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Biomedical subjects

T D Daley

Publications and source records attributed to T D Daley.

At least 19 recordsLinked to original sources

Atypical cartilage in reactive osteocartilagenous metaplasia of the traumatized edentulous mandibular ridge.

Eighteen cases of reactive osteocartilagenous metaplasia of the edentulous mandibular alveolar ridge forming clinical masses that mimic neoplasms are reported. Although most of these lesions appeared histologically benign, three exhibited atypical microscopic features suggestive of chondrosarcoma. Of those cases that were followed, none of the lesions recurred after simple surgical excision. Because many investigators consider all cartilagenous lesions of the jaws potentially malignant, the importance of recognizing this benign condition is stressed.

Adult

Foreign body gingivitis: clinical and microscopic features of 61 cases.

Gingival inflammation associated with foreign bodies in connective tissue is termed foreign body gingivitis. It is not recognized commonly by clinicians and has not been described fully in the literature. This study examined the clinical and microscopic features of 61 cases of foreign body gingivitis. It was more common in women and occurred at a mean age of 48 years. It presented most frequently as a red or red and white painful chronic lesion that had been present for less than 1 year. Often it was diagnosed clinically as lichen planus. There was no gingival site predilection. Microscopically, foreign bodies, usually less than 5 microns in diameter, were found in an area of moderate to severe inflammation composed of lymphocytes, histiocytes, and plasma cells. The inflammation frequently was granulomatous and sometimes lichenoid.

Adolescent

Foreign body gingivitis: identification of the foreign material by energy-dispersive x-ray microanalysis.

Foreign bodies identified in 61 cases of foreign body gingivitis were analyzed by energy-dispersive x-ray microanalysis. This was compared with the energy-dispersive x-ray microanalysis of 62 dental materials. Comparative analysis indicated most foreign bodies were of dental material origin, usually abrasives. It is suggested that they are factitially and iatrogenically introduced during a variety of self-administered and professionally performed dental hygiene and restorative procedures. Individual elements, and elements by class, were correlated with previously described clinical and microscopic features of the cases. There was no association between any microscopic or clinical attribute of FBG and the presence of allergenic or cytotoxic elements. It is postulated that the physical presence of foreign bodies may be sufficient for the development of foreign body gingivitis. Dentists should be aware of the potential for chronic tissue damage that can result from the unguarded use of abrasive material next to the gingiva.

Adolescent

Common salivary gland disorders: an update.

Disorders of the salivary glands range from common inflammatory and functional conditions, to rare types of neoplasms. An overview and update of selected, common non-neoplastic and neoplastic conditions is presented.

Humans

Osteopathia striata, short stature, cataracts, and microdontia: a new syndrome? A case report.

A case of osteopathia striata, childhood cataracts, short stature, elbow deformity, and microdontia with rhizomicry in a white male is reported. The report includes a detailed analysis of dental changes. The relationship of this syndrome to other similar conditions including osteopathia striata with cranial base sclerosis and Rothmund-Thomson syndrome are discussed.

Bone Diseases, Developmental

Salivary gland duct involvement in oral epithelial dysplasia and squamous cell carcinoma.

The clinical implications and prognostic significance of oral dysplastic or cancerous epithelium involving salivary gland ducts have not been previously investigated. Screened routine tissue sections of 1216 cases of oral epithelial dysplasias and squamous cell carcinomas revealed 26 examples (2.14%) that exhibited unequivocal ductal involvement. Ductal involvement was more likely to occur in floor of mouth lesions and in lesions exhibiting severe dysplasia or carcinoma in situ. Clinical follow-up on 23 cases showed that the recurrence rate of the preinvasive lesions that exhibited ductal involvement was equal to that of the squamous cell carcinomas. The depth of ductal dysplasia did not correlate with recurrence rate. These results suggest that the involvement of salivary gland ducts by oral epithelial dysplasias and carcinomas in situ is an uncommon but significant finding. Surgical stripping or ablation of such lesions should extend at least 3 mm below the surface to ensure eradication of these reservoirs of dysplastic cells.

Aged

Schwann cell differentiation of modified myoepithelial cells within adenoid cystic carcinomas and polymorphous low-grade adenocarcinomas: clinicopathologic assessment of immunohistochemical staining.

Adenoid cystic carcinomas and polymorphous low-grade adenocarcinomas have a known propensity for perineural invasion. Although modified myoepithelial cells have been shown to possess characteristics of a variety of cell types, they have not yet been found to mimic nerve tissue. Histologic evidence of Schwann cell differentiation would suggest the pathophysiologic mechanism by which these tumours exhibit neurotropism. An archival study of 41 specimens was performed to evaluate the Schwann cell staining properties of adenoid cystic and polymorphous low-grade adenocarcinomas using antibodies to S-100 protein, GFAP, neuron-specific enolase, and using a solochrome stain. Charts were reviewed to assess correlations between immunohistochemical and histochemical staining properties and various clinical parameters. The findings strongly suggest that neuronal differentiation does occur within these tumours. Furthermore, it was determined that solochrome positivity confers a significantly less favourable disease-free interval in these neoplasms. This new finding was highly statistically significant and has potential implications in the determination of prognosis for patients with these tumours.

Adenocarcinoma

The small dentigerous cyst. A diagnostic dilemma.

The dentigerous (follicular) cyst is recognized as one of the most common lesions of the jaws. Clinical, radiographic, histologic, and prognostic characteristics are well established for medium to large pericoronal cysts that are lined by nonkeratinized stratified squamous epithelium. However, it can be difficult, if not impossible, to distinguish between a small dentigerous cyst and a large dental follicle despite the availability of both radiographic and histologic information. Epidemiologic data derived from a comparative study of 1662 dentigerous cysts and 824 dental follicles showed considerable overlap in age distribution and site predilection and were therefore of minimal use in reaching a final diagnosis. At present, it appears that identifying a cystic cavity at the time of surgery may be the only reliable way to arrive at a definitive diagnosis when radiographic and histologic features are insufficient to distinguish between a small dentigerous cyst and a large dental follicle.

Adolescent

Exfoliative cheilitis.

Exfoliative cheilitis is an uncommon condition affecting the vermilion zone of the upper, lower or both lips. It is characterized by the continuous production and desquamation of unsightly, thick scales of keratin; when removed, these leave a normal appearing lip beneath. The etiology is unknown, although some cases may be factitious. Attempts at treatment by a wide variety of agents and techniques have been unsuccessful. Three patients with this disease are reported and its relationship to factitious cheilitis and candidal cheilitis is discussed.

Adolescent

Peripheral odontogenic fibroma.

The peripheral odontogenic fibroma is characterized by a fibrous or fibromyxomatous proliferation that contains varying amounts of odontogenic or presumed odontogenic epithelium. It has been considered a rare gingival neoplasm that, because of a lack of follow-up information in most reported cases, has had an unknown biologic behavior. Clinical data from this study indicate that the lesion is more common than previously reported and that it has a significant recurrence rate. Light and electron microscopic data reveal a relatively broad spectrum of epithelial and mesenchymal components, including a rare granular cell type. Because the presence of both epithelial and mesenchymal elements are required for its diagnosis, the lesion is logically classified as a mixed epithelial/mesenchymal odontogenic tumor, rather than a purely mesenchymal tumor.

Adolescent

Peripheral odontogenic keratocyst.

The gingival cyst of the adult exhibits an epithelial lining that is essentially the same as the lateral periodontal cyst. Although the gingival cyst of the adult exhibits some morphologic variability, its lining is generally considered to be nonkeratinized. Nonetheless, rare cases of gingival cyst of the adult that exhibit a keratinized epithelial lining have been reported in the literature. There is now a growing tendency to consider this variant as a separate entity. This article describes six cases of gingival cysts that exhibit the histologic features of the odontogenic keratocyst. Evidence from this series suggests that the biologic behavior of this subset of gingival cysts is different from that of the generic gingival cyst of the adult and that the term peripheral odontogenic keratocyst more accurately describes this entity.

Adult

Relative incidence of odontogenic tumors and oral and jaw cysts in a Canadian population.

The diagnoses of 40,000 consecutively accessioned oral biopsies from the Oral Pathology Diagnostic Service, University of Western Ontario, London, Canada, were reviewed. All odontogenic neoplasm, neoplasm-like lesions (tumors), and true cysts of the oral tissues and jaws were listed. Clinical data were reviewed, and microscopic diagnoses were confirmed for cases in which diagnoses were ambiguous. Records of all cases were examined to identify distant referrals that were not representative of the study population. Of a total of 445 (1.11%) odontogenic tumors, 392 (0.98%) were lesions from patients in the usual local drawing area of the biopsy service; 53 were referred from distant centers. From the local population, odontomas were by far the most common tumor (51.53%) followed by ameloblastomas (13.52%) and peripheral odontogenic fibromas (8.93%). Locally, radicular (periapical) cysts were the most common odontogenic cyst (65.15%) followed by the dentigerous cyst (24.08%) and the odontogenic keratocyst (4.88%). The most common nonodontogenic cyst was the nasopalatine duct cyst that accounted for 73.43% of this subset of cysts. Surprisingly few studies of this type are available, especially for odontogenic tumors. These data are important to assess geographic differences in the incidence of lesions and to allow clinicians to make realistic judgments in counseling patients before biopsy about the probability of diagnosis and risks associated with nonspecific clinical or radiographic lesions.

Humans

Intraoral sebaceous hyperplasia. Diagnostic criteria.

Surprisingly little is understood about the physiologic and pathologic processes that involve intraoral sebaceous glands. Neoplasms are rare. Hyperplasia of these glands is undoubtedly more common, but criteria for the diagnosis of intraoral sebaceous hyperplasia have not been established. These lesions are too often misdiagnosed as large "Fordyce granules" or, when very large, as sebaceous adenomas. On the basis of a series of 31 nonneoplastic sebaceous lesions and on published data, the following definition is proposed: intraoral sebaceous hyperplasia occurs when a lesion, judged clinically to be a distinct abnormality that requires biopsy for diagnosis or confirmation of clinical impression, has histologic features of one or more well-differentiated sebaceous glands that exhibit no fewer than 15 lobules per gland. Sebaceous glands with fewer than 15 lobules that form an apparently distinct clinical lesion on the buccal mucosa are considered normal, whereas similar lesions of other intraoral sites are considered ectopic sebaceous glands. Sebaceous adenomas are less differentiated than sebaceous hyperplasia.

Adenoma

Focal epithelial hyperplasia (Heck's disease) with generalized lesions of the gingiva. A case report.

Focal epithelial hyperplasia is an uncommon benign oral condition that occurs mainly in young individuals of certain racial groups. The lesions most commonly affect the mucosal surfaces of the lips and they have been observed frequently to regress within a few months. This is a report of an unusual case of focal epithelial hyperplasia in a young black adult presenting with generalized involvement of the gingiva. There is no clinical evidence of regression of the lesions and the case remains similar to the original appearance 2 years after diagnosis. The diagnosis and management of focal epithelial hyperplasia are discussed.

Adult

Palisaded encapsulated neuroma of oral mucosa.

The palisaded encapsulated neuroma is a solitary, small peripheral nerve lesion that occurs primarily on the facial skin of middle-aged adults. We report a series of 13 cases of palisaded encapsulated neuroma occurring on oral mucosa. The lesions presented as solitary, firm, sessile, partly or completely encapsulated, 2 to 3 mm nodules in adults with a mean age of 51 years (median 55 years). Nine of the neuromas occurred on the hard palate; the remainder were found on the soft palate, lower lip mucosa, upper lip mucosa, and maxillary anterior alveolar ridge. None of the cases was associated with neurofibromatosis or multiple endocrine neoplasia syndrome type III. Microscopically, the tumors were characterized by a moderately cellular, fascicular proliferation of spindle cells that showed some areas of nuclear palisading, suggestive of schwannoma. Immunohistochemical stains revealed that the lesions were composed largely of S-100 protein-positive Schwann cells and variable numbers of peripheral nerve axons, which were identified by their positive neurofilament staining. The fibrous capsule of the lesions showed positive staining for epithelial membrane antigen, indicative of perineurium.

Adult

Langerhans' cell histiocytosis in association with periapical granulomas and cysts.

This report describes a series of six cases of inflammatory periapical disease with small aggregates of Langerhans cells as a minor component. Immunohistochemical findings confirm that the cells are phenotypically related to Langerhans cells. Aggregates of these cells are not normally found in radicular cysts or periapical granulomas and have been interpreted to represent chronic localized Langerhans' cells histiocytosis. Whether these lesions, which arise within the context of chronic inflammatory periapical disease, represent incipient eosinophilic granulomas or are a more benign, minimally destructive form of Langerhans' cell histiocytosis is unknown. Clinical follow-up suggests that these lesions remain localized and that curettage is adequate treatment.

Adult

Oral pathology in Canada: a survey.

The Canadian Academy of Oral Pathology conducted a survey of its active members to obtain information on their demographics, professional activities and university affiliations, and to assess Canada's present and future oral pathology needs. Data were also collected on Canadian oral pathology diagnostic biopsy services. This paper reports the salient findings of the survey, and discusses their implications for the specialty of oral pathology as well as for the Canadian dental community.

Adult