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The aim of the study is to review the literature to observe studies that evaluate the extent of the thermal effect of different laser wavelengths on the histological evaluation of oral soft tissue biopsies. An electronic search for published studies was performed on the PubMed and Scopus databases between July 2020 and November 2022. After the selection process, all the included studies were subjected to quality assessment and data extraction processes. A total of 28 studies met the eligibility criteria. The most studied laser was the carbon dioxide (CO2) laser, followed by the diode laser 940 nm–980 nm. Six studies were focused on each of the Erbium-doped Yttrium Aluminium Garnet (Er:YAG), Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) lasers, and diode lasers of 808 nm and 445 nm. Three studies were for the Potassium Titanyl Phosphate (KTP) laser, and four studies were for the Erbium, Chromium-doped Yttrium, Scandium, Gallium, and Garnet (Er,Cr:YSGG) laser. The quality and bias assessment revealed that almost all the animal studies were at a low risk of bias (RoB) in the considered domains of the used assessment tool except the allocation concealment domain in the selection bias and the blinding domain in the performance bias, where these domains were awarded an unclear or high score in almost all the included animal studies. For clinical studies, the range of the total RoB score in the comparative studies was 14 to 23, while in the non-comparative studies, it was 11 to 15. Almost all the studies concluded that the thermal effect of different laser wavelengths did not hinder the histological diagnosis. This literature review showed some observations. The thermal effect occurred with different wavelengths and parameters and what should be done is to minimize it by better adjusting the laser parameters. The extension of margins during the collection of laser oral biopsies and the use of laser only in non-suspicious lesions are recommended because of the difficulty of the histopathologist to assess the extension and grade of dysplasia at the surgical margins. The comparison of the thermal effect between different studies was impossible due to the presence of methodological heterogeneity.

Oral biopsy is a common surgical practice. To date, few authors have described the healing of mucosal wounds following oral biopsy. The aim of the present single-center, prospective, randomized, controlled study is to evaluate the differences between two chlorhexidine (CHX) mouthrinses and a treatment-free approach in the immediate postoperative period following oral mucosal biopsy. 354 patients were included in this study and were randomly allocated to three groups: A) CHX 0.12% mouthrinse (twice daily, 10 mL rinse for 30 s), B) CHX 0.20% mouthrinse (twice daily, 10 mL rinse for 30 s), and C) no topical treatment. 118 patients were treated in group A and 115 in group B; 121 received no therapy in group C, reporting the greatest improvement in related symptoms. Outcome variables included the age, gender, site and size of lesions, visual analog score (VAS), Oral Health Impact Profile questionnaire (OHIP-14), and number of painkillers taken during the first week post-surgery. Use of a CHX 0.12% mouthrinse exhibited the poorest outcome. On the other hand, best clinical healing was found for patients treated with CHX 0.20%. These findings suggest that regardless of its concentration, CHX was found to be ineffective in reducing related symptoms, whereas CHX 0.20% can be recommended to facilitate enhanced healing.

Blue diode laser emits a 445 nm wavelength light, which is extremely effective with hemoglobin, and has an optimal hemostatic effect. This work analyzes its thermal effects and clinical efficacy, when used to perform excisional biopsies. Forty-two excisional biopsies were performed with the laser; then, the extent of perincisional thermal effects was evaluated and patients were followed up. Average alteration on epithelial tissue was 507.07 µm, and on connective tissue was 320.39 µm. In all the cases, it was possible to obtain a histological diagnosis. Diode lasers can be safely used to perform biopsies; various intra- and postoperative advantages were confirmed.

Oral lichen planus (OLP) is a common premalignant chronic inflammatory disorder. Optical Coherence Tomography (OCT) provides a real-time, non-invasive, and in-situ optical signature using light of varying wavelengths to examine tissue. Aim of the present study was to assess the possible role of OCT as diagnostic tool for atrophic-erosive OLP by examining OCT scans of healthy buccal mucosa, and comparing their ultrastructural features with those of a buccal mucosa affected by atrophic-erosive OLP, using their histopathological counterparts as the gold standard. Through grayscale (enface scan) and an application in which the vascularization of the tissue is visible (dynamic scan), it was possible to distinguish the healthy from the lichenoid pattern from 20 controls (12 M; 8 F; mean age: 41.32 years) and 20 patients with histologically confirmed atrophic-erosive OLP (7 M; 13 F; mean age: 64.27 years). In detail, mean width of stratified squamous epithelium (EP) and lamina propria (LP) were evaluated. Among controls, EP and LP showed a mean width of 300 (±50) and of 600 (±50) μm respectively; among cases, disruption of membrane basement prevented from any measurement. Furthermore, a differential pattern of EP and LP emerged between the two groups: a light-grayish, hypo-reflective, homogeneous area of EP recurring in controls turned into a hyper-reflective, non-homogeneous area among cases. Dynamic scan showed a differential profile of LP vascularization, varying from a hypo-reflective red area with small blood vessels in the control group, to a hypo/hyper-reflective area, completely overrun by a denser, wider blood flow amid OLP cases. Although histopathological examination remains the gold standard for OLP diagnosis, OCT could be a potentially helpful tool for the clinician and the pathologist, since it allows analysis of the vascularization of the sample without adversely affecting histological processing.

The aim of this study is to evaluate secondary intention healing process and postoperative pain of oral soft tissues after laser surgery with the use of a compound containing chlorhexidine and sodium hyaluronate. This double-blind, randomized clinical study included 56 patients affected by benign oral lesions and subjected to excisional biopsy with diode laser and randomly divided into three groups. Study group (SG) received 0.2% chlorhexidine digluconate and 0.2% sodium hyaluronate treatment; control group (CG) received 0.2% chlorhexidine digluconate; and placebo group (PG) followed the same protocol, taking a neutral solution having the same organoleptic characteristics. Wound healing was evaluated using percentage healing index (PHI). Numeric rating scale (NRS) was used to evaluate postoperative pain. PHI (T1 = 7 days) was 67.25% for SG, 58.67% for CG, and 54.55% for PG. PHI (T2 = 14 days) was 94.35% for SG, 77.79% for CG, and 78.98% for PG. A statistically significant difference was between the groups for PHI at T2 p = 0.001. No difference was detectable for pain index. A solution containing sodium hyaluronate and chlorhexidine is a good support to increase wound healing by secondary intention after laser biopsy, but no differences were in postoperative perception of pain. The use of the tested solution can be recommended after laser oral biopsies, to achieve a healing without suture. About the postoperative pain, the compound has not showed the same results and did not have measurable effects.

In oral pathology, laser devices can provide important advantages, especially in the treatment of certain lesions. However, there is controversy about the use of some wavelengths in the analysis of suspected dysplastic or neoplastic lesions, raising doubt about the laser's suitability for use in biopsy procedures. In recent studies, the KTP and diode lasers have been used in biopsy procedures without histological artefacts. The aim of this in vitro study was to evaluate the exact extent of peripheral thermal damage to oral soft tissues caused by an Er:YAG laser (λ 2,940 nm) without water cooling. The study was performed on five swine cadaver tongues. Nine samples from each tongue were taken by the same operator using the Er:YAG laser with increasing energies (from 60 to 150 mJ) and fluencies (from 21 to 53 J/cm 2 ). In addition to the laser samples, a specimen obtained using a scalpel was used as control. The samples were placed in 10% formalin solution and were examined by optical microscopy by two blinded patholo- gists who assigned a thermal damage score (from 0 to 3) to each sample. The Er:YAG laser produced less damage at 80 and 100 mJ and 28 and 35 J/cm 2 (intermediate parameters). Although in some samples thermal damage was minimally visible, in all samples histological evaluation was clearly possible. The study demonstrated that the Er:YAG laser can be safely used in oral biopsy investigations while ensuring a successful histological evaluation, which is fundamental to correct clinical management.

Aim: The aim of this study is to describe an unusual case of an Epidermoid Cyst (EC) of the tongue treated by a Potassium Titanium Phosphate (KTP) laser. Presentation of Case: A 38 young male patient came to our attention since a little painless swelling, yellowish, on the lateral left side of the tongue. After an accurate clinical examination, a surgical excision with a KTP laser was performed. Control at 7 and 21 days showed a complete healing of lesion and the histological diagnosis was EC. Discussion: EC generally appear like a firm, usually painless swelling that sometimes raises the tongue. In the differential diagnosis of the EC the clinician has to consider a wide range of pathologic conditions that could be classified as development, neoplastic and infective pathologies. Surgical enucleation is the only effective treatment for these kinds of lesions and prognosis is very good, with a very low incidence of relapse. Conclusion: Several techniques are reported in the literature but the use of KTP laser for the excisional biopsy of ORAL EC is very effective, since the relative ease and speed of execution, the compliance of patience, the absence of bleeding and suture.

Many oral lesions may need to be diagnosed by removing a sample of tissue from the oral cavity. Biopsy is widely used in the medical field, but the practice is not quite widespread in dental practice. As oral pathologists, we have found many artifacts in the tissue specimen because of poor biopsy technique or handling, which has led to diagnostic pitfalls and misery to both the patient and the clinician. This article aims at alerting the clinicians about the clinical faults arising preoperatively, intraoperatively and postoperatively while dealing with oral biopsy that may affect the histological assessment of the tissue and, therefore, the diagnosis. It also reviews the different techniques, precautions and special considerations necessary for specific lesions.

Celiac disease (CD) is a lifelong, T cell—mediated enteropathy, triggered by the ingestion of gluten and related prolamins in genetically susceptible subjects, resulting in minor intestinal mucosal injury, including villous atrophy with crypt hyperplasia and intraepithelial lymphocytosis, and subsequent nutrient malabsorption. Although serological tests for antiendomysial (EMA) and anti—tissue transglutaminase (anti-tTG) autoantibodies are used to screen and follow up on patients with CD, diagnostic confirmation is still based on the histological examination of the small intestinal mucosa. Although the small intestinal mucosa is the main site of the gut involved in CD, other mucosal surfaces (such as gastric, rectal, ileal, and esophageal) belonging to the gastrointestinal tract and the gut-associated lymphoid tissue (GALT) can also be involved. A site that could be studied less invasively is the mouth, as it is the first part of the gastrointestinal system and a part of the GALT. Indeed, not only have various oral ailments been reported as possible atypical aspects of CD, but it has been also demonstrated that inflammatory changes occur after oral supramucosal application and a submucosal injection of gliadin into the oral mucosa of CD patients. However, to date, only two studies have assessed the capacity of the oral mucosa of untreated CD patients to EMA and anti-tTG antibodies. In this paper, we will review studies that evaluate the capacity of the oral mucosa to produce specific CD autoantibodies. Discrepancies in sensitivity from the two studies have revealed that biopsy is still not an adequate procedure for the routine diagnostic purposes of CD patients, and a more in-depth evaluation on a larger sample size with standardized collection and analysis methods is merited. However, the demonstration of immunological reactivity to the gluten ingestion of the oral mucosa of CD, in terms of IgA EMA and anti-tTG production, needs to be further evaluated in order to verify whether the oral mucosa is colonized by lymphocytes activated in the intestine or if gluten could stimulate naïve lymphocytes directly in the oral mucosa. This would have important implications for the pathogenesis, diagnosis, and treatment of CD.

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:24:43Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:30:46Z : No. of bitstreams: 1 2-s2.0-77958123471.pdf: 451667 bytes, checksum: 4e6dfbedf99b5ca0bd0b6dd5d3566db6 (MD5) Made available in DSpace on 2014-05-27T11:24:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-07-01 Mucocele forms because of salivary gland mucous extravasation or retention and is usually related to trauma in the area of the lower lips. Ruptured ducts release the mucous that accumulates into adjacent tissues, leading to swelling. This report describes a large mucocele involving the lower lip, which was produced in a child by incorrect use of a pacifier. A few important concepts are discussed to help clinicians in the diagnosis and treatment of this pathology. © 2010 Dermatology Online Journal. Department of Orthodontics and Pediatric Dentistry Clinic State University of São Paulo São José dos Campos Dental School - UNESP Department of Orthodontics and Pediatric Dentistry Clinic State University of São Paulo São José dos Campos Dental School - UNESP

Oral soft tissue lesions are commonly seen in the daily dental practice. The quick diagnosis of oral potentially malignant disorders and oral precancer disease is of highest clinical importance given the mortality rate of late stage disease. Since the oral cavity is more accessible to complete examination, it could be used in early detection of precancerous and cancerous lesions. But either due to ignorance or inaccessibility of medical care, the disease gets detected in the later stages. Thus, there is a need for improvement in early detection of oral disease, because in the initial stages, treatment is more effective and the morbidity is minimal. Aim of this report is to highlight how collagen membrane graft application seems to offer a perfect healing of the soft tissue after the lesion removal. Some reports and the microstructure of the collagen used have been recorded. The healing of the soft tissue, the bleeding control and the management of postoperative discomfort seem to be more favorable by avoiding a intraoral soft tissue graft and applying a collagen membrane. Oral soft tissue lesions are commonly seen in the daily dental practice. The quick diagnosis of oral potentially malignant disorders and oral precancer disease is of highest clinical importance given the mortality rate of late stage disease. Since the oral cavity is more accessible to complete examination, it could be used in early detection of precancerous and cancerous lesions. But either due to ignorance or inaccessibility of medical care, the disease gets detected in the later stages. Thus, there is a need for improvement in early detection of oral disease, because in the initial stages, treatment is more effective and the morbidity is minimal. Aim of this report is to highlight how collagen membrane graft application seems to offer a perfect healing of the soft tissue after the lesion removal. Some reports and the microstructure of the collagen used have been recorded. The healing of the soft tissue, the bleeding control and the management of postoperative discomfort seem to be more favorable by avoiding a intraoral soft tissue graft and applying a collagen membrane.

Introduction The frequency of pediatric and adolescent oral and maxillofacial lesions is various in different societies. The present study aimed at investigating the frequency of oral and maxillofacial pediatric and adolescent biopsies in Zahedan (southeast Iran), and compare the results with other epidemiologic studies.Methods and Materials This retrospective study reviewed oral and maxillofacial lesions in patients with 0-18 years old referring to the treatment centers of Zahedan University of Medical Sciences during 12-years period. Patients’ demographic information including age, gender and location of the lesion were collected and statistically analyzed.ResultsIn general, among 1112 oral and maxillofacial lesions, 154 (13.9%) cases were related to children and adolescents younger than 18 years old. The average age of patients was 11.4 ± 4.9, 53.2% and 46.8% of them were boys and girls, respectively. The most frequent sites of lesions were the gingiva and lip. The most prevalent lesions included inflammatory/reactive, cystic and neoplastic lesions, respectively. Benign and malignant tumors comprised 12.3% and 4.5% of cases. Moreover, pyogenic granuloma and peripheral giant cell granuloma (PGCG) were the most frequent lesions.ConclusionThe most prevalent oral and maxillofacial lesions in patients under 18 years old were inflammatory/reactive lesions in gingiva and in the 13-18 age range. Determining the characteristics of these lesions in the children and adolescents population provides a firm groundwork for proper diagnosis and treatment.