Flow cytometric analysis of nuclear DNA content in oral leukoplakia

DNA ploidy has been studied in 31 paraffin-embedded specimens of oral leukoplakia and in 10 specimens of oral leukoplakia that have undergone malignant transformation after a 5-year observation period. Three out of 31 specimens (9.7%) showed an aneuploid DNA pattern, with DNA indices of 1.17, 1.28 and 1.32. It was not possible to establish a statistically significant difference of DNA ploidy related to the presence or absence of dysplasia. One out of the 10 oral leukoplakias that underwent malignant transformations had a multiploid pattern with DNA indices of 1.44 and 2.37. In this study the DNA index has not proved to be of value in the identification of dysplastic leukoplakia among the non-dysplastic ones.     

Er,CR:YSGG lasers induce fewer dysplastic-like epithelial artefacts than CO2 lasers: an in vivo experimental study on oral mucosa

Our aim was to assess wounds made by lasers (CO₂ and Er,Cr:YSGG) for their epithelial architectural changes and width of damage. We allocated 60 Sprague–Dawley^® rats into groups: glossectomy by CO₂ laser at 3 different wattages (n = 10 in each); glossectomy by Er,Cr:YSGG laser at two different emissions (n = 10 in each), and a control group (n = 10). Histological examination assessed both prevalence and site of thermal artefacts for each group. Both lasers (CO₂ and Er,Cr:YSGG) caused the same type of cytological artefacts. The 3 W Er,Cr:YSGG laser produced the fewest cytological artefacts/specimen, and was significantly different from the other experimental groups: 3 W CO₂ laser (95% CI = 0.8 to 1.0); the 6 W CO₂ laser (95% CI = 0.1 to 2.0) and the 10 W CO₂ laser (95% CI = 1.1 to 3.0). CO₂ lasers (3–10 W) generate epithelial damage that can simulate dysplastic changes with cytological atypia that affects mainly the basal and suprabasal layers. Irradiation with Er,CR:YSGG laser (2–4 W) produces significantly fewer cellular artefacts and less epithelial damage, which may be potentially useful for biopsy of oral mucosa.     

Nursing, diabetes, and periodontal disease

In primary health care, the specific contribution nurses make to the community they serve manifests itself clearly when treating individuals suffering from chronic illnesses, with whom nurses basically fulfill an educational role. In the control of diabetics, a nurse plays a fundamental role in their periodical check-ups and their education about diabetes. Nonetheless, it is not a common practice to provide an adequate treatment for these pathologies nor oral hygiene self methods during these office visits, when the time requirements are not extensive and when the information available highlights the need to contemplate oral hygiene in both educational aspects and check-ups for diabetics, regardless of his/her age or the degree of metabolic control.     

Assessment of dental students' ability to recognise precancerous lesions and conditions

The role of dentists in both primary (promoting a healthier lifestyle) and secondary (early diagnosis) prevention of oral cancer is undeniable, and becomes particularly important as oral cancer is thought to be preceded by premalignant lesions or conditions in about one half of the cases. In these situations, there is the possibility for an early diagnosis which will definitively influence the survival rate. Thus, it is an undergraduate educational objective related to secondary prevention of oral cancer to increase the efficacy of screening of precancerous lesions/conditions. A questionnaire with 38 clinical cases including 16 benign lesions, 9 malignant lesions and 13 precancerous lesions or conditions was applied voluntarily to 3rd, 4th and 5th year University of Santiago de Compostela dental students on April 1996. The participation rate was 90% of the 3rd-year students, 60% in 4th-year class, and 50% of the 5th-year group. The agreement in the diagnosis with a panel of experts reached 81.45% for 5th-year students. Students of 3rd- and 4th-year scored lower percentages, probably due to the rarity of some of the conditions in our area. 5th-year students scored significantly higher values than 3rd-and 4th-year students.     

Gingival squamous cell carcinoma: diagnostic delay or rapid invasion?

BACKGROUND: The similarity between gingival squamous cell carcinoma (GSCC) and more common periodontal lesions may lead to a delay in diagnosis or misdiagnosis. Neoplastic lesions of gingival tissues are frequently diagnosed at an advanced stage. METHODS: To assess the relative time from when patients first become aware of the problem to histopathologic diagnosis (total diagnostic time), 59 consecutive oral cancer cases were examined in this study. The following variables were considered: age, gender, smoking habits, tumor stage at diagnosis, and total diagnostic time. The median of the patients' total diagnostic time (1.5 months) was used as a cutoff point to distinguish between delayed and non-delayed cases. Analysis of the variables was undertaken using the Student t test and chi2 test, with a 95% confidence interval (CI). RESULTS: The total diagnostic time was <1.5 months for 75% of gingival carcinomas, 50% of tongue carcinomas, and 78% of floor-of-the-mouth carcinomas. It was >1.5 months for 25% of gingival carcinomas, 50% of tongue carcinomas, and 21% of floor-of-the-mouth carcinomas. No significant differences in time before diagnosis were found when gingival cancers were compared to other oral tumors (chi2=0.21; 95% CI=-0.40 to 0.26). However, by the time of diagnosis, gingival cancers had invaded adjacent structures more frequently than other oral cancers (chi2=13.51; 95% CI=0.18 to 0.85). CONCLUSIONS: The gingival location of oral squamous cell carcinoma (OSCC) was associated with advanced stages at the time of diagnosis, due to early invasion of contiguous bone tissue (T4-primary tumor). This would indicate that even earlier referral and diagnosis are necessary.     

Technological bases for teledermatopathology: state of the art

Teledermatopathology can be defined as a telemedicine application related to histological diagnosis of cutaneous specimens. Its development and implementation around the world is very heterogeneous due to the wide range of existing geographical, social and healthcare conditions. This paper reviews the technological bases for static (use of images generated at one side, stored on a computer, and then transmitted to another site for a second diagnosis) and dynamic teledermatopathology (interaction between an user located on a remote area and a histological video image captured from a microscopy which allows navigation across the slide) as well as for virtual microscopy. The use of teledematopathology could increase the healthcare standard and the accessibility to the health care system in developing countries. However, some limitations related to economic, medico-legal and technical issues still remain, particularly when dealing with inflammatory skin diseases.