John A. Svirsky

Actinic cheilitis: A review of 152 cases ☆ ☆☆

OBJECTIVE The purpose of this study was to determine whether any clinical or histopathologic variables are associated with the severity of epithelial change in lesions of actinic cheilitis. STUDY DESIGN A total of 152 acceptable cases of actinic cheilitis were identified from 66,067 cases accessioned from February 1989 to June 1998. For each case, the clinical information supplied by the submitting practitioner at the time of the biopsy and 8 histopathologic variables were evaluated. RESULTS The following 5 histopathologic variables were positively correlated with an increased degree of epithelial change: acanthosis, basophilic change within the connective tissue, the presence of inflammation within the connective tissue, perivascular inflammation, and thickness of the keratin layer. None of the clinical variables was associated with an increased degree of epithelial change. CONCLUSIONS The presence of any of the aforementioned histopathologic changes should prompt a close evaluation of the lesion for the presence of either epithelial dysplasia or carcinoma.

Cherubism: Diagnosis, treatment, and comparison with central giant cell granulomas and giant cell tumors

An extensive case of cherubism in a 17-year-old girl with no apparent familial history is presented. The rationale for treatment is presented and is compared with previous reports that have advocated nontreatment. The clinical and histologic similarities of cherubism to central giant cell granuloma and the giant cell tumor of bone are also discussed.

Dental management of patients after liver transplantation

Liver transplantation over the past 10 years has become a nonexperimental therapy for patients with end-stage liver disease and offers hope to many for whom no treatment was previously available. As more patients undergo liver transplantation and survival rates continue to improve, the dental profession must adopt a protocol for dealing with these patients. With this in mind, a protocol for dental management of the patient who has had a liver transplant is presented. Two cases are presented to illustrate the importance of dental intervention.

The prevalence of oral lesions in smokeless tobacco users and an evaluation of risk factors

Background. The widespread use of smokeless tobacco (ST) has prompted concern in regard to the development of oral lesions in long‐term users.

Intraosseous and extraosseous calcifying odontogenic cyst (Gorlin cyst).

This retrospective study of 15 central and five peripheral calcifying odontogenic cysts (COCs) was undertaken to compare the characteristics of these two lesions. The data reveal that the central COCs were more common than peripheral lesions by a 3:1 ratio and that they were usually diagnosed in the second decade of life, whereas the peripheral ones were usually noted after the age of 50. Seven of the 15 central COCs (47%) were associated with odontomas, and three (20%) with dentigerous cysts. Conservative enucleation or excision was the treatment of choice.

Oral melanotic macules. A review of 353 cases.

Clinical and histopathologic data were obtained on 353 cases of oral melanotic macules. The mean age at the time of diagnosis for all sites was 43.1 years. A significant predilection for females (p < 0.001) was noted and the most common location was the lower lip (33.0%). The mean size of the lesions was 6.8 mm. Brown was the most common color (64.9%), and most (66.0%) of the lesions were described as flat. Melanin was evident in both the basal cell layer and lamina propria in 93.5% of the cases.

Nevus of Ota with associated palatal involvement

The nevus of Ota is a macular discoloration of the face which is most commonly found in the Japanese. The sclera is also often affected. The oral cavity is less commonly involved in the Japanese and is rarely affected in non-Orientals. The present case is only the seventh reported in a non-Oriental patient with clinical oral involvement and the first to illustrate the histopathologic features of an oral-lesion.

Adult smokeless tobacco use and age of onset.

To determine if an earlier age of onset is associated with greater levels of adult smokeless tobacco (SLT) use and to evaluate if this relationship differs by SLT type, 345 current adult SLT users were interviewed to obtain the age at first onset and current frequency of SLT use. The results indicated that more than twice as many SLT users began during adulthood than during preadolescence. Although preadolescent onset was associated with greater chewing tobacco use than adolescent onset, the greatest levels of both chewing tobacco and snuff use were associated with adult onset, suggesting an increased need for SLT prevention programs for young adults.

Comparison of articles published in Oral Surgery Oral Medicine Oral Pathology in 1972 and 1992.

The articles published in the Oral Pathology section of Oral Surgery Oral Medicine Oral Pathology in 1972 and 1992 were analyzed and compared. A significant increase in the number of authors and the number of references per article was noted. There was also a significant increase in the number of articles that dealt with bacterial/viral/fungal diseases. A trend toward the origination of more articles from outside the United States was noted.