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This paper reports, for the first time, gingival hyperplasia in a patient treated with felodipine, a drug which belongs to the group of calcium ion antagonists. The observed gingival overgrowth was most significant in the area of interdental papillae of the anterior region of the mouth. The described hyperplastic tissue was characterized by a firm and pale appearance, with a normally stippled pattern. Histopathologically, a conspicuous increase of fibrous connective tissue, as well as an inflammatory infiltrate and hyperplasia of the overlying epithelium were observed. Consequently, the present observation adds another drug to the list of substances capable to induce gingival hyperplasia. [ABSTRACT FROM AUTHOR]

The histogenesis of jaw myxoma is still debated. According to some authors it arises from the primitive mesenchymal components of developing teeth. In this study, we have studied the expression of S-100 protein and vimentin in dental follicle, dental papilla and periodontal ligament cells using monoclonal and polyclonal antibodies. Myxoma of the jaw expresses vimentin and S-100 protein. On the contrary, as compared to jaw myxoma, the normal developmental structures were immunonegative for S-100 protein but stained for vimentin. These results could indicate a difference in the derivation other than tooth mesenchyma.

Twenty human healthy teeth were extracted for orthodontic purposes and processed for histological, and immunohistochemical examination. Odontoblasts were pseudostratified in depth of 1-8 cells in pulpward direction showing the zone of Weil and the cell-rich zone in coronal third pulp. In the central part of pulp tissue, fibroblasts were arranged as a network. These cells strongly immunoreacted with an antibody (monoclonal and polyclonal) directed against the intermediate filament vimentin. The product reaction was specifically located in the cytoplasm. Near vessels occasional lymphocytes and mast cells were also present. Collagen fibers formed a plexus below the cell-rich zone in middle and coronal pulp.

A review of the literature and two observations made by the Authors regarding maxillary myxoma allow a closer analysis to be made of this rare benign tumour which is, however, often recurrent in young adults. Maxillary myxoma is identified by the appearance of a non-inflammatory and often painless swelling which, in radiological terms, appears to have a zone of multilocular and sometimes unilocular osteolysis. In histological terms, this globular whitish-greyish gelatine-like tumour is made up of an abundant stroma which encloses star-shaped or fusiform cells and rare collagen fibres. Treatment should be conservative where possible since radical surgery does not preclude recurrence; follow-up should be regular and long in order to ensure an early diagnosis of recividation. Although it is considered an odontogenic tumour, the odontogenic nature of maxillary myxoma has not been undisputably ascertained. The term maxillary myxoma is therefore preferable to that of odontogenic myxoma.

Five cases of "focal epithelial hyperplasia" (FEH) of the oral mucosa observed in Switzerland are reported. The patients were of Turkish and North African extraction. The lesions of FEH were multiple, painless, located at various sites of the oral mucosa including the tongue in the form of either soft papules or hard nodules. Evidence of a human papilloma virus origin was ascertained. Among the 1067 cases reported in the literature and reviewed for this study, this condition has been described to occur among American Indians, Eskimos and North African, also in Israeli and European cases the disorder was often reported in individuals of Turkish or North African extraction.

Psychogenic oral paresthesia represent a proteiform condition, more and more frequent. The failure to recognize it can lead to unjustified investigations or/and procedures. These manifestations are secondary to a psychic problem which varies in severity. In most cases, the establishment of a trust relationship, explanations to the patient and eventually a psychotherapy are sufficient to eliminate the symptoms. In severe cases, a psychotherapy or a psychiatric treatment are almost always necessary.

Lichen planus is a common mucocutaneous disease of unknown etiology which was initially described a century ago. The specific etiology remains unclear. A number of relationships between lichen planus and other conditions have been noted. The lesions occur most commonly on the buccal mucosa. Gingival involvement occurs in approximately 10% of reported cases. The appearance of lichen planus is extremely variable which leads to confusion with other clinically similar disease entities.

Salivary gland tissue inclusions in the mandible appear as well delimited radiolucency areas, asymptomatic, usually located in the mandibular angle and sometimes in the premolar canine and symphysis regions. The examination of 8,500 radiographs has demonstrated an incidence of one radiolucent area at the mandibular angle every 500 radiographs. Our result is slightly inferior to the mean reported in the literature. Seven cases were examined. Six of them have been treated surgically and histologically. At exploration a defect in the lingual cortical plate was found. The cavities were filled by salivary gland tissue. The contents of the cavities were attached via the lingual cortical defect to the near salivary gland. The cause of such radiolucency situated in the mandibular angle seems to be an altered resorption and apposition process of the bone triggered by a modification of the salivary glands elasticity; on the contrary, the salivary inclusions in the symphysis region is referred to as embryonic origin. In the literature different terms are used often in relation with a pathogenetical hypothesis; in this paper we suggest rather a description terminology such as intramandibular salivary tissue.

The clinical, radiological and histological aspects of acute histiocytosis X of Letterer-Siwe disease are reviewed after personal observation of such cases. In spite of many advanced hypotheses the etiopathogenesis of Histiocytosis X is wide open to research. The diagnosis became possible by the discovery of histiocyte cells of a special order, the X-bodies, under the E. M. Recent research allows a classification of Letterer-Siwe disease, Hand-Schüller-Christian disease, and the eosinophilic granuloma under the same nosologic grouping. Finally, the prognosis of the Letterer-Siwe disease-so far much in the dark-may be improved by a properly conducted therapy.

Stomatodynies are functional manifestations often observed in anxious and depressive individuals, in the form of glosso-, cheilo-, uranodynia. It may show itself in disturbances of the mucosa or of salivary secretion. It is necessary to reassure the patients, to explain the nature of the disease and to prevent them from autotherapy of local or psychic factors.

In the course of the extensive tissue remodeling occurring after flap surgery and during the subsequent gingival reattachment in man, numerous intracellular vacuoles were observed in fibroblasts of the lamina propria. These vacuoles contained one or several typical collagen fibrils and had either an electron-lucent matrix or contained an electron-dense material obscuring the fibrillar outlines and cross-striations.

These 8 cases of multiple hamartoma syndrome are the first reported in Switzerland. Two men aged respectively of 65 and 28 years presented a cobblestone appearance of the gingiva and of the tongue ("pebbly tongue"), which suggested Cowden disease. This diagnosis was confirmed by the discovery of numberous skin lesions, a thyroid goiter, gastrointestinal polyposis, and a mild skelettal dysmorphosis. The older patient had a grade one carcinoma of the bladder; his son and his daughter presented the syndrome, which was also discovered in the family of the second patient (his father, his brother, his sister and one of her daughters). The ultrastructural study of two skin biopsies demonstrated anomalies of the fibroblasts and collagen fibers.

Contrary to common opinion the intraepithelial cancer of the buccal mucosa presents clinical symptoms, but they are discreet and different from those observed in an invasive carcinoma. Usually, there is leucoplakia with an erythema and an irregular keratosis or a punctuated one. There is an erythematous variation (Queyrat's erythroplasia) which is without keratinasation. Only histological evidence can confirm the diagnosis cancer. It should be differentiated against Bowen's disease and the light, intermediated and severe dysplasias.

Described by Lloyd and Dennis in 1963, Cowden's disease is a familial affection in which are found associated lesions of the buccopharyngeal mucosa (papillomatosis, papules, scrotal tongue), various types of skin lesions (verruciform keratotic papules, papilloma, lipoma, angioma, etc...), visceral manifestations usually related to lesions in the thyroid, breasts, or digestive tract (hamartoma or malignant tumors), and skeletal dysmorphism. The two patients were from different families, were aged 65 and 28 years, and had presented for consultation because of buccal mucous membrane papillomatosis, and in one case, hemorrhagic gingivitis. Cowden's disease was diagnosed from the clinical examination, past history, and investigations after hospital admission. The main value of the mucosal and cutaneous lesions is their diagnostic significance, enabling a synthesis of the multiple dispersed manifestations to be made, and a possible visceral tumor to be discovered in the early stages.

Recent research has shown that the cytoplasm of several varieties of non muscular cells contains contractile proteins similar to those of striated muscle (actin and myosin, with the control complex of troponin and tropomyosin). Using indirect immunofluorescent staining with specific antisera, the authors demonstrate that the cytoplasm of the cells of oral squamous cell carcinoma contains actin, myosin and actinin (tropomyosin seems to be lacking). They have found these contractile proteins inconstantly in various precarcinomatous states, but never in normal epithelium, except in a few basal cells. In electronic microscopy, these contractile proteins correspond to a network of microfilaments of 40-80 A, more rarely 100-120 A, Clearly different from tonofilaments, located mainly in the peripheral part of the cytoplasm, just under the plasmalemmal membrane. It is tempting to speculate that the occurence of a contractile filamentous apparatus in the cells of oral carcinomas--already described in skin and mammal gland carcinomas--allows to these cells amoeboid movements and active migration, which might to some extent explain their tendency to invade surrounding tissues and to produce metastasis.

Three cases of 'focal epithelial hyperplasia' (FEH) of the oral mucosa observed for the first time in Switzerland are reported. The patients were of Turkish and North African extraction. The lesions of FEH were multiple, painless, located at various sites of the oral mucosa including the tongue, in the form of either soft papules or hard nodules. Evidence of a human papilloma virus origin was ascertained. Among the 1,067 cases reported in the literature and reviewed for this study, this condition has been described to occur among American Indians, Eskimos and Cape Coloureds; also in Israeli and European cases the disorder was often reported in individuals of Turkish or North African extraction.

Means to detect pemphigus vulgaris at an early stage are described. Its grave evolution in absence of treatment makes an early diagnosis imperative. The first signs are frequently localized in the oral mucosa and sometimes the disease remains confined to this mucosa only. Efficient and early therapy may favourably influence the course of disease, and the dentist is in a prime position to detect the characteristic lesions.