Gingival fibrous nodule.

Five patients with small, exophytic, asymptomatic fibrous nodules, single or multiple, of the mandibular mucogingival zone of the anterior labial gingiva are presented. Such nodules are benign and resemble small fibromas. The clinical and histologic appearance distinguishes them from entities such as retrocuspid papilla, reticular mandibular gingival ridges, oral hamartomas associated with Cowden's syndrome, tuberous sclerosis oral lesions, and oral nodules secondary to epidermolysis bullosa. Gingival fibrous nodule, or gingival nodule, is the proposed name for this lesion, which is essentially a variation of normal oral structures that may be mistaken for disease.

Relationships among education, dentate status, and diet in adults.

The Nutrition and Oral Health Study (NOHS) was established to study the interrelationship of oral health status, dietary intake, and education, and to define their relative impact on the middle aged and elderly. Two hundred forty-seven partially or fully dentate (at least 6 teeth) subjects returned two food diaries over a 16-month period. Despite the investigators' efforts to enroll from a socio-economically diverse Boston population, the volunteers were health-conscious, with 85% having been to the dentist within the last year; 95% brushed, and 60% flossed daily. More than half the volunteers had attended college. With the exception of cholesterol intake, which was high in both the higher- and lower-educated males, most individuals, despite their dentate status, sought good nutrition. People who wore dentures consumed more refined carbohydrates and sucrose. As the number of teeth declined, Vitamin A, crude fiber, and calcium declined, while cholesterol rose. These factors may have a significant implication for general health.

Dental changes in hypervitaminosis D.

Vitamin D is required for the normal development of teeth and bones. When there is excess vitamin D, systemic and dental changes may occur. This is a case report of a girl who experienced hypercalcemia secondary to excess vitamin D derived from the consumption of milk that was incorrectly fortified. The changes in the permanent dentition to date are enamel hypoplasia and focal pulp calcification. These changes correspond to the timing of the toxemia caused by hypervitaminosis D.

Relationship of diet to root caries.

A Nutrition and Oral Health Study was conducted on 141 middle-aged and elderly adults (54% female and 46% male; aged 47-83 y, mean = 67; 51% college educated; and 89% white). This study reports on the relationship between root caries and diet. Nutritional composition was derived from two 3-d food diaries. Root caries was measured according to the 1985 Adult Survey Diagnostic Criteria of the National Institute of Dental Research. When the individuals were segregated by their root DFS (decayed and filled surfaces) status into highest (> or = 7) and lowest (< or = 1) quartiles, the sucrose consumption was significantly higher in the higher DFS group. Mean energy consumption and mean number of teeth were the same in both groups. When the individuals were segregated by sucrose consumption into highest (> or = 89 g) and lowest (< or = 31 g) quartiles, DFS root status was significantly higher (P < 0.01) in the highest quartile group (7 g) vs the lowest group (4 g). By using data from subjects with two food diaries, a stepwise-linear-regression model for root caries showed that 4.2% of the variance for root caries was explained by sucrose, 2.8% by plaque, 3.8% by total number of teeth, and 5.6% by gingival recession. These data suggest that root caries has a similar dietary etiology to coronal caries.

Unusual external resorption of a maxillary lateral.

This article defines an unusual previously unreported entity afflicting a maxillary lateral incisor. Labial idiopathic external root resorption just apical to the cemento-enamel presented as a gingival (periodontal) problem and was misinterpreted as cervical dental caries. This report defines a new possibility for a radicular defect in a maxillary lateral incisor that may cause periodontal problems.

Peripheral, soft tissue odontomas. Two case reports.

Two cases of rare, peripheral, soft tissue odontomas, in different growth phases, are reported. Case one, discovered in an early, rapid growth phase, had no radiographic appearance, was presumed to be a periodontal abscess, and presented a diagnostic challenge. Case two was diagnosed radiographically in its mature phase. Both were treated successfully by excisional biopsy and did not recur. Comparisons are made to the classic intrabony odontomas.

Parakeratosis of the labial mucosa in zinc-deficient rats.

Epithelial parakeratosis has been observed in zinc-deficient animals of several species. In the rat, it has been reported on the epidermis, footpad, esophagus, soft palate, buccal mucosa, and dorsal tongue. This study reports that the lower lip also shows a striking hyperparakeratosis, as well as epithelial hyperplasia and an increase in mitoses. The appearance of these features was rapid with changes noted at Day 7 and persisting through Day 14 and Day 28. On Day 32, zinc was restored to the diet at control levels and by 42 days the zinc-deficient group showed dramatic increases in food intake, body weight, femur zinc and, in addition, mucosa of the lower lip resembled zinc-adequate controls. These differences are statistically significant. Morphometric comparison of spinous cells from zinc-deficients with those of the controls did not show significant differences.

Reflex vasoconstriction following dental injections.

Three case reports of transient facial blanching or vasoconstriction that followed administration of dental anesthetic are presented. A review of vasomotor cutaneous control is given, along with a proposal to explain this phenomenon.

Bacterial plug versus pseudocyst of the tonsils.

This article presents several cases of two types of yellow lesions of the tonsils. The bacterial plug is a small, sometimes symptomatic lesion composed of mats of bacteria that fill a tonsillar crypt and is treated by dislodging the plug. The pseudocyst is a small, mostly asymptomatic smooth, epithelium-covered lesion that can regress spontaneously and need not be surgically removed for diagnosis. Both lesions are compared and contrasted to delineate diagnostic features and to suggest management. Terms are differentiated, and the relationship to the lymphoepithelial cyst is discussed.

Flushing of the face as a result of chewing food.

This case depicts a clinical situation in which the patient's face became flushed after chewing food for approximately 30 seconds. The distribution of the flushing accurately defines the distribution of the zygomaticofacial branch of the trigeminal nerve. A theory involving the parasympathetic supply to this area is presented to explain this clinical pattern.

Facts about gonorrhea and dentistry.

This article reviews gonorrhea and discusses various misconceptions that have appeared in the dental literature and in verbal presentations about gonorrhea and dentistry. Facts are presented and some conclusions are offered for the dental profession.

The reversibility of leukoplakia caused by smokeless tobacco.

This case describes an instance of reversibility of bilateral mucosal leukoplakic lesions caused by the long-term use of smokeless tobacco. The dentist should recognize the lesion, advise the patient to stop the tobacco usage, observe the reversibility of the lesion, and assist the patient in stopping the tobacco habit permanently.

Reticular mandibular gingival ridges.

This paper reports five cases of a heretofore unreported condition of the gingiva named reticular mandibular gingival ridges. Occurring in middle-aged males, macroscopically, they are bilateral ridges on the mandibular attached gingivae resembling rugae and having a reticular pattern that may be mistaken for lichen planus. Microscopically, they are formed of fibrous tissue with vessels that have a minimal perivascular infiltrate; the epithelium has extension of rete ridges. Of unknown etiology, the condition does not appear to change, is innocuous and does not require treatment.

Orofacial involvement secondary to trapezius muscle trauma.

The case reported in this article demonstrates an unusual referral mechanism for signs and symptoms of the face and the oral cavity emanating from a traumatized trapezius muscle. A theory for this referral, based on central connections of nerves V, VII, IX, X, and XI, is proposed.

The median mandibular cyst and its endodontic significance.

The median mandibular cyst is a very rare cyst of debatable origin that occurs in the midline of the mandible. A review of the literature and an additional case are presented, with emphasis on diagnosis, treatment planning and the need for endodontic therapy in the area of the lesion.

Atypical central neurilemmoma of the mandible.

Neurilemmomas arising within the jawbones are rare. Most occur in the mandible as slowly growing enlargements that may or may not be painful; radiographically, they are large single or multiloculated radiolucencies mimicking other benign jaw lesions. The histology is characteristic, with Antoni A and B tissues and a well-defined capsule. This article reports an unencapsulated neurilemmoma of the mandible and reviews and summarizes the features of the central neurilemmomas in the literature.