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The odontogenic fibroma is a rare tumor that has generated controversy, perhaps disproportionately to its importance in the family of odontogenic tumors. The clinical and radiographic features are well documented but the histologic aspects have generated controversy. The behavior is benign, and published accounts indicate a low recurrence rate following treatment by curettage. The tumor recognized by the World Health Organization (WHO) is the legitimate odontogenic fibroma. Histologic variants include the granular cell type and the hybrid odontogenic fibroma giant cell-like tumor. Although the extraosseous "peripheral" odontogenic fibroma presents as a gingival enlargement clinically indistinguishable from other gingival lesions, its histomorphology is similar to the central tumor. A normal dental follicle around the crown of an unerupted tooth may histologically mimic the odontogenic fibroma and other odontogenic tumors.

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Lichen sclerosus et atrophicus is a depigmenting mucocutaneous disease most frequently affecting the female genitalia. Genital lesions are symptomatic and may be functionally debilitating. Oral lesions are of little significance other than the esthetic concerns of perioral lesions. In view of the rarity of reported cases, one lesion of the labial mucocutaneous area and a second of the palate are presented along with a description of the disease's clinical and histopathologic findings and a brief review of the literature. The lip lesion was partially resolved with topical corticosteroids and was then fully eliminated with topical testosterone. Histologic verification and examination for the simultaneous occurrence or absence of oral and the more common genital-cutaneous lesions is essential if meaningful information in the medical-dental literature is to be obtained in the future.

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Papillary lesions of the oral cavity are extremely common, and inflammatory palatal hyperplasia is well known to dental practitioners. Advanced sophistication in viral laboratory technologies makes it apparent that various forms of the human papilloma virus are often causative. However, this is not true for inflammatory palatal hyperplasia. This article describes a patient with anatomically well-demarcated, multiple squamous cell papillomas of the palate that could not be classified as inflammatory palatal hyperplasia, nor could a viral etiology be ascertained, despite exhaustive laboratory studies. The lesion recurred despite numerous surgical ablation attempts. Eradication was achieved only after applying free soft-tissue grafts over the areas of excision. The differential diagnosis of papillary lesions with an emphasis on viral etiology, laboratory studies associated with their identification, and a hypothesis that explains why grafting was the only successful means of treatment are also discussed.

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The authors describe an 11-year-old boy who had persistent oral lesions that clinically mimicked first-episode herpetic stomatitis. A biopsy revealed noncaseating sterile granulomas. Investigation of the small and large bowels revealed that the child had Crohn's disease. The oral lesions responded favorably to topical steroid therapy. The authors also discuss the range of oral lesions in inflammatory bowel disease and the differential diagnoses.

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This report details the experience of two people who suffered a unique type of periodontal atrophy following trigeminal sensory rhizotomy. The cause is unknown but it may be the result of unintentional self-mutilation.

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The purpose of this pictorial essay is to illustrate the radiologic appearances of diseases involving the maxilla and mandible. The high prevalence of dental disease results in inflammatory, infectious, and reactive processes that must be distinguished from more serious conditions with similar radiologic features. Because of their association with odontogenic tissues, lesions of the maxilla and mandible may have radiologic findings not seen in other bones. Furthermore, nonodontogenic cysts and tumors that occur elsewhere in the skeleton may exhibit unique radiologic characteristics when associated with teeth. This pictorial essay presents the radiologic characteristics of inflammatory lesions, developmental abnormalities, fibroosseous lesions, benign cysts and tumors, and malignant lesions of the maxilla and mandible.

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A case of herniation of the antral membrane through a recent extraction site is presented. The lesion was initially diagnosed as a tumor by the referring dentist. Oroantral fistulas are not an uncommon finding after dental extractions. It is rare, however, to see herniation of the antral membrane with large polyps extending through the fistula into the oral cavity. A search of the literature revealed only two other such cases. Surgical removal of the polyps and closure of the oroantral fistula by means of a buccal sliding flap technique is discussed.

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This case illustrates the importance of a thorough clinical history and the benefit of histopathologic examination. The history of contact allergy to jewelry provided an early clue, and the microscopic features confirmed the clinical impression of allergic stomatitis.

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Histoplasmosis is a fungal disease resulting from inhalation of airborne spores of the organism Histoplasma capsulatum. The disease is endemic to the Ohio and Mississippi river valleys. Oral lesions are not common, but when present, they are usually associated with the severe disseminated form of histoplasmosis. This particular case is presented as an example of chronic pulmonary histoplasmosis in which a localized gingival lesion represented the initial clinical manifestation of the disease. Diagnosis was based on a positive biopsy and the results of chest radiographic examination. If, as in this case, serologic, hematologic, and physical examination results are negative, the biopsy of suspicious lesions is of paramount importance to the clinical differential diagnosis.

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Hyaline ring-like structures are often encountered during microscopic evaluation of inflamed tissues from the oral cavity. The exact etiology remains unknown. Two theories exist. One favors intrinsic origin, most likely collagen, while the other suggests extrinsic origin, vegetable material. The literature is reviewed and histologic features are illustrated.

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Diagnostic problems within the oral cavity may be associated with lesions of the odontogenic apparatus, salivary glands, bone, mucosa, and connective tissue. Some lesions are unique to the oral cavity, others have a systemic distribution. Several unique and controversial lesions have been selected for discussion, including (1) necrotizing sialometaplasia, a benign salivary gland disease easily mistaken for malignancy; (2) verrucous lesions including verrucous carcinoma, verrucous hyperplasia, and papillary carcinoma; (3) spindle-cell carcinoma, which is often confused with sarcoma; (4) named and unnamed embryonic rests, which may resemble metastatic carcinomas; (5) dental pulp mistaken for odontogenic myxoma; and (6) granular cell tumor with associated pseudoepitheliomatous hyperplasia.

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Two examples of central odontogenic fibroma, WHO type, are reported. The radiographic and microscopic features are discussed and illustrated. Both were treated by curettage, and neither has recurred after 10 and 9 years, respectively. We postulate an ectomesenchymal-epithelial interaction in the histogenesis of this unusual tumor.

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Two cases of myospherulosis are reported. The history, histopathology, and nature of this condition are discussed. The placement of antibiotic ointment with a petrolatum base in oral wounds may be of significance. Petrolatum may provoke an inflammatory reaction and remain in tissue for years.

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Seven examples of an unusual hyalin degenerative change in the walls of blood vessels are discussed. We believe this is a localized phenomenon, not connected to systemic vascular disease. Inflammation is usually present, and in each case a dental procedure had previously been performed. Dental extraction was the most common procedure. Giant cells of the foreign-body type are present, but particulate foreign material was seen in only one case.

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The administration of two different doses of indomethacin, 9 and 18 mg/kg, to two different groups of rabbits was followed 6 h later by a significant decrease in plasma renin activity, and these levels were not increased by hemorrhage. The administration of 2 mg/kg of indomethacin did not alter the basal levels of plasma renin activity, but it was effective in diminishing the peripheral increase of renin produced by hemorrhage. Similar effects were obtained in other groups of rabbits treated with 9 mg/kg of meclofenamate or 18 mg or aspirin. The lowering effect of indomethacin on plasma renin activity is not specifically related to hemorrhage because it also prevented the increase in plasma renin activity elicited by 5 mg/kg of furosemide. Further studies showed that indomethacin did not exert any significant effect in vivo on the plasma level of renin substrate or on the generation of angiotensin from normal plasma by exogenous renin. And indomethacin did not interfere with the binding capacity of anti-angiotensin I for angiotensin I in the radioimmunoassay reaction or with the in vitro formation of angiotensin from hog renin-nephrectomized rabbit plasma reaction. The results thus indicate that the lowering effect of indomethacin on plasma renin activity is due to the interference with renal renin release. That this effect may be related to the blockade of prostaglandin synthesis is suggested by the similar effect exhibited by other blockers of prostaglandin synthesis.

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