Nickel allergy and orthodontics, a review and report of two cases.

Nickel is a common component in many orthodontic materials. An allergy to nickel is commonly seen in the population, more frequently in women. This allergy has increased with the more frequent use of nickel containing jewellery and intraoral piercings. As a result, this allergy can be expected to be more readily encountered in dental practice. Possible allergy to nickel should be a question in the initial patient health history questionnaire. The dental practitioner should be mindful of this allergy during the course of orthodontic treatment, and know how to diagnose a nickel allergy if it appears and subsequent action in treatment and referral if it is suspected. This paper provides a summary of nickel allergy, its epidemiology, diagnosis and recommendations and alternatives to treatment. A detailed description of two cases where it was discovered in orthodontic patients is also reported.

Immunohistochemical study of vestibular gingival blood vessel density and internal circumference in smokers and non-smokers.

BACKGROUND: This study was undertaken to determine: 1) if sections stained with monoclonal antibody to CD34 can be used for measurement of gingival blood vessel density and circumference and 2) if long-term smoking affects either of these 2 parameters. METHODS: Vestibular gingival biopsy samples were obtained from 17 adults (5 smokers and 12 non-smokers) who were undergoing routine periodontal surgery independently of this study. Hematoxylin and eosin staining was used for histological assessment of inflammation, while immunohistochemical staining with CD34 mouse monoclonal antibody was used to mark the endothelial cells of the blood vessels within each sample. Stringent selection criteria were applied to the 17 biopsy samples, and 7 (from 3 smokers and 4 non-smokers) were chosen to have their vascular density (number of vessels/unit area) and internal vessel circumference (IC) measured under a blinded protocol. RESULTS: Repeated measurements of vascular density and internal circumference showed small standard deviations, indicating the high reproducibility of the measurement technique. The smoker group showed a higher proportion of small (IC < 50 microns) and a lower proportion of large blood vessels (IC > 100 microns), which was statistically significant (P = 0.0403 and P < 0.001, respectively). The difference between the vascular density of smokers and non-smokers was not significant (P = 0.092). CONCLUSIONS: The present study indicates that the CD34 immunohistochemical staining technique is a simple and reproducible method for the measurement of density and internal circumference of gingival blood vessels. Based on this technique, cigarette smokers show a higher percentage of smaller blood vessels and a lower percentage of larger vessels, but similar vascular density, to non-smokers.

Tobacco-associated lesions of the oral cavity: Part II. Malignant lesions.

Nonmalignant tobacco-associated lesions of the oral cavity were discussed in the first part of this two-part article. Here, we describe malignant lesions associated with tobacco use, basic biopsy principles for such lesions and intervention strategies that dental professionals may use to reduce the chances of their patients developing precancerous lesions or primary malignancies.

Tobacco-associated lesions of the oral cavity: Part I. Nonmalignant lesions.

The excessive use of tobacco products has been associated with various lesions in the oral cavity. Tobacco-associated lesions include tooth stains, abrasions, smoker's melanosis, acute necrotizing ulcerative gingivitis and other periodontal conditions, burns and keratotic patches, black hairy tongue, nicotinic stomatitis, palatal erosions, leukoplakia, epithelial dysplasia and squamous-cell carcinoma. A routine intraoral examination by a dental health professional can reveal most of these lesions at an early stage, and early intervention may prevent serious sequelae. Thus, detection of tobacco-associated lesions in conjunction with tobacco-use counselling by dental professionals has become the standard of care. The significance and treatment of nonmalignant tobacco-associated lesions are addressed in the first part of this two-part series. Malignant lesions, basic biopsy principles and prevention and intervention strategies are discussed in the subsequent part.

Adult rhabdomyoma. A light microscopic, ultrastructural, virologic, and immunologic analysis.

Adult rhabdomyoma is a rare benign tumor of skeletal muscle origin that frequently arises from musculature of the head and neck region. In this study we report five cases of adult rhabdomyoma. Light and electron microscopic examination revealed the typical cellular features as described by others. The results of immunophenotyping and quantitation of nucleolar organizer regions were consistent for a benign skeletal muscle tumor. Epstein-Barr virus and human papillomavirus genomic DNA could not be detected by in situ hybridization.

Intracytoplasmic lumina in squamous epithelial lesions of the oral cavity.

Intracytoplasmic lumina are considered a diagnostic feature of adenocarcinomas and have not been reported in squamous cell carcinomas. We are documenting intracytoplasmic lumina in a case of primary squamous cell carcinoma of the oral mucosa and in the oral squamous mucosa in two cases of graft versus host disease, confirming that intracytoplasmic lumina are also present in squamous epithelia and their tumors. Likely explanations for the presence of intracytoplasmic lumina in non-neoplastic and malignant squamous cells of the oral cavity include multiple differentiation, phagocytosis and immune attack on desmosomes.

Oral pathology in Canada: a survey.

The Canadian Academy of Oral Pathology conducted a survey of its active members to obtain information on their demographics, professional activities and university affiliations, and to assess Canada's present and future oral pathology needs. Data were also collected on Canadian oral pathology diagnostic biopsy services. This paper reports the salient findings of the survey, and discusses their implications for the specialty of oral pathology as well as for the Canadian dental community.