Fogorvosi szemle, 2006 (99. évfolyam, 1-6. szám)
2006-04-01 / 2. szám
FOGORVOSI SZEMLE ■ 99. évf. 2. sz. 2006. 73 The innovative part of the lecture is the overview on the opportunities for instrumental patient-monitoring before and during theraphy, the adoptation of algorithms in the dentist’s surgery. At the end of the course, the author gives exposition for the suggestible medicines, and offers some pieces of practical advice. DR. F. KOPPÁNY, DR. Á. JOÓB-FANCSALY, DR. L. PATAKY, DR. GY. SZABÓ, DR. J. BARABÁS Semmelweis University, Department of Oral and Maxillofacial Surgery, Budapest THE TOLE OF THE DENTIST IN OSTEOPOROSIS CHECK-UP - DIAGNOSTIC POSSIBILITIES Osteoporosis severely affects global health involving 200 million people worldwide. 7-10 percent of the inhabitants suffer from it in Hungary. People with osteoporosis have decreased working abilities and the treatment of the consequential diseases is very expensive. The numbers show an increasing rate: the number of osteoporotic fractures in the EU increased by 25 percent during the past four years and there is a fracture in every 30 seconds. Early diagnosis can decrease the fracture risk by 40 percent. The disorders of bone turnover affects the whole skeleton so dental panoramic imaging with densitométrie evaluation can play an important role in assessing osteopenia. DR. V. KOVÁCS, DR. GY. KÖVESI, DR. I. GERA Semmelweis University, Department of Periodontology, Budapest NECROTIZING SIALOMETAPLASIA - A CASE REPORT N.S. is a rare, self-limiting, variably ulcerated, benign, inflammatory process, predominantly affecting salivary tissue. It can appear anywhere where minor salivary glands exists, mostly on the palate. Although the aetiopathogenesis of N.S. remains unknown, there is a general consensus that an ischemic event in the salivary gland precedes the development of the lesion. N.S. resolves spontaneously, no treatment is necessary. The clinical and histopathological features of N.S. often simulate those of malignancies, such as squamosus cell carcinoma or mucoepidermoid carcinoma. All subsequent reports on N.S. stress the importance of correct differential diagnosis. Familiarity with N.S. and correct diagnosis are paramount in avoiding misdiagnosis and inappropriate treatment. Case report: N.S. is a rare disease. This statement is also proved by the fact that only two (!) cases had been documented in the last 30 years at the Oral Medicine department of the Semmelweis University. The first case appeared more than 25 years ago, in 1980. The 30 year-old-man has been sent to our Clinic with the diagnosis of palatal carcinoma. On the palate we could see two symmetric, yellow, ulcerated and necrotic circle. The patient had been treated with 1000 mg Tetracyclin/day and controlled 2 times a week. The deep ulcers cleaned up in a week, and 2 weeks later they had been almost totally reepitheliased. The second case had been found in December of 2004. At the first visit we could see a big necrotic ulcer (3 cm in diameter), without any inflammatory demarcation. As treatment we made wound-toilette and prescribed 100 mg/day Doxycyclin for two weeks. First the patient was controlled every three days, later once a week. On the second week a biopsy was taken from the marginal area of the necrosis to prove our preliminary clinical diagnosis. The histological finding was: Hyperkeratotic tissue with some dysplasia in it, without any sign of malignancy. Subsequently patient was on a one week recall, to follow up her healing. The complete healing needed more than two months. Results, discussion: Despite the fearsome look of the N.S., it is a benign lesion with spontaneous healing. It is an extremely rare but important condition, because it often simulates the clinical features of malignancies. Incorrect diagnosis often leads to inappropriate and unnecessary treatment, not to mention that the patient lives for weeks under the psychological stress of having a malignancy. DR. GY. KÖVESI, DR. B. SZENDE * I. Semmelweis University, Department of Periodontology, and I. Pathology and Cancer Research Institute and MTA-SE EKS Molecular Pathology Research Group, Budapest PROGNOSTIC SIGNIFICANCE OF CYCLIN D1, P27 AND P63 IN ORAL LEUKOPLAKIA Studies on expression of genes regulating cell proliferation and apoptosis are of importance in relation to understanding the severity of the process and the possibility of malignant transformation. In the present study immuno-histochemical demonstration of cyclin D1, p27 and p63 has been added to our previous investigation on KÍ67, p53 and apoptosis index. Clinical and pathological-immuno-histochemical studies on oral leukoplakia of 18 patients were performed. Clinically homogenous, non-homogenous or nodular, and erythroleukoplakia were distinguished. Pathologically the grading was made according to the degree of dysplasia. Immunoperoxidase reactions for cyclin D1, p27 and p63 were carried out, and the positivity was expressed in percent considering 1000 epithelial cells. Expression of cyclin D1 increased in parallel with the severity of leukoplakia. P27 expression was 14-16 percent in homogenous and nodular leukoplakia, whereas in erythroleukoplakia it decreased to 1-2 percent. P63 expression 10 percent in average in homogenous and 5 percent in nodular leukoplakia. While in erythroleukoplakias it increased to 20 percent. The characteristic cyclin D1, p27 and p63 phenotype in various forms of leukoplakia may consider as prognostic factors.
