Pub Date : 2025-02-01DOI: 10.1016/j.oooo.2024.10.081
Gabriel Lima Braz DDS , Ana Carolina Uchoa Vasconcelos DDS, PhD , Ana Paula Neutzling Gomes DDS, PhD , Camila Barcellos Calderipe DDS , Alini Cardoso Soares DDS
Objective
To systematically review available data regarding adenomatoid hyperplasia of minor salivary glands (AHMSG).
Study Design
Electronic searches were performed in six databases and gray literature. The risk of bias was assessed using the Joanna Briggs Institute tool.
Results
Forty studies reporting 121 cases of AHMSG were included. There is a male predominance (n = 72/64.29%), with individuals in their fourth and fifth decade of life being the most affected. The palate was the main anatomical location (n = 90/74.39%), and most lesions presented as single, asymptomatic nodules. The mean size of AHMSGs was 1.48 ± 0.77 cm, and the mean evolution time was 16.84 ± 25.67 months. Immunohistochemical evaluation in three cases (2.48%) showed a low labeling index for Ki-67 (n = 2/66.67%) and proliferating cell nuclear antigen (n = 1/33.33%).
Conclusions
AHMSG is an uncommon benign lesion with no tendency to recur after initial surgical removal. The main histological features include an abundant proliferation of glandular acini, occasional ductal dilation, and sometimes the presence of inflammatory infiltrate. Pathologists and clinicians should be aware of AHMSG, as it can closely resemble both benign and malignant salivary gland lesions.
{"title":"Adenomatoid hyperplasia of minor salivary glands: a systematic review","authors":"Gabriel Lima Braz DDS , Ana Carolina Uchoa Vasconcelos DDS, PhD , Ana Paula Neutzling Gomes DDS, PhD , Camila Barcellos Calderipe DDS , Alini Cardoso Soares DDS","doi":"10.1016/j.oooo.2024.10.081","DOIUrl":"10.1016/j.oooo.2024.10.081","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review available data regarding adenomatoid hyperplasia of minor salivary glands (AHMSG).</div></div><div><h3>Study Design</h3><div>Electronic searches were performed in six databases and gray literature. The risk of bias was assessed using the Joanna Briggs Institute tool.</div></div><div><h3>Results</h3><div>Forty studies reporting 121 cases of AHMSG were included. There is a male predominance (<em>n</em> = 72/64.29%), with individuals in their fourth and fifth decade of life being the most affected. The palate was the main anatomical location (<em>n</em> = 90/74.39%), and most lesions presented as single, asymptomatic nodules. The mean size of AHMSGs was 1.48 ± 0.77 cm, and the mean evolution time was 16.84 ± 25.67 months. Immunohistochemical evaluation in three cases (2.48%) showed a low labeling index for Ki-67 (<em>n</em> = 2/66.67%) and proliferating cell nuclear antigen (<em>n</em> = 1/33.33%).</div></div><div><h3>Conclusions</h3><div>AHMSG is an uncommon benign lesion with no tendency to recur after initial surgical removal. The main histological features include an abundant proliferation of glandular acini, occasional ductal dilation, and sometimes the presence of inflammatory infiltrate. Pathologists and clinicians should be aware of AHMSG, as it can closely resemble both benign and malignant salivary gland lesions.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Pages 229-241"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the potential of near-infrared Raman spectroscopy (RS) in distinguishing between various types of bone, dental hard tissues, and bone graft materials, and to determine the correlation between pixel intensity values (PIVs) in cone beam computed tomography (CBCT) and Raman values.
Study Design
A thinly sliced section of mandible was utilized to evaluate cancellous and cortical bone. Extracted human teeth were used to prepare the enamel and dentin samples. Bone graft materials were tested by compacting them into edentulous tooth sockets in a dry human mandible. CBCT and RS scans of the samples were performed. The following RS outcomes were evaluated: 960 cm-1 phosphate peak location and width, carbonate:phosphate ratio, mineral:matrix ratio, and collagen coiling ratio. One-way ANOVA and primary component analysis (PCA) statistics were used to assess RS outcomes.
Results
The 960 cm-1 phosphate peak location was able to effectively differentiate between various tissues and graft materials. PCA of the spectra successfully differentiated native bone from graft materials, underscoring the tissue characterization capability of RS. Varied correlations between RS outcomes and CBCT PIVs were observed.
Conclusions
Various parameters of RS can differentiate between cancellous bone, cortical bone, dental hard tissues, and bone graft materials. The varied correlations between Raman parameters and CBCT PIVs warrant further research to clarify the nature of these relationships.
{"title":"An ex vivo comparison of near-infrared Raman spectroscopy and cone beam computed tomography in the assessment of bone, dental hard tissues, and bone graft materials","authors":"Anusha Vaddi BDS, MDentSci , Aditya Tadinada BDS, MDentSci , Alix Deymier PhD","doi":"10.1016/j.oooo.2024.10.076","DOIUrl":"10.1016/j.oooo.2024.10.076","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the potential of near-infrared Raman spectroscopy (RS) in distinguishing between various types of bone, dental hard tissues, and bone graft materials, and to determine the correlation between pixel intensity values (PIVs) in cone beam computed tomography (CBCT) and Raman values.</div></div><div><h3>Study Design</h3><div>A thinly sliced section of mandible was utilized to evaluate cancellous and cortical bone. Extracted human teeth were used to prepare the enamel and dentin samples. Bone graft materials were tested by compacting them into edentulous tooth sockets in a dry human mandible. CBCT and RS scans of the samples were performed. The following RS outcomes were evaluated: 960 cm<sup>-1</sup> phosphate peak location and width, carbonate:phosphate ratio, mineral:matrix ratio, and collagen coiling ratio. One-way ANOVA and primary component analysis (PCA) statistics were used to assess RS outcomes.</div></div><div><h3>Results</h3><div>The 960 cm<sup>-1</sup> phosphate peak location was able to effectively differentiate between various tissues and graft materials. PCA of the spectra successfully differentiated native bone from graft materials, underscoring the tissue characterization capability of RS. Varied correlations between RS outcomes and CBCT PIVs were observed.</div></div><div><h3>Conclusions</h3><div>Various parameters of RS can differentiate between cancellous bone, cortical bone, dental hard tissues, and bone graft materials. The varied correlations between Raman parameters and CBCT PIVs warrant further research to clarify the nature of these relationships.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Pages 248-259"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.oooo.2024.09.006
Arwa Farag BDS, DMSc , Matthew Finkelman PhD , Scarlet Charmelo-Silva DDS , Christina Sun , Madison Mondry , Mohammed Bindakhil DDS, MS
Objectives
The objectives of this study were to determine the types and frequency of potentially inappropriate medications (PIMs) prescribed to geriatric patients while considering the patients’ age groups and their American Society of Anesthesiologists (ASA) physical status.
Study Design
We performed a 5-year retrospective chart review of patients aged 65 years and above who were seen in a dental institution. Patients’ medical history, PIM prescriptions, and prescribers’ specialty and professional status were analyzed.
Results
Out of 10,675 geriatric patients identified, 6.2% (n = 662) received PIM prescriptions. Of those, 77% received one PIM whereas the others (23%) received anywhere between 2 and 6; the majority (73.7%) of these 662 patients fell within an ASA III physical status. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most prescribed PIM (provided to 60.1% of subjects) followed by opioids (provided to 32.5% of subjects). Both NSAIDs and opioids were largely provided by providers in oral and maxillofacial surgery followed by those in restorative dentistry and periodontics. Benzodiazepines were mostly prescribed by endodontics providers, whereas tricyclic antidepressants, muscle relaxants, and anticonvulsants were mostly prescribed by oral medicine providers. Residents prescribed opioids at similar rates to the faculty (P = .78) but exceeded the faculty in prescribing benzodiazepines (P < .001).
Conclusion
PIMs were prescribed at low percentages to geriatric patients; however, most prescriptions were provided to patients classified with ASA III status. Further efforts are indicated, at institutional and national levels, to monitor/limit PIMs provided to geriatric population. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)
{"title":"Prescription of potentially inappropriate medications in older adults: data from a dental institution","authors":"Arwa Farag BDS, DMSc , Matthew Finkelman PhD , Scarlet Charmelo-Silva DDS , Christina Sun , Madison Mondry , Mohammed Bindakhil DDS, MS","doi":"10.1016/j.oooo.2024.09.006","DOIUrl":"10.1016/j.oooo.2024.09.006","url":null,"abstract":"<div><h3>Objectives</h3><div>The objectives of this study were to determine the types and frequency of potentially inappropriate medications (PIMs) prescribed to geriatric patients while considering the patients’ age groups and their American Society of Anesthesiologists (ASA) physical status.</div></div><div><h3>Study Design</h3><div>We performed a 5-year retrospective chart review of patients aged 65 years and above who were seen in a dental institution. Patients’ medical history, PIM prescriptions, and prescribers’ specialty and professional status were analyzed.</div></div><div><h3>Results</h3><div>Out of 10,675 geriatric patients identified, 6.2% (n = 662) received PIM prescriptions. Of those, 77% received one PIM whereas the others (23%) received anywhere between 2 and 6; the majority (73.7%) of these 662 patients fell within an ASA III physical status. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most prescribed PIM (provided to 60.1% of subjects) followed by opioids (provided to 32.5% of subjects). Both NSAIDs and opioids were largely provided by providers in oral and maxillofacial surgery followed by those in restorative dentistry and periodontics. Benzodiazepines were mostly prescribed by endodontics providers, whereas tricyclic antidepressants, muscle relaxants, and anticonvulsants were mostly prescribed by oral medicine providers. Residents prescribed opioids at similar rates to the faculty (<em>P</em> = .78) but exceeded the faculty in prescribing benzodiazepines (<em>P</em> < .001).</div></div><div><h3>Conclusion</h3><div>PIMs were prescribed at low percentages to geriatric patients; however, most prescriptions were provided to patients classified with ASA III status. Further efforts are indicated, at institutional and national levels, to monitor/limit PIMs provided to geriatric population. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Pages 188-200"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kabuki syndrome is a rare genetic disorder characterized by distinct facial features including long palpebral fissures, arched eyebrows, and other facial abnormalities. This syndrome causes developmental delay and intellectual disabilities along with growth retardation. Immune incompetence may be present with various clinical presentations. Often blood transfusion and/or immunoglobulin infusions are required. Management typically involves a multidisciplinary approach.
Case Summary
A 12-year-old male patient sought attention at Penn Oral Medicine for a lip lesion accompanied by swelling on the left side of the lower lip and pain at the tongue's tip. Originating around March 2021, the lesion exhibited self-limiting characteristics, albeit with intermittent recurrences unrelated to identifiable triggers. Mild sharp pain was noted, particularly accentuated during the consumption of crunchy foods. A review of systems and COVID-19 screening yielded negative results. During the initial examination, enlarged, tender, and mobile bilateral submandibular and submental lymph nodes were observed. Initially attributed to a traumatic origin, intraoral ulcers prompted a closer examination, revealing a previously undisclosed medical history. The patient, born with Kabuki syndrome associated with dextrocardia and rectal atresia, had undergone previous treatment in his home country. Under the care of pediatric specialists in the United States, a connection was established with the patient's medical provider to gather crucial information about his medical status, symptom history, and treatment. With evaluation of the patient's historical bloodwork, a pattern emerged, linking the ulcers appearance to his leukopenia, thrombocytopenia, neutropenia, and high eosinophilic count. The pediatric team, initially unaware of the ulceration incidents, validated the discovery. Subsequently, the patient was directed to pediatric care for a comprehensive blood workup to monitor his condition.
Conclusion
This case highlights the intricate interplay between oral manifestations and systemic health in Kabuki syndrome. Initially perceived as trauma-related, the ulcers' connection to the patient's leukopenia, thrombocytopenia, neutropenia, and high eosinophilic count emphasizes the importance of integrating oral findings with systemic considerations. Collaborative interdisciplinary efforts become paramount, underscoring the necessity for nuanced approaches tailored to the complexities of Kabuki syndrome and associated hematological patterns within the realm of Rare Genetic Diseases.
{"title":"A rare presentation of Kabuki syndrome in a dental setting","authors":"Natalia Trehan , Thomas Sollecito , Sunday Akintoye , Agnieszka Radwan-Woch","doi":"10.1016/j.oooo.2024.10.108","DOIUrl":"10.1016/j.oooo.2024.10.108","url":null,"abstract":"<div><h3>Introduction</h3><div>Kabuki syndrome is a rare genetic disorder characterized by distinct facial features including long palpebral fissures, arched eyebrows, and other facial abnormalities. This syndrome causes developmental delay and intellectual disabilities along with growth retardation. Immune incompetence may be present with various clinical presentations. Often blood transfusion and/or immunoglobulin infusions are required. Management typically involves a multidisciplinary approach.</div></div><div><h3>Case Summary</h3><div>A 12-year-old male patient sought attention at Penn Oral Medicine for a lip lesion accompanied by swelling on the left side of the lower lip and pain at the tongue's tip. Originating around March 2021, the lesion exhibited self-limiting characteristics, albeit with intermittent recurrences unrelated to identifiable triggers. Mild sharp pain was noted, particularly accentuated during the consumption of crunchy foods. A review of systems and COVID-19 screening yielded negative results. During the initial examination, enlarged, tender, and mobile bilateral submandibular and submental lymph nodes were observed. Initially attributed to a traumatic origin, intraoral ulcers prompted a closer examination, revealing a previously undisclosed medical history. The patient, born with Kabuki syndrome associated with dextrocardia and rectal atresia, had undergone previous treatment in his home country. Under the care of pediatric specialists in the United States, a connection was established with the patient's medical provider to gather crucial information about his medical status, symptom history, and treatment. With evaluation of the patient's historical bloodwork, a pattern emerged, linking the ulcers appearance to his leukopenia, thrombocytopenia, neutropenia, and high eosinophilic count. The pediatric team, initially unaware of the ulceration incidents, validated the discovery. Subsequently, the patient was directed to pediatric care for a comprehensive blood workup to monitor his condition.</div></div><div><h3>Conclusion</h3><div>This case highlights the intricate interplay between oral manifestations and systemic health in Kabuki syndrome. Initially perceived as trauma-related, the ulcers' connection to the patient's leukopenia, thrombocytopenia, neutropenia, and high eosinophilic count emphasizes the importance of integrating oral findings with systemic considerations. Collaborative interdisciplinary efforts become paramount, underscoring the necessity for nuanced approaches tailored to the complexities of Kabuki syndrome and associated hematological patterns within the realm of Rare Genetic Diseases.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Pages e55-e56"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.oooo.2024.10.100
Ana Carolina Prado-Ribeiro , Leticia Rodrigues-Oliveira , Ana Leticia Mores , Maria Claudia Cuzzullin , Carolina Alves Guimarães , Natalia Palmier , Maria Cecilia Querido de Oliveira , Pablo Vargas , Alan Roger Santos-Silva , Thaís Bianca Brandão
Objective
This study aimed to assess the efficacy of photobiomodulation (PBM) in preventing oral mucositis (OM) in adults with blood cancer undergoing high-dose methotrexate (HD-MTX ≥1 g/m2) treatment. Additionally, the correlation between serum creatinine and MTX, urinary pH, and the development and severity of OM were investigated.
Methods
A prospective, randomized, and double-blind study recruited patients before their first cycle of HD-MTX. Participants were assigned to 2 groups: group 1 (prophylactic PBM) and group 2 (placebo), and assessments were conducted at infusion (D0)/D1 (24 h)/D2 (48 h) /D3 (72 h) /D4 (96 h)/D10. Group 1 received PBM (660 nm, 100 mW, spot size 0.028 cm2, fluence 10 J/cm2 per point/10 s) in the oral mucosa from the first day until D5 post HD-MTX infusion or until MTX plasma concentrations were <5 µmol/L at D1, <1 µmol/L at D2, and <0.1 µmol/L at D3. Serum MTX and creatinine, and urine pH were assessed at D1/D2/D3. OM was classified according to World Health Organization criteria. Logistic regression, Mann-Whitney U, and χ2 tests were used to identify predictive factors for OM.
Results
A total of 36 patients were allocated to the PBM or placebo group (50% each). Most patients (66.6%) were female, with mean ages of 39.8 and 39.6 in groups 1 and 2, respectively. Regarding OM, group 2 developed grade 2 earlier at D2 (5.6%), D3 (11.1%), and D4 (50%) compared with group 1, which only developed grade 2 at D4 (5.6%). The Mann-Whitney test for overall OM grade comparison (group 1 vs group 2) at D4 showed a P < .001, and the χ2 test demonstrated a P = .003 (grades 0 and 1 vs grades 2/ 3). Elevated creatinine serum levels at D2 postinfusion predicted the incidence of OM. No correlation was found between serum MTX levels, urine pH, and OM.
Conclusion
PBM proves effective in preventing OM and reducing its incidence and severity in patients undergoing HD-MTX protocols. Elevated creatinine serum levels at D2 appear to be a predictor of OM.
{"title":"Photobiomodulation in the prevention of oral mucositis in blood cancer patients undergoing high-dose methotrexate: preliminary findings of a prospective, randomized, double-blind clinical study","authors":"Ana Carolina Prado-Ribeiro , Leticia Rodrigues-Oliveira , Ana Leticia Mores , Maria Claudia Cuzzullin , Carolina Alves Guimarães , Natalia Palmier , Maria Cecilia Querido de Oliveira , Pablo Vargas , Alan Roger Santos-Silva , Thaís Bianca Brandão","doi":"10.1016/j.oooo.2024.10.100","DOIUrl":"10.1016/j.oooo.2024.10.100","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the efficacy of photobiomodulation (PBM) in preventing oral mucositis (OM) in adults with blood cancer undergoing high-dose methotrexate (HD-MTX ≥1 g/m<sup>2</sup>) treatment. Additionally, the correlation between serum creatinine and MTX, urinary pH, and the development and severity of OM were investigated.</div></div><div><h3>Methods</h3><div>A prospective, randomized, and double-blind study recruited patients before their first cycle of HD-MTX. Participants were assigned to 2 groups: group 1 (prophylactic PBM) and group 2 (placebo), and assessments were conducted at infusion (D0)/D1 (24 h)/D2 (48 h) /D3 (72 h) /D4 (96 h)/D10. Group 1 received PBM (660 nm, 100 mW, spot size 0.028 cm<sup>2</sup>, fluence 10 J/cm<sup>2</sup> per point/10 s) in the oral mucosa from the first day until D5 post HD-MTX infusion or until MTX plasma concentrations were <5 µmol/L at D1, <1 µmol/L at D2, and <0.1 µmol/L at D3. Serum MTX and creatinine, and urine pH were assessed at D1/D2/D3. OM was classified according to World Health Organization criteria. Logistic regression, Mann-Whitney <em>U</em>, and χ<sup>2</sup> tests were used to identify predictive factors for OM.</div></div><div><h3>Results</h3><div>A total of 36 patients were allocated to the PBM or placebo group (50% each). Most patients (66.6%) were female, with mean ages of 39.8 and 39.6 in groups 1 and 2, respectively. Regarding OM, group 2 developed grade 2 earlier at D2 (5.6%), D3 (11.1%), and D4 (50%) compared with group 1, which only developed grade 2 at D4 (5.6%). The Mann-Whitney test for overall OM grade comparison (group 1 vs group 2) at D4 showed a <em>P</em> < .001, and the χ<sup>2</sup> test demonstrated a <em>P</em> = .003 (grades 0 and 1 vs grades 2/ 3). Elevated creatinine serum levels at D2 postinfusion predicted the incidence of OM. No correlation was found between serum MTX levels, urine pH, and OM.</div></div><div><h3>Conclusion</h3><div>PBM proves effective in preventing OM and reducing its incidence and severity in patients undergoing HD-MTX protocols. Elevated creatinine serum levels at D2 appear to be a predictor of OM.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Page e52"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.oooo.2024.10.109
Michelle Yuchen Huang , Grace Bradley , Tra Truong , Hagen Klieb , Ilan Weinreb , Marco Magalhaes
Background
This case illustrates the clinical challenges associated with primary intraosseous squamous cell carcinoma (PIOSCC). This rare entity can arise from otherwise-benign odontogenic cysts, leading to delays in diagnosis and management. The clinical, radiographic, and histologic features of PIOSCC can be heterogeneous, thus creating a diagnostic challenge for clinicians.
Case Summary
This otherwise-healthy 45-year-old man with a history of a childhood accident leading to anterior tooth loss and subsequent bridge placement in 2017, presented at the dentist in 2021 with a 1-year history of swelling and pain in the left maxillary alveolus. On examination, the radiographs showed a well-defined, corticated, homogenously radiolucent entity centered at the apices of 8, 10, 11, and edentulous 9 area, in which it was interpreted as a radicular cyst. He was subsequently referred to the endodontist but declined treatment because of cost. In October 2022, he presented again with a swollen and irregular appearance of the anterior maxilla and adjacent white mucosal patch measuring 1 × 1 cm. An immediate referral was made to an oral surgeon at the local hospital, and an intraosseous biopsy was performed showing a cystic lesion with well-differentiated squamous cell carcinoma. The patient was referred to the Odette Cancer Centre at Sunnybrook Health Sciences Centre and underwent a surgical resection and a bilateral neck dissection with the ENT team in May 2023. The pathologic examination confirmed a well-differentiated squamous cell carcinoma, staged as pT1N0M0. The patient is currently 6 months postrecovery and is doing well.
Conclusion
PIOSCC manifests as a jaw carcinoma originating from odontogenic cysts or remnants of odontogenic epithelium surrounding teeth, as defined by the World Health Organization (5th edition). This case presents as a diagnostic dilemma given the presence of the superficial mucosa changes and the underlying benign appearing cystic entity. Careful analysis of the specimen by an experienced pathologist is critical in these cases to identify the true origin of this tumor. Careful correlation of the clinical and radiographic findings, along with a timely biopsy, is also imperative for the precise diagnosis and effective management of PIOSCC.
{"title":"Primary intraosseous squamous cell carcinoma: a clinical, radiographic and histopathological challenge","authors":"Michelle Yuchen Huang , Grace Bradley , Tra Truong , Hagen Klieb , Ilan Weinreb , Marco Magalhaes","doi":"10.1016/j.oooo.2024.10.109","DOIUrl":"10.1016/j.oooo.2024.10.109","url":null,"abstract":"<div><h3>Background</h3><div>This case illustrates the clinical challenges associated with primary intraosseous squamous cell carcinoma (PIOSCC). This rare entity can arise from otherwise-benign odontogenic cysts, leading to delays in diagnosis and management. The clinical, radiographic, and histologic features of PIOSCC can be heterogeneous, thus creating a diagnostic challenge for clinicians.</div></div><div><h3>Case Summary</h3><div>This otherwise-healthy 45-year-old man with a history of a childhood accident leading to anterior tooth loss and subsequent bridge placement in 2017, presented at the dentist in 2021 with a 1-year history of swelling and pain in the left maxillary alveolus. On examination, the radiographs showed a well-defined, corticated, homogenously radiolucent entity centered at the apices of 8, 10, 11, and edentulous 9 area, in which it was interpreted as a radicular cyst. He was subsequently referred to the endodontist but declined treatment because of cost. In October 2022, he presented again with a swollen and irregular appearance of the anterior maxilla and adjacent white mucosal patch measuring 1 × 1 cm. An immediate referral was made to an oral surgeon at the local hospital, and an intraosseous biopsy was performed showing a cystic lesion with well-differentiated squamous cell carcinoma. The patient was referred to the Odette Cancer Centre at Sunnybrook Health Sciences Centre and underwent a surgical resection and a bilateral neck dissection with the ENT team in May 2023. The pathologic examination confirmed a well-differentiated squamous cell carcinoma, staged as pT1N0M0. The patient is currently 6 months postrecovery and is doing well.</div></div><div><h3>Conclusion</h3><div>PIOSCC manifests as a jaw carcinoma originating from odontogenic cysts or remnants of odontogenic epithelium surrounding teeth, as defined by the World Health Organization (5th edition). This case presents as a diagnostic dilemma given the presence of the superficial mucosa changes and the underlying benign appearing cystic entity. Careful analysis of the specimen by an experienced pathologist is critical in these cases to identify the true origin of this tumor. Careful correlation of the clinical and radiographic findings, along with a timely biopsy, is also imperative for the precise diagnosis and effective management of PIOSCC.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Page e56"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.oooo.2024.10.091
Lei Pan , Junjun Chen , Yirao Lai , Minghua Feng , Yiwen Deng , Guanhua Du , Lei Sun , Guoyao Tang , Yufeng Wang
Background
Oral lichen planus (OLP) is commonly accepted as an interface mucositis. The immunogen from keratinocytes is considered as the agonist priming the topical immunity. Our previous study has identified increased dendritic cell (DC) infiltration and TLR9 expression in OLP lesions. Heat shock protein 90 (HSP90) has been widely considered as an autoantigen and TLR9 agonist that could activate DCs. However, the significance and impact of HSP90 as an immunogen in OLP remain unclear.
Objective
To investigate the effects of the HSP90 complex from OLP lesion tissues on DCs activation and the polarization of naïve T cells.
Methods
The expression pattern of HSP90 in OLP lesions and healthy control mucosa was evaluated by single-cell RNA sequence, immunohistochemistry, quantitative reverse transcription polymerase chain reaction, and immunoblotting. The HSP90 complex was further extracted by immunoprecipitation from the OLP lesions and healthy control mucosa as the agonist of DCs. The peripheral DCs were collected and stimulated with the extractives. When challenged, DCs’ expression of interferon-alpha and MHC molecules was detected by flow cytometry. Hence, after cocultured with pre-stimulated DCs, polarization of naïve T cells was investigated by cytokines profile analysis.
Results
HSP90 expression was significantly greater in the lamina propria of OLP lesion and closely related with lymphocyte infiltration. The HSP90 complex in OLP lesion tissues activated DCs via TLR9 and increased their interferon-α secretion and MHC II expression. Prestimulated DCs increased the proportion of Th17 cells.
Conclusions
The HSP90 complex isolated from OLP lesion tissue activated a TLR9/interferon-α pathway of DC and further promoted the polarization of naïve T cells towards Th17 immunity.
{"title":"Heat shock protein 90 complex from oral lichen planus lesion induces T cells polarization via activation of dendritic cells","authors":"Lei Pan , Junjun Chen , Yirao Lai , Minghua Feng , Yiwen Deng , Guanhua Du , Lei Sun , Guoyao Tang , Yufeng Wang","doi":"10.1016/j.oooo.2024.10.091","DOIUrl":"10.1016/j.oooo.2024.10.091","url":null,"abstract":"<div><h3>Background</h3><div>Oral lichen planus (OLP) is commonly accepted as an interface mucositis. The immunogen from keratinocytes is considered as the agonist priming the topical immunity. Our previous study has identified increased dendritic cell (DC) infiltration and TLR9 expression in OLP lesions. Heat shock protein 90 (HSP90) has been widely considered as an autoantigen and TLR9 agonist that could activate DCs. However, the significance and impact of HSP90 as an immunogen in OLP remain unclear.</div></div><div><h3>Objective</h3><div>To investigate the effects of the HSP90 complex from OLP lesion tissues on DCs activation and the polarization of naïve T cells.</div></div><div><h3>Methods</h3><div>The expression pattern of HSP90 in OLP lesions and healthy control mucosa was evaluated by single-cell RNA sequence, immunohistochemistry, quantitative reverse transcription polymerase chain reaction, and immunoblotting. The HSP90 complex was further extracted by immunoprecipitation from the OLP lesions and healthy control mucosa as the agonist of DCs. The peripheral DCs were collected and stimulated with the extractives. When challenged, DCs’ expression of interferon-alpha and MHC molecules was detected by flow cytometry. Hence, after cocultured with pre-stimulated DCs, polarization of naïve T cells was investigated by cytokines profile analysis.</div></div><div><h3>Results</h3><div>HSP90 expression was significantly greater in the lamina propria of OLP lesion and closely related with lymphocyte infiltration. The HSP90 complex in OLP lesion tissues activated DCs via TLR9 and increased their interferon-α secretion and MHC II expression. Prestimulated DCs increased the proportion of Th17 cells.</div></div><div><h3>Conclusions</h3><div>The HSP90 complex isolated from OLP lesion tissue activated a TLR9/interferon-α pathway of DC and further promoted the polarization of naïve T cells towards Th17 immunity.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Page e48"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.oooo.2024.10.104
Amanda De Farias Gabriel , Júlia Breda Soares , Luan Nathiel Santana Kovalski , Marina Curra , Mariana Bitu-Ramos Pinto , Vivian Petersen Wagner , Lauro José Gregianin , Marco Antonio Trevizani Martins , Fábio Abreu Alves , Manoela Domingues Martins
Objective
To compare the efficacy of intraoral (IOPBM) and extraoral photobiomodulation (EOPBM) protocols in the management of oral mucositis (OM) in pediatric patients.
Methods
This is a randomized, blinded clinical trial. Ten pediatric oncology patients were included and randomized into 2 groups: the IOPBM group (n = 5) received intraoral PBM using low-level laser, and the EOPBM group (n = 5) received extraoral PBM using defocused high-power laser. PBM therapy was administered to all patients, with a mean follow-up period of 8.8 days. Patients were evaluated daily, and OM was classified according to the World Health Organization and National Cancer Institute (NCI) scales. Additionally, oral pain, functional scores (chewing, dysphagia, fluid intake, and dysgeusia), and comfort with the procedure were assessed.
Results
Eight boys and 2 girls were included, with an average age of 8.4 years. Diagnoses included 50% acute lymphoblastic leukemia, 30% lymphomas, and 20% osteosarcoma. OM was classified by World Health Organization as grade 0 (10%), 1 (30%), 2 (50%), and 3 (10%). No patient experienced grade 4 OM. The mean duration of grade 2 OM was 2.2 days, and grade 3 was 1 day. No differences were observed between groups regarding OM grades, duration of OM, functional score, and comfort. Pain scores were similar between groups on days 3, 10, and 14. On Day 7, EOPBM exhibited a pain score of 2.2, which was higher than IOPBM (P = .018).
Conclusion
EOPBM could be considered as effective as IOPBM in the prevention and treatment of OM in pediatric oncology patients.
{"title":"Efficacy of extraoral photobiomodulation therapy in the management of oral mucositis in pediatric oncology patients: a preliminary study","authors":"Amanda De Farias Gabriel , Júlia Breda Soares , Luan Nathiel Santana Kovalski , Marina Curra , Mariana Bitu-Ramos Pinto , Vivian Petersen Wagner , Lauro José Gregianin , Marco Antonio Trevizani Martins , Fábio Abreu Alves , Manoela Domingues Martins","doi":"10.1016/j.oooo.2024.10.104","DOIUrl":"10.1016/j.oooo.2024.10.104","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the efficacy of intraoral (IOPBM) and extraoral photobiomodulation (EOPBM) protocols in the management of oral mucositis (OM) in pediatric patients.</div></div><div><h3>Methods</h3><div>This is a randomized, blinded clinical trial. Ten pediatric oncology patients were included and randomized into 2 groups: the IOPBM group (n = 5) received intraoral PBM using low-level laser, and the EOPBM group (n = 5) received extraoral PBM using defocused high-power laser. PBM therapy was administered to all patients, with a mean follow-up period of 8.8 days. Patients were evaluated daily, and OM was classified according to the World Health Organization and National Cancer Institute (NCI) scales. Additionally, oral pain, functional scores (chewing, dysphagia, fluid intake, and dysgeusia), and comfort with the procedure were assessed.</div></div><div><h3>Results</h3><div>Eight boys and 2 girls were included, with an average age of 8.4 years. Diagnoses included 50% acute lymphoblastic leukemia, 30% lymphomas, and 20% osteosarcoma. OM was classified by World Health Organization as grade 0 (10%), 1 (30%), 2 (50%), and 3 (10%). No patient experienced grade 4 OM. The mean duration of grade 2 OM was 2.2 days, and grade 3 was 1 day. No differences were observed between groups regarding OM grades, duration of OM, functional score, and comfort. Pain scores were similar between groups on days 3, 10, and 14. On Day 7, EOPBM exhibited a pain score of 2.2, which was higher than IOPBM (<em>P</em> = .018).</div></div><div><h3>Conclusion</h3><div>EOPBM could be considered as effective as IOPBM in the prevention and treatment of OM in pediatric oncology patients.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Page e54"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.oooo.2024.09.003
Gustavo Souza Galvão MS , Juliana Bertoldi Franco PhD , Maria Paula Siqueira de Melo Peres MS , Gabriela Bănacu Melo MS , Jefferson R. Tenório MS, PhD , Janaina B. Medina MS , Camila de Barros Gallo MS, PhD , Karem L. Ortega MS, PhD
Objective
The objective of this study was to identify the association between tooth extraction and occurrence of spontaneous bacterial peritonitis (SBP) and to assess delayed soft tissue healing of extraction sockets in patients with cirrhosis.
Study Design
One hundred nineteen participants awaiting liver transplantation who required tooth extraction were included. Seven days before the surgery, the patients underwent panoramic radiography and laboratory examinations. Soft tissue healing was evaluated 7 days after the tooth extraction and medical records were checked after 21 days for development of SBP. The relationship between predictive factors and outcomes was assessed by using multiple binomial logistic regression.
Results
One hundred ninety-five teeth were extracted, resulting in 146 alveolar wounds, in which the majority (47%) consisted of alveolar sockets of multirooted teeth. One participant was diagnosed with SBP (Escherichia coli [E. coli]) and another diagnosed with bacterascites (Streptococcus viridans [S. viridans] group), occurring 11 and 6 days after tooth extraction. Poor soft tissue healing was observed in 20 (13.7%) patients, which was correlated to 2 risk factors, that is, jaundice (P = .007, adjusted odds ratio [OR] = 4.91, 95% confidence interval [CI] = 1.56-15.47) and moderate neutropenia (P = .048, adjusted OR = 13.99, 95% CI = 1.02-192.07).
Conclusions
No association was found between tooth extraction and SBP in patients with cirrhosis. The delayed soft tissue healing was related to jaundice (hyperbilirubinemia) and moderate neutropenia.
{"title":"Spontaneous bacterial peritonitis and soft tissue healing after tooth extraction in liver cirrhosis patients","authors":"Gustavo Souza Galvão MS , Juliana Bertoldi Franco PhD , Maria Paula Siqueira de Melo Peres MS , Gabriela Bănacu Melo MS , Jefferson R. Tenório MS, PhD , Janaina B. Medina MS , Camila de Barros Gallo MS, PhD , Karem L. Ortega MS, PhD","doi":"10.1016/j.oooo.2024.09.003","DOIUrl":"10.1016/j.oooo.2024.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to identify the association between tooth extraction and occurrence of spontaneous bacterial peritonitis (SBP) and to assess delayed soft tissue healing of extraction sockets in patients with cirrhosis.</div></div><div><h3>Study Design</h3><div>One hundred nineteen participants awaiting liver transplantation who required tooth extraction were included. Seven days before the surgery, the patients underwent panoramic radiography and laboratory examinations. Soft tissue healing was evaluated 7 days after the tooth extraction and medical records were checked after 21 days for development of SBP. The relationship between predictive factors and outcomes was assessed by using multiple binomial logistic regression.</div></div><div><h3>Results</h3><div>One hundred ninety-five teeth were extracted, resulting in 146 alveolar wounds, in which the majority (47%) consisted of alveolar sockets of multirooted teeth. One participant was diagnosed with SBP (<em>Escherichia coli</em> [<em>E. coli</em>]) and another diagnosed with bacterascites (<em>Streptococcus viridans</em> [<em>S. viridans</em>] group), occurring 11 and 6 days after tooth extraction. Poor soft tissue healing was observed in 20 (13.7%) patients, which was correlated to 2 risk factors, that is, jaundice (<em>P</em> = .007, adjusted odds ratio [OR] = 4.91, 95% confidence interval [CI] = 1.56-15.47) and moderate neutropenia (<em>P</em> = .048, adjusted OR = 13.99, 95% CI = 1.02-192.07).</div></div><div><h3>Conclusions</h3><div>No association was found between tooth extraction and SBP in patients with cirrhosis. The delayed soft tissue healing was related to jaundice (hyperbilirubinemia) and moderate neutropenia.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Pages 177-187"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.oooo.2024.10.094
Alan Roger Santos-Silva , Caique Mariano Pedroso , Luiz Alcino Gueiros , Rícheal Ní Ríordáin , Arwa Farag , Thomas Sollecito , Alexander Ross Kerr , Giovani Lodi
Objective
This study used bibliometric methodologies to explore the body of research presented at the World Workshop on Oral Medicine (WWOM) over the past 35 years.
Methods
A systematic tracking of articles across 8 editions of WWOM was conducted using databases such as Web of Science, Scopus, and PubMed. Comprehensive bibliographic analysis and data visualization were executed through Bibliometrix, Rstudio, and VOSviewer, facilitating an in-depth examination of citation metrics and collaborative networks.
Results
The investigation revealed that WWOM, held in 6 cities spanning 4 countries and addressing 33 distinct topics, has demonstrated an annual citation growth rate of 8.29%, with an average of 49.31 citations per article. Notably, WWOM IV garnered the highest number of citations (1,342), reaching its peak in 2021 with 365 citations. Key contributors to the most-cited articles included Al-Hashimi, Dawes, and Syrjänen et al. Since its inception, the workshops have engaged 505 faculty members from 37 nations, with significant participation from the Americas and Europe, notably the United States and the United Kingdom, which also led in terms of publications. Network analysis delineated 6 country clusters, underscoring robust connections between the United States and the United Kingdom. Co-authorship analysis revealed 18 clusters involving 267 authors.
Conclusion
The influence of the WWOM on the field of oral medicine is clearly demonstrated by the outcomes of its publications, reflecting a collaborative effort to enhance comprehension and treatment modalities for patients with oral diseases. The study's findings provide insights into future research directions within the WWOM legacy.
{"title":"Mapping the legacy of the world workshop on oral medicine: a 35-year global bibliometric analysis","authors":"Alan Roger Santos-Silva , Caique Mariano Pedroso , Luiz Alcino Gueiros , Rícheal Ní Ríordáin , Arwa Farag , Thomas Sollecito , Alexander Ross Kerr , Giovani Lodi","doi":"10.1016/j.oooo.2024.10.094","DOIUrl":"10.1016/j.oooo.2024.10.094","url":null,"abstract":"<div><h3>Objective</h3><div>This study used bibliometric methodologies to explore the body of research presented at the World Workshop on Oral Medicine (WWOM) over the past 35 years.</div></div><div><h3>Methods</h3><div>A systematic tracking of articles across 8 editions of WWOM was conducted using databases such as Web of Science, Scopus, and PubMed. Comprehensive bibliographic analysis and data visualization were executed through Bibliometrix, Rstudio, and VOSviewer, facilitating an in-depth examination of citation metrics and collaborative networks.</div></div><div><h3>Results</h3><div>The investigation revealed that WWOM, held in 6 cities spanning 4 countries and addressing 33 distinct topics, has demonstrated an annual citation growth rate of 8.29%, with an average of 49.31 citations per article. Notably, WWOM IV garnered the highest number of citations (1,342), reaching its peak in 2021 with 365 citations. Key contributors to the most-cited articles included Al-Hashimi, Dawes, and Syrjänen et al. Since its inception, the workshops have engaged 505 faculty members from 37 nations, with significant participation from the Americas and Europe, notably the United States and the United Kingdom, which also led in terms of publications. Network analysis delineated 6 country clusters, underscoring robust connections between the United States and the United Kingdom. Co-authorship analysis revealed 18 clusters involving 267 authors.</div></div><div><h3>Conclusion</h3><div>The influence of the WWOM on the field of oral medicine is clearly demonstrated by the outcomes of its publications, reflecting a collaborative effort to enhance comprehension and treatment modalities for patients with oral diseases. The study's findings provide insights into future research directions within the WWOM legacy.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Page e49"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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