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Ameloblastomas are benign aggressive odontogentic tumors that exhibit insidious growth rates with attainment of extensive dimesions. Because ameloblastomas are not usually symptomatic until late in their clinical course, few are detected early. This article reports an atypical case of a small, painful ameloblastoma arising between the roots of the mandibular left canine and lateral incisor in a 66-year-old female. The patient underwent an en bloc resection of the mandible, and no recurrence was demonstrated on an 11-month recall examination. Histopathology revealed a 'hybrid' ameloblastoma with a pronounced desmoplastic pattern and acanthomatous changes. Practitioners should be vigilant for diminutive radiolucent lesions of the jaws with poorly defined borders. Timely recognition and intervention of ameloblastomas may improve treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: 4-methylimidazole is a ubiquitous and potentially carcinogenic environmental toxicant. Genetic factors that contribute to variation in susceptibility to its toxic effects are challenging to assess in human populations. We used the Drosophila melanogaster Genetic Reference Panel (DGRP), a living library of natural genetic variation, to identify genes with human orthologs associated with variation in susceptibility to 4-methylimidazole., Results: We screened 204 DGRP lines for survival following 24-hour exposure to 4-methylimidazole. We found extensive genetic variation for survival, with a broad sense heritability of 0.82; as well as genetic variation in sexual dimorphism, with a cross-sex genetic correlation of 0.59. Genome-wide association analyses identified a total of 241 candidate molecular polymorphisms in or near 273 unique genes associated with survival. These polymorphisms had either sex-specific or sex-antagonistic effects, and most had putative regulatory effects. We generated interaction networks using these candidate genes as inputs and computationally recruited genes with known physical or genetic interactions. The network genes were significantly over-represented for gene ontology terms involving all aspects of development (including nervous system development) and cellular and organismal functions as well as canonical signaling pathways, and most had human orthologs., Conclusions: The genetic basis of variation in sensitivity to acute exposure to 4-methylimidazole in Drosophila is attributable to variation in genes and networks of genes known for their effects on multiple developmental and cellular processes, including possible neurotoxicity. Given evolutionary conservation of the underlying genes and pathways, these insights may be applicable to humans., (© 2024. The Author(s).)

Abstract: Suicide by firearm is a significant public health concern in specific regions of the world. Depending on firearm availability, any type of firearm may be used, including handguns, shotguns, and long rifles. Common entrance wound sites in suicidal gunshot wounds include the head, with classic gunshot wound locations including the temple, the forehead, the submental aspect of the chin, and inside the mouth. Occasionally, suicidal gunshot wounds occur in atypical body locations such as the back of the head and neck. Given their relative rarity, suicidal gunshot wounds in these regions may be mistaken for homicides. In this report, we present 5 cases of suicidal gunshot wounds to the back of the head and/or neck. In our series, we focus on differentiating each case from homicides involving gunshot wounds in similar areas of the head and neck., Competing Interests: The authors report no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

The presence of facial jewelry and medical devices within a radiographic field of view may promote the formation of artifacts that challenge diagnostic interpretation. The objective of this article is to describe a previously unreported radiographic anomaly produced by an oral piercing site below the lower lip. This unusual artifact masqueraded as a severe resorptive defect, dental caries, or cervical abfraction and occurred following removal of an extremely large labret below the lower lip and subsequent acquisition of a radiographic image. The radiolucency was ultimately attributed to an extensive aperture below the lower lip created by a series of sequentially larger soft tissue expanders. Clinicians should seek correlation of atypical radiographic presentations with soft tissue defects secondary to injury or intentional oral piercing., Competing Interests: No conflicts of interest reported.

Aim: To review published cases and case series of the peripheral odontogenic keratocyst (POKC) of the gingiva, report an unusual presentation, and discuss lesional recurrence., Materials and Methods: A search of the English language literature for gingival OKCs was conducted. The inclusion of new case yielded a database containing 29 affected patients. Clinical, surgical, radiographic, and histopathologic findings have been summarized., Results: With available patient demographics, 62.5% were female and 37.5% were male, with an overall mean age at diagnosis of 53.8 years. There was near-equal lesional affinity for the jaws, of which 44.0% occurred in the posterior region, 32.0% anteriorly, and 24.0% overlapped these areas. Twenty-five percent of lesions had a normal color, 30.0% appeared yellow, 20.0% were white, and 10.0% were blue. The majority of lesions were < 1 cm and nearly 42% manifested exudation or fluctuance. Lesional pain was infrequent. Pressure resorption was recorded in 45.8% of cases. Most lesions were managed with conservative surgical modalities. Follow-up information was available in 16 primary cases, of which 5 recurred, signifying a 31.3% recurrence rate, including the featured case, which recurred twice., Conclusion: To reduce recurrence of a gingival OKC, supraperiosteal dissection is advocated. Further, it is advised to follow POKCs for 5-7 years postoperatively, remaining vigilant for subtle clinical manifestations of recurrence. Timely discovery and excision of a POKC of the gingiva may decrease the incidence of a mucogingival defect., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Stiff person spectrum disorder (SPSD) is a rare progressive autoimmune neuromuscular syndrome, primarily resulting in severely painful spasms and rigidity of the axial and appendicular musculature. Affected individuals are predisposed to develop an array of other neuropathies, including cerebellar ataxia and seizure activity, ophthalmologic abnormalities, and other autoimmune-based systemic diseases, notably type 1 diabetes mellitus, thyroiditis, pernicious anemia, and malignancy. Limited information exists in the oral medicine literature regarding SPSD. Thus, the objective of this paper is to review the clinicopathologic features of SPSD, with particular emphasis on head and neck involvement. Additionally, clinical guidelines for dental management of affected individuals and a summary of surgical procedures and outcomes performed in the head and neck are provided. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range)., Competing Interests: Disclosures None of the coauthors have any financial conflicts of interest. There was no funding for the preparation of this manuscript. The coauthors declare that all procedures were performed in compliance with relevant laws and institutional guidelines., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Orthodontic therapy in patients with osteopetrosis (OP) of the jaws has typically been contraindicated owing to the presence of poorly perfused and extremely compact bone, and the potential risk for infection and osteomyelitis. As such, completed orthodontic cases in association with OP have rarely been published., Patient Concerns: A patient aged 14 years 6 months, with no known diagnosis of OP, sought orthodontic assessment for anterior crowding., Clinical Findings: The patient exhibited a straight facial profile and increased mandibular facial height, competent lips, shallow mentolabial sulcus with mild mentalis strain, flat/reverse smile arc and wide buccal corridors on smiling., Primary Diagnosis: The patient had a Class I incisor relationship on Class I skeletal bases with bilateral Class I molars and Class II canine relationships. This was complicated by a crossbite involving the lateral incisors and a Bolton discrepancy due to small maxillary lateral incisors. A radiologic assessment revealed polyostotic OP of the oromaxillofacial complex., Interventions: Treatment consisted of maxillary and mandibular fixed orthodontic therapy, bite turbos and elastics to level and align the dentition. Extractions of permanent teeth were not needed., Outcomes: At the conclusion of treatment, there was a slight left Class II malocclusion, with incomplete intercuspation on the left side due to tooth size discrepancy, possibly attributed to inadequate elastics compliance and the presence of osteopetrotic bone. The treatment was completed in 3 years, 1 year longer than anticipated., Conclusion: This report represents the second published account of a patient with OP successfully managed with comprehensive orthodontic care and without osseous complications. Obtaining cephalometric measurements on OP-affected patients may be imprecise owing to the presence of extremely dense bone and difficulty to identify bony landmarks. To reduce osteopetrotic sequelae, attending clinicians should consider reduced exertional orthodontic forces and closely monitor patients for adverse alveolar events., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: The aim of this report was to review oral follicular lymphoid hyperplasia, with emphasis on palatal lesions., Method and Materials: A comprehensive search was performed on PubMed for case reports and case series of palatal follicular lymphoid hyperplasia published in the English language literature. Relevant data from collated articles was sought, including patient demographics, clinical manifestations, imaging modalities and findings, comorbidities, etiopathogenesis, lesional management, and lesional outcome. A new palatal case has also been provided to illustrate several features of this lesion., Results: In total, 32 cases were assembled to establish clinicopathologic correlations, representing the largest aggregation of published cases. Most of the affected patients were at least 60 years old and with a decisive female predilection. The majority of lesions were ≤ 3 cm, appearing as normal color, purple-red or red, and varied from soft to firm. Notably, 32% of palatal follicular lymphoid hyperplasias were associated with denture wear, and lesional recurrence was recorded in 16% of cases. To date, none of the reported cases of palatal follicular lymphoid hyperplasia has undergone malignant transformation., Conclusions: Palatal follicular lymphoid hyperplasias often arise as a reactive process. Critical histopathologic and histochemical assessments are necessary to establish benignity. Postoperatively, clinicians should follow patients for at least 5 years for recurrence and remain vigilant for neoplastic change as several published accounts of non-oral follicular lymphoid hyperplasias have undergone malignant transformation, usually to lymphoma.

Background: Neurofibromas are benign peripheral nerve sheath tumors usually featured with neurofibromatosis type 1 syndrome. Recurrent gingival neurofibromas have been rarely reported in the periodontal literature, particularly affecting elderly patients., Methods and Results: A 70-year-old man with a pale, rubbery, and painless thickening along the facial/buccal gingiva of the mandibular right canine and first premolar. Ten years prior, the patient had undergone excision of a neurofibroma within the same region. The patient denied a history of cutaneous disease or neurofibromatosis. Histopathologic and immunostaining of the excised lesion confirmed the diagnosis as a recurrent gingival neurofibroma., Conclusions: With cases of suspected recurrent neurofibroma, attending practitioners should consult with an oral pathologist whether the primary lesion had exhibited tumor cells to the surgical specimen margin. Preoperative use of a cone beam computed tomography scan may enhance determination of tumor depth. Clinicians should also carefully weigh the decision for conservative excision of gingival neurofibromas and greater risk of recurrence versus performing a somewhat wider extirpation and possible formation of a mucogingival defect., Key Points: What are important clinical considerations when performing a gingival biopsy? Gingival neurofibromas may be associated with an increased risk for recurrence owing to decisions for tissue-sparing excision and prevention of a mucogingival defect; supplemental use of cone beam computed tomographic scans may provide greater appreciation of tumor depth. What is a reasonable length of time of postoperative assessment for gingival neurofibromas? Patients who have undergone surgical removal of a gingival neurofibroma should undergo yearly surveillance for at least 10 years. What is a key limitation to this case study? Preoperatively, attending clinicians should consult with an oral pathologist to ascertain whether a primary lesion had manifested tumor cells to the surgical margin. Conservative gingival resection of a neurofibroma may promote recurrence., (© 2023 American Academy of Periodontology.)

Background: Diffuse idiopathic skeletal hyperostosis (DISH) is a potentially serious osteopathic disorder associated with coalescing ossifications of the anterior vertebrae and may be concomitant with a constellation of symptomatology and systemic comorbidities. There is limited dental literature describing this finding on panoramic radiographs and cone beam computed tomography (CBCT) scans., Case Presentations: Two case reports of DISH are provided. One patient manifested extensive ossifications along the cervical vertebrae and consequent episodes of dysphagia and hoarseness. The other affected patient's cervical ossification was found at an earlier stage of formation and without symptomatology. Panoramic radiography, cervical spine radiography, and CBCT examinations have been provided., Conclusion: Attending dental healthcare practitioners should carefully evaluate all areas of interest and surrounding fields of view when taking panoramic radiographs and CBCT scans for manifestations of DISH and other potential disorders of the cervical vertebrae. A suspected radiologic finding of DISH should prompt timely referral for comprehensive medical assessment to mitigate neurologic deficits and other comorbidities., (© 2024 Special Care Dentistry Association and Wiley Periodicals LLC.)

Patients with chronic and severe hearing loss, refractory to nonsurgically-worn devices, may consider use of cochlear implants to regain auditory capability. Cochlear implants consist of surgically emplaced and externally worn components. There are few published examples of the radiographic presentation of these devices appearing in the special needs-based dental literature. This article features a case report and panoramic radiographic examination involving a 67-year-old patient who received bilateral cochlear implants after experiencing a traumatic brain injury and onset loss of hearing. A brief review of strategies for communicating with individuals with severe hearing impairment has also been provided., (© 2023 Special Care Dentistry Association and Wiley Periodicals LLC.)

The custom of oral tattooing is mainly performed in Ethiopia and Eritrea, and usually results in blue pigmentation of the maxillary gingiva in dentate individuals. However, its usefulness has not been explored in the forensic literature. The aim of this article is to provide a review of this custom and include an unusual case study involving persistent gingival pigmentation. Herein, this report describes a 43-year-old woman from Eritrea who presented with slight bluish hue of the edentulous maxillary ridge associated with cultural tattooing. Elucidation of the cause of subtle blue hyperpigmentation may be challenging as cultural tattooing typically fades with age. Timely recognition of this oral pseudopathologic process may serve as secondary evidence for forensic identification and possibly provide aid in localizing one's ethnogeographic origin., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

The zoonotic infectious disease mpox (previously known as monkeypox) is caused by the monkeypox virus (MPXV) from the Poxviridae family. Presently, mpox is receiving worldwide attention because of its emergence in countries that have never previously documented the illness, resulting in a public health emergency. MPXV is transmitted via human-to-human contact, and sexual contact is especially implicated in spread of the disease. Affected individuals experience fever, headache, malaise, and early lymphadenopathy, followed by a secondary mucotaneous rash. Oral ulcers and perioral papules may be the first evidence of the disease. Although there are numerous articles in medical publications documenting the cutaneous presentations of mpox, there is limited information in the dental literature regarding oral lesions. The objective of this article is to review the oral manifestations of mpox and strategies for management of the disease., Competing Interests: No conflicts of interest reported.

Implant failures have been associated with a diversity of etiologic processes, predominately arising from bone loss (peri-implantitis) due to inadequate maintenance of oral hygiene or excess luting agents. The aim of this article is to report a novel case of the apparent failure of a dental implant to undergo osseointegration in the presence of submerged pencil graphite. Practitioners are advised to carefully evaluate the clinical and radiographic site of a proposed implant for occult foreign substances. Embedded pencil graphite in the jawbone may promote a foreign body reaction and should be considered in the list of possible contributing factors to dental implant complications., Competing Interests: No conflicts of interest reported.

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of disease burden in the world and is highly correlated with chronic elevations of LDL-C. LDL-C-lowering drugs, such as statins or monoclonal antibodies against proprotein convertase subtilisin/kexin type 9 (PCSK9), are known to reduce the risk of cardiovascular diseases; however, statins are associated with limited efficacy and poor adherence to treatment, whereas PCSK9 inhibitors are only prescribed to a "high-risk" patient population or those who have failed other therapies. Based on the proven efficacy and safety profile of existing monoclonal antibodies, we have developed a peptide-based vaccine against PCSK9, VXX-401, as an alternative option to treat hypercholesterolemia and prevent ASCVD. VXX-401 is designed to trigger a safe humoral immune response against PCSK9, resulting in the production of endogenous antibodies and a subsequent 30-40% reduction in blood LDL-C. In this article, VXX-401 demonstrates robust immunogenicity and sustained serum LDL-C-lowering effects in nonhuman primates. In addition, antibodies induced by VXX-401 bind to human PCSK9 with high affinity and block the inhibitory effect of PCSK9 on LDL-C uptake in a hepatic cell model. A repeat-dose toxicity study conducted in nonhuman primates under good laboratory practices toxicity indicated a suitable safety and tolerability profile, with injection site reactions being the main findings. As a promising safe and effective LDL-C-lowering therapy, VXX-401 may represent a broadly accessible and convenient option to treat hypercholesterolemia and prevent ASCVD., Competing Interests: Conflict of interest All studies described herein were funded by Vaxxinity, Inc All authors are past or current Vaxxinity employees and hold company stock/stock options., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Neuroblastoma is the most common extracranial tumor, accounting for 15% of all childhood cancer-related deaths. The long-term survival of patients with high-risk tumors is less than 40%, and MYCN amplification is one of the most common indicators of poor outcomes. Zika virus (ZIKV) is a mosquito-borne flavivirus associated with mild constitutional symptoms outside the fetal period. Our published data showed that high-risk and recurrent neuroblastoma cells are permissive to ZIKV infection, resulting in cell type-specific lysis. In this study, we assessed the efficacy of ZIKV as an oncolytic treatment for high-risk neuroblastoma using in vivo tumor models. Utilizing both MYCN-amplified and non-amplified models, we demonstrated that the application of ZIKV had a rapid tumoricidal effect. This led to a nearly total loss of the tumor mass without evidence of recurrence, offering a robust survival advantage to the host. Detection of the viral NS1 protein within the tumors confirmed that a permissive infection preceded tissue necrosis. Despite robust titers within the tumor, viral shedding to the host was poor and diminished rapidly, correlating with no detectable side effects to the murine host. Assessments from both primary pretreatment and recurrent posttreatment isolates confirmed that permissive sensitivity to ZIKV killing was dependent on the expression of CD24, which was highly expressed in neuroblastomas and conferred a proliferative advantage to tumor growth. Exploiting this viral sensitivity to CD24 offers the possibility of its use as a prognostic target for a broad population of expressing cancers, many of which have shown resistance to current clinical therapies., Significance: Sensitivity to the tumoricidal effect of ZIKV on high-risk neuroblastoma tumors is dependent on CD24 expression, offering a prognostic marker for this oncolytic therapy in an extensive array of CD24-expressing cancers., (© 2024 The Authors; Published by the American Association for Cancer Research.)

The odontoma is regarded as a hamartomatous process of the jaws. Most are discovered as an incidental radiographic finding, averaging 15 mm in size. This report describes a case of a diminutive odontoma that was surgically removed before the onset of eruptive and pathologic consequences. A compilation of documented complications and syndromes associated with odontomas is also presented., Competing Interests: No conflicts of interest reported.

Clear aligner therapy (CAT) has gained popularity in recent years. As technological advancements increase within the field of dentistry, clinicians have opted to prouce orthodontic appliances within their own offices or clinics, often referred to as in-house CAT. Construction of in-house aligners utilizes 3-dimensional printing devices, potentially offering practitioners enhanced control and improving patient comfort. The aim of this article is to review the materials, methods, advantages, disadvantages, and procedural outcomes associated with the fabrication of aligners within a dental office or clinic., Competing Interests: No conflicts of interest reported.

Conventional radiography is the mainstay for evaluation of developmental and pathologic disorders of oral and maxillofacial structures. Occasionally, clinicians may experience diagnostic pitfalls during interpretation of these imaging modalities. The aim of this article is to present 4 cases of pseudopathologic disorders found on intraoral and panoramic radiographs. Subsequent use of cone beam computed tomographic (CBCT) imaging determined that the initial concerning findings represented anatomical or radiographic anomalies rather than pathologic processes. Supplemental use of CBCT scans may enhance diagnostic assessment, possibly reducing the need for surgical intervention, and elucidate structurally compromised regions of the jaw that could predispose it to fracture., Competing Interests: No conflicts of interest reported.

Vestibular schwannoma (VS) is a benign peripheral nerve sheath tumor involving the vestibulocochlear nerve. Affected patients typically experience a gradual emergence of episodic imbalance and unilateral hearing loss, tinnitus, and headache. Less often, VS may be associated with facial pain; ocular, otic, and taste disturbance; paresthesia of the tongue and face; and temporomandibular disorder-like presentations. There is limited information in the dental literature relating the myriad of oral and maxillofacial manifestations of VS. The objective of this article is to underscore the importance for dental clinicians to seek clinicopathologic correlations with VS-related symptomatology, potentially resulting in a timelier diagnosis and improved patient outcomes. To convey this clinical challenge, a detailed narrative of a 45-year-old patient with an 11-year delay in diagnosis has been reported. In addition, the typical radiographic appearance of an implanted cranial device placed following VS resection has been provided.

Background: The hypoglossal nerve stimulator (HNS) device has been employed in some patients with refractory or unsatisfactory outcomes to chronic obstructive sleep apnea management. The objective of this article is to increase recognition of the radiologic appearances of this device within the head and neck region, as seen on extraoral radiographic and cone beam computed tomography (CBCT) images., Clinical Presentation: A 55-year-old man, refractory to a multitude of apneic medical therapies, underwent a series of preorthognathic radiologic studies. Notably, an implanted HNS lead and ribbon electrodes appeared as hyperdense structures on the panoramic radiograph, lateral cephalogram, and CBCT scan., Conclusion: This article provides various radiologic views of the primary components of an HNS. Clinicians should be able to recognize the presence of neurostimulator devices used for management of chronic sleep apnea within the radiologic field of view of examinations of the head and neck.

Pemphigus vulgaris (PV) is a rare painful and blistering autoimmune mucocutaneous disorder that appears in middle-aged adults. Oral lesions typically precede cutaneous involvement and tend to be more recalcitrant to therapy. The objective of this article is to present a case of oral and cutaneous PV in an atypical patient, a 23-year-old woman. The case was distinguished by the patient's age, which was 2 to 3 decades younger than the reported mean age of onset, and its coincidence with celiac disease, an immunopathologic process rarely seen in association with PV. Intravenous administration of the monoclonal antibody rituximab provided rapid clinical improvement in the cutaneous lesions and gradual improvement in the oral lesions after 2 infusions. Dental practitioners should remain vigilant for oral manifestations of dermatologic disease and refer affected patients to appropriate healthcare providers for long-term management., Competing Interests: The authors report no conflicts of interest pertaining to any of the topics discussed in this article.

Charcot-Marie-Tooth disease (CMTD) is an uncommon progressive neuromuscular disorder of the peripheral nervous system and primarily leads to distal extremity weakness and sensory deficits. Frequently, affected patients manifest pes cavus, drop foot, and digit contractures that may pose significant challenges in ambulation and grasping objects. Although there are numerous articles of this syndrome in the medical literature, there is a limited number of dental publications. The objective of this article is to review the general and head and neck/oral and maxillofacial features of CMTD. General guidelines for dental management are also provided., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Central osteomas of the jaws have been infrequently reported, mostly presenting as a well-defined opacity on conventional radiography projections and as a hyperdensity on computed tomography scans. To increase the knowledge of the phenotypic expression of gnathic central osteomas, an unusual case has been described, including the clinical, radiographic, cone beam computed tomography (CBCT) and histopathologic findings. The lesion was initially discovered 4 years prior as an asymptomatic ovoid radiolucency in the posterior mandible. A 25-year-old female presented with a hyperdense expansile mass with a hypodense rim on a CBCT scan. The enucleated mass was diagnosed as a compact central osteoma. A literature search has identified 4 other cases with similar hypodense borders on CT scans. We propose that a subset of central osteomas should be considered in the differential diagnosis of osteopathologies of the jaws with hyperdense internal architecture and hypodense borders, as seen on CT images., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Electronic cigarette (EC) use is on a steady rise, leading to increased concerns about its efficacy with regard to tobacco cessation goals and safety with regard to systemic and oral health. Recent studies have shown that EC flavoring agents can have adverse effects similar to those of combustible tobacco products. Evidence is mounting that EC use should not be considered a healthier alternative to tobacco smoking. The aerosols produced by ECs have been associated with respiratory, cardiac, and central nervous system disease as well as oral mucosal alterations. In addition, ECs can affect kidney and liver function. Their use has also resulted in EC explosions and burn injuries, some of which have been fatal. The aim of this article is to review the systemic and oral health concerns associated with EC use., Competing Interests: The authors report no conflicts of interest pertaining to any of the topics discussed in this article.

Human papillomavirus (HPV) has a nearly ubiquitous prevalence within the adolescent and adult populations worldwide. The virus has been implicated for decades in cervical and uterine cancers, but recent data have shown an increase in cases of virally related oropharyngeal squamous cell carcinoma in both male and female cohorts. The objective of this article is to review the oral health implications of HPV infection, including oral and oropharyngeal prevalence, manifestations, neoplastic potential of HPV-associated head and neck lesions, treatment modalities, and vaccine use. The article will also discuss the continuing education needs of oral healthcare providers. Dental professionals should routinely screen patients for oral and oropharyngeal manifestations of HPV infection, seek timely referral for therapeutic intervention of potentially malignant lesions, and become strong proponents of HPV vaccinations for at-risk patients., Competing Interests: The authors report no conflicts of interest pertaining to any of the products or companies discussed in this article.

With the adoption of limited-volume cone beam computed tomographic (CBCT) imaging in dentistry, high resolution of the maxillomandibular complex has led to the recognition of numerous accessory neurovascular canals. The preoperative identification of these structures is essential to facilitate the safe performance of an assortment of invasive dental procedures; however, there is limited information in the endodontic literature regarding mapping of these neurovascular canals and their anatomic variants. To emphasize the utility of accessory neurovascular channel mapping in conjunction with endodontic therapy, we have presented the clinical findings of 4 diverse cases. Comprehensive evaluation of the CBCT scans showed relevant underlying etiopathologies, prompting clinical modifications that led to enhanced patient outcomes., (Copyright © 2020 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Panoramic radiography is a useful screening tool for an array of dental and nonodontogenic disorders related to calcification as well as assessment of trauma and development of the oral and maxillofacial complex. Rotational movements of the radiographic source and detector plate may promote ghost image formation, particularly with larger radiopaque objects, and complicate the radiographic interpretation. This article describes cases of a giant submandibular gland sialolith and a giant tonsillolith, each of which appeared as a bilateral presentation due to contralateral ghost images, and discusses their clinical, demographic, and radiographic characteristics. Computed tomographic examinations were used to confirm the unilateral presentation of these objects and for determination of the extent of adjacent soft tissue impingement. Distinguishing an actual panoramic image from a ghost artifact may avoid unnecessary surgical intervention and improve clinical outcomes.

The oral mucosa has superior wound healing potential compared to other mucosal tissues. The objective of this article is to review the current state of evidence on the mechanisms that govern accelerated oral mucosal wound healing and explore clinical approaches that facilitate the natural course of these processes.