of jaw bone remodeling which is causes by carcinomatous invasion.

Peripheral ossifying fibroma--a clinical evaluation of 134 pediatric cases.

PURPOSE: Reported clinicopathologic studies on the peripheral ossifying fibroma (POF), a reactive gingival lesion, have not addressed the pediatric population in specific detail. This study, the first devoted to children, investigated the clinical features of a large number of POFs and compared the findings to cases reported in the English language literature. METHODS: Detailed clinical and historical information of 134 surgically removed POFs in patients aged 1-19 formed the basis of this study. Clinical manifestations, histogenesis, treatment rationale with pediatric considerations, and biologic behavior were emphasized. RESULTS: The POF was found more frequently in females (60%). It had a predilection for the maxillary gingiva (60%) and for the incisor/cuspid region. The average patient age was 14 years. Only 2 (1%) POFs were found to be unequivocally associated with primary teeth. The clinician seldom included the POF in the differential diagnosis. The recurrence rate after surgical excision was 8%. CONCLUSIONS: This study revealed that a POF arising from the periodontal ligament of a primary tooth is most likely a rare event. However, the pediatric patient with a POF has special management considerations compared to the adult. Because of the POF behavior pattern, a proper treatment protocol is warranted with close postoperative follow-up.

Autocrine and paracrine motility factors and their involvement in invasiveness in a human oral carcinoma cell line.

Invasive potentials of malignant cancer cells are regulated by cell motility factors. To examine the regulation of motility and invasiveness in oral squamous carcinoma, we investigated autocrine- and/or paracrine-acting cell motility factors, using a newly established human cell line (IF cells) from oral squamous cell carcinoma, which has highly invasive and metastatic characteristics. Conditioned medium derived from IF cells stimulated cell scattering and migration of GB-d1 gallbladder carcinoma cells, indicating that IF cells secreted cell motility factors. Using antibodies, IF-derived cell motility factors proved to be transforming growth factor (TGF)-alpha and TGF-beta1. Antibodies against TGF-alpha and TGF-beta1 inhibited autonomous migration of the IF cells. On the other hand, in vitro invasion of IF cells was strongly enhanced by hepatocyte growth factor (HGF) but only slightly by TGF-alpha and TGF-beta1. The conditioned medium from fibroblasts enhanced in vitro invasion of IF cells, an event abrogated by anti-HGF antibody, but not by antibodies against TGF-alpha and TGF-beta1. Importantly, IF cells secreted a factor inducing HGF production in fibroblasts and the factor was identified as interleukin-1, which means that a mutual interaction exists between tumour cells and fibroblasts, as mediated by the HGF/HGF-inducer loop. These results indicate that IF cells utilize TGF-alpha and TGF-beta1 as autocrine-acting motility factors and HGF as a paracrine-acting motility factor, and that invasiveness of IF cells is particularly stimulated by HGF derived from stromal fibroblasts. Utilization of multiple cell motility/invasion factors that act in distinct pathways may confer highly invasive and metastatic potentials in IF oral squamous carcinoma cells.

[Smoking and periodontal health]. / Le tabagisme et la santé parodontale.

The nature of the relationship between smoking and periodontal disease is not clear. However, from the information available today, the evidence, when carefully weighted, strongly suggests that smoking exerts a substantial and detrimental effect on periodontal health and disease. It is associated with an increased disease rate in terms of periodontal bone loss, attachment loss as well as periodontal pocket formation and it seems to worsen the host's defense by means of its major metabolite, nicotine. Nevertheless, new, sensitive and adequate investigations should be developed and performed in order to better explain the pathogenic mechanisms.

A study of an in vitro model for invasion of oral squamous cell carcinoma.

An in vitro model for studying the invasion mechanism of oral squamous cell carcinoma (SCC) was developed using a specific culture matrix composed of collagen gel combined with human fibroblasts. Five SCC cell lines cultured on collagen-only gels showed stratified growth on the gels. However, all five cell lines showed invasive growth into the matrix when cultured on the fibroblast-incorporated collagen gels. Moreover, fibroblast-conditioned medium was shown to promote the invasion of HSC-3 cells into the collagen gels. These results suggest that fibroblasts play an important role in the invasion of oral SCC cells in vitro. Four cell lines, which were newly established in our laboratory, were tested in this assay system. These cell lines cultured on fibroblast-incorporated collagen gels expressed morphologic and biologic characteristics in vitro, similar to those in vivo.

Growth potential of peripheral ossifying fibroma.

The peripheral ossifying fibroma (POF), a benign gingival overgrowth, occurs mainly in the anterior portion of the maxilla in young adults. The size of the lesion is usually less than 1.5 cm. A unique case of POF in the posterior mandible of a 70-year-old female is presented. The lesion was 6 cm in the largest diameter. It is apparent that POF can become a sizeable tumor unless it is surgically excised in an early stage.

Classification and behaviour after surgery of canine 'epulides'.

Seventy-five surgically excised canine gum neoplasms, which had previously been diagnosed as epulis or ameloblastoma, were reclassified on the basis of their presumed tissue of origin. They included 42 tumours of fibroblastic origin, which contained small foci of odontogenic epithelium and were classified as peripheral odontogenic fibroma, whilst 31 epithelial tumours were classified as basal cell carcinomas arising from the gum epithelium. Two epithelial tumours which apparently arose within the bone of the mandible and were not connected with the surface mucosa were classified as ameloblastomas. Follow-up studies after surgery revealed a recurrence rate of 17 per cent for the odontogenic fibromas and 50 per cent for basal cell carcinomas. Neither of the ameloblastomas, which were initially treated by radical excision, recurred locally and no metastases were detected from any of these tumours.