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To assess the clinical scenarios in which nerve blocks are employed in the context of burning mouth syndrome (BMS). This scoping review followed the PRISMA-ScR. A protocol was generated on Open Science Framework. Electronic searches were performed in the following databases: PubMed, Scopus, EMBASE, Web of Science, LILACS, and Cochrane, in addition to the grey literature and citations from Grémeau-Richard et al. (2010). Nerve blocks were used for treatment purposes in all cases. The mandibular nerve and the stellate ganglion were both blocked in 50% studies, while the maxillary nerve and lingual nerve were blocked in 25% study each. The anesthetics used were lidocaine (50%) and bupivacaine (50%). Relief was generally reported after immediate block, and at a mean follow-up of 4.5 weeks, there was considerable improvement compared to the initial conditions when the mandibular and/or maxillary nerve were targeted. The use of nerve blocks has been employed in the treatment of patients with refractory BMS. Clinical studies with standardized methodology are necessary to validate and understand the potential role of mandibular and maxillary nerve block in this setting. [ABSTRACT FROM AUTHOR]

To determine the prevalence of smokeless tobacco (SLT) use and its association with oral potentially malignant disorders (OPMDs) and head and neck cancer (HNC) in the Pan-American Health Organization (PAHO) region. A literature search was conducted across 9 databases and other sources. The eligibility criteria were pediatric (0-18 years old) and adult (19 years and older) populations consuming any type of SLT. Meta-analysis was performed to determine the prevalence of SLT and the association between its use and OPMDs/HNC in the PAHO region; the Grading of Recommendations Assessment, Development, and Evaluation tool was used to verify the certainty of evidence. Fifty-nine studies from 6 PAHO countries were included, of which 51 were also subjected to quantitative analysis. The pooled SLT prevalence of use was 15% (95%CI: 11.93-18.69) overall, 17% (95%CI: 13.25-22.65) in adults, and 11% (95%CI: 8.54-14.78) in the pediatric population. The highest reported SLT prevalence of use was 33.4% (95%CI: 27.17-39.93) in Venezuela. HNC was positively associated with SLT use (OR = 1.98, 95%CI: 1.54-2.55), with a moderate certainty of evidence. Among OPMDs, only leukoplakia reported a positive association with SLT use (OR = 8.38; 95%CI: 1.05-67.25). However, the quality of the evidence was very low. A high consumption of SLT use, chewing tobacco and snuff, is reported among the adult population residing in the PAHO region with a positive association with the development of oral leukoplakia and HNC. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the clinical outcomes of dental implants (DIs) in patients with head and neck cancer (HNC) treated with radiotherapy (RT), isolated chemotherapy, or bone modifying agents (BMAs). This study was registered in the Prospective Register of Systematic Reviews (CRD42018102772); conducted via the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist; and based on PubMed, Scopus, Embase, Cochrane Library, Web of Science, and gray literature searches. The selection of studies was performed in 2 phases by 2 independent reviewers. The risk of bias (RoB) was assessed by the Measurement Tool to Assess the Methodological Quality of Systematic Reviews 2. Twenty systematic reviews were included in the qualitative analysis. The majority scored as having high RoB (n = 11). Primary DIs placement in the mandible of patients with HNC subjected to RT doses <50 Gy was associated with better survival rates. The placements of DIs could be considered safe in patients with HNC in sites of alveolar bone that received RT (≤5000 Gy); however, no conclusions could be made in patients with cancer managed by chemotherapy or BMAs. Due to the heterogeneity of studies included, the recommendation for DIs placement in patients with cancer should be carefully considered. Future better controlled randomized clinical trials are required to provide enhanced clinical guidelines for best patient care. [ABSTRACT FROM AUTHOR]

This systematic review investigated the dosimetric parameters used in preclinical studies. Searches were performed in 3 databases (PubMed, Scopus, and Embase) and gray literature to identify studies for review. In vitro and ex vivo studies that examined the effect of radiation on human permanent teeth were included. The modified Consolidated Standards Of Reporting Trials checklist of items for reporting preclinical in vitro studies was used to assess the risk of bias. In total, 32 studies met the inclusion criteria. The average radiation dose of in vitro studies was 53 (±22) Gy and in ex vivo studies was 69 (±1) Gy. Twenty-two studies used 5 different fractionation schemes. Twenty-two of the included studies did not report the radiotherapy modality of those reporting. Twenty studies used linear accelerators, and 7 used Cobalt-60 with the source-surface-distance of radiation ranging from 1.5 to 100 cm. Distilled water was the storage solution for the dental structure used most commonly. Biases were observed, including small sample sizes, lack of randomization, and blinding processes. The dosimetric parameters used in the preclinical studies, including radiation dose, radiotherapy modality, fractionation regime, and the storage solutions used did not support the hypothesis of direct effects of radiation on the dental structure. [ABSTRACT FROM AUTHOR]

Breaking bad medical news is a complex task of clinical practice. The manner in which this is done has a significant impact on patients. This study aimed to assess patient's perceptions regarding oral and oropharyngeal cancer diagnosis disclosure according to the "SPIKES" protocol. This cross-sectional study used a questionnaire with 21 SPIKES-based items. The questionnaire was administered to 100 patients with recently diagnosed oral and oropharyngeal squamous cell carcinoma who evaluated each item according to their preference and experience. Nineteen items showed a significant difference between patient's preference and recalled experience. Eighteen of these items showed lower experience scores primarily related to the amount of information desired by patients, presence of a companion, time to express feelings, and summary of information. Most patients preferred receiving as much information as possible about the diagnosis. However, only 35% reported that they had obtained sufficient information. Patients who were aware of cancer diagnostic suspicion had better communication experiences. Protocols may be useful to guide health professionals to support patient-centered strategies to disclose oral cancer diagnoses. [ABSTRACT FROM AUTHOR]

To implement a Deep Learning model for the automatic classification of clinical photographs into potentially malignant and malignant lesions. A dataset of 527 clinical images from three institutions was used to train (n=519) and validate (n=58) a ConvNext. The CNN was pre-trained on the ImageNet dataset and fine-tuned with the training subset, with the Adam optimizer at a learning rate of 0.0001. The model reached a mean accuracy of 0.98, precision of 0.98, recall of 0.98, and F1score of 0.98 during training. The internal validation reached a mean accuracy of 0.81, precision of 0.80, recall of 0.82, and F1score of 0.80. These preliminary results demonstrate the great performance of a Deep Learning algorithm for classifying potentially malignant and malignant lesions, which can be a premise of an innovative non-invasive screening tool for cancer detection. Further steps will seek to extend the dataset and perform external tests to better evaluate the model´s generalization capabilities. [ABSTRACT FROM AUTHOR]

Objective: Electronic cigarette (e-cigarette) use is growing significantly worldwide, especially among young people. This product has been associated with renormalizing smoking and hindering quit attempts in smokers. Moreover, among nonsmokers, it can lead to subsequent cigarette smoking and nicotine dependence. The present study aimed to assess the epidemiological profile of e-cigarette users worldwide.Study Design: A systematic review was performed using 3 main electronic databases (Medline/PubMed, SCOPUS, and EMBASE). Studies were independently assessed by 2 reviewers based on established eligibility criteria. The risk of bias was assessed using the MAStARI critical appraisal instrument.Results: From 4,496 records, 43 were included. Among the 1,238,392 participants, 132,786 (10.72%) were e-cigarette users. The age range with the highest percentage of e-cigarette users was 18-24 years old, with 40,989 (30.86%) males, 34,875 (26.26%) females, and 33.6% being current cigarette smokers. The highest prevalence of users was 52.88% in Croatia and 49.62% in New Zealand. Other possible correlations were observed with e-cigarette use, such as a high level of education.Conclusion: Overall, e-cigarette users tended to be male young adults with a higher level of education. The highest prevalence of use was found in Croatia. This systematic review provides valuable information to improve the development of appropriate intervention strategies targeting e-cigarette users for more accurate anti-smoking actions. [ABSTRACT FROM AUTHOR]

Objective: We performed a systematic review dedicated to pooling evidence for the associations of clinical features with malignant transformation (MT) and recurrence of 3 oral potentially malignant disorders (OPMDs) (actinic cheilitis [AC], oral leukoplakia [OL], and proliferative verrucous leukoplakia [PVL]).Study Design: We selected studies that included clinical features and risk factors (age, sex, site, size, appearance, alcohol intake, tobacco use, and sun exposure) of OL, PVL, and AC associated with recurrence and/or MT.Results: Based on the meta-analysis results, non-homogeneous OL appears to have a 4.53 times higher chance of recurrence after treatment. We also found 6.52 higher chances of MT of non-homogeneous OL. Another clinical feature related to higher MT chances is the location (floor of the mouth and tongue has 4.48 higher chances) and the size (OL with >200 mm2 in size has 4.10 higher chances of MT). Regarding habits, nonsmoking patients with OL have a 3.20 higher chance of MT. The only clinical feature related to higher chances of MT in patients with PVL was sex (females have a 2.50 higher chance of MT).Conclusions: Our study showed that some clinical features may indicate greater chances of recurrence after treatment and MT of OPMD. [ABSTRACT FROM AUTHOR]

Established restorative protocols for patients after head and neck radiotherapy are lacking, increasing the failure rates of dental adhesive restorations. The purpose of this systematic review and meta-analysis was to analyze the evidence regarding the impact of head and neck radiotherapy on the longevity of dental adhesive restorations. A search was performed using PubMed, Scopus, and Embase in May 2018 (updated in November 2020). Data extraction was performed regarding the percentage of restoration failure among dental adhesive materials, including glass ionomer cements, resin-modified glass ionomer cements, and composite resins. Risk of bias was assessed by the meta-analysis of statistics assessment and review instrument (MAStARI). Confidence in cumulative evidence was evaluated by the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) protocol. Four studies met the inclusion criteria. All included studies were classified as having a moderate risk of bias and reported results regarding class V restorations. Overall, composite resins presented lower failure rates at 2 years (30%) when compared with resin-modified glass ionomer (41%) and glass ionomer cements (57%). Meta-analysis showed that the risk of failure with glass ionomer cements was greater than with resin-modified glass ionomer cements (RR: 1.71, P <.001). Composite resins presented lower risk of failure when compared with glass ionomer (RR: 2.29, P <.001) and resin-modified glass ionomer cements (RR: 1.30, P =.03). Three studies reported results regarding fluoride compliance, which had a negative effect on the survival rates of glass ionomer and resin-modified glass ionomer cements and a positive effect on composite resin restorations. The results suggest that composite resin restorations associated with fluoride gel compliance seems to be the best alternative for restoring class V lesions in patients after head and neck radiotherapy. However, the results showed moderate certainty of evidence, which justifies the need for more randomized clinical trials regarding this subject. [ABSTRACT FROM AUTHOR]

This review outlines the historical perspective, status, and future challenges of oral medicine (stomatology) in Brazil based on the records of the Brazilian Society of Stomatology and Oral Pathology (SOBEP) and the Brazilian Federal Dental Council as well as expert evidence input from academic leaders from 3 different generations of Brazilian oral medicine specialists. The beginning of oral medicine in Brazil dates to 1969, followed by the organization of SOBEP in 1974; however, official recognition as an independent specialty was achieved more recently within the Brazilian Federal Dental Council in 1992. After a 50-year maturation period of oral medicine in Brazil in terms of specialty crystallization across dentistry, medicine, and research, it is now time to follow the historical trends of the specialty internationally and establish a standard curriculum at a post-graduate level that will lead to uniformity of training for oral medicine in Brazil. [ABSTRACT FROM AUTHOR]

Objective: Infective endocarditis (IE) may cause devastating complications with high morbidity and mortality rates. The aim of the present study was to study the demographic, cardiological, microbiologic, and dental profiles of patients with oral bacteria-related IE.Study Design: We present a retrospective study of patients with oral bacteria-related IE treated at Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Brazil, between January 2009 and December 2019.Results: Of the 100 patients included, 70% were male with a mean age of 45.4 years at diagnosis. The most affected sites were aortic and mitral valves, 60% in prosthetic heart valves, 34% in native valves, and 3% in pacemakers. The most common cause of valvular disease was rheumatic cardiopathy (51.9%), and the most frequent complications were valvular and perivalvular damage (26%). Streptococcus viridans was the most common species (96%), dental caries were present in 57% of the patients, 78% had tooth loss, 45% had apical periodontitis, and 77% were at high/moderate risk for periodontal disease.Conclusion: Oral bacteria-related IE among Brazilians was predominant in the prosthetic heart valves of young male adults previously affected by rheumatic cardiopathy. Streptococcus viridans was the main cause of IE, which was linked to patients with a poor oral health status. [ABSTRACT FROM AUTHOR]

Objectives: Radiation-related caries (RRC) is one of the most aggressive complications of radiotherapy (RT) in survivors of head and neck cancer (HNC). Lack of RRC awareness may contribute to the occurrence of this oral cavity complication. RRC may be considered a "forgotten oral complication" by patients with HNC, oncologists, and dentists. The present study aimed to assess the level of awareness of RRC among physicians, dentists, and patients.Study Design: Physicians (group 1, G1), dentists (group 2, G2), and patients with HNC undergoing RT (group 3, G3) answered questionnaires concerning their awareness of RRC. Physicians (G1) were divided into group 1A (oncological experience) and group 1B (general physicians/other specialties). Dentists (G2) were divided into group 2A (oncological experience) and group 2B (general dentists/other specialties). Personalized questionnaires were designed for each group.Results: Recruitment was as follows: physicians (n = 124): 1A (n = 64), 1B (n = 60); dentists: (n = 280), 2A (n = 160), 2B (n = 120). In addition, 58 patients answered the questionnaire. In terms of RRC awareness, 46.77% of physicians, 81.78% of dentists, and 24.13% of patients had some knowledge of the problem.Conclusion: Patient awareness of RRC was poor. The heterogeneity of answers among physicians and dentists suggests an opportunity to improve patient education and prevention of this serious oral complication of RT. [ABSTRACT FROM AUTHOR]

To compile evidence regarding the use of Machine Learning models to diagnose intraosseous lesions in gnathic bones, and to understand the impact and usefulness of these. The present SR was conducted following the guidelines of the PRISMA 2022 and registered in the PROSPERO database (CRD42022379298). The acronym PICOS was used to develop the focused review question "Should Computer vision be used to diagnose intraosseous lesions in radiographic images?" and the eligibility criteria. Electronic database search encompassed PubMed, Embase, Scopus, Cochrane Library, Web of Science, Lilacs, and IEEE Xplore, and Gray Literature (Google Scholar and ProQuest). Risk of Bias (RoB) was assessed through PROBAST, and the results were synthesized based on the task and according to the dataset sampling strategy. A total of 12 studies were included (21,146 radiographic images). Ameloblastomas, odontogenic keratocysts, dentigerous cysts, and periapical cysts were the most commonly investigated lesions. According to the TRIPOD, the majority of studies were classified as type 2 (randomly splited). Artificial intelligence application, safety, and generalization must be tested using more universal methodologies, since the diagnostic performance may differ according to the algorithms used. [ABSTRACT FROM AUTHOR]

We aimed to find biomarkers of progression from oral leukoplakias (OL) to oral squamous cell carcinoma (OSCC) using the noninvasive liquid biopsy of tear fluids. Unstimulated tears from patients with OL (N=10), proliferative verrucous leukoplakia (PVL) (N=10), OSCC (n=14), and control patients (N=10) were collected and submitted to discovery-based proteomics by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The data were analyzed by the software MaxQuant (proteomics), Byonics (N-glycoproteomics), and PEAKS database (post-translational modifications) (ANOVA following the Tukey test assuming p<0.05). Proteomic data were integrated with analysis of public databases to validate the findings. We identified a panel of proteins with differential abundance among the groups that present the potential capacity to predict malignant transformation. Many proteins are correlated with clinicopathological features, such as epithelial dysplasia, lymph node metastasis, and clinical stages of the disease. In addition, using public databases we demonstrated that some proteins identified in our panel of biomarkers are druggable and may be useful as therapeutic targets. Liquid biopsy from tear fluids may be a powerful noninvasive tool to provide insights into the biology of OSCC. Financial Support: FAPESP 22/04490-1. [ABSTRACT FROM AUTHOR]

To describe demographic and clinicopathological aspects of a South-American cohort of incipient oral squamous cell carcinomas (OSCCi patients). A cross-sectional study was performed to assess patients from 6 South-American institutions. 107 patients within the histopathological spectrum of OSCCi (in situ and microinvasive) were included in this sample. Fifty-eight (54.2%) patients were men with a mean age of 60.69 years. Forty-nine (45.8%) and 39 (36.5%) patients had a history of tobacco and alcohol use, respectively. Clinically, most of the lesions were plaques (82.2%), ≥ 2 cm in extension (72%), affecting the lateral tongue (55.1%), and soft palate (12.1%) with a mixed (with and red) appearance. Eighty-two (76.7%) lesions were predominantly white and 25 (23.3%) were predominantly red. This is the largest cohort of OSCCi patients reported in the literature so far, which raises awareness of clinicians' inspection accuracy by demonstrating the most frequent clinical aspects of OSCCi, potentially contributing to oral cancer secondary prevention strategies. This study was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES [ABSTRACT FROM AUTHOR]

The diagnosis of high-grade lymphomas remains challenging for pathologists. This study aimed to implement a deep learning-based model (DLBM) to assist pathologists in differentiating diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), and plasmablastic lymphoma (PL). Whole slide images from 30 patients (10 with DLBCL, 10 with BL, and 10 with PL) were annotated, segmented, and fragmented into 41,227 patches (DLBCL=13,813, BL=14,705, and PL=12,709) of 299×299 pixels to use in training the DLBM for classification of high-grade lymphomas. Pre-trained models VGG16, Xception, and ResNet101, and other open-source libraries for machine learning and image processing were used. The pre-trained models VGG16, Xception, and ResNet101 achieved accuracies of 91.66%, 95.24%, and 94.41%, respectively, with a training ratio of 50%. F1-score for VGG16 was 0.91, for Xception was 0.95 and for ResNet101 was 0.94. The ROC curve analysis showed that VGG16 had a fine class separation ability of 93.68%, Xception had 96.39%, and ResNet101 had 95.76%. The DLBM used in this study is feasible to differentiate DLBCL, BL, and PL. Taken together, these results suggest that although the three pre-trained models performed well in differentiating the high-grade lymphomas, Xception was the best among them. [ABSTRACT FROM AUTHOR]

A 5-year-old Caucasian boy was referred for evaluation due to the chief complaint of missing lower teeth. The patient's father mentioned that during a previous dental appointment, a panoramic radiograph was taken, and the dentist raised the possibility of cherubism. Upon extra-oral examination, the boy displayed hyperpigmented periocular skin, reduced eyebrow and eyelash density, a hypoplastic midface, prominent lips, dry skin, and thin, sparse hair. Intraoral examination revealed oligodontia, conoid-shaped teeth, and dry oral mucosa. The panoramic radiograph confirmed the absence of dental germs for permanent teeth. The combination of clinical and radiographic findings strongly supported the diagnosis of Hypohidrotic Ectodermal Dysplasia. The patient was subsequently referred for genetic counseling and pediatric dentistry. This case emphasizes the significance of a stomatologist in establishing the correct diagnosis. [ABSTRACT FROM AUTHOR]

Oral pulse granuloma (OPG) is an infrequent condition characterized as a foreign body reaction to vegetable particles. This study aimed to report two cases of OPG on the tongue, an unusual location for this lesion. Two female patients, aged 75 and 53 years, presented with painless, well-defined submucosal nodules on the dorsal tongue. Due to the similar clinical features, both cases were clinically diagnosed as mesenchymal benign neoplasms. Excisional biopsies were performed in both instances. Histological assessment revealed a mixed inflammatory infiltrate surrounding a foreign body resembling a vegetable particle, along with the presence of bacterial colonies. Based on these findings, the diagnosis of OPG was established for both cases. In both instances, the tongue healed without complications, and there have been no signs of recurrence after 8 and 12 months of follow-up, respectively. Diagnosing OPG can be challenging due to the clinical presentation overlapping with other oral conditions, primarily benign mesenchymal neoplasms. [ABSTRACT FROM AUTHOR]

Oral soft tissue necrosis is a rare complication of head and neck radiotherapy, often underreported in the literature, yet associated with significant morbidity in cancer survivors. In this case series, four patients with a mean age of 60 years were diagnosed. Their medical histories included squamous cell carcinoma in the posterior regions of the oral cavity, diabetes mellitus, hypertension, intracranial aneurysms, and a risk of thrombosis. Clinical diagnosis of soft tissue necrosis occurred between 2 and 5 months after radiotherapy, presenting as extensive chronic ulcers and painful necrotic masses. Patients received treatment involving oral hygiene protocols, photobiomodulation, and PENTO. The response to treatment, as reported in the literature, is gradual, and patients are continuously monitored and supported. The case series emphasizes the diagnostic and therapeutic challenges associated with this oral toxicity resulting from radiation therapy. [ABSTRACT FROM AUTHOR]

Oral verruciform xanthoma (OVX) is an uncommon lesion of uncertain origin, allegedly related to trauma, inflammation, or altered immune response. Two cases of OVX are reported. The first patient, a 31-year-old man, with a history of graft-versus-host disease (GVHD) after allogeneic transplantation for acute myelocytic leukemia, presented painful nodular lesions on the lingual dorsum and hard palate, and diffuse lichenoid lesions. The provisional clinical diagnosis was verruciform xanthoma and lichenoid lesions in a patient with GVHD. The patient is currently taking Apixaban for six months due to a pulmonary thromboembolism, what postponed the biopsy. The second patient, also a 31-year-old man, smoker, presented an asymptomatic wart on the lower lip and a plaque on the right buccal mucosa with 1 year of evolution. Clinical appearance suggested verrucous leukoplakia or hyperkeratosis, however, histopathological and immunohistochemical examinations were compatible with OVX. Eight months after excisional biopsy, the patient remains well without recurrence. [ABSTRACT FROM AUTHOR]

A 78-year-old woman sought a diagnosis for symptomatic gingival lesions that had been troubling her for the past nine months. Upon intraoral examination, vesiculobullous lesions were observed on both upper and lower gingiva. Additionally, there were irregular and multiple ulcers, indicative of desquamative gingivitis. The patient also reported a persistent conjunctivitis that was affecting her right eye, causing irritation. As a result, the primary diagnostic consideration was mucous membrane pemphigoid (MMP). An incisional biopsy was conducted, and microscopically, it confirmed the diagnosis of MMP. The patient was subsequently referred to dermatologists and ophthalmologists for further evaluation and treatment. They prescribed both topical and systemic anti-inflammatory steroids, but the patient declined the therapy, expressing concerns about potential medication side effects. During follow-up, the condition in her right eye worsened, leading to symblepharon formation and a compromised vision. Over subsequent visits, it was noted that the disease had progressed, and the patient's left eye was also affected, mirroring what had occurred with her right eye. [ABSTRACT FROM AUTHOR]

Keratocyst is a developmental odontogenic cyst with a slight male predilection. It most commonly occurs in the posterior mandible. Radiographically, it typically presents as a well-defined radiolucent area with regular, well-defined radiopaque margins. In some cases, when it occurs in the midline anterior maxillary region, it can mimic other lesions like a nasopalatine duct cyst or periapical cyst. In the presented case, a 48-year-old man was referred for evaluation of a radiolucent lesion located between the roots of teeth 11 and 21. Upon clinical examination, a discreet swelling was noted in the vestibular region near the apices of teeth 11 and 21. A CT scan revealed an independent lesion from the nasopalatine duct, leading to the initial diagnostic hypothesis of a periapical cyst. However, as there was no regression of the lesion following endodontic retreatment, it was surgically removed. Microscopic analysis confirmed the diagnosis of a keratocyst. This case underscores the importance of correctly diagnosing and closely monitoring intraosseous lesions to ensure appropriate management and treatment. [ABSTRACT FROM AUTHOR]

Sialoliths, or sialolithiasis, are benign lesions and represent the most common cause of obstruction and swelling in the major salivary glands. We report two cases of patients attended at different dental services. In Case 1, a 49-year-old man with no comorbidities presented to the dental office with complaints of pain, fever, and swelling on the left side of the floor of the mouth. In Case 2, a 41-year-old man with no comorbidities was referred by a healthcare professional due to the presence of a lesion, also on the left side of the floor of the mouth, although he had no specific complaints. In both cases, panoramic radiography and cone-beam tomography were performed, leading to the diagnosis of large sialoliths obstructing the duct of the left submandibular gland. The first case had a sialolith measuring 25x10mm, while the second case had a sialolith measuring 31x15mm. The treatment of choice for both cases was surgical excision, and both patients are currently under follow-up with no signs of recurrence. [ABSTRACT FROM AUTHOR]

Warthin Tumor, also known as papillary cystadenoma lymphomatosum, is the second most prevalent benign parotid gland tumor, accounting for approximately 2 to 15% of all cases. A 62-year-old male patient presented with a progressively painless swelling in the lower left face region that had been developing for 4 years. During the extraoral examination, a well-defined, firm mass with a diameter of 10 centimeters was identified. As part of the diagnostic process, magnetic resonance imaging and a fine-needle aspiration biopsy (FNAB) were performed, both of which confirmed the diagnosis of a Warthin Tumor in the parotid gland. The patient was referred to a head and neck surgeon for treatment. However, he returned after 3 years with no clinical evidence of the tumor. Interestingly, he reported that no surgery had been performed, and after the FNAB, he experienced pain, erythema, and the drainage of fluid for several days. Following this occurrence, complete regression of the lesion was observed. [ABSTRACT FROM AUTHOR]

Crohn's Disease is an inflammatory condition of the gastrointestinal system characterized by symptoms such as abdominal pain, diarrhea, fever, and weight loss due to malabsorption of nutrients. A 9-year-old boy was referred for evaluation due to multiple mouth ulcers that had experienced periods of regression and exacerbation. Additionally, the patient presented widespread redness in the gingiva. Initially, the main hypothesis was hypovitaminosis, and blood exams were conducted, which revealed extremely low serum iron levels. During this time, the patient's mother reported episodes of abdominal swelling and diarrhea, which had required hospitalization on several occasions. Consequently, the patient was referred for medical evaluation, including imaging exams and serum calprotectin levels, ultimately leading to the diagnosis of Crohn's Disease. Currently, the patient is undergoing maintenance therapy for Crohn's Disease and does not exhibit oral manifestations of the condition. [ABSTRACT FROM AUTHOR]

This report aims to describe a case of white sponge nevus (WSN) diagnosed in a 9-year-old male patient who has been presenting multiple white intraoral lesions since he was eight months old. No other family member exhibited similar manifestations. The intraoral examination revealed generalized, non-scrapable, thick, irregular, white plaques affecting the lips, bilateral buccal mucosa, tongue, floor of the mouth, and oropharynx. His lower lip exhibited painful fissures. An incisional biopsy and exfoliative cytology were performed, and the findings revealed parakeratotic epithelial cells with dense perinuclear hyperchromatic condensation and cells with cytoplasmic vacuolization. A diagnosis of WSN was established, and topical clobetasol was administered to alleviate the patient's symptoms. The clinical appearance is currently stable. WSN is an uncommon benign disorder characterized by dyskeratotic hyperplasia of mucous membranes. Exfoliative cytology represents a non-invasive technique to aid in the diagnosis of WSN. [ABSTRACT FROM AUTHOR]

Lichenoid and granulomatous stomatitis (LGS) is an uncommon inflammatory condition of the oral mucosa with distinctive clinical and microscopic features. We report three new LGS cases, emphasizing detailed clinicopathologic correlation for a definitive diagnosis. Case 1 involves a 53-year-old female with a 3-month history of a painful white lesion in the upper labial mucosa. Case 2 features a 56-year-old female presenting with whitish papules in the anterior gingiva and upper labial mucosa, accompanied by irritation symptoms. Case 3 includes a 43-year-old female with an erythematous lesion and a burning sensation in the upper lip mucosa. The differential diagnoses for all three cases considered oral lichenoid lesion or oral lichen planus. Microscopically, lymphocytic infiltration, granulomas, and lymphoid nodules in the perivascular and perineural regions were evident. Symptomatic treatment with topical steroids was administered. However, the lesions persisted, remaining localized, and patients are undergoing clinical follow-up. [ABSTRACT FROM AUTHOR]

A 44-year-old man previously reported severe pain in tooth 21, which had received endodontic treatment. Shortly thereafter, swelling developed on the gingiva and hard palate, leading to scaling, root planning, and laser therapy procedures. Despite these efforts, the patient's condition did not improve, prompting a referral for further evaluation. Physical examination revealed a fibroelastic swelling in the anterior region of the left maxilla, exhibiting a purplish hue and a telangiectatic surface. Tomographic examination unveiled an expansile hypodense lesion in the periapical region spanning teeth 21 to 24, characterized by ill-defined boundaries. An incisional biopsy was conducted, and immunohistochemical analysis exhibited positivity for LCA, CD20, PAX5, CD10, and BCL-6 in over 30% of cells. Additionally, BCL-2 was positive in fewer than 30% of cells, while CD3 and MUM-1 antibodies returned negative results. The definitive diagnosis of Diffuse Large B-Cell Non-Hodgkin Lymphoma was rendered, prompting the patient's referral to an oncologist. Subsequent chemotherapy led to a marked improvement in the patient's condition. [ABSTRACT FROM AUTHOR]

Objective: This systematic review aimed to evaluate the epidemiologic profile, screen for possible risk factors, and evaluate the spectrum of clinical characteristics of oral squamous cell carcinoma (OSCC) around dental implants (DIs).Methods: The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta- Analyses statement.Results: Thirty-three articles met the eligibility criteria. In total, the sample consisted of 63 patients, and women comprised the majority (55.5%). The mean age of patients was 66.7 years. Oral potentially malignant disorders were reported in 46% of patients, of which 65.5% occurred in women. The most common lesion found in women was oral lichen planus (52.6%). In 88.8% of patients OSCC around DIs occurred in the mandible, and the most common clinical appearance of the lesions was an exophytic mass (46%). Most of these lesions were initially treated as peri-implantitis.Conclusions: Most patients with OSCC around DIs were women without known risk factors. It is important to emphasize that these lesions may present clinical and radiographic features that could resemble peri-implantitis, which can lead to delay in the diagnosis and subsequent treatment. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to estimate the frequency of oral leukoplakia and oral erythroplakia in young patients.Study Design: The systematic review was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and performed in the following electronic databases: PubMed, Scopus, and Embase. The studies included were cross-sectional, cohort, and diagnostic, which provided with clinical and microscopic data of patients younger than 40 years. The Critical Appraisal Checklist for Prevalence Studies from the Joanna Briggs Institute and the Quality Assessment Tool for Diagnostic Accuracy Studies were used to assess the risk of bias.Results: Five studies met eligibility criteria and were included. The total number of patients from the studies was 1246, of which 115 were young patients (9.2%) with oral leukoplakia as the only oral potentially malignant disorder reported. Oral epithelial dysplasia was identified in 40 cases (34.7%), of which 8 (6.9%) presented malignant transformation.Conclusions: The frequency of oral leukoplakia is low in young patients. Observational studies are necessary for understanding oral leukoplakia and other oral potentially malignant disorders in younger patients. [ABSTRACT FROM AUTHOR]

Objective and Study Design: This narrative review summarizes the current state of art of radiation-related caries (RC), an aggressive disease that affects approximately 30% of post-head and neck radiotherapy (HNRT) patients.Results: RC mainly affects the tooth cervical areas and incisal/cuspal tips and develops 6 to 12 months after HNRT. Early RC signs include black/brownish tooth discoloration and enamel cracks, which progress to enamel delamination, exposing underlying dentin to a highly cariogenic oral environment and rapid tooth destruction/dental crown amputation. As RC advances and renders the tooth nonrestorable, it may lead to osteoradionecrosis spontaneously or upon extraction if the tooth is in a highly irradiated field of the oral cavity. This requires aggressive treatment, which would have a negative impact on a cancer survivor's quality of life and contribute to the incremental cost of cancer care. Chlorhexidine mouth rinses and topical fluoride applications are effective agents used in RC prevention; however, there are no well-established treatment protocols. Once RC progresses, dental restorations should be performed with adhesive materials in association with systematic fluoride application as illustrated in the clinical case presented in this review. Post-HNRT patients should be closely followed up for optimal RC prevention, early diagnosis, and prompt treatment.Conclusions: Future clinical studies are necessary to establish a contemporary, clinically validated protocol for RC management. [ABSTRACT FROM AUTHOR]

Objective: This review aimed to explore the paradigms of disclosing a cancer diagnosis with a focus on oral and oropharyngeal cancer and patient-related considerations.Study Design: A search of MEDLINE, Embase, and Scopus was conducted using the following keywords: oral cancer; mouth lesions; oncology; breaking bad news; truth disclosure; and communication skills training. English and Spanish language studies published through October 2019 were included.Results: The way bad news is conveyed to patients with cancer may affect their comprehension of information, emotional distress, treatment adherence, and health outcomes. Models of communication that are focused on patients' preferences may result in better treatment outcomes. Available protocols, such as SPIKES and ABCDE, have useful recommendations for health care professionals communicating an oral cancer diagnosis. However, it is important to be attentive to the particular information needs of patients.Conclusions: When communicating a cancer diagnosis, providers should employ validated methods of information delivery and support for oncology patients. Further studies are needed to evaluate the experiences and preferences of patients with oral cancer during these communications. [ABSTRACT FROM AUTHOR]

Objective: Although radiation-related caries (RRC) are a well-known toxicity of head and neck radiotherapy, a clinical classification system for RRC has not yet been clinically validated. Therefore, the aim of this study was to assess whether the International Caries Detection and Assessment System (ICDAS) and the Post-Radiation Dental Index (PRDI) were viable methods for the assessment of RRC.Study Design: Clinicopathologic data and intraoral digital photographs of 60 patients (833 teeth) affected by RRC were assessed and classified according to the ICDAS and PRDI criteria.Results: A total of 814 (97.7%) teeth presented RRC lesions ranging from early stage to complete tooth destruction. Mean scores for the whole sample were 5 for ICDAS and 3 for PRDI, indicating that RRC were diagnosed predominately in late stages. ICDAS and PRDI criteria underestimate the clinical expressivity of RRC by not including the whole qualitative clinical spectrum of RRC, such as enamel cracks, delamination, dental crown amputation, surface color alterations, and atypical lesions topography (incisal/cuspal caries).Conclusions: ICDAS and PRDI may not be considered viable for the assessment of RRC. The development of a specific clinical classification system is urgently needed to help clinicians recognize the peculiar patterns of RRC, particularly in incipient cases. [ABSTRACT FROM AUTHOR]

Objective: Recent studies suggested that head and neck radiotherapy increases active forms of matrix metalloproteinases (MMPs) in the dentin-enamel junction (DEJ), leading to enamel delamination and radiation-related caries. This study aimed to assess the expression and activity of the gelatinases MMP-2 and MMP-9 in the DEJ and dentin-pulp complex tissues of teeth irradiated in vivo.Study Design: Thirty-six teeth were studied, including 19 irradiated and 17 non-irradiated controls. In situ zymography was used to investigate the gelatinolytic activity in the micromorphologic components of enamel, DEJ, dentin-pulp complex, and caries. Immunohistochemical analysis was conducted on the demineralized samples to assess MMP-2 and MMP-9 expression levels in the DEJ, dentin-pulp complex components, and caries.Results: No statistically significant differences were detected between groups in gelatinolytic activity or in MMP-2 expression levels (P > .05). Odontoblast MMP-9 expression was reduced in the irradiated group (P = .02).Conclusions: The study rejected the hypothesis that MMP-2 and MMP-9 would be overexpressed or more activated in the DEJ and dentin-pulp complex of irradiated teeth. Direct effects of radiation should not be regarded as an independent factor for explaining radiation-related caries onset and progression. [ABSTRACT FROM AUTHOR]

Objective: To test the hypothesis that intravenous (IV) bisphosphonate (BP) therapy thickens or alters the micromorphology of cementum and periodontal ligament (PDL) in cancer patients.Study Design: Thirty-two teeth extracted from 24 cancer patients and separated into test (patients who have undergone IV BP therapy, n = 16) and control (patients naive to BP therapy, n = 16) groups were studied. Cementum thickness was measured in 3 different areas of the dental root with polarized light microscopy. PDL was assessed by optical light microscopy and the immunohistochemical expression of periostin.Results: No significant difference was detected in cementum thickness (apical, P = .06; medium, P = .16; cervical, P = .18) between groups. The numbers of fibroblasts in PDL (P = .56), incremental lines of cementum (P = .51) and the immunohistochemical patterns of periostin expression in PDL (P = .68) did not differ between groups.Conclusion: IV BP therapy does not thicken cementum or change the micromorphology of PDL. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to characterize the histomorphometric features of subgemmal neurogenous plaques (SNPs) to better understand their relationship to surrounding microanatomy included in the tissue biopsy samples of the tongue.Study Design: A 12-year retrospective study on the files of 3 oral pathology centers yielded 28 SNPs. Hematoxylin and eosin-stained sections were used for histologic analysis, and immunohistochemical staining for S100 protein was performed to better characterize the neural structures. Slides were scanned and histomorphometric analysis carried out using ImageScope software.Results: Twenty-one women (75%) and 6 men (21.4%) comprised the sample (mean age 46.4 and 49 years, respectively). Twenty cases (71.4%) were juxtaposed to the tongue epithelium and 16 cases (57.1%) were associated with lymphoid tissue. The mean area of the SNPs was 0.160 mm2, and the mean distance to the overlying epithelium was 0.312 mm.Conclusions: SNPs are normal neural structures located on the posterior border of the tongue that represent a non-neoplastic regional anatomic variation. In some cases, signs or symptoms may be present, and further investigation should be performed. Pathologists should be aware of this entity to avoid confusion with neural lesions. [ABSTRACT FROM AUTHOR]