Henry M. Goldman

SOME ASPECTS OF COLLAGEN FORMATION

Despite the fact that the deficiency state known as scurvy had been recognized since antiquity, and had been classically described by Walter (1746) as involving the healing of wounds as well as the maintenance of wounds that have already healed, it was not until 1919 that Aschoff and Koch and then Hojer in 1924 carried out detailed histological studies. These were soon followed by those of Wolbach and Howe (1926), which related the action of the accessory factor vitamin C to the formation of proper connective tissue, particularly of collagen. A number of investigations based on histological examination or tensile strength studies have established beyond question the relationship between ascorbic acid and collagen formation. Nevertheless, little is known concerning the exact mechanism by which ascorbic acid acts; both the celluhr physiology and the biosynthetic mechanisms await clarification. Two early theories have been the basis of much of the work attempting to elucidate the mechanism of the interaction between ascorbic acid and collagen fiber formation. Aschoff and Koch (1919) suggested that the defect in scurvy involves an inability to produce extracellular substance. Wolbach and Howe (1926) suggested that the secretion of intercellular ground substance and of collagenous precursor materials proceeds quite normally, but that some factor is lacking that normally causes gelling and fibrillation of a precursor in the extracellular material, and that this factor is not involved in the formation of fibroblasts. They found, from histological examination of scorbutic teeth and bones, an apparent accumulation of a fluid substance presumably secreted by the odontoblasts and osteoblasts that remained fluid due to the absence of a gelling factor. When vitamin C was administered, gelation occurred with such rapidity that they believed there had not been sufficient time for a new formation of collagen and suggested that “the failure of cells to produce intercellular substances in scorbutus is due to the absence of an agent common to all supporting tissues which is responsible for setting or gelling of a liquid product.” Soon after the administration of vitamin C to depleted animals, an apparently homogeneous, amorphous substance that stained blue with Mallory’s connective tissue stain formed around the cells. This was followed rapidly by the formation of reticulin fibers embedded in the amorphous material that Wolbach (1933) believed to be amorphous collagen. Opposed to this concept of normal precursor formation in the absence of some * This investigation was supported in part by Grants A-1270 and D-320 from the National Institute of Arthritis and Metabolic Diseases and the National Institute of Dental Research, Public Health Service, Bethesda, Md., and in part by a generous grant from Eli Lilly and Company, Indianapolis, Ind. to whom we express our thanks.

Oral papillomas: Clinicopathologic evaluation and retrospective examination for dyskeratosis in 110 lesions☆

Abstract A series of 110 oral papillomas is reviewed in order to ascertain incidence pertinent to age, sex, site, and recurrence. The tumors are found to occur most often in adults with an average age of 38 years. The tongue is the most frequent location, and females are affected slightly more often than males. Dyskeratosis is used as a barometer of premalignant change in the histologic evaluation of the lesions and is found to be conspicuously absent in all cases. These lesions seldom recur if properly excised.

ORAL DISEASE IN PRIMATES

The increasing use of primates for investigations of oral tissues is evident from a perusal of the literature. This is to be expected when one examines the many anatomic and physiological similarities found among the dentitions, supporting structures, and other oral tissues in nonhuman primates and humans. That many of these species are susceptible to the same oral diseases as is man enhances their value in the laboratory. An effort will be made in this presentation to cite the various pathological conditions that occur in the oral cavities of nonhuman primates.

Clinical observations on the modification of human oral tissue metabolism by local intraoral factors.

The uniqueness of the oral tissues, from the standpoints of anatomic relationships and local environment, has aroused the curiosity of many investigators of organ systems. There exists an overwhelming variety of intraoral influences capable of triggering the complex reactions resulting in changes in oral tissue metabolism, especially for one beginning the study of oral disease. The picture is additionally complicated by systemic factors which are also capable of affecting the metabolism of oral tissues. This discussion will attempt to depict the delicate interplay of local and systemic etiological factors and the resultant clinical manifestations of certain oral diseases.

Desquamative gingivitis and its response to topical triamcinolone therapy.

Abstract A concept of desquamative gingivitis has been expressed. The condition probably is a reflection, clinically, of a variety of etiologic factors—both local and somatic in origin; in the majority of cases these influences cannot be elicited with clarity, and it is necessary to direct therapy to local alleviation of the gingival manifestations. The topical administration of triamcinolone acetate in Orabase constituted an effective form of therapy. The histopathologic characteristics of desquamative gingivitis include the detachment of epithelium, either intra- or subepithelially, with a variably severe connective tissue inflammatory reaction; it is difficult to collate this response to a specific etiologic agent.

Primary osteogenic sarcoma and metastatic renal-cell carcinoma of the mandible: Case reports and necropsy findings

Abstract We have presented two cases of malignant tumors of the mandible with necropsy findings. The dentists opportunity to diagnose primary and metastatic cancer of the jaws has been stressed.