A number of diagnostic techniques exist to ascertain whether a mouth lesion could become an oral cancer. In a review article, Diana V Messadi from the University of California, Los Angeles School of Dentistry, USA, details the known pathological conditions considered to be precancerous. These include leukoplakia and erythroplakia, both of which are marked by abnormally colored patches of cells on the mucous membrane that lines that inside of our cheeks, as well as the inflammatory diseases oral lichen planus and oral submucous fibrosis. Messadi also catalogues non-invasive screening tools such as dye systems, fluorescent technologies and cell-collection kits, all of which can catch signs of cancer before lesions turn malignant. She notes that early diagnosis is the most important predictor of patient outcome for anyone with oral cancer, requiring dentists to have adequate knowledge and training.

Researchers in Canada have explained the current theories on different tooth replacement patterns in vertebrate species. Like other vertebrates, the teeth we develop early in life are merely a ‘starter set’ that will ultimately be replaced. Mammals typically only undergo one round of replacement, while many fish and reptiles experience lifelong tooth replacement. Yet, the basis for this difference is not fully understood. In their review, John Whitlock and Joy Richman of the University of British Columbia, also present data suggesting that mammals may lose the dental lamina where tooth-forming stem cells reside, or fail to form the ‘successional lamina’ that contributes to later rounds of replacement in reptiles. The authors also explain mechanisms by which patterns of tooth renewal are established within the jaw, and recommend further study in reptile and mouse models.

Blocking an enzyme that helps bring calcium into cells could be a promising strategy for therapeutic intervention in oral cancers. In a review article, Rajini Rao from the Johns Hopkins University School of Medicine, USA, and her former graduate student Ming-Ye Feng, now at Sichuan University, China, and Stanford University, USA, discuss how a calcium-pumping enzyme known as secretory pathway Ca²⁺-ATPase 2 (SPCA2) is often upregulated in cancer cells compared to their non-malignant counterparts. Salivary glands express this protein during normal tissue development. When SPCA2 is overexpressed, however, calcium ions rush into the cells, leading to increased proliferation and other characteristics consistent with tumorigenic growth. Therefore, SPCA2 or the calcium channels it interacts with could be a useful new drug target in patients with oral cancer.

An important protein involved in tooth development also plays a critical role in the formation of the surrounding dental tissues and the tooth-root. To investigate the role of bone morphogenetic protein 2 (BMP2) in the development of structures that support teeth, a team led by Stephen Harris at the University of Texas Health Science Center at San Antonio, USA, deleted the Bmp2 gene in a mouse model. They observed major defects in tooth-root formation, as well as in the establishment of cementum, periodontal ligament and alveolar bone — all part of supporting structures that surround tooth-roots. BMP2 is also involved in the proper development of teeth themselves. As such, the findings shed light on one key developmental pathway shared by cells across the dental tissue spectrum.

Exposure to low-power laser light could stimulate the repair of jaw tissues that have been damaged in the course of periodontal disease. Dentists have several strategies for addressing severe plaque build-up in the teeth and gums, but these are generally inadequate for repairing the resulting destruction of root, jaw and connective tissue. Inspired by research demonstrating that low-power laser irradiation (LPLI) may promote wound-healing, Yan-Hsiung Wang of Kaohsiung Medical University in Taiwan and colleagues investigated the potential benefits of LPLI in treating periodontal damage. They demonstrated that this treatment stimulated active proliferation and bone-producing activity in human periodontal ligament (hPDL) cells, which are primarily responsible for the formation and maintenance of periodontal tissue. These results indicate that LPLI could be a valuable tool for promoting tissue regeneration in patients.

Patients with oral lichen planus (OLP) have higher rates of infection with microbes that cause periodontal disease, researchers in Turkey have shown. The findings could help to explain the causes of this poorly understood chronic inflammatory condition that produces red or lacy white lesions in the mouth. Researchers had characterized the association between OLP and infection with herpes-family viruses, but not with pathogenic bacteria. Abdullah seckin Ertugrul of the Yuzuncu Yil University and co-workers used genetic methods, which can identify anaerobic bacteria more efficiently than culturing, to screen the microbes in plaque samples from patients with OLP and without the condition. The OLP patients had significantly higher rates of infection with pathogens such as Porphyromonas gingivalis and Treponema denticola. The authors recommend long-term studies to investigate whether these microbes play a direct role in causing OLP.

Projecting images of a surgical site onto a patient’s face may allow quicker, more precise dental surgery, scientists in Japan report. Dental and facial surgery is anatomically complex, with underlying structures and tissues often hidden from view. Surgeons can view an individual’s two-dimensional (2D) scans on computer monitors during surgery, but this is time-consuming. Hideyuki Suenaga and colleagues at the University of Tokyo have developed a way to superimpose 3D anatomical images directly onto a patient’s face during surgery. Their augmented reality system uses data from CT and MRI scans to generate a series of points mapped in 3D space. The image is then projected using lenses and mirrors that can be viewed at any angle without special glasses. The technology is accurate to within one millimeter and uses optical tracking to update when a patient moves.

The application of bioglass during hydrogen peroxide tooth bleaching may greatly improve enamel protection, researchers in China report. Bleaching with hydrogen peroxide is a popular way of improving tooth appearance, but can cause significant chemical and structural damage to both the surface and internal structure of tooth enamel. Ji-Yao Li and colleagues at Sichuan University and Zhejiang Chinese Medical University analyzed the use of bioglass — a silica-based synthetic material widely used for bone and tissue reconstruction — as an enamel repair agent in bleaching. The team investigated the effect of adding bioglass to the bleaching procedure before, during and after the application of 35% hydrogen peroxide onto bovine teeth. They found that applying bioglass during bleaching was most effective: it reduced mineral loss and retained the surface integrity of the enamel.

We report a case of hemangiopericytoma of the soft palate of 60-year-old patient, who noticed a mass of the soft palate and experienced difficulty in speaking. We found a pediculate, hard, elastic mass measuring 38 mm (cross-sectional diameter). Computed tomography (CT) scans and dynamic magnetic resonance imaging (MRI) confirmed irregularly shaped mass and revealed a heterogeneous internal composition, consistent with vascular tumors. We excised the tumor under general anesthesia. Histopathological diagnosis was based on positive immunoreactivity of CD99 and vimentin and weak, positive staining of CD34. Three and half years following tumor excision, there is no recurrence or metastasis.

We present an uncommon case (female patient aged 59 years) of the clear-cell variant of calcifying epithelial odontogenic tumor (CEOT) (also known as Pindborg tumor) in the mandible. The clinical characteristics and probable origins of the clear tumor cells of previously reported cases of clear-cell variant of intraosseous CEOT are also summarized and discussed.