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Hyperplastic dental follicles (HDFs) represent odontogenic hamartomatous lesions originating from the pericoronal tissues and are often associated with impacted or embedded teeth. These lesions may occasionally feature unique calcifying bodies, known as calcifying whorled nodules (CWNs), characterized by stromal cells arranged in a whorled or spiral fashion. CWNs are typically observed in multiple calcifying hyperplastic dental follicles or regional odontodysplasia. In our study, we examined 40 cases of HDFs, including nine instances with characteristics of CWNs, referred to as calcifying hyperplastic dental follicles (CHDFs), which are infrequently accompanied by odontodysplasia. The median ages of the HDFs and CHDFs were 16 (ranging from 3 to 66) and 15 (ranging from 11 to 50) years, respectively. The lower third molars were the most frequently affected by HDSFs and CHDFs, followed by the upper canines. A histological examination was conducted on all 40 cases, with an immunohistochemical analysis performed on 21 of them. Among the cases with CWN, nine affected a single embedded tooth, with one exception. CWNs exhibited diverse calcifications featuring sparse or entirely deposited psammoma bodies, and some displayed dentinoid formation. Immunohistochemically, the stromal cells of HDFs were frequently positive for CD56 and nestin. By contrast, CWNs were negative for CD56 but positive for nestin as well as hairy and enhancer split 1 (HES1), with a few dentin sialoprotein (DSP)-positive calcified bodies. Our results revealed that hamartomatous CHDFs can impact multiple and single-embedded teeth. CWNs composed of nestin and HES1-positive ectomesenchymal cells demonstrated the potential to differentiate into odontoblasts and contribute to dentin matrix formation under the influence of HES1. This study is the first report documenting odontoblastic differentiation in HDFs. The rare occurrence of HDFs and CHDFs contributes to limited comprehension. To prevent misdiagnosis, a better understanding of these conditions is necessary. [ABSTRACT FROM AUTHOR]

Hobnail hemangioma is a vascular tumor that typically occurs in young or middle-aged individuals. It usually affects the limbs or trunk but rarely the head and neck region. Hobnail hemangioma is classified as a benign vascular tumor. However, some authors emphasize that hobnail hemangioma is not a vascular tumor but a lymphatic malformation. Here, we report an unusual case of a hobnail hemangioma on the tongue with pyogenic granuloma-like appearances. A 50-year-old woman visited our department with a chief complaint of bleeding and pain on the right lateral side of her tongue. On intraoral examination, an irregular swelling of approximately 28 × 15 mm in size with a 10 × 10 mm ulcer with a well-defined border in the center was seen on the right lateral side of the tongue. Histopathologically, the subepithelial lesion demonstrated numerous neutrophilic infiltrates and capillary proliferation resembling a pyogenic granuloma. The deeper lesion showed abnormal dilated and slit-like vessels with a hobnail appearance intervening between collagen and vascular bundles, accompanied by minute hemosiderin deposition. All abnormal vessels were D2-40 positive, but WT1 was negative, which could indicate the nature of the hobnail hemangioma with inflammation. The patient shows no evidence of recurrence 2 years after surgery. Hobnail hemangioma is extremely rare but should be considered a differential diagnosis of oral vascular lesions. [ABSTRACT FROM AUTHOR]

Background: Odontogenic keratocysts constitute 10%–20% of odontogenic cysts and exhibit a distinctive corrugated parakeratinized lining epithelium. Considering that cornified envelope formation is an important phenomenon during keratinocyte differentiation, this study aimed to clarify the characteristics of cornified envelope formation in odontogenic keratocysts. Methods: We investigated the cellular distribution of cornified envelope‐related proteins (transglutaminases and their substrates), as well as the upstream regulatory protein c‐Fos, by immunohistochemical analysis of the lining epithelium of 20 odontogenic keratocysts. We examined the corresponding mRNA levels by quantitative polymerase chain reaction. Ten dentigerous cysts served as control non‐keratinized cysts. Results: The distributions of transglutaminase and their substrates except loricrin and small protein‐rich protein 1a significantly differed between odontogenic keratocysts and dentigerous cysts. There was no significant difference in c‐Fos expression between odontogenic keratocysts and dentigerous cysts. The mRNA levels of transglutaminases and their substrates were significantly higher in odontogenic keratocysts than in dentigerous cysts. However, c‐Fos mRNA levels did not significantly differ between groups. Conclusion: Surprisingly, the overall appearance of cornified envelope‐related proteins of odontogenic keratocysts was consistent with the characteristics of non‐keratinized oral mucosa identified in previous studies. These findings indicate that the contribution of cornified envelope‐related molecules in odontogenic keratocysts is similar to that in non‐keratinized oral epithelium, rather than keratinized oral epithelium, suggesting that odontogenic keratocysts are not genuine keratinized cysts. The upregulation of cornified envelope‐related genes in odontogenic epithelium could be an important pathognomonic event during odontogenic keratocyst development. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the physico-mechanical properties of a new cavity base material containing mineral trioxide aggregate, LA-T1, prototyped by Neo Dental Chemical Products for indirect restoration. Three base materials, LA-T1, Cavios (CAV, Neo Dental Chemical Products), and Bulk Base Hard (BBH, Sun Medical), were examined. The depth of cure, microshear bond strength with a resin-based luting cement, and the compressive strength of these materials were investigated. The depth of cure of LA-T1 was similar to that of CAV, while the depth of cure of BBH was above the measurement limit. The distance from the base material to the light source, 0 mm and 4 mm, did not significantly affect the depth of cure of all materials. The microshear bond strength of LA-T1 bonded to a resin-based luting cement was slightly higher than that of CAV and similar to that of BBH, both of which were bonded to the same luting cement under the same conditions. The compressive strength of LA-T1 was similar to that of CAV but less than that of BBH. The results of this study indicate that LA-T1 has properties that are similar to those of CAV and thus can be clinically applied. [ABSTRACT FROM AUTHOR]

Extraskeletal Ewing sarcoma, a high-grade soft tissue tumor, is extremely rare in the stomatognathic region. We report the case of a 47-year-old man with probable extraosseous Ewing sarcoma of the maxillary gingiva that occurred concurrently during chemoradiotherapy for non-small cell lung cancer. Owing to the rapid growth of the mass, debulking surgery was performed for the suspected round cell tumor under intravenous anesthesia. The tumor was considered as having extraosseous Ewing sarcoma showing unusual features based on the following features: it was not continuous with the maxilla; histopathological examination revealed proliferation of small round cells with pleomorphic and voluminous round nuclei in the fibrous connective tissue; tumor cells were immunohistochemically positive for CD99 and ETS-related gene (ERG); and fluorescence in situ hybridization analysis showed EWSR1 gene translocation. Despite satisfactory postoperative recovery, the patient died of respiratory failure due to rapid lung cancer deterioration on postoperative day 16. To our knowledge, in the English literature, there are only 17 reported cases of extraskeletal Ewing sarcoma in the stomatognathic region, and this is the only one with concurrent other organ cancer. More data on cases of extraskeletal Ewing sarcoma in the oral region are needed to establish its pathophysiology, prognosis, and treatment guidelines. [ABSTRACT FROM AUTHOR]

A dentinogenic ghost cell tumor (DGCT), the rarest locally invasive odontogenic tumor, is considered a solid variant of the calcifying odontogenic cyst. Histopathologically, DGCT is characterized by ameloblastoma-like islands of epithelial cells in a mature connective tissue stroma and aberrant keratinization in the form of ghost cells associated with varying amounts of dysplastic dentin. DGCT is classified into the intraosseous type (central) and the extraosseous type (peripheral). The peripheral type is even rarer than the central type. We describe a case of peripheral DGCT measuring a size of 33 × 28 × 19 mmin the mandibular anterior region in a 61-year-old woman. The tumor was diagnosed as a peripheral DGCT based on biopsy findings and radiographic images. Under general anesthesia, the lesion was excised by detaching it from the bone on the periosteum with a safety margin, and the bone in contact with the tumor was curetted and shaped. The wound was covered with polyglycolic acid-absorbable reinforcement material and fibrin glue spray. At approximately one year postoperatively, the patient remains recurrence-free. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to delve deeper into the hypothesis that normal salivary gland tissue expresses both protein and mRNA of mammaglobin (MGB).Methods: Formalin-fixed paraffin-embedded samples of submandibular (10), parotid (5), palatal (5) and labial glands (30) salivary glands were immunohistochemically investigated. The labial samples were used to examine the MGB positive ratio (MGB-PR), and localize MGB by double immunofluorescence staining and quantitative mRNA gene expression. Mann-Whitney U and Kruskal Wallis rank-sum test for group comparison, and Spearman's rank correlation coefficient for correlation analysis were used.Results: The distribution of MGB-positive cells was variable throughout samples with significantly higher MGB-PR of acini than ducts (P = 0.00376), and there was no difference when compared based on age (P = 0.0646) and gender (P = 0.245). Besides acinar cells, a number of myoepithelial cells and ductal cells also demonstrated strong MGB reactivity with varying MGB mRNA expression levels in 6 of the 7 samples (with MGB-PR > 20%) tested.Conclusion: This novel study shows that unlike aberrant protein expression in some carcinomas, MGB expression in salivary gland neoplasms represents the nature of original cells, giving a better insight into the neoplasms expressing MGB. [ABSTRACT FROM AUTHOR]

Diagnostic utility of a homeobox transcription factor, engrailed homeobox 1 (En1) in the histopathology of salivary gland neoplasms was studied. The expression of En1 was immunohistochemically examined in 51 cases of adenoid cystic carcinoma (AdCC) and 143 cases of other salivary gland neoplasms. In all 51 AdCCs, En1 was expressed in 30–100% of tumor cells. In eight of nine polymorphous adenocarcinomas (PACs), En1 was expressed in 40–100% of tumor cells. Less than 5% of tumor cells expressed En1 in three of 12 epithelial–myoepithelial carcinomas, one of 17 basal cell adenomas (BCAs), and one of 34 pleomorphic adenomas (PAs). Among 55 other carcinoma cases, 1–30% of tumor cells expressed En1 in three salivary duct carcinomas (SDCs) ex PA. None of the myoepitheliomas and Warthin tumors expressed En1. When the cut‐off value of the percentage of En1‐expressing cells was set to 25%, all 51 AdCCs, eight of nine PACs and one SDC ex PA were En1‐positive and the others were En1‐negative. En1 is expressed consistently in AdCCs, frequently in PACs, but rarely in other salivary gland neoplasms. En1 is a possible diagnostic marker for AdCC and PAC in the histopathology of salivary gland neoplasms. [ABSTRACT FROM AUTHOR]

Cornified envelope formation is crucial for the final differentiation of keratinized epithelium. However, the mechanisms of cornified envelope formation in the oral epithelium remain unclear. The aim of this study was to clarify the differences in the distribution and expression of cornified envelope related proteins and genes between keratinized and non‐keratinized oral epithelia. We immunohistochemically investigated the distribution patterns of transglutaminase 1 (TG1), transglutaminase 3 (TG3), and their substrate proteins involucrin (IVL), loricrin (LOR), and small proline rich proteins (SPRs), in 19 keratinized and 14 non‐keratinized oral epithelium samples. TG1 and TG3 mRNA levels were investigated in both types of epithelium by real time reverse transcription polymerase chain reaction (RT‐PCR) using paraffin‐embedded specimens. Data were analyzed to identify factors involved in cornified envelope formation. We demonstrate that 11 localization patterns show statistically significant differences between keratinized and non‐keratinized oral epithelia. These factors clearly drove the separation of the two groups during cluster analysis. TG1 mRNA levels in keratinized oral epithelium were significantly higher than those in non‐keratinized oral epithelium. In conclusion, the characteristic distribution of transglutaminases and their substrates and the mRNA levels of TG1 can regulate cornified envelope formation in keratinized oral epithelium, together with the contribution of TG3 first reported in this paper. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to clarify by histopathological examination the origin of oral membranous substances deposited on the palate, tongue, buccal mucosa and teeth.Background: Several investigators have reported membranous substances deposited in the mouths of bedridden elderly persons requiring nursing care without oral intake. However, the precise nature and origin of the substances are poorly understood.Methods: Sixty-nine specimens were taken from the oral cavity of bedridden patients, that is, the palate, dorsum of the tongue, the cheek and teeth. Sections were stained with haematoxylin and eosin stain, alcian-blue and periodic acid-Schiff stain (AB-PAS) and antibodies for pankeratin (AE1AE3) and leukocyte common antigen (LCA).Results: All specimens showed a film-like nature coloured from tan to white, accompanied by a mucous substance. Histologically, specimens of all sites had a similar feature of the combination of basophilic amorphous and eosinophilic lamellar features. The basophilic substance was positive for AB-PAS, and PAS-positive glycogen granules were also noted in the lamellar structure. Immunochemistry revealed various degrees of pankeratin positive substance and LCA-positive inflammatory cell infiltration.Conclusion: The oral membranous substance was composed of keratin and mucin with inflammation. These results suggest that the deposition of the oral membranous substance is a pathological condition or oral mucositis caused by dry mouth. [ABSTRACT FROM AUTHOR]

Abstract Adenomatoid odontogenic tumor is a relatively rare tumor that typically occurs at the anterior part of the maxilla. Most cases arise as a central or intraosseous tumor accompanying an impacted tooth; thus, the radiological appearance resembles that of an odontogenic cyst. The tumor is divided into three subtypes depending on its location and relationship with the impacted tooth: the central variant associated with the crown of an unerupted tooth (follicular type); the central variant with no association with the crown of an unerupted tooth (extrafollicular type); and the peripheral (gingival) variant. Among them, the occurrence of peripheral variant is reportedly very rare, and they usually exhibit an epulis-like or fibroma-like appearance. This paper reports an unusual case of adenomatoid odontogenic tumor. Remarkably, the tumor extended into the buccal periodontal space, expanding the space possibly due to tumor growth without relevant absorption of labial alveolar bone. The adjacent gingiva looked normal except for the slight swelling. On histopathological analysis, the tumor showed no direct connection to the periodontal ligament, which may indicate the possible origin of this tumor as an epithelial remnant of the dental lamina in the peripheral gingiva. [ABSTRACT FROM AUTHOR]

Renal dysfunction was reported to be closely associated with clinical outcomes in patients with chronic heart failure (CHF). Renal tubulointerstitial damage has been shown to be an important factor in the development of renal dysfunction as well as glomerular damage. However, the impact of renal tubular damage on clinical outcomes in patients with CHF remains to be determined.Urinary β2-microglobulin-creatinine ratio was measured in 315 patients with CHF. Renal tubular damage was defined as a urinary β2-microglobulin-creatinine ratio ≥300 μg/g, as previously reported. Patients were prospectively followed up for a median period of 1097 days. There were 91 cardiac events, including 16 cardiac deaths and 75 rehospitalizations for worsening heart failure. Log10 urinary β2-microglobulin-creatinine ratio was increased with worsening New York Heart Association functional class. Multivariate analysis revealed that renal tubular damage was an independent predictor of cardiac events. Kaplan-Meier analysis demonstrated that the rate of cardiac events was higher in patients with renal tubular damage compared with those without it. Patients were divided into 4 groups according to the presence of chronic kidney disease and renal tubular damage. The Cox proportional hazard analysis revealed that comorbidity of chronic kidney disease and renal tubular damage was associated with the highest risk for cardiac events compared with other groups.Renal tubular damage was related to the severity of heart failure and was associated with poor outcomes in patients with CHF. Renal tubular damage could add clinical information to chronic kidney disease in patients with CHF. [ABSTRACT FROM AUTHOR]

To present a vertical ridge augmentation with a composite synthetic bone graft by the mixed bone-filling materials and autogenous bone chips retrieved from the implant osteotomy site for a case for esthetic implant prosthesis on the atrophied alveolar bone. Materials: Nonresorbable and resorbable hydroxyapatite and demineralized freeze-dried bone allograft particles were used at ratio of 1:2:2 (volume ratio). Titanium micromesh was used for alveolar ridge configuration and retention: After 8 months, implant placement and interimplant bone augmentation were performed Results: 15-mm vertical and 10-mm horizontal bone augmentation has been achieved. Marginal bone heights and periiniplant mucosa remained stable in cases of loading after >4 years offollow-up. Conclusion: These results suggest that this method has the potential for use in esthetic implant rehabilitation on the highly atrophied alveolar bone. [ABSTRACT FROM AUTHOR]