E. Anne Field

P16 Promoter Methylation Is a Potential Predictor of Malignant Transformation in Oral Epithelial Dysplasia

Management of the patient with oral epithelial dysplasia depends on the ability to predict malignant transformation. Histologic grading of this condition fails in this regard and is also subject to interpathologist and intrapathologist variability. This study uses longitudinal clinical samples to explore the prognostic value of a previously validated panel of methylation biomarkers in a cohort of patients with histologically proven oral dysplasia. Methylation enrichment pyrosequencing assays were used to provide the sensitivity of traditional methylation-specific PCR with the additional specificity advantages of a subsequent confirmatory sequencing reaction. In 57% (8 of 14) patients with a lesion that transformed to oral squamous cell carcinoma, 26% (26 of 100) of longitudinal samples collected over ≥3 years showed p16 methylation. Only 1% (2 of 184) of samples from 8% of patients (2 of 24) not undergoing malignant transformation within 3 years had p16 methylation. Both of these samples with p16 promoter methylation were the most recently collected and the patients remain under continuing clinical review. Promoter methylation of MGMT, CYGB, and CCNA1 did not correlate with malignant progression. We thus conclude that methylation of the p16 gene promoter shows promise as a predictor for malignant transformation (Fishers exact, P = 0.002) in a subset of patients. (Cancer Epidemiol Biomarkers Prev 2008;17(8):2174–9)

DRY SOCKET INCIDENCE COMPARED AFTER A 12 YEAR INTERVAL

A survey was conducted over a 3 month period in 1983 to examine the influence of clinical factors on the incidence of dry socket (DS) after extractions of permanent teeth under local analgesia. The findings were compared with those of a similar 3 month survey in the same hospital in 1971. Age, sex and extraction site each significantly influenced the incidence of DS. The major difference from the 1971 survey was an increase in the DS incidence from 3.0% to 4.0% of extractions. This occurred mainly following multiple extractions and may indicate that patients, particularly in this group, are nowadays less tolerant of any post-extraction discomfort and hence more readily return for attention. This is particularly relevant in the present study since the broad definition of DS used in both surveys embraced even the mildest presentations of disturbed socket healing.

Atopy and other risk factors for UK dentists reporting an adverse reaction to latex gloves

A study was conducted to assess the significance of a personal history of atopy and other risk factors for UK dentists reporting an adverse reaction to natural rubber latex (NRL) gloves. 2535 dentists completed a self‐administered questionnaire and, of these, 1034 (group 1) reported an adverse reaction to NRL gloves and 1501 (group 2) did not. Risk factors investigated were: sex, years in clinical practice, exposure to gloves and a history of atopy or food allergy. The signs and symptoms reported by group 1 dentists were recorded. Logistic regression analysis was used to identify a set of risk factors that produced the most discrete model for a dentist reporting an adverse reaction to NRL gloves. A personal history of atopy was a significant risk factor. Dentists with a history of eczema and hand eczema in childhood were most likely to report an adverse reaction to NRL gloves.

Necrotizing sialometaplasia occurring during pregnancy: Report of a case

A case of NSM presenting as bilateral ulceration of the palate developing in the seventh month of pregnancy is reported. The lesions caused initial problems of differential diagnosis because they were more extensive than is often the case in NSM. However, healing followed simple palliative treatment for the ulcers. The etiology of NSM is discussed in relation to the vascular and hormonal changes of pregnancy.

Management of proliferative verrucous leukoplakia: Justification for a conservative approach

Proliferative verrucous leukoplakia (PVL) is a progressive, multifocal, exophytic form of leukoplakia with high rates of malignant transformation. The purpose of this study was to evaluate a cohort of patients with PVL in a single tertiary referral clinic.