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Oral submucous fibrosis (OSF) is a chronic progressive condition affecting the oral cavity, oropharynx and upper third of the oesophagus. It is a potentially malignant disorder. The authors collated and analysed the existing literature to establish the overall malignant transformation rate (MTR). A retrospective analysis of medical and dental scientific literature using online indexed databases was conducted for the period 1956 to 2021. The quality of the enrolled studies was assessed by the Newcastle-Ottawa Scale (NOS). A meta-analysis using a random effects model of a single proportion was performed along with statistical tests for heterogeneity. The overall proportion of malignancy across all studies was 0.06 (95% CI, 0.02–0.10), indicating an overall 6% risk of malignant transformation across all studies and cohorts. Sub-group analyses revealed strong differences in proportion of malignancy according to ethnicity/cohort ; Chinese = 0.02 (95% CI 0.01–0.02), Taiwanese = 0.06 (95% CI, 0.03– 0.10), Indian = 0.08 (95% CI, 0.03–0.14) and Pakistani = 0.27 (95% CI 0.25–0.29). Overall, the MTR was 6% ; however, wide heterogeneity of the included studies was noted. Geographic variations in MTR were noted but were not statistically significant. Further studies are required to analyse the difference between cohort groups.

Simple Summary An established dataset of histopathology images obtained by biopsy and reviewed by two pathologists is used to create a two-stage oral squamous cell carcinoma diagnostic AI-based system. In the first stage, automated multiclass grading of OSCC is performed to improve the objectivity and reproducibility of histopathological examination. Furthermore, in the second stage, semantic segmentation of OSCC on epithelial and stromal tissue is performed in order to assist the clinician in discovering new informative features. Proposed AI-system based on deep convolutional neural networks and preprocessing methods achieved satisfactory results in terms of multiclass grading and segmenting. This research is the first step in analysing the tumor microenvironment, i.e., tumor-stroma ratio and segmentation of the microenvironment cells. Abstract Oral squamous cell carcinoma is most frequent histological neoplasm of head and neck cancers, and although it is localized in a region that is accessible to see and can be detected very early, this usually does not occur. The standard procedure for the diagnosis of oral cancer is based on histopathological examination, however, the main problem in this kind of procedure is tumor heterogeneity where a subjective component of the examination could directly impact patient-specific treatment intervention. For this reason, artificial intelligence (AI) algorithms are widely used as computational aid in the diagnosis for classification and segmentation of tumors, in order to reduce inter- and intra-observer variability. In this research, a two-stage AI-based system for automatic multiclass grading (the first stage) and segmentation of the epithelial and stromal tissue (the second stage) from oral histopathological images is proposed in order to assist the clinician in oral squamous cell carcinoma diagnosis. The integration of Xception and SWT resulted in the highest classification value of 0.963 (σ = 0.042) AUCmacro and 0.966 (σ = 0.027) AUCmicro while using DeepLabv3+ along with Xception_65 as backbone and data preprocessing, semantic segmentation prediction resulted in 0.878 (σ = 0.027) mIOU and 0.955 (σ = 0.014) F1 score. Obtained results reveal that the proposed AI-based system has great potential in the diagnosis of OSCC.

Dirofilariasis is an endemic infestation in tropical and subtropical countries caused by about 40 different species. It rarely occurs in the oral cavity and is mostly presented as mucosal and submucosal nodules. Differential diagnoses include lipoma, mucocele, and pleomorphic adenoma. We report a rare case of oral dirofilariasis mimicking mucocele in a 41-year-old male patient from Croatia without an epidemiological history of travelling outside the country. He came in because of non-painful lower lip swelling that had lasted for two months. The parasite was surgically removed from the lesion. This is the first reported case of oral dirofilariasis in Croatia. It is important to point out this rare diagnosis in order to make dentists aware of the possibility of the presence of such an infestation in common lesions of the oral mucosa.

Background: The objective of this study was to determine the most effective treatment option for burning mouth syndrome. Methods: Informative treatment alone, B vitamin injections, oral cavity probiotics, and low-level laser therapy were evaluated and compared. The study included new patients diagnosed with burning mouth syndrome, who were randomly allocated into one of four treatment groups. The primary outcome was improvement in patient’s quality of life as determined by a self-perceived Oral Health Impact Profile-14 (OHIP-14) quality of life questionnaire before and after therapy. The secondary outcome was determination of mucosal symptom intensity according to visual analog scale (VAS) grading from 0 to 10. Data were submitted to statistical analysis. Results: A total of 62 patients completed the study. Oral cavity probiotics and LLLT scores for OHIP-14 resulted in a statistically significant difference before and after therapy. Standardized effect sizes between OHIP scores before and after treatment were the greatest for patients who had received oral cavity probiotics. Conclusions: Oral cavity probiotics and LLLT were the most effective treatment for improvement in quality of life. Further investigation on a larger group of patients is required.

The incidence of inflammatory bowel diseases (IBD) - Crohn’s disease (CD) and ulcerative colitis (UC) - has been increasing on a global scale, and progressively, more gastroenterologists will be included in the diagnosis and treatment of IBD. Although IBD primarily affects the intestinal tract, extraintestinal manifestations of the disease are often apparent, including in the oral cavity, especially in CD. Specific oral manifestations in patients with CD are as follows: indurate mucosal tags, cobblestoning and mucogingivitis, deep linear ulcerations and lip swelling with vertical fissures. The most common non-specific manifestations, such as aphthous stomatitis and angular cheilitis, occur in both diseases, while pyostomatitis vegetans is more pronounced in patients with UC. Non-specific lesions in the oral cavity can also be the result of malnutrition and drugs. Malnutrition, followed by anemia and mineral and vitamin deficiency, affects the oral cavity and teeth. Furthermore, all of the drug classes that are applied to the treatment of inflammatory bowel diseases can lead to alterations in the oral cavity due to the direct toxic effects of the drugs on oral tissues, as well as indirect immunosuppressive effects with a risk of developing opportunistic infections or bone marrow suppression. There is a higher occurrence of malignant diseases in patients with IBD, which is related to the disease itself and to the IBD-related therapy with a possible oral pathology. Treatment of oral lesions includes treatment of the alterations in the oral cavity according to the etiology together with treatment of the primary intestinal disease, which requires adequate knowledge and a strong cooperation between gastroenterologists and specialists in oral medicine.

The etiology of BMS remains unknown. Role of various cytokines has been implicated in the development of BMS. The aim of this study was to evaluate levels of salivary IL-2 and IL-6 in patients with BMS, compared with age-matched healthy volunteers (control group). Whole saliva from 30 patients with BMS, age range 55–65, was tested for the presence of IL-6 and IL-2 by enzyme immunoassay. Control group consisted of 30 healthy participants, aged 55–65 years. Saliva IL-2 concentrations in BMS were significantly increased in patients compared to healthy subjects: mean34.1±9.7versus7.3±3.0pg/mL;P<.001. Patients with BMS had significantly higher concentrations of IL-6 compared to control: mean30.8±5.6versus5.2±2.8pg/mL;P<.001. In patients with BMS, IL-2 and IL-6 levels in saliva are elevated, correlating with the severity of illness.

Multiple sclerosis (MS) is an inflammatory disease of unknown etiology involving the central nervous system1. MS is characterized by a relapsing-remitting or progressive course and a pathologic triad of CNS inflammation, demyelination, and gliosis (scarring). Certain clinical manifestations affect the oro-facial region. Three in particular should be of interest to the dentist: trigeminal neuralgia (tic douloureux), sensory neuropathy of the trigeminal nerve (parasthesia) and facial palsy. The aim of this study was to determine oral health status, frequency of subjective symptoms and TMD subtype according to RDC/TMD among MS patients. Examinees in this study were 50 patients suffering from MS, who were treated during their disease for at least one time in Clinic Hospital Center Rijeka, Clinic for Neurology. All of the examinees had to meet diagnostic criteria for clinically and laboratory confirmed MS, according to Poser. Results shows difference in mean DMFT beetwen MS and control group. The number of decayed and missing teeth was higher, but number of filled teeth was significantly smaler in MS group. Eighty-two per cent of the subjects with MS had a least one symptoms of dysfunction compared with 24% of the subjects in the healthy control group. In the present study, pain, pain during mouth opening, difficulty with mouth opening and TMJ sounds were more commonly reported in the MS group than in control group. This study shows a statistically significant excess of dental caries and temporomandibular disorders among MS patients compared with control group. This results suggest that MS is possible etiological factor of temporomandibular disorders. Multiple sclerosis (MS) is an inflammatory disease of unknown etiology involving the central nervous system1. It is characterized by a relapsing-remitting or progressive course and a pathologic triad of CNS inflammation, demyelination, and gliosis (scarring). MS is a chronic, frequently progressive disease that predominently attacks the myelin sheath of the central nervous system (CNS - brain and spinal cord). Demyelination occurs, often with scarring at multiple sites throughout the CNS. It is hypothesized that an external "trigger" such as a virus may precipitate an autoimmune response in genetically susceptible individuals2-5. Lesions of MS are classically said to be disseminated in time and space. Manifestations of MS vary from a benign illness to a rapidly evolving and incapacitating disease requiring profound adjustments in life-style and goals for patients and their families. Complications from MS affect multiple body systems ; hence, a multidisciplinary approach is recommended to optimize clinical care. Symptoms vary widely, but most commonly include: gait disturbances, sensory complaints (numbness, paresthesias, burning, feelings of constriction or pain), visual problems, fatigue, incoordination, bladder, bowel and sexual dysfunction, and partial or complete paralysis in severe cases6-9. Mild cognitive impairment occurs in many patients with MS, while a smaller proportion (about 10%) experience serious intellectual deterioration. The cause and cure are unknown, although symptomatic management is possible and certain immunoregulatory agents reduce the relapse rate and may prove to slow disease progression. Since MS affects the whole body, orofacial aspects of the disease must be expected, particularly since loss of muscular coordination may result in a diminished ability to maintain oral hygiene10, 11. Certain clinical manifestations affect the oro-facial region. Three in particular should be of interest to the dentist: trigeminal neuralgia (tic douloureux), sensory neuropathy of the trigeminal nerve (parasthesia) and facial palsy12-14. Trigeminal neuralgia usually appears after the diagnosis of multiple sclerosis has been made and is present in about 1.9% of cases. It is, however, the first manifestation of the disease in 0.3% of cases15. The aim of this study was to determine oral health status, frequency of subjective symptoms and TMD subtype according to RDC/TMD among MS patients.