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Item Bisphosphonates Inhibit Expression of p63 by Oral Keratinocytes(2011-07) Scheller, E L; Baldwin, C M; Kuo, S; D'Silva, N J; Feinberg, S E; Krebsbach, P H; Edwards, Paul C.Osteonecrosis of the jaw (ONJ), a side-effect of bisphosphonate therapy, is characterized by exposed bone that fails to heal within eight weeks. Healing time of oral epithelial wounds is decreased in the presence of amino-bisphosphonates; however, the mechanism remains unknown. We examined human tissue from individuals with ONJ and non-bisphosphonate-treated controlindividuals to identify changes in oral epithelium and connective tissue. Oral and intravenous bisphosphonate-treated ONJ sites had reduced numbers of basal epithelial progenitor cells, as demonstrated by a 13.8 ± 1.1% and 31.9 ± 5.8% reduction of p63 expression, respectively. No significant differences in proliferation rates, vessel density, or macrophage number were noted. In vitro treatment of clonal and primary oral keratinocytes with zoledronic acid (ZA) inhibited p63, and expression was rescued by the addition of mevalonate pathway intermediates. In addition, both ZA treatment and p63 shRNA knock-down impaired formation of 3D Ex Vivo Produced Oral Mucosa Equivalents (EVPOME) and closure of an in vitro scratch assay. Analysis of our data suggests that bisphosphonate treatment may delay oral epithelial healing by interfering with p63-positive progenitor cells in the basal layer of the oral epithelium in a mevalonate-pathway-dependent manner. This delay in healing may increase the likelihood of osteonecrosis developing in already-compromised bone.Item Introduction to the Oral and Maxillofacial Pathology focus issue on “Preneoplastic Oral Epithelial Lesions”(Elsevier, 2018) Edwards, Paul C.; Oral Pathology, Medicine and Radiology, School of DentistryItem The Patient Educator Presentation in Dental Education: Reinforcing the Importance of Learning About Rare Conditions(2016-05) Edwards, Paul C.; Graham, Jasmine; Oling, Rebecca; Frantz, Kate E.; Department of Oral Pathology, Medicine & Radiology, IU School of DentistryThe aim of this study was to determine whether a patient educator presentation (PEP) on pemphigus vulgaris would increase second-year dental students’ awareness of the importance of learning about rare conditions and improve their retention of rare disease knowledge. The study involved students’ subjective assessments of a PEP experience at two U.S. dental schools. In this mixed methods study, cross-sectional data were obtained by surveys and in-depth interviews. Questions focused on students’ assessment of the messages acquired from the PEP and its likely impact on their future clinical care. At University 1, students completed paper surveys with open-ended questions and participated in a focus group. At University 2, students completed an online survey consisting of rating scale and open-ended questions. Responses to open-ended questions were categorized into themes. At University 1, 79 students (out of a possible 102; response rate 77.5%) completed the survey, and an additional ten students participated in a focus group. At University 2, 30 students (out of a possible 104; response rate 28.8%) completed the survey. At Universities 1 and 2, 88% and 100%, respectively, of respondents stated the PEP would influence their future clinical decision making. The vast majority of respondents (94% and 100% at University 1 and University 2, respectively) were of the opinion that the personal testimonial from a patient would help them recall information about pemphigus vulgaris in five years’ time. Respondents from both universities commented that the PEP emphasized the importance of not dismissing a patient’s concerns. These results suggest that a presentation by a patient with a rare condition can be an effective educational tool for preclinical dental students.Item Verruciform xanthoma of the buccal gingiva: two cases with different clinical presentations(Wiley, 2018) Marlow, Allison K.; Ramos, Elizabeth; Blanchard, Steven; Periodontics and Allied Dental Programs, School of DentistryIntroduction: Verruciform xanthoma is an uncommon, benign, asymptomatic lesion commonly affecting the attached tissues in the oral cavity, especially the gingiva. Clinical presentation can be variable and requires biopsy to confirm the diagnosis. Case Series: Two cases of verruciform xanthoma in a 21‐year old male and a 46‐year old female are reported, emphasizing the need for thorough comprehensive analysis of all oral lesions. The clinical features, differential diagnoses, typical and atypical histological features and potential etiology are presented. Conclusions: Verruciform xanthoma should be considered in the differential diagnosis of solitary lesions in the oral cavity with a papillary, granular or verrucous surface texture, and confirmed with histopathological examination. Continued monitoring for recurrence at routine examination is necessary especially in sites where the lesion may not have been completely excised.