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Biomedical subjects

P Holmstrup

Publications and source records attributed to P Holmstrup.

At least 55 records · Page 3Linked to original sources
PubMed1990

Oral mucosal lesions related to silver amalgam restorations.

A total of 49 consecutive patients with lesions of the oral mucosa that were in contact with corroding dental amalgam restorations were subdivided into two groups. In group 1 the lesions were restricted to the contact area opposing the dental restoration, whereas the extent of the lesions in group 2 exceeded that of the contact area. Epicutaneous test for mercury allergy showed that a significantly greater proportion of the patients in group 1 had positive reactions to mercury than in group 2 (p = 0.019). The amalgam restorations were replaced by composite resin or porcelain fused to gold crowns, or contact between amalgam fillings and oral mucosa was prevented by an acrylic splint. After this treatment regression of lesions was far more pronounced in group 1 than in group 2 (p less than 0.001). On the basis of these findings, contact allergy to mercury is suggested as a possible etiologic factor of the mucosal changes in group 1, and the designation contact lesion is proposed for such lesions. The lesions of patients in group 2 seem unrelated to a contact allergy to mercury, and other causes such as lichen planus should be considered.

Acrylic Resins↗
PubMed1990

Effect of dental plaque control on gingival lichen planus.

Eleven patients, all women, aged 43 to 76 years, with atrophic or ulcerative lichen planus lesions of gingiva were included in this preliminary study. After initial examination, the patients received an intensive individual hygiene treatment. The patients continued using the most appropriate, atraumatic method resulting in the best possible oral hygiene over a 1 year period during which they were seen for follow-up examinations at 3-month intervals. The mean plaque scores decreased after the initial treatment followed by an increase. The mean scores for severity of subjective symptoms and for type and extension of lesions initially decreased with the plaque scores and remained lower throughout the study. It is concluded that in some cases both subjective and objective improvement of atrophic and ulcerative gingival lichen planus may be obtained by means of intensive oral hygiene procedures although such procedures do not remove the basic cause of lichen planus. However, further studies are needed to examine the role of dental plaque control in patients with oral lichen planus.

Adult↗
PubMed1990

Amalgam associated mercury accumulations in normal oral mucosa, oral mucosal lesions of lichen planus and contact lesions associated with amalgam.

Fourty-three patients with oral mucosal lesions were divided into 3 groups based on the relationship between lesions and amalgam restorations. Group I consisted of patients with contact lesions confined to mucosal areas in contact with amalgam fillings. Group II patients had lichen planus lesions exceeding the area of contact with an amalgam filling and Group III comprised patients with lichen planus lesions without relation to amalgam fillings. Biopsies were embedded in epon and subjected to autometallography in order to demonstrate a possible accumulation of mercury in the affected mucosa. In 20 our of 21 patients in Group I, 4 of 11 patients in Group II and 4 of 11 patients in Group III, mercury was found in the lysosomes of macrophages and fibroblasts. In Group I the number of cells loaded with mercury was much higher than in Group II and in particular Group III. In the latter groups autometallographically demonstrated mercury was found almost exclusively in macrophages. Nineteen biopsies taken from patients with normal mucosa served as controls. Ten had occlusal (Group IV) and seven buccal fillings (Group V). The biopsies from the latter group were taken from areas opposing amalgam restorations. Two patients had no amalgam fillings (Group VI). The histochemical technique showed that three biopsies in Group IV (occlusal fillings only) and two in Group V (opposing buccal fillings) contained traces of mercury in the juxtaepithelial connective tissue. The silver enhanced mercury was found in macrophages. The two controls (Group VI) without amalgam fillings were devoid of precipitates.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Classification and clinical manifestations of oral yeast infections.

By tradition oral candidosis has been classified into acute pseudomembranous (thrush), acute atrophic, chronic atrophic, and chronic hyperplastic types. However, pseudomembranous candidosis is not always acute but may last for many months. Furthermore, the value of using the term atrophic to describe an erythematous area is limited. Moreover, some of the various types have been associated with other clinical entities, which appear to have a combined bacterial/mycologic etiology. A revision of the classification should be based on the use of clinical terms, and in a previous study of multifocal oral candidosis, erythematous, plaque-like, and nodular forms were identified. A revised classification of oral candidosis which considers these aspects could be as follows: acute types: pseudomembranous and erythematous; chronic types: pseudomembranous, erythematous, plaque-like, and nodular; and Candida-associated lesions: denture stomatitis, angular cheilitis, and median rhomboid glossitis.

Acute Disease↗
PubMed1989

Inflammatory paradental cysts in the globulomaxillary region.

Cysts located in the maxilla between the roots of an erupted lateral incisor and a canine were studied. Radicular cysts were excluded by the prerequisite of a positive pulp vitality test in both adjacent teeth, and odontogenic keratocysts were excluded by histologic examination. In the period from 1971-1987, 8 cysts were found which fulfilled the criteria for inclusion. The average age of the patients was 18.8 yr. All cysts were lined by a hyperplastic non-keratinized stratified squamous epithelium and there was always a heavy infiltrate of inflammatory cells in the connective tissue. The clinical and histologic features were similar to those previously reported for inflammatory paradental cysts (IPC) in the mandible. Therefore, it seems justified to suggest that some of the previously described globulomaxillary cysts are in fact IPCs.

Adolescent↗
PubMed1989

Oral candidiasis and human immunodeficiency virus infection.

The association of oral candidiasis with the human immunodeficiency virus (HIV) infection has been known since the advent of the acquired immunodeficiency syndrome (AIDS) pandemic. Oral candidiasis is one of the earliest premonitory signs of HIV infection and its diagnosis may have grave prognostic implications for the eventual development of full blown AIDS. There is now an expanding body of data on novel clinical variants of this 'old' disease, its epidemiology in HIV seropositive individuals and, advances in its management, particularly with respect to the recently introduced bis-triazole antifungals. Current concepts pertaining to the epidemiology, clinical features, pathogenesis, laboratory diagnosis and management of oral candidiasis in HIV infection are reviewed.

Antifungal Agents↗
PubMed1989

Behavior of in vitro grown normal human mucosal epithelial cells and tumorigenic rat cells inoculated into nude mice.

The present study describes the behavior of in vitro grown normal human oral mucosal epithelial cells and that of a tumorigenic epithelial cell line following subcutaneous inoculation into nude mice. A successful recovery of viable human epithelial cell inocula was seen in 25-90% of mice and there was no improvement in recovery rates after addition of fibroblasts. These inocula resulted in cyst formation lined by a 2-6 cell layer unkeratinized squamous epithelium without rete ridges. There was no increase in recovery rate or size of cysts when coinoculated with fibroblasts. The tumorigenic cell inocula were successfully recovered in all cases. Tumors established from these inocula had a low grade of differentiation and were without signs of metastasis. Inocula of tumorigenic cells showed an increased size after addition of fibroblasts to the inocula. The model may be useful in studies of interactions between inoculations of heterologous normal and pathologic cells as well as in studies of differentiation of carcinogen-treated epithelial cells.

Animals↗
PubMed1988

Course of various clinical forms of oral lichen planus. A prospective follow-up study of 611 patients.

The course of reticular, papular, bullous, plaque-type, atrophic and ulcerative lesions of oral lichen planus (OLP) was studied in 611 patients. Mean age of the patients was 53 years and two-thirds were women. The patients were followed for periods from 1 to 26 years (mean, 7.5 years). The various clinical types had somewhat different courses. Papular affections were seen mainly in the initial phase and had a transitory course. Ulcerative lesions, although more persistent, also generally showed a short-term course. The atrophic form was fluctuating with many remissions and new-established affections. The plaque-type was a more constant form, but also demonstrated many newly established affections. After a few years, many patients had persistent lesions that no longer included the affections most characteristic of OLP, i.e. the reticular and the papular form. Initial presence of papular affections was associated with ages below 50 and atrophic lesions with ages above 60. Plaque-type affections were seen with a significantly higher frequency among tobacco smokers at the onset of OLP. No other correlation was found between the initial presence, the remission and the development of the different clinical forms and various factors as age, sex, general diseases, medication and tobacco smoking. Treatment with topical steroid and/or antimycotics had no effect on the long-term course of the various clinical forms, and it had no persistent effect on symptoms related to OLP. Complete remission was seen in 17% of the patients, and it showed a reverse association with the initial presence of plaque-type affections. However, complete remission was associated with an initial presence of papular affections.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1988

Malignant development of lichen planus-affected oral mucosa.

The present report describes malignant development in oral lichen planus (OLP) among 611 patients (409 F, 202 M) followed for periods from 1-26 years (mean: 7.5). During follow-up, 9 patients (1.5%), 8 women (1.9%) and 1 man (0.5%) developed oral squamous cell carcinomas (SCC) in areas of lichen planus lesions. The age of the patients at diagnosis of carcinoma ranged from 56-79 years (mean: 70.4) and the length of follow-up before malignant development ranged from 4.9-24 years (mean: 10.1). The estimated number expected to develop oral cancer in a sample of the general Danish population of similar size, age distribution and follow-up was 0.18 (0.11 F, 0.07 M) i.e., OLP cases showed a 50-fold increase (F = 70- M = 14-fold). The observed number of cancer cases was significantly higher than the estimated number (p less than 0.00001). Therefore, oral lichen planus fulfils the WHO criterion of a premalignant condition.

Aged↗
PubMed1988

Premalignant and malignant oral lesions are associated with changes in the glycosylation pattern of carbohydrates related to ABH blood group antigens.

The distribution of carbohydrate structures related to the ABO(H) blood group antigen system was studied in biopsies from eight squamous cell carcinomas, and eight erythroplakias with epithelial dysplasia. Twenty oral lesions without histological evidence of malignancy (13 lichen planus lesions and 7 homogeneous leukoplakias) were also examined. The distribution of Lex, Ley, H type 2 chain, and N-acetyllactosamine, all type 2 chain carbohydrate structures, was investigated by immunohistological staining using monoclonal antibodies with selected specificity. The histological pattern of expression of these antigens in the benign lesions was similar to that of normal oral mucosa, i.e. expression of: N-acetyllactosamine on basal cells, H antigen on parabasal cells, and Lex and Ley on spinous cells. However, lesions with epithelial dysplasia showed H antigen on all spinous cells, and often also on basal cells, with expression of Lex and Ley restricted to the most superficial part of the epithelium above the H-positive cell layers. In carcinomas most cells were negative for H antigen but were positive for Ley and Lex in 5 out of 8 cases.

ABO Blood-Group System↗
PubMed1988

Fluconazole in the treatment of Candida-associated denture stomatitis.

A double-blind trial was carried out to study the effect of oral administration of fluconazole in the treatment of Candida-associated denture stomatitis. The study group consisted of 38 denture stomatitis patients who harbored yeasts, predominantly Candida spp., in significant numbers as determined by culture from the lesions. Half of the patients received 50 mg of fluconazole per day orally for 14 days, and the other half received placebo capsules. The following parameters were studied: degree of palatal erythema, presence of yeast cells (by plate count and microscopy of smears), identification to the species level of dominant yeast organisms, biotyping of Candida albicans, and treatment-related side effects. A significant reduction of erythema was seen after treatment with fluconazole, but the inflammation showed partial relapse 2 to 4 weeks after treatment was terminated. Reduced soreness of the oral mucosa was reported by six of the patients in the fluconazole group. No significant clinical or yeast flora changes were observed in the placebo group. Extensive changes in the yeast flora were observed in the fluconazole group, both in quantity and in composition of yeast species and C. albicans strains (biotypes), which perhaps indicated differences in pathogenicity and fluconazole susceptibility among various yeast species and C. albicans strains. Fluconazole did not produce any changes in the results of blood and urine analyses. The results indicate that fluconazole is a safe and well-tolerated antimycotic drug. The transient clinical and antimycotic effect may have been due in part to the possibility that therapeutic concentrations of the drug were not reached beneath the fitting denture surface and within the denture plaque.

Aged↗
PubMed1988

Origin of cells in human oral mucosa heterotransplants in nude mice.

Species identification of cells was performed in a model to study epithelial-mesenchymal interactions using combinations of human and murine tissue. The study comprised 34 successfully recovered transplants of human palatal mucosa with 15 human epithelial outgrowths formed on uncertainly species-identified connective tissue. Formalin-fixed and paraffin-embedded 5-micron sections were stained with bisbenzimide (0.8 microgram/ml) and examined in an epifluorescence microscope. The nuclear-staining pattern revealed limited peripheral invasion of the transplanted connective tissue by murine fibroblasts. In areas of epithelial outgrowth a small number of fibroblasts could not be identified but most subepithelial fibroblasts were murine. The study supports previous findings which indicate that the altered differentiation of the human epithelial outgrowths was caused by the murine connective tissue underlying the human epithelium.

Animals↗
PubMed1987

Yeast species and biotypes associated with oral leukoplakia and lichen planus.

Of 36 patients, 17 had oral leukoplakia, including homogeneous and nonhomogeneous types, and 19 had reticular lesions of oral lichen planus. A sample of yeast flora in each patient was taken from the pathologic lesion as well as from normal-appearing mucosa. The isolated yeasts were identified according to species level, and identification was extended beyond the species level for one species, Candida albicans, to reveal the biotype by means of the Odds and Abbott procedure comprising tests for acid and salt tolerance, proteinase production, resistance to 5-fluorocytosine and safranine, and assimilation of urea, sorbose, and citrate. Yeasts were present in the lesions of 82% of leukoplakia patients, compared to 37% of lichen planus patients, a frequency of yeasts corresponding to that in healthy adults. C. albicans was the dominating species in lesions of both diseases, constituting 82% of all yeasts in the leukoplakia lesions. In addition, the following species were identified: Candida tropicalis, Candida pintolopesii, Torulopsis glabrata, and Saccharomyces cerevisiae. Eighteen biotypes of C. albicans were encountered, the most frequently occurring biotypes being 355 and 177. Differences between C. albicans biotypes isolated from pathologic and normal mucosa were encountered in five of eleven leukoplakia patients and in one of three lichen planus patients. This indicates that the oral cavity comprises several ecologic niches for yeasts. As nonhomogeneous leukoplakias are more likely to develop into carcinoma than are homogeneous leukoplakias, it is interesting to note that the C. albicans biotypes isolated from nodular lesions (one type of nonhomogeneous leukoplakia)--biotypes 145, 175, and 575--rarely occur.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗