NNK (4-(methylnitrosamino)―1-(3-pyridyl)-1-butanone) is a major form of nitrosamine abundant in cigarette smoke and is a powerful carcinogen. Mercury is a major component of the amalgam that is widely used as dental filling material. Concurrent exposure to these two agents may result in their interaction and alter their carcinogenic potential. The present study used an immortalized human epithelial cell system that allows continuous exposure to potential carcinogens, in an attempt to elaborate the carcinogenic potential of mercury and NNK in humans. Cytotoxicity of mercury chloride and NNK was measured by an MTT assay. Parameters of neoplastic cellular transformation such as cell saturation density, soft-agar colony formation, and cell aggregation were analyzed to examine the carcinogenic potential of mercury chloride and NNK. The study showed that exposure to mercury chloride with NNK resulted in increased soft agar colony formation and cell aggregation. ROS generation by mercury chloride was further enhanced by treatment with NNK. The apoptosis that was observed following mercury chloride exposure was further increased upon co-treatment with NNK. The interaction between these two agents was also observed in cytokine mRNA induction. In the present study, mercury alone did not seem to pose a significant threat as a carcinogen, but it may have potential to enhance the carcinogenic potential of a known carcinogen from cigarette smoke. The present study provides valuable data regarding the evaluation of potential carcinogenic risk of mercury chloride and NNK on concurrent exposure.

External root resorption is one of the rare pathological condition of tooth. It is occurred when periodontal ligament or cementum on the root surface are either damaged or denuded. The causes and classifications have been variously described. Because of the various causes and patterns, and absence of sufficient and consistent evidence for treatment, proper diagnosis and treatment plan based on clinician’s experience and close communication with patient is important. This case report represents the rare case of external root resorption and the treatment. The tooth was retained functionally in oral cavity showing good healing state in 2-year follow-up.

A nineteen years old male patient showed a cystic lesion in left maxillary canine to premolar area (#23-#25). This lesion was asymptomatic, and found during his routine radiological check in local clinic. In the radiological observation the cystic lesion showed round radiolucent image containing many calcified bodies which were usually small but irregular in shape, expanding tumorously and resulted in the displacement of canine and second premolar in the absence of first premolar. The lesion was surgically enucleated, and a cystic fibrous tissue containing abnormal teeth was removed and examined pathologically. With the histological observation of tumorous odontogenic epithelium including many ghost cells, which were closely associated with abortive teeth, the lesion was finally diagnosed as CCOT associated with complex odontoma. The ghost cells of CCOT was strongly positive for β-catenin, GADD45, and LC3, and slightly positive for MMP-9, while they were rarely positive for BCL2, Wnt1, HSP-70, and p38. Therefore, it was presumed that the ghost cells of CCOT might undergo dormant cell state through altered cytodifferentiation stimulated by severe growth arrest, DNA damage signaling, and abundant autophage formation.

Oral Fibrolipoma on Palate: A case report Jung-Won Park, Tea-Young Jung, Sang-Jun Park Department of Oral and Maxillofacial Surgery, Inje University Busan Paik Hospital, Busan, Korea Fibrolipoma, a variant of lipoma, is rare in oral cavity, and the pathogenesis is uncertain. The diagnosis and differentiation of fibrolipoma with other clinically similar lesions is very essential for proper treatment planning. We present a case of fibrolipoma on palate of a 28-year-old male.

Oral hyperpigmentation is common in patients older 40 years. But lesions in a newborn are unusual and congenital melanotic macule of the tongue has rarely been reported. A 2-month-old infant with 3 pigmented lesion on the right side of the dorsal tongue was evaluated. They were brown black but not homogeneous in color, smooth, nonblanchable, and nonpalpable, with irregular margins. We recommend excisional biopsy under general anesthesia because of possibility of malignancy, but parents refuse invasive procedure. On a following-up examination of the child at the age of 1 year, the pigmented lesions were unchanged. We report a case of congenital melanotic macules on the tongue and a review of literature about the lesion.

Cisplatin is a well-known platinum-containing anti-cancer drug against bladder, ovarian, lung and testicular cancer. However, the potential effects and molecular targets of cisplatin in human mucoepidermoid carcinoma (MEC) are not fully understood. Here, we investigated the apoptotic effect and underlying mechanism of cisplatin in human MEC cells. The potential effects of cisplatin were evaluated by trypan blue exclusion assay, Western blotting, 4’-6-diamidino-2-phenylindole (DAPI) staining, live/dead assay and immunocytochemistry. Cisplatin suppressed cell growth and enhanced expression of cleaved PAPR in MC3 and YD15 cells. Cisplatin caused morphological change of nuclei and increased the number of ethidium homodimer-1-stained cells. In addition, cisplatin commonly increased Bax activation in both cells, while other Bcl-2 family proteins were not affected. These results suggest that cisplatin might induce apoptosis by activating Bax protein, which would provide baseline data for development of effective treatment strategy against MEC.

Aneurysmal bone cyst (ABC) in maxilla is a rare and benign lesion but shows extensive bony destruction, occasionally accompanied with secondary osseous lesions, i.e., central giant cell granuloma, ossifying fibroma, fibrous dysplasia, etc. As the pathogenesis of ABC has not been clearly defined, ABC is diagnostically challenged due to its variable histological features. A 17-year-old boy showed a huge radiolucent lesion at right anterior maxilla, which was accidentally found in routine dental-radiological examination for orthodontic treatment. He had no medical history of systemic disease, and did not remember any traumatic experience on his right anterior maxilla. The radiolucent lesion involved periapical area from right central incisor to right first premolar, and was clinically diagnosed as odontogenic keratocyst. During surgical operation a cyst-like sac was enucleated with severe hemorrhage. In the histological observation the thick fibrous sac showed no lining epithelium, and its luminal side disclosed multiple aneurysmal spaces which were shrunken and almost obliterated. The fibrous sac itself was hyperplastic with abundant vascular channels, and produced fibromatous thickening associated with ossifying trabecular bones. This fibro-osseous tissue was hamartomatous, which was not directly connected and organized with marrow bone of maxilla. Finally, the present case was diagnosed as secondary type ABC differentially from traumatic bone cyst (TBC), odontogenic cyst, and central reparative granuloma. And it was presumed that the hamartomatous proliferation of fibro-osseous tissue in the cystic sac of ABC could produce the swelling pressure effect in the bone marrow similar to the overgrowth of central giant cell granuloma, ossifying fibroma, fibrous dysplasia, etc., in the secondary type ABC.

The follicular lymphoid hyperplasia is a very rare nonneoplastic lymphoproliferative disease in the oral mucosa. Clinically, it usually presents as asymptomatic, non-ulcerated, normal-colored, soft, sessile, unilateral and slow growing mass in the posterior hard palate. Therefore, soft-tissue mass of the hard palate can be a difficult diagnostic challenge for the clinician. Herein, we report a case of follicular lymphoid hyperplasia located in the left posterior hard palate. A 40-year-old male presented a soft, non-ulcerated, painless mass of 1.5 × 1.0cm in size. Radiographically, it was no bony involvement. Histology revealed germinal center surrounding mantle zone of small lymphocytes. Immunohistochemistry showed CD3,CD20 were postive but Bcl-2 and cyclin D1 were negative. The patient underwent surgical excision and 3-year follow-up has not shown any evidence of recurrence.

Calcipex II, calcium hydroxide paste, is used widely as intracanal dressing material during root canal treatment. When extrusion of calcium hydroxide through root canal occurred, various tissue reactions have been reported. Herein, we report a case of chronic maxillary sinusitis induced by extrusion of Calcipex II. A 20-year-old male was referred our institution during #26 root canal treatment. Radiographically, it was presented radiopaque round mass with sinus mucosal thickening. The mass was excised and analyzed histologically. Histology revealed Calcipex II granules engulfed by macrophages and chronic maxillary sinusitis around Calcipex II granules.

Composite resins are developed as restorative materials to improve esthetics and mechanical properties. To improve the physical properties of resin material, resin filler have to be added. However, no imaging method is adopted for resin filler distribution. Optical coherence tomography (OCT) is a optical imaging technique to delineate microscopic structures within biological tissue. The OCT application to dental composites resin and its filler is not described yet. So, this new and advanced optical method is needed for clinical application for evaluation of dental composite resin. To analyze the spatial distribution of dental composite resin and to evaluate the resin restoration in cavity, frequency domain optical coherence tomography (FD-OCT) was used for their analysis. Resin restored tooth was prepared. For morphological observation, serially sectioned teeth, conventional X-ray taking and micro computed-tomography (CT) images were compared with OCT images. The experiment has done to evaluate the success of the resin restoration using 3 dimensional structure OCT image. In this research, OCT is evaluated as a new technique to image resin restoration. The evaluation of resin restored tooth was performed by OCT. Inappropriate restoration such as marginal adaptation, large porosities, internal integrity and poor contour could be detected. Resin filler also could be checked by OCT. The distribution, number, regularity and size of resin filler can be differentiated from several commercial products. Considering the characteristics of the OCT, it can be used to evaluate the defects of resin restoration, resin filler distribution, and internal integrity between resin material and tooth structure. The OCT can be considered to be a new and advanced method for the evaluation of resin restorations.

Extramedullary plasmacytomas (EMPs) are rare soft tissue malignant neoplasms composed of plasma cells. They are sometimes found in soft tissues. The majority of primary EMPs occur in the head and neck region, especially in the upper respiratory tract and oral cavity. We present a case of a 52-year-old female with an EMP. The patient’s initial chief complaint was swelling of the soft palate. An excisional biopsy was performed under general anesthesia. Final pathologic diagnosis was EMP of the soft palate with partial involvement of the resection margin. In order to exclude the possibility of multiple myeloma, a bone marrow exam with chromosomal study was completed. The patient was also referred to the Department of Radiation Oncology for postoperative radiation therapy (PORT); however, the patient refused to undergo PORT. The patient is currently under close observation for signs and symptoms of recurrence or metastases through regular follow-up visits and imaging studies.

The purpose of this case report was describe the management of impacted and dilacerated mandibular secondary primary molar with cystic formation associated with odontoma. A four-year-old male patient was presented unerupted mandibular left secondary primary molar. Radiographic examination revealed radiopaque mass on left posterior mandible, an impacted and dilacerated mandibular secondary primary molar, and a well defined osteolytic lesion surrounding crown of the impacted tooth. Under local anesthesia, the patient was treated by surgical removal of the odontoma and marsupialization of the cystic cavity. After 14 months, the secondary primary molar had erupted and there was no recurrence.