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Background Despite the wide application of lasers and electrosurgery in dermatology, the pertinent literature provides conflicting data regarding the lateral thermal injury (LTI) associated with these instruments and its effects on wound healing. This study aims to quantitate the LTI produced by CO2-laser, monopolar electrosurgery (MES), and radiosurgery (MRS) and determine its effects on the healing process (re-epithelialization and inflammatory response) of incisional wounds. Methods Five adult swine of similar weight (22.8-25 kg) were submitted to standardized full-thickness incisions on the lateral abdominal skin by the above instruments (at settings similar to those used in clinical practice) and scalpel (control group). Full-thickness specimens from the surgical site were harvested immediately afterwards and 48 hours later (days 1 and 3). The animals were euthanized by intravenous administration of propofol and pentobarbital. All specimens were formalin fixed, paraffin embedded, cut, and stained with hematoxylin-eosin to quantitate the extent of LTI and inflammatory infiltration. Sections of day 3 were stained with the MIB-1 monoclonal antibody to detect Ki-67 as a marker of epithelial cell proliferation adjacently to the incisions. Results LTI was most extensive in the CO2-laser-group but did not differ significantly between MES- and MRS-groups. Immunohistochemistry ascertained significantly greater epithelial cell proliferation in the CO2-laser-group. Inflammatory infiltration was significantly greater in the CO2-laser-group, when compared with the controls but did not differ significantly between the MES/MRS and control groups. Conclusion CO2 laser incisions exhibit more extensive LTI, epithelial cell proliferation, and inflammatory response. Confirmation of these findings requires a greater sample. [ABSTRACT FROM AUTHOR]

Objective: This study aims to compare lateral thermal damage (LTD) produced by CO2-laser, monopolar electrosurgery (MES), and radiosurgery (MRS) and its effects on the reepithelialization of oral mucosa incisional wounds. Study design: Five adult swine were submitted to standardized incisions at the tongue and gingiva by MES, MRS, CO2-laser and scalpel. Full-thickness specimens were harvested sequentially on days 1 and 3. All specimens were formalin fixed, paraffin embedded, cut, and stained with hematoxylin-eosin to quantify LTD extent. Sections of day 3 were stained for Ki-67 to assess epithelial proliferation at the incision margins. A multiple linear regression model and an analysis of variance were used to determine the correlation of each instrument with LTD extent and Ki-67 expression respectively. Results: LTD was most extensive in the CO2-laser but did not differ between the MES and MRS groups. No statistically significant differences regarding reepithelialization were noted among the investigated instruments. Conclusions: CO2-laser produced more extensive LTD, without evident impact on reepithelialization. [ABSTRACT FROM AUTHOR]

Background: Oral neural tumors (ONTs) are rare lesions and represent reactive or neoplastic proliferations of nerve sheath cells. The purpose of the present study is to report the clinical, demographic and histopathologic features of 157 ONTs diagnosed in a single Oral Pathology Department and review the pertinent literature., Material and Methods: 157 cases of ONTs diagnosed during a 44-year period were retrospectively collected and the diagnosis was reconfirmed by studying representative haematoxylin and eosin stained tissue sections. The patients' gender and age, as well as the main clinical features of the lesions, were retrieved from the biopsy submission forms., Results: The 157 ONTs represented approximately 0.4% of 35,590 biopsies accessioned during the study period. They affected 71 male and 86 female patients with a mean age of 38.4±18.8 years. They mainly appeared as asymptomatic nodules of normal or white colour on the tongue, lip mucosa and hard palate. The most common ONT was granular cell tumour (38.9%) followed by neurofibroma (19.7%), schwannoma (15.9%), traumatic neuroma (15.9%), palisaded encapsulated neuroma (8.3%) and nerve sheath myxoma (1.3%)., Conclusions: This study confirmed the rarity of ONTs. Their clinical characteristics mimic other oral lesions; thus, microscopic examination is the only mean to arrive at a definitive diagnosis. Key words: Oral neural tumors; oral neural neoplasms; neurofibroma; oral neurofibroma; schwannoma; oral schwannoma; neurilemmoma; oral neurilemmoma; granular cell tumor; oral granular cell tumor; traumatic neuroma; oral traumatic neuroma; palisaded encapsulated neuroma; oral palisaded encapsulated neuroma., Competing Interests: Conflict of interest statement:Author Tamiolakis Paris declares that he has no conflict of interest Author Chrysomali Evanthia declares that she has no conflict of interest Author Sklavounou – Andrikopoulou Alexandra declares that she has no conflict of interest Author Nikitakis Nikolaos G declares that he has no conflict of interest This study has been presented as a Poster Presentation in the 2019 Annual Scientific Meeting of the British Society for Oral and Maxillofacial Pathology (BSOMP) in Dublin, Ireland and has been awarded with “Specialist Registrar, Early Career Researcher & Postgraduate Student Clinical Prize”., (Copyright: © 2019 Medicina Oral S.L.)

Methotrexate (MTX) is an established immunomodulating agent used in low doses (LDMTX) to treat several autoimmune diseases. Ulcerative stomatitis (US) may be observed as a long-term LDMTX adverse effect showing a wide histopathologic spectrum. A 73-year old female presented with painful oral ulcers of 5 days duration. The patient had been under treatment for rheumatoid arthritis with LDMTX, while one week before presentation she was prescribed ciprofloxacin for a urinary infection. Histopathologic examination of a lingual ulcer revealed a polymorphous lymphohistiocytic proliferation with scattered binucleated atypical lymphocytes. Immunohistochemically, most cells were of T-cell lineage while the EBER test was negative and a diagnosis of MTX-induced reactive ulceration was rendered. MTX cessation resulted in complete resolution of the ulcers with no recurrences reported so far. The clinical and histopathologic features of MTX-induced oral ulcers are not always diagnostic and a detailed history and an extensive clinicopathologic investigation may be needed to exclude a lymphoproliferative disorder. Key words: Atypical oral ulcers, ciprofloxacin, lymphoproliferative disorders, methotrexate., Competing Interests: The authors declare that they have no conflict of interest.

Oral squamous cell carcinoma (OSCC) is the sixth most common cancer in the world. The phosphatidylinositol 3 kinase (PI3K) signalling pathway has been reported to play an important role in OSCC. Since we have previously detected absence of hotspot PIK3CA gene mutations in the Greek population, we hypothesized that BRAF or HRAS may be activated as upstream effectors of the pathway. Furthermore, the status of the HRAS and BRAF mutations in OSCC has never been assessed before in the Greek population. Eighty-six primary paraffin-embedded tumors were screened for BRAF and HRAS hotspot mutations. In HRAS, two hotspot mutations in codon 12 (2.3%) and eight new genetic alterations were detected (8.6% overall). One new missense mutation, Alanine53Valine (Ala53Val), one silent mutation, two mutations in the 5'UTR region and four mutations in intron 1 were detected. No hotspot mutations in Braf were found. A new silent mutation/polymorphism T1803C was detected at a percentage of 30%. This study is the first to report HRAS mutations in the Greek population. The results suggest that RAS is an important member of the PI3K signalling pathway and may play a role in the tumorigenesis of OSCC.

Objectives: the expression of the osteoclastogenic cytokines TNF-α, IL-6 and IL-1β were immunohistochemically evaluated in peripheral (PGCG) and central (CGCG) giant cell granulomas of the jaws in order to determine differences between these two lesions and between the two distinct tumor cell populations (multinucleated giant cells, MGCs and stromal spindle-shaped cells)., Study Design: Paraffin-embedded tissue sections from 40 PGCG and 40 CGCG were immunohistochemically stained using antibodies against TNF-α, IL-6 and IL-1β. The percentage of positively stained cells and the staining intensity were assessed to provide a combined immunoreactivity score value., Results: TNF-α, IL-6 and IL-1β were expressed in all lesions. The CGCG compared to the PGCG showed significantly increased expression of TNF-α and IL-6 and decreased expression of IL-1β by the spindle-shaped cells and increased expression of IL-1β by the MGCs. The MGCs demonstrated in comparison to the stromal spindle-shaped cells significantly increased expression of all three cytokines in both PGCG and CGCG., Conclusions: The proinflammatory cytokines TNF-α, IL-6 and IL-1β seem to be involved in the growth process of PGCG and CGCG of the jaws. A possible alteration in the synthesis or/and activity of these cytokines by the stromal spindle cells in the CGCGs may enhance osteolysis through the stimulation of osteoclast progenitor cells, given the fact that the intraosseous lesions cause bone resorption.

Osseous choristoma is a rare, benign lesion of the oral cavity occurring usually in the tongue. It appears as a tumorous mass of normal bony structure with mature cells in an ectopic position. The case of a 72 years Caucasian male is presented and analyzed along with 52 similar cases reported in the English literature between 1967 and 2007. Lingual choristoma shows a female predilection, whereas the commonest anatomic location is the posterior third of the tongue, occurring at or close to the foramen caecum and the circumvallate papillae. Histologically the lesions show signs of a well-circumscribed mass of vital bone located under the surface oral epithelium. Some lesions represent developmental malformations, whereas others may be reactive lesions after trauma or chronic irritation. Treatment of lingual osseous choristoma consists of simple excision.