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Aims: Radiation caries (RC) is a highly prevalent and chronic complication of head and neck radiotherapy (HNRT) and presents a challenge for clinicians and patients. The present study aimed to assess the impact of RC on the morbidity and mortality outcomes of head and neck squamous cell carcinoma (HNSCC) patients. Methods and Results: Patients were divided into three groups: (1) RC (n = 20), (2) control (n = 20), and (3) edentulous (n = 20). Information regarding the number of appointments, dental procedures, osteoradionecrosis (ORN), prescriptions, and hospital admissions were collected. Mortality outcomes were assessed through disease‐free survival (DFS) and overall survival (OS) rates. RC patients required more dental appointments (p <.001), restorations (p <.001), extractions (p =.001), and antibiotic and analgesic prescriptions (p <.001). Kaplan–Meier subgroup analyses showed a significantly increased risk of ORN in RC compared to edentulous patients (p =.015). RC patients presented lower DFS rates (43.2 months) than the control and edentulous groups (55.4 and 56.1 months, respectively). Conclusions: RC impacts morbidity outcomes among cancer survivors due to increased demand for medication prescriptions, multiple specialized dental appointments, invasive surgical treatments, increased risk of ORN, and increased need for hospital admissions. [ABSTRACT FROM AUTHOR]

A 55-year-old female patient, previously diagnosed with breast carcinoma and having undergone surgery, chemotherapy, and radiotherapy, presented with two foci of bone metastasis. She was referred for evaluation due to numbness on her lower lip and chin. A panoramic X-ray revealed a discreet, poorly delimited radiolucent area in the right mandibular ramus region. Cone-beam computed tomography confirmed a hypodense image in the mandibular medullary bone with indistinct borders and signs of cortical bone resorption. Given the patient's clinical symptom of paresthesia, her history of metastatic breast cancer, and the imaging findings, the primary diagnosis hypothesis was another bone metastasis. The patient was subsequently referred to her oncologist. During follow-up, the patient developed extraoral asymmetry with an increased volume in the right mandibular ramus region. There was also an evolution of radiolucent and hypodense areas, along with severe disruption of the distal cortex of the right mandibular ramus. Unfortunately, the patient passed away 3 years after the initial evaluation. [ABSTRACT FROM AUTHOR]

Syphilis, a sexually transmitted disease caused by Treponema pallidum, manifests in distinct stages, each characterized by different oral lesions. A 38-year-old male presented with ulcerated lesions on the lateral border of the tongue and anterior vestibule fornix, evolving over 40 days. The patient reported additional symptoms such as weight loss, fever, and fatigue. An incisional biopsy of the anterior vestibule lesion revealed non-specific chronic ulceration. Following referral to the infectious and contagious diseases center, the patient received diagnoses of syphilis and HIV/AIDS, leading to a 6-month hospitalization. Treatment was administered, resulting in the patient's current well-being with an undetectable viral count. Timely and accurate diagnosis, along with proper referral, is crucial for determining an appropriate treatment strategy. [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 51-year-old female patient, who is HIV-positive, was referred for the assessment of a white lesion on the buccal mucosa on the left side, near the labial commissure. The lesion measured approximately 2 cm and had well-defined, verrucous surfaces, encircled by a brownish halo, indicative of melanin pigmentation. An incisional biopsy was conducted, and the histopathological examination revealed squamous epithelium with hyperkeratosis, acanthosis, and severe epithelial dysplasia. Furthermore, superficial cells displayed koilocytosis, indicating a viral infection. Immunohistochemistry for p16 demonstrated widespread nuclear and cytoplasmic positivity in the surface epithelium. In situ hybridization for broad-spectrum HPV detected viral DNA within the nucleus of epithelial cells. These findings led to the diagnosis of HPV-associated severe epithelial dysplasia. The patient was referred to a head and neck surgeon, and a complete resection of the lesion was performed. The patient is currently under observation and shows no clinical signs of recurrence. [ABSTRACT FROM AUTHOR]

Photobiomodulation (PBM) therapy is an effective method for preventing and managing oral mucositis (OM) in head and neck squamous cell carcinoma (HNSCC) patients undergoing radiotherapy alone or in combination with chemotherapy. However, the potential effects of PBM therapy on premalignant and malignant cells eventually present in the treatment site are yet unknown. The aim of this systematic review was to analyze the effects of PBM therapy on HNSCC. A literature search was conducted in four indexed databases as follows: MEDLINE/PubMed, EMBASE, Web of Science, and Scopus. The databases were reviewed for papers published up to and including in October 2018. In vitro and in vivo studies that investigated the effects of PBM therapy on HNSCC were selected. From the 852 initially gathered studies, 15 met the inclusion criteria (13 in vitro and 2 in vivo). Only three in vitro studies were noted to have a low risk of bias. The included data demonstrated wide variations of study designs, PBM therapy protocols, and study outcomes. Cell proliferation and viability were the primary evaluation outcome in the in vitro studies. Of the 13 in vitro studies, seven noted a positive effect of PBM therapy on inhibiting or preventing an effect on HNSCC tumor cells, while six studies saw increased proliferation. One in vivo study reported increased oral SCC (OSCC) progression, while the other observed reduced tumor progression. Overall, the data from the studies included in the present systematic review do not support a clear conclusion about the effects of PBM therapy on HNSCC cells. [ABSTRACT FROM AUTHOR]