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Objectives: When performing CBCT sialography (sialo-CBCT), space-occupying lesions may be identified incidentally. The objective was to describe their radiologic-clinical-histopathologic correlations. Method and materials: The archive of sialo-CBCT scans was retrospectively searched for suspected space-occupying lesions. Based on the scan and clinical-histopathologic data, the cases were divided into "pathologic" vs "normal," "intra-parenchymal" vs "extra-parenchymal," and "benign" vs "malignant." Two precalibrated, blinded radiologists performed a survey of the radiographic features of each scan. Cohen kappa, chi-square, Kruskal-Wallis, and Mann-Whitney tests assessed inter-observer agreement and radiologic-clinical-histopathologic correlations. Results: In total, 27 (1.5%) suspected space-occupying lesions were found in 1,758 reports. Full follow-up data were available for 15 cases: four were "malignant," six were "benign," and the remaining five were "normal." Kappa showed substantial inter-observer agreement (0.8 to 1.0). Constant swelling correlated with "pathologic" cases (P = .003). Lesion diameter was greater in "pathologic" than "normal" (P < .001) cases, with a cut-off of 12.6 mm. Clinical and radiographic features were similar in "benign" and "malignant" lesions. "Intra-parenchymal" and "extra-parenchymal" space-occupying lesions correlated with "no-fillregion" (P = .01) and "main-duct-displacement" (P = .002), respectively. Conclusions: Suspected space-occupying lesions in sialo-CBCT with a diameter greater than 12.6 mm are likely to be "pathologic." No radiographic features were able to differentiate between "malignant" and "benign" space-occupying lesions. [ABSTRACT FROM AUTHOR]

Objective: The familial type of oral lichen planus (OLP) is rare, with a paucity of data regarding its clinical significance. Our objective was to characterize patients with familial OLP. Methods: Families with at least two members diagnosed with OLP were included. Clinical and demographic data and medical history were recorded. Results: Twenty families, 19 Jewish and 1 Arab, were identified. Of the Jewish families, 57.8% were non‐Ashkenazi, originating mainly from central Asia. Of those with OLP there were 14 males and 23 females with an average age of 49.1. Dyslipidemia, cardiovascular, and thyroid disorders (27.7%, 22.2%, and 16.6%, respectively) were the most common comorbidities. Five patients from five distinct families had oral cancer, two with second primary. Conclusions: To the best of our knowledge, this is the largest study describing familial OLP. The predominant and common ethnicity of the families with multiple members diagnosed with OLP may imply an ethnic tendency. The higher tendency of hypothyroidism and the high percentage of OSCC among familial OLP patients might be connected to familial OLP and the latter suggests that this population is predisposed to malignant transformation. Thus, this group should be considered as a high‐risk group. [ABSTRACT FROM AUTHOR]

An easy-to-use and reliable tool is essential for gait assessment of people with gait pathologies. This study aimed to assess the reliability and validity of the OneStep smartphone application compared to the C-Mill-VR+ treadmill (Motek, Nederlands), among patients undergoing rehabilitation for unilateral lower extremity disability. Spatiotemporal gait parameters were extracted from the treadmill and from two smartphones, one on each leg. Inter-device reliability was evaluated using Pearson correlation, intra-cluster correlation coefficient (ICC), and Cohen's d, comparing the application's readings from the two phones. Validity was assessed by comparing readings from each phone to the treadmill. Twenty-eight patients completed the study; the median age was 45.5 years, and 61% were males. The ICC between the phones showed a high correlation (r = 0.89–1) and good-to-excellent reliability (ICC range, 0.77–1) for all the gait parameters examined. The correlations between the phones and the treadmill were mostly above 0.8. The ICC between each phone and the treadmill demonstrated moderate-to-excellent validity for all the gait parameters (range, 0.58–1). Only 'step length of the impaired leg' showed poor-to-good validity (range, 0.37–0.84). Cohen's d effect size was small (d < 0.5) for all the parameters. The studied application demonstrated good reliability and validity for spatiotemporal gait assessment in patients with unilateral lower limb disability. [ABSTRACT FROM AUTHOR]

Sialography combined with cone beam computerized tomography (sialo-CBCT) is an imaging technique that demonstrates the ductal system of the major salivary glands and allows evaluation of gland function. This review describes the sialo-CBCT technique, terminology, common pitfalls and limitations, as well as radiographic features and suggested pathogenicity of various salivary gland disorders, based on 1,758 sialo-CBCT examinations conducted over the last decade in one institution, and the current literature. The adoption of standardized terminology is proposed to prevent miscommunication, facilitate formulation of differential diagnoses, and thereby promote patient management: (1) Sialo-CBCT requires specific training, and operator experience is required for adequate glandular filling with minimal extravasation; (2) Limit injection-to-scan time to avoid premature emptying; (3) The sialo-CBCT report should include a description of the morphology of the primary duct as well as the secondary, tertiary, and descending branches, the maximal branching level, the presence of sialectasis, overall glandular size, and parenchymal findings; (4) Functional evaluation is based on assessment of iodine clearance in the post evacuation image; (5) Sialectasis and ductopenia are the main findings in Sjogren syndrome and recurrent juvenile parotitis; (6) Sialodochitis with or without fillings defects or hyperdense calcifications characterize obstructive sialadenitis and sialolithiasis; (7) The findings following radioactive-iodine-induced damage are similar to obstructive sialadenitis, with atrophy in late stages; (8) In chronic graft-versus-host disease (cGVHD), variable presentations of ductopenia, sialectasis, and sialodochitis may be evident; (9) The red flags indicating a space-occupying lesion include areas of no filling, splaying of ducts, and primary duct deviation. [ABSTRACT FROM AUTHOR]

The relationship between ethnicity and chronic pain has been studied worldwide. The population of Israel includes two main ethnic groups, 75% Jews and 21% Arabs. The purpose of this study was to compare orofacial chronic pain characteristics and treatment outcomes between Jewish and Arab Israeli citizens. Two hundred patients admitted to the Orofacial Pain Clinic at Hebrew University–Hadassah School of Dental Medicine between 2017 and 2022 were selected randomly for this historical cohort study. Our cohort included 159 (79.5%) Jews and 41 (20.5%) Arabs. Twenty-six pain-related variables were compared of which only two differed significantly between the two groups, awakening due to pain and mean muscle sensitivity; both indicators were higher in the Arab group (p < 0.05). No differences were found in any of the other variables such as diagnosis, pain severity, onset, and treatment outcome. This minimal difference may be explained by the equal accessibility to medical services for all citizens, and the diversity of our staff that includes Jew as well as Arab service providers. These factors minimize or even eliminate racial bias, language, and cultural barriers, and is reflected in the minor differences in orofacial pain characteristics found between the two main ethnic groups in Israel. [ABSTRACT FROM AUTHOR]

Soft tissue oral biopsies (STOB) are commonly performed in the medical field to obtain tissue samples for diagnostic purposes. However, like all invasive procedures, these biopsies may carry risks, such as the development of chronic long-lasting neuropathic pain. This study aims to examine the occurrence of chronic pain following STOBs. A retrospective study was conducted on the medical records of 695 patients who underwent STOBs at the Maxillofacial Surgery Department of Hadassah Medical Center between the years 2013 and 2022. Demographic information, details of the procedure, histopathological diagnosis, and data related to post-procedure pain in the biopsy area were collected and analyzed. Out of the 695 patients, only 4 reports of chronic pain with mild intensity lasting more than three months following oral biopsy were documented, with incidence rate of 0.57%; all were females with a median age of 59 ± 2.0 years. The biopsies were taken from various sites and the common diagnoses were lichen planus, venous malformation, and fibromas. In conclusion, chronic pain after oral soft-tissue biopsies is rare, generally mild, and typically does not require extra therapy. These insights can aid clinicians and patients in making informed decisions about these procedures. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess and present, using sialo-cone beam computed tomography (sialo-CBCT) examination, cases of submandibular gland (SM) chronic obstructive sialadenitis (COS) caused by dental rehabilitation. Data Sources: Clinical and radiographic data of all patients referred for SM sialo-CBCT imaging in the Oral and Maxillofacial Imaging Unit with recurrent SM swelling between January 2012 and July 2015 were reviewed. Cases with suggested iatrogenic cause were selected and described. A literature review of similar cases was also performed. Results: Seventy-one patients with salivary gland (SG) swelling were referred for SM sialo-CBCT. Of these, 16 had implant-supported fixed partial prostheses and seven had full mandibular overdentures. In five patients, COS was diagnosed and a causal relationship between their dental rehabilitation and symptoms was suggested. A literature search revealed 11 cases of SM COS secondary to anterior mandibular rehabilitation. Conclusion: Clinicians rehabilitating the anterior edentulous mandibular region should be aware that both fixed and removable devices may block the orifices of the SM, causing COS. [ABSTRACT FROM AUTHOR]

Necrotizing sialometaplasia (NS) is a self-limiting, ulcerated, benign process, affecting minor salivary glands most commonly in the palate. The comorbidity of eating disorders with NS is rare. We present a patient with bilateral NS who suffered from frequent episodes of vomiting. Review of the literature revealed a handful of such cases. The possible role of vomiting in the pathogenesis of NS is argued. [ABSTRACT FROM AUTHOR]

Objective: Sjogren's syndrome (SjS) causes salivary gland impairment leading to oral dryness. Parotid sialo‐cone‐beam computerized tomography (sialo‐CBCT) demonstrates ductal architecture and to a lesser extent gland activity. This study characterizes radiographic features of patients suspected for SjS and looks for a possible correlation with the diagnosis of SjS. Methods: The clinical and radiographic data of suspected SjS/dry mouth patients referred for sialo‐CBCT in 2011–2014 were reviewed retrospectively. Two observers studied the scans for various radiographic features including duct morphology, level of branching, ductopenia and sialectasia. These features were analysed taking the specific clinical data and two sets of SjS criteria: The 2002 American‐European Consensus Group (AECG) and the 2012 American College of Rheumatology (ACR) Group. Results: Sialo‐CBCT scans of 67‐referred patients suffering from dry mouth (115 parotid glands) were included. Intraradiographic association was found between ductopenia and all other radiographic parameters. Minimal, yet important, radiographic differences were found between left and right parotid glands. AECG‐confirmed‐SjS patients showed strong correlation with radiographic features, whereas ACR 2012‐confirmed‐SjS patients did not. Conclusion: Sialo‐CBCT demonstrates novel radiographic features which may clarify the diagnosis of SjS. Further studies are needed to determine the role of sialo‐CBCT in diagnosis of SjS. [ABSTRACT FROM AUTHOR]

Purpose: Sirolimus, currently used as an immunosuppressant, is a potent mammalian target of rapamycin blocker with antiproliferative activity. Its potential for the management of oral pathologies and cancer and has been suggested. Topical application in the oral cavity can enhance availability and efficacy of the drug. The objective of this study was to establish an analytical method for determining sirolimus levels in human saliva in those using sirolimus chronically as well as calculation of the blood vs. saliva ratio. Materials and methods: Chemiluminescent microparticle immunoassay technology was used to determine blood and saliva levels of sirolimus in kidney transplant patients. All patients signed informed consent forms and an examination of the oral cavity was performed, clinical findings and oral symptoms, if any, were recorded along with the medical status of the patient. Blood and saliva samples were collected at the same time and analyzed. The study was approved by the institutional review board. Results: An analytical method for determining sirolimus levels in human saliva was established. Four patients were enrolled in the study. In all patients medication blood levels were stable. None of the patients had pathological lesions in their oral cavities. A substantial variability was observed among samples. No linear correlation was found. The saliva levels were on average four times lower than blood levels. Conclusions: The sensitive Chemiluminescent microparticle immunoassay method determined sirolimus levels both in saliva and blood in treated patients. Sirolimus saliva levels are significantly lower than blood levels.These results emphasize the need for delivery methods with better oral topical biological availability and reinforce the rationale for using sirolimus topically for the treatment of responsive oral pathologies. [Copyright &y& Elsevier]

Background: Sirolimus is a potent blocker of mammalian target of Rapamycin (MTOR), with anti proliferative activity. Its potential for the management of oral cancer has been suggested. Our aim was to establish an analytical method for determining sirolimus levels in human saliva and to calculate the blood vs. saliva ratio in individuals using sirolimus chronically in order to evaluate the total oral tissue exposure., Patients and Methods: Chemiluminescent microparticle immunoassay technology (CMIA) was used to determine the blood and saliva levels of sirolimus in four transplant patients chronically-treated with sirolimus., Results: An analytical method for determining sirolimus levels in human saliva was established. We demonstrated that saliva levels were on average six times lower than blood levels., Conclusion: The specific sensitive analytical method showed that the saliva levels of sirolimus are significantly lower than blood levels, thus reinforcing the rationale for the use of topical oral sirolimus to enhance availability, efficacy and safety for treating oral malignancies.