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The early detection and accurate diagnosis of potentially malignant oral lesions, such as actinic cheilitis, leukoplakia, and oral lichen planus, are crucial for improving patient outcomes. Dermatoscopy, a non-invasive diagnostic technique, offers enhanced visualisation of these lesions, enabling precise assessment of morphological features critical for early recognition and differential diagnosis. This article aims to present dermatoscopic findings from cases of these common conditions, highlighting their importance in refining clinical management. Dermatoscopy not only improves diagnostic accuracy by revealing detailed lesion characteristics but also assists in evaluating malignancy risk, monitoring progression, and guiding the decision-making process for biopsy and treatment. While biopsy remains definitive for diagnosis, dermatoscopy serves as a valuable preliminary tool. Future research should focus on establishing standardised dermatoscopic criteria for oral lesions and integrating dermatoscopy into regular oral health evaluations to advance patient care.

Geographic Tongue (GT), also known as benign migratory glossitis, is a benign inflammatory condition characterised by irregular, smooth, red patches on the tongue surface, often with a white or light-coloured border. Despite being a common oral condition, its pathophysiology remains poorly understood. This review aims to shed light on the latest insights into the pathophysiology of GT, exploring its etiological factors, immunological aspects, and potential genetic predispositions. We discuss the role of environmental factors, such as stress and dietary habits, and delve into the immunopathological mechanisms that may contribute to the manifestation of GT. The review also examines the possible genetic and epigenetic factors involved in GT and their interaction with environmental triggers. Recent advancements in molecular biology and genetics offer new perspectives in understanding the complex nature of GT, paving the way for improved diagnostic and therapeutic approaches. This review concludes with a discussion on the potential future directions in GT research, focusing on the need for larger epidemiological studies and the exploration of novel therapeutic targets.

Recurrent Aphthous Stomatitis (RAS) is a prevalent oral mucosal disorder characterized by recurring painful ulcers. The pathogenesis of RAS remains incompletely understood, but emerging evidence suggests a significant link between gut microbiota and the development of RAS. This review aims to explore the existing literature on the interplay between gut microbiota and RAS, focusing on how intestinal dysbiosis may influence the onset and severity of RAS. We discuss the role of gut microbiota in immune modulation, the breakdown of oral tolerance, and the possible pathways through which gut bacteria can affect oral health. Additionally, we examine the impact of diet, antibiotics, and probiotics on the gut microbiota and, subsequently, on RAS. The review concludes with potential therapeutic strategies targeting gut microbiota to manage and prevent RAS, paving the way for novel interventions in this field.

Angular Cheilitis (AC) represents a multifaceted oral pathology characterized by erythematous lesions at the labial commissures. Despite its prevalence, AC is often inadequately addressed due to its polymorphic etiology, which can encompass infectious agents, nutritional deficits, and systemic conditions. This article provides a systematic review of the pathophysiology, clinical presentation, and etiological factors of AC, including nutritional deficiencies, infectious agents, and systemic diseases. Emphasizing a multidisciplinary strategy, we discuss the collaborative roles of dental, medical, and dermatological expertise in the accurate diagnosis and effective management of AC. We outline diagnostic criteria, appropriate laboratory tests, and imaging techniques tailored to address the multifaceted nature of the condition. Management strategies encompass a range of options from topical treatments and medications to dietary modifications and preventative measures, with an emphasis on evidence-based practices. This review advocates for integrated care models to optimize treatment efficacy, patient compliance, and to mitigate the recurrence of AC. Our analysis aims to enhance the understanding of AC and to provide a framework for its management, contributing to better patient care and opening avenues for future research.

Corticosteroids, including glucocorticoids, mineralocorticoids, and androgenic hormones, are hormonal mediators produced by the adrenal glands and are widely used in the treatment of various conditions, including dental diseases. While systemic corticosteroid therapy offers significant therapeutic benefits, it is crucial to understand the potential adverse effects on oral health. This paper aims to highlight the impact of systemic corticosteroid therapy on oral health, focusing particularly on the associated complications and management strategies. The paper emphasizes specific complications that may occur in the oral cavity as a result of corticosteroid use, the most important being an increased susceptibility to oral infections such as candidiasis and impaired bone metabolism, with a significant reduction in the mineral density of the mandibular bone (BMD), as well as delayed wound healing, the occurrence of oral ulcers, and changes in the oral microbiome. Furthermore, the importance of rigorous oral care and regular dental monitoring for patients undergoing systemic corticosteroid therapy is underlined. The role of oral health specialists in the early detection and efficient management of oral complications, as well as patient education regarding proper oral hygiene practices and possible side effects, is of crucial importance. In conclusion, it is essential for healthcare providers to be vigilant regarding the potential oral health complications associated with systemic corticosteroid therapy, and early detection, prevention, and the implementation of appropriate management strategies are fundamental for optimizing oral health outcomes in patients undergoing corticosteroid treatment.

Squamous cell carcinoma is the most common epithelial neoplasm of the head and neck, and it is estimated to represent over 90% of oral neoplasms. Despite therapeutic advances, morbidity and mortality from oral squamous cell carcinoma have not improved significantly in the last 30 years, mainly due to the detection of cases in advanced stages. While tobacco and alcohol use are major risk factors for oral cancer, other known causes are: genetic mutations, dietary deficiencies, prolonged exposure to UV radiation, immunosuppressive conditions, oral or systemic infections. Poor oral hygiene, gingival or periodontal chronic inflammatory conditions, as well as chronic oral erosive lesions favor the appearance of oral infections. Bacterial colonization and adjacent pro-inflammatory status induce the initiation and progression of oncogenic processes by stimulating cell proliferation, angiogenesis, and mutagenic processes. Studies investigating the salivary microbiome, performed on people with precancerous or neoplastic lesions, have shown a decrease in microbial diversity and abundance, especially of the species Firmicutes and Actinobacteria together with the increase in the representation of Lactobacillus. Two theories are formulated to clarify the relationship between the salivary microbiome and oral squamous cell carcinoma. The first discusses bacterial colonization as a direct pathogenic cause of carcinoma, the second describes microbiome abnormalities after tumor onset. In both concepts, metagenomic and transcriptomic changes occur in the salivary microbiome and influence oral cellularity and the immune response. In addition, a combination of both theories is very likely to occur during the progression of oral carcinoma. The analysis of the salivary microbiome as a biomarker for the detection of potentially malignant oral lesions and early oral carcinoma is an innovative and non-invasive method that offers promising prospects. To standardize it, there are numerous molecular and genomic biology studies in progress, extensive studies, including new therapeutic approaches to oral carcinoma by correcting salivary microbiome dysfunctions.

The medical and dental fields are experiencing a significant shift in approach thanks to the integration of artificial intelligence (AI). With a vast influx of patient data, there is a pressing need for sophisticated software capable of organizing and preserving this information effectively. The emergence of AI-driven models and computer vision techniques for identifying patterns in clinical and histopathological images related to oral pathology lesions holds promise for enhancing diagnostic accuracy and prognostic predictions. While microscopic morphology remains the gold standard in diagnostic pathology, its reliance on individual pathologists introduces variability. Consequently, AI presents a potential solution for achieving consistent and more precise diagnoses. Moreover, by analyzing extensive data from the patients’ medical chart the artificial neural network could provide a presumptive diagnosis and an invaluable screening tool in predicting individual risk for oral pathology based on information regarding their risk factors, systemic diseases and conditions and clinical pathological data. Within oral and maxillofacial pathology, AI stands poised to elevate diagnostic accuracy, tailor treatment, and ultimately enhance patient outcomes. Nevertheless, the integration of AI in healthcare demands meticulous attention to ethical, legal, and regulatory complexities. Moreover, given the nascent nature of AI technology, prudence is paramount when deploying it in this specialized domain.

Periodontitis patients are known to have increased circulating lipopolysaccharide activity and metabolic disturbances, which may be either the cause or effect of endotoxemia. This review approaches endotoxemia as a possible molecular mediator between periodontitis and increased risk of cardiometabolic disorders. Observations that bacteria disseminate into circulation after toothbrushing and periodontal procedures and assumptions that endotoxin may disseminate through inflamed periodontium and bleeding gums support the idea of endotoxemia in periodontitis. However, the evidence that periodontitis-associated dysbiosis contributes to endotoxemia is not as strong as in the case of gut microbiome dysbiosis. Although the causality is insufficiently demonstrated thus far, many studies have associated changes of the gut microbiome composition, function, and specific bacterial metabolites with cardiometabolic diseases, whereas research on the oral microbiome has severely fallen behind.