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To describe the historical evolution and dissemination of the Oral Medicine and Oral and Maxillofacial Pathology international societies and associations across the globe, and to provide insights into their significant contributions toward oral health promotion. This review was conducted in accordance with the JBI Scoping Review Methodology Group guidance. The reporting followed the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR). Search strategy was applied to 5 databases (MEDLINE/PubMed, Scopus, Embase, Web of Science, Latin American and Caribbean Health Sciences (LILACS)) and grey literature (Google Scholar, Open Grey and ProQuest), as well as additional sources, such as organization websites. Eighty-nine sources were included in this review. Forty-six professional associations/societies were identified, of which 39 represented a country or geopolitical region, 2 represented continents, 2 represented multinational organizations and 3 multinational study groups. Documentation of the historical establishment and development of Oral Medicine and Oral and Maxillofacial Pathology organizations worldwide is limited and describing these processes remains challenging. Analysis of global data reveals heterogeneous development and distribution, resulting in disparities in accessibility and standardization. Further efforts toward oral health promotion should be implemented. [ABSTRACT FROM AUTHOR]

To investigate the reliability of gingival thickness measurements obtained from the registration of intraoral scans with cone beam computed tomography (CBCT) examinations at different acquisition modes. CBCT examinations of 9 porcine hemimandibles were acquired using the OP300 Maxio unit operating at the highest-dose protocol with the smallest voxel size as the reference standard for visualizing the gingival surface. Subsequently, the hemimandibles were surrounded by water to simulate soft tissue attenuation of radiation, and additional CBCT examinations were acquired in 4 modes: Endo, High-resolution, Standard-resolution, and Low-dose. These CBCT datasets were registered with corresponding intraoral scans obtained with the Carestream Dental 3600 intraoral scanning system using the Blue Sky Plan 4 software. Four oral radiologists measured the buccal gingival thickness on cross-sectional reconstructions at 4 measurement sites and 2 distances from the gingival margin in the CBCT reference standard examinations and examinations obtained with water and intraoral scan registration. Multifactorial analysis of variance was used to assess the influence of acquisition mode, measurement site, and distance from the gingival margin on measurements (α = 5%; statistical power = 90%). Buccal gingival thickness measurements obtained via CBCT after registration with intraoral scanning were not significantly influenced by acquisition mode (P =.153) or measurement site (P =.089). Gingival thickness measurements derived from the registration of intraoral scans with CBCT examinations at different acquisition modes appear to be reliable. [ABSTRACT FROM AUTHOR]

To evaluate the diagnostic capability of artificial intelligence (AI) for detecting and classifying odontogenic cysts and tumors, with special emphasis on odontogenic keratocyst (OKC) and ameloblastoma. Nine electronic databases and the gray literature were examined. Human-based studies using AI algorithms to detect or classify odontogenic cysts and tumors by using panoramic radiographs or CBCT were included. Diagnostic tests were evaluated, and a meta-analysis was performed for classifying OKCs and ameloblastomas. Heterogeneity, risk of bias, and certainty of evidence were evaluated. Twelve studies concluded that AI is a promising tool for the detection and/or classification of lesions, producing high diagnostic test values. Three articles assessed the sensitivity of convolutional neural networks in classifying similar lesions using panoramic radiographs, specifically OKC and ameloblastoma. The accuracy was 0.893 (95% CI 0.832-0.954). AI applied to cone beam computed tomography produced superior accuracy based on only 4 studies. The results revealed heterogeneity in the models used, variations in imaging examinations, and discrepancies in the presentation of metrics. AI tools exhibited a relatively high level of accuracy in detecting and classifying OKC and ameloblastoma. Panoramic radiography appears to be an accurate method for AI-based classification of these lesions, albeit with a low level of certainty. The accuracy of CBCT model data appears to be high and promising, although with limited available data. [ABSTRACT FROM AUTHOR]

This study aimed to assess the performance of a convolutional neural network (CNN) model in detecting the pubertal growth spurt by analyzing cervical vertebrae maturation (CVM) in lateral cephalometric radiographs (LCRs). In total, 600 LCRs of patients from 6 to 17 years old were selected. Three radiologists independently and blindly classified the maturation stages of the LCRs and defined the difficulty of each classification. Subsequently, the stage and level of difficulty were determined by consensus. LCRs were distributed between training, validation, and test datasets across 4 CNN-based models. The models' responses were compared with the radiologists' reference standard, and the architecture with the highest success rate was selected for evaluation. Models were developed using full and cropped LCRs with original and simplified maturation classifications. In the simplified classification, the Inception-v3 CNN yielded an accuracy of 74% and 75%, with recall and precision values of 61% and 62%, for full and cropped LCRs, respectively. It achieved 61% and 62% total success rates with full and cropped LCRs, respectively, reaching 72.7% for easy-to-classify cropped cases. Overall, the CNN model demonstrated potential for determining the maturation status regarding the pubertal growth spurt through images of the cervical vertebrae. It may be useful as an initial assessment tool or as an aid for optimizing the assessment and treatment decisions of the clinician. [ABSTRACT FROM AUTHOR]

We evaluated the prognostic value of 3 histopathological grading systems in lower lip squamous cell carcinoma (LLSCC) and oral tongue SCC (OTSCC) cases. We examined 62 OTSCC cases and 69 LLSCC cases using the tumor budding/depth (BD), tumor–stroma ratio (TSR), and TSR/tumor budding models and analyzed the relationship between clinicopathological parameters and patient prognosis based on overall survival (OS) and disease-free survival (DFS). In OTSCC cases, T3 and T4 tumors were significantly associated with 5 or more tumor buds and a high BD score. In LLSCC cases, tumor budding was significantly associated with OS, BD score (OS and DFS, P <.001), and TSR/tumor budding score (OS, P =.002; DFS, P =.012). Invasion depth was also associated with OS in LLSCC (P =.019). Multivariate analysis revealed that tumor budding in LLSCC remained significantly associated with OS and BD risk score with DFS, demonstrating their independent prognostic value. The BD grading system was associated with clinicopathologic parameters of greater aggressiveness in OTSCC, whereas the BD and TSR/tumor budding systems showed prognostic value in LLSCC. These findings suggest the potential use of these grading systems as adjuvant methods for prognostic analysis in patients with OTSCC and LLSCC. [ABSTRACT FROM AUTHOR]

To assess the accuracy and reproducibility of cephalometric landmark identification performed by 2 artificial intelligence (AI)-driven applications (CefBot and WebCeph) and human examiners. Lateral cephalometric radiographs of 10 skulls containing 0.5 mm lead spheres directly placed at 10 cephalometric landmarks were obtained as the reference standard. Ten radiographs without spheres were obtained from the same skulls for identification of cephalometric points performed by the AI applications and 10 examiners. The x- and y-coordinate values of the cephalometric points identified by the AI applications and examiners were compared with those from the reference standard images using one-way analysis of variance and the Dunnet post-hoc test. The intraclass correlation coefficient (ICC) was used to evaluate reproducibility. Mean radial error (MRE) in identification was calculated with respect to the reference standard. Statistical significance was established at P <.05. Landmark identification by CefBot and the examiners did not exhibit significant differences from the reference standard on either axis (P >.05). WebCeph produced a significant difference (P <.05) in 4 and 6 points on the x- and y-axes, respectively. Reproducibility was excellent for CefBot and the examiners (ICC ≥ 0.9943) and good for WebCeph (ICC ≥ 0.7868). MREs of CefBot and the examiners were similar. With results similar to those of human examiners, CefBot demonstrated excellent reliability and can aid in cephalometric applications. WebCeph produced significant errors. [ABSTRACT FROM AUTHOR]

To evaluate the prevalence of oral manifestations of leprosy. This systematic review with meta-analysis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included cross-sectional studies by 2 independent reviewers in 2 phases, who reported bacilloscopic-confirmed oral manifestations of leprosy. Studies were selected based on predetermined eligibility criteria. Searches in 6 main databases were performed, such as PubMed/MEDLINE, Embase, Scopus, Web of Science, LILACS/BVS, and LIVIVO, in addition to the gray literature. The risk of bias was assessed using the JBI Checklist for Analytical Cross-Sectional Studies, and the quantitative synthesis of the data was performed using the Jamovi 2.3 application. Ten studies were included, and the meta-analysis was performed with 917 patients with different types of leprosy. The overall prevalence of oral alterations was 6.0% (95% IC, 0.02-0.11; I2 = 97.01%; Q = 75.56), with plaques (27.2%), infiltrations (18.1%), and macules (15.1%) being the most prevalent fundamental lesions, especially in multibacillary patients. Even though there is no oral pathognomonic lesion of leprosy, this infectious disease can manifest in oral tissues in different ways, depending mainly on the leprosy type and stage of treatment. [ABSTRACT FROM AUTHOR]

We investigated the influence of voxel and field of view (FOV) sizes on expression of the volumetric alteration artifact (VAA) of 5 high-density materials in 2 cone beam computed tomography (CBCT) devices. Cylinders of amalgam, cobalt-chromium, gutta-percha, titanium, and zirconium were individually positioned in a polymethyl methacrylate phantom. OP300 Maxio and ProMax 3D Classic CBCT devices were used to acquire images with varying voxel and FOV sizes, totaling 585 scans. Two evaluators segmented the high-density cylinder images to obtain the tomographic volumes. The difference between the tomographic and physical volume of each cylinder (i.e., volumetric alteration) was calculated. Statistical analysis was conducted with multiway ANOVA and the Tukey post hoc test (α = 5%). Evaluator reliability was measured with the intraclass correlation coefficient (ICC). All studied parameters and nearly all interactions influenced the VAA (P <.05). The post hoc test demonstrated less volumetric alteration for the smallest voxel sizes, 61 × 78 mm FOV, and gutta-percha for OP300, and for the smallest voxel sizes, 80 × 80 mm FOV, and gutta-percha and titanium for ProMax 3D (P <.05). The ICC demonstrated perfect reliability (1.00). Voxel and FOV sizes influenced VAA expression. Using smaller voxel sizes, the 61 × 78 mm FOV for OP300 and the 80 × 80 mm FOV for ProMax 3D, and materials with lower density and lower atomic number reduced VAA expression. [ABSTRACT FROM AUTHOR]

This retrospective study analyzed the errors generated by a convolutional neural network (CNN) when performing automated classification of oral lesions according to their clinical characteristics, seeking to identify patterns in systemic errors in the intermediate layers of the CNN. A cross-sectional analysis nested in a previous trial in which automated classification by a CNN model of elementary lesions from clinical images of oral lesions was performed. The resulting CNN classification errors formed the dataset for this study. A total of 116 real outputs were identified that diverged from the estimated outputs, representing 7.6% of the total images analyzed by the CNN. The discrepancies between the real and estimated outputs were associated with problems relating to image sharpness, resolution, and focus; human errors; and the impact of data augmentation. From qualitative analysis of errors in the process of automated classification of clinical images, it was possible to confirm the impact of image quality, as well as identify the strong impact of the data augmentation process. Knowledge of the factors that models evaluate to make decisions can increase confidence in the high classification potential of CNNs. [ABSTRACT FROM AUTHOR]

We evaluated the influence of an adjacent zirconium implant, tube current (mA), and a metal artifact reduction algorithm (MARA) on horizontal root fracture (HRF) diagnosis in cone beam computed tomography (CBCT). Nineteen teeth (9 with HRF, 10 without) were individually placed in a human maxilla. Scan volumes were acquired without and with a zirconium implant adjacent to the tooth at settings of 4, 8, and 10 mA, with MARA disabled and enabled, using a 5×5 cm field of view, 0.085-mm voxel size, and 90 kV. Four maxillofacial radiologists individually assessed the scans. Diagnostic metrics were compared by multiway analysis of variance (α=5%). Inter- and intraexaminer agreements for HRF diagnosis were evaluated with the weighted kappa test. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were significantly lower in the presence of the implant (P≤.005). AUC values were higher in scans obtained with 8 and 10 mA compared with 4 mA (P= 0.010), but 10 mA without MARA was better with the implant present. MARA did not significantly influence outcomes (P≥ 0.240). Inter- and intraexaminer agreements ranged from moderate to almost perfect. The presence of the zirconium implant impairs HRF detection. Settings of 8 or 10 mA improve HRF detection regardless MARA condition without the implant. With an adjacent implant, 10 mA without MARA is recommended to improve diagnostic performance. [ABSTRACT FROM AUTHOR]

We evaluated artifact expression in a root adjacent to a dental implant located in the endomass or exomass in cone beam computed tomography (CBCT). We placed a single titanium or zirconia implant adjacent to a premolar root in a dried human mandible and acquired CBCT scans using an OP300 Maxio and a Picasso Trio 3D unit exposing a 5x5cm field of view with the implant in the endomass or exomass (implant groups) or without an implant (control group). We measured the mean gray values (MGVs) for 8 lines of interest (LOIs) around the root canal of the premolar and compared the MGVs by analysis of variance, with significance established at P < 0.05. For the OP300 Maxio scans, the MGVs of both implant groups in the endomass were lower than the MGVs of the control group. In the exomass, the titanium group had MGVs similar to the control group, but the zirconia group produced significantly lower MGVs than control and titanium groups (P <.0001), indicating the presence of hypodense artifacts. For the Picasso Trio 3D scans, the MGVs of both implant groups in the endomass were similar to the MGVs of the control group. In the exomass, the zirconia group generated lower MGVs than control and titanium groups (P <.0001), indicating hypodense artifacts. When performing CBCT examination , titanium implants produce less artifact expression in the exomass, and zirconia implants have less artifact expression in the endomass. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate cytology diagnosis accuracy using adjuvant methods in clinical routine for oral cancer. This prospective study was conducted on 98 patients with clinically potentially malignant or malignant oral cavity lesions. One oral lesion smear was taken from each patient using a cytobrush before biopsy and stored at PreservCyt Thinprep. Samples were cytologically analyzed, and DNA ploidy measurement was performed on the same slide. The diagnostic methods' accuracy was then calculated. In clinical inspection, 61 patients had suspicious lesions for malignancy, whereas 37 had potentially malignant disorders. Cytology associated with DNA image cytometry presented a sensitivity of 81.2% and specificity of 90.9%. When analyzing lesions located in high-risk sites to oral malignancies individually, cytology associated with DNA image cytometry presented a sensitivity of 88.2%, specificity of 100.0%, accuracy of 90.0%, and Kappa value of 0.77 (CI 95%: 0.48-1.00). Association between cytology and DNA image cytometry is an objective and non-invasive diagnostic method that demonstrated high sensitivity and specificity in diagnosing malignant epithelial squamous cell transformation in the oral cavity. [ABSTRACT FROM AUTHOR]

This study evaluated changes in image quality and the presence and size of artifacts on radiographs obtained with photostimulable phosphor (PSP) plates after disinfection with 70% ethyl alcohol and 70% isopropyl alcohol. Eight PSP receptors (4 Express and 4 VistaScan) were used for the investigation. Two Express and 2 VistaScan receptors were disinfected with 70% ethyl alcohol, and 2 Express and 2 VistaScan receptors were disinfected with 70% isopropyl alcohol. Before disinfection and after every 5 disinfections, 2 radiographs of an aluminum stepwedge and 2 radiographs of an acrylic block were acquired using each receptor. The gray values of the radiographs were analyzed regarding contrast, density, uniformity, and noise. Four oral radiologists evaluated the images for the presence of artifacts, and 2 measured the artifacts. Differences in image contrast were significantly larger with isopropyl alcohol (P <.0001). Artifact size was significantly greater with the VistaScan system when isopropyl alcohol was used as the disinfectant (P <.0001). The correlation between the number of disinfections and artifact size was moderately positive with the Express system (P <.05) and strongly positive with the VistaScan system (P <.05) with both disinfectants. Small artifacts restricted to the edges of the image were observed with disinfection using both types of alcohol, and a positive correlation was found between artifact size and the number of disinfections. However, artifacts appeared earlier and of greater size with the VistaScan system when disinfected with 70% isopropyl alcohol. Thus, we recommend using 70% ethyl alcohol to disinfect PSP receptors, with attention placed on its action and evaporation times. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the role of SNAIL1, E-cadherin, and N-cadherin immunoexpression in oral tongue carcinogenesis. In addition, we evaluated in vitro the impact of silencing of the nuclear transcription factor SNAIL1 on the viability, apoptosis, proliferation, migration, and invasion of SCC-9 and HSC-3 cells. Immunohistochemical analysis of SNAIL1, E-cadherin, and N-cadherin was carried out in 47 samples representing oral epithelial dysplasia (OED) and 41 oral tongue squamous cell carcinoma (OTSCC). The suppression of SNAIL1 expression was performed using shRNA-expression vectors in HSC-3 and SCC-9 cells to investigate in vitro the impact of SNAIL1 on proliferation, apoptosis, viability, migration, and invasion of SCC-9 and HSC-3 cells. Significant differences were observed in the expression of SNAIL1, E-cadherin, and N-Cadherin between OTSCC and OED. A low membrane expression of E-cadherin was strongly associated with poor overall survival in patients with OTSCC (P <.05), but the association did not withstand the Cox multivariate survival analysis. SNAIL1 silencing played a key role in the suppression of epithelial-mesenchymal transition and inhibited migration and invasion of HSC-3 cells (P <.0001, P <.01, respectively). In SCC-9 cells, SNAIL1 silencing promoted a significant reduction in the proliferation (P <.0001) and invasion (P <.0001). The epithelial-mesenchymal transition is present in different stages of oral tongue carcinogenesis, and SNAIL1 plays a key role in this process, although the underlying mechanisms still need to be elucidated. Thus, SNAIL1 might be a promising therapeutic target in OTSCC. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the risk and prevalence of oral cancer in patients with systemic lupus erythematosus (SLE) or discoid lupus erythematosus (DLE). The review included observational cohort and cross-sectional studies that investigated the incidence or prevalence of oral cancer in adults with confirmed diagnoses of SLE or DLE. Studies were selected based on predefined eligibility criteria, including the use of specific diagnostic criteria for SLE and DLE. After searches in PubMed/MEDLINE, EMBASE, Scopus, Web of Science, LILACS, and LIVIVO databases and gray literature for relevant studies, the selection process was conducted by independent reviewers. A total of 5,545 articles were identified. After screening, 8 studies met the inclusion criteria. The pooled risk estimate indicated a significantly increased risk of oral cancer in patients with SLE (risk ratio = 2.69; 95% confidence interval, 1.75 to 4.16; I 2 = 0%; P =.78) compared with the general population. The pooled prevalence of oral cancer in patients with DLE was 10% (95% ci, 0.03 to 0.13; I 2 = 59%; P =.12). This review provides evidence supporting an elevated risk for individuals with SLE or DLE developing oral cancer. The findings highlight the importance of monitoring oral mucosa in patients with these conditions. [ABSTRACT FROM AUTHOR]

A core outcome set (COS) is the minimum agreed-on data set required to be measured in interventional trials. To date, there is no COS for oral lichen planus (OLP). This study describes the final consensus project that brought together the results of the previous stages of the project to develop the COS for OLP. The consensus process followed the Core Outcome Measures in Effectiveness Trials guidelines and involved the agreement of relevant stakeholders, including patients with OLP. Delphi-style clicker sessions were conducted at the World Workshop on Oral Medicine VIII and the 2022 American Academy of Oral Medicine Annual Conference. Attendees were asked to rate the importance of 15 outcome domains previously identified from a systematic review of interventional studies of OLP and a qualitative study of OLP patients. In a subsequent step, a group of OLP patients rated the domains. A further round of interactive consensus led to the final COS. The consensus processes led to a COS of 11 outcome domains to be measured in future trials on OLP. The COS developed by consensus will help reduce the heterogeneity of outcomes measured in interventional trials. This will allow future pooling of outcomes and data for meta-analyses. This project showed the effectiveness of a methodology that could be used for future COS development. [ABSTRACT FROM AUTHOR]

There is a lack of consensus regarding clinician- and patient-reported oral lichen planus (OLP) outcomes. The World Workshop on Oral Medicine Outcomes Initiative for the Direction of Research (WONDER) Project aims to develop a core outcome set (COS) for OLP, which would inform the design of clinical trials and, importantly, facilitate meta-analysis, leading to the establishment of more robust evidence for the management of this condition and hence improved patient care. Ovid MEDLINE, Embase, CINAHL, CENTRAL, and Clinicaltrials.gov were searched for interventional studies (randomized controlled trials, controlled clinical trials, and case series including ≥5 participants) on OLP and oral lichenoid reactions published between January 2001 and March 2022 without language restriction. All reported primary and secondary outcomes were extracted. The searches yielded 9,135 records, and 291 studies were included after applying the inclusion criteria. A total of 422 outcomes were identified. These were then grouped based on semantic similarity, condensing the list to 69 outcomes. The most frequently measured outcomes were pain (51.9%), clinical grading of the lesions (29.6%), lesion size/extension/area (27.5%), and adverse events (17.5%). As a first step in developing a COS for OLP, we summarized the outcomes that have been used in interventional studies over the past 2 decades, which are numerous and heterogeneous. [ABSTRACT FROM AUTHOR]

This study aimed to explore the lived experience of patients with oral lichen planus (OLP) and investigate what treatment-related outcomes are the most important to them and should be included in a core outcome set (COS) for OLP. A qualitative study involving focus group work with 10 participants was conducted. Interviews with each focus group were held twice: session 1 explored the lived experience of patients with OLP, and session 2 allowed patients to review a summary of the outcome domains used in the OLP literature to date. The discussions were recorded, transcribed verbatim, and analyzed using framework analysis. In session 1, 4 themes and 8 sub-themes emerged from the data analysis. An additional outcome, 'knowledge of family and friends,' was suggested in session 2. We have gained valuable insight into the lived experience of patients with OLP via this qualitative study. To our knowledge, this study is the first to explore the patient perspective on what should be measured in clinical trials on OLP, highlighting an important additional suggested outcome. This additional outcome will be voted upon in a consensus process to determine a minimum COS for OLP. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the influence of the extensive use of a photostimulable phosphor (PSP) receptor on the diagnosis of proximal carious lesions. Forty posterior teeth were paired and mounted in 20 phantoms. Using a PSP receptor of the Express intraoral system, 1 radiograph of each phantom was acquired, totaling 20 radiographs (group 1). After 400 acquisitions, another radiograph of each phantom was obtained, totaling 20 new radiographs (group 2). This procedure was also done after 800 (group 3), 1,200 (group 4), and 1,600 (group 5) acquisitions, resulting in 100 radiographs. Another 40 radiographs (20 phantoms × 2 groups) were obtained with a second PSP sensor to evaluate the diagnostic replicability of the receptors. All 140 radiographs were assessed independently by 5 examiners for the presence of proximal caries. Area under the receiver operating characteristic curve, sensitivity, and specificity were calculated and compared among the groups by analysis of variance. The Student t test evaluated the diagnostic replicability of the receptors. The significance level was set at 5% (P <.05). The diagnostic outcomes for proximal caries did not differ among the groups (P ≥.37). The diagnostic values did not differ among the radiographs acquired with the 2 PSP receptors (P ≥.75). The diagnosis of proximal carious lesions was not affected by extensive use of the PSP receptor. [ABSTRACT FROM AUTHOR]

This study aimed to compare the immunoexpression profile of tumor stem cell (TSC) biomarkers CD44, aldehyde dehydrogenase 1 (ALDH1), OCT4, and SOX2 in salivary gland tumors (SGTs). Sixty tissue specimens of SGTs, including 20 pleomorphic adenomas, 20 adenoid cystic carcinomas (ACCs), and 20 mucoepidermoid carcinomas, in addition to 4 samples of normal glandular tissue, were subjected to immunohistochemistry. The expression of the biomarkers in the parenchyma and stroma was evaluated. Data were analyzed statistically by nonparametric tests (P <.05). Higher parenchymal expression of ALDH1, OCT4, and SOX2 was observed in pleomorphic adenomas, ACCs, and mucoepidermoid carcinomas, respectively. Most ACCs did not express ALDH1. Higher immunoexpression of ALDH1 in major SGTs (P =.021) and of OCT4 in minor SGTs (P =.011) was found. Immunoexpression of SOX2 was related to lesions without myoepithelial differentiation (P <.001) and malignant behavior (P =.002). Furthermore, OCT4 was related to myoepithelial differentiation (P =.009). CD44 expression was related to a better prognosis. Stromal immunoexpressions of CD44, ALDH1, and OCT4 were higher in malignant SGTs. Our findings suggest the participation of TSCs in the pathogenesis of SGTs. We emphasize the need for further investigations into the presence and role of TSCs in the stroma of these lesions. [ABSTRACT FROM AUTHOR]

To evaluate the diagnostic efficacy of cone beam computed tomography (CBCT) examinations acquired with varying dose protocols in the diagnosis of simulated tooth ankylosis (TA). Tooth ankylosis was simulated in 15 of 30 teeth, and CBCT examinations were acquired at 3 mA levels (8, 6.3, and 5) and 3 voxel sizes (0.08, 0.125, and 0.2 mm). Four radiologists independently assessed the presence of TA using a 5-point scale. Sensitivity, specificity, and area under the curve (AUC) obtained through receiver operating characteristic analysis were compared among mA levels and voxel sizes using two-way analysis of variance (α = 0.05). Intra- and interexaminer reliability levels were assessed with the weighted kappa examination. Sensitivity was low (0.32-0.49), and specificity was reasonably high (0.71-0.83). Mean values of AUC were low, ranging between 0.54 and 0.67, which reveals poor overall discrimination between health and disease. The detection of TA was not significantly influenced by mA level or voxel size (P >.05). Intra- and interexaminer agreements ranged from slight to moderate (0.160-0.535) and from fair to substantial (0.236-0.697), respectively. Despite the limited efficacy of CBCT for TA detection, when indicated as a complementary examination, mA reduction should be considered for dose optimization purposes. [ABSTRACT FROM AUTHOR]

To evaluate the prognostic value of three histopathological grading systems in cases of lower lip (LLSCC) and oral tongue (OTSCC) squamous cell carcinoma. Sixty-two OTSCC cases and 69 LLSCC cases were included in this retrospective study. The cases were analyzed using the histopathological grading systems proposed by Almangush et al. (2015), van Pelt et al. (2018), and Dourado et al. (2020). The relationship between clinicopathological parameters and patient prognosis was analyzed based on overall survival (OS) and disease-free survival (DFS). In OTSCC cases, T3 and T4 tumors were significantly associated with ≥5 tumor buds (p=0.025) and high-risk BD scores (p=0.01). In LLSCC cases, tumor budding was significantly associated with survival (OS, p=0.001; DFS, p=0.004), BD score (OS and DFS, p<0.001), and TSR/tumor budding (OS, p=0.002; DFS, p=0.012). Invasion depth was also associated with OS in LLSCC (p=0.019). In LLSCC, multivariate analysis revealed that tumor budding remained significantly associated with OS (p=0.04) and BD risk score with DFS (p=0.011), demonstrating an independent prognostic value. The results showed an association of the BD grading system with clinicopathological parameters of aggressiveness in OTSCC, as well as the prognostic value of the BD and TSR/tumor budding systems in LLSCC [ABSTRACT FROM AUTHOR]

The objective of this case report is to describe a case of Sweet's syndrome in a patient with acute myeloid leukemia. The patient was a 58-year-old white male with a previous diagnosis of acute myeloid leukemia and myelodysplastic syndrome. He presented with a purplish swelling, along with a necrotic surface, pain, and spontaneous gingival bleeding in the lower gingiva. Additionally, he had papules and violaceous macules with necrotic crust in various sizes on the skin, which were tender to the touch. An incisional biopsy was performed, and the anatomopathological report revealed a marked neutrophilic inflammatory infiltrate with leukocytoclasia and areas of hemorrhage in the connective tissue, which was suggestive of Sweet's syndrome. The patient was started on systemic and topical corticosteroids, which led to the regression of the skin and oral mucosa lesions. Unfortunately, due to the severity of the underlying disease, the patient passed away. Sweet's syndrome presents a complex array of signs and symptoms that can make diagnosis challenging, necessitating an interdisciplinary approach. The final diagnosis is typically based on a combination of clinical manifestations, laboratory test results, and anatomopathological features. [ABSTRACT FROM AUTHOR]

Cannabinoids are substances that act on the endocannabinoid system present in the body, including the mouth and various physiological mechanisms of the immune system. There is a need to understand the effect of using cannabinoids extracted from Cannabis sativa as a therapeutic option. A crossover randomized clinical trial is being carried out to test the comparative effect of using cannabinoids with or without photobiomodulation to control radio-induced oral mucositis in patients with head and neck cancer (CAAE 66171122.5.0000.031). The outcomes to be evaluated are the degree of severity of oral mucositis, pro and anti-inflammatory cytokines, oral symptoms, adherence to treatment and quality of life. Expected Scientific evidence indicates that cannabinoids can act in the control of symptomatic and postoperative lesions, as they have action on vanilloid receptors. It stimulates the production of saliva, and in lesions of an inflammatory nature such as oral mucositis, traumatic ulcers and periodontitis, it modulates the inflammatory response. In addition, they may be useful in controlling the anxiety of patients undergoing cancer treatment. It is believed that, with the results to be achieved by the use of cannabinoids, they may constitute another therapeutic option for the control of oral mucositis, anxiety and hyposalivation. [ABSTRACT FROM AUTHOR]

To estimate the network structure of 21 symptoms of anxiety and depression in individuals diagnosed with oral lichen planus (OLP) and compare it with salivary biomarkers. A case-control study was performed, with 21 cases with OLP, and 21 controls. Beck Anxiety and Depression Inventories were administered. Levels of salivary cortisol and alfa-amylase were determined. The Fisher and Pearson's χ2 tests were used to compare the distribution of participants´ answers to the items in the instruments. Regarding network analysis, data were statistically analyzed using regularized partial correlation network models. The shaky/unsteady symptom was the most central within the network of anxiety symptoms of individuals with the disease and, in relation to depression symptoms, feelings of punishment and self-criticism. When exploring the relationship between cortisol and alpha-amylase, weak relationships were found. When comparing the network structures of cases and controls, the networks of anxiety symptoms did not differ between groups (p = 0.18). For depression, the global strength showed that the network of the control group was more connected (69.29 vs. 27.35, p < 0.000). The network approach brings a new methodological way to explore symptom configurations. Financial support for this research was provided by the FAPESB. [ABSTRACT FROM AUTHOR]

Two female patients sought oral medicine services. The first patient, aged 27, presented with a normochromic dome-shaped nodule, measuring 10mm in width, on the floor of her mouth, initially suspected to be a ranula. The second patient, aged 35, had an exophytic, fingerlike, 1mm wide white lesion on the right dorsal tongue, with a clinical suspicion of squamous papilloma. Both patients underwent total resection of the lesions using a high-power laser configured in continuous mode (1500mW) with an infrared wavelength (808nm) and a 400µm optic fiber. The procedures were performed successfully, and histological reports confirmed the initial clinical hypotheses. The histological analysis indicated that there was sufficient material with adequate margins for diagnostic purposes, and there were no significant differences compared to scalpel biopsies. After a 2-week follow-up, there were no signs of recurrence, and the wound healing was consistent with the surgical intervention. High-power lasers are valuable surgical instruments that enable the resection of lesions of all sizes without significant histological alterations. They offer an atraumatic and efficient approach with the added benefit of instant hemostasis. [ABSTRACT FROM AUTHOR]

A 44-year-old woman developed mouth sores that persisted for 20 days after having her front teeth extracted a month earlier. No anomalies were found during the general physical examination. Upon intraoral examination, a sessile, purplish nodule measuring 1.3 cm, soft to the touch, and painless, was discovered in the region of the upper incisors. Concurrently, an ulcer in the upper right molar area with raised edges, reddish in color, measuring 2 cm, and being asymptomatic was also observed. Incisional biopsies were performed on both lesions, and they exhibited similar histopathological characteristics. Both lesions were primarily composed of round cells that tested positive for CD138 and demonstrated lambda light chain restriction. They were, however, negative for CD20 and CD3. Based on the cell morphology and the immunohistochemical profile, a final diagnosis of plasmablastic lymphoma was established. Subsequently, the patient was diagnosed with HIV through serological testing and was referred to the hematology team for appropriate treatment. [ABSTRACT FROM AUTHOR]

Objective: This systematic review was undertaken to determine the risk of oral cancer in patients with chronic graft-vs-host disease (cGvHD).Study Design: The search was conducted in 6 electronic databases (PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, and LIVIVO) and gray literature (Google Scholar, Open Gray, and ProQuest) for studies published up to November 2021.Results: Of the 13 cohorts included in qualitative synthesis, 9 were eligible for the quantitative analysis. The meta-analysis showed that the presence of cGvHD increased the risk of developing oral cancer (risk ratio [RR] = 2.78; 95% CI, 1.27-6.08; I2 = 46%; P = .01). A subgroup meta-analysis revealed a higher risk of oral cancer in Asian samples exposed to cGvHD (RR = 2.50; 95% CI, 1.54-4.04; I2 = 0%; P = .0002), which was not seen in the pooled analysis of European samples (P = .24). The overall methodological quality of most studies included was "good." The cumulative evidence (Grading of Recommendations Assessment, Development and Evaluation) was considered moderate and of very low confidence for Asian and European studies, respectively.Conclusions: Patients with cGvHD resulting from allogenic hematopoietic stem cell transplantation run an increased risk of developing oral cancer. Hence, it is recommended that patients with cGvHD be monitored to allow for the early detection and treatment of secondary malignant disease. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to assess the influence of ambient lighting levels and horizontal viewing angle (HVA) on the radiographic detection of fractured endodontic instruments in root canals in extracted human mandibular molars.Study Design: Thirty-two root canals were selected. Endodontic instrument fracture was induced in 24 canals, and all canals were endodontially treated. Periapical radiographs were obtained at orthoradial, mesioradial, and distoradial projection angles. Five oral radiologists examined the radiographs for detection of fractured endodontic instruments under 3 ambient lighting levels (high, 450 lux; medium, 28 lux; and low, 2.5 lux) and 3 HVAs (90°, 67.5°, and 45°). Area under the receiver operating characteristic curve (AUROC), accuracy, sensitivity, and specificity were calculated and compared by 2-way analysis of variance using Tukey post hoc tests (α = .05).Results: AUROC data indicated that ambient lighting (P = .739) and HVA (P = .238) did not significantly influence the detection of fractured endodontic instruments. Overall mean diagnostic values were 0.745, 0.57, 0.46, and 0.90 for AUROC, accuracy, sensitivity, and specificity, respectively.Conclusions: The viewing conditions assessed in this study did not influence the radiographic detection of fractured endodontic instruments in root canals. [ABSTRACT FROM AUTHOR]

Objective: The presence of lymphatic and blood vessels in oral squamous cell carcinoma (OSCC) should play a key role in progression and dissemination. This study aimed to evaluate the correlation between the lymphatic and blood vessel densities with prognostic outcomes in advanced stage OSCC.Study Design: Immunohistochemical reactions for D-240, CD34, and CD105 were performed in 88 advanced stage OSCC cases located at the oral tongue and the floor of the mouth. The lymphatic vascular density (LVD), blood vascular density (BVD), and neoformed vascular density (NVD) were assessed by counting positive reactions in 4 hotspot areas, both intratumoral (IT) and peritumoral (PT), at high magnification (× 40).Results: High IT LVD was associated with extracapsular spread of lymph node metastasis (P = .03). Recurrence rates were correlated with IT LVD (P < .0001), IT BVD (P = .036), and IT NVD (P = .047), and overall survival was associated with high IT LVD (P = .0016) and IT NVD (P = .009). Yet, IT LVD was an independent factor for disease-free survival and for overall survival based on the Cox proportional hazards model.Conclusions: Our results suggest that high IT LVD has a strong impact on survival outcomes in advanced stage OSCC. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to evaluate the influence of voxel size on artifacts arising from the exomass in cone beam computed tomography (CBCT).Study Design: An imaging phantom was scanned using 2 CBCT units, each adjusted to 2 voxel sizes: 0.2 and 0.3 mm. From 1 to 3 metal inserts of titanium, cobalt-chromium, or amalgam were placed in the exomass and additional CBCT scans were acquired. Mean voxel gray values were obtained from 16 homogeneous areas of the phantom and averaged, and the standard deviation was calculated to obtain voxel gray value variability. The data were analyzed using 2-way analysis of variance, Tukey, and Dunnett tests (α =.05).Results: Overall, mean voxel gray values and voxel gray value variability did not differ significantly between CBCT scans obtained with voxel sizes of 0.2 and 0.3 mm for either CBCT model tested (P > .05). Despite some exceptions in which significant differences were observed between the 2 voxel sizes (P < .05), the mean voxel gray values and voxel gray value variability resulting from different metal compositions and, in most situations, for different numbers of metal inserts in the exomass were not affected.Conclusion: Voxel size has little influence on exomass-related CBCT artifacts. [ABSTRACT FROM AUTHOR]

To conduct a systematic review of the available data on pycnodysostosis (PYCD), determining clinical and imaging craniofacial characteristics. Systematic review in specific search engines with the research question: "What are the craniofacial oral and imaging alterations in patients with pycnodysostosis?". A total of 84 published articles were included, totaling 179 cases. PYCD showed a slight preference for females (55.3%), with a mean age of 14.7 years at the time of diagnosis. Clinically, there was a predominance of short stature (86.1%), brachydactyly (66%), presence of frontal cranial bossing (82.1%), exophthalmos (49.2%), and prominent nose (57.5%). Regarding the craniofacial imaging characteristics, acroosteolysis (58.1%), open cranial sutures (53.6%), open fontanelles (67.1%), increased bone density (56.4%), and obtuse mandibular angle (84.3%) predominated. Concerning oral alterations, malocclusion (59.2%), micrognathia (62.6%), dental crowding (54.2%), narrow and grooved palate (54.2%), and dental anomalies such as impacted teeth, agenesis, delayed eruption, and enamel hypoplasia predominated. PYCD is a rare osteosclerotic dysplasia, which, despite genetic tests for diagnosis, reinforces the knowledge of the most common clinical and imaging characteristics to thus raise suspicion of PYCD. [ABSTRACT FROM AUTHOR]

Understand and evaluate the clinical and demographic profile, diagnostic methods, and treatment of patients with pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP). A database search was performed and studies describing cases of PV and MMP diagnosed by direct immunofluorescence that exhibited intraoral manifestations were included. Thirty-two articles were included (18 studies on PV and 15 on MMP). Most patients with PV (64%) and MMP (81.3%) were women in the fifth and sixth decade of life, respectively. The mouth was the primary site of involvement both in PV (71.4%) and in MMP (91%). The buccal mucosa and gingiva were the most frequently affected intraoral sites in PV (30%) and MMP (64.2%), respectively. Direct immunofluorescence was positive for IgG in all cases of two conditions. The treatment of choice was systemic corticosteroid therapy for patients with PV (50%) and topical treatment for patients with MMP (53.7%). Clinical differences and the results of diagnostic tests allow us to trace the clinical, demographic, and diagnostic profile of PV and MMP that contributes to differential diagnosis and therapeutic management in an attempt to better control these diseases and to ensure the quality of life of affected patients. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the accuracy of artificial intelligence (AI) algorithms based on individual epithelial dysplasia (ED) features in predicting malignant transformation (MT) in oral leukoplakia (OL). The microscopic features of cell architecture and atypia were analyzed in 99 cases of OL to identify individual predictors of MT. The associations between each dysplasia feature and MT were evaluated by the Spearman´s test, area under the curve (AUC), as well as accuracy. AI algorithms were developed using Random Forest models. The results showed that loss of cohesion, increased number and size of nucleoli, and inflammation were the single most important predictors of MT. When combined, these 3 features generated AUC=0.73 with a positive predictive value (PPV) of 35% (61% sensitivity, 75% specificity). The AI algorithms identified six key predictors and had a 95% PPV (100% sensitivity and 71% specificity). In conclusion, 3 individual ED features were key predictors, and AI algorithms were significantly superior to traditional methods in establishing MT risk in oral leukoplakia. [ABSTRACT FROM AUTHOR]

The aim of this prevention campaign is to inform and evaluate sun exposure and lip lesions on street vendors in Guarujá beaches. There were made three classes to empower the 20 evaluators about approaching and questions and answers calibrations. 182 people were evaluated, they received information related to solar prevention forms, care, and symptoms and a folder developed by the researchers. Oral examination was done trough inspection of lips and perioral mucosa, and those who needed it were referred to care. The outcomes showed 35.3 mean age, 27.5% were smokers, and 20.3% were alcoholics. Only 11.5% use lip balm, 48.4% body balm, and 72% use a cap or hat as protection. Lip mucosa alterations were observed in 40.7% of the evaluated population, 82.4% of them were male and 83.3% were directly exposed to UV rays during their workday. More attention is required for this vulnerable population about solar exposure, protective care is not properly taken by most of the street vendors. [ABSTRACT FROM AUTHOR]

GALR2 is considered an oncogene in OSCC and CD8+ T cells are associated with anti-tumoral responses and better prognosis. The purpose was to investigate the prevalence of CD8+ T cells and GALR2 expression in peripheral blood mononuclear cells (PBMCs) of OSCC patients. Venous whole blood from 16 OSCC cases (n=8 T1/T2 and n=8 T3/T4) was collected at the moment of surgical resection of tumors and PBMCs were isolated. Flow cytometry was performed to identify CD3+CD8+ T cells. Prevalence of CD8+ T cells was correlated with TNM clinical staging. RT-qPCR was performed using RNA extracted from aliquots of the same PBMC samples of a subgroup of these patients (n= 6) to determine the expression of GALR2. There was no statistical trend of an increased number of CD8+ T cells in OSCC patients with larger tumors (T3 or T4). GALR2 expression was significantly greater (p=0.005) in samples with a higher number of CD8+ T cells. There was no association between tumor size and GALR2 expression in PBMC. Larger OSCC tumors tend to be associated with an increased number of CD8+ T cells in the peripheral blood. GALR2 expression in PBMC was greater in cases with higher numbers of CD8+ T cells. Financial Support: FAPESP #2022/01484-0, #2020/00394-2 [ABSTRACT FROM AUTHOR]

This randomized double-blind controlled trial compared the effects of photobiomodulation therapy (PBMT) and topical clonazepam for managing burning mouth syndrome (BMS). Twenty-one patients were randomly allocated to either the intervention group that underwent six PBMT sessions with an infrared low-power laser (880nm, 90mW, 6J/cm2) or the control group, which rinsed with 5ml of 0.5mg/ml clonazepam solution three times a day for 21 days. All patients were evaluated according to the IMMPACT-II recommendations for outcome assessment in pain clinical trials by a blinded researcher at the baseline, end of treatment, 30-day, and 60-day follow-up. Both treatments achieved significant symptom relief in BMS patients without a significant difference between them. PBMT provided an earlier effect that was maintained for at least 30 days, while topical clonazepam had a slightly higher long-term effect at the 60-day follow-up. Both PBMT and topical clonazepam are effective in controlling pain symptoms in BMS patients. Funding: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001 [ABSTRACT FROM AUTHOR]

To describe the epidemiological, clinical, and pathological profile of cases diagnosed as oral epithelial dysplasia in a reference center for oral lesions. This is a descriptive study, based on secondary data from clinical records and histopathological reports, from 2010 to 2019. Data were analyzed descriptively. 88 cases of oral epithelial dysplasia were diagnosed, most of them in females (51.1%), over 45 years of age (83.3%), non-white race/color (74.2%), with education at elementary school (42.4%), and smokers (59.7%). Leukoplasia (45.8%) was the most frequent clinical lesion, with the lower lip (23.2%) being the anatomical site with the greatest involvement. Regarding the histopathological diagnosis, there was a predominance of cases of moderate dysplasia (38.6%). There was an even distribution between the degrees of dysplasia, with a slight predominance of moderate dysplasia. The knowledge of the clinical epidemiological profile of individuals diagnosed with oral epithelial dysplasia should enable the early diagnosis of oral cavity cancer and the establishment of more adequate protection measures and treatment protocols for these lesions. [ABSTRACT FROM AUTHOR]

To describe the clinicopathological aspects of chronic sclerosing sialadenitis of the submandibular gland and those in the spectrum of IgG4-Related Disease (DR-IgG4). Focal and diffuse Chronic inflammation, periductal fibrosis and sclerosis, reduction of the secretory parenchyma, lymphoid follicles, and those which are common in DR-IgG4 (obliterative phlebitis, storiform fibrosis, dense lymphoplasmacytic infiltrate, eosinophilic infiltrate, presence of sialolith) were identified). All cases were according to the following scores: absent, mild, moderate, and abundant. Demographic and clinical data were also included. Seventeen cases were identified. Stage 3 was the most frequent, with only three cases in the DR-IgG4 spectrum and 53% had sialoliths. There was a predilection for males, the mean age of 55 years, 3.8 cm on average diameter, equally affecting both sides. Chronic sclerosing sialadenitis is a rare fibro-inflammatory disease with a varied histopathological spectrum, in which DR-IgG4 must be included in the differential diagnosis. [ABSTRACT FROM AUTHOR]

The aims of this study were to evaluate the oral condition, the presence of late oral and orofacial complications and to analyze the quality of life in patients who underwent radiotherapy in the head and neck region during childhood and adolescence. A total of 52 patients were evaluated, being 53.8% males and 46.2% females. The most frequent diagnoses were Hodgkin's Lymphoma (69.2%), and the most common late alterations were trismus, prolonged retention of primary teeth, agenesis, and microdontia. For salivary flow, 19.6% of the patients had hyposalivation for stimulated saliva and 1.9% for non-stimulated saliva. The mean of visible plaque index was 7.8% and the mean of gingival bleeding index was 2.3%. As regards the International caries detection and assessment system score, 91.4% of the sample had a score of "0". Regarding the assessment of the quality of life related to oral symptoms, the domain of the questionnaire entitled "dry mouth" was the most affected in our sample, where 18.9% of the patients had xerostomia to some degree of intensity. Patients who received radiotherapy for the treatment of tumors in the head and neck in childhood and adolescence may develop late oral changes which may have an impact on their quality of life. [ABSTRACT FROM AUTHOR]

COVID-19 has been associated with long-term complications, including persistent symptoms like anosmia (loss of smell) and ageusia (loss of taste). These symptoms can endure for weeks or even years after the initial infection, affecting patients with both mild and severe COVID-19 cases. Here, we present a case involving a 71-year-old Caucasian female who experienced anosmia and ageusia that began after a COVID-19 infection and persisted for a year. To address this issue, intrabuccal photobiomodulation was administered by irradiating nine points on the lingual dorsum and borders with 3J per point, using 660 and 808nm wavelengths. Additionally, intranasal irradiation was performed in each nostril using 2J with the same wavelengths. This procedure was repeated weekly for a two-month period. The patient used a visual analogue scale to monitor the progress of the treatment. Notably, the patient experienced initial improvement as soon as the day following the first session, with gradual enhancement observed over the following weeks. The patient was followed up for a total of 7 months, during which the functions of smell and taste were fully restored. [ABSTRACT FROM AUTHOR]

Paragangliomas are well-differentiated non-epithelial neoplasms that originate from paraganglion cells of the autonomic nervous system. Most cases typically develop around the carotid body, affecting approximately 40-60% of female patients, with a female-to-male ratio of 1.7:1. These cases are usually seen in the 6th decade of life and generally exhibit a low metastatic potential. We present an exceedingly rare case of a paraganglioma that affected the posterior mandible of a 28-year-old male. The patient presented with an asymptomatic, ill-defined multilocular radiolucency characterized by irregular margins in the ascending ramus of the mandible. The patient had a previous medical history of a paraganglioma located in the carotid body, which had been diagnosed 8 years earlier. An incisional biopsy was performed, revealing a zellballen architectural pattern composed of chief cells with abundant pale cytoplasm and atypical nuclei. These chief cells were peripherally delimited by sustentacular cells within a highly vascular stroma. Mitotic figures were rare. Immunohistochemical staining showed that the tumor chief cells were positive for synaptophysin and GATA3, while sustentacular cells were positive for S-100 and enolase. The Ki-67 index was less than 1%. It's important to note that metastatic paraganglioma can manifest as an ill-defined radiolucency in the mandible.. [ABSTRACT FROM AUTHOR]

While squamous cell carcinoma (SCC) is often associated with the lateral border of the tongue, there have been occasional cases affecting the dorsum of the tongue. We present seven cases of SCC of the dorsal tongue that were diagnosed at a Brazilian Oral Pathology laboratory between 2016 and 2022. Among these cases, there were five men and two women, with ages ranging from 29 to 98 years. The primary clinical presentation typically featured asymptomatic, rapidly growing nodules (4 cases) and ulcers (3 cases) that were exclusively located on the dorsal surface of the tongue. The medical history of most patients included long-term habits of smoking and alcohol consumption, as well as previous conditions such as esophageal cancer with cervical lymph node metastasis, erythematous lupus, and tuberculosis in the context of HIV infection. Alongside the consideration of oral cancer, clinical differential diagnoses encompassed reactive and infectious lesions. The exclusive involvement of the dorsal tongue by SCC is relatively uncommon and may be associated with immunosuppression status. [ABSTRACT FROM AUTHOR]

Merkel cell carcinoma (MCC) is an aggressive primary cutaneous neuroendocrine carcinoma typically characterized by a rapidly growing, violaceous nodule or plaque that appears on sun-damaged skin, primarily in elderly Caucasians. Microscopically, it is defined by small to intermediate round blue cells with a salt-and-pepper chromatin pattern, and it shows positivity for neuroendocrine and epithelial markers. We present a rare case of an exuberant MCC on the face. An otherwise healthy 82-year-old woman presented with a 6 x 5.5 cm rapidly growing, painful, ulcerated nodule on her right cheek. The duration of the lesion was unknown. Microscopically, the lesion displayed infiltrative small round cells with pleomorphic nuclei and granular chromatin. These cells were positive for pan-cytokeratin and CK20 (paranuclear dot-like pattern), chromogranin and synaptophysin (cytoplasmic pattern), as well as for CD56 (membrane pattern). The Ki-67 index labeling was 80%. Consequently, the final diagnosis was confirmed as MCC. Clinicians should consider the possibility of MCC when evaluating a large-sized, violaceous nodule on the face, especially in elderly individuals. [ABSTRACT FROM AUTHOR]

Lipoma is a benign mesenchymal tumor primarily composed of adipose tissue. This case report aims to describe an instance of oral lipoma. The patient, a 61-year-old male with leukoderma, presented with a two-year history of a 2 cm lesion on the right lower labial mucosa. The lesion was painless and did not exhibit any bleeding. An excisional biopsy was performed, with a preliminary diagnostic hypothesis of mucocele or lipoma. During the procedure, a tissue fragment with a well-defined, yellowish appearance, elastic consistency, and smooth surface was observed. Microscopic examination revealed mucosa fragments lined by parakeratinized stratified squamous epithelium and a fibrous connective tissue lamina propria containing a benign adipose tissue neoplasm. The diagnosis of oral lipoma was confirmed, with lobules of mature adipocytes separated by strands of fibrous connective tissue. The patient is still under follow-up, and as of six months post-surgery, no recurrence of the lesion has been observed. [ABSTRACT FROM AUTHOR]

This case report presents the medical history of a 70-year-old female patient who experienced spontaneous pain in the left hemiface, accompanied by a dark lesion in the palatal vault of the same side. Computed Tomography scans revealed bilateral maxillary, ethmoidal, and sphenoidal sinusitis, along with diffuse bone rarefaction. Subsequently, debridement and biopsy procedures were performed to obtain cultures and antibiogram testing for fungi, bacteria, and mycobacteria. The analysis revealed the presence of the fungus Rhizopus spp., with a direct microscopic examination showing cenocytic hyphae. This led to the diagnosis of rhino-orbital-cerebral mucormycosis. The multidisciplinary treatment approach included the administration of antibiotics and antifungals, as well as surgical debridement procedures for addressing the oral manifestation of the disease. However, despite 18 days of hospitalization and treatment, the patient's condition deteriorated, leading to a cardiorespiratory arrest, and unfortunately, she passed away.. [ABSTRACT FROM AUTHOR]

A 37-year-old female patient was referred to our specialized oral surgery service due to pain in the right posterior mandible. Upon radiographic examination, a cystic lesion associated with tooth 48 was identified. Subsequently, the patient underwent surgical treatment for the cystic lesion, along with the reconstruction of the residual area using a titanium plate. Initially, the procedure was successful; however, it was later complicated by recurrent infections. Further hematological examinations showed no signs of infection, but a non-specific eosinophilia was observed. The patient was subsequently referred to an allergist, who diagnosed her with a rare immune disorder known as variable immunodeficiency. This diagnosis explained the lack of success in the surgical treatment. Following the immunodeficiency diagnosis, the patient was managed with immunoglobulin infusions. After 12 months from the initial surgery, the patient's condition had stabilized, and she was showing signs of good recovery. [ABSTRACT FROM AUTHOR]

As the name's etymology implies, mucositis denotes inflammation of mucous tissue, often found in the oral cavity and linked to various factors. In this report, we present a case of contact oral mucositis attributed to toothpaste in a 47-year-old female patient with phoderma. She visited our service with a complaint of "burning in the gums" for approximately 6 months. Intraoral examination revealed linear erythematous lesions in the upper and lower free marginal gums, displaying a slight erosive appearance. Given the clinical presentation of the lesion and the patient's report of worsening symptoms following toothbrushing, it was decided to replace the toothpaste with a sodium lauryl sulfate-free alternative. After 7 days, there was a noticeable improvement in her condition, thereby confirming the clinical diagnosis of contact oral mucositis induced by toothpaste. [ABSTRACT FROM AUTHOR]

Mucormycosis is an uncommon and aggressive fungal infection caused by Mucorales, typically affecting individuals with compromised immune systems, such as those with diabetes or HIV. In this case, a 51-year-old male presented with extensive devitalized areas involving the mucosa and maxillary bone on both sides. Notably, the patient had discontinued treatment and monitoring for his HIV infection. An incisional biopsy confirmed the diagnosis of mucormycosis. Subsequently, the patient was referred for treatment of his underlying HIV condition and prescribed long-term antifungal and antibiotic medications. Surgical intervention was also necessary, involving maxillary sequestotomy and the removal of necrotic tissue from both bone and soft tissues. Following treatment, the patient has been monitored for twelve months with no signs of recurrence. The combined surgical and medical approaches achieved a favorable outcome, rendering the patient eligible for prosthetic rehabilitation. [ABSTRACT FROM AUTHOR]