Dentistry › Periodontics

Oral Health Pathology and Treatment

Works Count: 56330

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Description

This cluster of papers focuses on the nomenclature, classification, pathogenesis, diagnosis, management, and malignant transformation risk of oral mucosal disorders, particularly oral lichen planus and potentially malignant disorders. It also explores the epidemiology of areca nut usage, diagnostic aids for detection of oral cancer, and the clinical features and systemic associations of these disorders.

Keywords

Oral Mucosal Disorders; Potentially Malignant Disorders; Malignant Transformation; Oral Lichen Planus; Areca Nut Usage; Diagnostic Aids; Epidemiology; Pathogenesis; Clinical Management; Risk Factors

PURIFICATION OF THE HYPERGLYCEMIC-GLYCOGENOLYTIC FACTOR FROM INSULIN AND FROM GASTRIC MUCOSA

1949-09-01

Earl W. Sutherland , Carl F. Cori , Robert C. Haynes +1 more

Nomenclature and classification of potentially malignant disorders of the oral mucosa

2007-07-26

Saman Warnakulasuriya , Newell W. Johnson , I. van der Waal

At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Precancer in the UK issues related to terminology, definitions and classification of oral precancer were discussed by … At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Precancer in the UK issues related to terminology, definitions and classification of oral precancer were discussed by an expert group. The consensus views of the Working Group are presented here. The term, ‘potentially malignant disorders’, was recommended to refer to precancer as it conveys that not all disorders described under this term may transform into cancer. Critically evaluating all definitions proposed so far for oral leukoplakia, the Working Group agreed that the term leukoplakia should be used to recognize ‘white plaques of questionable risk having excluded (other) known diseases or disorders that carry no increased risk for cancer’. An outline was proposed for diagnosing oral leukoplakia that will prevent other oral white disorders being misclassified as leukoplakia. The Working Group discussed the caveats involved in the current use of terminology and classification of oral potentially malignant disorders, deficiencies of these complex systems, and how they have evolved over the past several decades. The terminology presented in this report reflects our best understanding of multi‐step carcinogenesis in the oral mucosa, and aspires to engender consistency in use.

Pathogenesis of oral lichen planus - a review

2010-10-04

M. R. Roopashree , Rajesh Gondhalekar , MC Shashikanth +3 more

J Oral Pathol Med (2010) 39: 729–734 Oral lichen planus (OLP) is a T-cell-mediated chronic inflammatory oral mucosal disease of unknown etiology. OLP presents as white striations, white papules, white … J Oral Pathol Med (2010) 39: 729–734 Oral lichen planus (OLP) is a T-cell-mediated chronic inflammatory oral mucosal disease of unknown etiology. OLP presents as white striations, white papules, white plaques, erythema, erosions, or blisters affecting predominantly the buccal mucosa, tongue and gingiva. Both antigen-specific and non-specific mechanisms are hypothesized to be involved in the pathogenesis of oral lichen planus (OLP). Antigen-specific mechanisms in OLP include antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing by CD8+ cytotoxic T cells. Non-specific mechanisms include mast cell degranulation and matrix metalloproteinase activation in OLP lesions. These mechanisms may combine to cause T cell accumulation in the superficial lamina propria, basement membrane disruption, intra-epithelial T cell migration and keratinocyte apoptosis in OLP. The various hypotheses proposed for pathogenesis of oral lichen planus are discussed in this review.

Oral epithelial dysplasia classification systems: predictive value, utility, weaknesses and scope for improvement

2008-02-03

Saman Warnakulasuriya , Jesper Reibel , Bouquot Je +1 more

At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Precancer in the United Kingdom issues related to potentially malignant disorders of the oral cavity were discussed … At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Precancer in the United Kingdom issues related to potentially malignant disorders of the oral cavity were discussed by an expert group. The consensus views of the Working Group are presented in a series of papers. In this report, we review the oral epithelial dysplasia classification systems. The three classification schemes [oral epithelial dysplasia scoring system, squamous intraepithelial neoplasia and Ljubljana classification] were presented and the Working Group recommended epithelial dysplasia grading for routine use. Although most oral pathologists possibly recognize and accept the criteria for grading epithelial dysplasia, firstly based on architectural features and then of cytology, there is great variability in their interpretation of the presence, degree and significance of the individual criteria. Several studies have shown great interexaminer and intraexaminer variability in the assessment of the presence or absence and the grade of oral epithelial dysplasia. The Working Group considered the two class classification (no/questionable/ mild – low risk; moderate or severe – implying high risk) and was of the view that reducing the number of choices from 3 to 2 may increase the likelihood of agreement between pathologists. The utility of this need to be tested in future studies. The variables that are likely to affect oral epithelial dysplasia scoring were discussed and are outlined here; these need to be researched in longitudinal studies to explore the biological significance of a low‐risk or high‐risk dysplasia.

Natural history of potentially malignant oral lesions and conditions: an overview of the literature

2007-07-05

Séamus S. Napier , Paul M. Speight

At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Pre‐cancer in the UK issues related to potentially malignant disorders of the oral cavity were discussed by … At a workshop coordinated by the WHO Collaborating Centre for Oral Cancer and Pre‐cancer in the UK issues related to potentially malignant disorders of the oral cavity were discussed by an expert group. The consensus views of the Working Group are presented in a series of papers. In this report we review the literature on the epidemiology and natural history of potentially malignant disorders (PMD), detailing those characteristics of the patients and lesions thought to be associated with future development of oral squamous cell carcinoma (OSCC). Older patients, particularly females are more at risk than younger patients; the duration of PMD may be important. Those who have never used tobacco seem at greater risk than smokers. OSCC is more likely with PMD on the lateral and ventral tongue, floor of mouth and retromolar/soft palate complex than with those elsewhere. The vast majority of PMD in which OSCC develop are non‐homogenous although 5% of homogenous PMD will develop carcinoma. Large lesions covering several intraoral subsites also appear more at risk.

Oral submucous fibrosis: Review on aetiology and pathogenesis

2005-12-01

Wanninayake Mudiyanselage Tilakaratne , M.F. Klinikowski , Takashi Saku +2 more

Verrucous carcinoma.Clinical and pathologic study of 105 cases involving oral cavity, larynx and genitalia

1966-01-01

Frederick T. Kraus , Carlos Perez‐Mesa

Verrucous carcinoma, a distinctive variant of epidermoid carcinoma, was found in the oral cavity (77 cases), larynx (12 cases), nasal fossa (4 cases), glans penis (8 cases), vulva (1 case), … Verrucous carcinoma, a distinctive variant of epidermoid carcinoma, was found in the oral cavity (77 cases), larynx (12 cases), nasal fossa (4 cases), glans penis (8 cases), vulva (1 case), vagina (1 case), scrotum (1 case). A relationship between the use of chewing tobacco and oral cavity lesions was evident in this indigent, predominantly rural patient group. Locally aggressive behavior with bone invasion occurred in 15 instances. Lymph node metastases were not found except in 4 patients treated by radiation, apparently as a result of alteration of the biologic character of the lesion. Radiation therapy (17 patients) failed to control the lesion in all instances. The response to surgical excision (88 patients) was excellent.

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Oral mucosal disease: Lichen planus

2007-09-06

Crispian Scully , M Carrozzo

Update On Oral Lichen Planus: Etiopathogenesis and Management

1998-01-01

C Scully , M. Beyli , Miguel Castro Ferreiro +7 more

Lichen planus (LP) is a relatively common disorder of the stratified squamous epithelia, which is, in many ways, an enigma. This paper is the consensus outcome of a workshop held … Lichen planus (LP) is a relatively common disorder of the stratified squamous epithelia, which is, in many ways, an enigma. This paper is the consensus outcome of a workshop held in Switzerland in 1995, involving a selection of clinicians and scientists with an interest in the condition and its management. The oral (OLP) eruptions usually have a distinct clinical morphology and characteristic distribution, but OLP may also present a confusing array of patterns and forms, and other disorders may clinically simulate OLP. Lesions may affect other mucosae and/or skin. Lichen planus is probably of multifactorial origin, sometimes induced by drugs or dental materials, often idiopathic, and with an immunopathogenesis involving T-cells in particular. The etiopathogenesis appears to be complex, with interactions between and among genetic, environmental, and lifestyle factors, but much has now been clarified about the mechanisms involved, and interesting new associations, such as with liver disease, have emerged. The management of lichen planus is still not totally satisfactory, and there is as yet no definitive treatment, but there have been advances in the control of the condition. There is no curative treatment available; immunomodulation, however, can control the condition. Based on the observed increased risk of malignant development, OLP patients should be offered regular follow-up examination from two to four times annually and asked to report any changes in their lesions and/or symptoms. Follow-up may be particularly important in patients with atrophic/ulcerative/erosive affections of the tongue, the gingiva, or the buccal mucosa. Much more research is required into the genetic and environmental aspects of lichen planus, into the premalignant potential, and into the possible associations with chronic liver, and other disorders. More clinical studies are required into the possible efficacy of immunomodulatory drugs such as pentoxifylline and thalidomide.

Snuff Dipping and Oral Cancer among Women in the Southern United States

1981-03-26

Deborah M. Winn , William J. Blot , Carl M. Shy +3 more

A case-control study in North Carolina involving 255 women with oral and pharyngeal cancer and 502 controls revealed that the exceptionally high mortality from this cancer among white women in … A case-control study in North Carolina involving 255 women with oral and pharyngeal cancer and 502 controls revealed that the exceptionally high mortality from this cancer among white women in the South is primarily related to chronic use of snuff. The relative risk associated with snuff dipping among white nonsmokers was 4.2 (95 per cent confidence limits, 2.6 to 6.7), and among chronic users the risk approached 50-fold for cancers of the gum and buccal mucosa--tissues that come in direct contact with the tobacco powder. In the absence of snuff dipping, oral and pharyngeal cancer resulted mainly from the combined effects of cigarette smoking and alcohol consumption. The carcinogenic hazard of oral snuff is of special concern in view of the recent upswing in consumption of smokeless tobacco in the United States.

Oral leukoplakia and malignant transformation. A follow-up study of 257 patients

1984-02-01

Sol Silverman , Meir Gorsky , Francina Lozada

Two hundred fifty-seven patients with oral leukoplakia were studied and followed for an average period of 7.2 years. All lesions were more than one cm in size and had been … Two hundred fifty-seven patients with oral leukoplakia were studied and followed for an average period of 7.2 years. All lesions were more than one cm in size and had been present and observed for a minimum of 6 months. Of the initial biopsies, 235 revealed a benign hyperkeratosis and 22 others contained some degree of epithelial dysplasia. Seventy-three percent of the patients used tobacco, with cigarette usage being the predominant form. Forty-five patients (17.5%) subsequently developed squamous carcinomas in the hyperkeratotic epithelial site in an average time of 8.1 years. Eight of these malignant transformations came from patients who originally had epithelial dysplasia. High risks for malignant transformation also included non-smoking patients, the clinical presence of erythroplasia (erythroleukoplakia), and a clinical verrucous-papillary hyperkeratotic pattern. Duration of the leukoplakia progressively increased the total number of malignant transformations, with the largest rate occurring in the second year. This study confirms that oral leukoplakia is a precancerous lesion and that certain characteristics indicate greater risks and warrant consideration of more aggressive management.

The Pathogenesis of Senile Plaques

1997-04-01

Dennis W. Dickson

Senile plaques (SP) are complicated lesions composed of diverse amyloid peptides and associated molecules, degenerating neuronal processes, and reactive glia. Evidence suggests that diffuse, neurocentric amyloid deposits evolve over time … Senile plaques (SP) are complicated lesions composed of diverse amyloid peptides and associated molecules, degenerating neuronal processes, and reactive glia. Evidence suggests that diffuse, neurocentric amyloid deposits evolve over time with formation of discrete niduses that eventually become neuritic SP. The evidence for differential amyloid precursor protein metabolism that may favor deposition of Aβ17-42 in this early, possibly aging-related lesion is discussed. This latter molecule, also known as P3, may represent a benign form of amyloid, since it lacks domains associated with activation and recruitment of glia to SP. Subsequent to deposition of Aβ1-42 and then growth of the amyloid with precipitation of soluble Aβ1-40, in an Alzheimer disease-specific process, SP increasingly become associated with activated microglia and reactive astrocytes. In response to interaction with amyloid peptides and possibly glycated proteins, microglia and astrocytes produce a number of molecules that may be locally toxic to neuronal processes in the vicinity of SP, including cytokines, reactive oxygen and nitrogen intermediates, and proteases. They also produce factors that lead to their reciprocal activation and growth, which potentiate a local inflammatory cascade. Paired helical filament- (PHF) type neurites appear to be associated with SP only in so far as neurofibrillary degeneration has progressed to affect neurons in those regions where the plaque forms. Thus, PHF-type neurites are readily apparent in SP in the amygdala at an early stage, while they are late in primary cortices and never detected in cerebellar plaques, where only dystrophic neurites are detected. If the various stages of SP pathogenesis can be further clarified, it may be possible to develop rational approaches to therapy directed at site-, cell type-, and stage-specific interventions. Although controlling the local inflammatory microenvironment of SP may hold promise for slowing lesion pathogenesis, it still remains a fundamental challenge to determine the mechanism of neurodegeneration that results in widespread neurofibrillary degeneration and eventual synaptic and neuronal loss, which is considered to be the proximate cause of the clinical dementia syndrome.

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Global epidemiology of oral and oropharyngeal cancer

2008-09-19

Saman Warnakulasuriya

Oral submucous fibrosis

1966-12-01

J. J. Pindborg , Satyavati M. Sirsat

P<scp>rognosis of</scp> O<scp>ral</scp> P<scp>re-malignant</scp> L<scp>esions:</scp> S<scp>ignificance of</scp> C<scp>linical,</scp> H<scp>istopathological, and</scp> M<scp>olecular</scp> B<scp>iological</scp> C<scp>haracteristics</scp>

2003-01-01

Jesper Reibel

The concept of a two-step process of cancer development in the oral mucosa, i.e., the initial presence of a precursor subsequently developing into cancer, is well-established. Oral leukoplakia is the … The concept of a two-step process of cancer development in the oral mucosa, i.e., the initial presence of a precursor subsequently developing into cancer, is well-established. Oral leukoplakia is the best-known precursor lesion. The evidence that oral leukoplakias are pre-malignant is mainly derived from follow-up studies showing that between < 1 and 18% of oral pre-malignant lesions will develop into oral cancer; it has been shown that certain clinical sub-types of leukoplakia are at a higher risk for malignant transformation than others. The presence of epithelial dysplasia may be even more important in predicting malignant development than the clinical characteristics. Three major problems, however, are attached to the importance of epithelial dysplasia in predicting malignant development: (1) The diagnosis is essentially subjective, (2) it seems that not all lesions exhibiting dysplasia will eventually become malignant and some may even regress, and (3) carcinoma can develop from lesions in which epithelial dysplasia was not diagnosed in previous biopsies. There is, therefore, a substantial need to improve the histologic assessment of epithelial dysplasia or, since epithelial dysplasia does not seem to be invariably associated with or even a necessary prerequisite for malignant development, it may be necessary to develop other methods for predicting the malignant potential of pre-malignant lesions. As a consequence of these problems, numerous attempts have been made to relate biological characteristics to the malignant potential of leukoplakias. Molecular biological markers have been suggested to be of value in the diagnosis and prognostic evaluation of leukoplakias. Markers of epithelial differentiation and, more recently, genomic markers could potentially be good candidates for improving the prognostic evaluation of precursors of oral cancer. As yet, one or a panel of molecular markers has not been determined that allows for a prognostic prediction of oral pre-cancer which is any more reliable than dysplasia recording. However, these new markers could be considered complementary to conventional prognostic evaluation.

Reduced Plaque Formation by the Chloromethyl Analogue of Victamine C

1970-09-01

Samuel Turesky , Neville D. Gilmore , Irving Glickman

T H E C H L O R O M E T H Y L A N A L O G U E of Victamine C,* a cationic surface-active agent, … T H E C H L O R O M E T H Y L A N A L O G U E of Victamine C,* a cationic surface-active agent, reduces the formation of dental calculus in humans. 1 2 This chemical prevents crystallization of calcium phosphate in calculus smears in vitro, 3 but the mechanism whereby it inhibits calculus formation in vivo is not known. The following study was conducted to determine whether the chloromethyl analogue of Victamine C reduces the formation of dental plaque considered a precursor of calculus. 4 6

Smokeless tobacco and health in India and South Asia

2003-11-04

Prakash C. Gupta , Cecily S. Ray

Abstract: South Asia is a major producer and net exporter of tobacco. Over one‐third of tobacco consumed regionally is smokeless. Traditional forms like betel quid, tobacco with lime and tobacco … Abstract: South Asia is a major producer and net exporter of tobacco. Over one‐third of tobacco consumed regionally is smokeless. Traditional forms like betel quid, tobacco with lime and tobacco tooth powder are commonly used and the use of new products is increasing, not only among men but also among children, teenagers, women of reproductive age, medical and dental students and in the South Asian diaspora. Smokeless tobacco users studied prospectively in India had age‐adjusted relative risks for premature mortality of 1.2–1.96 (men) and 1.3 (women). Current male chewers of betel quid with tobacco in case‐control studies in India had relative risks of oral cancer varying between 1.8–5.8 and relative risks for oesophageal cancer of 2.1–3.2. Oral submucous fibrosis is increasing due to the use of processed areca nut products, many containing tobacco. Pregnant women in India who used smokeless tobacco have a threefold increased risk of stillbirth and a two‐ to threefold increased risk of having a low birthweight infant. In recent years, several states in India have banned the sale, manufacture and storage of gutka , a smokeless tobacco product containing areca nut. In May 2003 in India, the Tobacco Products Bill 2001 was enacted to regulate the promotion and sale of all tobacco products. In two large‐scale educational interventions in India, sizable proportions of tobacco users quit during 5–10 years of follow‐up and incidence rates of oral leukoplakia measured in one study fell in the intervention cohort. Tobacco education must be imparted through schools, existing government health programmes and hospital outreach programmes.

Reduction of residual ridges: A major oral disease entity

1971-09-01

Douglas Allen Atwood

Global epidemiology of areca nut usage

2002-01-01

Priti Gupta , Saman Warnakulasuriya

Abstract A substantial proportion of the world's population is engaged in chewing areca nut and the habit is endemic throughout the Indian subcontinent, large parts of south Asia and Melanesia. … Abstract A substantial proportion of the world's population is engaged in chewing areca nut and the habit is endemic throughout the Indian subcontinent, large parts of south Asia and Melanesia. A large variety of ingredients, including tobacco, may be used along with areca nut constituting a betel quid. The composition and method of chewing can vary widely from country to country and these population variations are described in this review. Some populations are known to use areca nut without tobacco providing good opportunities to further research the carcinogenecity of areca nut. Some interesting trends on chewing patterns have emerged from recent data, suggesting a decline in the habit in some countries such as Thailand while the prevalence of areca nut use is rising in India and Taiwan.

Frequent microsatellite alterations at chromosomes 9p21 and 3p14 in oral premalignant lesions and their value in cancer risk assessment

1996-06-01

Li Mao , Jin S. Lee , You Hong Fan +5 more

Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

2014-01-01

Farzam Gorouhi , Parastoo Davari , Nasim Fazel

Lichen planus (LP) is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival … Lichen planus (LP) is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations.

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Effect of screening on oral cancer mortality in Kerala, India: a cluster-randomised controlled trial

2005-06-01

Rengaswamy Sankaranarayanan , Kunnambath Ramadas , Gigi Thomas +4 more

Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications

2003-09-09

E.H. van der Meij , I. van der Waal

Abstract Introduction: Confirmation of a clinical diagnosis of oral lichen planus (OLP) by means of histopathologic study of a biopsy specimen is generally advised. However, hardly any data exist about … Abstract Introduction: Confirmation of a clinical diagnosis of oral lichen planus (OLP) by means of histopathologic study of a biopsy specimen is generally advised. However, hardly any data exist about the correlation between clinical and histopathologic diagnoses of OLP. The aim of the present investigation was to study the correlation between the clinical and histopathologic assessment of OLP, and to propose diagnostic refinements, if appropriate. Methods: Clinical and histopathologic data of two previously published studies were used for this purpose. The number of clinical cases in which all clinicians agreed as well as the number of microscopic slides on which all reviewing pathologists agreed were calculated and compared with each other in order to assess the clinicopathologic correlation. Results: In 42% of the cases in which all clinicians agreed about the clinical diagnosis being diagnostic of OLP, there appeared to be no consensus on the histopathologic diagnosis. Conversely, in 50% of the cases in which all pathologists agreed about the histopathologic diagnosis being diagnostic of OLP there was a lack of consensus on the clinical diagnosis. Conclusion: Based on the findings of the present study, there appears to be a lack of clinicopathologic correlation in the diagnostic assessment of OLP. We therefore propose a set of revised diagnostic criteria of OLP and oral lichenoid lesions, based on the WHO definition of OLP, including clinical as well as histopathologic aspects.

Alert for an epidemic of oral cancer due to use of the betel quid substitutes gutkha and pan masala: a review of agents and causative mechanisms

2004-06-23

U. J. Nair

In south-east Asia, Taiwan and Papua New Guinea, smoking, alcohol consumption and chewing of betel quid with or without tobacco or areca nut with or without tobacco are the predominant … In south-east Asia, Taiwan and Papua New Guinea, smoking, alcohol consumption and chewing of betel quid with or without tobacco or areca nut with or without tobacco are the predominant causes of oral cancer. In most areas, betel quid consists of a mixture of areca nut, slaked lime, catechu and several condiments according to taste, wrapped in a betel leaf. Almost all habitual chewers use tobacco with or without the betel quid. In the last few decades, small, attractive and inexpensive sachets of betel quid substitutes have become widely available. Aggressively advertised and marketed, often claimed to be safer products, they are consumed by the very young and old alike, particularly in India, but also among migrant populations from these areas world wide. The product is basically a flavoured and sweetened dry mixture of areca nut, catechu and slaked lime with tobacco (gutkha) or without tobacco (pan masala). These products have been strongly implicated in the recent increase in the incidence of oral submucous fibrosis, especially in the very young, even after a short period of use. This precancerous lesion, which has a high rate of malignant transformation, is extremely debilitating and has no known cure. The use of tobacco with lime, betel quid with tobacco, betel quid without tobacco and areca nut have been classified as carcinogenic to humans. As gutkha and pan masala are mixtures of several of these ingredients, their carcinogenic affect can be surmised. We review evidence that strongly supports causative mechanisms for genotoxicity and carcinogenicity of these substitute products. Although some recent curbs have been put on the manufacture and sale of these products, urgent action is needed to permanently ban gutkha and pan masala, together with the other established oral cancer-causing tobacco products. Further, education to reduce or eliminate home-made preparations needs to be accelerated.

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Critical evaluation of diagnostic aids for the detection of oral cancer

2007-09-07

Mark W. Lingen , John R. Kalmar , Theodore Karrison +1 more

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The clinical features, malignant potential, and systemic associations of oral lichen planus: A study of 723 patients

2002-02-01

Drore Eisen

T<scp>he</scp> P<scp>athogenesis of</scp> O<scp>ral</scp> L<scp>ichen</scp> P<scp>lanus</scp>

2002-07-01

Philip B. Sugerman , Neil Savage , Laurence J. Walsh +5 more

Both antigen-specific and non-specific mechanisms may be involved in the pathogenesis of oral lichen planus (OLP). Antigen-specific mechanisms in OLP include antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing … Both antigen-specific and non-specific mechanisms may be involved in the pathogenesis of oral lichen planus (OLP). Antigen-specific mechanisms in OLP include antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing by CD8 + cytotoxic T-cells. Non-specific mechanisms include mast cell degranulation and matrix metalloproteinase (MMP) activation in OLP lesions. These mechanisms may combine to cause T-cell accumulation in the superficial lamina propria, basement membrane disruption, intra-epithelial T-cell migration, and keratinocyte apoptosis in OLP. OLP chronicity may be due, in part, to deficient antigen-specific TGF-β1-mediated immunosuppression. The normal oral mucosa may be an immune privileged site (similar to the eye, testis, and placenta), and breakdown of immune privilege could result in OLP and possibly other autoimmune oral mucosal diseases. Recent findings in mucocutaneous graft- versus-host disease, a clinical and histological correlate of lichen planus, suggest the involvement of TNF-α, CD40, Fas, MMPs, and mast cell degranulation in disease pathogenesis. Potential roles for oral Langerhans cells and the regional lymphatics in OLP lesion formation and chronicity are discussed. Carcinogenesis in OLP may be regulated by the integrated signal from various tumor inhibitors (TGF-β1, TNF-α, IFN-γ, IL-12) and promoters (MIF, MMP-9). We present our recent data implicating antigen-specific and non-specific mechanisms in the pathogenesis of OLP and propose a unifying hypothesis suggesting that both may be involved in lesion development. The initial event in OLP lesion formation and the factors that determine OLP susceptibility are unknown.

Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations

2007-02-02

Ibtisam Al‐Hashimi , Mark Schifter , Peter B. Lockhart +7 more

Dimensions and Relations of the Dentogingival Junction in Humans

1961-07-01

Anthony W. Gargiulo , Frank M. Wentz , Balint Orban

Oral Cancer and Precancerous Lesions

2002-07-01

Bryan W Neville , Terry A. Day

In the United States, cancers of the oral cavity and oropharynx represent approximately three percent of all malignancies in men and two percent of all malignancies in women. The American … In the United States, cancers of the oral cavity and oropharynx represent approximately three percent of all malignancies in men and two percent of all malignancies in women. The American Cancer Society estimates that 28,900 new cases of oral cancer will be diagnosed in 2002, and nearly 7,400 people will die from this disease. Over 90 percent of these tumors are squamous cell carcinomas, which arise from the oral mucosal lining. In spite of the ready accessibility of the oral cavity to direct examination, these malignancies still are often not detected until a late stage, and the survival rate for oral cancer has remained essentially unchanged over the past three decades. The purpose of this article is to review the clinical features of oral cancer and premalignant oral lesions, with an emphasis on early detection.

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Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management and malignant transformation

2007-01-01

Sumairi Ismail , Satish Kumar , Rosnah Binti Zain

Lichen planus, a chronic autoimmune, mucocutaneous disease affects the oral mucosa (oral lichen planus or OLP) besides the skin, genital mucosa, scalp and nails. An immune mediated pathogenesis is recognized … Lichen planus, a chronic autoimmune, mucocutaneous disease affects the oral mucosa (oral lichen planus or OLP) besides the skin, genital mucosa, scalp and nails. An immune mediated pathogenesis is recognized in lichen planus although the exact etiology is unknown. The disease most commonly affects middle-aged females. Oral lichenoid reactions (OLR) which are considered variants of OLP, may be regarded as a disease by itself or as an exacerbation of an existing OLP, by the presence of medication (lichenoid drug reactions) or dental materials (contact hypersensitivity). OLP usually presents as white striations (Wickham's striae), white papules, white plaque, erythema, erosions or blisters. Diagnosis of OLP is established either by clinical examination only or by clinical examination with histopathologic confirmation. Direct immunofluorescence examination is only used as an adjunct to the above method of diagnosis and to rule out specific autoimmune diseases such as pemphigus and pemphigoid. Histopathologic features of OLP and OLR are similar with suggestions of certain discriminatory features by some authors. Topical corticosteroids are the treatment of choice for OLP although several other medications have been studied including retinoids, tacrolimus, cyclosporine and photodynamic therapy. Certain OLP undergo malignant transformation and the exact incidence and mechanisms are still controversial. In this paper, etiopathogenesis, diagnosis, management and malignant transformation of OLP and OLR have been reviewed. (J. Oral Sci. 49, 89-106, 2007)

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Potentially malignant disorders of the oral and oropharyngeal mucosa; terminology, classification and present concepts of management

2008-08-01

I. van der Waal

A review of human carcinogens—Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish

2009-10-30

Béatrice Secretan , Kurt Straíf , Robert A. Baan +7 more

Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan

1995-11-01

Ying‐Chin Ko , Yeou‐Lih Huang , Chien‐Hung Lee +3 more

A hospital‐based case‐control study of matched pairs was conducted to explore (a) the relationship between the use of betel quid chewing, cigarette smoking, alcohol drinking and oral cancer and (b) … A hospital‐based case‐control study of matched pairs was conducted to explore (a) the relationship between the use of betel quid chewing, cigarette smoking, alcohol drinking and oral cancer and (b) synergism between these factors. The case group consisted of 104 male and 3 female oral cancer patients and these were compared with 194 male and 6 female matched controls. We found by univariate analysis that alcohol consumption, smoking, betel quid chewing, educational level and occupation were associated with oral cancer. The adjusted odds ratios were to be found elevated in patients who were smoking and betel quid chewing. After adjusting for education and occupation covariates, the incidence of oral cancer was computed to be 123‐fold higher in patients who smoked, drank alcohol and chewed betel quid than in obstainers. The synergistic effects of alcohol, tobacco smoke and betel quid in oral cancer were clearly demonstrated, but there was a statistically significant association between oral cancer and betel quid chewing alone. Swallowing betel quid juice (saliva extract of betel quid produced by chewing) or including unripened betel fruit in the quid both seemed to enhance the risks of contracting oral cancer.

Loss-of-function mutations in the cathepsin C gene result in periodontal disease and palmoplantar keratosis

1999-12-01

Carmel Toomes , Jacqueline A. James , Andrew J. Wood +7 more

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Incidence rates of oral cancer and natural history of oral precancerous lesions in a 10‐year follow‐up study of Indian villagers

1980-08-01

Prakash C. Gupta , Fali S. Mehta , D. K. Daftary +7 more

Oral lichen planus

1968-01-01

Jens Ove Andreasen

13-<i>cis</i>-Retinoic Acid in the Treatment of Oral Leukoplakia

1986-12-11

Waun Ki Hong , J Endicott , Loretta M. Itri +7 more

13-cis-Retinoic acid has been reported to be effective in treating oral leukoplakia. We randomly assigned 44 patients with this disease to receive 13-cis-retinoic acid (24 patients) or placebo (20), 1 … 13-cis-Retinoic acid has been reported to be effective in treating oral leukoplakia. We randomly assigned 44 patients with this disease to receive 13-cis-retinoic acid (24 patients) or placebo (20), 1 to 2 mg per kilogram of body weight per day for three months, and followed them for six months. There were major decreases in the size of the lesions in 67 percent (16 patients) of those given the drug and in 10 percent (2 patients) of those given placebo (P = 0.0002); dysplasia was reversed in 54 percent (13 patients) of the drug group and in 10 percent (2 patients) of the placebo group (P = 0.01). The clinical response to the drug correlated with the histologic response in 56 percent (9 of 16) of the patients evaluated. Relapse occurred in 9 of 16 patients two to three months after treatment ended. The toxic effects of the drug were acceptable in all but two patients. Cheilitis, facial erythema, and dryness and peeling of the skin were common; conjunctivitis and hypertriglyceridemia also occurred. All adverse reactions could be reversed by reducing the dose or temporarily discontinuing the drug. We conclude that 13-cis-retinoic acid, even in short-term use, appears to be an effective treatment for oral leukoplakia and has an acceptable level of toxicity.

Problems and proposals for recording gingivitis and plaque.

1975-12-01

J Ainamo , Bay I

Essentials of oral cancer.

2015-01-01

César Rivera

Oral cancer is one of the 10 most common cancers in the world, with a delayed clinical detection, poor prognosis, without specific biomarkers for the disease and expensive therapeutic alternatives. … Oral cancer is one of the 10 most common cancers in the world, with a delayed clinical detection, poor prognosis, without specific biomarkers for the disease and expensive therapeutic alternatives. This review aims to present the fundamental aspects of this cancer, focused on squamous cell carcinoma of the oral cavity (OSCC), moving from its definition and epidemiological aspects, addressing the oral carcinogenesis, oral potentially malignant disorders, epithelial precursor lesions and experimental methods for its study, therapies and future challenges. Oral cancer is a preventable disease, risk factors and natural history is already being known, where biomedical sciences and dentistry in particular are likely to improve their poor clinical indicators.

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[Depot effects of various antibiotics mixed with Palacos resins].

1970-11-01

Buchholz Hw , H.E. Engelbrecht

Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology

2016-07-10

Yi-Shing Lisa Cheng , Alan R. Gould , Zoya Kurago +2 more

Oral cancer: Etiology and risk factors: A review

2016-01-01

Malay Kumar , Ronak Nanavati , Tapan G Modi +1 more

Oral cancer is the sixth most common malignancy in the world. Oral cancer is of major concern in Southeast Asia primarily because of the prevalent oral habits of betel quid … Oral cancer is the sixth most common malignancy in the world. Oral cancer is of major concern in Southeast Asia primarily because of the prevalent oral habits of betel quid chewing, smoking, and alcohol consumption. Despite recent advances in cancer diagnoses and therapies, the 5.year survival rate of oral cancer patients has remained at a dismal 50% in the last few decades. This paper is an overview of the various etiological agents and risk factors implicated in the development of oral cancer.

Oral potentially malignant disorders: risk of progression to malignancy

2017-12-29

Paul M. Speight , Syed Ali Khurram , Omar Kujan

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Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer

2020-10-31

Saman Warnakulasuriya , Omar Kujan , José M. Aguirre‐Urizar +7 more

Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature … Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature and the classification of OPMDs, based predominantly on their clinical features, following discussions by an expert group at a workshop held by the World Health Organization (WHO) Collaborating Centre for Oral Cancer in the UK. The first workshop held in London in 2005 considered a wide spectrum of disorders under the term "potentially malignant disorders of the oral mucosa" (PMD) (now referred to as oral potentially malignant disorders: OPMD) including leukoplakia, erythroplakia, proliferative verrucous leukoplakia, oral lichen planus, oral submucous fibrosis, palatal lesions in reverse smokers, lupus erythematosus, epidermolysis bullosa, and dyskeratosis congenita. Any new evidence published in the intervening period was considered to make essential changes to the 2007 classification. In the current update, most entities were retained with minor changes to their definition. There is sufficient evidence for an increased risk of oral cancer among patients diagnosed with "oral lichenoid lesions" and among those diagnosed with oral manifestations of 'chronic graft-versus-host disease'. These have now been added to the list of OPMDs. There is, to date, insufficient evidence concerning the malignant potential of chronic hyperplastic candidosis and of oral exophytic verrucous hyperplasia to consider these conditions as OPMDs. Furthermore, due to lack of clear evidence of an OPMD in epidermolysis bullosa this was moved to the category with limited evidence. We recommend the establishment of a global research consortium to further study the natural history of OPMDs based on the classification and nomenclature proposed here. This will require multi-center longitudinal studies with uniform diagnostic criteria to improve the identification and cancer risk stratification of patients with OPMDs, link them to evidence-based interventions, with a goal to facilitate the prevention and management of lip and oral cavity cancer.

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CLINICAL PERIODONTOLOGY

2011-01-01

Satoshi Sekino

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Definition of leukoplakia and related lesions: An aid to studies on oral precancer

1978-10-01

Verrucous carcinoma of the oral cavity

1949-01-01

T.J.C

Ethnobiological Classification

1992-12-31

Brent Berlin

Oral Stomatitis Mimicking Lichenoid Lesions Following Pembrolizumab Therapy

2025-06-25

Hee-Won Kim , Yong‐Woo Ahn , Sung‐Hee Jeong +2 more | Journal of Oral Medicine and Pain

Latest Pathophysiology of Oral Lichen Planus: A Narrative Review

2025-06-25

Kun-Hwa Kang , Ji-Rak Kim , Jae‐Kwang Jung +1 more | Journal of Oral Medicine and Pain

Efficacy of Ibuprofen Gargle for Oral Lichen Planus: A Single-Center, Placebo-Controlled, Double-Blind, Randomized Crossover Study Trial

2025-06-24

Y. Kakei , Masaya Akashi | International Journal of Oral and Maxillofacial Surgery

Efficacy of Combination of Intralesional Pentoxifylline and Dexamethasone with Intralesional Pentoxifylline, Intralesional Dexamethasone alone in the Treatment of Oral Submucous Fibrosis- A Pilot Study

2025-06-24

Seema Dengra , Nitin Bhola | Journal of Maxillofacial and Oral Surgery

Nintedanib-Loaded Microneedle Mucoadhesive Patch: A Perspective for Potential Application in the Management of Oral Submucous Fibrosis

2025-06-24

Gazal Jain , Smriti Gaur | International Journal of Oral and Maxillofacial Surgery

Orogenital Aphthae with Blindness- A Look Beyond The ‘Silk Road’

2025-06-24

Afrin Dewan , Md Mokhleshur Rahman Sarker , Sulagna Sarkar +1 more | Journal of Rangpur Medical College

Behcet’s disease is a vasculitis affecting small arteries and venules, more common in 'Silk Route' countries, the Mediterranean, and Japan due to a strong genetic association with HLA-B51. Oral ulcers … Behcet’s disease is a vasculitis affecting small arteries and venules, more common in 'Silk Route' countries, the Mediterranean, and Japan due to a strong genetic association with HLA-B51. Oral ulcers are common, with genital ulcers occurring in 60%-80% of cases. Skin lesions include erythema nodosum or acneiform, while migratory thrombophlebitis and vasculitis also occur. Ocular involvement is common, and neurological involvement occurs in 5%, mainly involving the brainstem with rare renal involvement. A 32-year-old lady presented with recurrent painful, herpetiform oral ulceration and painful genital ulceration, central retinal artery occlusion (CRAO) of left eye and intermediate uveitis of right eye with positive HLA-B51. J Rang Med Col. March 2025; Vol.10, No.1: 99-102

Oral Histology and Oral Anatomy : A Question Based Approach

2025-06-24

Tribikram Debata | NEWREDMARS EDUCATION PVT LTD eBooks

Oral Histology & Oral Anatomy: A Question-Based Approach is a comprehensive educational resource designed to simplify the learning process for Dental, Medical, Nursing, Pharmacy students and professionals. The question-based format … Oral Histology & Oral Anatomy: A Question-Based Approach is a comprehensive educational resource designed to simplify the learning process for Dental, Medical, Nursing, Pharmacy students and professionals. The question-based format encourages readers to engage deeply with the material, facilitating better understanding and retention of complex topics such as tooth development, oral tissues, salivary glands, and maxillofacial structures. Each chapter integrates foundational knowledge with clinical correlations, helping readers connect theory to practice. Ideal for self-study, revision, and examination preparation, this book aims to empower students with the confidence and knowledge necessary for academic success and clinical competence in the dental & medical field.

Evaluation of Tumour Microenvironment and Stroma in Oral Leukoplakia: An Overlooked Denominator

2025-06-24

DevendraS Pawar , Shilpa S. Shetty , Merchant Yash | International Journal of Oral and Maxillofacial Surgery

Exploring Salivary Metabolomics to Predict Malignant Transformation in Oral Submucous Fibrosis: A Pilot Study

2025-06-24

T. Preeti | International Journal of Oral and Maxillofacial Surgery

Therapeutic Efficacy of Intralesional Steroid Injection in the Treatment of Oral Lichen Planus

2025-06-24

Sung Min Kim , Seulgi Bae , H. Lee +2 more | International Journal of Oral and Maxillofacial Surgery

Institutional Insights on the Role of Myotomy and a Novel Physiotherapy Protocol in Managing 105 Cases of Oral Submucous Fibrosis

2025-06-24

A. Rai | International Journal of Oral and Maxillofacial Surgery

Clinical and Histopathological Features of Oral Squamous Cell Carcinoma in Sri Lankan Young Adults: Should We Treat Oral Squamous Cell Carcinoma of 21-45 Years Cohort as a Separate Disease Entity?

2025-06-24

Lalith Jayasinghe , Prith Peiris , B. S. M. S. Siriwardena | International Journal of Oral and Maxillofacial Surgery

Intra-lesional 5-FU use in Oral Submucous fibrosis- Beyond Just Trismus Release

2025-06-24

Shruthi Agarwal , Satish Rao | International Journal of Oral and Maxillofacial Surgery

Periodontitis and Oral Cancer Risk

2025-06-20

Nika Mehrnia , Stephen T. Sonis | Dental Clinics of North America

Areca nut extract increased stromal tumor-infiltrating lymphocytes in 4-nitroquinoline-1-oxide-tumor-induced Sprague-Dawley rats

2025-06-20

Liza Meutia Sari , Cut Fera Novita , Poppy Andriany +1 more | F1000Research

<ns3:p>Background Oral squamous cell carcinoma (OSCC) is one of the most common oral cancers with a high mortality rate. The biodiversity source in Indonesia makes areca nut a potential antioxidant … <ns3:p>Background Oral squamous cell carcinoma (OSCC) is one of the most common oral cancers with a high mortality rate. The biodiversity source in Indonesia makes areca nut a potential antioxidant in treating disease. Objective The study aimed to evaluate the effect of areca nut extract on 4-nitroquinoline-1-oxide (NQO)-tumor-induced rats. Methods Twenty-eight male Sprague-Dawley rats were divided into four groups. Group 1 served as the control group, group 2 was 4NQO-induced rats without treatment, and groups 3 and 4 were given 4NQO-tumor inducer with 500 and 1000 mg/kg BW of areca nut extract, respectively. The rats in groups 2,3, and 4 received 30 ppm of 4NQO tumor inducer in drinking water for 12 weeks. In the end, all rats were euthanized, and the tongue was removed. The body, liver, kidney, heart, and lung weights were measured. Tongue tumor volume and dysplasia lesions were analyzed. The tumor-infiltrating lymphocytes (TILs) in the tumor and stromal areas were scored semi-quantitatively associating the infiltrate grade (0-3) and analyzed histologically. Results There were significant differences in body weight loss between the initial and final phases in groups 1 and 2 (p<0.05). The areca nut at 500 and 1000 mg/kg BW significantly reduced the tumor size compared with groups 1 and 2 (p<0.05). The incidence of OSCC in rats with 500 and 1000 mg/kg BW of areca nut extract after 22 weeks was 0%, but the dysplasia lesions were observed at 28.57% and 85.71%, respectively. The highest mean of stromal TILs was in group 3 and there were significant differences in stromal TILs between groups 2 and 3 (p<0.05). Conclusion Areca nut extract induced infiltrating lymphocytes in the stromal tumor area on the OSCC lesion of the tongue in 4NQO-induced rats.</ns3:p>

Periodontitis Frequently Exists in Patients with Colorectal Carcinoma and Causes Supplementary Impairment of Insulin Resistance

2025-06-19

Mario Živković , Marko Boban , Domagoj Vražić +5 more | Metabolites

Background: There are known associations between periodontitis and colorectal cancer, but knowledge on the connections existing between the two are not fully understood. The aim of our study was to … Background: There are known associations between periodontitis and colorectal cancer, but knowledge on the connections existing between the two are not fully understood. The aim of our study was to assess prevalence and clinical severity of periodontitis in patients with localized colorectal cancer. Secondly, the dynamics of metabolic derangements, particularly glucose metabolism, insulin resistance, and diabetes mellitus were studied as well. Methods: Diagnostic procedures included endoscopies with patohistology, laboratory exams, the insulin resistance homeostatic model assessment method (HOMA index), anthropometrics, and radiology imaging. Periodontal status was evaluated by full-mouth periodontal examination. Results: A total of 79 patients with localized colorectal carcinoma, with slight male predominance of 55.7%, and an age of 65.7 ± 12.4 years participated in this study. Three-quarters of patients (73.4%; 95% CI: 63.0-82.2%) were diagnosed with periodontitis. Patients with periodontitis and colorectal cancer had significantly increased glucose levels (fasting and after oral glucose challenge), (both p < 0.05). Also, increased values of the HOMA index were found in patients with periodontitis vs. controls (without periodontitis) and colorectal cancer; 6.38 ± 5.74 vs. 3.58 ± 2.6 (p = 0.012); Spearman's Rho correlation coefficient = 0.271 (p = 0.039). There were significant differences in high-density cholesterol in patients with periodontitis vs. controls, 1.41 ± 0.28 vs. 1.23 ± 0.35 mmol/L (p = 0.016), but correlations were insignificant; Rho c.c. = 0.045 (p = 0.738). Conclusions: The most consorted connections between periodontitis and colorectal cancer were found among parameters of metabolic domain, especially glucose concentrations and insulin resistance. Further studies, which would include novel and emerging antidiabetic treatments and their effects on the prevention or control of both diseases, would be warranted.

Circulating Antibodies Against DSG1 and DSG3 in Patients with Oral Lichen Planus: A Scoping Review

2025-06-18

Domenico De Falco , Francesco Salvatore Iaquinta , D. Pedone +3 more | Antibodies

Oral Lichen Planus (OLP) is a chronic autoimmune disease with potential overlap with Pemphigus Vulgaris (PV), particularly in erosive forms. Desmoglein 1 and 3 are transmembrane glycoproteins of desmosomes, typically … Oral Lichen Planus (OLP) is a chronic autoimmune disease with potential overlap with Pemphigus Vulgaris (PV), particularly in erosive forms. Desmoglein 1 and 3 are transmembrane glycoproteins of desmosomes, typically involved in PV. This scoping review aims to evaluate the presence and potential pathogenetic role of anti-desmoglein 1 (Dsg1) and anti-desmoglein 3 (Dsg3) antibodies in OLP. A literature search was conducted on MEDLINE/PubMed, Ovid, and Scopus up to April 2025. Human studies reporting OLP patients with anti-Dsg1 and/or anti-Dsg3 antibodies were included. Data from 11 studies were analyzed by diagnosis, age/sex, oral site involvement, immunofluorescence, and ELISA testing. Erosive OLP was most frequently associated with anti-Dsg1/Dsg3 positivity, mainly in women aged 40-60. Immunofluorescence was positive in some cases, while the ELISA test almost consistently detected anti-Dsg1 and Dsg3 antibodies. However, in many instances, antibody titers did not reach the threshold value, despite the presence being detectable. This finding suggests that anti-Dsg1/Dsg3 antibodies may represent epiphenomena of chronic inflammation in erosive OLP, indicating an immune-serological overlap with PV but lacking direct pathogenicity. Furthermore, the role of Dsg3 in oral squamous cell carcinoma, by promoting enzymes that degrade the extracellular matrix and enhance tumor invasiveness, highlights the complex functions of desmogleins beyond autoimmunity.

Human leukocyte antigen and its association with oral potentially malignant disorders – a Systematic review and Meta-analysis

2025-06-18

Bharathi Purohit , Uma Kanga , Abhinav Singh +1 more | Human Immunology

Knowledge, Attitudes, and Practices of Iranian Practitioners regarding Oral Lesions: A Cross-Sectional Study Using Image-Based Clinical Scenarios

2025-06-18

Mahrokh Amiri , Samane Shirahmadi , Marjaneh Meschi +3 more | Research Square (Research Square)

<title>Abstract</title> Background Oral lesions (OLs) encompass a diverse range of conditions, from benign disorders to potentially malignant and malignant entities. In Iran, general practitioners (GPs) and general dental practitioners (GDPs) … <title>Abstract</title> Background Oral lesions (OLs) encompass a diverse range of conditions, from benign disorders to potentially malignant and malignant entities. In Iran, general practitioners (GPs) and general dental practitioners (GDPs) often serve as the first points of contact for patients with OLs. However, delays in diagnosis and inappropriate management remain common, partly owing to inadequate training and unclear referral protocols. Methods A cross-sectional study was conducted from November 2023–December 2024 among 213 clinicians (91 GPs and 122 GDPs) registered with the Islamic Republic of Iran Medical Council (IRIMC). The participants completed a validated, image-based questionnaire assessing their knowledge, attitudes, and practices (KAP) regarding OLs. Clinical scenarios and high-quality images were used to simulate real-world decision-making. Descriptive and inferential statistics were applied to analyze the KAP scores and demographic correlations. Results GDPs demonstrated significantly higher knowledge scores than GPs did (M = 33.2 vs. 29.3, <italic>p</italic> < .001), particularly among female practitioners. Knowledge was positively correlated with appropriate clinical decisions across the scenarios. However, misconceptions persist, particularly among GPs, regarding benign tongue lesions and systemic associations. Only 7% of the participants reported performing biopsies, whereas 88.3% referred patients when needed. The attitudes toward OLs were generally positive, and 87.8% expressed interest in further education. Conclusion Despite favorable attitudes, significant knowledge and practice gaps exist among primary care providers in Iran, especially GPs. Integrating image-based, scenario-driven training into undergraduate curricula and continuing education programs is essential to improve the early recognition and management of OLs.

Changes in risk habits and influencing factors in the Taiwan oral cancer screening program

2025-06-18

Pattaranan Munpolsri , Chiu-Wen Su , Hsu-Fei Yang +6 more | PLoS ONE

This study examines changes in oral risk habits and identifies factors influencing these changes among participants in a population-based oral cancer screening program to support effective public health interventions. The … This study examines changes in oral risk habits and identifies factors influencing these changes among participants in a population-based oral cancer screening program to support effective public health interventions. The study included 2,569,920 individuals aged 30 and older who participated in Taiwan’s Oral Cancer Screening Program at least twice between 2010 and 2021. Changes in cigarette smoking and betel quid chewing were assessed between the first and last screenings and categorized as improved, unchanged, or worsened. A logistic regression model evaluated factors associated with habit improvement, including baseline oral habits, sex, age, education, screening adherence, and oral potentially malignant disorder (OPMD) findings. Among participants, 25.3% improved their oral habits. Baseline habits influenced how OPMD screening results affected behavior change. Among smokers, a positive screening result increased the likelihood of quitting or reducing smoking (adjusted odds ratio [aOR] = 1.18, 95% CI 1.16–1.20). However, among betel quid chewers, whether or not they smoked, a positive screening result was negatively associated with improved habits (aOR 0.79–0.88). Being female, older, college-educated, and regularly attending screenings were positively linked to behavior improvement. The program led to habit improvements in about one-quarter of participants, particularly older individuals, those with higher education, and frequent attendees. However, a diagnosis of OPMD motivated change only among smokers, not those engaging in both smoking and betel quid chewing, highlighting a lack of awareness in high-risk groups. Strengthening collaboration between health organizations and the screening program could enhance public awareness, improve program effectiveness, reduce oral cancer incidence, and lower long-term healthcare costs.

Impact of Information Provided in Remote Case Discussions on Oral Medicine Teleconsultants' Diagnostic Impression

2025-06-18

Liliana Wolf Braun , Elza Cotrim Soares , Alan Roger Santos‐Silva +7 more | Journal of Oral Pathology and Medicine

ABSTRACT Background To evaluate the impact of case descriptions, alongside clinical photographs, on telediagnosis accuracy in Oral Medicine. Methods An analytical cross‐sectional observational study used 100 cases from Oral Medicine … ABSTRACT Background To evaluate the impact of case descriptions, alongside clinical photographs, on telediagnosis accuracy in Oral Medicine. Methods An analytical cross‐sectional observational study used 100 cases from Oral Medicine services at three universities. Three specialists in Oral Diagnosis remotely analyzed these cases. Simulated teleconsultations were presented via Google Forms, requesting: (a) diagnostic hypotheses based solely on clinical photographs; (b) identification of essential information for diagnosis; and (c) revised hypotheses after reviewing case descriptions. The specialists' opinions, with and without case descriptions, were compared to in‐person diagnoses and categorized as: negative impact, maintenance of incorrect opinion, maintenance of correct opinion, and refinement of the response. Results Diagnostic accuracy based on images alone were 84%, 83%, and 75%. There was no statistically significant difference in accuracy before and after accessing case descriptions. Although these descriptions were not essential for a correct diagnosis, they contributed to refining diagnostic hypotheses in some cases. The most frequently requested information was the “duration of the condition” (84% of cases). Conclusion Experienced Oral Diagnosis specialists demonstrate satisfactory diagnostic accuracy when analyzing cases of oral lesions from a distance using photos, even when no clinical information is provided about the cases.

miRNA-21 and miRNA-27b Expression in Saliva of Patients with Oral Lichen Planus: A Systematic Review

2025-06-18

Dario Di Stasio , Fausto Fiori , Antonio Romano +5 more | International Journal of Molecular Sciences

Oral lichen planus (OLP) is a chronic inflammatory disorder of the oral mucosa with a recognized risk of malignant transformation. MicroRNAs, particularly miRNA-21 and miRNA-27b, have been implicated in the … Oral lichen planus (OLP) is a chronic inflammatory disorder of the oral mucosa with a recognized risk of malignant transformation. MicroRNAs, particularly miRNA-21 and miRNA-27b, have been implicated in the pathogenesis and progression of various diseases, including OLP. Their altered expression in saliva may provide diagnostic and prognostic insights for this condition. This systematic review examines the expression profiles of miRNA-21 and miRNA-27b in the saliva of OLP patients to assess their potential as biomarkers. The review was conducted in accordance with PRISMA guidelines and was registered in the PROSPERO database. A comprehensive search was conducted in PubMed, Embase, and Scopus using specific keywords. Retrieved titles and abstracts were screened based on predefined eligibility criteria, and relevant studies were analyzed. The initial search identified 71 studies. After screening, 17 abstracts were selected for full-text review. Following evaluation, 11 studies were excluded, resulting in 6 studies being included. Findings indicate a consistent upregulation of miRNA-21 and a downregulation of miRNA-27b in OLP saliva samples. These alterations suggest a potential role in disease pathogenesis and risk assessment. The dysregulation of miRNA-21 and miRNA-27b in OLP underscores their potential as salivary biomarkers for diagnosis and disease monitoring. Moreover, the non-invasive nature of salivary miRNAs offers promising clinical applications, enhancing early detection and personalized management strategies for OLP.

Efficacy of Virechana Karma by Patolmooladi Kashayam: A Pilot Study

2025-06-18

Sandip Chavan , Gaurav Shrivastava , Renu Gupta +1 more | Journal of Neonatal Surgery

Background: Ayurvedic classical texts emphasize that cleansing therapies (Shodhana) are vital for eradicating chronic disorders from the root, especially in skin diseases (Kushtha) which often involve vitiated Pitta and Rakta … Background: Ayurvedic classical texts emphasize that cleansing therapies (Shodhana) are vital for eradicating chronic disorders from the root, especially in skin diseases (Kushtha) which often involve vitiated Pitta and Rakta (blood). Virechana (therapeutic purgation) is regarded as the treatment of choice for Pitta-dominant conditions and can expel accumulated Doshas through the lower gastrointestinal tract. Patolamooladi Kashayam is an herbal decoction traditionally indicated in Kushtha Roga (Skin disorders, including various types of Kushtha and Shwitra (Vitiligo), Grahani (IBS), Arsha (Piles), Hrida Shoola, Basti Shoola and Visham Jwar and Known for its Virechan Karma too. This pilot study evaluates the efficacy of Virechana Karma performed with Patolamooladi Kashayam in patients with various skin diseases. Methods: A total of 22 patients with various dermatological conditions classified as various types of Kushtha or Shwitra were recruited from the Panchakarma Out Patient Department of Bharati Ayurved Hospital, Pune. All patients underwent classical Purva Karma (pre-treatment) with internal oleation (Snehan) and fomentation (Swedan) followed by Pradhana Karma Virechana Karma using Patolamooladi Kashayam as the sole Virechaka drug (purgative agent). Patient baseline Koshtha (bowel habit) and Agni (digestive fire) were assessed, and outcomes recorded included the number of purgative bouts (Vegas), subjective signs of proper purgation (Laingiki Shuddhi), and the nature of the final stool (Antiki Shuddhi). Descriptive statistics and graphical analyses were used to evaluate the cleansing efficacy across different patient constitutions. Results: All 22 patients achieved successful purgation (Samyak Virechana), as evidenced by attainment of Laingiki Shuddhi (presence of classical post-purgation relief signs in every case). The number of purges (Vegas) obtained per patient ranged from 7 to 23, with a mean of 13.5 ± 5.0. Notably, 82% of patients (18/22) had their purgation end with a Kaphānta stage (evacuation of Kapha in the last stools), indicating a high-grade cleanse, while 4 patients (18%) ended with Pittānta which is moderate completion. Patients with Mridu Koshtha (soft bowel) experienced a higher average purge count than those with Krura Koshtha (hard bowel), reflecting the classical understanding that Pitta-predominant, soft-boweled individuals purge more easily. Similarly, those with Vishama Agni (irregular digestion) tended to have more purgation bouts than patients with Tikshna Agni (hypermetabolic digestion) or Manda Agni (slow digestion), though all Agni types responded effectively to the protocol. No significant complications were observed apart from transient fatigue and thirst, which are expected transient symptoms of proper Virechana Karma. Conclusion: The results of this pilot study suggest that Patolamooladi Kashayam is a potent and safe herbal formulation for. inducing Virechana Karma (therapeutic purgation). It achieved effective Samyak Virechana (detoxification) in a majority of patients, evidenced by substantial purge counts and attainment of desired end-point criteria in over 80% of cases. This aligns with classical Ayurvedic literature and other clinical reports that highlight the role of Virechana Karma in breaking the pathogenesis of various types of Kushtha or Shwitra (skin disorders). Given the significant improvements observed (including reduction in itching, lighter skin lesions, and subjective feelings of “lightness” post-therapy), Patolamooladi Kashayam can be considered a viable primary purgative for Panchakarma cleansing in Pitta dominant skin conditions. Further studies with larger sample sizes and control groups are recommended to statistically validate these findings and to explore long-term benefits, such as recurrence prevention, which has been noted in other Virechana-centric studies

INFECÇÃO ORAL PELO HPV E SUA ASSOCIAÇÃO COM LESÕES EPITELIAIS E CARCINOMA ESPINOCELULAR

2025-06-17

V. Martins , MARIA CLARA ALVES MIKI , Luiz Fernando Coutinho de Oliveira +7 more | Editora Pasteur eBooks

Clinicopathological correlations and cellular dynamics in a murine model of oral carcinogenesis

2025-06-16

Cheyenne Coscia Bueno , Isadora Peres Klein , Michael Éverton Andrades +6 more | JORDI - Journal of Oral Diagnosis

Objective: To investigate clinicopathological correlations, cell proliferation, and immortalization during induced oral carcinogenesis. Methods: Forty-three Wistar rats were divided into a control group (n=10) or a 4-Nitroquinoline 1-oxide (4NQO) group … Objective: To investigate clinicopathological correlations, cell proliferation, and immortalization during induced oral carcinogenesis. Methods: Forty-three Wistar rats were divided into a control group (n=10) or a 4-Nitroquinoline 1-oxide (4NQO) group (n=33). Control animals were euthanized after 20 weeks, and 4NQO-treated animals after 4 (n=10), 12 (n=10), or 20 weeks (n=13). Oral lesions were classified macroscopically and histologically, with Ki-67 and BMI-1 immunolabeling used to assess cell proliferation and immortalization. Results: Histological alterations, including hyperplasia/hyperkeratosis (n=4) and severe dysplasia (n=2), were observed in clinically normal mucosa. Leukoplakic lesions exhibited varying severity, ranging from hyperplasia/hyperkeratosis (n=3) to squamous cell carcinoma (SCC, n=2). Most SCCs appeared as ulcers (n=3) or nodules (n=4). Ki-67 expression increased progressively with histopathological changes, while BMI-1 levels rose significantly in later stages. A positive correlation was found between Ki-67 and BMI-1 (R=0.33, p=0.03). Conclusion: Cellular alterations often precede visible clinical lesions. Clinical appearances, particularly of leukoplakic lesions, frequently did not align with histopathological findings. Proliferation and immortalization were interconnected but occurred at distinct stages of carcinogenesis.

Anti‐Inflammatory and Immunomodulatory Phytochemicals for Management of Oral Lichen Planus: A Multi‐Omics System Biology and Experimental Assessment

2025-06-16

Alaka Sahoo , Shasank S. Swain , Satya Ranjan Singh +3 more | Chemistry & Biodiversity

ABSTRACT Oral lichen planus (OLP) is a chronic autoimmune inflammatory disorder where the exact pathophysiology remains unclear, posing challenges to effective treatment. The accumulative evidence suggested that anti‐inflammatory and immunomodulatory … ABSTRACT Oral lichen planus (OLP) is a chronic autoimmune inflammatory disorder where the exact pathophysiology remains unclear, posing challenges to effective treatment. The accumulative evidence suggested that anti‐inflammatory and immunomodulatory phytochemicals showed alternative therapeutic effects. Accordingly, the present study selected 28 multimodal phytochemicals (P1 to P28) and further assessed their potency and drug‐ability using computer‐aided drug design (CADD) and experimental methods. At first, the putative targets for OLP were selected through network pharmacology, and then molecular docking scores with predicted drug‐ability profiles recommended that P12 (epicatechin gallate/ECG) be the lead candidate among all. Furthermore, the protein–ligand stability of ECG against the nonsteroidal target cyclooxygenase‐2 (COX‐2) and the steroidal target glucocorticoid receptor (GR) was investigated using molecular dynamics (MD) simulations over 200 ns, and free energy calculations (MM/PBSA) were performed with GROMACS‐2020 software. The nontoxic dose for ECG was observed to be > 100 µM in three cell lines (HEK293, Huh7, and THP‐1). The gene expression results demonstrated that the COX‐2 and the proinflammatory cytokine IL‐1β significantly reduced, and the anti‐inflammatory cytokine IL‐10 slightly increased in a concentration‐dependent manner in inflammation‐induced (LPS‐treated) THP‐1 cells. Overall, the systematic computational and experimental results suggested that ECG could be a potent therapeutic option for managing OLP among the listed treatments.

Risk Factors of Oral Leukoplakia in Iraqi Patients: A Case Control Study

2025-06-15

Faris Talib Mohammed , Maha Ali Hasan , Sahar SH Kadhim +1 more | Osol journal for medical sciences.

Background: Oral leukoplakia is a precancerous condition that causes white and grey patches inside the mouth. The patches are hyperplastic lesions of oral squamous epithelium, with some cases tending to … Background: Oral leukoplakia is a precancerous condition that causes white and grey patches inside the mouth. The patches are hyperplastic lesions of oral squamous epithelium, with some cases tending to malignancy. The WHO Collaboration Centre for oral cancer identified 11 oral disorders as potentially malignant disorders, and oral leukoplakia was the most frequent finding in clinical practice. There are several risk factors for the development of oral leukoplakia. These factors will be evaluated and assessed in this study in Iraqi patients. Aim: To determine the risk factors for oral leukoplakia in Iraqi patients. Methods: A case-control study was conducted in Osol Al-elm University College’s clinics from the 3rd of March 2021 to 17th August 2024. The study included 331 patients divided into two groups: a case group included 131 patients with oral leukoplakia (n=131) and a control group included 200 patients (n=200) who attended the outpatient clinics. Any patient with oral leukoplakia visiting dental clinics in Osol Al-elm University College is included in the study and regarded as a case group. In contrast, the control group is selected haphazardly from patients visiting dental clinics for one reason or another. Criteria for selecting the control group include: age of more than 20 years for both sexes (males and females). Results: In this study, the age of the patient was evaluated as a risk factor for oral leukoplakia. The mean age for the case group was 55.46 with SD±8.5, while for the control group, 44.9 with SD±13.5. Regarding the age, patients aged more than 50 years are associated with increased risk for oral leukoplakia (P value = 0.01), especially the age group 50-59 years old as shown in fig. 1. Regarding the gender: sex difference was not significantly associated with leukoplakia (P value= 0.4), as 73 patients out of 131 with oral leukoplakia are males while 58 out of 131 are females comparing with control group as male patients are 112 out of 200, while females are 88 out of 200, showing no significant difference between the two groups. Considering smoking as a risk factor, heavy smoking patients are associated with increased risk for oral leukoplakia (P value 0.04). Conclusion: The current study identifies 2 risk factors for the development of oral leukoplakia in Iraqi patients. These risk factors were age and cigarette smoking, while excluding gender and denture use as risk factors for the development of oral leukoplakia.

Clinical, Epidemiological, and Dermoscopic Features of Different Clinical Variants of Cutaneous Lichen Planus in the Indian Population: A Prospective Observational Study

2025-06-15

A Malhotra , Arvind Krishna , Robin Chugh +1 more | Cureus

Pattern of Oral and Maxillofacial Biopsy Results in a Teaching Hospital; An 11-year Retrospective Study

2025-06-14

Ochuko Ebrorhie , Michael O. Adeyemi , Mohammed Adam Sheikh Abdullahi +4 more | Nigerian Dental Journal

Background Biopsy remains a cornerstone in diagnostic pathology, enabling definitive diagnosis, guiding treatment planning, and informing tumor classification. This study evaluated the distribution of histopathologically diagnosed lesions in the oral … Background Biopsy remains a cornerstone in diagnostic pathology, enabling definitive diagnosis, guiding treatment planning, and informing tumor classification. This study evaluated the distribution of histopathologically diagnosed lesions in the oral and maxillofacial region over an 11-year period. Methods A retrospective review was conducted at the Department of Oral and Maxillofacial Surgery, Oral Pathology, and Molecular Biology, Lagos University Teaching Hospital, Nigeria. Biopsy records from January 2013 to December 2023 were analyzed. Ethical approval was obtained from the Health Research and Ethics Committee (HREC Approval No. ADM/DSCST/HREC/APP/5714). Results A total of 756 biopsies were reviewed. Females accounted for 52.2% of cases. The highest frequency of tumors occurred in the fourth decade of life (20.8%). Odontogenic tumors were the most prevalent lesion group, with ameloblastoma being the most common histologic diagnosis, predominantly involving the mandible. Conclusion A broad spectrum of lesions affects the maxillofacial region. Biopsy remains indispensable for definitive diagnosis. Knowledge of lesion distribution patterns is vital for clinical decision-making among oral surgeons and pathologists.

Candesartan-Associated Lichenoid Drug Eruption

2025-06-13

Kazuyoshi Iijima , Yoshihito Mima | Cureus

Assessing the prognosis mortality in patients with cutaneous verrucous carcinoma using Lasso-cox regression model: a retrospective study

2025-06-13

Santosh Chokkakula , Siomui Chong , Yunfan Yang +7 more | Discover Oncology

Abstract Elucidating risk factors and prognostic indicators for cutaneous verrucous carcinoma (CVC) is crucial for rapid medical intervention. This study examined CVC incidence risk and prognostic factors, emphasizing sex disparities. … Abstract Elucidating risk factors and prognostic indicators for cutaneous verrucous carcinoma (CVC) is crucial for rapid medical intervention. This study examined CVC incidence risk and prognostic factors, emphasizing sex disparities. Utilizing SEER Database records, we analyzed patients diagnosed with primary CVC from 2004 to 2015. Multivariate logistic regression identified risk factors for the incidence model, while multivariate Cox regression developed the mortality prognosis model. Lasso regression and lasso Cox models determined key factors for respective models. Restricted cubic spline (RCS) models measured age-related risk associated with CVC presence and survival. The study included 1,125 CVC patients (668 males, 59.4%; 457 females, 40.6%) at the time of diagnosis. Lasso regression identified independent risk factors including age, sex, race, marital status, AJCC Stage, Combined Summary Stage, radiation, surgery, tumor size, chemotherapy, and regional lymph node involvement. The Age, sex, marital status, AJCC stage, combined summary stage, and surgery were independently associated with overall survival (OS) and statistically significant. Kaplan-Meier analysis revealed significantly shorter OS in female CVC patients compared to males ( P < 0.05). The RCS model demonstrated a U-shaped pattern, indicating a significant nonlinear relationship between age and CVC incidence. The current study uncovered sex-related variations in incident risk and mortality prognostic factors, prediction of complications among CVC patients, offering valued insights for healthcare professionals in clinical assessments and interventions.

Esophageal Lichen Planus: a Narrative Review of the Literature.

2025-06-12

A Oosterbosch , Petra De Haes , Gert De Hertogh +2 more | PubMed

Lichen planus is a mucocutaneous chronic inflammatory disorder that can also affect the esophagus in a minority of patients. Esophageal lichen planus (ELP) is likely an underdiagnosed and underreported disease … Lichen planus is a mucocutaneous chronic inflammatory disorder that can also affect the esophagus in a minority of patients. Esophageal lichen planus (ELP) is likely an underdiagnosed and underreported disease entity, although it can lead to significant morbidity with esophageal stenosis or malignant transformation. A non-systematic search of Pubmed was performed using search terms 'esophageal lichen planus' and variants thereof combined with terms related to prevalence, diagnosis, and management. The cutaneous and oral forms of lichen planus are relatively common, but certain mucosal forms such as genital lichen planus are rare and esophageal planus (also a mucosal form) is very rare. ELP occurs predominantly in middle-aged women. Current guidelines regarding lichen planus do not mention a screening strategy for ELP. Diagnosis of ELP is based on endoscopic and histopathological criteria. The foremost complication of ELP is formation of esophageal strictures. Malignant transformation of ELP to squamous cell carcinoma, although rare, has also been reported. We summarize the current evidence regarding optimal management of ELP. Even if esophageal lichen planus is a rare cause of esophageal strictures, it is important to raise awareness of this condition among gastroenterologists and endoscopists. The cornerstone of ELP treatment is an anti-inflammatory agent in conjunction with endoscopic dilatation of strictures. Further research is needed to devise an evidence-based treatment algorithm that describes the optimal anti-inflammatory drug in different stages/severities of ELP.

A Rare Case of Bullous Lichen Planus in a Young Male Patient With Nephrotic Syndrome

2025-06-12

Sulhera Khan , Sonia Golani , Zara Saeed +2 more | Cureus

Single cell dissection reveals SFRP2+ fibroblasts amplifying inflammatory responses in oral lichen planus

2025-06-12

Juehua Cheng , Jia Liu , Yuchi Zhu +3 more | Frontiers in Immunology

Objectives Oral lichen planus (OLP) is a chronic inflammatory mucosal disease with an incompletely understood pathogenesis. This study aimed to investigate the role of disease-specific fibroblasts in OLP. Methods We … Objectives Oral lichen planus (OLP) is a chronic inflammatory mucosal disease with an incompletely understood pathogenesis. This study aimed to investigate the role of disease-specific fibroblasts in OLP. Methods We performed single-cell RNA sequencing on buccal mucosa of 4 OLP patients and one healthy control. Additionally, mRNA expression and immunofluorescence staining were analyzed in primary fibroblasts from 51 OLP patients and 24 healthy individuals. The spatial cellular interactions were assessed using multiplex immunofluorescences in OLP tissues. Results Using single-cell RNA sequencing, we identified SFRP2+ fibroblasts as the origin of inflammatory fibroblasts in OLP. A subset of SFRP2+ fibroblasts specifically expressed Wnt5a and was implicated in antigen processing and presentation pathway in OLP. Furthermore, SFRP2+Wnt5a+ fibroblasts amplified and maintained the local immune inflammation by interacting with CD8+ T cells and epithelial cells. Compared to the healthy control group, upregulated expressions of pro-inflammatory molecules (CXCL12, CXCL14) and antigen presenting associated molecules (HLA-A, HLA-B, HLA-C and ERAP2) were displayed in OLP group at mRNA level. Colocalization of SFRP2 and Wnt5a was displayed in the primary cultured fibroblasts of OLP in vitro . Besides, SFRP2+ Wnt5a+ fibroblasts were located around CD8+ T cells in the superficial layer of the lymphocyte infiltration zone. Conclusions Our findings reveal the heterogeneity and pathogenic mechanisms of fibroblasts in OLP, providing new insights into the cellular drivers of chronic inflammation in OLP.

An in-vitro exploration of the antifibrotic activity of Naringenin: A potential therapeutic agent for oral submucous fibrosis management

2025-06-12

S. Samyuktha Aarthi , Deepak Pandiar , Raghunandhakumar Subramanian +1 more | Journal of Oral Biology and Craniofacial Research

Слизисто-кожный лимфонодулярный синдром (Кавасаки) у ребенка трех лет (клиническое наблюдение)

2025-06-10

Alexander Pakhomov , Е.В. Савельева , И. В. Зорин +1 more | Лечащий врач

Введение. Синдром Кавасаки (слизисто-кожный лимфонодулярный синдром) — острое системное заболевание с поражением мелких и средних артерий и развитием деструктивно-пролиферативного васкулита, который возникает преимущественно у детей в возрасте до пяти лет. … Введение. Синдром Кавасаки (слизисто-кожный лимфонодулярный синдром) — острое системное заболевание с поражением мелких и средних артерий и развитием деструктивно-пролиферативного васкулита, который возникает преимущественно у детей в возрасте до пяти лет. Его этиология и патогенез до сих пор неясны, но считается, что заболевание является проявлением сочетаний сложного взаимодействия генетических факторов, инфекций и иммунитета. Ввиду особенностей клинической картины (полиорганности поражения и сложности диагностики) заболевание занимает особое место в работе практикующего педиатра. Цель работы. Представить особенности течения случая синдрома Кавасаки у ребенка 3 лет на основе клинического наблюдения. Материалы и методы. Анализ медицинской карты стационарного больного ф.003/у, клинико-генеалогический метод, функциональные методы исследования (ультразвуковое исследование органов брюшной полости, лимфатических узлов, электрокардиография, эхокардиоскопия), клинико-биохимическое исследование крови и мочи. Выполнен обзор по результатам поиска литературных источников в базе данных eLIBRARY.RU, PubMed. В анализ включались обзоры литературы, научные статьи, клинические исследования. Заключение. Приведенный нами случай подтверждает необходимость настороженности педиатров в отношении детей, имеющих следующие клинические проявления: лихорадку, инъекцию конъюнктивы, изменения слизистых оболочек (сухие губы в трещинах; малиновый язык, гиперемия губ и ротоглотки), сыпь (полиморфная – макулопапулезная, уртикарная, скарлатиноподобная или даже кореподобная без везикул или корочек). Синдром Кавасаки может протекать под маской острой респираторной инфекции, эндокардита, ряда ревматологических заболеваний. Детям, у которых отмечается катаральный (катаральные явления со стороны слизистой ротоглотки, конъюнктивит), суставной, кожный синдромы в сочетании с фебрилитетом, а также шейным лимфаденитом, в обязательном порядке необходимо проводить эхокардиоскопию. Background. Kawasaki syndrome (mucocutaneous lymphonodular syndrome) is an acute systemic disease with damage to small and medium arteries and the development of destructive-proliferative vasculitis, which occurs mainly in children under five years of age. Its etiology and pathogenesis are still unclear, but it is believed that the disease is a manifestation of a combination of complex interactions of genetic factors, infections and immunity. Due to the peculiarities of the clinical picture (multiple organ damage and complexity of diagnosis), the disease occupies a special place in the work of a practicing pediatrician. Objective. The purpose of the work is to present the features of the course of a case of Kawasaki syndrome in a 3-year-old child based on clinical observation. Materials and methods. Analysis of the medical record of an inpatient f.003/u, clinical and genealogical method, functional research methods (ultrasound of the abdominal organs, lymph nodes, electrocardiography, heart ultrasound), clinical and biochemical analysis of blood and urine. A literature review based on the results of a search of literary sources in the eLIBRARY.RU, PubMed databases. The analysis included literature reviews, scientific articles, monographs, and clinical studies. Conclusion. The case we presented confirms the need for pediatricians to be alert to children with the following clinical manifestations: fever, conjunctival injection, changes in the mucous membranes (dry, cracked lips; raspberry tongue, hyperemia of the lips and oropharynx), rash (polymorphic – maculopapular, urticarial, scarlet fever-like, or even morbilliform without vesicles or crusts). Kawasaki syndrome can occur under the "mask" of an acute respiratory infection, endocarditis, and a number of rheumatological diseases. Children who have catarrhal (catarrhal symptoms of the mucous membrane of the oropharynx, conjunctivitis), articular, skin syndromes in combination with fever, as well as cervical lymphadenitis, must undergo heart ultrasound.

Identification of Bacteria in Dental Plaque

2025-06-10

Syahdiana Waty , Nurul Hidayah | Contagion Scientific Periodical Journal of Public Health and Coastal Health

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Oral health has an important role in overall body health. This study aims to evaluate the antibacterial efficacy of toothpaste with cinnamon ethanol extract against … <div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Oral health has an important role in overall body health. This study aims to evaluate the antibacterial efficacy of toothpaste with cinnamon ethanol extract against Streptococcus bacteria in vivo, analyze changes in the number of bacterial colonies before and after using toothpaste, and identify the type of Streptococcus bacteria in dental plaque. This pure experimental research was conducted at the Pharmacy Laboratory of the Poltekkes Kemenkes Medan and the Microbiology Laboratory of the Faculty of Medicine, University of North Sumatra. Samples included cinnamon extract, toothpaste formulation with 12.5% extract concentration, and dental plaque from 40 respondents. Data analysis used descriptive univariate test with SPSS 22.0 application. Results showed Gram-positive bacterial infections, especially Rothia dentocariosa (24%), dominated dental plaque, followed by Streptococcus mitis (16.4%). The use of cinnamon-active toothpaste was able to significantly reduce the number of bacterial colonies, especially at high concentrations. In addition, active compounds in cinnamon extracts such as cinnamaldehyde and eugenol showed the ability to damage bacterial cell walls and inhibit biofilm formation. Gargling was also shown to be effective in reducing bacterial colonies by clearing plaque and food debris. The conclusion of this study suggests that Gram-positive bacterial infections in dental plaque require special attention in management with appropriate antibiotics, while gargling and the use of cinnamon-based antimicrobial agents can be an effective preventive strategy. These findings support the development of natural ingredient-based oral health products to improve infection prevention and the quality of oral health care</em><em>.</em><em></em></p><p><em> </em></p></td></tr></tbody></table></div><strong><em>Keywords: Oral Health, Streptococcus, Cinnamon, Antibacterial, Dental Plaque, Gargling</em></strong>

Evaluation of The Efficacy of Oral Mini Pulse Dexamethasone Therapy in The Treatment of Lichen Planus

2025-06-10

Ali Mansour , Hany Othman Aboelwafa , Emad Elgmal | International Journal of Medical Arts

Evaluation Of Internal Echogenic Pattern And Thickness Of Masseter Muscle With Ultrasonography In Chronic Areca Nut/ Tobacco Chewers And Oral Submucous Fibrosis Patients In A Tertiary Care Hospital Chengalpattu District, Tamilnadu

2025-06-09

Poornima Anandan , K. Saravanan , More Sanjaykumar R | Journal of Neonatal Surgery

Introduction: Ultrasonography (USG) serves as a valuable, non-invasive tool to monitor these changes, providing insights into the muscle’s structure and function. The normal thickness of the masseter muscle differs by … Introduction: Ultrasonography (USG) serves as a valuable, non-invasive tool to monitor these changes, providing insights into the muscle’s structure and function. The normal thickness of the masseter muscle differs by gender, with males generally having thicker muscles both at rest and during contraction compared to females. Oral submucous fibrosis (OSMF), a potentially malignant disorder, significantly increases the risk of oral cancers, particularly squamous cell carcinoma. Aims and objective: To evaluate the difference in cross-sectional thickness and internal echogenic pattern of masseter muscle at rest and at maximum clenching position using ultrasonography in chronic areca nut /tobacco chewers, OSMF patients and control groups. Materials and methods: The study participants were categorized into three groups with 75 partcipants ,consisting of 25 participants each with the following conditions; Group 1 with chronic chewers, group 2 with OSMF and group 3 with healthy individuals as controls. An ultrasonographic examination of masseter was performed in all subjects for masseter muscle thickness and echogenic pattern, the echogenic pattern was classified into Types I, II and III. Differences in masseter muscle thickness and echogenic pattern between study groups and control group was evaluated. Results: the age group were between 20 and 50 years of age with significant male predominance. The thickness of the masseter muscle was significantly greater in chronic chewers, both in the relaxed and contracted states, on both sides, when compared to both the OSMF group and the control group. In contrast, the OSMF group exhibited a decrease in masseter muscle thickness compared to the control group. Conclusion: The findings revealed a statistically significant increase in masseter muscle thickness in chronic chewers, both in the relaxed and contracted states, on both sides, when compared to both OSMF patients and the control group. A slight muscle atrophy that is decrease in the muscle thickness was observed in OSMF patients in comparison to the control group