Aparna Naidu

The effects of bisphosphonates on osteoblasts in vitro

OBJECTIVE The purpose of this study was to test the effects of bisphosphonates on osteoblast viability and function. STUDY DESIGN Primary rat osteoblasts were cultured in normal media or media containing increasing concentrations of 2 bisphosphonates, alendronate and zoledronate. Enzyme-linked immunoabsorbent assays (ELISAs) were used to measure interleukin (IL)-6, transforming growth factor (TGF) beta1, and receptor activator of nuclear factor kappaB ligand (RANKL) expression in supernatants after 24, 48, and 72 h. Live and necrotic cell numbers were assessed with trypan blue assays. RESULTS As drug concentrations increased, cell viability decreased significantly. The ELISAs revealed significant increases in TGF-beta1 in treatment groups, but no significant change in RANKL or IL-6. CONCLUSIONS High concentrations of alendronate and zoledronate were cytotoxic, decreasing cell viability at 72 h. Transforming growth factor beta1 increased even as viability decreased, suggesting a mechanism for bisphosphonate action. These data suggest that lower concentrations of bisphosphonates may have therapeutic benefits without the cytotoxic effects which may result in osteonecrosis.

CD56 (NCAM) expression in ameloblastomas and other odontogenic lesions.

Cairns L, Naidu A, Robinson C M, Sloan P, Wright J M & Hunter K D
(2010) Histopathology 57, 544–548
CD56 (NCAM) expression in ameloblastomas and other odontogenic lesions

Local application of zoledronate for maximum anchorage during space closure

INTRODUCTION Orthodontists have used various compliance-dependent physical means such as headgears and intraoral appliances to prevent anchorage loss. The aim of this study was to determine whether 1 local application of the bisphosphonate zoledronate could be used to prevent anchorage loss during extraction space closure in rats. METHODS Thirty rats had their maxillary left first molars extracted and their maxillary left second molars protracted into the extraction space with a 10-g nickel-titanium closing coil for 21 days. Fifteen control rats received a local injection of phosphate-buffered saline solution, and 15 experimental rats received 16 μg of the bisphosphonate zoledronate. Bisphosphonate was also delivered directly into the extraction site and left undisturbed for 5 minutes. Cephalograms and incremental thickness gauges were used to measure tooth movements. Tissues were analyzed by microcomputed tomography and histology. RESULTS The control group demonstrated significant (P <0.05) tooth movements throughout the 21-day period. They showed significantly greater tooth movements than the experimental group beginning in the second week. The experimental group showed no significant tooth movement after the first week. The microcomputed tomography and histologic observations showed significant bone loss in the extraction sites and around the second molars of the controls. In contrast, the experimental group had bone preservation and bone fill. There was no evidence of bisphosphonate-associated osteonecrosis in any sample. CONCLUSIONS A single small, locally applied dose of zoledronate provided maximum anchorage and prevented significant bone loss.

Epstein-Barr virus-positive oral ulceration simulating Hodgkin lymphoma in a patient treated with methotrexate: case report and review of the literature.

Immunosuppressive therapy for patients diagnosed with rheumatoid arthritis has long been implicated in the development of various neoplastic processes, including leukemia and lymphoma. Methotrexate is a commonly administered antimetabolic medication thought to improve the symptoms of rheumatoid arthritis through its anti-inflammatory effects. Longterm methotrexate therapy and concurrent rheumatoid arthritis have both been independently suggested as risk factors for developing lymphoma. The mechanism has been theorized to be severe immunosuppression and an increased frequency of latent infection with pro-oncogenic viruses, such as the Epstein-Barr virus (EBV). Spontaneous remission of these malignancies has been seen after discontinuation of the methotrexate therapy. In the present study, we report the case of a patient diagnosed with rheumatoid arthritis and treated with methotrexate and prednisone. She developed intraoral ulcerations that histopathologically resembled Hodgkins lymphoma.

Clinical Pathologic Conference Case 3: Nodular Fasciitis

Intraoral nodular nodular fasciitis is a rare entity that is important to recognize because it may simulate a malignancy clinically and histologically. The rapid growth and high mitotic index seen in nodular fasciitis may suggest a malignant neoplastic process, but it is generally considered to be a benign reactive proliferation. Recognizing the unique histologic features of nodular fasciitis is important to avoid a possible misdiagnosis as a malignancy, leading to unnecessary further treatment.

Localized juvenile spongiotic gingival hyperplasia possibly originates from the junctional gingival epithelium-an immunohistochemical study.

To immunohistochemically evaluate the cytokeratin (CK) pattern of expression in localized juvenile spongiotic gingival hyperplasia (LJSGH) as compared with the gingival epithelium (GE).

Effectiveness of a novel topical powder on the treatment of traumatic oral ulcers in orthodontic patients: A randomized controlled trial

OBJECTIVE To determine if 2-DeNT Oral Topical Powder is an effective treatment for traumatic oral ulcers. MATERIALS AND METHODS Of the 46 patients who were randomly allocated, 20 patients from the experimental group and 17 from the placebo control group completed the study. The patients, operators, and evaluators were all blinded. Patients applied the powder twice a day and completed a diary twice a day for 10 days. The diary was used to monitor the size of the lesions and pain levels (using a 10-cm visual analog scale). RESULTS By day 5, the ulcers in the experimental group had reduced in size by approximately 70%; and ulcers in the control group had reduced in size by 56%. The experimental-group ulcers were significantly (P < .05) smaller than the control-group ulcers from day 5 through day 9. Ulcers in the experimental group were completely resolved by day 8, whereas control-group ulcers were still present on day 10. Patients experienced a significant amount of stimulated pain until the night of day 2 in the experimental group and until the night of day 5 in the control group, but group differences in pain were not statistically significant. CONCLUSIONS The 2DeNT Oral Topical powder was more effective than the placebo powder at accelerating the healing of oral traumatic ulcers.

Scalp mass in a 66-year-old female.

CLINICAL PRESENTATION A 66-year old female presented to the Oral & Maxillofacial Surgery clinic at Parkland Memorial Hospital with a scalp mass that had been present for approximately 28 years. She described the mass as increasingly painful and easily traumatized during routine activities, such as washing and brushing her hair (Figure 1). The lesion had been very slowly increasing in size and appeared to be changing in surface topography. She requested surgical removal of the lesion and a histopathologic analysis. Her medical history was significant for hypertension and depression. Additionally, she reported a history of breast cancer that had been identified as ductal carcinoma in situ and had been surgically resected 2 years before her presentation for evaluation of the scalp mass. A sentinel lymph node biopsy was completed at the time of treatment of her breast cancer, and this biopsy was negative. She reported that she had been monitoring her breast disease with yearly mammograms, all of which had been negative to date for adverse findings. The patient’s surgical history included remote cesarean section five times, exploratory laparotomy secondary to a shotgun injury, and left partial mastectomy for the breast cancer. Her current medications included tamoxifen, citalopram, lisinopril, hydrochlorothiazide, and potassium chloride. She denied allergies to medications and reported non-use of tobacco, alcohol, or illicit drugs. Finally, she reported no significant family history. On physical examination, she was found to be afebrile and normotensive and had a normal heart rate. Her body mass index was calculated at 28.6. A solitary 2 2 1 cm soft tissue mass was observed on the right scalp, approximately 4 cm superior to the right auricle (Figure 1). The lesion exhibited a pink-to-purple hue and was firm, mobile, slightly tender, and granular both in appearance and to palpation. Several small, fine