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Introduction: The routine assessment of intraoperative margins has long been the standard of care for oral cavity cancers. However, there is a controversy surrounding the best method for sampling surgical margins. The aim of our study is to determine the precision of a new technique for sampling tumor bed margins (TBMs), to evaluate the impact on survival and the rate of free flap reconstructions. Methods: This retrospective cohort study involved 156 patients with primary cancer of the tongue or floor of the mouth who underwent surgery as initial curative treatment. Patients were separated into 2 groups: one using an oriented TBM derived from Mohs' technique, where the margins are taken from the tumor bed and identified with Vicryl sutures on both the specimen and the tumor bed, and the other using a specimen margins (SMs) driven technique, where the margins are taken from the specimen after the initial resection. Clinicopathologic features, including margin status, were compared for both groups and correlated with locoregional control. Precision of per-operative TBM sampling method was obtained. Results: A total of 156 patients were included in the study, of which 80 were in TBM group and 76 were in SM group. Precision analysis showed that the oriented TBM technique pertained a 50% sensitivity, 96.6% specificity, 80% positive predictive value, and an 87.5% negative predictive value. Survival analysis revealed nonstatistically significant differences in both local control (86.88% vs 83.50%; P =.81) as well as local-regional control (82.57% vs 72.32%; P =.21). There was a significant difference in the rate of free flap-surgeries between the 2 groups (30% vs 64.5%; P <.001). Conclusion: Our described oriented TBM technique has demonstrated reduced risk of free flap reconstructive surgery, increased precision, and similar prognostic in terms of local control, locoregional control, and disease-free survival when compared to the SM method. [ABSTRACT FROM AUTHOR]

Ranula is a mucous cyst that occurs in the sublingual gland (SLG) in the floor of the mouth. It can be classified into two types based on origins: One is the the lesser sublingual gland (LSLG) in the anterior segment and the Rivini duct, which is connected to it, and the other is the greater sublingual gland (GSLG) in the posterior segment. Because of the anatomical characteristics, surgical resection of the cysts carries the risk of damaging adjacent tissues and has a high recurrence rate. Intralesional injection of sclerotherapy may be a better alternative treatment. We summarized 65 cases of ranula treated with intralesional injections of bleomycin(BML). According to the origin of the ranula, 60 cases were from the LSLG and the Rivini duct, and 5 cases were from the GSLG. The results showed that 60 cases of ranula from LSLG and Rivini ducts were 100% cured during the follow-up period. The median number of injections for all patients was 1.16. All 5 cases of ranula from the GSLG did not wholly recover. This study confirmed that BLM intralesional injection is a safe and effective treatment modality for cysts from LSLG or the ducts of Rivini rather than GSLG. Therefore, before treatment, it is necessary to determine the type and origin of the cyst by characterizing its morphology to ensure the effectiveness of the treatment. [ABSTRACT FROM AUTHOR]

Objectives: Sublingual varices are characterized by abnormally dilated veins. Some systemic conditions such as cardiovascular disease have been suggested to be associated with sublingual varices. Due to the convenience in examining the sublingual area, the present study aimed to assess the relationship between sublingual varices and hypertension. Materials and Methods: In this descriptive-analytic study, 500 patients were categorized into two groups: those with sublingual varices and those without. Two oral medicine specialists assessed the lesions, and the blood pressure of all patients was measured while they were in a relaxed sitting position. Age and gender data were recorded for all participants. Statistical analysis included t-test, chi-square, and logistic regression, with significance set at P<0.05. Results: The frequency of sublingual varices was 21.8%. Mean systolic blood pressure was 139.68±19.01mmHg in patients with sublingual varices and 118.09±13.78mmHg in patients without the lesions (P=0.561). Mean diastolic blood pressure was 100.45±17.81mmHg and 80.31±12.08mmHg in patients with and without sublingual varices, respectively (P<0.001). Smoking was significantly more prevalent among patients who had the lesions (P<0.05). Gender (P=0.686) and age (P=0.875) showed no significant relationship with sublingual varices, while smoking and blood pressure levels were significantly associated with these varices (P<0.001). Conclusion: It is advisable to monitor and manage blood pressure in patients with sublingual varices who may not be aware of their blood pressure status. Our results showed that smoking could be one of the predictive factors for sublingual varices. [ABSTRACT FROM AUTHOR]

Background: Acetaminophen (ACT) has been studied in septic patients with detectable plasmatic levels of cell-free hemoglobin (Hb), where it demonstrated to inhibit the hemoprotein-mediated lipid peroxidation and oxidative injury, with a potential of beneficial effect on the endothelium. On the basis of this background, the aim of this study was to evaluate the sublingual microcirculation and the peripheral tissue perfusion before-and-after administration of ACT on clinical judgment in a cohort of febrile septic and septic shock patients. Methods: Prospective observational study. 50 adult septic and septic shocks treated with ACT for pyrexia, where the sublingual microcirculation and the peripheral tissue perfusion with Near Infrared Spectroscopy (NIRS) and vascular occlusion test (VOT) were evaluated before ACT (t0), after 30 min (t1) and after 2 h (t2). Cell-free Hb and the markers of oxidative stress and endothelial damage were measured at t0 and t2. Results: The study showed a significant increase of the density of the perfused small and total vessels of the sublingual microcirculation 30 min after the infusion of ACT; it also showed an increase of the Microvascular Flow Index (MFI) and a decrease in the heterogeneity of the flow. At a peripheral muscular level, we found an acceleration in the reperfusion curve after VOT at t1, expression of a higher reactivity of the microvasculature. Conclusions: ACT infusion did not show a clear correlation with cell-free Hb; however, it exhibited protective effect toward the microcirculation that was evident in particular in septic patients. This correlation merits further exploration. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the occurrence of oral mucosal lesions (OML) in domestic waste collectors and their association with occupational exposure to domestic waste. This cross-sectional study included 295 adult men who worked in a waste management company: 129 men were exposed to domestic waste during their labor of waste collection, and 166 were not. The waste collectors used personal protective equipment. The lips, buccal mucosa and sulcus, gum, alveolar ridge, tongue, the floor of the mouth, and soft and hard palate were evaluated. The chisquare or Fisher's exact test assessed the variables associated with OML (P = 0.05). Twenty-five OMLs were observed in 22 volunteers, 8 in the exposed and 17 in the non-exposed group. Actinic cheilitis in the lips and candidiasis were the most common lesions in both groups. OML was not associated with waste exposure (OR= 0.72, 95% CI = 0.29-1.77, P = 0.47). There was no association between domestic waste exposure and actinic cheilitis (OR = 0.70, 95% CI= 0.23-2.15, P = 0.37), candidiasis (OR = 0.42, 95% CI= 0.08-2.12, P = 0.24) or leukoplakia (OR = 0.99, 95% CI= 0.97-1.01, P = 0.32). Actinic cheilitis in the lips and candidiasis were the most common lesions in both exposed and non-exposed groups. Occupational exposure to domestic waste was not related to OML. Proper use of personal protective equipment may have prevented the development of OML in domestic waste collectors. [ABSTRACT FROM AUTHOR]

The aim of the study was to dosimetrically compare interstitial high-dose-rate (HDR) brachytherapy (BT) and modern external beam radiotherapy modalities, as volumetric modulated arc therapy (VMAT) and stereotactic radiotherapy with Cyberknife (CK) of tumours of the tongue and floor of the mouth in terms of dose to the critical organs. In National Institute of Oncology, Budapest, between March 2013 and August 2022 twenty patients (11 male/9 female) with stage T1–3N0M0 tongue (n = 14) and floor of mouth (n = 6) tumours received postoperative radiotherapy because of close/positive surgical margin and/or lymphovascular and/or perineural invasion. High-dose-rate interstitial brachytherapy applying flexible plastic catheters with a total dose of 15 × 3 Gy was used for treatment. In addition to BT plans VMAT and stereotactic CK plans were also made in all cases, using the same fractionation scheme and dose prescription. As for the organs at risk, the doses to the mandible, the ipsilateral and the contralateral salivary glands were compared. The mean volume of the planning target volume (PTV) was 12.5 cm3, 26.5 cm3 and 17.5 cm3 in BT, VMAT and CK techniques, respectively, due to different safety margin protocols. The dose to the mandible was the most favourable with BT, as for the salivary glands (parotid and submandibular) the CK technique resulted in the lowest dose. The highest dose to the critical organs was observed with the VMAT technique. The mean values of D2cm3 and D0.1cm3 for the critical organs were as follows for BT, VMAT and CK plans: 47.4% and 73.9%, 92.2% and 101.8%, 68.4% and 92.3% for the mandible, 4.8% and 6.7%, 7.3% and 13.8%, 2.3% and 5.1% for the ipsilateral parotid gland, 3.5% and 4.9%, 6.8% and 10.9%, 1.5% and 3.3% for the contralateral parotid gland, 7.3% and 9.4%, 9.0% and 14.3%, 3.6% and 5.6% for the contralateral submandibular gland. The present results confirm that BT, despite being an invasive technique, is dosimetrically clearly beneficial in the treatment of oral cavity tumours and is a modality worth considering when applying radiotherapy, not only as definitive treatment, but also postoperatively. The use of the CK in the head and neck region requires further investigation. [ABSTRACT FROM AUTHOR]

Dermoid cysts and epidermoid cysts in the floor of the mouth are rare in the pediatric age group. In this case report, we have discussed the presentation, management, and literature review of a 6-month-old female child presenting with both dermoid and epidermoid cysts in the floor of the mouth with an orocutaneous fistula. [ABSTRACT FROM AUTHOR]

Objectives: Sublingual varices are characterized by abnormally dilated veins. Some systemic conditions such as cardiovascular disease have been suggested to be associated with sublingual varices. Due to the convenience in examining the sublingual area, the present study aimed to assess the relationship between sublingual varices and hypertension. Materials and Methods: In this descriptive-analytic study, 500 patients were categorized into two groups: those with sublingual varices and those without. Two oral medicine specialists assessed the lesions, and the blood pressure of all patients was measured while they were in a relaxed sitting position. Age and gender data were recorded for all participants. Statistical analysis included t-test, chi-square, and logistic regression, with significance set at P

Background: Sublingual varices (SV) are benign vascular lesions that have questionable associations with aging, smoking, and hypertension. This study purposed to evaluate whether SV frequency differs between hypertensive patients and healthy persons. Methods and Material: This cross-sectional study was conducted on 120 dental patients referred to Yazd Oral Medicine Department. At first sublingual surface of the tongue were examined before the routine oral survey, and blood pressure (BP) was measured in a sitting position. SV were classified into Grade 1 (no/mild), Grade 2 (medium to severe), and Grade 3 (multi-focal). Blood pressure was measured in all participants. Participants based on the obtained BP, divided into normal, prehypertension, stage 1, and 2 groups. Frequency of SV was compared in regarding age, gender, and stage of hypertension. All of the analyses were conducted at a p < 0.05 level of significance by the SPSS22 statistical package using chi-square test. Results: Out of 120 patients, 84 (70%) had SV. The frequency of SV in patients with hypertension (HT) (86.8%) was significantly higher than in others (48.1%); (p < 0.001). Data analysis showed there was a significant difference between the age groups. There was no significant difference based on SV between two genders. There was no significant difference in the frequency of sublingual varices between males and females. Aging could impact the frequency of SV. Conclusion: This study revealed that patients with hypertension had more SV. A simple valuable method for dental clinicians to be active in preventive health care is evaluating sublingual surface of tongue. [ABSTRACT FROM AUTHOR]

Implant dentistry is considered to be a safe and routine surgical procedure. However, cases of life-threatening hematoma of the floor of the mouth resulting in airway obstruction were previously reported as a complication of implant placement in the anterior mandible. Massive bleeding in this anatomical site may be caused by perforating the lingual cortex and/or damaging the lingual perimandibular vessels. In the long term, dental implants can fail, mainly due to peri-implantitis, and must be removed. Explantation procedure may occasionally become a complex challenge, with a risk for various complications. Case report: This report presents the first case of life-threatening hematoma of the floor of the mouth, as a complication secondary to a failed attempt of dental implant removal at the anterior mandible. The proximity of the implant to the lingual vascular canal might have served as a cause for vascular damage during explantation. Conclusions: Implant removal complications are scarcely described in the literature. Nonetheless, damaging blood vessels during explantation should not be underestimated. Computed tomography (CT) may be of value not only in preoperative implant planning but also before implant removal in jeopardized anatomical zones such as the anterior mandible. Lingual vascular canals should be looked for on computed tomography scans. [ABSTRACT FROM AUTHOR]

Context: Cellulitis of the floor of the mouth is dangerous condition because of their life-threatening potential due to their locations. Aims: The objective of this study was to evaluate and document the pattern of cellulitis of the floor of the mouth seen in a hospital of rural region of Cameroon. Settings and Design: This descriptive and prospective study was conducted in the Odontostomatology Unit of the Garoua Regional Hospital (Cameroon). Subjects and Methods: All patients presenting with cellulitis of the floor of the mouth between December 2020 and February 2021 were included in the study. The data concerning demography (age and sex), clinic (risk factors, symptoms, signs, etiology, and evolutionary stage), treatment (medical, surgical, and their evolution), and prognosis were analyzed using quantitative descriptive analysis. Results: Thirty-four patients representing 10.39% of the total consulted were enrolled. The male represented 55.88%. The mean age was 31.68 years. The etiology was odontogenic in 91.18% of cases. Swelling (100%), pain (100%), trismus (97.65%), dysphagia (88.23%), asthenia (76.47%), cervical spreading (58.82%), and poor oral hygiene (94.11%) were the main clinical signs. The cellulitis was suppurative in 76.47% of cases. All patients received probabilistic antibiotic therapy. Corticosteroids (61.76%), surgical (91.18%), and etiological treatment (82.35%) were associated. Complications occurred in 8.82% of cases. A favorable evolution was seen in 94.12% of cases. Death occurred in 5.88% of cases. Conclusions: Cellulitis of the floor of the mouth is still frequent in developing countries. Adequate management of these pathologies is the main condition to reduce their mortality rate. [ABSTRACT FROM AUTHOR]

Introduction: Opportunistic oral cancer screening during visits to the dentist is a non-invasive and accessible option for detection of pre-malignant lesions and early-stage malignancies. The objective of this study was to investigate the knowledge, practices, and attitudes towards oral cancer screening among dentists. Methods: A 42-item survey was sent to 650 dental professionals affiliated with the University of Toronto. Data regarding training/practice characteristics, knowledge of oral cavity cancer, current screening practices, attitudes towards screening, and remuneration were collected. Results: Ninety-one dentists responded. Most obtained their dental degree from Canada (71.4%) and were practicing in large urban centers (87.9%). Most dentists correctly identified the oral tongue (87.8%) and floor of mouth (80%) as the two of most common sites of oral cavity cancer but only 56% correctly identified the most common presentation. 91% performed intra/extra oral examinations at every patient visit. Only 9.9% of dentists discussed the risk factors of oral cancer and 33% were not familiar with resources for smoking cessation and alcohol abuse. International medical graduates were more likely to discuss risk factor management than Canadian medical graduates (p < 0.01). Over 80% of dentists referred to a specialist when a suspected lesion was found. The greatest barrier for oral cancer screening was lack of time. Almost all dentists (98.8%) reported that their screening practices do not differ depending on the patient's insurance status and 63.8% reported compensation would not influence their decision to perform oral examinations. Conclusion: Most dentists have a good knowledge of the presentation and risk factors associated with oral cavity cancer. Most dentists perform screening with every patient, with no influence from compensation and insurance status. Dentists are therefore an excellent first contact for oral cavity cancer screening for the general public and for high-risk populations. [ABSTRACT FROM AUTHOR]

A dermoid cyst is a benign congenital lesion of ectodermal origin that can arise in any region of the body, though occurrence is rare. A young girl aged 2 years 4 months was referred to our hospital because of a painless mass in the floor of the mouth. Intraoral examination findings revealed a painless movable elastic soft mass on the floor of the mouth measuring approximately 15 mm in diameter. Magnetic resonance imaging indicated a cystic lesion, with low signal intensity shown in T1-weighted and extremely high signal intensity in T2-weighted images. These clinical findings indicated the presence of a dermoid cyst and removal was planned. Under general anesthesia with nasal intubation, surgical removal was performed through an incision on the floor of the mouth. Blunt dissection exposed the integrity of the cyst capsule, which was weakly attached to adjacent tissue. The excised mass was 19 mm × 14 mm × 11 mm in size. Histological examination findings confirmed a diagnosis of dermoid cyst. The operation was successfully completed without any complications and the postoperative course was good. It is important to properly evaluate cysts in children and provide proper treatment with appropriate timing. [ABSTRACT FROM AUTHOR]

The floor of the mouth is an important anatomical region of the oral cavity where primary benign and malignant disease processes can originate or secondary pathologies can extend into adjacent spaces. Knowledge of the anatomy is crucial for accurate localisation of pathology and understanding the spread of disease. The sublingual space is the dominant component of the floor of the mouth, bounded inferiorly by the mylohyoid muscle that separates it from the submandibular space. Imaging is immensely important to characterise and map the extent of disease, considering the fact that the bulk of the disease may be submucosal and not visible on clinical inspection. Contribution: The floor of the mouth is a complex anatomical region for radiological evaluation. The purpose of this pictorial review is to present an understanding of the relevant anatomy and to demonstrate the role and appropriate application of different imaging modalities. This article highlights the imaging spectrum of a wide range of various benign conditions including normal variants and a variety of malignant lesions at different tumour stages, with an aim to establish the correct diagnosis, avoid misinterpretation and help in treatment planning. [ABSTRACT FROM AUTHOR]

Simple Summary: This brief review describes cases of oral cancer arising from GVHD in patients who underwent haematopoeitic stem cell transplantation (HSCT) as children. The risk of developing secondary solid malignancies after HSCT is well known, and, of the various cancers, oral squamous cell carcinoma (OSCC) is one of the most common. In the literature, there are no summary studies on this topic in the population of patients who have been transplanted as children. So, here we report all the published data on HSCT pediatric patients, affected by oral GVHD, who have been developed OSCC, with the aim of promoting the prevention of oral cancer in this patient setting. After haematopoietic stem cell transplantation and a history of GVHD, the risk of developing secondary malignancies, including oral cancer, is higher. This risk increases with time post-transplantation; therefore, pediatric patients undergoing HSCT, who have long-term survival chances, are in a high-risk category. The aim of this review is to provide data on HSCT, GVHD, clinical manifestations, histological features and treatment of oral cancer, and outcomes in HSCT pediatric patients, affected by oral GVHD, who have been developed OSCC. Descriptive statistics were used to validate data. Fifteen studies on a total of 33 patients were selected. Data on oral cancer showed that the tongue was the most frequently involved site (13 pts; 39.39%), followed by the floor of the mouth (4 pts; 12.12%), and buccal mucosa (4 pts; 12.12%). Oral squamous cell carcinoma was the histological feature reported. There were 19 (57.58%) deaths occurring between 2 and 46.5 months after OC diagnosis. Eleven patients survived with a median follow-up of 34 months. Considering the high risk of developing oral cancer, a conventional oral examination every 6 months is recommended for HSCT pediatric patients who have developed GVHD. [ABSTRACT FROM AUTHOR]

Introduction: Body piercings consist of small holes made with a needle in different parts of the skin or body to introduce a jewel or decorative element. In the oral cavity, most piercings are placed in the tongue. However, some complications may occur, and surgical techniques must be used for their removal. These complications present a certain degree of difficulty due to their position and may challenge the ability of the clinician to access the specific anatomical location. The different imaging techniques, from simple radiography to intraoperative techniques such as image intensifiers, have become an extremely useful tool for locating an object in the three dimensions of space, allowing safe location and extraction. Objective: The aim of this study is to report the case of a complication of a body piercing in the oral cavity and how the use of imaging was decisive for surgical planning and for the quick and effective resolution of the case. Material and Methods: A 14-year-old female patient came looking for treatment. Her mother reported the onset of the condition after the insertion of a needle-like metallic object while performing an artistic perforation in the lingual region. Since the girl was unable to extract the object, she sought medical advice at the Carlos Arvelo Military Hospital in Caracas, Venezuela. Subsequently, an imaging study was performed by means of a Computed Tomography to locate the metallic object. It was observed that the foreign body had migrated to the floor of the mouth/sublingual region, requiring the area to be surgically approached. It was also decided to use an intraoperative image intensifier. The removal of the object was performed satisfactorily. Conclusion: The extraction of foreign bodies placed in the lingual and sublingual region represents a challenge for the clinician due to the number of important anatomical structures that pass through that area. This makes clinicians plan their surgical removal using pre- and intraoperative imaging, to find a less traumatic location, reduce surgical time as well as the risk of damaging adjacent anatomical structures.

Dermoid cysts are benign cutaneous neoplasms that contain germ cells from the ectoderm and mesoderm. Approximately 70% are diagnosed during childhood before the age of 5. Although they can present throughout the body, the prevalence is 7% for those arising from the head and neck. These lesions present primarily as midline masses and are classified as sublingual, submental, or overlapping depending on their relationship with the muscles of the floor of mouth. A 10-year-old female presented with a 2-week history of right submental swelling. She denied pain, dysphagia, odynophagia, or respiratory distress. Physical examination showed nontender fullness of the submental region without erythema or induration and no palpable cervical lymphadenopathy. Ultrasound showed an oval-shaped cystic mass measuring 4.8 × 4.0 × 2.6 cm. After a course of clindamycin, a computed tomography was obtained which showed a right 4.5 × 4.0 × 2.6 cm fluid filled lesion, within the right lateral floor of mouth. Intraoral resection was performed and the mass was freed from the geniohyoid and mylohyoid. Histopathology was consistent with a dermoid cyst. Submental masses have a broad differential, but rarely are they dermoid cysts if they arise lateral to the midline. With appropriate diagnosis and total surgical excision, patients and their families can be reassured in similar cases. [ABSTRACT FROM AUTHOR]

Simple Summary: Viruses are well known causes of several human malignancies. Oral squamous cell carcinoma (OSCC) is rising in patients with limited exposure to traditional risk factors, including smoking. As a causative factor of OSCC is yet to be found, our study aimed to identify a virus that may drive this cancer. First, we examined whole genome sequencing data from 28 patients under the age of 50 with limited exposure to carcinogens for viruses. Using viral detection software that screens for >700,000 viruses, we identified one 49 year old male patient with human papillomavirus (HPV). We further validated our findings in 657 patients, using immunohistochemistry and RNA in situ hybridization specific for HPV, and identified 8 (1.2%) male patients with HPV integration. Through a comprehensive search for viruses and evaluation in a large patient OSCC cohort, we demonstrate that viral integration occurs in a minority of male OSCC patients. Viruses are well known drivers of several human malignancies. A causative factor for oral cavity squamous cell carcinoma (OSCC) in patients with limited exposure to traditional risk factors, including tobacco use, is yet to be identified. Our study aimed to comprehensively evaluate the role of viral drivers in OSCC patients with low cumulative exposure to traditional risk factors. Patients under 50 years of age with OSCC, defined using strict anatomic criteria were selected for WGS. The WGS data was interrogated using viral detection tools (Kraken 2 and BLASTN), together examining >700,000 viruses. The findings were further verified using tissue microarrays of OSCC samples using both immunohistochemistry and RNA in situ hybridisation (ISH). 28 patients underwent WGS and comprehensive viral profiling. One 49-year-old male patient with OSCC of the hard palate demonstrated HPV35 integration. 657 cases of OSCC were then evaluated for the presence of HPV integration through immunohistochemistry for p16 and HPV RNA ISH. HPV integration was seen in 8 (1.2%) patients, all middle-aged men with predominant floor of mouth involvement. In summary, a wide-ranging interrogation of >700,000 viruses using OSCC WGS data showed HPV integration in a minority of male OSCC patients and did not carry any prognostic significance. [ABSTRACT FROM AUTHOR]

BackgroundMildly elevated lactate levels (i.e., 1-2 mmol/L) are increasingly recognized as a prognostic finding in critically ill patients. One of several possible underlying mechanisms, microcirculatory dysfunction, can be assessed at the bedside using sublingual direct in vivo microscopy. We aimed to evaluate the association between relative hyperlactatemia, microcirculatory flow, and outcome.MethodsThis study was a predefined subanalysis of a multicenter international point prevalence study on microcirculatory flow abnormalities, the Microcirculatory Shock Occurrence in Acutely ill Patients (microSOAP). Microcirculatory flow abnormalities were assessed with sidestream dark-field imaging. Abnormal microcirculatory flow was defined as a microvascular flow index (MFI)  1.5 mmol/L was independently associated with a MFI

Reporting a case of simultaneous bilateral oral ranula treated by marsupialization and to present a literature review on the profile of affected patients and also to correlate the treatment. Woman presenting a simultaneous bilateral oral ranula with no apparent etiology. Marsupialization was performed on both sides with the preservation of sublingual glands. No recurrence has been noted for 2 years of following. The literature review was conducted in August 2021 using PubMed, Web of Science, Embase, Scopus, LILACS and OpenGrey databases. Included articles were reviewed for mean age at presentation, gender, average size, treatment and recurrence. Literature review revealed 6 previous reported cases of bilateral oral ranula occurring simultaneously. Only 6 cases of bilateral oral ranula occurring simultaneously have been described in the literature. In general, the treatment is the excision of the lesion and also of the associated gland, as it has a lower recurrence rate. However, in the present case, we proposed marsupialization as a less invasive conduction of bilateral oral ranula occurring simultaneously, and the remission of the lesion occurred after this treatment with preservation of the gland. [ABSTRACT FROM AUTHOR]

Sublingual hematoma is a serious complication associated with anterior mandible surgery. It presents considerable risk due to the potential for airway obstruction, which can be life-threatening and necessitates prompt diagnosis and intervention. This case report describes the occurrence of sublingual hematoma following mandibular midline osteotomy and the subsequent management of this condition. Mandibular midline osteotomy is performed to correct skeletal or dental discrepancies in the transverse plane. Sublingual hematoma as a complication of a midline osteotomy has not been previously documented in the literature. This article provides a comprehensive review of the various etiologies associated with sublingual hematoma, along with its management modalities.

Objective: To investigate whether sublingual varices are constant or inconstant over time and whether this is connected to background variables, cardiovascular risk factors or disease. Design: This longitudinal observational study was performed between 2010 and 2020 at the Public Dental Services Västra Vall, Varberg, Sweden. The study was based on 431 patients included in a previous study in which the relationship between sublingual varices and hypertension was examined. In connection to the annual dental examination, 281 patients were included in the follow-up study. They completed a questionnaire about background and health factors and diseases. Length and weight were measured. Two intraoral photos were taken with a digital camera. Two dentists independent of each other graded all photographs as none/few visible sublingual varices (nSV) or medium/severe sublingual varices (SV). Results: The prevalence of SV was 25.6% at baseline and 30.6% at follow-up. At the follow up, a total of 76.5% had maintained their sublingual vascular status. Of those with nSV at baseline (n209), 80.9% still had nSV, and 19.1% had developed SV during the 8-year follow-up period. Of those 72 participants who had SV at baseline, 46 (63.9%) were unchanged at follow-up, and 26 (36.1%) were classified as nSV. Those who had developed SV at follow-up had a higher mean age (p = 0.003) and a higher prevalence of cardiovascular disease (CVD), 13.2% versus 3.0% (p = 0.021). This association with CVD did not persist after an adjustment for sex and age (OR 3.2, 95% CI 0.81–12.46). They exhibited more hypertension (35.0% vs. 22.5%) and diabetes type 2 (7.5% vs. 3.0%), but with no significant difference. Conclusions: This study revealed that 76.5% of the participants had an unchanged status regarding sublingual varices during an 8-year period and that the development from nSV to SV was associated with advanced age. [ABSTRACT FROM AUTHOR]

Background: Schwannomas or neurilemmomas are well-encapsulated, benign, solitary, and slow-growing tumors that originate from Schwann cells of the nerve sheath. Extracranial schwannoma is reported to have a relatively high incidence in the tongue while an extremely low incidence in the floor of mouth. In the current study, we presented the first case series of hypoglossal nerve-derived schwannoma in the floor of mouth in Asia. Methods: A retrospective study of 9 surgical cases of hypoglossal nerve-derived schwannoma in the floor of mouth was performed. The patient and tumor characteristics were evaluated by physical, radiological and pathological examination. Details of operation and complications were also recorded. Results: Hypoglossal nerve-derived schwannoma in the floor of mouth showed a well-defined boundary with a firm texture, smooth surface and good mobility on palpation. The median maximum diameter of the tumors was 4.3 cm (range 2.8–7.0 cm). The median operative time and bleeding volumes were 89.4 min (range 47–180 min) and 99.2 mL (range 15–200 mL), respectively. All cases received complete surgical excision. Conclusion: In this study, we presented the diagnosis and management of hypoglossal nerve-derived schwannoma in the floor of mouth for the first time in Asia. The study provided us with a recommendation for consideration of the diagnosis of hypoglossal schwannoma when a patient presents with a mass in the floor of mouth. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate long-term survival rates and radiographic stability of sinus floor elevations carried out using a two-layer grafting technique. Materials and Methods: Records were analyzed for patients treated with sinus floor elevations using a modified technique. Phycogenic hydroxyapatite (Algipore, Dentsply Sirona Implants) and autogenous bone particles harvested from intraoral sites were grafted in two distinct layers after elevation of the sinus mucosae. In this approach, the basal part of the sinus floor is grafted with autogenous bone, while the cranial part is grafted with the phycogenic hydroxyapatite. In some cases, implants were placed simultaneously, such that the entire surface of each implant was covered by autogenous bone particles. A titanium membrane was used to close the sinus window, and the implants were loaded 3 months later. In two-stage approaches, the implants were inserted 3 to 4 months after the grafting and loaded after 3 additional months. Panoramic radiographs were taken after the grafting procedure, after implant insertion, after the prosthetic restoration, and then annually for 10 years. These radiographs were used to measure the height between the implant shoulders and the top of the graft. Results: Of the 214 sinus floor elevations performed on 129 patients using the bilayering technique, 198 procedures in 118 patients were included in the study (136 one-stage and 62 two-stage). Membrane perforations during surgery occurred in 17.9% of the procedures and were sutured and sealed with fibrin glue. A total of 487 implants were placed in the grafted areas. No severe postoperative complications occurred, but three implants were lost throughout the 10-year follow-up period. A small decrease of vertical height was observed between the grafting surgery and the stage-two surgery (mean: 1.8 mm). After that, no bone height was lost over the 10 years. Conclusion: The layer grafting technique in combination with sinus floor elevation resulted in radiographically stable vertical bone height for 10 years. This technique enabled early placement and loading of implants in the grafted areas. The survival rate obtained with this procedure is similar to that expected for implants placed in nongrafted areas. [ABSTRACT FROM AUTHOR]

Background: Infection caused by Actinomyces species is a rare cause of head and neck infection in children. This chronic cervicofacial infection can present with localized swelling, abscess formation, sinus drainage and can be complicated by osteomyelitis. Methods: Presented are 2 pediatric cases of secondary actinomycosis in the context of congenital lesions: 1 patient with a previously excised preauricular sinus and another with a persistent sublingual mass. A comprehensive literature search was conducted for reported cases of pediatric actinomycosis in the cervicofacial region. Results: Both cases presented were successfully treated with a combination of complete surgical excision of the lesions and prolonged antibiotic therapy. Thirty-four pediatric cases of cervicofacial actinomycosis are reviewed, 2 presented herein, and 32 from the published literature. There was equal gender distribution and the median age was 7.5 years. The most common site for infection was the submandibular area. Four (12%) of cases arose in pre-existing congenital lesions. Most patients were treated with penicillin-based antibiotics for a median duration of 6 months following surgical excision or debridement. Conclusions: Actinomycosis is a rare infection of the cervicofacial region; secondary infections arising from congenital lesions of the head and neck are even more rare. A previously excised pre-auricular sinus and a sublingual dermoid cyst are not previously reported sites of infection. Actinomycosis should be suspected in chronically draining sinuses of the head and neck region and confirmed through anaerobic culture. Osteomyelitis is a potential complication and magnetic resonance (MR) imaging is warranted. Long-term antibiotic therapy with a penicillin-based antibiotic and surgical excision should be considered. [ABSTRACT FROM AUTHOR]

Oral varices are a common acquired vascular malformation that might be associated with several heart diseases. The aim of this study was to investigate whether an association exists between the severity of sublingual varices and stage of hypertension. Oral examinations were conducted, and the sublingual varicosity of 151 patients was categorized as grade 0,1, or 2 based on severity. The blood pressure of the patients was measured and classified as normal, prehypertenslon, stage 1 hypertension, or stage 2 hypertension according to the guidelines of the National Heart, Lung, and Blood Institute. Pearson chi-square test, linear-by-linear association, and logistic regression were used for data analysis. Of 151 patients, 91 (60.3%) had sublingual varices, with 68 (45.0%) having grade 1 varicosity and 23 (15.2%) having grade 2. Sublingual varices were seen most frequently (84.4%) in patients older than 60 years. The frequency of hypertension (stage 1 or 2) among the sample was found to be 24.5%. The Pearson chi-square test showed a positive correlation between hypertension and sublingual varicosity (P < 0.0001; y = 0.499). Logistic regression showed that the risk of hypertension in patients with grades 1 and 2 sublingual varicosity was 2.53 and 7.57 times greater, respectively, than that In patients with grade 0. In addition, sublingual varicosity (grade 1 or 2) was 2.32 times more frequent in men than in women (P = 0.022; 95% CI = 1.12-4.79) and 3.55 times more frequent in smokers than in nonsmokers (P = 0.003; 95% CI = 1.01-1.06). Therefore, sublingual varicosity may be a sign of hypertension. [ABSTRACT FROM AUTHOR]

The lymph node ratio (LNR) has been proposed as an independent prognostic factor for survival in patients with oral squamous cell carcinoma (OSCC). However, little attention has been paid to its role in the specific subsite of the floor of the mouth (FOM). The purpose of this study was to evaluate the prognostic significance of the LNR in patients with FOM SCC. A retrospective analysis of 92 patients with FOM SCC who were treated with primary curative resection and neck dissection was conducted. Overall survival (OS) and disease-free survival (DFS) were used to evaluate the prognostic significance of the LNR. Both of these parameters were significantly worse (P < 0.001) in patients with neck metastases. The mean LNR was 0.145 in patients with positive lymph nodes. A LNR <0.145 was predictive of longer DFS, while the receiver operating characteristic curve analysis demonstrated that a LNR ≥0.175 indicated a significantly lower OS. This study confirms that metastatic cervical lymph nodes correlate with an adverse prognosis in patients with FOM SCC, and specifically, a LNR ≥0.145 is predictive. Therefore, the LNR in patients with FOM SCC may be a predictor of survival in these patients. [ABSTRACT FROM AUTHOR]

Shallow lingual vestibule and lack of keratinized attached mucosa are considered risk factors for the long‐term success of dental implants. This article describes a modified surgical approach accompanied by a free gingival graft to correct the shallow lingual/buccal vestibule and to increase the keratinized tissue around dental implants. [ABSTRACT FROM AUTHOR]

Background: Oral floor ranulas are pseudocysts located in the floor of the mouth that result from the extravasation of mucus from a sublingual gland. Historically, there has been little consensus on the ideal first-line treatment. Currently, definitive treatment involves sublingual gland excision, which can injure the lingual nerve and submandibular duct. Minimally invasive surgical techniques have been proposed, but so far have been associated with a high rate of recurrence. Methods: The so-called piercing–stretching suture technique was performed in 14 naïve adult and paediatric patients (6 females, with a mean age of 20.3 years (range, 7–55 years)). Clinical and ultrasonographic evaluations were performed in all patients; post-operative sialendoscopy was conducted in two paediatric patients. Results: The surgical procedure was successful in all patients, and complete recovery of the ranula was seen in all but one of the patients who underwent suture replacement. No major or minor complications were encountered. Conclusion: This minimally invasive procedure may be considered a reliable and first-line treatment for management of simple oral floor ranulas. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to retrospectively evaluate the radiation dose and complications in soft tissue and mandible caused by 198Au grain brachytherapy alone or the combination with other modalities in patients with the cancer of the floor of the mouth. Materials and methods: Twelve patients with T1 (n = 5) and T2 (n = 7) squamous cell carcinoma of the floor of the mouth, who were treated with 198Au grain brachytherapy alone (n = 5) or the combination of external beam radiotherapy (EBRT) and/or chemotherapy and 198Au grain brachytherapy (n = 7) from January 2005 to December 2016, were included. The relationships between the radiation dose and the complications of the soft tissue or mandible were investigated. Results: Seven of 12 patients had died. Of these 7 patients, one with T1 and 2 with T2 had died of the causes related to the cancer of the floor of the mouth. Two with T1 and 2 with T2 had died of other diseases. Two patients had grade 2 complications of the soft tissue and mandible. These patients were treated by the combination of EBRT and/or chemotherapy and 198Au grain brachytherapy and irradiated with 123 or 139 Gy in total dose, respectively. And one of these patients was treated by the chemotherapy in addition to EBRT. Conclusion: Our study showed that the combination of EBRT and 198Au grains brachytherapy for the floor of the mouth cancer patients might be associated with risks of developing complications of soft tissue ulcer and mandibular bone necrosis. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to use magnetic resonance imaging (MRI) to determine the relationship between the pathological depth of invasion (DOI), undetectability, and tumor thickness of squamous cell carcinoma of the floor of the mouth. Materials and methods: We retrospectively evaluated the relationship between pathological DOI and MRI detectability, as well as the relationship between pathological DOI and tumor thickness on coronal fat-suppressed contrast-enhanced T1-weighted imaging or coronal T2-weighted imaging. Results: We analyzed 30 patients with squamous cell carcinoma of the floor of the mouth; MRI revealed that the pathological DOI of the 11 undetectable lesions (median 2 mm) was smaller than that of the 19 detectable lesions (median 14 mm) (p < 0.001), and the cut-off value was 3 mm (sensitivity, 0.84; specificity, 0.91; area under the curve, 0.89). Tumor thickness on coronal fat-suppressed contrast-enhanced T1-weighted imaging was assessed in all 19 detectable lesions; however, tumor thickness on coronal T2-weighted imaging could not be assessed in eight cases. Tumor thickness on coronal fat-suppressed contrast-enhanced T1-weighted imaging was found to be significantly associated with the pathological DOI. Conclusions: Undetectability on MRI indicates superficial lesions with a pathological DOI value that is less than 3 mm. In detectable lesions, tumor thickness on coronal fat-suppressed contrast-enhanced T1-weighted imaging is associated with pathological DOI. [ABSTRACT FROM AUTHOR]

Abstract Various cases of introduction of air into soft tissues have been reported in the dental literature. Here, we report a rare case of localized sublingual emphysema after alveoloplasty. There was no facial involvement. The patient responded to treatment and recovered uneventfully.

Abstract Shallow lingual vestibule and lack of keratinized attached mucosa are considered risk factors for the long‐term success of dental implants. This article describes a modified surgical approach accompanied by a free gingival graft to correct the shallow lingual/buccal vestibule and to increase the keratinized tissue around dental implants.

Background: The aim of this study is to evaluate the implant survival/success rate, gain in alveolar bone height, crestal bone loss, and complications associated with implants placed in the posterior maxilla after osteotome sinus floor elevation without bone substitutes. Methods: The electronic databases, such as MEDLINE, EMBASE, CENTRAL, and SCOPUS were systematically and manually searched for publications in peer-reviewed journals. The included articles were subjected to qualitative and quantitative analyses, and the meta-analysis was carried out for single-arm studies. Methodological quality assessment was made for all the included studies. Results: The included studies were of moderate quality, with the overall implant success and survival rates of 98.3% and 97.9% respectively. The most frequent intra-surgical complication was sinus membrane perforation, accounting for 3.08% of the total implants with reported perforations. The overall crestal bone loss in patients with immediate implants placed with OSFE after a 5-year follow-up was 0.957 mm 95%CI (0.538, 1.377). Conclusion: Within the limitations of this review, it can be concluded that the survival and success rates of implants placed immediately along with OSFE without any bone substitutes are acceptable and show adequate implant stability with less crestal bone loss over 5 years. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the existence of any connection between smoking and sublingual varices (SLV) in the older population. Methods: This case-control study was conducted in 2019 on adults > 65 years old at Kahrizak Charity Nursing Home, Alborz, Iran. We conducted clinical examination and inspection of 222 elderly patients. Both the case group and control group contained the same number of patients (n = 111). SLV were classified as grade 0 (few or none visible) and grade 1 (moderate or severe). The case group included patients with SLV and the control group consisted of those older adults without SLV and who were matched with the case group based on age, gender, blood pressure, denture wearing, and varicose veins in their legs. Cigarette smoking habits were investigated in both groups. Smokers were considered those who smoked at least one cigarette per day for more than six months. Chi-square and odds ratio (OR) were used to statistically analyze the exposure of participants to smoking in both groups. Results: Among 222 participants, 21.6% and 5.4% were smokers in the case and control groups, respectively. The results of our data analysis revealed that SLV were significantly associated with smoking (p < 0.001, OR = 4). Conclusions: Elderly patients with SLV are more likely to be cigarette smokers. Therefore, cigarette smoking cessation programs are recommended for older adults in society. [ABSTRACT FROM AUTHOR]

Introduction: To compare Submental Island flap versus pectoralis major myocutaneous flap as reconstruction options for large oral cavity defects after resection of malignant tumors. Patients and methods: This study is a retrospective observational cohort that included 44 patients from March 2009 to March 2018. In this study, we evaluated two options for oral cavity reconstruction: submental island flap (28 patients) and pectoralis major myocutaneous flap (PMMF) (16 patients), as regards the functional, aesthetic, and oncologic outcomes. Results: The mean operative time was 4.71 ± 1.88 hours, and the mean operative blood loss was 512 ± 186.42 ml. The mean hospital stay was 16.72 ± 10.77 days. The mean time to start of oral fluids intake was 14.1 ± 6.62 days. There were two postoperative deaths. Reconstruction related complications occurred in 21.4% in the submental island flap group and 6.2% in the PMMF group. Total flap loss was reported in 4 of our patients (9.1%) [3 submental; 1 PMMF], while partial flap loss was reported in 3 submental flaps (6.8%). There was no statistical significance in functional outcomes except in feeding function. There was no statistical significance in aesthetic outcomes between the 2 groups. Conclusion: Pedicled flaps for oral cavity reconstruction especially submental island flap and PMMF are considered simple, timesaving, relatively safe, with minimal donor site morbidity. [ABSTRACT FROM AUTHOR]

Introduction: One of the most challenging cases in implantology is severely atrophic alveolar ridges which do not have adequate bone for implant placement. One common treatment option for dealing with this challenge is LeFort I osteotomy with inlay bone graft which allows implant insertion and correction of the maxillomandibular relationship simultaneously. Although this method has a high success rate, it is somewhat invasive and has potential complications in some cases. In recent decades, implant surgeons have focused on less invasive and more predictable treatment options for bone augmentation and implant rehabilitation. Now a question comes into mind when there are not much discrepancies in maxillomandibular skeletal relationship and inter arch distance, do we really need LeFort I down-grafting and take its risks? Methods: In this study, we present a case who did not need any change in the skeletal relationship of the jaws and inter arch space based on examination and prosthetic consultation, so we implemented bilateral simultaneous sinus and nasal floor augmentation instead of LeFort 1 interpositional inlay bone graft. Results: Six months after the surgery, new radiography showed adequate height and width of augmented bones gained in and under sinuses and nose floor. So there is no limitation on choosing suitable implant lengths and diameters. Conclusion: This study indicated successful augmentation of severely resorbed maxillary alveolar ridge with bilateral sinus and nose floor grafting technique instead of LeFort I interpositional bone graft in a case who didn't have more discrepancies in skeletal and inter arch space. [ABSTRACT FROM AUTHOR]

Typically, the greater the atrophy of the process, the more extensive and invasive the sinus floor elevation procedure is. This case of a 39-year-old man demonstrates a minimally invasive hydrostatic sinus lift from 1.7-mm height process in the site of lost tooth No. 16. Using a small flap, safe drills for a crestal approach diameter of 2.8 mm, 2 mL of saline solution under pressure of a syringe plunger, and 1 g of particulated bovine xenograft, a 14-mm height and 12-mm width sinus floor elevation was obtained. The implant was placed with a torque of 30 Ncm, and a healing cap was attached. Despite the very difficult conditions, the presented method not only resulted in a very good therapeutic effect but also reduced the number of procedures and time necessary for complete rehabilitation of the patient. The total treatment time to the final crown delivery was 6 months. [ABSTRACT FROM AUTHOR]

A correction to the article "Relationship between sublingual varices and hypertension: a systematic review and meta-analysis" is presented, addressing a clarification regarding the classification of sublingual varices used in previous studies.

Surgical excision is an effective treatment for a dermoid cyst (DC) of the floor of the mouth (FOM). A dichotomy of opinions exist regarding the appropriate approach to surgical excision. In this study, we discuss our experience with excising a large DC via an intraoral route. An 18-year-old female presented with swelling of the submental region for one year. Under general anesthesia, an incision was conducted in the mucosa of FOM. By removing some contents, the cyst was delivered in toto. While some studies have stressed that the location of origin and size of the DC influence the route of excision, other authors have pointed out that by the time both median genioglossal and geniohyoid cysts become large enough to produce symptoms, both the muscles are splayed out and thus, the cysts are more amenable to excision by intraoral approach. This case highlights a dichotomy of opinion regarding the existing literature and to educate the clinicians about the benefits of the intraoral route of excision. [ABSTRACT FROM AUTHOR]

Lipomas are relatively rare in the head and neck, and sialolipoma was described as an entity about 20 years ago as lipoma that entraps salivary gland tissue. Less than 10 cases have been described in the floor of the mouth not related to the major salivary glands. Here, we report a case of sialolipoma affecting the floor of the mouth in a 47-year-old patient and reviewed the clinical, histologic, and immunohistochemical characteristics of the lesion. [ABSTRACT FROM AUTHOR]

Background: Histologic grade assessment plays an important part in the clinical decision making and prognostic evaluation of squamous cell carcinoma (SCC) of the oral tongue and floor of mouth (FOM).Purpose: To assess the value of apparent diffusion coefficient (ADC)-based radiomics in discriminating between low- and high-grade SCC of the oral tongue and FOM.Material and Methods: We included data from 88 patients (training cohort: n = 59; testing cohort: n = 29) who underwent diffusion-weighted imaging with a 3.0-T magnetic resonance imaging scanner before treatment. A total of 526 radiomics features were extracted from ADC maps to construct a radiomics signature with least absolute shrinkage and selection operator logistic regression. Receiver operating characteristic curves and areas under the curve (AUCs) were used to evaluate the performance of radiomic signature.Results: Five features were selected to construct the radiomics signature for predicting histologic grade. The ADC-based radiomics signature performed well for discriminating between low- and high-grade tumors, with AUCs of 0.83 in both cohorts. Based on the cut-off value of the training cohort, the radiomics signature achieved accuracies of 0.78 and 0.79, sensitivities of 0.65 and 0.71, and specificities of 0.85 and 0.82 in the training and testing cohorts, respectively.Conclusion: ADC-based radiomics can be a useful and promising non-invasive method for predicting histologic grade of SCC of the oral tongue and FOM. [ABSTRACT FROM AUTHOR]

This clinical report describes a combined lateral-crestal approach to elevate the sinus floor when placing implants on a wide maxillary posterior ridge. The buccally enlarged osteotomy broadens the vision of practitioners and facilitates access of instruments in the sinus. Compared with the traditional lateral approach of sinus lift, the proposed technique offers a more conservative treatment modality. A clinical study with sufficient subjects and long-term follow-up is needed to validate the potential and limitations of the proposed technique. [ABSTRACT FROM AUTHOR]

Juvenile primary Sjögren's syndrome (pSS) is rare. Although recurrent parotitis is reported to be the most common symptom of juvenile pSS, the clinical symptoms and features of the syndrome are not well understood and are poorly defined. Here we report a rare case of juvenile pSS in a patient with plunging ranula. The patient had no symptoms other than swelling of the oral floor and had no symptoms of parotitis. Magnetic resonance imaging (MRI) revealed the diagnosis of plunging ranula. In addition, the findings of the bilateral parotid glands on MRI and subsequent ultrasonography (US) strongly suggested SS. On the basis of these imaging findings and laboratory data, a pediatric rheumatologist confirmed the diagnosis of juvenile pSS. The ranula may be one clinical sign of SS. However, this association remains generally unknown. Hypothesizing that SS might cause ranula development, we retrospectively investigated cases of patients with ranula who underwent MRI at our hospital. We found that many of these patients (> 20%) had characteristic findings strongly suggestive of SS. This result suggests that SS-induced changes in the sublingual glands are one cause of ranula formation. We think that ranula is a sign of early-stage SS. Therefore, patients with ranulae, whether adults or children, should undergo careful assessment of not only the sublingual glands but also the parotid and submandibular glands with MRI and/or US to investigate possible SS. This assessment may lead to early detection of SS. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: Early diagnosis of oral diseases affects the prognosis and treatment. Despite advances in oral health, there are still oral health problems worldwide. Considering that culture, gender, age, ethnicity and habits may have a significant impact on the prevalence of lesions, this study was performed to investigate the frequency of oral lesions over 10 years and its relationship with some variables. METHODS: In this cross-sectional study, the medical records of 1092 patients with various types of oral lesions who referred to the Department of Oral and Maxillofacial Diseases of Babol Dental School during 2009-2017 were evaluated and compared based on year, age, gender, type of lesion (white and red, pigmented, vesiculobullous, orofacial and tumoral pains, and disorders associated with systemic and peripheral or central diseases). FINDINGS: In this study, out of 1092 cases, 672 cases were related to female clients (61.5%) and 420 cases (38.5%) were related to male clients (p<0.001). The mean age of the subjects was 43.2±16.81 years. The highest frequency was related to white and red lesions with 305 cases (27.9%), which was 193 cases in women (28.7%) and 112 cases in men (26.7%) (p<0.001). The highest frequency of lesions was related to the cheeks with 351 cases (32.1%) including 235 cases (35%) in women and 116 cases (27.6%) in men (p<0.01). The lowest frequency was observed in the floor of mouth in 68 cases (6.2%). Tumoral lesions had a higher mean age of involvement than other lesions (p<0.001). The frequency of orofacial pain and burning symptoms in women was significantly higher than men (p=0.006). CONCLUSION: The results of the study showed that the frequency of white and red lesions of the mouth is more than other cases and its most common location is in the buccal mucosa. The frequency of lesions also has a significant positive relationship with female gender. [ABSTRACT FROM AUTHOR]

A third molar displaced in the orbital floor is a very rare sighting. The usual surgical approach to such a case is the Caldwell Luc procedure that has its own complications. Here in this article, we present a 17-year-old male patient with third molar displaced in the orbital floor with egg shell thin anterior wall. The aim of the article is to report the unusuality of the case and to emphasize the endoscopic assisted approach to the orbital floor through a relatively small sub-labial incision. Endoscope aids in preserving the integrity of vital structures, facial aesthetics and complete eradication of the disease with faster recovery. Though, endoscopic approach requires requisite expertise, it is a learnable skill and can be mastered with ease. [ABSTRACT FROM AUTHOR]

Objectives: Reliable automated handheld vital microscopy image sequence analysis and the identification of disease states and effects of therapy are prerequisites for the routine use of quantitative sublingual microcirculation measurements at the point-of-care. The present study aimed to clinically validate the recently introduced MicroTools software in a large multicentral database of perioperative and critically ill patients and to use this automatic algorithm to data-mine and identify the sublingual microcirculatory variable changes in response to disease and therapy.Design: Retrospective algorithm-based image analysis and data-mining within a large international database of sublingual capillary microscopy. Algorithm-based analysis was compared with manual analysis for validation. Thereafter, MicroTools was used to identify the functional microcirculatory alterations associated with disease conditions and identify therapeutic options for recruiting functional microcirculatory variables.Setting: Ten perioperative/ICU/volunteer studies in six international teaching hospitals.Patients: The database encompass 267 adult and pediatric patients undergoing surgery, treatment for sepsis, and heart failure in the ICU and healthy volunteers.Interventions: Perioperative and ICU standard of care.Measurements and Main Results: One thousand five hundred twenty-five handheld vital microscopy image sequences containing 149,257 microscopy images were analyzed. 3.89 × 10 RBC positions were tracked by the algorithm in real time, and offline manual analysis was performed. Good correlation and trending ability were found between manual and automatic total and functional capillary density (r = 0.6-0.8; p < 0.0001). RBC tracking within the database demonstrated changes in functional capillary density and/or RBC velocity in septic shock, heart failure, hypovolemia, obstructive shock, and hemodilution and thus detected the presence of a disease condition. Therapies recruiting the microcirculatory diffusion and convection capacity associated with systemic vasodilation and an increase in cardiac output were separately identified.Conclusions: Algorithm-based analysis of the sublingual microcirculation closely matched manual analysis across a broad spectrum of populations. It successfully identified a methodology to quantify microcirculatory alterations associated with disease and the success of capillary recruitment, improving point-of-care application of microcirculatory-targeted resuscitation procedures. [ABSTRACT FROM AUTHOR]

Various cases of introduction of air into soft tissues have been reported in the dental literature. Here, we report a rare case of localized sublingual emphysema after alveoloplasty. There was no facial involvement. The patient responded to treatment and recovered uneventfully. [ABSTRACT FROM AUTHOR]