Cases reported "Mouth Diseases"

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1/154. Oral wart associated with human papillomavirus type 2.

    More than 100 human papillomavirus (HPV) types have been identified to date. Of these, 24 types have been described as being associated with oral lesions. HPV-2 has been frequently associated with skin lesions, but the reports of oral lesions as features of mucosal infection are limited. A biopsy specimen of an oral wart on the right palate was taken from a 48-year-old man and examined for the presence of HPV The sections showed papillary growth of the epithelium with hyperkeratosis and parakeratosis, and koilocytotic changes of the cells located in the upper layers of the oral squamous cell epithelium. These histological features corresponded well to those of verruca vulgaris on the skin. Immunohistochemically, papillomavirus genus-specific capsid antigen was detected in most of the koilocytotic cells. In addition, Southern blot hybridization analysis revealed that the lesion harbored HPV-2 dna. in situ hybridization with a biotinylated HPV-2 dna probe clearly demonstrated viral dna in the nuclei of squamous cells, which were located in a deeper layer of the epithelium than viral antigen-positive cells.
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2/154. The use of the CO 2 laser in oral surgery in the military.

    From 1987 to 1990, there were 122 soldiers treated with the CO 2 laser (Sharplan 1010) in the Laser Center of the israel Defense Forces. A variety of benign oral lesions, vascular tumors, and other oral lesions were excised or vaporized. Twenty-four soldiers with impacted wisdom teeth and wide pericoronitis underwent operculectomy using the CO 2 laser. The CO 2 laser has the ability to perform accurate hemostasis surgery, with minimal postoperative pain and edema, and rapid healing, resulting in fast recovery without significant discomfort. These advantages are particularly important in the military since soldiers can return to their duties immediately after surgery.
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3/154. Linear IgA disease histopathologically and clinically masquerading as lichen planus.

    In each of 2 cases reported, the patient presented with features of erosive lichen planus or lichenoid drug eruptions and an incisional biopsy taken from the patient was diagnosed histologically as lichen planus. Subsequent recurrences or exacerbations were associated with vesiculobullous lesions. Simultaneous or subsequent direct immunofluorescence studies--from the same tissue sample in one case and from a similar site in the other case--demonstrated classic features of linear IgA disease. Both patients were originally treated for lichen planus with systemic and/or topical corticosteroids with limited success. One patient was treated with sulfapyridine with minimal improvement. Both patients were subsequently treated with dapsone and demonstrated significant clinical improvement. We propose that linear IgA disease may be more common than reported in the oral cavity, inasmuch as many cases of recalcitrant lichen planus, erosive lichen planus, and lichenoid drug eruptions, especially those with a vesiculobullous component, may in reality represent linear IgA disease. We recommend that direct immunofluorescence be done in any case in which bullous lichen planus is suspected.
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4/154. Assessment of the radiographic image: recognition of abnormal features.

    Radiographs, due to their ability to pass through materials differentially, are used in dental practice to obtain information that is not available by other means. Recognition of the presence of a variation from normal is the first step to accurate interpretation of abnormalities. This article presents an outline of a method for examining radiographs in order to recognize that an abnormality is present, and to learn from the visual information some of the characteristics of the abnormality. A number of clinical examples are used to illustrate the conclusions that we can draw from the radiographic changes.
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5/154. Felty's syndrome.

    The clinical and pathologic findings of Felty's syndrome are discussed. A case is presented which demonstrates the nonspecific inflammatory oral lesions commonly seen with this syndrome. The role of the dentist in relating these nonspecific lesions to the basic disease process is emphasized.
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6/154. Acute (toxic) epidermal necrolysis. Report of a case.

    A case of acute (toxic) epidermal necrolysis is reported in the dental literature for the first time. This severe, life-threatening mucocutaneous syndrome resembles severely scalded skin. Sloughing vesiculobullous oral lesions are a frequent component. staphylococcus aureus and drug reactions may cause separate entities presenting clinically as acute epidermal necrolysis. This case of drug-induced epidermal necrolysis ina child was successfully treated with methicillin and hydrocortisone.
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7/154. Medico-dental dilemmas.

    patients with a variety of diseases in the oro-facial region are frequently confused when trying to decide from which of the professions of medicine and dentistry to seek treatment. Furthermore, during the process of arriving at a diagnosis, numerous practitioners and specialists in both professions may be called in for consultation, thus adding to the dilemma. Four cases are reported in this article to illustrate the problem, and some conclusions are drawn as to how it may be minimized albeit not completely solved.
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8/154. Plasma cell granuloma of the oral mucosa with angiokeratomatous features: a possible analogue of cutaneous angioplasmocellular hyperplasia.

    We report a plasma cell granuloma arising in the movable mucosa of the oral cavity of a 50-year-old man. Histologically, the lesion was characterized by a dense nodular infiltrate of mature plasma cells. Immunostaining for kappa and lambda light chains confirmed a polyclonal plasma cell population. Elongated rete ridges of the overlying epithelium formed collarettes around dilated blood and lymph vessels in focal areas. Based on the overall histologic architecture, we hypothesize that these peculiar changes are secondary to local blood flow alteration with congestive vasodilation caused by a dense plasma cell infiltrate. We believe that the plasma cell population may represent the oral counterpart of the cutaneous angioplasmocellular hyperplasia.
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9/154. Complete dentures and the associated soft tissues.

    Some of the conditions of the soft tissues related to complete dentures encountered during a period of 25 years at a university clinic were presented and discussed from the standpoint of the clinical prosthodontist. During this time, over 1,000 denture patients were treated each year. For some conditions, a method of management was offered with treatment by sound prosthodontic principles rather than unneccessary medication. That denture fabrication involves much more than mere mechanical procedures is an understatement. Complete dentures are foreign objects in the oral cavity that are accepted and tolerated by the tissue to a degree that is surprising. As prosthodontists, we can gain satisfaction from the realization that the incidence of oral cancer due to dentures is less than extremely low. At the same time, we must be ever mindful of the statement by Sheppard and associates. "Complete dentures are not the innocuous devices we often think they are." Every dentist must remember that one of his greatest missions is to serve as a detection agency for cancer. The information discussed indicates (1) the need for careful examination of the mouth, (2) the value of a rest period of 8 hours every day for the supporting tissues, and (3) the importance of regular recall visits for denture patients. Robinson stated that while the dental laboratory technician can be trained to aid the dentist in the fabrication of prosthetic devices, his lack of knowledge of reactions and diseases of the oral tissues limits him to an auxiliary role. Complete prosthodontics is a highly specialized health service that greatly affects the health, welfare, and well-being of the patient. It can be rendered only by the true professional who is educated in the biomedical sciences.
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10/154. Delayed and immediate hypersensitivity reactions associated with the use of amalgam.

    hypersensitivity to the constituents of dental amalgam is uncommon. When it occurs it typically manifests itself as a lichenoid reaction involving a delayed, type IV, cell-mediated hypersensitivity response. Rarely, a more acute and generalised response can occur involving both the oral mucosa and skin. We describe two cases that illustrate the presentation and management of these two types of reaction.
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