Pub Date : 2025-02-01DOI: 10.1016/j.oooo.2024.08.002
Satu Manninen BDS, Johanna Snäll MD, DDS, PhD, Tero Puolakkainen DDS, PhD, Aleksi Haapanen DDS, PhD
Objectives
This study clarified possible delays and deficiencies in severe odontogenic infection (OI) treatment in patients with mental disorders.
Study design
Data of hospitalized patients with severe OI were evaluated retrospectively. The outcome variable was preceding health care visits prior to hospitalization. The primary predictor was patient's mental disorder. Explanatory variables were age, sex, smoking, heavy alcohol use, immunocompromised disease or medication, and time span from beginning of symptoms to hospitalization. Also, factors leading to intensive care unit (ICU) care were evaluated.
Results
Preceding visits prior to hospitalization were found in 61 (35.5%) out of 172 patients with OI. In total, 27 patients (15.7%) had a current mental disorder, more commonly in women (26.0%) than in men (8.1%) (P = .001). Patients with mental disorders had preceding health care visits related to the current infection notably more often than patients without recent psychiatric history (51.9% vs. 32.4%), P = .053. Patient-related treatment delay remained nonsignificant. Heavy alcohol use (P = .010) and smoking (P = .025) predicted ICU treatment, but no association with patient's mental disorder was found.
Conclusions
A patient's mental disorder can complicate diagnosis of OI. Effective and timely treatment requires the professional's ability to simultaneously identify the patient's mental health challenges and progressing OI.
{"title":"Severe odontogenic infections in patients with mental disorders: the challenge of ineffective initial treatment","authors":"Satu Manninen BDS, Johanna Snäll MD, DDS, PhD, Tero Puolakkainen DDS, PhD, Aleksi Haapanen DDS, PhD","doi":"10.1016/j.oooo.2024.08.002","DOIUrl":"10.1016/j.oooo.2024.08.002","url":null,"abstract":"<div><h3>Objectives</h3><div>This study clarified possible delays and deficiencies in severe odontogenic infection (OI) treatment in patients with mental disorders.</div></div><div><h3>Study design</h3><div>Data of hospitalized patients with severe OI were evaluated retrospectively. The outcome variable was preceding health care visits prior to hospitalization. The primary predictor was patient's mental disorder. Explanatory variables were age, sex, smoking, heavy alcohol use, immunocompromised disease or medication, and time span from beginning of symptoms to hospitalization. Also, factors leading to intensive care unit (ICU) care were evaluated.</div></div><div><h3>Results</h3><div>Preceding visits prior to hospitalization were found in 61 (35.5%) out of 172 patients with OI. In total, 27 patients (15.7%) had a current mental disorder, more commonly in women (26.0%) than in men (8.1%) (<em>P</em> = .001). Patients with mental disorders had preceding health care visits related to the current infection notably more often than patients without recent psychiatric history (51.9% vs. 32.4%), <em>P</em> = .053. Patient-related treatment delay remained nonsignificant. Heavy alcohol use (<em>P</em> = .010) and smoking (<em>P</em> = .025) predicted ICU treatment, but no association with patient's mental disorder was found.</div></div><div><h3>Conclusions</h3><div>A patient's mental disorder can complicate diagnosis of OI. Effective and timely treatment requires the professional's ability to simultaneously identify the patient's mental health challenges and progressing OI.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Pages 139-145"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185691","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.2024.08.023
Petra Pandurevic , Ian Furst DDS, MSc , Mark Roger Darling BChD, MSc (Dent), MSc (Med), MChD
{"title":"Ulcerated mass and radiolucency of the left mandible","authors":"Petra Pandurevic , Ian Furst DDS, MSc , Mark Roger Darling BChD, MSc (Dent), MSc (Med), MChD","doi":"10.1016/j.oooo.2024.08.023","DOIUrl":"10.1016/j.oooo.2024.08.023","url":null,"abstract":"","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Pages 134-138"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267334","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.2024.10.096
Thomas Grader-Beck , Benjamin A. Fisher , Xavier Mariette , Athena Papas , Hendrika Bootsma , Wan-Fai Ng , P.L.A. Van Daele , Stephanie Finzel , Sergio Elgueta , Josef Hermann , Sara S. McCoy , Arthur Bookman , Monika Sopala , Wen-Lin Luo , Cornelia Scheurer , Wolfgang Hueber
Objective
Sjögren disease (SjD) is an autoimmune disease with no approved systemic treatments. Here, the week 24 results from TWINSS, a phase 2b dose-ranging trial assessing the safety and efficacy of multiple doses of iscalimab, an anti-CD40 mAb, in 2 patient populations with SjD are presented.
Methods
Patients fulfilling American College of Rheumatology/European League Against Rheumatism (EULAR) 2016 classification criteria and stimulated salivary flow (SF) rates of ≥0.1 mL/min, were included. In cohort 1 (C1), patients with EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) ≥5 and EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) ≥5 were randomized (1:1:1:1) to placebo or iscalimab 150, 300, or 600 mg subcutaneously once every 2 weeks. In cohort 2 (C2), patients with ESSDAI <5, ESSPRI (fatigue or dryness) ≥5, and impact of dry eye on everyday life ≥30 were randomized (1:1) to placebo or iscalimab 600 mg. Multiple comparison procedure–modeling was used to assess the dose response of ESSDAI change from baseline (C1) and a mixed model for repeated measures to estimate the placebo-adjusted mean change from baseline of ESSDAI (C1 and C2).
Results
In total, 173 patients were assigned to C1 and 100 to C2. In C1, ESSDAI change from baseline at week 24 showed significant improvements with iscalimab 150 and 600 mg compared with placebo (least square mean difference [Δ]: −3.0 and −2.9, respectively; P < .005); the 300-mg dose showed a similar trend (Δ: −1.4; P = .16). The primary objective of a significant dose-response based on ESSDAI change from baseline at week 24 (P = .004) with a log-linear dose response was met. ESSPRI, FACIT-F, and SF rates showed trends of improvement with iscalimab. In C2, the primary objective of ESSPRI change from baseline showed a strong trend (Δ: −0.57; P = .12) toward improvement; dryness (P = .016) and fatigue (P = .067) were the response drivers. A significant increase in SF rates was observed with iscalimab. At week 24, SAE rates in C1 (placebo, iscalimab 150, 300, and 600 mg) were 2.3%, 2.3%, 7.1%, and 9.1%, respectively; in C2, the rate was 4% for both groups.
Conclusions
Iscalimab was well tolerated and showed improvements over placebo in 2 distinct SjD populations, and important signals for improvement in salivary flow.
{"title":"Iscalimab (CFZ533) in patients with Sjögren disease: week 24 efficacy and safety results of a randomized, placebo-controlled, phase 2b dose-ranging study","authors":"Thomas Grader-Beck , Benjamin A. Fisher , Xavier Mariette , Athena Papas , Hendrika Bootsma , Wan-Fai Ng , P.L.A. Van Daele , Stephanie Finzel , Sergio Elgueta , Josef Hermann , Sara S. McCoy , Arthur Bookman , Monika Sopala , Wen-Lin Luo , Cornelia Scheurer , Wolfgang Hueber","doi":"10.1016/j.oooo.2024.10.096","DOIUrl":"10.1016/j.oooo.2024.10.096","url":null,"abstract":"<div><h3>Objective</h3><div>Sjögren disease (SjD) is an autoimmune disease with no approved systemic treatments. Here, the week 24 results from TWINSS, a phase 2b dose-ranging trial assessing the safety and efficacy of multiple doses of iscalimab, an anti-CD40 mAb, in 2 patient populations with SjD are presented.</div></div><div><h3>Methods</h3><div>Patients fulfilling American College of Rheumatology/European League Against Rheumatism (EULAR) 2016 classification criteria and stimulated salivary flow (SF) rates of ≥0.1 mL/min, were included. In cohort 1 (C1), patients with EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) ≥5 and EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) ≥5 were randomized (1:1:1:1) to placebo or iscalimab 150, 300, or 600 mg subcutaneously once every 2 weeks. In cohort 2 (C2), patients with ESSDAI <5, ESSPRI (fatigue or dryness) ≥5, and impact of dry eye on everyday life ≥30 were randomized (1:1) to placebo or iscalimab 600 mg. Multiple comparison procedure–modeling was used to assess the dose response of ESSDAI change from baseline (C1) and a mixed model for repeated measures to estimate the placebo-adjusted mean change from baseline of ESSDAI (C1 and C2).</div></div><div><h3>Results</h3><div>In total, 173 patients were assigned to C1 and 100 to C2. In C1, ESSDAI change from baseline at week 24 showed significant improvements with iscalimab 150 and 600 mg compared with placebo (least square mean difference [Δ]: −3.0 and −2.9, respectively; <em>P</em> < .005); the 300-mg dose showed a similar trend (Δ: −1.4; <em>P</em> = .16). The primary objective of a significant dose-response based on ESSDAI change from baseline at week 24 (<em>P</em> = .004) with a log-linear dose response was met. ESSPRI, FACIT-F, and SF rates showed trends of improvement with iscalimab. In C2, the primary objective of ESSPRI change from baseline showed a strong trend (Δ: −0.57; <em>P</em> = .12) toward improvement; dryness (<em>P</em> = .016) and fatigue (<em>P</em> = .067) were the response drivers. A significant increase in SF rates was observed with iscalimab. At week 24, SAE rates in C1 (placebo, iscalimab 150, 300, and 600 mg) were 2.3%, 2.3%, 7.1%, and 9.1%, respectively; in C2, the rate was 4% for both groups.</div></div><div><h3>Conclusions</h3><div>Iscalimab was well tolerated and showed improvements over placebo in 2 distinct SjD populations, and important signals for improvement in salivary flow.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Page e50"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173839","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.2024.10.103
Michael Brennan , Michael Passineau , Deborah Saunders , Herve Sroussi , Dyani Gaudilliere , Arthur Fernandez , Jun Liu , Nathalie Dubois , Robert Zeldin
Objective
Grade 2/3 late xerostomia is a chronic, debilitating complication of radiotherapy for head and neck cancers. We assessed the safety and efficacy of AAV2-hAQP1 gene therapy as a treatment for this condition.
Methods
Twenty-four participants with grade 2/3 xerostomia at least 5 years after completing radiotherapy (2 years if HPV+) were enrolled in this multicenter, open-label, dose-escalation study. AAV2‑hAQP1 was delivered to the parotid gland(s) via cannulation of the Stensen duct. Twelve participants received AAV2-hAQP1 in 1 gland and 12 in both glands. Participants were followed for 12 months posttreatment. Safety parameters included adverse events, physical examinations, laboratory tests, and electrocardiograms. Efficacy assessments included the Xerostomia-specific Questionnaire (XQ), MD Anderson Symptom Inventory-Head and Neck Module (MDASI-HN), Global Rate of Change Questionnaire (GRCQ), and measurement of unstimulated and stimulated whole saliva flow rates (UWSFR, SWSFR).
Results
No treatment-related serious adverse events or dose-limiting toxicities were reported, and all participants completed the study. Statistically significant improvements were seen in the patient-reported outcome instruments by day 30 and were maintained through month 12, with greater improvement in the bilateral versus unilateral cohorts. At month 12, the mean percent change from baseline (%CFB) was −39.5% and −42.2% for the XQ Total Score and the Dry Mouth question of the MDASI-HN, respectively, and the mean GRCQ symptom score was 3.8. Overall, 16 of 24 participants reported an improvement of ≥8 points in the XQ Total Score, and 19 of 24 participants reported important improvements in xerostomia symptoms based on the GRCQ. The improvement reported across patient-reported outcome instruments, measuring different aspects of xerostomia symptoms, provides compelling evidence of treatment effectiveness. The mean %CFB in UWSFR at month 12 was 112.5%, and a trend toward improved SWSFR was observed.
Conclusion
Treatment with AAV2-hAQP1 was safe and well-tolerated at all doses and resulted in meaningful improvements in xerostomia symptoms and unstimulated whole saliva flow rate.
{"title":"Results of a phase 1, open-label, dose-escalation study of gene therapy with AAV2-hAQP1 as treatment for grade 2 and 3 radiation-induced late xerostomia and parotid gland hypofunction","authors":"Michael Brennan , Michael Passineau , Deborah Saunders , Herve Sroussi , Dyani Gaudilliere , Arthur Fernandez , Jun Liu , Nathalie Dubois , Robert Zeldin","doi":"10.1016/j.oooo.2024.10.103","DOIUrl":"10.1016/j.oooo.2024.10.103","url":null,"abstract":"<div><h3>Objective</h3><div>Grade 2/3 late xerostomia is a chronic, debilitating complication of radiotherapy for head and neck cancers. We assessed the safety and efficacy of AAV2-hAQP1 gene therapy as a treatment for this condition.</div></div><div><h3>Methods</h3><div>Twenty-four participants with grade 2/3 xerostomia at least 5 years after completing radiotherapy (2 years if HPV+) were enrolled in this multicenter, open-label, dose-escalation study. AAV2‑hAQP1 was delivered to the parotid gland(s) via cannulation of the Stensen duct. Twelve participants received AAV2-hAQP1 in 1 gland and 12 in both glands. Participants were followed for 12 months posttreatment. Safety parameters included adverse events, physical examinations, laboratory tests, and electrocardiograms. Efficacy assessments included the Xerostomia-specific Questionnaire (XQ), MD Anderson Symptom Inventory-Head and Neck Module (MDASI-HN), Global Rate of Change Questionnaire (GRCQ), and measurement of unstimulated and stimulated whole saliva flow rates (UWSFR, SWSFR).</div></div><div><h3>Results</h3><div>No treatment-related serious adverse events or dose-limiting toxicities were reported, and all participants completed the study. Statistically significant improvements were seen in the patient-reported outcome instruments by day 30 and were maintained through month 12, with greater improvement in the bilateral versus unilateral cohorts. At month 12, the mean percent change from baseline (%CFB) was −39.5% and −42.2% for the XQ Total Score and the Dry Mouth question of the MDASI-HN, respectively, and the mean GRCQ symptom score was 3.8. Overall, 16 of 24 participants reported an improvement of ≥8 points in the XQ Total Score, and 19 of 24 participants reported important improvements in xerostomia symptoms based on the GRCQ. The improvement reported across patient-reported outcome instruments, measuring different aspects of xerostomia symptoms, provides compelling evidence of treatment effectiveness. The mean %CFB in UWSFR at month 12 was 112.5%, and a trend toward improved SWSFR was observed.</div></div><div><h3>Conclusion</h3><div>Treatment with AAV2-hAQP1 was safe and well-tolerated at all doses and resulted in meaningful improvements in xerostomia symptoms and unstimulated whole saliva flow rate.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Pages e53-e54"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174463","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}
Melanoma is a malignancy originating from melanocytes, with the potential to affect not only the skin but also any melanocyte-containing tissue, including mucosal surfaces. Mucosal melanoma (MM), although less common than its cutaneous counterpart, is characterized by a more aggressive course and poorer prognosis. In the head and neck region, MM primarily involves the nasal and sinonasal cavities, with the oral cavity being less frequently affected, particularly at the hard palatal mucosa and maxillary gingiva. Distinct from cutaneous melanoma, which has a well-established link to ultraviolet exposure, MM lacks definitive risk factors. This gap in understanding poses a significant challenge in early detection and prevention strategies. The prognosis remains dire, as evidenced by a 5-year overall survival rate ranging from 0 to 45%, largely due to late-stage diagnosis.
Case Summary
A 65-year-old female patient with a history of hypertension, eczema, and hyperlipidemia was notified by her general dentist during routine dental prophylaxis of a pigmented macule on the left hard palatal mucosa. Routine surveillance was recommended. Three months later, she noted an asymptomatic blister-like swelling in the same area as what she believed to be the unchanged macule. Two months later, the patient presented to the oral medicine clinic. Intra-oral examination revealed a 2.0- × 1.3- × 0.4-cm ulcerated brown sessile mass, concerning for neoplasia. An incisional biopsy revealed mucosal melanoma. Comprehensive imaging work-up, including positron emission tomography and computed tomography, revealed an incidental fluorodeoxyglucose-avid lung nodule. Biopsy of the nodule revealed primary lung adenocarcinoma. Treatment will include left hemi-maxillectomy for the MM, followed by evaluation by thoracic surgery and radiation oncology for treatment of the lung adenocarcinoma.
Conclusions
MM is a rare, aggressive malignancy with a poor prognosis that can affect the oral cavity. Oral health providers should routinely screen for suspicious pigmented lesions to facilitate early diagnosis and treatment. Additionally, it has been reported that patients with MM are more likely to have a second primary malignancy compared with those with other types of melanoma. Herein, we present such a case of primary oral MM and primary lung adenocarcinoma that was diagnosed incidentally during the MM workup process.
{"title":"The intended and incidental","authors":"Abdulrahman Nakshabandi , Joud Omari , Petros Yoon , Hervè Sroussi","doi":"10.1016/j.oooo.2024.10.112","DOIUrl":"10.1016/j.oooo.2024.10.112","url":null,"abstract":"<div><h3>Background</h3><div>Melanoma is a malignancy originating from melanocytes, with the potential to affect not only the skin but also any melanocyte-containing tissue, including mucosal surfaces. Mucosal melanoma (MM), although less common than its cutaneous counterpart, is characterized by a more aggressive course and poorer prognosis. In the head and neck region, MM primarily involves the nasal and sinonasal cavities, with the oral cavity being less frequently affected, particularly at the hard palatal mucosa and maxillary gingiva. Distinct from cutaneous melanoma, which has a well-established link to ultraviolet exposure, MM lacks definitive risk factors. This gap in understanding poses a significant challenge in early detection and prevention strategies. The prognosis remains dire, as evidenced by a 5-year overall survival rate ranging from 0 to 45%, largely due to late-stage diagnosis.</div></div><div><h3>Case Summary</h3><div>A 65-year-old female patient with a history of hypertension, eczema, and hyperlipidemia was notified by her general dentist during routine dental prophylaxis of a pigmented macule on the left hard palatal mucosa. Routine surveillance was recommended. Three months later, she noted an asymptomatic blister-like swelling in the same area as what she believed to be the unchanged macule. Two months later, the patient presented to the oral medicine clinic. Intra-oral examination revealed a 2.0- × 1.3- × 0.4-cm ulcerated brown sessile mass, concerning for neoplasia. An incisional biopsy revealed mucosal melanoma. Comprehensive imaging work-up, including positron emission tomography and computed tomography, revealed an incidental fluorodeoxyglucose-avid lung nodule. Biopsy of the nodule revealed primary lung adenocarcinoma. Treatment will include left hemi-maxillectomy for the MM, followed by evaluation by thoracic surgery and radiation oncology for treatment of the lung adenocarcinoma.</div></div><div><h3>Conclusions</h3><div>MM is a rare, aggressive malignancy with a poor prognosis that can affect the oral cavity. Oral health providers should routinely screen for suspicious pigmented lesions to facilitate early diagnosis and treatment. Additionally, it has been reported that patients with MM are more likely to have a second primary malignancy compared with those with other types of melanoma. Herein, we present such a case of primary oral MM and primary lung adenocarcinoma that was diagnosed incidentally during the MM workup process.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Page e57"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174474","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.2024.10.111
Joud Y Omari , Eric Saiz , Daniel Hawkins , Sook-Bin Woo
Sarcoidosis is a granulomatous disease that is likely a hypersensitivity reaction to an environmental agent, characterized by the presence of noncaseating granulomas typically affecting the hilar lymph nodes and the lungs. The disease affects adults in their third to fifth decades and extramediastinal involvement affects mainly the lymph nodes, liver, skin, and eyes. Within the oral cavity, sarcoidosis affects the minor salivary glands in 25% to 50% of patients. Osseous involvement has been documented in 3% to 13% of patients but only 26 cases have been reported in the jawbones.
Here we present 2 new cases of sarcoidosis affecting the jaw bones. The first case was that of a 65-year-old female patient with a known history of sarcoidosis with respiratory symptoms managed with budesonide inhaler who presented with an expansile radiolucent lesion of the anterior maxilla in the area of the right maxillary canine and incisors. The second case is of a 55-year-old female patient with stable pulmonary sarcoidosis not currently undergoing therapy who presented with a radiolucency of the right maxilla with the right maxillary canine “floating in space.” The differential diagnoses included odontogenic cysts and tumors, Langerhans cell histiocytosis, and central giant cell granuloma.
Biopsies from both patients revealed non-necrotizing granulomatous inflammation consistent with the patients’ known history of sarcoidosis. Histochemical studies to rule out an infectious cause for the granulomas were negative. Of the 26 previously reported cases of sarcoidosis involving the jaw bones, the mean age at diagnosis was 37.4 years (range 16-59 years) and there was a female predilection (1.9:1) Involvement of jaw bones was observed primarily in tooth-bearing areas with two cases affecting the mandibular condyles. The mandible and maxilla were equally affected in 38.5% of cases and all presented as poorly defined radiolucencies. In four cases, there was generalized involvement of both the mandible and the maxilla. In 11 cases (42.3%), oral involvement preceded identification of systemic disease. Management of patients ranged from surgical to nonsurgical intervention including the use of steroid treatment. Patients who received surgical treatment exhibited improvement of the jaw lesions, often exhibiting osseous regeneration on follow-up visits.
{"title":"Sarcoidosis affecting the maxilla: report of 2 cases","authors":"Joud Y Omari , Eric Saiz , Daniel Hawkins , Sook-Bin Woo","doi":"10.1016/j.oooo.2024.10.111","DOIUrl":"10.1016/j.oooo.2024.10.111","url":null,"abstract":"<div><div>Sarcoidosis is a granulomatous disease that is likely a hypersensitivity reaction to an environmental agent, characterized by the presence of noncaseating granulomas typically affecting the hilar lymph nodes and the lungs. The disease affects adults in their third to fifth decades and extramediastinal involvement affects mainly the lymph nodes, liver, skin, and eyes. Within the oral cavity, sarcoidosis affects the minor salivary glands in 25% to 50% of patients. Osseous involvement has been documented in 3% to 13% of patients but only 26 cases have been reported in the jawbones.</div><div>Here we present 2 new cases of sarcoidosis affecting the jaw bones. The first case was that of a 65-year-old female patient with a known history of sarcoidosis with respiratory symptoms managed with budesonide inhaler who presented with an expansile radiolucent lesion of the anterior maxilla in the area of the right maxillary canine and incisors. The second case is of a 55-year-old female patient with stable pulmonary sarcoidosis not currently undergoing therapy who presented with a radiolucency of the right maxilla with the right maxillary canine “floating in space.” The differential diagnoses included odontogenic cysts and tumors, Langerhans cell histiocytosis, and central giant cell granuloma.</div><div>Biopsies from both patients revealed non-necrotizing granulomatous inflammation consistent with the patients’ known history of sarcoidosis. Histochemical studies to rule out an infectious cause for the granulomas were negative. Of the 26 previously reported cases of sarcoidosis involving the jaw bones, the mean age at diagnosis was 37.4 years (range 16-59 years) and there was a female predilection (1.9:1) Involvement of jaw bones was observed primarily in tooth-bearing areas with two cases affecting the mandibular condyles. The mandible and maxilla were equally affected in 38.5% of cases and all presented as poorly defined radiolucencies. In four cases, there was generalized involvement of both the mandible and the maxilla. In 11 cases (42.3%), oral involvement preceded identification of systemic disease. Management of patients ranged from surgical to nonsurgical intervention including the use of steroid treatment. Patients who received surgical treatment exhibited improvement of the jaw lesions, often exhibiting osseous regeneration on follow-up visits.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Page e57"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143174786","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.2024.10.106
Felipe Martins Silveira , Sven Eric Niklander , Wilfredo Alejandro Gonzalez Arriagada , René Martínez-Flores , Ronell Eduardo Bologna-Molina
Objective
Interleukin (IL)-1 comprises a family of inflammation-regulating cytokines that govern various innate immune processes. This study aims to evaluate the immunohistochemical expression of IL-1 family members in oral squamous cell carcinoma (OSCC) and elucidate the association of their expression with clinicopathological features.
Methods
Immunohistochemical expressions of IL-1α, IL-1β, IL-1RA, and IL-1R1 were assessed in the parenchyma (invasion front) of 44 OSCC resections. Immunoreactivity was evaluated in association with histologic grade, perineural invasion, recurrence, and clinical staging of OSCC cases. The χ2 test was employed to correlate expression levels of IL-1 family members with clinicopathologic variables, and Cox regression was used to identify independent risk factors related to poor 5-year survival.
Results
Tumor islands at the invasion front of all evaluated OSCC cases were positive, showing varying degrees of immunoreactivity for IL-1α, IL-1β, IL-1RA, and IL-1R1, with a greater proportion of cases exhibiting high IL-1RA expression (62.5%). Low IL-1α immunoreactivity demonstrated a statistically significant association with increased recurrence (P = .007) and less-differentiated tumors (P = .036). No significant association of other IL-1 family members with any evaluated prognostic factors was observed.
Conclusions
The results suggest that reduced tissue expression of IL-1α is associated with increased recurrence and less-differentiated OSCC cases. The role of pro-inflammatory factors in the IL-1 signaling pathway appears to be more crucial in etiopathogenesis than in the prognostic factors of OSCC.
{"title":"Correlation of the expression of the interleukin-1 signaling pathway with prognostic factors in oral squamous cell carcinoma: an immunohistochemical study","authors":"Felipe Martins Silveira , Sven Eric Niklander , Wilfredo Alejandro Gonzalez Arriagada , René Martínez-Flores , Ronell Eduardo Bologna-Molina","doi":"10.1016/j.oooo.2024.10.106","DOIUrl":"10.1016/j.oooo.2024.10.106","url":null,"abstract":"<div><h3>Objective</h3><div>Interleukin (IL)-1 comprises a family of inflammation-regulating cytokines that govern various innate immune processes. This study aims to evaluate the immunohistochemical expression of IL-1 family members in oral squamous cell carcinoma (OSCC) and elucidate the association of their expression with clinicopathological features.</div></div><div><h3>Methods</h3><div>Immunohistochemical expressions of IL-1α, IL-1β, IL-1RA, and IL-1R1 were assessed in the parenchyma (invasion front) of 44 OSCC resections. Immunoreactivity was evaluated in association with histologic grade, perineural invasion, recurrence, and clinical staging of OSCC cases. The χ<sup>2</sup> test was employed to correlate expression levels of IL-1 family members with clinicopathologic variables, and Cox regression was used to identify independent risk factors related to poor 5-year survival.</div></div><div><h3>Results</h3><div>Tumor islands at the invasion front of all evaluated OSCC cases were positive, showing varying degrees of immunoreactivity for IL-1α, IL-1β, IL-1RA, and IL-1R1, with a greater proportion of cases exhibiting high IL-1RA expression (62.5%). Low IL-1α immunoreactivity demonstrated a statistically significant association with increased recurrence (<em>P</em> = .007) and less-differentiated tumors (<em>P</em> = .036). No significant association of other IL-1 family members with any evaluated prognostic factors was observed.</div></div><div><h3>Conclusions</h3><div>The results suggest that reduced tissue expression of IL-1α is associated with increased recurrence and less-differentiated OSCC cases. The role of pro-inflammatory factors in the IL-1 signaling pathway appears to be more crucial in etiopathogenesis than in the prognostic factors of OSCC.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Page e55"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173349","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.2024.08.011
Eduardo Morato de Oliveira , Cinthia Veronica Bardález Lopéz de Cáceres , Carla Isabelly Fernandes-Rodrigues , Paulo Victor Mendes Penafort , Juan Manuel Arteaga Legarrea , Nathalia Rodrigues Gomes , Hélder Antônio Rebelo Pontes , Pablo Agustin Vargas , José Narciso Rosa Assunção Júnior , Ciro Dantas Soares , Felipe Paiva Fonseca
Objective
The objective of this study was to describe a series of peripheral T-cell lymphoma, not otherwise specified (PTCL NOS) affecting the oral cavity and to review the available literature.
Study Design
Cases diagnosed as PTCL-NOS affecting the oral cavity were retrospectively retrieved from pathology files. Original hematoxylin and eosin-stained slides and immunohistochemical reactions were reviewed for microscopic confirmation. The presence of Epstein-Barr virus (EBV) was investigated by in situ hybridization. Clinical and follow-up data were retrieved from patients’ pathology and medical files.
Results
A total of 5 cases were obtained with a mean age of 51.8 years old, 3 male patients and 2 female patients. Three cases affected the palate and 2 cases affected the gingiva, whereas 1 case affected the maxillary bone. Tumors presented as destructive, infiltrative, and painful lesions causing swelling, ulceration, and tissue necrosis. All cases exhibited CD3 expression. GATA3 was expressed in 3 cases. Four patients were deceased of the disease during follow-up.
Conclusions
PTCL NOS affecting the oral cavity is rare and usually present as a very aggressive disease, associated with a poor prognosis and dismal outcome. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)
{"title":"Oral manifestations of peripheral T cell lymphoma, not otherwise specified: case series and review of the current literature","authors":"Eduardo Morato de Oliveira , Cinthia Veronica Bardález Lopéz de Cáceres , Carla Isabelly Fernandes-Rodrigues , Paulo Victor Mendes Penafort , Juan Manuel Arteaga Legarrea , Nathalia Rodrigues Gomes , Hélder Antônio Rebelo Pontes , Pablo Agustin Vargas , José Narciso Rosa Assunção Júnior , Ciro Dantas Soares , Felipe Paiva Fonseca","doi":"10.1016/j.oooo.2024.08.011","DOIUrl":"10.1016/j.oooo.2024.08.011","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to describe a series of peripheral T-cell lymphoma, not otherwise specified (PTCL NOS) affecting the oral cavity and to review the available literature.</div></div><div><h3>Study Design</h3><div>Cases diagnosed as PTCL-NOS affecting the oral cavity were retrospectively retrieved from pathology files. Original hematoxylin and eosin-stained slides and immunohistochemical reactions were reviewed for microscopic confirmation. The presence of Epstein-Barr virus (EBV) was investigated by in situ hybridization. Clinical and follow-up data were retrieved from patients’ pathology and medical files.</div></div><div><h3>Results</h3><div>A total of 5 cases were obtained with a mean age of 51.8 years old, 3 male patients and 2 female patients. Three cases affected the palate and 2 cases affected the gingiva, whereas 1 case affected the maxillary bone. Tumors presented as destructive, infiltrative, and painful lesions causing swelling, ulceration, and tissue necrosis. All cases exhibited CD3 expression. GATA3 was expressed in 3 cases. Four patients were deceased of the disease during follow-up.</div></div><div><h3>Conclusions</h3><div>PTCL NOS affecting the oral cavity is rare and usually present as a very aggressive disease, associated with a poor prognosis and dismal outcome. (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 e37-e45"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113857","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.2024.08.018
Nathaly de Oliveira Ciaramicolo DDS, MS , Gabriela Barbosa Bisson DDS, MS , Osny Ferreira Júnior DDS, MSc
Carbolic acid or phenol is considered a chemical agent that produces intense facial rejuvenation when used correctly, however, solutions containing this substance are dangerous and their action must be controlled. The aim of this study was to collect information on the adverse effects of the use of phenolic compounds for facial esthetic purposes. Phenol promotes the denaturation and coagulation of epidermal keratin proteins, deep chemical peels carried out with phenol, when well indicated and properly conducted, produce incomparable results, however, the ignorant use of these solutions can produce ectropion, keloids, and unsightly scars on the face and neck, in addition, systemic absorption is related to hepatorenal and cardiac toxicity. Although the cardiotoxicity of phenol is well described in the literature, its carcinogenic potential is still unknown and further studies are needed. It is known that the substance induces unscheduled DNA synthesis, inducing genetic mutation. Successful results depend on a balance among art and technique and safety standards. Future research investigating the carcinogenic potential of phenol peels is desirable to ensure patient safety and adequate information for professionals. We believe that the indiscriminate use of phenol peels can cause serious problems for patients and their general health. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)
石碳酸或苯酚被认为是一种化学制剂，如果使用得当，可以产生强烈的面部年轻化效果，然而，含有这种物质的溶液是危险的，其作用必须受到控制。本研究旨在收集有关将酚类化合物用于面部美容的不良影响的信息。酚会促进表皮角蛋白的变性和凝固，使用酚进行深层化学换肤，如果适应症明确且操作得当，会产生无与伦比的效果，但如果不加注意地使用这些溶液，则会在面部和颈部产生外翻、瘢痕疙瘩和难看的疤痕，此外，全身吸收还与肝肾和心脏毒性有关。虽然文献中对苯酚的心脏毒性有详细描述，但其致癌潜力尚不清楚，需要进一步研究。众所周知，该物质会诱导计划外的 DNA 合成，从而诱发基因突变。成功的结果取决于艺术和技术与安全标准之间的平衡。为了确保患者的安全和为专业人员提供足够的信息，今后最好对苯酚去皮的致癌潜力进行调查研究。我们认为，滥用苯酚换肤可对患者及其总体健康造成严重问题。(Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)
{"title":"Adverse effects associated with the irresponsible use of phenol peeling: literature review","authors":"Nathaly de Oliveira Ciaramicolo DDS, MS , Gabriela Barbosa Bisson DDS, MS , Osny Ferreira Júnior DDS, MSc","doi":"10.1016/j.oooo.2024.08.018","DOIUrl":"10.1016/j.oooo.2024.08.018","url":null,"abstract":"<div><div>Carbolic acid or phenol is considered a chemical agent that produces intense facial rejuvenation when used correctly, however, solutions containing this substance are dangerous and their action must be controlled. The aim of this study was to collect information on the adverse effects of the use of phenolic compounds for facial esthetic purposes. Phenol promotes the denaturation and coagulation of epidermal keratin proteins, deep chemical peels carried out with phenol, when well indicated and properly conducted, produce incomparable results, however, the ignorant use of these solutions can produce ectropion, keloids, and unsightly scars on the face and neck, in addition, systemic absorption is related to hepatorenal and cardiac toxicity. Although the cardiotoxicity of phenol is well described in the literature, its carcinogenic potential is still unknown and further studies are needed. It is known that the substance induces unscheduled DNA synthesis, inducing genetic mutation. Successful results depend on a balance among art and technique and safety standards. Future research investigating the carcinogenic potential of phenol peels is desirable to ensure patient safety and adequate information for professionals. We believe that the indiscriminate use of phenol peels can cause serious problems for patients and their general health. (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 161-165"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267336","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.2024.10.080
Hanqing Lin MD, PhD , Yu Heng MS , Xiaoke Zhu MS , Tian Wang MS , Lei Tao MD, PhD
Background
To investigate the impact of radiotherapy (RT) on the distribution and function of peripheral CD8+ T lymphocytes in patients with hypopharyngeal squamous cell carcinoma (HPSCC).
Methods
A total of 105 HPSCC patients who underwent definitive RT were enrolled. Baseline levels of peripheral immune cells were obtained, and their alteration during RT was evaluated. Flow cytometry was used to analyze T-cell distribution, cytokine secretion, and CD8+ T lymphocyte proliferation capacity.
Results
Lymphocyte count significantly decreased following radiation and remained in a low level after 1 year of RT. CD3+ T lymphocyte counts decreased significantly, and the CD4+/CD8+ ratio increased in HPSCC patients following radiation. The secretion of IFN-γ from peripheral CD8+ T lymphocytes was significantly reduced after irradiation, while the secretion of TNF-α and perforin did not change significantly. Furthermore, the proliferation capacity of peripheral CD8+ T lymphocytes was decreased following RT.
Conclusions
RT significantly decreased the number of peripheral T lymphocytes and impaired the secretory function and proliferation ability of CD8+ T lymphocytes in HPSCC patients. These findings provide insight into the mechanisms underlying the therapeutic effects of RT on HPSCC and have implications for optimizing treatment strategies.
背景：研究放疗（RT）对下咽鳞状细胞癌（HPSCC）患者外周 CD8+ T 淋巴细胞分布和功能的影响：研究放疗（RT）对下咽鳞状细胞癌（HPSCC）患者外周CD8+ T淋巴细胞分布和功能的影响：方法：共招募了105名接受明确RT治疗的下咽鳞状细胞癌患者。获得了外周免疫细胞的基线水平，并评估了它们在 RT 期间的变化。流式细胞术用于分析 T 细胞分布、细胞因子分泌和 CD8+ T 淋巴细胞增殖能力：结果：淋巴细胞计数在放射后明显下降，RT 1 年后仍处于较低水平。放疗后，HPSCC 患者的 CD3+ T 淋巴细胞数量明显减少，CD4+/CD8+ 比率增加。照射后，外周 CD8+ T 淋巴细胞分泌的 IFN-γ 明显减少，而 TNF-α 和穿孔素的分泌则无明显变化。此外，外周 CD8+ T 淋巴细胞的增殖能力在 RT 后也有所下降：结论：RT明显降低了HPSCC患者外周T淋巴细胞的数量，损害了CD8+ T淋巴细胞的分泌功能和增殖能力。这些发现深入揭示了RT对HPSCC治疗作用的机制，对优化治疗策略具有重要意义。
{"title":"Impact of radiotherapy on peripheral T lymphocytes in hypopharyngeal squamous cell carcinoma","authors":"Hanqing Lin MD, PhD , Yu Heng MS , Xiaoke Zhu MS , Tian Wang MS , Lei Tao MD, PhD","doi":"10.1016/j.oooo.2024.10.080","DOIUrl":"10.1016/j.oooo.2024.10.080","url":null,"abstract":"<div><h3>Background</h3><div>To investigate the impact of radiotherapy (RT) on the distribution and function of peripheral CD8<sup>+</sup> T lymphocytes in patients with hypopharyngeal squamous cell carcinoma (HPSCC).</div></div><div><h3>Methods</h3><div>A total of 105 HPSCC patients who underwent definitive RT were enrolled. Baseline levels of peripheral immune cells were obtained, and their alteration during RT was evaluated. Flow cytometry was used to analyze T-cell distribution, cytokine secretion, and CD8<sup>+</sup> T lymphocyte proliferation capacity.</div></div><div><h3>Results</h3><div>Lymphocyte count significantly decreased following radiation and remained in a low level after 1 year of RT. CD3<sup>+</sup> T lymphocyte counts decreased significantly, and the CD4<sup>+</sup>/CD8<sup>+</sup> ratio increased in HPSCC patients following radiation. The secretion of IFN-γ from peripheral CD8+ T lymphocytes was significantly reduced after irradiation, while the secretion of TNF-α and perforin did not change significantly. Furthermore, the proliferation capacity of peripheral CD8<sup>+</sup> T lymphocytes was decreased following RT.</div></div><div><h3>Conclusions</h3><div>RT significantly decreased the number of peripheral T lymphocytes and impaired the secretory function and proliferation ability of CD8<sup>+</sup> T lymphocytes in HPSCC patients. These findings provide insight into the mechanisms underlying the therapeutic effects of RT on HPSCC and have implications for optimizing treatment strategies.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 2","pages":"Pages 220-228"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630966","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号