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The sensitivity of detection of human papillomavirus (HPV) DNA in premalignant and malignant oral lesions by in situ hybridization (ISH) and polymerase chain reaction (PCR) were compared. With both methods HPV DNA was found in 4 of 24 cases of epithelial dysplasia, 4 of 14 cases of verrucous hyperplasia, and 1 of 10 cases of squamous cell carcinoma. The 10 cases of smokeless tobacco keratoses and 3 cases of verrucous carcinoma that we examined were all negative for HPV DNA. The PCR for the E6 open reading frame of HPV-16 correctly identified all cases that were positive by ISH. Only a single case that was positive by PCR was negative by ISH for HPV DNA. However, the PCR demonstrated the presence of HPV-16 infection in one case, which had hybridized most intensely with the probe for types 31/33/35 in the ISH. This discrepancy probably is due to the high degree of cross-hybridization in the ISH assay. PCR appears to be an effective technique for identifying HPV-16 DNA sequences in biopsy material from premalignant and malignant oral lesions.

Sickle-cell disease is characterized by chronic hemolytic anemia, rapid destruction of defective erythrocytes, with consequent circulatory disturbances. Thromboses and infarctions with resultant osseous manifestations tend to be localized in the ends of the long bones or in the medullary area, the latter often becoming apparent in the jaws. Three case reports are presented to illustrate osseous changes observed in the jaws of these sickle-cell patients. The radiographic findings demonstrate the adaptive mechanisms of bone metabolism in response to vascular infarction, infection, or both in some sickle-cell anemia patients. A differential diagnosis is suggested for osseous lesions observed in the jaws of these patients.

An experimental study was implemented to determine the effectiveness of isobutyl-2-cyanoacrylate (bucrylate) as an oral hemostat, its influence on sequential wound healing, and its potential as a carcinogen. Segregated groups of equal numbers of male and female Long-Evans Hooded Rats underwent deep (socket) and superficial (surface) aerosol placement of bucrylate to maxillary molar extraction sites. Bucrylate proved to be an effective oral hemostat, rapidly retarding postextraction hemorrhage. Deep placement of the adhesive resulted in retarding of healing and lingering macrohistiocytic aggregates in wounds. Superficial placement of the material resulted in very little long-term macrohistiocytic response, and would healing showed little retardation. A neoplastic potential was not demonstrated for bucrylate.

A few months before her sixth birthday, a Caucasian girl suffered progressively worse episodes of painful, nontender, erythematous swellings of the palate lingual to apparently healthy primary second molars. Neither of the developing maxillary second premolars was discerned clearly in radiographs, but, upon surgical exploration, incomplete crowns were found in both follicles. All the other premolars appeared to be developing normally. Histologic, histochemical, and chemical analyses showed that the enamel was hypocalcified, apparently as a result of hypomaturation; the dentin was essentially normal; and morphogenesis had ceased when the heights of contour of the crowns had not yet been reached. This pattern of developmental defects differs from those of well-characterized odontogenic disorders, such as regional odontodysplasia and amelogenesis imperfecta. We suggest that focal odontodysgenesis might be an appropriate term for it. The bilateral symmetry suggests a genetic component in the etiology.

The use of smokeless tobacco appears to be finding its way onto middle school, high school and college campuses as a socially acceptable and popular habit. Numerous reports in the literature have described the oral changes that appear to be associated with the use of smokeless tobacco in adults. Such information is unavailable for the lower age groups. A study was therefore undertaken to determine the prevalence and frequency of oral hard- and soft-tissue alterations associated with the use of smokeless tobacco in a teen-age population. High school students in grades 9 to 12 were evaluated on a random basis. From a total sample of 1,119 students, 117 users of smokeless tobacco were identified. Four distinct lesions associated with smokeless tobacco use were identified clinically: (1) hyperkeratotic or erythroplakic lesions of the oral mucosa, (2) gingival or periodontal inflammation, (3) a combination of oral mucosal lesions and periodontal inflammation, and (4) cervical erosion of the teeth. Among the smokeless tobacco users, 113 were boys and 4 were girls. Fifty-seven (48.7 percent) of the users had soft-tissue lesions and/or periodontal inflammation or erosion of dental hard tissues. Ninety-nine of the 117 users were Caucasian, 6 were Hispanic, 1 was black, 1 was Asian, 1 was an American Indian, and 6 failed to identify an ethnic origin. Use ranged from one to twenty "dips" per day, with an average time per dip of 30 minutes. Most users had been dipping for an average of 2 years, and twelve different tobacco brands were identified.