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Smokeless tobacco keratosis is a benign lesion characterized by the formation of white, gray, or pale macules or papules with wrinkling or rugae. It forms in the oral mucosa in response to the use of smokeless tobacco products. We present a 50-year-old man with an extensive history of smokeless tobacco use and development of the characteristic lesion. Shave biopsy showed typical changes of this benign condition and tobacco cessation was recommended.

Identification and classification of cell-graph features using graph-neural networks (GNNs) has been shown to be useful in digital pathology. In this work, we consider the role of edge labels in cell-graph modeling, including histological modeling techniques, edge aggregation in GNN architectures, and edge label prediction. We propose EAGNN (Edge Aggregated GNN), a new GNN model that aggregates both node and edge label information to take advantage of topological information about cellular data and facilitate edge label prediction. We introduce new edge label features that improve histological modeling and prediction. We evaluate our EAGNN model for the task of detecting the presence and location of the basement membrane in oral mucosal tissue, as a proof-of-concept application., Part of ISBN 9783031340475QC 20230823

Practical relevanceFeline chronic gingivostomatitis (FCGS) is a debilitating disease for cats and a challenge for veterinarians and cat caregivers alike. Recent literature indicates that the disease is immune-mediated in nature and likely associated with a chronic viral infection in patients with higher alpha diversity of their subgingival microbiome. The immune-mediated nature of FCGS includes both local as well as systemic effects, and the transcriptomic analysis of affected patients supports these findings.Treatment optionsLocalized therapy in the form of surgical extraction of all, or nearly all, teeth continues to be the mainstay of treatment. For cats that do not respond to surgical management, medical management, in the form of immunosuppressive or immunomodulatory therapy, remains an option. Analgesia is of fundamental importance. Immunomodulation utilizing mesenchymal stromal cell therapy provides an alternative treatment avenue for refractory patients and likely targets the chronic viral infection present in this disease. The potential for treatment stratification and use of novel systemic treatment options may be revealed as the molecular pathways involved in this disease are better described.AimsThis review outlines current and emerging concepts linking available science pertaining to FCGS and clinical management of the disease.Evidence baseThe article draws on the best evidence base at this juncture and is also driven by the authors' collective experience of working on the disease for over a decade.

The main objective of this study is the evaluation of the use of a synthetic membrane, Nuclepore, as a model for permeation studies through sublingual mucosa. The permeability of two types of membranes, porcine sublingual oral mucosa and a synthetic Nuclepore membrane, to water was compared. Moreover, the water permeability of membranes modified with waterproofing formulations was measured to study their ability to protect against the penetration of viruses, toxins, etc. A relatively high correlation (R2 0.88) was obtained between the transmucosal water loss (TMWL) values of the artificial membrane and the mucosa. These results support the possible use of this synthetic membrane in the screening of the water permeability of formulations. In addition, studies of the permeation of different actives, drugs, and biocides through the two membranes were carried out, and these results were compared with their skin permeation data. The synthetic membrane does not seem to discern between compounds in terms of permeability. However, the permeation of caffeine through intact or modified membranes incorporating waterproofing formulations presents similar permeation profiles through the synthetic membrane and mucosa. The results from these assays should lend support to the use of this synthetic membrane when screening formulations to be applied in oral penetration studies, This work was supported by the Consejo Superior de Investigaciones Científicas “Modificación de la mucosa como protección frente al SARS-CoV-2” (CSIC-COV19-130), Postprint (published version)

Background: Recurrent aphthous stomatitis (RAS) is a common ulcerative disease of the oral mucosa, which is difficult to treat. In Ayurveda, several medicinal plants have been evaluated for their anti-inflammatory and antioxidant effects in many oral diseases as an alternative for modern medicines. Method: A study with open-label, non-comparative single-arm design was conducted to evaluate the efficacy of “Stomatab” capsules in improving oral health in 30 subjects with RAS. The secondary objectives were to assess the improvement in oral health and tolerability of the herbal formulation. Subjects were instructed to take one capsule thrice daily after meals for 14 days. Patients were evaluated at three assessment points: screening and baseline (Visit 1, Day 0) with follow-ups done at Visit 2 (Day 5 ± 2) and Visit 3 at the end of the study (Day 14 ± 2). Results: There was a significant reduction in the mean ulcer size from 3.66 ± 1.27 mm (V1) to 0.64 ± 0.78 (V3). The mean number of ulcers reduced from 1.97 ± 0.72 (V1) to 0.90 ± 0.66 (V3). Significant improvement in ulcer-related symptoms of pain (Ruja), burning sensation (Daha) and redness (Raktavarnata) was noted. The total ulcer symptom scores decreased from 7.67 ± 2.38 (V1) to 0.63 ± 0.56 (V3). No side effects were reported by the study participants. Conclusion: These results show that the polyherbal formulation “Stomatab” capsule is safe and effective for the treatment of RAS.

Background: A growing body of evidence demonstrates a different bacterial composition in the oral cavity of patients with oral lichen planus (OLP). Patients and methods: Buccal swab samples were collected from affected and non-affected sites of six patients with reticular OLP and the healthy oral mucosa of six control subjects. 16S rRNA gene MiSeq sequencing and mass spectrometry-based proteomics were utilised to identify the metataxonomic and metaproteomic profiles of the oral microbiome in both groups. Results: From the metataxonomic analysis, the most abundant species in the three subgroups were Streptococcus oralis and Pseudomonas aeruginosa, accounting for up to 70% of the total population. Principal Coordinates Analysis showed differential clustering of samples from the healthy and OLP groups. ANCOM-BC compositional analysis revealed multiple species (including P. aeruginosa and several species of Veillonella, Prevotella, Streptococcus and Neisseria) significantly over-represented in the control group and several (including Granulicatella elegans, Gemella haemolysans and G. parahaemolysans) in patients with OLP. The metaproteomic data were generally congruent and revealed that several Gemella haemolysans-belonging peptidases and other proteins with inflammatory and virulence potential were present in OLP lesions. Conclusion: Our data suggest that several bacterial species are associated with OLP. Future studies with larger cohorts should be conducted to determine their role in the aetiology of OLP and evaluate their potential as disease biomarkers.

Background: Florid oral papillomatosis is characterized by its tendency to local recurrence that requires multiple treatments, leading to important functional sequelae. Methods: We present 74‐year‐old woman with oral florid papillomatosis (OFP) who refused a new surgical treatment, and was treated with imiquimod 5% in orabase on alternate days for 16 weeks. Treatment was complemented with application of hyaluronic acid gel. Results: There were no side effects to the treatment, nor signs of local recurrence, in the treated area at 2 years of follow‐up. Conclusions: After reviewing the literature and according to our knowledge, this is the first published case of oral florid papillomatosis treated topically with imiquimod 5% successfully. Topical treatment with imiquimod 5% in orabase may be a valid alternative for patients with recurrent OFP located in the anterior area of the oral cavity who refuse surgical treatment, although we must closely monitor the patient for the possibility of recurrence or malignant degeneration.

Background Histological feature representation is advantageous for computer aided diagnosis (CAD) and disease classification when using predictive techniques based on machine learning. Explicit feature representations in computer tissue models can assist explainability of machine learning predictions. Different approaches to feature representation within digital tissue images have been proposed. Cell-graphs have been demonstrated to provide precise and general constructs that can model both low- and high-level features. The basement membrane is high-level tissue architecture, and interactions across the basement membrane are involved in multiple disease processes. Thus, the basement membrane is an important histological feature to study from a cell-graph and machine learning perspective. Results We present a two stage machine learning pipeline for generating a cell-graph from a digital H &E stained tissue image. Using a combination of convolutional neural networks for visual analysis and graph neural networks exploiting node and edge labels for topological analysis, the pipeline is shown to predict both low- and high-level histological features in oral mucosal tissue with good accuracy. Conclusions Convolutional and graph neural networks are complementary technologies for learning, representing and predicting local and global histological features employing node and edge labels. Their combination is potentially widely applicable in histopathology image analysis and can enhance explainability in CAD tools for disease prediction., QC 20221216

Oral fibroma or Fibrous hyperplasia is a benign tumor in oral cavity may be found at any sites of oral mucosa with clinical feature as a single mass, soft, sessile or pedunculated, smooth surface, painless with or without inflammation. Due to clinical presentation variation, the histopathology examination may be necessary to obtain definitive diagnosis especially in unidentified causes. This case report aimed to present oral fibrous hyperplasia cases in oral cavity with unknown causes. A 50-year-old and 48-year old women complained single mass on anterior palate and left buccal mucosa, pedunculated, slow progress with soft constancy with history of unidentified causes. The excision was taken for the treatment and histopathology examination with clinical diagnosed by fibroma. The wound completely closed after several weeks after treatment. The conclusion of these two cases report showed that the diagnosis of a single mass in oral cavity with unidentified causes need histopathology examination to have final diagnosis., El fibroma bucal o hiperplasia fibrosa es un tumor benigno de la cavidad bucal que se puede encontrar en cualquier sitio de la mucosa oral con la característica clínica de ser una masa única, blanda, sésil o pedunculada, de superficie lisa, indolora con o sin inflamación. Debido a la variación de la presentación clínica, el examen histopatológico puede ser necesario para obtener un diagnóstico definitivo, especialmente en causas no identificadas. Este reporte de caso tuvo como objetivo presentar casos de hiperplasia fibrosa oral en cavidad oral con causas desconocidas. La conclusión de este informe de dos casos demostró que el diagnóstico de una masa única en la cavidad oral con causas no identificadas necesita un examen histopatológico para establecer un diagnóstico final.

Oral mucosal melanoma is an unusual and aggressive malignant tumor that mainly affects the palate of men aged between 50 and 60 years. We present a literature review focusing on the etiopathogenesis and the clinicopathologic features of this entity. In addition, we reported a rare case of an oral mucosal melanoma arising in the left cheek of a 60-yearold man. Computed tomography scan revealed infiltration of the tumor to other anatomic structures including the maxillary sinus, the zygomatic bone and the pterygoid processes. Based on its extension, the lesion was considered inoperable and treatment with three-dimensional conformal radiation therapy was proposed but the patient only attended to the first session and died from cancer progression 6 months after the diagnosis. This paper reinforces the importance of inclusion of this malignant tumor in the differential diagnosis of pigmented lesions of the oral mucosa.

The aim of this work was the simultaneous loading of quercetin and mint essential oil (mint oil) in phospholipid vesicles specifically tailored to obtain an antibacterial and antioxidant mouthwash. The vesicles were prepared using soy lecithin and Tween 80 as bilayer components, and a mixture of phosphate buffer solution (33%), propylene glycol (33%) and ethanol (33%) as dispersing phase. The formation of regularly shaped, spherical and unilamellar vesicles was con-firmed by cryogenic transmission electron microscopy analyses. Similarly, light scattering results disclosed that the size of the vesicles increased by increasing the concentration of mint oil, but at the same time the high amount of mint oil ensured high stability, as the size of these vesicles re-mained unchanged during 12 months of storage. All tested formulations were highly biocompatible towards epithelial cells and capable of counteracting oxidative cell damages caused by hydrogen peroxide. Moreover, the vesicles prepared with the highest concentration of mint oil inhibited the proliferation of the cariogenic Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. aci-dophilus).

Oral pigmented lesions can be physiological or pathological, exogenous or endogenous, as well as focal, multifocal, or diffuse. Among them, the oral melanotic macule (OMM) is a small, well-delimited brown-to-black macule, often affecting the lip and gingiva. Amalgam tattoo (AT) is a grey or black area of discoloration on the oral mucosa as a result of entry of dental amalgam into the soft tissues, commonly gingiva and alveolar ridge. Herein, we present a patient with gingival pigmentation with features of both OMM and AT in the same location.

The results of research usual thrush have shown, that positive dynamics (chages) began with 3-rd day of treatment and was characterized by normalization of subjective sensations by day, that proved to be true by objective microbiological researches. At psevdomembranous to the form thrush positive dynamics (changes) is revealed since 5-6 days from a beginning of treatment. And at hyperplasic the form thrush has not revealed positive result. &nbsp

Lichen planus (LP) is one of the most common, often recurrent and therapy-resistant dermatoses localized to the oral mucosa. The incidence of the disease varies from 30 to 35% among the entire pathology of the oral mucosa (OOM), affecting mainly women of the climacteric period and menopause [Kubanova A. A. 2010, Perlamutrov Yu.N. 2010, Julia S. Lehman 2009]. Psychoemotional stress is considered to be one of the triggering factors in the onset of LPO OCPR, and the activity of the processes of free radical oxidation of lipids and the lack of capacity of the antioxidant potential of the body determine the ineffectiveness of therapy, as a result of which it can be concluded that it is necessary to include drugs with antioxidant and anxiolytic properties in the traditional treatment regimen

In most cases, non-specific and specific immune defense factors neutralize bacteria and viruses. However, often microorganisms overcome these barriers, penetrate into the internal environment of the body and cause disease. This is facilitated by the weakening of local immunity, in particular against the background of coronavirus infection.

This work shows the synthesis of a polyvinylpyrrolidone (PVP) hydrogel by heat-activated polymerization and explores the production of hydrogels with an open porous network by lyophilisation to allow the three-dimensional culture of human oral mucosa stem cells (hOMSCs). The swollen hydrogel showed a storage modulus similar to oral mucosa and elastic solid rheological behaviour without sol transition. A comprehensive characterization of porosity by scanning electron microscopy, mercury intrusion porosimetry and nano-computed tomography (with spatial resolution below 1 mu m) showed that lyophilisation resulted in the heterogeneous incorporation of closed oval-like pores in the hydrogel with broad size distribution (5 to 180 mu m, d(50) = 65 mu m). Human oral mucosa biopsies were used to isolate hOMSCs, expressing typical markers of mesenchymal stem cells in more than 95% of the cell population. Direct contact cytotoxicity assay demonstrated that PVP hydrogel have no negative effect on cell metabolic activity, allowing the culture of hOMSCs with normal fusiform morphology. Pore connectivity should be improved in future to allow cell growth in the bulk of the PVP hydrogel.

Spindle cell carcinoma (SCSCC) with osteoid and/or cartilage formation in the head and neck is rare; only one case was reported in the tongue. Herein, we report an SCSCC with osteoid and cartilage formation of the tongue developed in an 85-year-old man, and then review the report.

The COVID-19 was first reported in China at late December 2019 and was listed as a pandemic on March 19, 2020 by the WHO. The virus protein S, which mediates the entry and fusion process, has been reported to require ACE-2, the angiotensin converting enzyme-2 as an anchoring receptor. ACE-2 is expressed in oral and gingival tissue, epithelial cells and fibroblast in the oral mucosa, making it a high-risk factor for infectious virus susceptibility. On the other hands, the importance of saliva has been reported for its role as a vehicle for the transmission of viral particles, which allows it to be considered as an instrument of potential diagnostic value in the detection of COVID-19. To know the etiology of SARS-CoV-2 and its impact at the oral level, as well as to recognize and execute biosecurity measures for the management of patients in dental clinical practice is the fundamental object of this review, for this reason, a retrospective cross-sectional study with electronic search was carried out through NCBI, Virtual Health Library, Scielo, LILACS and Redalyc. The reports given by the WHO, CDC and Ministries of Health in Latin America are analyzed. The dissemination of information and the adaptation of knowledge in time of pandemic by COVID-19, will protect the health conditions of both, dentist and patient, which is why it is necessary to put biosafety protocols into practice and constantly update them regarding to health care at the clinical and hospital level., La epidemia por COVID-19 se informó por primera vez en China a finales de diciembre de 2019; fue catalogada como pandemia el 19 de marzo de 2020 por la OMS. Se ha reportado que la proteína S del virus que medio el proceso de entrada y fusión, requiere como receptor de anclaje a ECA-2, la enzima convertidora de angiotensina. ECA-2 se expresa en tejido bucal y gingival, células epiteliales y fibroblastos de la mucosa oral, por lo que se le considera como factor de riesgo potencialmente alto en la susceptibilidad infecciosa del virus. Por otra parte, se ha informado de la importancia de la saliva por su papel como vehículo de transmisión de partículas virales, lo que permite considerarla como instrumento de valor diagnóstico en la detección de COVID-19. Conocer la etiología del SARS-CoV-2 y su impacto a nivel bucal, así como reconocer y ejecutar las medidas de bioseguridad para el manejo de pacientes en la práctica clínica odontológica es el objeto fundamental de esta revisión, por tal motivo, se realizó un estudio retrospectivo de corte transversal con búsqueda electrónica a través de NCBI, Biblioteca Virtual en Salud, Scielo, LILACS y Redalyc. Se analizaron los informes reportados por la OMS, CDC y Ministerios de Salud en Latinoamérica. La difusión de información y la adaptación del conocimiento en época de pandemia por COVID-19, permitirá resguardar las condiciones de salud tanto del odontólogo como del paciente, por lo que es necesaria la puesta en práctica de los protocolos de bioseguridad y la constante actualización respecto a los cuidados sanitarios a nivel clínico, asistencial y hospitalario.Recibido: 14/12/2019Aprobado: 4/01/2020

Introduction: The literature shows that there is a discrepancy between the clinical and histopathological diagnosis of oral mucosa lesions, which may be due to the lack of knowledge of professionals, the variability of a disease and specific patient variables. Objective: The purpose of this study was to determine the degree of concordance between the clinical and histopathological diagnosis of soft tissue lesions in the oral cavity, at the Faculty of Dentistry, Universidad de Costa Rica, during the period 2016-2018. Material and methods: The study was based on analyzing the correlation between the clinical and histopathological diagnosis of soft tissue lesions in the oral cavity, in a group of 35 patients. The statistical technique was descriptive, using the mean and the measure of range dispersion, based on a distribution of frequencies, and in the analysis of concordance between both diagnoses, according to the data obtained. Results: The total sample was 40 lesions, of which 2 were excluded. The female sex predominated in the study in 57.1%. The average age was 52.1 years. The correlation of the clinical and histological diagnosis in the study was 52.6%; being higher the percentage of success in focal fibrous hyperplasia lesions. Conclusions: Although there was a correlation of clinical and histopathological diagnosis of 52.6%, it is essential to reinforce the professional skills and abilities to distinguish oral mucosa lesions in order to reach a definitive diagnosis, define a treatment and give the respective monitoring., Introducción: En la literatura se evidencia que existe discrepancia entre el diagnóstico clínico e histopatológico de lesiones de mucosa oral, lo que puede deberse a la falta de conocimientos de los profesionales, a la variabilidad de una enfermedad y a variables específicas del paciente. Objetivo: Determinar el grado de concordancia existente entre el diagnóstico clínico e histopatológico de lesiones en tejidos blandos en cavidad oral, en la Facultad de Odontología, Universidad de Costa Rica, durante el período 2016-2018. Material y métodos: El estudio se basó en analizar la correlación entre el diagnóstico clínico e histopatológico de lesiones de tejidos blandos en la cavidad oral, en un grupo de 35 pacientes. La técnica estadística fue descriptiva, utilizando la media y la medida de dispersión de rango, basada en una distribución de frecuencias, y en el análisis de concordancia entre ambos diagnósticos, según los datos obtenidos. Resultados: La muestra total fue de 40 lesiones, de las cuales se excluyeron 2. El sexo femenino predominó en el estudio en un 57.1%. El promedio de edad fue 52,1 años. La correlación del diagnóstico clínico e histológico en el estudio fue de 52.6%; siendo mayor el porcentaje de acierto en lesiones de hiperplasia fibrosa focal. Conclusiones: A pesar de que hubo una correlación del diagnóstico clínico e histopatológico de 52.6%, es fundamental reforzar, las destrezas y habilidades del profesional para distinguir las lesiones de mucosa oral con el fin de alcanzar un diagnóstico definitivo, definir un tratamiento y dar el seguimiento respectivo.

This work shows the synthesis of a polyvinylpyrrolidone (PVP) hydrogel by heat-activated polymerization and explores the production of hydrogels with an open porous network by lyophilisation to allow the three-dimensional culture of human oral mucosa stem cells (hOMSCs). The swollen hydrogel showed a storage modulus similar to oral mucosa and elastic solid rheological behaviour without sol transition. A comprehensive characterization of porosity by scanning electron microscopy, mercury intrusion porosimetry and nano-computed tomography (with spatial resolution below 1 mu m) showed that lyophilisation resulted in the heterogeneous incorporation of closed oval-like pores in the hydrogel with broad size distribution (5 to 180 mu m, d(50) = 65 mu m). Human oral mucosa biopsies were used to isolate hOMSCs, expressing typical markers of mesenchymal stem cells in more than 95% of the cell population. Direct contact cytotoxicity assay demonstrated that PVP hydrogel have no negative effect on cell metabolic activity, allowing the culture of hOMSCs with normal fusiform morphology. Pore connectivity should be improved in future to allow cell growth in the bulk of the PVP hydrogel.

This work shows the synthesis of a polyvinylpyrrolidone (PVP) hydrogel by heat-activated polymerization and explores the production of hydrogels with an open porous network by lyophilisation to allow the three-dimensional culture of human oral mucosa stem cells (hOMSCs). The swollen hydrogel showed a storage modulus similar to oral mucosa and elastic solid rheological behaviour without sol transition. A comprehensive characterization of porosity by scanning electron microscopy, mercury intrusion porosimetry and nano-computed tomography (with spatial resolution below 1 mu m) showed that lyophilisation resulted in the heterogeneous incorporation of closed oval-like pores in the hydrogel with broad size distribution (5 to 180 mu m, d(50) = 65 mu m). Human oral mucosa biopsies were used to isolate hOMSCs, expressing typical markers of mesenchymal stem cells in more than 95% of the cell population. Direct contact cytotoxicity assay demonstrated that PVP hydrogel have no negative effect on cell metabolic activity, allowing the culture of hOMSCs with normal fusiform morphology. Pore connectivity should be improved in future to allow cell growth in the bulk of the PVP hydrogel.

Objective: Recurrent aphthous stomatitis (RAS) is a condition that affects 20% of the world population and is characterized by painful ulcers in the oral mucosa. So far, the epidemiology and risk factors of RAS have been infrequently studied. Our objective was to determine whether sleep-related factors are related to the occurrence of RAS in the first prospective study carried out on this topic. Methods: A cohort of 11210 Spanish students, 13–17 years old, was followed up for one year. Sleep disorders were assessed at baseline using a standard validated questionnaire. Results: We detected 2655 new cases of RAS with a total of 287,262 person-week of follow-up. Subjects with high (4th quartile) Insomnia Index showed an incidence rate ratio (IRR) of RAS of 1.29 (95% confidence interval (CI) 1.15–1.45), while subjects with high Hypersomnia Index presented an IRR of 1.42 (95% CI 1.26–1.61). A high score of sleep-related phenomena was also associated with an increased IRR: 1.53 (95% CI 1.37–1.69). Adolescents with high level of sleep satisfaction were at lower risk of RAS: 0.88 (95% CI 0.77–1.01). Conclusion: These findings suggest that sleep disorders are moderately associated with RAS in adolescents

Pyogenic granuloma is a type of inflammatory hyperplasia of the oral mucosa and skin that occurs commonly. Histopathologically, it mimics an angiomatous lesion instead of granulomatous disease. These lesions generally appear as a sessile papule or solitary nodule and may have a smooth or lobulated surface clinically. These granulomas present in a variety of sizes, ranging from a few millimeters to several centimeters. About 75% of the pyogenic granulomas of the oral cavity are associated with the gingiva. In this case report a 31 years old female presented in the department of oral and maxillofacial surgery with the complaint of abnormal growth of gingiva in maxillary anterior region. The patient was diagnosed with the pyogenic granuloma (pregnancy tumor), which had developed in the second trimester of her pregnancy. Surgical excision was done to remove the lesion.

The findings indicate that delmopinol interacts with the salivary film of the upper labial mucosa and affects its polarity. It appears that delmopinol assists in the maintenance of the hydrophilicity of the mucosal pellicle and thereby also reinforcing hydration of the mucosa. The rat autoradiograms, showed that radioactivity remains in the oral mucosa after 24 h, but diffuses through the mucosal membranes into the systemic circulation.

BackgroundThe ability of mesenchymal stem cells (MSCs) to modulate immune responses inspired a series of clinical trials addressing oral mucosal inflammation. We previously reported on the safety and efficacy of fresh, allogeneic and autologous, adipose-derived mesenchymal stem cells (ASCs) to treat feline gingivostomatitis (FCGS), an oral mucosal inflammatory disease that shares similarities with human oral lichen planus.MethodsTo meet clinical demand and goals for future commercialization, we determined the feasibility of shipping fresh ASCs to distant clinics and extended our pilot studies to expand safety and efficacy data for shipped and non-shipped ASCs in a cohort of 18 FCGS cats enrolled locally and at a few different locations within the USA.ResultsWe found that ASCs retained their viability, phenotype, and function after shipment. ASCs administered systemically resulted in a 72% positive response rate, identical to that noted in our previous studies. Cats that responded to ASC therapy had a significant decrease in circulating globulin concentration and histological evidence of decreased CD3+ T cells and CD20+ B cells in the oral mucosa. Responder cats also had significantly decreased percentages of CD8lo cells in blood prior to and at 3 months post-ASC therapy. CD8lo cells may serve as a potential "predictor" for response to systemic ASC therapy.ConclusionFresh feline ASCs can be successfully shipped and administered to cats with FCGS. ASCs modulate the immune response and demonstrate efficacy for chronic oral mucosal inflammatory lesions that are characterized by CD8+ T cell inflammation and T cell activation. FCGS is a potentially useful naturally occurring large animal model of human oral inflammatory diseases.

Feline chronic gingivostomatitis is a frustrating disease to manage owing to its elusive etiopathogenesis and its subsequently suboptimal treatment options. Nevertheless, efforts to shed light on the disease over the past few decades have advanced the knowledge on its potential etiopathogenesis and the success rates of available treatment options. Further research is ongoing, with promising attempts to better understand and treat this, likely, multifactorial disease.

Background: In this cross-sectional study we investigated the oral mucosal changes in a middle-aged Finnish population. We analyzed the prevalence of potentially malignant disorders and the influence of smoking, snuff and alcohol use on the mucosal changes. Methods: Of the 12,068 members of the NFBC 1966, a total of 1961 participants (16.2%) constituted the study population. Mucosal changes were diagnosed and photographed by seven general dentists, and two specialists re-analyzed all the diagnoses based on the documentation Cross-tabulation with Chi-square tests and logistic regression analysis were used to analyze the data. Results: Of the participants, 10.5% had some mucosal changes, of which 81.8% were diagnosed as oral mucosal lesions (OML) and 18.2% as normal variations. Of the normal variations, the most common were Fordyce granules (1.2%), fissured tongue (1.1%) and geographic tongue (0.9%). The most common OMLs were white lesions (6.5%), of which oral lichen planus (OLP) and lichenoid reactions (OLR), grouped as oral lichenoid diseases, were present in 3.5%, males more often (3.8% vs. 3.1%). OLP was found in 1.5% of all participants, females more often (1.8% vs. 1.2%), while OLR was more common in males (2.7% vs. 1.3%). Leukoplakia was identified in 0.5% of the population; twice more often in males (0.6% vs. 0.3%). Erythroplakia was not found. Current smokers had higher risk for oral mucosal changes than former or non-smokers (OR 3.0, 95% CI 2.11–4.28), and snuff, used occasionally or regularly, also raised the risk (OR 2.6, 95% CI 1.48–4.70). Conclusions: In the middle-aged northern Finland population, 4% of OMLs were potentially malignant disorders, including OLR (2%), OLP (1.5%) and leukoplakia (0.5%). In particular, smoking and snuff use increased the risk for having any oral mucosa changes.

Ağız mukozasını örten çok katlı yassı epitel irritasyonlara açıktır ve anormal reaktif proliferasyonlar gösterebilir. Bu değişiklikler anormal bir klinik kitle yaratabilir ve histolojik olarak neoplastik lezyonları taklit edebilir. Bu reaksiyonlar psödoepitelyomatöz hiperplazi veya psödokarsinomatöz değişiklik olarak adlandırılmaktadır. Epitelin rejeneratif amaçla gösterdiği bu tür anormal proliferasyonlar oral patolojide deneyimsiz hekimlerin yanlışlıkla ağız kanseri tanısı koymalarına neden olabilir. Diğer yandan histolojik benzerliklerden dolayı oral kanserler de reaktif lezyon olarak yanlış tanı alabilirler ve bu da hastaların doğru tedavi almalarında gecikmelere neden olacaktır. Bu makalede ağız ve çevre dokularında psödoepitelyomatöz hiperplaziye yol açabilen nedenlere ve ilişkili olduğu spesifik hastalıklara değinilecektir. Aynı zamanda bu lezyonun morfolojik özellikleri ile histolojik benzerlik gösterebilen oral kanserlerle ayırıcı tanısı işlenecektir. Klinik özelliklerin iyi bilinmesi ve histolojik bulguların dikkatli değerlendirilmesi ileride gelişebilecek istenmeyen sorunları önleyecektir. Bu yazıda verilen bilgiler daha çok patologların kullanımına yönelik olmakla birlikte, klinisyenlerin de tanı sürecindeki sorunları ve güçlükleri bilmeleri doğru tanıyı koymada yol gösterici olacaktır., Squamous epithelium covering the oral mucosa is open to a variety of irritations and may show aberrant reactive proliferations. These changes may create an abnormal clinical mass and histologically mimic neoplastic lesions. These reactions are called pseudoepitheliomatous hyperplasia or pseudocarcinomatous change. Exaggerated abnormal reactive changes may cause misdiagnosis of oral cancer in the mouth by inexperienced persons in oral pathology. On the other hand, due to histological similarities, also oral cancers may underdiagnosed wrongly as reactive lesions and lead to delays in cancer diagnosis and treatment. In this article, the causes of pseudoepitheliomatous hyperplasia and related specific diseases will be discussed. Additionally, the differential diagnosis of oral cancers from reactive lesions will be covered. The well knowing of the clinical features and a careful histological evaluation will prevent undesirable problems in the future. The information of the article is more useful for the pathologists; however, it will be helpful for the clinicians to know the problems and difficulties in the accurate diagnostic process.

The basement membrane zone (BMZ) consists of multiple components, including collagen XVII (COL17), which is the major targeted antigen of pemphigoid diseases such as bullous pemphigoid (BP) and mucous membrane pemphigoid (MMP). The blistering mechanisms in pemphigoid have not been fully elucidated, especially in MMP, which mainly affects the mucosa. No research has addressed the differences in BMZ components between the skin and the oral mucosa. In this study, we investigate the differences of BMZ proteins especially COL17 between the skin and the oral mucosa to elucidate the pathogenesis of oral lesion in pemphigoid. We showed that the MMP sera react preferentially to the oral mucosal substrates than the skin substrates. As well as the diversity of the reactivity of MMP autoantibodies, it was suggested that there are certain differences between the skin and the oral mucosa as autoantigens itself. We found that the expression levels of COL17 were significantly higher in normal human oral mucosal keratinocytes (NHOMKs) than in normal human epidermal keratinocytes (NHEKs). The high expression levels of COL17 compensate for COL17-depletion induced by pemphigoid IgG. These results may influence the clinical differences in pemphigoid. Furthermore, using immunoprecipitation, we revealed that COL17 directly binds to collagen IV (COL4) in NHEKs and NHOMKs. In particular, the C-terminus of COL17 is binding site to COL4 in NHOMKs. MMP-IgG or monoclonal antibody recognizing the C-terminus hindered the interaction of COL17 with COL4 in NHOMKs. These results are clinically relevant to less inflammatory phenotype in MMP. The inflammatory infiltrates around perilesions were significantly less in MMP compared to BP. These results indicate that pemphigoid IgG targeting the C-terminus plays a pathogenic role in blister formation in the oral mucosa to inhibit protein interactions with less inflammation.

The frequency of yeast-like fungal colonization of the oral mucosa in patients with Sjögren’s syndrome constitutes 40.0 ± 1.63%. Fungi are detected on the mucous membrane of the tongue more often (36.7 ± 1.61%) than on the mucous membrane of the gums (23.3 ± 1.41%). The extent of tongue mucosa colonization is also higher in comparison with the gum colonization. The extent of Candida colonization of tongue mucosa is 2.5 times higher in women with Sjögren’s syndrome as compared to men. The objective of the research was to study the level of candida colonization of various oral mucosa areas in patients with Sjögren’s syndrome. 26 fungal cultures were isolated from the examined patients. Candida albicans predominated among them constituting 14 strains (53.8±1.92%). C. albicans colonization of the oral mucosa was detected in 10 patients with Sjögren’s syndrome (30.0±1.53%). The extent of tongue mucosa colonization was 3.95±1.32 lg CFU/ml and the extent of gum colonization constituted 3.08±0.60 lg CFU/ml.

Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous disease that often affects the anogenital area; oral mucosal lesions are extremely rare. A 52-year-old woman presented for evaluation of an 8-year history of a persistent whitish plaque in the buccal mucosa. Intraoral examination revealed multiple elevated whitish plaques diffusely distributed in the buccal mucosa associated with an area of tissue atrophy. Although both leukoplakia and lichen planus were considered, incisional biopsy and later, full excision confirmed the histopathological diagnosis of oral LS. After 6 months of follow-up, there are no clinical signs of relapse. This case highlights the importance of clinical and histopathological findings for the correct diagnosis and treatment of oral LS.

The purpose of this case is to show the efficacy of buccal mucosa as an alternative to treat a case of severe necrotizing sclero-uveitis (NSU) associated with ocular perforation. We show a severe inflammatory NSU case that did not improve with topical treatment and scleral patch. We performed a buccal mucosa graft taken from the lower lip with excellent functional and anatomical result, with no signs of relapse of the NSU after 2 years of follow-up. Buccal mucosa can be a safe, useful, and effective alternative for the reconstruction of the scleral wall.

Optical coherence tomography (OCT) is a real-time, in-situ, non-invasive imaging device that is able to perform a cross-sectional evaluation of tissue microstructure based on the specific intensity of back-scattered and reflected light. The aim of the present study was to define normal values of epithelial thickness within the oral cavity. OCT measurements of epithelial thickness were performed in 28 healthy patients at six different locations within the oral cavity. Image analysis was performed using Image J 1.52 software. The healthy epithelium has a mean thickness of 335.59 ± 150.73 µm. According to its location within the oral cavity, the epithelium showed highest values in the region of the buccal mucosa (659.79 µm) and the thinnest one was observed in the mouth’s floor (100.07 µm). OCT has been shown to be useful for the evaluation of oral mucosa in vivo and in real time. Our study provides reference values for the epithelial thickness of multiple sites within the oral cavity. Knowledge of the thickness values of healthy mucosa is, therefore, of fundamental importance.

Hereditary Hemorrhagic Telangiectasia or Rendu-Osler-Weber syndrome is an incomplete penetrance dominant autosomal transmission disease which determines microcirculatory beds alterations (capillary and venules), caused by the loss of the support tissues that usually enclose blood vessels, and hemorrhage potentially in every organ. The syndrome clinical manifestations are multiple telangiectasia of small proportions on the skin or on the mucous membranes (e.g. of the gastrointestinal tract or other organs), in association with recurring bleedings of the affected areas and external and internal melena. The treatment is a supportive one so to prevent complications. This study reports a case of a patient affected by this syndrome in need of a dental implant following the fracture of a tooth. Furthermore, a bibliographical review of etiopathogenesis, clinical manifestations and therapy options has been made.

Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a recently described clinical entity and should be considered in children who present with oral (94% of patients), ocular (82% of patients), and urogenital lesions (63% of patients). MIRM was first described as a distinct clinical entity from Stevens Johnson syndrome/Toxic epidermal necrolysis (SJS)/(TEN) in 2015 [1]. As a new, uncommon diagnosis it frequently poses a diagnostic and therapeutic challenge for pediatricians and dermatologists. We report a case of MIRM in a previously healthy 15-year-old boy.

Резюме. Проаналізовано сучасні дані стосовно механізмів ураження пародонта та слизової оболонки ротової порожнини у хворих на цукровий діабет., Резюме. Проанализированы современные данные относительно механизмов поражения пародонта и слизистой оболочки полости рта у больных сахарным диабетом., Up to-date conserning a mechanisms of periodont and oral mucosa destruction in patients with diabetes mellitus.

Mucous membrane pemphigoid (MMP) is a rare organ-specific autoimmune subepithelial blistering disease with predominantly mucosal erosions, most frequently affecting the gingiva. Erosions in the oral cavity usually result in markedly decreased quality of life. The major autoantigens are BP180 and laminin332, which are components of basement membrane proteins in the skin and mucosa. Diagnosis is usually difficult due to histological destruction of the tissue and low autoantibody titers. In this study, we evaluated the diagnostic value of direct immunofluorescence (DIF) using non-lesional buccal mucosa in seven cases of MMP. In all seven patients, gingival lesions were clinically observed, and in one of the seven patients, buccal lesions were also clinically observed. First, we performed DIF to detect tissue-bound autoantibodies and complement. DIF from non-lesional buccal mucosa revealed linear deposits of IgG and C3 at the basement membrane zone in all cases. To detect autoantibodies, indirect immunofluorescence (IIF), BP180-NC16A ELISA and immunoblotting were performed. Surprisingly, circulating autoantibodies were unable to be detected in any of the cases by ELISA, IIF, or immunoblotting. Furthermore, histological separation was observed in one patient. In conclusion, DIF using non-lesional buccal mucosa was found to be superior to histological and serological tests for diagnosing mucous membrane pemphigoid. The procedure is technically easy and has high diagnostic value.

Many oral diseases, such as oral leukoplakia and erythroplakia, which have a high potential for malignant transformations, cause abnormal structural changes in the oral mucosa. These changes are clinically assessed by visual inspection and palpation despite their poor accuracy and subjective nature. We hypothesized that non-invasive bioimpedance spectroscopy (BIS) might be a viable option to improve the diagnostics of potentially malignant lesions. In this study, we aimed to design and optimize the measurement setup and to conduct feasibility testing on pork oral tissues. The contact pressure between a custom-made concentric ring probe and tissue was experimentally optimized. The effects of loading time and inter-electrode spacing on BIS spectra were also clarified. Tissue differentiation testing was performed for ex vivo pork oral tissues including palatinum, buccal mucosa, fat, and muscle tissue samples. We observed that the most reproducible results were obtained by using a loading weight of 200 g and a fixed time period under press, which was necessary to allow meaningful quantitative comparison. All studied tissues showed their own unique spectra, accompanied by significant differences in both impedance magnitude and phase (p ≤ 0.014, Kruskal-Wallis test). BIS shows promise, and further studies are warranted to clarify its potential to detect specific pathological tissue alterations.

Mesenchymal stem cells (MSCs) have potent immunomodulatory functions and are a promising therapy for immune-mediated inflammatory disorders. We previously demonstrated the efficacy of fresh, autologous, adipose-derived MSCs (ASCs) to treat feline chronic gingivostomatitis (FCGS), a chronic oral mucosal inflammatory disease similar to human oral lichen planus. Here, we investigate the use of fresh allogeneic ASCs for treatment of FCGS in seven cats. Radiolabeled ASCs were also tracked systemically. Each cat received two intravenous injections of 20 million ASCs, 1 month apart. Oral inflammation, blood lymphocyte subsets, anti-fetal bovine serum antibody levels, ASC crossmatching and serum proteins and cytokine concentrations were determined. Four of the 7 cats (57%) responded to treatment [complete clinical remission (n = 2) or substantial clinical improvement (n = 2)]. Three cats were nonresponders. Prior to therapy, most cats had increased circulating CD8+ T cells, decreased CD8lo cells, and a decreased CD4/CD8 ratio, however clinical resolution was not associated with normalization of these parameters. Nonresponders showed more severe systemic inflammation (neutrophilia, hyperglobulinemia and increased interferon gamma and tumor necrosis factor alpha concentration) prior to ASC therapy. Clinical remission took up to 20 months and no clinical relapse has occurred. A higher fraction of radiolabeled ASCs were identified in the oral cavity of FCGS affected cats than the control cat. The administration of fresh, allogenic ASCs appeared to have lower clinical efficacy with a delayed response as compared to the fresh, autologous ASCs. In addition, the mechanism(s) of action for autologous and allogenic ASCs may differ in this model of oral inflammation. Stem Cells Translational Medicine 2017;6:1710-1722.

In the work modern data on mechanisms of diabetic angiopathy and its role in violation of morphological and functional state of oral mucosa are overviewed., Обобщены современные данные о механизмах развития диабетических ангиопатий и их роли в нарушении морфофункционального состояния слизистой оболочки ротовой полости., Узагальнено сучасні дані щодо механізмів розвитку діабетичних ангіопатій та їх ролі в порушенні морфофункціонального стану слизової оболонки ротової порожнини.