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Electronic cigarettes are a type of electronic nicotine delivery system. In the United States, electronic cigarettes have surged in popularity since their introduction to the market in 2007. Health and safety concerns primarily have focused on e-liquid/aerosol composition and whether these devices represent a gateway versus lower risk alternative to conventional cigarettes. Furthermore, recent incidents have demonstrated the potential for significant orofacial injury caused by device explosion while in use. Herein we report a case of a 20-year-old male who sustained oral burns, lacerations, and tooth loss when an electronic cigarette exploded in his mouth shortly after he charged the battery. Only seven other cases of trauma from intraoral electronic cigarette explosions have been reported in the scientific literature to date, although several similar incidents also have been reported by the news media. Treatment of such patients often requires a multidisciplinary approach. Design/manufacturing issues and improper handling may cause an increase in internal battery temperature. An investigation by the United States Fire Administration concluded that user education may aid in preventing some electronic cigarette explosions, and safety design improvements also could help. Although some studies and authorities support the use of electronic cigarettes for tobacco cessation and harm reduction, recent reports of electronic cigarette explosions raise important safety concerns and point to the need for further studies. [ABSTRACT FROM AUTHOR]

Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy, and despite advances in treatments, the 5-year survival has remained at less than 50%. One treatment strategy is to focus on patients with premalignant oral lesions that carry a high-risk for developing recurrent premalignant lesions and HNSCC disease. As an initial attempt to determine if immune therapy has the potential to be protective in these patients, studies determined if premalignant lesions express tumor antigens that have previously been shown to be expressed on HNSCC. Immunohistochemical analyses showed prominent expression of epidermal growth factor receptor in premalignant lesions, even in lesions with mild dysplasia. MUC-1 and carcinoembryonic antigen were expressed in most patient samples, while NY-ESO-1 was less frequently expressed. Each of these antigens was expressed on HNSCC. This provided the rationale for determining if premalignant oral lesions could be used to stimulate autologous peripheral blood mononuclear leukocytes (PBML) to react against heterologous premalignant lesions and HNSCC. Following sensitization with autologous premalignant lesions, PBML responded to a challenge with either heterologous premalignant oral lesion cells or HNSCC by releasing IFN-γ. In addition, sensitization with autologous premalignant lesion lysates generated cytolytic activity by both PBML and T cells against allogeneic premalignant lesion cells and HNSCC. These studies show the feasibility of using premalignant oral lesions to stimulate immune reactivity against both premalignant oral lesions as well as HNSCC. [ABSTRACT FROM AUTHOR]

Objective: Malignant mucosal melanomas of the head and neck comprise a very small portion of all melanomas, particularly in the oral cavity. These lesions are associated with high rates of local recurrence, distant metastasis, and a very poor 5-year survival rate; however, the clinical outcomes of mucosal melanoma in situ of the oral cavity are unclear. Therefore, we present a case report of mucosal melanoma in situ and a systematic review of the literature to shed light on this rare but important disease. Methods: PubMed, Scopus, and CINAHL were searched per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were only considered for inclusion if they described oral cavity melanoma in situ and documented specific data pertaining to treatment including modality, lesion size, or outcomes. Results: A total of 28 reported cases from the literature fulfilled the inclusion criteria, as well as one case from our own institution. Men comprised the majority (64.3%) of the cases, and the average age at presentation was 57.4 years. The hard palate was the most common location, and most cases were treated with surgical excision. Eight had no evidence of disease after a minimum of six months of follow-up, one reported spread to the cervical lymph nodes, and only one reported progression with distant metastasis. Conclusion: Oral mucosal melanoma in situ is a rare entity and most commonly treated with surgical excision. High rates of recurrence necessitate long term follow-up. Further studies may be useful to determine whether adjuvant therapy may play a role in reducing recurrence. [ABSTRACT FROM AUTHOR]

Mönckeberg arteriosclerosis is a disease of unknown etiology characterized by dystrophic calcifications within the tunica media of small- and medium-sized arteries, leading to reduced arterial compliance. The authors report a case discovered incidentally on dental radiographs. A 78-year-old man with a complex medical history was seen for routine oral health care. Panoramic and bite-wing radiographs revealed a tortuous, linear calcification in the area of the left mandibular first molar anterior to the angle of the mandible and suggestive of a calcified facial artery. Medical radiologists have used the presence of arterial calcifications to determine the severity and prognosis of such diseases as primary hyperparathyroidism, secondary hyperparathyroidism, coronary artery disease, and diabetes. The presence of Mönckeberg arteriosclerosis on dental radiographs can help oral health care professionals identify patients with undiagnosed systemic disease. [ABSTRACT FROM AUTHOR]

Purpose: Oral potentially malignant disorders (OPMDs) may have varying degrees of oral epithelial dysplasia (OED). Traditional grading schemes separate OED into three-tiers (mild, moderate, and severe). Alternatively, a binary grading system has been previously proposed that stratifies OED into low-risk and high-risk categories based on a quantitative threshold of dysplastic pathologic characteristics. This systematic review evaluates the predictive value of a binary OED grading system and examines agreement between pathologists. Methods: This meta-analysis queried 4 databases (PubMed, Ovid-MEDLINE, Cochrane, and SCOPUS) and includes 4 studies evaluating binary OED grading systems. Meta-analysis of proportions and correlations was performed to pool malignant transformation rates (MTR), risk of malignant transformation between OED categories, and measures of interobserver agreement. Results: Pooled analysis of 629 lesions from 4 different studies found a six-time increased odds of malignant transformation in high-risk lesions over low-risk lesions [odds ratio (OR) 6.14, 95% 1.18–15.38]. Reported ORs ranged from 2.8 to 22.4. The overall MTR was 26.8%, with the high-risk and low-risk lesions having MTRs of 57.9% (95% CI 0.386–0.723) and 12.7% (95% CI − 0.210 to 0.438), respectively. Pooled unweighted interobserver kappa values for the binary grading system and three-tiered system were 0.693 (95% CI 0.640–0.740) and 0.388 (95% CI 0.195–0.552), respectively. Conclusion: Binary grading of OED into low-risk and high-risk categories may effectively determine malignant potential, with improved interobserver agreement over three-tiered grading. Improved grading schemes of OED may help guide management (watchful waiting vs. excision) of these OPMDs. [ABSTRACT FROM AUTHOR]

Purpose: To study the differential expression of Ceramide Synthase isoforms in oral mucosal dysplasia and its malignant transformation. Methods: We identified 12 cases of oral mucosal dysplasia with subsequent malignant transformation from the College of Dental Medicine, Division of Oral Pathology Database at the Medical University of South Carolina. These were formalin fixed paraffin embedded (FFPE) biopsy specimens of dysplasia from one oral subsite at one time point and a matching specimen from the same subsite and same patient at a later time-point with frank invasive squamous cell carcinoma. We also identified 42 cases of alveolar ridge keratosis which were age and gender matched to our set of cases with malignant transformation. Two sections, 5 microns each from the FFPE blocks to extract RNA using the High Pure RNA FFPE micro-kit from Roche Applied Sciences (Catalog No. 04823125001), followed by reverse transcription and q-PCR using Ceramide Synthase (CerS) isoform 1, 4 and 6 probes. Results: CerS 1 levels are higher in malignancy compared to the matched dysplasia samples whereas CerS 4 levels are lower in malignancy compared to the matched dysplasia samples. The levels of CerS6 are not significantly changed across the two sample sets. Conclusion: Ceramide synthase isoforms play a role in malignant transformation of oral mucosal dysplasia however the mechanism needs to be further studied and understood. This could be a novel marker for early detection of potentially malignant lesions in the oral mucosa and may serve as a target for chemoprevention strategies in oral squamous cell carcinoma. [Copyright &y& Elsevier]

The 5-year survival rate for oral cavity cancer is poorer than for breast, colon or prostate cancer, and has improved only slightly in the last three decades. Hence, new therapeutic strategies are urgently needed. Here we demonstrate by tissue micro array analysis for the first time that RNA-binding protein La is significantly overexpressed in oral squamous cell carcinoma (SCC). Within this study we therefore addressed the question whether siRNA-mediated depletion of the La protein may interfere with known tumor-promoting characteristics of head and neck SCC cells. Our studies demonstrate that the La protein promotes cell proliferation, migration and invasion of lymph node-metastasized hypopharyngeal SCC cells. We also reveal that La is required for the expression of β-catenin as well as matrix metalloproteinase type 2 (MMP-2) within these cells. Taken together these data suggest a so far unknown function of the RNA-binding protein La in promoting tumor progression of head and neck SCC. [ABSTRACT FROM AUTHOR]