Cemento-osseous dysplasia : a diagnostic challenge

Cemento-osseous dysplasia is the most common fibroosseous lesion affecting the jaw bones. Due to the potential risk of introducing an infection, biopsy of an asymptomatic lesion is contra-indicated and it is therefore mandatory to establish an accurate diagnosis only on clinical and radiological information. In order to achieve this, a thorough knowledge of the clinical manifestations of cemento-osseous dysplasia together with the pertinent radiological features is required. This paper is aimed at providing oral health practitioners with the diagnostic features and clinical differential diagnosis of the spectrum of lesions categorised as cemento-osseous dysplasia.http://www.sada.co.zaam2019Oral Pathology and Oral Biolog

Clinical and pathological differences between the pyogenic granuloma and lobular capillary hemangioma in the oral cavity : a scoping review

Since initially described, the terms “pyogenic granuloma” (PG) and “lobular capillary hemangioma” (LCH) have undergone a significant change in meaning, which leads to a confusion in the literature. In this study, we attempted to investigate if there are any clinical and pathological differences between the pyogenic granuloma and lobular capillary hemangioma through a scoping review of the available literature. A Medline search has identified 342 articles from 2001 to 2018, from which English papers, case series, retrospective studies, and cross-sectional studies were selected. Data from the articles was charted using appropriate subheadings for the clinical question (e.g., number of patients, clinical features, histology, pathogenesis, differential diagnosis, treatment). Compared to LCH, PG seems to occur more in the middle-aged range, has a clearer predilection for (pregnant) females, and has more frequently a known triggering factor in the history. Histologically, PGs appear as radially organized capillaries (while LCHs have a lobular pattern), have a mixed inflammatory infiltrate (compared to the occasional lymphocytic infiltrate in LCHs), and can undergo fibrosing transformation when chronic, which is not seen in LCHs. Finally, besides basic excision, several other treatment options have been described for both lesions. Since the pyogenic granuloma and lobular capillary hemangioma show clinical and pathological differences, we propose them to be considered as distinct lesions, which makes interpreting the literature much easier.https://www.termedia.pl/Journal/Journal_of_Stomatology-137am2021Oral Pathology and Oral Biolog

Human papillomavirus infection of the oral cavity : what the dentist should know

The incidence of human papilloma virus-induced oropharyngeal carcinoma is steadily rising globally and the observation has become widely publicised in recent times. Human papilloma virus (HPV) is therefore an important infectious oncogenic agent. The aim of this article is to highlight the modes of transmission in HPV-related oral and oropharyngeal lesions whilst explaining the morphological spectra of benign and malignant disease which are attributed to low-risk and high-risk subtypes respectively. These issues as well as the topic of vaccination against HPV are likely to be the concern of many dental patients. The oral health care worker is therefore expected to provide appropriate counselling and education when informing patients of the potential health risks posed by HPV.https://www.sada.co.za/the-sadjam2018Oral Pathology and Oral Biolog

Human papillomavirus and carcinoma of the mucosal surfaces of the head and neck

Human papillomavirus induced cervical cancer is the fourth most prevalent malignancy affecting females globally. Over the past two decades scientific information unveiled an increasing role for the virus in the pathogenesis of malignancies developing from the mucosal surfaces of the oropharynx. It is feasible to postulate that we may be in the beginning of a global pandemic of oropharyngeal cancer if the mode of transmission of the virus is taken into account. The main goals of this manuscript are to present a brief summary of the mechanisms of human papillomavirus induced malignant transformation, provide guidelines for the microscopic diagnosis of high risk human papillomavirus involvement in mucosal biopsies and highlight the implications thereof in cancers of the mucosal surfaces of the head and neck.http://www.elsevier.com/locate/jomsmp2019-01-01hj2017Oral Pathology and Oral Biolog

Mixed adenoneuroendocrine carcinoma of the tongue arising within a congenital enteric cyst

BACKGROUND : Primary intestinal‐type adenocarcinoma of the tongue is rare. This represents the first reported case of a primary mixed adenoneuroendocrine carcinoma (MANEC) of the tongue arising within a congenital enteric cyst. METHODS : A 52‐year‐old man presented with a midline tongue mass that was connected to the mucosal surface with an epithelial‐lined sinus tract. orphological examination and immunohistochemical profiling of the neoplasm were performed. RESULTS : Histopathological evaluation showed a primary MANEC arising within a preexisting congenital enteric cyst, comprising both adenocarcinoma and neuroendocrine components. The adenocarcinoma had a colonic‐type morphology and coexpressed CK7, CK20, and CDX2. Imaging and colonoscopy excluded a distant primary colorectal neoplasm. CONCLUSION : The association of primary MANEC of the tongue with a gastrointestinal heterotopic cyst supports an origin from entrapped endodermal elements as opposed to salivary duct origin. This case raises the awareness of a rare yet prognostically important complication of a gastrointestinal heterotopic cyst.http://wileyonlinelibrary.com/journal/hed2019-05-01hj2018Oral Pathology and Oral Biolog

Recent advances in the pharmaceutical manipulation of bone remodelling : the quest for a healthy skeleton

INTRODUCTION : Biochemical characterisation of the autocrine, paracrine and endocrine mediators of bone remodelling provides a scientific basis for the development of pharmaceuticals and autoantibodies which could induce a desired skeletal phenotype. The manipulation of bone remodelling in patients at risk for skeletal disease is gaining clinical momentum due to the benefits of maintaining quality of life rather than restoring the long-term dire consequences of skeletal catabolism. METHODS : A narrative review of current literature pertaining to the modes of action of pharmaceuticals and autoantibodies which manipulate skeletal metabolism was performed. RESULTS : Pharmaceuticals and autoantibodies which manipulate skeletal remodelling can be broadly divided into three categories: bone resorption inhibitors, bone formation stimulators and bone resorption and formation modulators. The mechanisms of action of these medications are briefly summarised and reference is made to the relevant pharmaceuticals and autoantibodies available. LEVEL OF EVIDENCE : Level 5.http://journal.saoa.org.zaam2019Oral Pathology and Oral Biolog

Recent advances in the pharmaceutical manipulation of bone remodelling: the quest for a healthy skeleton

INTRODUCTION : Biochemical characterisation of the autocrine, paracrine and endocrine mediators of bone remodelling provides a scientific basis for the development of pharmaceuticals and autoantibodies which could induce a desired skeletal phenotype. The manipulation of bone remodelling in patients at risk for skeletal disease is gaining clinical momentum due to the benefits of maintaining quality of life rather than restoring the long-term dire consequences of skeletal catabolism. METHODS : A narrative review of current literature pertaining to the modes of action of pharmaceuticals and autoantibodies which manipulate skeletal metabolism was performed. RESULTS : Pharmaceuticals and autoantibodies which manipulate skeletal remodelling can be broadly divided into three categories: bone resorption inhibitors, bone formation stimulators and bone resorption and formation modulators. The mechanisms of action of these medications are briefly summarised and reference is made to the relevant pharmaceuticals and autoantibodies available. LEVEL OF EVIDENCE : Level 5.http://journal.saoa.org.zaam2019Oral Pathology and Oral Biolog

Pharmaceutical management of bone catabolism : the bisphosphonates

BACKGROUND: Conditions associated with catabolism of bone are common and progress sub-clinically with devastating skeletal consequences. Over the past two decades, bisphosphonates have become increasingly popular for the preventative management of the skeleton in these conditions. METHODS: Recent literature pertaining to the mechanisms of action, clinical indications and complications of bisphosphonate therapy was retrieved using Google Scholar and Pubmed. AIMS OF STUDY: To provide an overview of the mechanisms of action, indications, contraindications and complications of the bisphosphonates available for clinical use in South Africa. RESULTS: Despite the availability of alternative management regimens, bisphosphonates remain the pharmaceuticals of choice for the management of hypercalcaemia and generalised catabolic skeletal disorders such as osteoporosis, skeletal metastatic disease, Paget’s disease of bone, glucocorticoid bone disease and osteogenesis imperfecta. Although adverse complications such as tachycardia, bowel and oesophageal irritation, pain, jawbone necrosis and atypical femur fractures are well documented, information remains limited on the long-term effects of bisphosphonate therapy on skeletal health. This manuscript provides an update on the mechanisms of action, principles applied to the selection of the most appropriate management regimen, monitoring of the response and complications of the bisphosphonates marketed in South Africahttp://journal.saoa.org.zapm2020Oral Pathology and Oral Biolog