Oral diseases最新文献

Objectives: This study aimed to retrospectively analyze the prevalence and clinical characteristics of TUGSE and explore the potential role of viral agents in these lesions.

Methods: Fifty-seven TUGSE and 50 non-specific ulcer patients were included. Patient demographic and clinical data were collected. Formalin-fixed paraffin-embedded tissues were screened by PCR for Epstein-Barr virus (EBV), cytomegalovirus (hCMV), human papillomavirus (HPV), herpes simplex virus (HSV), and Helicobacter pylori (H. pylori).

Results: The majority of TUGSE patients were in their sixth (29.8%) and seventh (24.6%) decades of life, with a 1:1.6 male-to-female ratio. The tongue is the most common site (47.4%), followed by buccal mucosa (28.1%). The average duration was 13.5 weeks, and almost one-fourth of the lesions were clinically diagnosed as oral squamous cell carcinoma (24.6%). TUGSE showed a significantly higher propensity to harbor macrophage infiltrates and inflammatory involvement with skeletal muscle fibers or salivary gland tissues, compared to non-specific ulcers. EBV was observed in two TUGSE cases (3.5%) and one patient with a non-specific ulcer (2.0%). Other viral agents were undetectable in TUGSE.

Conclusion: TUGSE frequently affects the elderly population with a female predilection. The observed low prevalence of viral agents suggests that these pathogens may not play a direct role in TUGSE development.

Background: Mucosal-dominant pemphigus vulgaris (MD-PV) and low-risk mucous membrane pemphigoid (LR-MMP) are autoimmune bullous diseases primarily affecting the oral mucosa, yet their oral microbiome profiles remain inadequately characterized.

Methods: Using 16S rRNA sequencing of saliva from 21 MD-PV patients, 26 LR-MMP patients, and 14 healthy controls (HC), we analyzed microbial diversity, differential taxa (LEfSe), and functional potential (PICRUSt2/BugBase).

Results: Both patient groups showed significant microbial restructuring without major richness changes, featuring increased Firmicutes and decreased Proteobacteria. Disease-specific signatures included Flavobacteriia enrichment in MD-PV and Coriobacteriia/Actinobacteria in LR-MMP. Shared metabolic alterations involved "Biosynthesis of amino acids," "Phosphotransferase system," and "Ribosome" pathways, while distinct activations included "all-trans-farnesol biosynthesis" in MD-PV and "peptidoglycan biosynthesis" in LR-MMP. Phenotype prediction revealed increased Gram-positive bacteria and reduced pathogenic and stress-tolerant taxa. Microbial dysbiosis scores positively correlated with clinical disease severity.

Conclusion: Our study identifies distinct oral microbial dysbiosis patterns in MD-PV and LR-MMP, with conserved functional shifts and disease-specific metabolic adaptations. The microbiota-severity correlation highlights its potential role in disease mechanisms, offering new insights for therapeutic exploration.

Trial registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR2500105460.

Background: This study aimed to analyze the temporal trends of oral tongue squamous cell carcinoma (OTSCC) in Brazil from 2013 to 2023, comparing young adults (20 to 44 years) to older adults (≥ 45 years).

Methods: Sex, age, staging, year, and Federative Unit of diagnosis were evaluated for all cases registered under the ICD-C02 code in a public nationwide database. Statistics encompassed the Dickey-Fuller and Mann-Kendall tests, Kendall's Tau coefficient, and Sen's Slope Estimator.

Results: The registry of OTSCC increased from 2013 to 2023, with a stronger and more consistent trend in young adults. OTSCC showed a stronger, more consistent, and higher rate of increase in young females than in young males. OTSCC was diagnosed at advanced stages in both age groups. OTSCC increasing trends were pronounced in the North region.

Conclusion: This study presented an overview of the temporal trends of OTSCC in Brazil, evidencing an increase among young women.

Background: Traditional oral mucosal disease (OMD) diagnosis relies heavily on clinicians' experience and visual assessment, suffering from high subjectivity and low efficiency. OMD images also have insufficient supervision information and fuzzy lesion boundaries, failing to meet mobile medicine's high accuracy requirements.

Methods: To solve these issues, we proposed a weakly supervised OMD segmentation model with multi-task collaboration (WSSM). Using Mamba as the backbone, WSSM realizes efficient lesion segmentation via classification-segmentation dual-branch collaboration. The classification branch captures multi-directional, multi-scale features via a dedicated network, and its pseudo-label module fuses class activation maps, box annotations, and predictive annotations for deeper supervision. The segmentation branch adopts a symmetric network to extract overall lesion features, with a boundary adaptive module enhancing fuzzy boundary representation to improve accuracy.

Results: Experiments on the OMD dataset demonstrated that WSSM outperformed existing weakly supervised methods significantly, with its Dice index increasing by 6.06% compared to WSSL.

Conclusions: Our model, with Mamba as the backbone (balancing local texture feature extraction and long-range semantic dependency modeling of OMD lesions), enables deeper supervision via dual-branch collaboration, significantly improving boundary segmentation accuracy in scenarios with insufficient OMD supervision and unclear boundaries. PAPER CODE: https://github.com/XJ156/WSSM3.git.

Background: Ultrasonography is widely used to evaluate salivary gland involvement in primary Sjögren's disease (SjD). However, distinguishing SjD-related dry mouth from idiopathic xerostomia (IX) remains challenging. This study evaluates whether elastography, an advanced ultrasonographic technique measuring gland stiffness, can improve differentiation.

Methods: In this retrospective study, 192 patients diagnosed with SjD (n = 83) or IX (n = 109) were assessed for xerostomia severity and underwent conventional, Doppler ultrasonography, and shear wave elastography (SWE) of salivary glands. Additional SjD-related indicators, including serological and pathological markers, were analyzed. Univariate and multivariate logistic regression identified key differentiators, and generalized additive model (GAM) examined nonlinear associations.

Results: SjD patients showed significantly higher parotid gland stiffness (23.9 ± 10.9 kPa) compared to IX patients (15.1 ± 6.7 kPa, p < 0.0001). Additionally, submandibular gland homogeneity and parotid stiffness were independent predictors of SjD. Multivariate analysis revealed parotid stiffness as the strongest factor associated with SjD (OR = 1.152 per kPa increase, 95% CI: 1.080-1.241). GAM analysis revealed a nonlinear exposure-response pattern, with the modeled proportion of SjD reaching approximately 50% at a parotid stiffness of 17.7 kPa.

Conclusion: Parotid gland stiffness shows promise as a clinical tool for distinguishing SjD from IX.

Objective: The relationship between periodontitis and bruxism has always been a matter of debate. The aim of the present paper is to investigate the association between advanced stages of periodontitis (Stage III/IV) and the intensity and duration of sleep bruxism events, measured as bruxism work index (BWI) and bruxism time index (BTI) through surface electromyography.

Methods: Subjects were selected from patients regularly attending the School of Dentistry of the University of Siena, Siena, Italy, with the aim of having a test group of patients with periodontitis and a control group without periodontitis. Two calibrated operators performed the periodontal assessment. The sleep-time surface electromyographic activity of the left masseter muscle was registered through a portable device (dia-BRUXO, Biotech-Novations, Sanremo, Italy). Differences between cases and controls in the outcome variables concerning masseter activities were assessed.

Results: No significant difference was found between the two groups for the sleep bruxism work index and bruxism time index. Instead, a moderately negative significant correlation was found between the bruxism work index and the full mouth bleeding score.

Conclusion: Patients with advanced stages of periodontitis (Stage III and Stage IV) do not exhibit a higher frequency and intensity of sleep bruxism events compared to healthy individuals.

Objective: To investigate gingival and periodontal characteristics in Ectodermal dysplasia (ED), focusing on soft-tissue phenotype, anatomical variations, and periodontal architecture.

Materials and methods: Observational clinical study of 11 individuals (16-30 years) with confirmed clinical or genetic ED diagnosis. Only periodontally healthy patients were included. Assessments comprised Plaque Index and modified Gingival Index, Probing Depth (PD), Bleeding on Probing (BoP), Gingival Phenotype, Widths of Attached Gingiva (AGW) and Keratinized Mucosa (KMW). A histological sample of keratinized gingiva was obtained from a single patient to complement the clinical evaluation.

Results: A consistently thin gingival phenotype was found, with medium/thick tissues confined to isolated molars. AGW and KMW were within ranges but unevenly distributed; several mandibular areas showed reduced or absent attached gingiva. Some sites with minimal AGW lacked recession, suggesting a congenital condition. Gingival fragility and translucency complicated standard indices, potentially overestimating PD and BoP. Histology showed epithelial projections into the submucosa and poorly organized connective tissue with loosely arranged collagen and loss of normal supracrestal orientation. Scattered epithelial nests and ectopic enamel matrix deposits are visible within the submucosa.

Conclusions: Individuals with ED may exhibit soft-tissue features and periodontal architecture distinct from typical patterns, supporting the need for tailored clinical assessment and potentially modified diagnostic criteria.

Background: Professional tooth cleaning is a simple, low-cost preoperative oral intervention. Its role in reducing postoperative complications in oral squamous cell carcinoma (OSCC) remains unclear.

Methods: This retrospective cohort study included 415 OSCC patients undergoing radical resection with free flap reconstruction. After propensity score matching, 174 well-matched pairs were analyzed. Patients were divided into a tooth cleaning group (n = 174) and a control group (n = 174). Outcomes included postoperative pneumonia (PP), surgical site infection (SSI), fever, length of stay, and unplanned reoperation were recorded.

Results: Preoperative tooth cleaning was significantly associated with lower PP risk (OR = 0.30). Significant independent risk factors for PP included tumor location at the floor of the mouth (OR = 4.70), hypertension (OR = 2.93), and longer operative duration (OR = 1.33 per hour). The radiographic severity of periodontitis was not a significant risk factor for PP. No associations were found between tooth cleaning and other outcomes. Stratified analyses showed significant protective effects in patients aged > 60 years (OR = 0.19), with hypertension (OR = 0.08), periodontitis (OR = 0.07), or surgeries > 5 h (OR = 0.18).

Conclusion: Preoperative professional tooth cleaning one day before surgery is associated with a reduced risk of PP in OSCC patients.

Objectives: The aim of this systematic review was to assess the impact of dental implants in osteoporotic patients undergoing treatment with denosumab on MRONJ development, considering both implant surgery-triggered osteonecrosis (ISTO) and implant presence-triggered osteonecrosis (IPTO).

Methods: An electronic literature search was conducted applying the clinical PICO question, "What is the effect of dental implants on the risk of developing MRONJ in osteoporotic patients undergoing treatment with denosumab?" The full texts of 239 retrieved articles were screened, and 10 studies were included in the quality assessment and data extraction process.

Results: 10 articles were selected for data extraction: 6 case series, 2 cohort studies, 1 case control study, and 1 randomized controlled trial. The main findings reported in these studies were evaluated, including factors such as the timing of implant placement, the influence of peri-implantitis and comorbidities, antiresorptive therapy, and the cases of MRONJ.

Conclusions: The current literature shows high heterogeneity, small sample sizes, and a lack of standardization, making it difficult to draw definitive conclusions. However, despite MRONJ being relatively rare, important factors were identified that could influence outcomes, such as transitioning from bisphosphonates to denosumab therapy, timing of implant placement, and the presence of peri-implantitis.

Background: Pediatric Sjögren's syndrome (pSS) diagnosis remains challenging due to its low prevalence, heterogeneous clinical presentation, and the lack of universally accepted pediatric-specific diagnostic criteria. This systematic review aims to clarify the diagnostic pathway in pSS, with emphasis on the utility of minor salivary gland biopsy.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Web of Science were searched up to November 2025. Observational, retrospective, cohort, cross-sectional studies, case series, and case reports were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist.

Results: Thirty-nine studies met the inclusion criteria. Recurrent or persistent parotitis emerged as the most frequent glandular manifestation. The most common extra-glandular features included joint involvement and lymphadenopathy. Serological analysis revealed positivity for anti-SSA in 64% and anti-SSB in 51% of cases, with antinuclear antibodies and rheumatoid factor detected in 69% and 53% of patients, respectively. Minor salivary gland biopsy yielded positive findings in approximately 70% of cases.

Conclusions: Minor salivary gland biopsy appears to represent a key component of the diagnostic work-up, particularly in the absence of standardized pediatric criteria. When integrated with clinical and serological findings, it may facilitate earlier and more accurate diagnosis.