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Gingival fibromas (GFs) are fibrous lesions of the gingiva that are not well defined in the literature. They are histologically similar to peripheral ossifying fibromas (POFs), both being characterized as cellular proliferations of dense fibrous tissue, with POFs differing in that they demonstrate foci of calcification. This study aims to expand upon the immunohistochemical characterization of GFs, and to confirm their osteoblastic phenotype.Formalin fixed, paraffin embedded GFs, POFs and fibroepithelial polyps (FEPs) of the gingiva were examined. Immunohistochemical staining was performed for special AT-rich sequence binding protein 2 (SATB2), runt-related transcription factor 2 (RUNX2), osteocalcin and alpha-smooth muscle actin (αSMA). Sections were evaluated by light microscopy and the immunohistochemical staining patterns were assigned immunoreactive scores (IRS) based on percentage of stained cells and intensity of staining.GFs, POFs, and FEPs of the gingiva expressed osteoblastic markers SATB2, RUNX2 and osteocalcin. GFs and POFs expressed αSMA while FEPs of the gingiva did not. GFs and POFs had similar staining patterns of SATB2, RUNX2 and αSMA.These findings demonstrate that GFs and POFs exhibit a similar immunohistochemical profile, and supports a theory that GFs are osteoblastic lesions possibly related to POFs.

Acquired Hypertrichosis Lanuginosa A 51-year-old woman presented with rapidly progressing hair growth on her face, neck, and upper body, findings consistent with acquired hypertrichosis lanuginosa....

Drug-induced gingival enlargement (DIGE) is a fibrotic condition associated with systemic administration of the anti-epileptic drug, phenytoin. We have previously demonstrated that periostin, which is transforming growth factor-beta (TGF-β) inducible gene, is upregulated in various fibrotic conditions including gingival enlargement associated with nifedipine. The objective of this study was to assess periostin expression in phenytoin-induced gingival enlargement (PIGE) tissues and to investigate the mechanisms underlying periostin expression. Human PIGE tissues were assessed using Masson's trichrome, with cell infiltration and changes in extracellular matrix composition characterized through labeling with antibodies to periostin, phospho-SMAD 3, TGF-β, as well as the macrophage markers CD68 and RM3/1. Using human gingival fibroblasts (HGFs) in vitro we examined the pathways through which phenytoin acts on fibroblasts. In PIGE tissues, which demonstrate altered collagen organization and increased inflammatory cell infiltration, periostin protein was increased compared with healthy tissues. p-SMAD2/3, the transcription factor associated with canonical TGF-β signaling, is localized to the nuclei in both gingival fibroblasts and oral epithelial cells in PIGE tissues, but not in healthy tissue. In vitro culture of HGFs with 15 and 30 μg/ml of phenytoin increased periostin protein levels, which correlated with p-SMAD3 phosphorylation. Inhibition of canonical TGF-β signaling with SB431542 significantly reduced phenytoin induction of SMAD3 phosphorylation and periostin expression in HGFs. Analysis of PIGE tissues showed a subset of CD68 stained macrophages were TGF-β positive and that RM1/3 regenerative macrophages were present in the tissues. Our results demonstrate that phenytoin up-regulates periostin in HGFs in a TGF-β-dependent manner.

To determine whether temporomandibular joint (TMJ) changes are similar between adolescent and older TMJ disorder (TMD) patients, a retrospective chart review for TMJ MRIs was done for disc and bone changes. Patients were divided into adolescent, adult and elderly groups.The groups had similar prevalence of joint changes and number of joints involved. Disc changes were more prevalent in adolescents (p = 0.008), while bone changes were more prevalent in the elderly group (p = 0.10). Anterior disc displacement was the most common finding and was most prevalent in adolescents (p0.001).Adolescents display similar disc/bone changes in their TMJ as older TMD patients.

To carry out an oral biopsy survey in geriatric patients from the participating institutions.The biopsy records of the participating institutions were reviewed for oral lesions from patients aged 65 years and older diagnosed from 2003 to 2012. Demographic data and the site of the lesions were collected. Histopathological diagnoses were categorized into two categories: non-neoplastic lesions (reactive/inflammatory lesion, cyst, allergic/immunologic disorders, potentially malignant disorders, infection and others) and neoplastic lesions (benign and malignant tumors). Data were analyzed by appropriate statistics using stata11.Of the 76,045 accessioned cases, 11,346 cases (14.92%) were in geriatric patients. The mean age of the patients was 72.98 ± 6.25 years. A total of 5010 cases (44.16%) were diagnosed in males, whereas 6336 cases (55.84%) were diagnosed in females. The male-to-female ratio was 0.79:1. Non-neoplastic lesions outnumbered the neoplastic counterpart. The five most prevalent oral lesions in the geriatric population in the present study in descending order of frequency were squamous cell carcinoma, focal fibrous hyperplasia (irritation fibroma), radicular cyst, osteomyelitis and epithelial dysplasia, respectively. The site of predilection was labial/buccal mucosa, followed by gingiva, mandibular bone, tongue and maxillary bone, respectively.The geriatric oral lesions from the present study showed a similar trend with studies based on histopathological data, but different from the studies based on clinical data. This study also shed more light on potentially malignant disorders, as well as benign and malignant tumors.

A 27 year old woman presented with urticated papules in a linear distribution on her limbs⇑. When staying in a hotel …

Malignancies, including oral Kaposi's sarcoma, may develop in transplant patients as a result of immunosuppressive therapy. Both the prevalence and the incidence of these malignancies vary. This article describes a renal transplant patient who was receiving immunosuppressive therapy and presented with oral Kaposi's sarcoma. The lesion was excised and did not recur. However, the patient died as a result of viral pneumonitis, secondary to her renal problems. The article also includes a review of the literature, with particular emphasis on oral presentation of immunosuppression-related malignancies.

Many malignant tumours other than squamous cell carcinoma may present in the oral cavity. Melanomas of the oral cavity are usually pigmented, aggressive tumours associated with a poor prognosis. Neoplasms of the minor salivary glands have a greater tendency to be malignant than those of the major glands, and some exhibit a predilection for occurring in the mouth. Many types of connective tissue malignant tumours (sarcomas) may arise in the mouth, including soft-tissue cancers and lesions of hematologic cells such as lymphoma, whereas osteosarcoma is the most common malignancy of the hard tissues found in the mouth. Cancers from distant organs such as breast, lung and prostate may metastasize to the oral cavity. This paper presents a brief overview of nonsquamous cell oral cancers, with emphasis on those most likely to be encountered by the practising dentist.

This case outlines the potential complexity of autosomal recessive polycystic kidney disease (ARPKD). It highlights the challenges involved in managing this condition, some of the complications faced and areas of uncertainty in the decision making process. With a paucity of published paediatric cases on this subject, this should add to the pool of information currently available.