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Risk factors for poor dental health include obesity, low socio-economic status, poor dietary habits, and dental anxiety. The aim of this study was to explore the complex relation between body mass index (BMI) and number of teeth in middle-aged women taking education, dietary intake patterns, dental care utilization, and dental anxiety into account. Three groups of women (37-60 years): reference women (group I, BMI 23.8 +/- 3.1 kg/m2), obese women (group II, BMI 35.0 +/- 2.6 kg/m2), and severely obese women (group III, BMI 41.0 +/- 3.4 kg/m2) were included. Questionnaires were used to assess education, smoking, number of teeth, dental care utilization, dental anxiety, dietary intake, and meal patterns. Age, education, and smoking habits did not differ significantly between groups. However, there were significant global differences in number of teeth (27.2 +/- 3.4, 23.0 +/- 9.2, 24.7 +/- 5.9) and reported daily energy intake (9756 +/- 3363 kJ, 10344 +/- 3850 kJ, 11970 +/- 3786 kJ in groups I, II, and m, respectively). In a multiple regression model, a lower number of teeth was independently associated with higher age, higher BMI, lower education, irregular dental care, high dental anxiety, higher energy intake, and lower iron intake. These variables explained 25% of the variation in number of teeth. In conclusion, BMI is an independent predictor of number of teeth in middle-aged women when socio-economic, dietary, and psychological factors are taken into account.

There has been a continuous debate regarding the possible malignant potential of oral lichen planus (OLP). Based on the results from follow-up studies, OLP is regarded by several authors as a pre-malignant condition, and patients with OLP have been recommended to have their lesions monitored two to four times annually. This recommendation needs reconsideration, because a recall system of all patients with OLP requires substantial economic resources. In a reality where such resources are limited, a recall system must be weighed against other benefits and the fact that the malignant potential of OLP is most likely very low. The present review focuses on the diagnostic criteria for OLP, the pre-malignant potential of OLP, and the extent to which the available information can be used to reduce morbidity and mortality of oral cancer related to OLP.

An information visualisation tool was implemented and tested as a solution to the problem of visualising clinical experience derived from large amounts of formalised clinical data. The tool was based on the idea of dynamic 3D parallel diagrams with support for direct manipulation, an idea similar to the notion of 3D parallel coordinates. The tool was tested on a knowledge base containing about 1500 examinations obtained from different clinics. Clinical practice showed that the basic idea is conceptually appealing to the involved clinicians as the tool can be used for generating and testing of hypothesis.

MedView is a joint project with participants from oral medicine and computer science. The aim of the project is to build a large database from patient examinations and produce computerized tools to extend, view, and analyze the contents of the database. The contents of the data base is based on a formalization of health-care processes and clinical knowledge in oral medicine harmonized within the network SOMNET. We give an overview of the current status of the MedView project and discuss background and future directions.

Cancer chemotherapeutic drugs may affect immunocompetent cells of oral soft tissues, causing an impaired capacity to induce immune defence reactions. This study was designed to investigate changes in the number of macrophages, dendritic cells and T lymphocytes in the oral mucosa and dental pulp following treatment with the antineoplastic agent 5-fluorouracil (5-FU). Rats were given 5-FU (30 mg/kg or 50 mg/kg) i.v. on days 0, 1, 2, 5, 6 and 7. The number of cells in buccal epithelium and dental pulp expressing ED2, MHC class II, or CD2 molecules was analyzed following immunohistochemical peroxidase staining. Major histocompatibility complex (MHC) class II molecules were analyzed in epithelial sheets and in epithelial cell suspensions by flow cytometry. Increasing concentrations of 5-FU changed the morphology of the epithelial Langerhans cells with a reduced dendritic appearance as the most prominent feature. At 50 mg/kg of 5-FU, the oral epithelium detached from the connective tissue at the basement membrane. MHC class II molecule-expressing cells were reduced in number in the lamina propria of the buccal mucosa and in the dental pulp after both low and high dose of 5-FU, but only after high dose in the epithelium. The number of ED2- and CD2-expressing cells in the dental pulp was only slightly reduced by 5-FU treatment at both low and high dose, while these cells decreased in number in the oral mucosa. The varying sensitivity to 5-FU by macrophages, dendritic cells, and T cells depending on the tissues in which they reside may be due to differences in cell origin or differences in antigenic load.

The objective of this study was to evaluate the significance of preoperative dental treatment for the development of complications in the form of infections during the first postoperative weeks after heart valve surgery. In one group of patients (n = 149), oral health was examined and dental treatment performed 3-6 months prior to heart valve surgery. In a second group (n = 104), oral health was examined postoperatively and these patients did not receive any dental treatment before surgery. Infections were recorded for all patients during the first three weeks after surgery and correlated to the dental status at the time of surgery. Sepsis or endocarditis occurred in 5.4% of the first group and in 1.9% of the second group. Freedom from all infections for the two groups was 55% and 56%, respectively. The results did not reveal any significant differences between the groups regarding patients' oral health at the primary oral examination. The frequencies of postoperative complications such as focal infections, fever and increased CRP were also found to be similar for both groups. The combined scores of complications were 2.1% and 1.8%, respectively. Data from the present study do not support the suggestion that dental intervention will decrease the rate of early complications following heart valve surgery.

The efficacy of oral fluconazole versus nystatin was evaluated as a treatment modality for oral candidosis. Of the included patients (n = 60), two-thirds presented with an erythematous candidosis, and the others showed clinical signs compatible with a pseudomembranous candidosis. Predisposing factors were xerostomia (n = 18), HIV (n = 5), immunosuppression in conjunction with organ transplantation (n = 10), and wearing of dentures (n = 14). For the remaining patients no specific predisposing factors were found. One patient who was treated with nystatin was excluded owing to nausea that was related to the antifungal treatment. After 7 days of treatment with fluconazole (50 mg/day), the affected oral mucosa, assessed by the investigator, was cured or showed considerable improvement in 87% of the patients (n = 30). The corresponding figure for the nystatin group (n = 30), rinsing with 1 mL 4 times a day for 21 days, was 80%. Following treatment with fluconazole, 20 of 22 patients with symptoms at the start (91%) reported improvement. The comparable figures for the nystatin group were 10 of 12 patients (83%). Half of the patients in the nystatin group reported inconvenience from taking the medication (mean value = 25.9) compared with 23% of the patients in the fluconazole group (mean value = 6.6). Eight patients in the fluconazole group and 12 patients in the nystatin group exhibited a relapse within 6 months. These differences were not found to be statistically significant. The patients in the fluconazole group reported less inconvenience from taking the medication, a finding that may have clinical implications for compliance.

Over the years of testing biocompatibility of endodontic filling materials, little attention has been paid to the potential adverse influences on the function of the immune system. Therefore, the purpose of this study was to investigate the extent to which extractable components of some commonly used root canal sealing materials (ERCS) may interfere with immunocompetent cells in vitro. The potential of these materials to cause delayed-type hypersensitivity (DTH) was also addressed in a rat model system. Extractable components were drawn in cell culture medium from freshly mixed or set material of AH 26. Grossman's sealer, Endomethasone, and Apexit. In-vitro assays included either spleen cells or rat pulp tissue cells that were released following enzymatic digestion with collagenase. Purified T cells for the pulpal cell assay were obtained from rat mesenteric lymph nodes. The effect of ERCS on the proliferation of concanavalin A (con A) stimulated spleen cell was measured by 3H-thymidine incorporation. Pulpal accessory cell function was monitored by the capacity of pulpal cells, pretreated with components of ERCS, to provide signals to con A stimulated T cells. DTH was tested after subcutaneous implantation of root canal sealers (RCS) in rats and challenge by ear injection. Pretreatment of pulpal cells with low dilutions of eluates from extracted AH 26 and Endomethasone resulted in a strong reduction of the T cell proliferation rate. The effect was considerably reduced (P < 0.01) when extracts of the solid material were employed. Extracts of Grossmans' sealer and Apexit affected T cell proliferation only to a limited extent in the pulpal cell assay. In general, assays on spleen cells showed a similar profile, although increased cell division was induced by Grossman's sealer at high eluate dilutions and a concentration-dependent decrease of cell division at lower concentrations of this material. ERCS evoked both immunosuppression and, in some instances, immunostimulation, but they did not release DTH.

Smokeless tobacco (ST) is known to adversely effect the oral mucosa, but knowledge about the influence on immune defence is limited. Few studies have investigated the effect of ST on the local immune response. In the present study, we have assessed the effect of a crude Swedish moist snuff (SS) extract, alkaloids, and nitrosamines on T-cell mitogenic response to Con A using epithelial cells, including Langerhans cells, of the rat oral mucosa as accessory cells. SS extract at a concentration of 4% reduced the T-cell proliferation by 50% (IC50 = 4%). Pretreatment of either oral epithelial cells or T-cells with SS extract also gave a significant inhibition of T-cell proliferation. This effect was not obtained following preincubation with SS components as alkaloids and different tobacco-specific nitrosamines (TSNA). None of the tested compounds were found to possess any mitogenic properties. This in vitro study showed that SS extract can evoke an immunosuppressive effect on mitogen-driven T-cell proliferation using cells from oral epithelium as accessory cells. This effect was more pronounced when SS extract was employed compared to when the single SS components were used alone.

Background/aims: In the present study, a model for measuring the intensity of skin erythema by computer-assisted digital image analysis (DIA) was elaborated. The DIA technique was compared with laser Doppler perfusion imaging (PIM) to evaluate the relationship between erythema and skin perfusion., Methods: To produce erythema, three different types of nicotine patches (Nicotinell®, Nicorette® and Nicorette® placebo) were randomly applied ventrally on the upper arms for the time period recommended by the manufactures. After removal of the patches, colour photographs for subsequent DIA were taken and laser Doppler scanning for PIM was performed. The relationship between PIM and DIA was estimated intra- and inter-individually., Results/conclusions: A statistically significant linear correlation between PIM and DIA data was found, but the relationship was relatively weak. This may be explained by the fact that DIA and PIM are influenced by different physiological factors such as skin chromophores and velocity of moving cells. The results strengthen the theory that erythema and perfusion measurements reflect separate physiological phenomena and that the methods should be considered complements to each other in the experimental situation.

In order to analyse the clonality of T cells in the inflammatory infiltrate of oral lichen planus (OLP), mucosal biopsies were obtained from seven patients with manifest disease. The biopsies were stained with MoAbs directed against 11 different T cell receptor (TCR) V-gene families, anti-CD4, anti-CD8 and IL-2 receptor (IL-2R). For comparison, the frequencies of the different TCR V-families were determined in biopsies from five patients with oral candidosis as well as in peripheral blood from three patients with OLP and from six healthy blood donors (HBD). The occurrence of the investigated TCR V-families varied between 0% and 7% in venous blood obtained from both HBD and OLP patients. T lymphocytes expressing the TCR V beta 3 and V alpha 2 in OLP biopsies were, however, detected in frequencies ranging between 18% and 40% of the total fraction of lymphocytes, a consistent finding for all the OLP infiltrates studied. The other nine TCR V-families examined appeared in low frequencies both in biopsies and in peripheral blood. V alpha 2+ and V beta 3+ cells were often localized adjacent to the basal membrane. In contrast, T cells in Candida-induced lesions did not express a biased TCR distribution, and most V-families studied appeared in frequencies of 0-6%. Thus, T lymphocytes in OLP lesions express a substantially higher frequency of TCR V alpha 2 and V beta 3 than expected from the distribution in blood. The clonal expansion of T cells observed in OLP suggests that a superantigen is involved in the pathogenesis of the disease. Whether this superantigen is of exogenous or endogenous origin needs to be investigated.

To improve diagnostic procedures and facilitate clinical decision-making, computer-assisted image analysis was performed on color slides from 30 patients with histopathologically verified oral lichenoid reactions. Areas from white hyperkeratotic and adjacent red inflamed areas of the lesions were selected and subjected to image analysis. The digitization of the color slides was done by means of an image scanner, and the digital information was transmitted to a personal computer for subsequent feature extraction and analysis. The different oral lesions were characterized as the difference in mean values between white hyperkeratotic and red inflamed areas, respectively, compared with clinically normal tissue. Statistical analyses were made on three different color systems: Red-Green-Blue (RGB), normalized red-green-blue (rgb), and Intensity-Hue-Saturation (IHS). The results showed statistically significant differences in all color systems for both the hyperkeratotic areas and adjacent inflammatory reactions. A linear correlation was obtained when the results of the image analysis of color variations were compared with a clinical score system for hyperkeratosis and inflammation evaluated by two investigators independently.

This communication focuses on the participation of accessory cells in the initial recognition and processing of antigenic substances in the dental pulp. Immunohistochemical analyses have demonstrated the presence of two types of accessory cells--one with a dendritic morphology located in the periphery of the pulp and one with a macrophage-like appearance located more centrally. Functional studies in vitro have provided evidence for the dendritic cells being the most significant of the two cells regarding their capacity to induce T-cell proliferation. Studies on ontogeny have revealed that the appearance of pulp accessory cells is delayed compared to other peripheral tissues. In experimentally induced pulp lesions a rapid increase of cells with morphologic and phenotypic features similar to normally occurring accessory cells was found. These data demonstrate that the dental pulp contains the necessary cellular constituents to mount an immunologic defense reaction. Future studies should focus on elucidating possible interactions between these immune cells and the neurovascular system of the pulp.

Class II antigen expressing cells are generally associated with the early phase of the immune response. Dendritic cells and macrophages expressing these cell surface antigens have recently been demonstrated and characterized in the dental pulp. The present study was undertaken to determine when the pulp receives its immunologic defense potential by examining the temporal appearance of class II antigen expressing cells in the rat incisor pulp. Pulp tissue specimens obtained at various time periods from a gestational age of 16 days to 14 wk after birth were examined by immunohistochemistry using O x 6 as a primary antibody and the ABC-technique. Comparisons were made with tissue samples from the spleen, intestine, skin and oral mucosa. At birth, all tissues, except for the pulp, presented cells expressing class II antigen with a dendritic appearance in a number and orientation resembling the mature tissue. A complete distribution of these cells was not seen in the dental pulp until 7 weeks following birth. Data show that the dental pulp acquires its ultimate structural arrangement of immune cells later than other tissues.

The molecular weight of highly phosphorylated phosphoprotein from rat incisor dentin was estimated by three different methods: sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis, gel chromatography in 6 M guanidinium chloride (GdnHCl) and analytical ultracentrifugation at high salt concentration. SDS-polyacrylamide gel electrophoresis revealed an abnormal migration of the phosphoprotein and its enzymatically dephosphorylated derivative in comparison to standard proteins. Depending on the acrylamide concentration in the gel (7.5-20%), the apparent molecular weight of the phosphoprotein varied from 90,000 to 27,000. Similar results were obtained for the dephosphorylated protein. In gel chromatography using 6 M GdnHCl as eluent the phosphoprotein had an elution volume corresponding to that of a standard protein with a molecular weight of 67,000, while the enzymatically dephosphorylated phosphoprotein showed an apparent molecular weight of 30,000. The phosphoprotein behaved non-ideally in equilibrium sedimentation runs. The apparent molecular weight was strongly concentration-dependent and the extrapolation to zero concentration was uncertain. However, after enzymatic dephosphorylation the concentration dependence disappeared and a molecular weight of 28,000 could be calculated. Since the phosphate groups represent 26% of the phosphoprotein by weight, the true molecular weight of the highly phosphorylated phosphoprotein components from rat incisor dentin should be 38,000. The study shows that it is not possible directly to estimate the molecular weight of this type of protein by standard methods elaborated for normal globular proteins.

Normal human peritoneal macrophages show a restricted capacity to differentiate into inflammatory macrophages in vivo. We now report that these cells are unable to cap and internalize HLA-DR, as compared to endometriosis, and other macrophages. Immunoelectron microscopy indicated that lack of modulation was not due to the presence of preclustered antigenic sites. Northern blot analysis demonstrated transcripts for HLA.DR, c-fms, and c-fos, indicating that the surface defects were not likely to be associated with a general depression of transcriptional activity. There was no correlation between the mobility of class II molecules and the ability to present antigen as determined by autologous lymphocyte responses to tetanus toxoid. The inability of normal peritoneal macrophages to modulate class II antigens may represent a normal and more general environmental alteration required to permit peritoneal cells a scavenging function without developing the deleterious effects leading to a peritoneal inflammatory response.

Nuclear magnetic resonance and electron paramagnetic resonance spectroscopy have been used to quantify metal binding to the phosphoprotein extractable from demineralized rat incisor dentine. Paramagnetic cation probes enable identification of the metal binding sites. Cations are able to diffuse across the protein surface while forming a relatively long-lived metal-phosphoprotein complex. The ability of the protein to sequester surface-mobile Ca(II) is discussed in terms of its ability to act as a possible nucleation site for the initial localization of Ca(II) within the dentine matrix.

The influence of macromolecules on the adherence of S. mutans was studied in an in vitro incubation system using 3H-labeled bacteria and hydroxyapatite beads. The bacterial adherence was strongly inhibited by treating the beads with an extremely acidic macromolecule. An even more pronounced effect was found when this substance was present during the incubation. To the contrary no effect was discernible when the bacteria only were pretreated with the acidic macromolecule. Even the basic substance decreased the adherence of the bacteria but to a less extent. The bacterial surface has a net negative charge and attracts basic molecules while hydroxyapatite beads analogously appear to have a net positive charge and attract acidic macromolecules. This adsorption of macromolecules might be a phenomenon of importance for the microbial colonization of teeth.

Rat incisor dentine was demineralized and extracted with 0.25 M EDTA containing protease inhibitors. The extract was purified by chromatography on DEAE-cellulose and sulfonated polystyrene. The Ca2+-finding properties of the phosphoprotein were studied by dynamic dialysis and by using a Ca2+-selective electrode. Two different binding sites were detected with Kd = 0.9 X 10(-7) M and 1.1 X 10(-5) M and displaying a Ca2+-binding capacity of 127 and 176 mol bound Ca2+/mol protein, respectively, assuming a molecular weight of 30 000. Upon enzymatic dephosphorylation of the phosphoprotein, the highest affinity sites disappeared and those with the lowest affinity were reduced. The optimum for Ca2+ binding by the phosphoprotein occurred at pH 8.2. The specificity of the Ca2+ ion interaction with the phosphoprotein was investigated by studying the competitive nature of other divalent and monovalent cations. It was found that Ca2+ ions were to a large extent displaced from the phosphoprotein by other cations in physiological concentrations.

A group of 16 patients received Class II restorations at two different sessions. During one session a dentist interacted positively with the patient. During another session, the dentist had little interaction with the patients. Patients' ratings indicated that both dentists were perceived as equally competent but that the dentist who interacted with the patients was rated significantly better. It is possible that dentists will gain more satisfaction from their patients as they increase their interaction.

In the present study we characterized the phenotypes of infiltrating mononuclear cells in angular cheilitis lesions to further explore the pathogenesis of this disorder. Frozen sections from lesions infected by Candida albicans and/or Staphylococcus aureus were subjected to immunohistochemical analysis utilizing monoclonal antibodies directed to subsets of T-lymphocytes, B-lymphocytes, and macrophages. In addition, the expression of Class II antigens (HLA-DP, -DQ, -DR), the interleukin 2- and transferrin-receptors was studied on resident and infiltrating cells. An intense infiltration of T-lymphocytes was accompanied by expression of Class II antigens on the epidermal keratinocytes in lesion infected by Candida albicans. The Staphylococcus aureus infected lesions displayed a diffuse infiltration of T-lymphocytes but virtually no expression of Class II antigen by epidermal keratinocytes. These observations suggest that the cell-mediated arm of the immune system is involved in the inflammatory reaction of lesions infected by Candida albicans. In addition, the present study confirms that epidermal expression of Class II antigens is closely related to the type and magnitude of the infiltrating T-lymphocyte. Finally, these findings indicate that the type of inflammatory reaction in angular cheilitis is primarily dependent on the isolated microorganism, although the clinical pictures of the disorder are virtually identical.

The incidence of recurrence of angular cheilitis following a successful antimicrobial treatment was studied in 48 patients. Clinical assessments including a microbial examination were carried out 8 months and 5 yr after termination of treatment. Eighty percent of the patients reported recurrence of their angular cheilitis on one or more occasions during the observation period. Patients with cutaneous disorders associated with dry skin or intraoral leukoplakia had an increased incidence of recrudescence. Neither the presence of denture stomatitis nor the type of microorganisms isolated from the original lesions of angular cheilitis, i.e. Candida albicans and/or Staphylococcus aureus, were associated with the number of recurrences. The present observations indicate that treatment of the majority of patients with angular cheilitis should be considered in a longer perspective than previously supposed, due to the short lasting therapeutic effects of the antimicrobial therapy.

This prospective study evaluated the significance of microbial analysis and antimicrobial treatment for the cure of angular cheilitis. Furthermore, various etiologic factors were investigated for their relative effect on the healing process. The study included 1) an open trial with 50 patients infected by Candida albicans and/or Staphylococcus aureus, and 2) an intraindividual comparison of eight patients with bilateral lesions infected by Candida albicans as the only detected pathogen. After a base-line examination the patients received ointments containing nystatin and/or fusidic acid, on the basis of the outcome of an initial microbial analysis. The patients were evaluated clinically, photographed, and examined for microorganisms at different time intervals. Ninety-six per cent of the patients who participated in the open trial had no sign of infection after 42 days of treatment. Lesions in the double-blind study, treated with nystatin, were healed after 28 days, whereas lesions that received placebo persisted throughout the treatment period. Increasing age, dry skin, and extended skinfolds at the corner of the mouth were factors closely related to the length of the healing process.

Ca2+-ATPase activity was solubilized, partly purified, and separated from nonspecific alkaline phosphatase activity (APase1) of dentinogenically active rat incisor odontoblasts. Attempts were made to extract the enzymes by various agents, such as Triton X-100, deoxycholate, butanol, EDTA, and buffers of decreasing ionic strength. Solubilization by butanol followed by extraction with low concentrations of EDTA proved to be most effective. Purification and separation were done by molecular sieve chromatography. Ca2+-ATPase showed no activity against p-nitrophenyl phosphate (p-NPP) or inorganic pyrophosphate (PPi) and was unaffected by R 8231 [+/-)-6(m-bromophenyl)-5,6-dihydroimidazo(2,1-b)thiazole oxalate]. It was activated by Ca2+ and Mg2+ ions in equimolar concentrations with the substrate. The enzyme was rapidly inactivated in the solubilized state. An apparent molecular weight of about 18,000 was obtained from molecular sieve data. APase, showing activity against ATP, PPi, and p-NPP, was virtually totally inhibited by R 8231. It was activated by Mg2+ ions but slightly reduced in activity by Ca2+ ions. It had an apparent mol. wt. of 79,000. The results provide direct evidence for earlier suggestions of the existence in hard tissue forming cells of two phosphatases active at alkaline pH.

Epidermal Langerhans' cells (LC) were studied in patients with pustulosis palmoplantaris (PPP) by utilizing the monoclonal antibodies anti-Leu6 and anti-HLA-DR in combination with an immunoperoxidase technique. In non-pustular areas of the skin lesions in PPP, an increased number of epidermal LC was found compared with control subjects. No change in LC counts was observed following etretinate monotherapy for 2 weeks. Etretinate was then combined with PUVA treatment of one palm/sole with the contralateral side as a non-UVA exposed control. After 6-12 weeks of etretinate + PUVA treatment the PPP had resolved and the number of epidermal dendritic HLA-DR+ and Leu6+ cells had normalized. On the contralateral side, etretinate treatment induced a marked clinical improvement and a reduction of HLA-DR+ cells. The observation of an increased LC population in active PPP and a reduction during clinical improvement indicates a close relationship between LC and the activity of PPP.

Rat-incisor phosphoprotein (RIP) has been subjected to isoelectric focusing at 4 degrees in (a) an Ampholine pH gradient of 2.5-4 and (b) an acid pH gradient created by electrolysis of a system of acids and acidic ampholytes and covering the pH range 0.5-3.5. In the Ampholine gradient, the RIP unexpectedly formed several adjacent and strongly opalescent bands in the pH range 2.5-3.1. These bands, which migrated slowly toward the anode on prolonged focusing, are interpreted as being the result of an interaction between the amino groups of the Ampholine and the numerous phosphate groups of the protein. In the acid pH gradient, the RIP focused into one narrow zone corresponding to an isoelectric pH of 1.1 at 4 degrees. This value is consistent with the amino-acid composition and the phosphate content of the protein,

Epidermal Langerhans' cells (LC) were studied in patients with chronic eczematous dermatitis of the palms. The monoclonal antibodies anti-Leu 6 and anti-HLA-DR were used, and the cells visualized with an immunoperoxidase technique. Increased numbers of LC were found in allergic contact dermatitis as well as in irritant contact dermatitis and hyperkeratotic dermatitis of the palms. The increased number of epidermal LC in lesional skin may facilitate presentation of exogenous or endogenous antigens to activated T-cells. One hand was treated with PUVA or UVB and the other hand served as a non-exposed control. PUVA treatment cleared the dermatitis and the LC number decreased markedly. With UVB treatment clinical improvement was achieved, and a less pronounced decrease in epidermal LC was noticed. There seems to be a crude relationship between the extent of clinical improvement and the reduction in epidermal LC numbers. The change in LC might be a primary event or secondary to a reduction of the inflammatory process.

HLA antigens were examined in patients with erosive oral lichen planus (OLPe), cutaneous lichen planus (CLP), or lichenoid reactions (LR) adjacent to amalgam fillings. The control group had amalgam restorations in contact with the oral mucosa but without any reactions. A strong association was found between HLA-DR3 and OLPe, with an RR value of 21.0 (p less than 0.05). The corresponding values for CLP and LR were 2.3 and 1.5, respectively (NS). The haplotype A1-B8-DR3 was more frequently found in OLPe (p less than 0.05) and CLP (p less than 0.05) than in LR and controls (NS). The data indicate that OLPe, CLP, and LR, which present with virtually the same histopathologic features, are different in their association with HLA-DR3. Moreover, the increased frequency of HLA-DR3 in OLPe suggests an autoimmune component in the pathogenesis of this disorder.

Fibronectin (FN) was localized in the dental pulp and predentine at different stages of dentinogenesis by indirect immunofluorescence. Fibronectin was present in the basement membrane between the inner enamel epithelium and the underlying dental mesenchyme and also in mantle predentine. Fibronectin was absent from predentine during further (circumpulpal) dentine formation, indicating that the FN molecule is not directly involved in mineralization. The findings emphasize the difference between the mantle and circumpulpal dentine formation. Fibronectin was localized in the odontoblast layer at the level where the cell processes leave the cell bodies and where the odontoblasts adhere to each other by junctional complexes.

This study was designed to investigate the influence of systemic immunosuppressive therapy on the HLA-DR expression of epidermal Langerhans cells. Fifteen renal allograft recipients immunosuppressed with cyclosporin A and steroids were studied. Skin biopsies were taken from the upper arm prior to transplantation and at different intervals during the post-transplantation period. The epidermis was separated from the dermis, and the epidermal sheet was subjected to immunohistochemistry in order to make the HLA-DR antigens on the Langerhans cells visible. Following 2 days of immunosuppression, the number of Langerhans cells expressing HLA-DR antigens started to decrease and after 1 week, only 60% of the initial number of positive cells were detected. The number of positive cells remained low throughout the experimental period. It is suggested that systemic immunosuppressive therapy will suppress the expression of HLA-DR antigens on epidermal Langerhans cells, something which may mirror a systemic effect on other antigen-presenting cells.

Odontoblasts isolated from rat incisors were incubated in vitro in the presence of tritiated leucine or fucose, and the amount of precursor incorporated into TCA-recipitated proteins was determined. The effect on precursor incorporation of varying the total precursor concentration was examined. The incorporation of leucine and fucose into TCA-precipitated proteins was found to be linear with time for at least 90 min. Inhibition studies with puromycin, cycloheximide and chloramphenicol demonstrated the presence of odontoblastic protein synthesis. One hour after in vivo administration of triated leucine the highest specific activity of odontoblast-predentin protein material was noted the corresponding maximum for pulp proteins was found to occur after 30 min. The in vivo incorporation of triated fucose was maximal after 4 h in both odontoblasts and pulp tissue.

The present morphological study was designed to evaluate the significance of Langerhans cells in the pathogenesis of cholesteatoma. Biopsies of middle ear cholesteatomas were examined for Langerhans' cells expressing HLA-DR and anti-Leu 6 antigens by immunohistochemistry using monoclonal antibodies. No apparent difference in number of cells was observed when epithelium of cholesteatoma was compared with epithelium of healthy ear canals. Expression of HLA-DR antigens was detected on keratinocytes in Aspergillus flavus infected epidermis, used as a control tissue. This finding indicated an increased immunosurveillance of this tissue. However, no such expression of HLA-DR antigens was detected on epidermal cells of cholesteatomas. The results of the present study did not support the hypothesis of Langerhans' cells as having a primary role in the development of cholesteatoma.

The present investigation was performed to elucidate possible etiological factors behind the complaints reported by 62 patients referred because of presumed oral galvanism. Twenty-nine patients, matched with a subsample of the test group regarding age and sex, comprised a control group. The patients were examined regarding oral medical and stomatognathic health. Their psychological and social health and symptoms were evaluated by means of a standardised interview and 5 self-rating questionnaires. A complex symptomatology including symptoms from both the oral regions and other parts of the body constituated the most distinctive feature of the patients in the test group. The clinical examination as well as patient-perceived symptoms revealed high prevalences of parafunction and dysfunction in the muscles of the stomatognathic system. Furthermore, general complaints were mainly related to muscles of the extremities, and diseases of the joints and muscles were the most commonly reported disorder. The findings at the oral medical examination revealed no differences between the groups, except for signs of parafunction. Patients in the test group gave evidence of being more exposed to negative social events and the results clearly indicate a psychogenic component behind the reported complaints.