Joshua Lustmann

Salivary and lacrimal gland involvement in a patient who had undergone a thyroidectomy and was treated with radioiodine for thyroid cancer

A patient with bilateral, insidiously developing enlargement of the parotid glands that started 1 year after a total thyroidectomy and ablative radioiodine therapy (200 mCi I131) for papillary carcinoma is presented. The patient displayed prolonged periods of hypothyroidism accompanied by hypercholesterolinemia, notwithstanding hormone replacement therapy. Three years after surgery, parotid and lacrimal gland functions were reduced and fatty degeneration of the parotid parenchyma was demonstrated histologically. The submandibular and sublingual glands were preserved. It is suggested that the hormonal and metabolic derangements are responsible for the glandular dysfunction, rather than a direct effect of iodine on the glands.

Odontodysplasia. Report of two cases and review of the literature.

Odontodysplasia is a rare developmental anomaly affecting the tooth structures in both deciduous and permanent dentitions. The enamel is thin and uneven in thickness, and the detinal tissue surrounds very large pulp chambers. Denticles are present in the pulp organ. The maxilla is involved twice as frequently as the mandible. Most of the affected teeth are in the anterior segments; however, all other teeth can be affected. The cause is unknown. Because of the tendency of the affected teeth to develop abscesses, the most common treatment is extraction. Two additional cases are reported, and the literature is reviewed.

Atraumatic Teeth Extraction in Bisphosphonate-Treated Patients

PURPOSE The purpose of this study was to suggest an alternative technique for atraumatic teeth extraction that would prevent bone exposure and the associated complication of osteonecrosis of the jaws in bisphosphonate (BP)-treated patients, without terminating the treatment. PATIENTS AND METHODS A total of 10 patients treated with BPs for multiple myeloma, metastatic breast cancer, and osteoporosis, requiring dental extractions of nontreatable teeth, were included in this study. The extractions were performed by means of orthodontic elastics placed around the roots, causing slow and gradual exfoliation of the teeth. RESULTS The technique was applied to 21 roots of 15 teeth. A total of 19 roots exfoliated spontaneously. Two roots had to be removed with minimal manipulation by forceps. The mean time required for exfoliation was 5.8 weeks. All sockets showed soft tissue secondary healing and there were no signs of inflammation or exposed bone during the 9-month follow-up. CONCLUSIONS Atraumatic extraction by use of elastics is a safe technique that may be used in BP-treated patients to prevent osteonecrosis of the jaws.

Mandibular fractures in infants: Review of the literature and report of seven cases

Mandibular fractures in infants are rare. During the last 50 years, only 13 cases have been recorded in the literature. In this study seven cases of mandibular fractures in infants treated within a period of 3 years are reported. The male-to-female ratio was 6:1. All fractures were caused by short falls, and in all cases the symphysis region was the injured site. The treatment approach was conservative, without any active intervention. The results were satisfactory; perfect alignment of the fractured bone segments was achieved in all cases.

Lip carcinoma in renal allograft recipient with long-term immunosuppressive therapy

Five years after a kidney transplant and immunosuppressive therapy a 42-year-old woman had squamous cell carcinoma of the lower lip with an innocent appearance. We present this as the first case of lip squamous cell carcinoma in a kidney transplant recipient to be reported in the dental literature. We review the medical literature.

Structural changes in odontodysplasia.

Report is made of a histologic and scanning electron microscopic (SEM) study of teeth affected by odontodysplasia. The enamel was found to be thinner than normal, and the entire surface showed numerous depressions. The prismatic orientation, diameter, and density were found to be normal. Although the mantle dentin remained normal, the rest of this tissue showed a tendency to globular formation. The orientation, density, size, and shape of the dentinal tubules appeared to be normal. The cementum, in general, was normal, but in some instances appeared to be scalloped or globular. The pulp consisted of normal tissue but was found to be larger than normal. The presence of denticles was an outstanding feature.

Salivary gland involvement in Wegener's granulomatosis: A case report and review of the literature

Late involvement of the parotid gland in a patient with a limited form of Wegeners granulomatosis is presented. We report the full course of the disease and the difficulties encountered in determining the nature of the parotid enlargement. We discuss the contribution of computerized tomography and ultrasonography to elucidate parenchymal morphologic findings and radioisotope studies to determine the functional capacity of the gland. In cases of Wegeners granulomatosis with salivary symptoms, measurement of salivary gland functional capacity, in addition to the c-ANCA test, may help to monitor disease activity. Despite the rarity of the disease, in cases when granulomatous diseases are considered, it should be recognized that Wegeners granulomatosis may result in salivary gland involvement.

Keratoacanthoma of the lower lip: Review of the literature and report of a case

Abstract A case of keratoacanthoma of the lip in a woman with xeroderma pigmentosum is presented, together with a review of the literature. Keratoacanthoma was found to occur five times more often in males than in females. The age of the patients at the onset of the lesions on the lip was found to be 12 years less, on the average, than that of patients in whom the lesions occurred elsewhere on the body. Keratoacanthomas were six times more prevalent on the lower lip than on the upper lip. The lesion is usually benign but occasionally may undergo malignant transformation. The recommended treatment for keratoacanthoma of the lip is surgical excision.

Tuftelin mRNA is expressed in a human ameloblastoma tumor.

RT-PCR, Southern blotting and DNA sequencing have established for the first time that tuftelin mRNA is expressed in human ameloblastoma tumor. The expression of amelogenin mRNA in ameloblastoma was also established, confirming earlier reports by Snead et al. These results corroborate, on a molecular level, the enamel organ epithelial origin of ameloblastoma. In view of the present results, it is interesting that previous studies have indicated that although ameloblastoma, a non-mineralized odontogenic tumor, transcribes amelogenin mRNA, amelogenin (and enamelin) proteins are not expressed in this tissue. However, in mineralizing odontogenic tumors, both these classes of proteins are expressed.

Paraganglioma of the tongue

The paraganglia are derived from neural crest cells and arise in association with autonomic ganglia throughout the body. Glenner and Grimley’ divided the extraadrenal paraganglion system on an anatomic and histologic basis into several groups: 1) branchiomeric paraganglia, closely related to arteries and cranial nerves in the head and neck and superior mediastinum; 2) intravagal paraganglia, located within the perineurum of the vagus nerve at the level of the ganglion nodosum; 3) aorticosympathetic paraganglia, in association with the sympathetic nervous system; and 4) viscera1 autonomic paraganglia. Histologically, the first two groups are similar; the cells are arranged in small nests (zellballen) and are generally chromaffln-negative. The tumors arising from these two groups are histologically and cytochemically identical. Tumors arising in the third group vary histologically and in chromoffinicity, some resembling branchiomeric paragangliomas, whereas others may resemble adrenal pheochromocytomas. In most tumors, the histologic pattern is that of epitheloid cells with finely granular eosinophilic cytoplasm and small round to oval nuclei arranged in round or oval distinct clusters (zellballen) or in cell cords, separated by a prominent capillary network. Pleomorphic cells may be present, but they show mitotic figures only rarely. A sarcomatoid pattern characterized by interlacing small spindle cells or an exaggerated vascular pattern resembling a glomangioma may be found occasionally. Malignant transformation occurs in about 6% to 10%; their histologic features are basically similar to those of the benign tumors.‘-5 The paraganglioma is a rare tumor, with the high-