Gingival fibromatosis is a rare disease characterized by enlargement of the gingiva. The purpose of this study was to analyze a case of idiopathic gingival fibromatosis, using histochemical and immunohistochemical staining and transmission electron microscopy. The patient was a 39-year-old Japanese man, in whom the gingiva was enlarged throughout the entire mandible and maxilla. Specimens of gingival fibromatosis exhibited epithelial hyperplasia and increased amounts of collagen fiber bundles in the connective tissue light-microscopically. Well-developed collagen bundles were strongly stained with Azan and Masson trichrome staining. Immunohistochemically, the gingival connective tissue was specifically stained by type I collagen and vimentin antibodies. Ultrastructurally, the lesion consisted of fibroblasts and mature collagen fibers running in all directions. No myofibroblasts were detected histochemically, immunohistochemically, or ultrastructurally. These findings suggested that this disease may be the result of an increase in collagen synthesis by the fibroblasts and/or that it may be associated with one of the findings of histologic heterogeneity.

Although oralCandidaeasily adheres to denture base materials, many denture detergents are effective only against bacteria but not againstCandida. Silver nanoparticles (AgNPs), which are known to have potent antibacterial and antifungal activity, have been used in the prevention of oral candidiasis (OC). We evaluated the adherence ofCandida albicansandCandida glabrataon a heat-cured Acron resin piece supported by AgNPs by low-vacuum scanning electron microscopy (SEM) and measuring colony-forming units.C. albicansandC. glabrataincreasingly adhered to the resin surface of the control piece over time, but the adhesion AgNP of bothCandidaspecies to the AgNP-coated surface was significantly inhibited (P<0.001). Low-vacuum SEM revealed thatC. albicansandC. glabrataon the resin surface of control pieces appeared as oval colonies, with a major axis of 3-4 μm and a smooth cell wall, but those on the AgNP-coated resin surface were less abundant than the control and showed swollen yeast features, with a major axis of more than 5 μm and a corrugated cell wall. Our results suggest a way to prevent denture-associated OC by using denture base materials processed by AgNPs.

The side effects of peroral bisphosphonate may cause mucous membrane disorders and oral exulceration if individuals dissolve the drug inside the oral cavity on oral administration. We experienced two cases in which we strongly suspected mucous ulcurs due to this drug. Finally, the oral exulceration disappeared after providing instructions on correct administration.An 83-year-old woman was referred because of exulceration of the right mandible. She suffered from osteoporosis, thoracic vertebra compression fracture, and dementia, while taking alendronate weekly. The exulceration appeared from the right lower lip to the right mandibular molar gingiva when we absorbed pooled saliva in the right oral cavity when the patient was lying down. We instructed the patient to confirm that the tablet was completely swallowed. The ulcers in the oral cavity completely disappeared 17 days after presentation.A 74-year-old woman with osteoporosis presented because of bleeding and pain in the gingiva of the right mandible. She was taking monthly minodronate while wearing incompatible dentures. Exulceration occurred with peripheral redness ranging from the right buccal mucosa to the right molar gingiva of the mandible and the tongue/floor of her mouth, along with a ventrolateral tongue. We taught her how to swallow minodoronate correctly without dentures, and the ulcers healed 4 weeks later. : bisphosphonate (ビスフォスフォネート製剤) ，oral ulcer (口腔潰瘍) ，improper administration (誤用) 1) 鹿児島市立病院歯科口腔外科 (主任：平原成浩科長) 2) 今村総合病院歯科口腔外科 (主任：坂元亮一部長) 3) 鹿児島大学大学院医歯学総合研究科先進治療科学専攻顎 顔面機能再建学講座顎顔面疾患制御学 (主任：杉浦 剛教授) 1)

BackgroundThe isolation frequency and susceptibility to antifungal agents of oral Candida isolates from patients with oral candidiasis (OC) were compared between studies conducted in 2006–2007 and 2012–2013.MethodsA total158 strains was isolated from 112 patients who visited Kagoshima University Hospital for the treatment of OC during the 14-month period from February 2012 and March 2013, and evaluated on the isolation frequency of each Candida strain and the susceptibility against antifungal drugs as compared to those evaluated in 2006–2007.ResultsThere was a higher frequency of xerostomia as a chief complaint and of autoimmune disease in the 2012–2013 study than in the 2006–2007 study. More than 95% of Candida isolates were C. albicans and C. glabrata. In addition, the proportion of the latter increased from 12.3% in the 2006–2007 study to 23.4% in the 2012–2013 study, while the proportion of the former decreased from 86.2% to 72.8%, respectively. C. albicans was isolated in almost all patients, while C. glabrata was only isolated concomitantly with C. albicans. Minimal inhibitory concentrations (MICs) were not significantly different between groups with a few exceptions. Candida isolates, of which MICs surpassed break points, apparently increased for miconazole and itraconazole against C. glabrata in the 2012–2013 study, but this was not statistically significant. As a result, more cases of autoimmune disease, a greater number of C. glabrata isolates, and higher resistance to azoles were seen in the 2012–2013 study than in the 2006–2007 study.ConclusionThese data indicate that with recent increases in C. glabrata infection, a causative fungus of OC, and in C. glabrata resistance to azoles, caution is needed in the selection of antifungal drugs for the treatment of OC.

Double autoimmunostaining by a sequential twice-repeated enzyme-labeled polymer method was examined on archival paraffin sections of formalin-fixed human tissue using an autoimmunostaining apparatus to determine optimal conditions for glycine treatment, to select the best combination of dyes for the horseradish peroxidase-hydrogen peroxide reaction, and to investigate mounting methods for preparing permanent specimens. The optimal glycine treatment determined by changing the incubation time in 0.1 M glycine hydrochloride buffer, pH 2.2, was glycine buffer washing three times for 1 min each, with suppression of nonspecific binding of the primary antibody by protein blocking. Combinations of DAB and AEC, SG and AEC with Ultramount, and DAB and VIP or NovaRED and SG with the VectaMount were found usable for the double autoimmunostaining, based on color analysis of the dyes. Pairs of primary antibodies, CD68 and anti-fascin antibodies CD3 and CD79a, and anti-Ki-67 antigen and anti-p53 antibodies were applicable in double autoimmunostaining with appropriate antigen retrieval for each pair of primary antibodies. Consequently, good sequential double autoimmunostaining should include masking the nonspecific binding of primary antibodies, optimal glycine treatment, and selection of adequate dyes and mounting methods.