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ObjectiveWith the shift toward utilization of sentinel lymph node biopsy (SLNB) in oral cavity cancer, improved techniques for intraoperative sentinel node identification are needed. This study investigates the feasibility of fluorescently labeled tilmanoscept in SLNB in an oral cancer rabbit model.MethodsAn animal study was designed using 21 healthy male New Zealand rabbits. Gallium-68-labeled tilmanocept labeled with IRDye800CW was injected submucosally into the buccal mucosa (n = 6) or lateral tongue (n = 7) followed by PET imaging. One hour after injection, SLNB was performed using fluorescence imaging followed by a bilateral neck dissection and sampling of non-nodal surrounding tissue. All tissues were measured for radioactivity and fluorescence. In addition, eight rabbits were injected with delayed SLNB performed 48 h after injection.ResultsBuccal injections all had ipsilateral SLN drainage and tongue injections exhibited 18.2% contralateral drainage. An average of 1.9 ± 1.0 SLN (range 1-5) were identified. In addition, an average of 16.9 ± 3.3 non-sentinel lymph nodes were removed per animal. SLNs had an average of 0.69 ± 0.60 percent-of-injected dose (%ID) compared with non-sentinel nodes with 0.012 ± 0.025 %ID and surrounding tissue with 0.0067 ± 0.015 %ID. There was 98.0% agreement between sentinel lymph nodes identified using fluorescence compared to radioactivity with Cohen's kappa coefficient of 0.879. In 48-h delayed SLNB, results were consistent with 97.8% agreement with radioactivity and Cohen's Kappa coefficient of 0.884. Fluorescence identified additional lymph nodes that were not identified by radioactivity, and with one false negative.ConclusionFluorescent-labeled Tc-99 m-tilmanocept represents a highly accurate adjunct to enhance SLNB for oral cavity cancer.Level of evidenceN/A Laryngoscope, 134:1299-1307, 2024.

Background: Dental caries, also known as tooth decay or cavity formation, is one of the world's most widespread dental conditions. It is a plaque-related infection caused mainly by Streptococcus mutans. People have relied on several plant species to treat oral infections; Heteropyxis natalensis, for example, has been used to treat toothache and gum infections. Methods: In this study, the antimicrobial and anti-adherence properties of H. natalensis and Camellia sinensis, as well as tea tree and peppermint essential oils were investigated on tooth enamel. Results: The bacterial load of S. mutans was reduced by approximately two orders of a magnitude after 48 h, with a lesser extent on the commensal bacteria, Lactobacillus paracasei. Scanning electron micrographs of enamel blocks showed a reduction in the attachment and chain formation of S. mutans and degraded cell morphology. Lastly, the combination and each component individually, showed low to no cellular toxicity when tested on human macrophages. Conclusions: This is the first report of this polyherbal regarding its selectivity and potential prevention of dental caries. [ABSTRACT FROM AUTHOR]

Background:Acanthamoeba​ species are recognized as the most prevalent free‐living amoebae (FLA). They can cause granulomatous amebic encephalitis (GAE) and pulmonary and ocular infections. The present study aimed to isolate and identify Acanthamoeba genotypes in cancer patients referred to Kashan's hospitals in Central Iran. Methods: This cross‐sectional study was conducted with oral and nasal swab samples collected from a hundred cancer patients referred to Kashan's Beheshti and Yasrebi hospitals during 2019–2020. The samples were cultured in 1.5% non‐nutrient agar (NNA) with heat‐killed Escherichia coli and examined for "FLA." A polymerase chain reaction (PCR) assay amplifying the 18S rRNA gene was performed, and Acanthamoeba‐positive isolates were subjected to nucleotide sequencing to identify their genotypes. Results: The prevalence of Acanthamoeba infection was 51% in the oral cavity and 38% in the nasal samples of cancer patients. The most frequent Acanthamoeba cysts were (51.3%) wrinkled polygonal and sized 9.55‐11.5 μm (Group II). Acanthamoeba genotypes T4, T11, and T5 were identified in the oral cavity samples, whereas T4 and T11 were detected in the nasal samples. Conclusion: The prevalence of Acanthamoeba infection in oral and nasal cancer patients was higher in Kashan, Iran, compared to other countries. Due to the high rate of oral Acanthamoeba contamination, oral sampling is recommended for better detection of this protozoan. Since T4 is the predominant genotype that can cause serious diseases in high‐risk groups, increasing physicians' awareness of infections associated with Acanthamoeba and preventive and control measures are strongly suggested. [ABSTRACT FROM AUTHOR]

Aging is associated with a decline in oral immune function, marked by reduced levels of antimicrobial peptides such as defensins. Capsaicin, a bioactive component found in chili peppers, has been theorized to modulate immune responses through specific receptor pathways. This study examined the effects of aging on oral defensin levels and the potential mitigating role of capsaicin, mediated by the immune response in oral tissues. We conducted a comparative analysis between young and aged mice, with or without capsaicin supplementation, for 3 months. The effect of capsaicin was also studied in vitro in senescence‐induced human oral keratinocytes. We found that aging did not reduce defensin levels uniformly but did so in some instances. Capsaicin treatment increased defensin levels in these cases, potentially through transient receptor potential cation channel subfamily V member 1 (TRPV1)‐mediated pathways in the oral cavity. Capsaicin supplementation may counteract age‐related declines in oral defensin levels, enabling the maintenance of oral immune function during aging. [ABSTRACT FROM AUTHOR]

Background: Dental caries is a multifactorial disease that can affect human teeth, and viruses play a hidden role in forming caries cavities and dental plaque. Objectives: This study attempted to assess the detection of the role of some viruses such as Epstein-Barr virus (EBV), cytomegalovirus (CMV), herpes simplex virus type1 (HSV-1), and human papillomavirus (HPV) using the ELISA technique to detect the presence of viral antigens from three samples (dentine caries, necrotic pulp, and saliva) and to assess the relation between the presence of viruses and gender and age. Materials and Methods: From March 2022 to October 2022, samples were collected from 90 patients which were divided into three age groups, such as >20 years, 21–40 years, and ˂41 years, at the Dental Teaching Hospital of the University of Mosul. These patients represented both genders (45 men and 45 women). Results: The results indicated that the prevalence of HSV-1 was 66.6%, CMV was 68.8%, EBV was 86.6%, and HPV was 16.0% out of 90. The percentages of these viruses HSV-1, CMV, and EBV were higher in females than in males at 60.2%, 58.1%, and 43.4%, respectively, especially in the age group 21–40 years, with dominant of HSV-1 at 50%. Many studies focus on the role of bacteria in different types of dental caries, while the hidden role of viruses is excluded. Viruses play an important role in forming dental biofilm, and failed therapy may be due to viral infection. Conclusion: This study concludes that viruses in this study were detected in higher numbers in dentine caries, necrotic pulp, and saliva by ELISA technique, except human papillomavirus 16, which did not give any result. [ABSTRACT FROM AUTHOR]

Background: HPV- associated squamous cell carcinoma (SCC) is uncommon in non-oropharynx sites and not well characterized. This study aims to investigate uncommon phenotypes of HPV-associated head and neck carcinoma, the prevalence and morphologic spectrum of HPV-associated SCC in the oral cavity, larynx and hypopharynx. Method: P16 immunostaining and HPV E6/7 in situ hybridization (ISH) were performed on tissue microarrays comprised of SCCs from different anatomic sites: oropharynx (n = 270), hypopharynx (n = 52), oral cavity (n = 95) and larynx (n = 123). Tumors were classified as HPV-associated based on a positive E6/7 ISH testing. RNA sequencing was performed on several selected cases. Result: 66% oropharynx SCCs (OPSCCs) were HPV-associated; all were p16/HPV testing concordant except one which was p16 negative. The p16-/HPV + OPSCC resembled similar gene expression signature with p16+/HPV + OPSCCs by transcriptome analysis. 6/95 (6%) oral cavity SCCs were HPV-associated, all from male patients and 5/6 (83%) arose from the floor of mouth. Morphologically, 3/6 (50%) showed keratinizing SCC and 5/6 (83%) demonstrated HPV-associated squamous dysplasia in adjacent mucosa. 1/123 (less than 1%) larynx SCCs and 0/52 hypopharynx SCCs were HPV-associated. Conclusion: Although uncommon, p16 negative HPV-associated OPSCC can occur, emphasizing the importance of judicious HPV testing. The morphology of HPV-associated oral cavity SCCs may deviate from prototypic nonkeratinizing SCC, making them difficult to recognize. Presence of HPV-associated squamous dysplasia could serve as a morphologic clue. [ABSTRACT FROM AUTHOR]

The aim of this study is to present the characteristics and a comparison of four different commercial materials dedicated to the CAD/CAM technique in dentistry, all of which can be classified as ceramic materials. Its purpose is also to evaluate the impact of surface treatment on the cytotoxicity and microbiological properties of the materials. The CAD/CAM technique has a perpetually growing role in modern reconstructive dentistry. It requires a material's possession of peculiar characteristics, such as mechanical resistance, durability, functionality (similar to natural tissues), good aesthetics and biocompatibility. To critically evaluate a biomaterial, both manufacturer claims and in vitro tests should be considered. Further steps of evaluation may include animal tests and clinical trials. There are certain attributes of biomaterials that may be modified by surface treatment that can be crucial to the clinical success of the material. The evaluated materials were Vita Suprinity (VITA-Zahnfabrik, Germany), Vita Mark II (VITA-Zahnfabrik, Germany), Celtra Duo (Dentsply Sirona, USA) and Empress Cad (Ivoclar Vivadent, Liechtenstein). They are available in the form of prefabricated blocks of various diameters and are popular among operators performing clinical procedures using CAD/CAM. Standardized blocks of each material were prepared. Half of them had their surface polished. Further, half of all the samples were covered by a nano-copper layer. The samples were evaluated for cytotoxicity, presented on a 0–4 scale, adhesion susceptibility and potential of forming a biofilm on their surface. Physicochemical properties such as the water contact angle (WCA) were evaluated for the tested materials. The influence of copper coating on cytotoxicity cannot be unequivocally stated or denied. Surface polishing did not affect the materials' cytotoxicity, but it increased the WCA of all materials and, therefore, their hydrophobicity. Different degrees of adhesion ability and biofilm formation were dependent on the species of microorganisms and properties of the dental materials. [ABSTRACT FROM AUTHOR]

Objective: To investigate primary site surgical resection and overall survival (OS) in clinically distantly metastatic (cM1) oral cavity squamous cell carcinoma (OCSCC). Methods: The 2006–2018 National Cancer Database was queried for patients presenting with cM1 OCSCC who underwent chemotherapy. Binary logistic, Kaplan–Meier, and multivariable Cox proportional hazards regression models were implemented. Results: Of 278 patients satisfying inclusion criteria, 139 (50.0%) underwent chemotherapy alone, 80 (28.8%) underwent chemoradiotherapy, 25 (9.0%) underwent surgical resection + adjuvant chemotherapy, and 34 (12.2%) underwent surgical resection + adjuvant chemoradiotherapy; 5‐year OS was 9.4%, 15.2%, 8.3%, and 23.8%, respectively (p <.001). Compared with those not undergoing surgical resection, patients undergoing surgical resection underwent radiotherapy more frequently (57.6% vs. 36.5%) but multiple‐agent chemotherapy less frequently (40.7% vs. 74.4%) (p <.005). Twenty‐one (36.2%) patients undergoing surgical resection had positive surgical margins. Academic facility (adjusted odds ratio [aOR] 3.19, 95% CI 1.54–6.62) and Charlson‐Deyo comorbidity score ≥1 (aOR 2.82, 95% CI 1.25–6.32, p <.025) were associated with increased odds of undergoing surgical resection. Compared with chemotherapy alone, chemoradiotherapy (adjusted hazard ratio [aHR] 0.56, 95% CI 0.38–0.83) and surgical resection + adjuvant chemoradiotherapy (aHR 0.37, 95% CI 0.21–0.66) were associated with higher OS (p <.005). Immunotherapy (aHR 0.48, 95% CI 0.28–0.81, p =.006) was also independently associated with higher OS. Conclusion: A minority of patients with cM1 OCSCC underwent primary site surgical resection. Despite the high rate of positive surgical margins, surgical resection + adjuvant chemoradiotherapy was associated with higher OS than chemotherapy alone, chemoradiotherapy, or surgical resection + adjuvant chemotherapy. Definitive local therapy may benefit select patients with cM1 OCSCC. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

Simple Summary: Mucosal melanoma is a rare and aggressive form of melanoma that primarily occurs in the mucosal tissues of the head and neck. Due to its rarity and complexity, treatment strategies for this type of cancer are challenging, with surgical removal often followed by radiation therapy. This review explores how modern radiation therapy techniques, such as intensity modulation, proton beam therapy, and carbon ions, are being used to enhance treatment effectiveness while minimizing damage to surrounding healthy tissues. By reporting on current practices and outcomes, this article aims to provide insights that could guide more effective treatment approaches and further improve outcomes for patients with head and neck mucosal melanoma. Mucosal melanoma of the head and neck (HNMM) is a rare but highly aggressive malignancy, often diagnosed at an advanced stage with poor prognosis. This review discusses current treatment strategies, emphasizing the role of radiotherapy in managing this challenging disease. A comprehensive analysis of 33 studies provides updated information on techniques and outcomes, highlighting the consistent benefit of adjuvant radiation in improving local control. Advances in conformal techniques, such as intensity-modulated radiotherapy (IMRT), have significantly reduced toxicity rates. Preliminary data on proton and carbon ion therapies suggest the potential for further enhancement of the therapeutic ratio, despite limited availability. Although recent studies report 3-year local control rates as high as 90%, overall survival within the same time frame remains well below 50–60%, underscoring the need for continued improvement in systemic therapies to address the persistent issue of distant metastases. [ABSTRACT FROM AUTHOR]

It is exceptionally unusual to see oral malignant melanoma, which is highly aggressive with dismal prognosis. A 61-year-old female patient presented with hyperpigmented and hemorrhagic areas in the anterior mandible. Microscopically, positive Immunohistochemistry staining with monoclonal antibody Human Melanoma Black (HMB45) and S100 protein, confirmed the diagnosis as malignant melanoma. [ABSTRACT FROM AUTHOR]

Previous research has reported high occult nodal metastases rates for T3/T4 mucoepidermoid carcinoma (MEC) of the oropharynx (OP) and oral cavity (OC). Our study evaluates if there is a benefit of neck dissection (ND) in these patients. The 2004–2016 National Cancer Database was queried for cases of adult MEC of the OC and OP. Patients with clinical T3/T4 disease were included while those with metastatic disease were excluded. Patients were divided into two cohorts: those treated with and without ND. Univariate chi-square, Kaplan-Meier, and multivariable Cox regression analyses were implemented. A total of 243 patients met inclusion criteria, of which 79 (32.5%) underwent ND. The majority of patients were less than 60 years old (60.1%), White (76.2%), and male (53.5%). 92 (37.9%) patients had clinically node-positive (cN+) disease. ND patients had higher rates of cN + disease (53.2% vs. 30.5%, p = 0.002). Of patients undergoing ND, 35 (44.3%) had cN0 disease while 42 (53.2%) had cN + disease. ND patients more commonly had grade III/IV tumors (45.1% vs. 23.4%, p = 0.002). Upon examination of dissected nodes, 20.3% of cN0 patients undergoing ND were found to have occult nodal metastases. There was no significant difference in 5-year overall survival between patients with and without ND (61.8% vs. 53.6%, p = 0.610), even on multivariable Cox analysis (hazard ratio: 1.52, 95% confidence interval: 0.73–3.18, p = 0.269). Our study found patients with cN0 MEC of the OC and OP have a high rate (20.3%) of occult nodal metastasis. In this cohort, patients with ND were not found to have improved survival, possibly due to statistical underpowering. Further research is needed to evaluate the indications and benefit of ND for this rare tumor presentation. Keypoints: Previous research has reported high occult nodal metastases rates for T3/T4 mucoepidermoid carcinoma (MEC) of the oropharynx (OP) and oral cavity (OC). Neck dissection patients had higher rates of cN + disease and more commonly had grade III/IV tumors. Patients with MEC of the OP and OC have a high rate of occult nodal metastasis, suggesting neck dissection should be given strong consideration for these patients. There was no significant difference in 5-year overall survival between patients treated with and without neck dissection. [ABSTRACT FROM AUTHOR]

Objectives: To describe the clinicopathologic presentation of buccal squamous cell carcinoma and identify risks factors for recurrence and overall survival. Methods: This is a retrospective case–control study of patients with oral cavity squamous cell carcinoma (OCSCC) treated at a single tertiary care center between 2010 and 2022. All patients with buccal subsite OCSCC treated during this time frame were included and paired with a randomly selected age and gender matched patient with non‐buccal OCSCC. Relevant data was collected via chart review. Results: Seventy‐seven patients with buccal SCC were matched with 77 non‐buccal OCSCC controls. The median follow‐up time was 27 months (IQR 14–61). Median age was 67 years (IQR 57–75) and 53% of the cohort was female. Twenty (26%) buccal SCC patients experienced a recurrence versus 19 (25%) in the controls. Age ≥65‐years‐old increased odds of all‐cause mortality in the buccal SCC group, but not in the control group. Perineural invasion and positive margins increased odds of recurrence in the buccal group only. Overall survival and progression‐free survival did not differ between the groups, despite a greater number of T2 buccal tumors and T1 non‐buccal tumors. Conclusions: Buccal SCC presents at a higher T stage than other oral cavity SCC subsite and may exhibit variance in the pathologic risk factors that predict poor outcomes versus non‐buccal OCSCC. Despite these relatively minor differences, however, oncologic outcomes between these groups were similar. [ABSTRACT FROM AUTHOR]

Objectives: Complex head and neck defects involving composite defects can be reconstructed using chimeric flaps or multiple flaps with separate anastomoses. Limited comparisons exist between chimeric and multiple flap reconstructions. We compare outcomes between chimeric and multiple flap reconstructions in oral cavity reconstruction. Data Sources: PubMed (NLM), Embase (Elsevier), Web of Science (Clarivate Analytics), and Cochrane CENTRAL (Wiley). Methods: A systematic review was conducted, including English articles reporting outcomes of oral cavity reconstruction with either chimeric flaps or multiple flaps. Data extraction included patient characteristics, flap type, and outcomes such as flap survival, partial flap loss, operating room time, hospital length of stay, and postoperative complications. Results: Forty‐seven articles comprising 1435 patients were included. Notably, 552 patients underwent multiple flaps, while 883 received chimeric flaps. Meta‐analysis revealed no statistically significant difference in flap survival between chimeric and multiple flap patients (98% vs. 99%, p = 0.198). Multiple flap patients had higher rates of operating room take‐backs for anastomotic issues and longer hospital stays compared with chimeric flap patients. There were no significant differences in partial flap failure, resumption of diet and speech, need for subsequent flaps, fistula formation, or general complications. Conclusion: This large‐scale meta‐analysis demonstrates equivalent flap survival between chimeric and multiple flaps in the reconstruction of composite oral cavity defects. Both approaches appear to be safe and acceptable, with comparable outcomes in terms of diet and speech resumption, rates of fistulization, and general postoperative complications. Multiple flap patients had higher rates of operating room take‐backs and longer hospital stays. Level of Evidence: NA Laryngoscope, 134:4196–4202, 2024 [ABSTRACT FROM AUTHOR]

The oral cavity may play a role as a reservoir and in the transmission and colonization of Helicobacter pylori. The route of transmission for H. pylori is not fully understood. The prevalence of this pathogen varies globally, affecting half of the world's population, predominantly in developing countries. Here, we review the prevalence of H. pylori in the oral cavity, the characteristics that facilitate its colonization and dynamics in the oral microbiome, the heterogeneity and diversity of virulence of among strains, and noninvasive techniques for H. pylori detection in oral samples. The prevalence of H. pylori in the oral cavity varies greatly, being influenced by the characteristics of the population, regions where samples are collected in the oral cavity, and variations in detection methods. Although there is no direct association between the presence of H. pylori in oral samples and stomach infection, positive cases for gastric H. pylori frequently exhibit a higher prevalence of the bacterium in the oral cavity, suggesting that the stomach may not be the sole reservoir of H. pylori. In the oral cavity, H. pylori can cause microbiome imbalance and remodeling of the oral ecosystem. Detection of H. pylori in the oral cavity by a noninvasive method may provide a more accessible diagnostic tool as well as help prevent transmission and gastric re-colonization. Further research into this bacterium in the oral cavity will offer insights into the treatment of H. pylori infection, potentially developing new clinical approaches. [ABSTRACT FROM AUTHOR]

The review aimed to investigate the diversity of oral microbiota and its influencing factors, as well as the association of oral microbiota with oral health and the possible effects of dysbiosis and oral disorder. The oral cavity harbors a substantial microbial burden, which is particularly notable compared to other organs within the human body. In usual situations, the microbiota exists in a state of equilibrium; however, when this balance is disturbed, a multitude of complications arise. Dental caries, a prevalent issue in the oral cavity, is primarily caused by the colonization and activity of bacteria, particularly streptococci. Furthermore, this environment also houses other pathogenic bacteria that are associated with the onset of gingival, periapical, and periodontal diseases, as well as oral cancer. Various strategies have been employed to prevent, control, and treat these disorders. Recently, techniques utilizing microbiota, like probiotics, microbiota transplantation, and the replacement of oral pathogens, have caught the eye. This extensive examination seeks to offer a general view of the oral microbiota and their metabolites concerning oral health and disease, and also the resilience of the microbiota, and the techniques used for the prevention, control, and treatment of disorders in this specific area. [ABSTRACT FROM AUTHOR]

Background: Staphylococcus spp. are widely distributed in nature and can cause nosocomial, skin infections, and foodborne illness, and it may lead to severe financial losses in birds by causing systemic infection in numerous organs. Aim: This study was conducted to determine the prevalence of Staphylococcus spp. in humans and birds in Baghdad city. Methods: Seventy-six oral cavity swabs were collected, including 41 from birds and 35 from breeders. All samples were examined by bacteriological methods and identified by using the VITEK technique, the samples were then further studied to test the ability of biofilm formation, and multidrug-resistant (MDR) factors and MAR index were tested with the use of seven antibiotics. Results: Among the 76 oral swabs, 37 samples were positive (48.68%) for Staphylococcus spp.: 7 human samples (20%) and 30 bird samples (73.17%). In humans, Staphylococcus lentus was the most prevalent (42.85%) followed by Staphylococcus aureus (28.57%), Staphylococcus hominis and Staphylococcus sciuri were at (14.29%) to each. In birds, Staphylococcus pseudintermedius, Staphylococcus gallinarum, S. lentus, Staphylococcus haemolyticus, Staphylococcus spp, S. sciuri, and Staphylococcus xylosus were detected in 36.67%, 16.67%, 10%, 10%, 13.33%, 3.33% and 3.33%, respectively. Staphylococcus isolates from the human samples demonstrated that only S. lentus was resistant 33.33% to ME, OX, and SXT. Furthermore, one of them was MDR and high MAR index value. The antimicrobial pattern of Staphylococcus spp. isolated from birds was as follows S. pseudintermedius isolates demonstrated 100% resistance to CN, CIP, SXT, and MDR (100%) and high MAR indices value; S. xylosus was resistant 100% against ME, CN, SXT, and Do and it was MDR with high MAR index; S. lentus was resistant 25% against ME, OX, C, and SXT, whereas, S. gallinarum was resistant 33.33% against ME and OX. The results demonstrated that biofilm formation of the Staphylococcus spp. isolated from human samples were weak biofilm formers: S. lentus, S. hominis, and S. aureus, while other S. aureus (50%) was moderate. In birds, the majority of the isolates had non-biofilm-producing capabilities, while 80% of S. lentus and 100% of S. xylosus showed moderate biofilm formation. Conclusion: Healthcare problem was observed in this study due to high MDR and MAR index among Staphylococcus spp. isolated from pet birds to their owners and vice versa. [ABSTRACT FROM AUTHOR]

Background: Metastatic tumors of the oro-facial tissuesare rare, with an incidence ranging between 1% and 8% of all oral malignant tumors. Generally reported with a peak of incidence in the 5–7th decades but possibly occurring at any age, metastases may represent the first sign of an occult cancer or manifest in patients with an already known history of a primary carcinoma, mostly from the lungs, kidney, prostate, and colon/rectum in males, and the uterus, breast, lung, and ovary in females. In the oro-facial tissues, the most involved sites are the oral mucosa, gingiva/jawbones, tongue, and salivary glands. Methods: A broad and deep literature review with a comprehensive analysis of the existing research on oro-facial metastases from renal-cell carcinoma (RCC) was conducted by searching the most used databases, with attention also paid to the clear-cell histological variant, which is the most frequent one. Results: Among the 156 analyzed studies, 206 cases of oro-facial metastases of renal cancer were found in patients with an average age of 60.9 years (145 males, 70.3%; 61 females, 29.6%). In almost 40% of the cases, metastasis represented the first clinical manifestation of the primary tumor, and 122 were histologically diagnosed as clear-cell renal-cell carcinoma (ccRCC) (59.2%). The tongue was involved in most of the cases (55 cases, 26.7%), followed by the gingiva (39 cases, 18.9%), mandible (35 cases, 16.9%), maxilla (23 cases, 11.1%), parotid gland (22 cases, 10.6%), buccal mucosa (11 cases, 5.3%), lips (7 cases, 3.3%), hard palate (6 cases, 2.8%), soft palate, masticatory space, and submandibular gland (2 cases, 0.9%), and lymph nodes, tonsils, and floor of the mouth (1 case, 0.4%). Among the 122 ccRCCs (84 males, 68.8%; 38 females, 31.1%), with an average age of 60.8 years and representing in 33.6% the first clinical manifestation, the tongue remained the most frequent site (31 cases, 25.4%), followed by the gingiva (21 cases, 17.2%), parotid gland (16 cases, 13.1%), mandibular bone (15 cases, 12.2%), maxillary bone (14 cases, 11.4%), buccal mucosa and lips (6 cases, 4.9%), hard palate (5 cases, 4%), submandibular gland and soft palate (2 cases, 1.6%), and lymph nodes, tonsils, oral floor, and masticatory space (1 case, 0.8%). The clinical presentation in soft tissues was mainly represented by a fast-growing exophytic mass, sometimes accompanied by pain, while in bone, it generally presented as radiolucent lesions with ill-defined borders and cortical erosion. Conclusions: The current comprehensive review collected data from the literature about the incidence, site of occurrence, age, sex, and survival of patients affected by oro-facial metastases from renal-cell carcinoma, with particular attention paid to the cases diagnosed as metastases from clear-cell renal-cell carcinoma, which is the most frequent histological variant. Clinical differential diagnosis is widely discussed to provide clinicians with all the useful information for an early diagnosis despite the effective difficulties in recognizing such rare and easily misdiagnosed lesionsTheir early identification represents a diagnostic challenge, especially when the clinical work-up is limited to the cervico–facial region. Nevertheless, early diagnosis and recently introduced adjuvant therapies may represent the key to better outcomes in such patients. Therefore, general guidelines about the clinical and radiological identification of oro-facial potentially malignant lesions should be part of the cultural background of any dentist. [ABSTRACT FROM AUTHOR]

Gingival cysts of the adult are rare and benign odontogenic lesions of the oral cavity, accounting for almost 0.3% of all odontogenic cysts. Their differential diagnosis is still challenging for surgeons as it includes other gingival inflammatory or non-inflammatory lesions and peripheral odontogenic tumors. The aim of this paper is to report a new case occurring in an adult, analyzing the clinical, radiographic, and histopathological features as guidelines for a differential diagnosis. We report a 49-year-old patient complaining of a small, pigmented lesion localized on the attached gingiva with no history of trauma, which was surgically excised and histologically diagnosed as a gingival cyst. A differential diagnosis may be challenging for clinicians it includes a wide spectrum of inflammatory and non-inflammatory lesions, so a correct diagnostical–therapeutical approach is needed to avoid possible overtreatment and minimize the recurrence rate. [ABSTRACT FROM AUTHOR]

This review aims to provide a comprehensive overview of the literature on the oral side effects caused by radiotherapy for head and neck cancers. Various treatments are examined to mitigate these sequelae, and a protocol is proposed for dentists and dental hygienists to manage oncological patients. A literature search was conducted to select relevant articles addressing the effects of radiotherapy treatments on the oral cavity, with a particular focus on the development of mucositis, candidiasis, changes in salivary pH, trismus, fibrosis, and alterations in the oral biofilm. PubMed and MedLine were used as search engines, with keyword combinations including: head and neck cancer, mucositis, candida, dental care, dental hygiene, epidemiology, oral microbiome, biofilm, trismus, fibrosis, and salivary pH. A total of 226 articles were identified, spanning the period from 1998 to 2023. Articles deemed inappropriate or in languages other than English or Italian were excluded. A management protocol for oncological patients was proposed, divided into two phases: home-based and professional. Despite the advancements in intensity-modulated radiation therapy, it is impossible to completely avoid damage to healthy tissues. Preventive education and counseling in the dental chair, ongoing motivation, and education about oral hygiene are crucial to combine a good therapeutic outcome with an improved quality of life for the patient. [ABSTRACT FROM AUTHOR]

Simple Summary: The problems associated with oral squamous cell carcinoma (OSCC) are becoming increasingly apparent. Namely, cancer of the oral cavity is the most common malignant tumor in the head and neck area worldwide. In addition to the usual risk factors for the development of OSCC, such as smoking and alcohol consumption, recent research has shifted its focus to the oral cavity microbiome, specifically dysbiosis. Numerous studies have concluded that disrupting the eubiosis of the oral cavity promotes the growth of oral pathogens, which, through their virulence factors and manifold pathogenicity factors, lead to inflammatory conditions that can damage tissue cells, potentially leading to cancer development. From an aetiological point of view, these pathogens can be bacteria, viruses, fungi, and parasites. Oral squamous cell carcinoma (OSCC) is the most common head and neck cancer. Although the oral cavity is an easily accessible area for visual examination, the OSCC is more often detected at an advanced stage. The global prevalence of OSCC is around 6%, with increasing trends posing a significant health problem due to the increase in morbidity and mortality. The oral cavity microbiome has been the target of numerous studies, with findings highlighting the significant role of dysbiosis in developing OSCC. Dysbiosis can significantly increase pathobionts (bacteria, viruses, fungi, and parasites) that trigger inflammation through their virulence and pathogenicity factors. In contrast, chronic bacterial inflammation contributes to the development of OSCC. Pathobionts also have other effects, such as the impact on the immune system, which can alter immune responses and contribute to a pro-inflammatory environment. Poor oral hygiene and carbohydrate-rich foods can also increase the risk of developing oral cancer. The risk factors and mechanisms of OSCC development are not yet fully understood and remain a frequent research topic. For this reason, this narrative review concentrates on the issue of dysbiosis as the potential cause of OSCC, as well as the underlying mechanisms involved. [ABSTRACT FROM AUTHOR]

Anatomy was initially developed out of necessity to decrease surgery complications. Over time, anatomists and surgeons have sometimes used different terms for the same anatomical structures, thus resulting in numerous discrepancies in terminology between anatomy and surgery. To avoid any confusion or misunderstanding and to better elucidate the oral anatomy terms, the Federative International Programme for Anatomical Terminology (FIPAT) organized a group of specialists on oral anatomy, Terminologia Oroanatomica (ToA) working group, composed of dentists, anatomy researchers, anatomy educators, oral and maxillofacial surgeons, and oral and maxillofacial radiologists. Within the ToA working group, major anatomical structures in the mandible, such as the mandibular canal, were focused and discussed to determine the most appropriate term, i.e., inferior alveolar canal. Although yet to be approved by the International Federation of Associations of Anatomists (IFAA), this article will preview some changes suggested by the ToA. [ABSTRACT FROM AUTHOR]

Herein we present a survey on the variation in the morphology of the structures that compose the larval buccopharyngeal cavity of Thoropa miliaris tadpoles based on samples of 18 different stages of development, from embryos (removed from the egg capsules) to stages near or at metamorphosis. Our observations revealed that several structures vary independently along the stages. This variation appears in the number of (sub) unities, shape, and positions. Structures observed acquire a "mature format", increase and decrease in size, and are reabsorbed during distinct tadpole stages. Our observations suggest that caution should be taken when assigning presence/absence or a specific morphology to characters derived from these structures and that samples of several semaphoronts (from as many different stages as feasible) should be evaluated prior to stating for instance that a structure is absent. We also discuss our findings regarding several interpretations of buccopharyngeal features of tadpoles and compare with the ontogenetic studies regarding this character system found in the literature. [ABSTRACT FROM AUTHOR]

Abstract Background Dental caries, also known as tooth decay or cavity formation, is one of the world’s most widespread dental conditions. It is a plaque-related infection caused mainly by Streptococcus mutans. People have relied on several plant species to treat oral infections; Heteropyxis natalensis, for example, has been used to treat toothache and gum infections. Methods In this study, the antimicrobial and anti-adherence properties of H. natalensis and Camellia sinensis, as well as tea tree and peppermint essential oils were investigated on tooth enamel. Results The bacterial load of S. mutans was reduced by approximately two orders of a magnitude after 48 h, with a lesser extent on the commensal bacteria, Lactobacillus paracasei. Scanning electron micrographs of enamel blocks showed a reduction in the attachment and chain formation of S. mutans and degraded cell morphology. Lastly, the combination and each component individually, showed low to no cellular toxicity when tested on human macrophages. Conclusions This is the first report of this polyherbal regarding its selectivity and potential prevention of dental caries.

Background: Staphylococcus spp. are widely distributed in nature and can cause nosocomial, skin infections, and foodborne illness, and it may lead to severe financial losses in birds by causing systemic infection in numerous organs. Aim: This study was conducted to determine the prevalence of Staphylococcus spp. in humans and birds in Baghdad city. Methods: Seventy-six oral cavity swabs were collected, including 41 from birds and 35 from breeders. All samples were examined by bacteriological methods and identified by using the VITEK technique, the samples were then further studied to test the ability of biofilm formation, and MDR factors and MAR index were tested with the use of seven antibiotics. Results: Among the 76 oral swabs, 37 samples were positive (48.68%) for Staphylococcus spp.: 7 human samples (20%) and 30 bird samples (73.17%). In humans, S. lentus was the most prevalent (42.85%) followed by S. aureus (28.57%), S. hominis and S. sciuri were at (14.29%) to each. In birds, S. pseudintermedius, S. gallinarum, S. lentus, S. haemolyticus, Staphylococcus spp, S. sciuri and S. xylosus were detected in 36.67%, 16.67%, 10%, 10%, 13.33%, 3.33% and 3.33% respectively. Staphylococcus isolates from the human samples demonstrated that only S. lentus was resistant 33.33% to ME, OX, and SXT. Furthermore, one of them was MDR and high MAR index value. The antimicrobial pattern of Staphylococcus spp. isolated from birds was as follows: S. pseudintermedius isolates demonstrated 100% resistance to CN, CIP, SXT, and MDR (100%) and high MAR indices value; S. xylosus was resistant 100% against ME, CN, SXT and Do and it was MDR with high MAR index;S. lentus was resistant 25% against ME, OX, C, and SXT, whereas, S. gallinarum was resistant 33.33% against ME and OX. The results demonstrated that biofilm formation of the Staphylococcus spp. isolated from human samples were weak biofilm formers: S. lentus, S. hominis, and S. aureus, while other S. aureus (50%) was moderate. In birds, the majority of the isolates had non biofilm-producing capabilities, while 80% of S. lentus and 100% of S. xylosus showed moderate biofilm formation. Conclusion: Healthcare problem was observed in this study due to high MDR and MAR index among Staphylococcus spp. isolated from pet birds to their owners and vice versa. [Open Vet J 2024; 14(9.000): 2215-2223]

Background: The pattern of head-and-neck cancer (HNC) differs across India due to considerable differences in regional customs, tobacco consumption behaviors, socio-economic status, and other regional risk-factors. Objectives: The primary objective of this study was to assess the epidemiological and demographic profile of patients with HNC from Bihar, India. The secondary objective was to evaluate differences in the incidence of HNC across different anatomical sites with respect to tobacco use, gender, and geographical location. Materials and Methods: We conducted a retrospective analysis of 3230 newly diagnosed, biopsy-proven HNC cases from Bihar, treated at the Department of Head-and-Neck Cancer, Mahavir Cancer Institute and Research Center, Patna, between January 2021 and December 2022. Data on age, gender, address, tobacco habit, site of disease, and other details were extracted from clinical records for statistical analysis. Results: This hospital-based study showed a predominance of male patients, with a male-to-female ratio of 5.37:1. The majority of patients were aged between 41-60 years, with significant gender disparities noted across all the age groups (P < 0.05). The oral cavity was identified as the most common site of HNC, accounting for 71.6% in males (n = 1949/2723) and 50.5% in females (n = 256/507). Within the oral cavity, the buccal mucosa and tongue were the most prevalent subsites. The number of patients from North Bihar was more in comparison to South Bihar. The most common tobacco habits were khaini and betel quid, both widely cultivated in Bihar. Conclusion: This study highlights a high prevalence of non-smoking tobacco consumption among the patients with HNC in Bihar. The oral cavity, particularly the buccal mucosa, was found to be the most affected site. Variations in the pattern of HNC were noted with respect to tobacco use, gender, and geographical location.

A mucocele stands out as the most prevalent mucosal lesion found in the oral cavity. It is characterized as a cyst filled with mucus that can manifest within the oral region. This condition arises from the buildup of mucus secretion triggered by the factors such as trauma, habits like lip-biting, or changes in minor salivary gland function. Oral mucoceles (OMs) represent benign masses of soft tissue, typically appearing as smooth, spherical, translucent nodules with a soft consistency, commonly observed in the buccal mucosa or lips. OM can manifest anywhere within the oral mucosa, including the lips, cheeks, and floor of the oral cavity, although it predominantly occurs in the lip region. There are two primary types of OMs such as extravasation and retention types. OM mostly affects young patients but can affect all groups. OMs typically present as asymptomatic, although occasionally they may cause discomfort by hindering chewing, speech, or swallowing. The diagnosis of OM is based on the clinical appearance and history. The histopathological study confirms the diagnosis of OM. Treatment options for OM encompass various approaches such as complete excision, marsupialization, cryosurgery, carbon dioxide laser therapy, electrocautery, and intralesional injection of sclerosing agents. This review focuses on details of OM including its etiopathology, classification, clinical features, and its current management.

Thrombocytopenia represents one of the most frequent causes of addressability for a hematological consultation. The purpose of the study is to establish a correlation between the degree of thrombocytopenia and the appearance of the mucocutaneous bleeding, with a therapeutic purpose. Materials and method: Our study is a retrospective observational study and was carried out on a group of 100 patients who were referred to the Hematology Clinic of Sp. St. Spiridon, Iași for a period of 12 months and who presented with isolated thrombocytopenia on admission. Other coagulopathy evolving with thrombocytopenia were excluded. To establish the correlation between the decrease in the number of platelets and the appearance of the hemorrhagic skin-mucosal syndrome, statistical methods were used – F Test – Two sample for Variance. Results and discussions: Thrombocytopenia was defined as the value of platelets below 150,000\mmc. 5 grades of thrombocytopenia were established: grade I (TR=150,000-100,000/mmc), grade II (TR= 100,000-50,000/mmc), grade III (TR=50,000-20,000/mmc), grade IV (TR= 20,000 -10,000/mmc), grade V (TR below 10,000/mmc)40% of the patients included in the study presented thrombocytopenia gr. I, 24% – grade II, 15% – grade III, 6% – grade IV and 15% presented severe thrombocytopenia (grade V). The mucocutaneous bleeding was manifested by: petechiae and ecchymosis, epistaxis, bleeding in the oral cavity (gingival bleeding, hemorrhagic bullae), menometrorrhagia, hematuria, melena. There is a statistical correlation between the number of platelets and the occurrence of mucocutaneous bleeding: p=0.000121 (p less than 0.001). The first clinical manifestations of the mucocutaneous bleeding appeared at the value of 70,000/mmc. No statistical correlation was obtained between the age of the patients and the number of platelets (p=0.0352). Conclusions: The occurrence of mucocutaneous bleeding is directly related to the decrease in the number of platelets. The oral cavity usually is involved in bleeding caused by the decrease in the number of platelets and requires a multidisciplinary approach.

Introduction. By fixing on the exposed surfaces of complete removable dentures and oral soft tissues, bacteria form a biofilm, thereby increasing their overall virulence and resistance. The microorganisms that make up the biofilm are often in a symbiotic relationship, which allows them to increase their pathogenic potential and cause the development of denture stomatitis. Accordingly, when a particular strain is present in the oral cavity, the risks of symbiosis are significantly increased. The aim of the study was to evaluate the effect of symbiotic relationships of oral bacteria on the development of inflammatory changes in the oral cavity in the absence of teeth. Materials and methods. Two groups of patients belonging to the elderly age according to WHO systematization (60–74 years) with complete absence of teeth (K08.1) were formed, differing in the presence of clinical manifestations of inflammation (82 men and 49 women). Biological material sampled from the oral cavity of patients was studied using the culture method and RT-PCR. To quantify the interaction between members of the microbiocenosis, we used the Jaccard similarity coefficient. Results. Coagulase-negative and coagulase-positive staphylococci, Neisseria, Candida spp., Enterobacterales and F. nucleatum were more frequently found in patients with complete absence of teeth. Expressed symbiotic relations between microorganisms of the Enterobacterales order, Lactobacillus, Neisseria and Corynebacterium genera, as well as S. salivarius, C. albicans, F. nucleatum were established. The nature of these relations depended on the presence of inflammatory changes in the oral mucosa and, in turn, influenced the development of the latter. Thus, in the absence of inflammation, Corynebacterium, Lactobacillus and S. salivarius showed stable synergism. In case of inflammation, the association between these bacteria was accompanied by the introduction of F. nucleatum and displacement of S. salivarius. Conclusion. Thus, conditionally pathogenic microorganisms, forming microbial associations with multidirectional symbiotic relations increase their virulence, which allows them to occupy free niches in the oral cavity and subsequently trigger the development of pathological process of inflammatory character of prosthetic bed tissues.

Aim: This study provides a comparative analysis of oral dysbiosis of patients with periodontal diseases: chronic catarrhal gingivitis and generalized periodontitis, associated with various systemic pathologies, using a combination of the enzymatic method and interval scale. Studying the differences in the oral microbiota of patients with periodontal diseases and systemic pathologies can help comprehend the underlying mechanisms and create successful treatments. Methods: An enzymatic method was used to diagnose and monitor the degree of oral dysbiosis of patients with different systemic pathologies and periodontal diseases. We applied particular inclusion and exclusion criteria to include patients in a study. The level of microbial presence in the oral cavity can be measured by analyzing urease enzyme activity. Results: The research established that oral dysbiosis is observed in all groups of patients with periodontal diseases and systemic pathology: chronic colitis, chronic pancreatitis, and primary hypothyroidism. The article discusses an express method of diagnosing the microbiota of the oral cavity in combination with an interval scale. This combination makes it possible to classify patients according to the level of oral dysbiosis and prescribe further recommendations for treatment. Conclusions: The association of periodontitis and linked comorbidities is a complex interplay involving common risk factors, pathophysiology, and bidirectional causal relationships. The imbalance of microorganisms in the oral cavities of patients with systemic and periodontal diseases highlights the need for a personalized medical treatment approach. Correcting dysbiosis of the oral cavity should complement antimicrobial treatment for periodontal diseases and the normalization of metabolic processes in the periodontium. It has been confirmed that there is a correlation between patients’ microbial colonization of the oral cavity and the values obtained by the enzymatic method, suggesting that this approach can serve as a rapid assessment of the oral cavity’s microbiocenosis.

Plasmablastic lymphoma (PBL) is a type of non-Hodgkin lymphoma commonly associated with human immunodeficiency virus (HIV) infection. In rare cases, PBL occurrence is noted in the oral cavity of elderly individuals who are HIV negative and EBV positive. The present report describes a case of oral mucosa-type PBL that occurred in the maxillary gingiva of the oral cavity. A 91-year-old male came to our clinic with enlarged swelling of the palatal gingiva of the right maxillary molar. The initial examination showed a smooth-surfaced extraordinary swelling with a diameter of approximately 20 mm. Cytology findings led to a class V determination and the patient was clinically diagnosed with a right-sided maxillary malignant tumor. Imaging studies also revealed a tumor in the right-side submandibular lymph node. For further confirmation of the diagnosis, a tissue biopsy was performed and a diagnosis of PBL determined, based on the histopathological and immunohistological findings of the specimen. Blood test results showed that the patient was HIV negative and EBV positive. Two years after the biopsy, there was no recurrence or enlargement in the affected area noted. [ABSTRACT FROM AUTHOR]

Ameloblastic carcinoma (AC) is an aggressive odontogenic tumor. Spindle cell variant of AC (SCAC) is a rare entity and only sixteen cases of SCACs have been reported in the literature till date. We reported a case of 42-years-old male presented with swelling in right lower posterior region for 3 years. Radiology revealed multilocular osteolytic with cortical thinning and rarefaction showing internal non-enhancing areas. Histologically, the tumor revealed areas characteristic of ameloblastoma along with hypercellular areas of monomorphic spindle shaped cells merging into the stroma displaying cytological atypia, suggestive of AC with spindle cell variant. The purpose of this case report is to document an unusual case of spindle cell variant of AC, which can mimic other oral spindle cell lesions. Additionally, proliferative marker along with histological parameters like cytological atypia, mitoses and cell morphology is emphasized. [ABSTRACT FROM AUTHOR]

Marginal mandibulectomy is indicated for oral cavity squamous cell carcinomas that involve floor of mouth, abut or minimally erode the mandible without gross invasion. Successful outcomes after Marginal mandibulectomy is predicated on accurate patient selection and appropriate adjuvant treatment based on specific host and tumor characteristics. To study the onclogical outcomes in terms of loco-regional recurrence free survival and disease specific survival of marginal mandibulectomy done for oral squamous cell carcinomas. Study Design—Retrospective study. Setting—The study was done from January 2018 to January 2021 at our tertiary care centre Madras Medical College, Chennai. Subjects—30 cases were included in our study who underwent Marginal Mandibulectomy for oral cavity SCC. Methods—The decision to perform a marginal mandibulectomy was taken based on preoperative clinical examination, contrast enhanced computed tomography (CECT) findings and intra-operative assessment under anesthesia. Disease-free survival, cause-specific survival, and local control rates were plotted using the Kaplan-Meier method. Oncologic outcomes in terms of Overall survival and Disease-specific survival at the end of 1 year and 3 years for the gingival, buccal, tongue, floor of mouth cancers were analyzed. Independent impacts including the site of tumor, T and N stage, microscopic bony invasion, grade of differentiation, adjuvant radiotherapy on the loco-regional control and cause-specific survival were evaluated using Kaplan meier method. Our study group was comprised of 20(66.67%) males and 10 (33.33%) females of mean age 54 years. None of them had prior radiotherapy to the head and neck region. A total of 7 (23.33%) marginal mandibulectomies were carried out for SCC in the gingival region, 11(36.67%) for buccal mucosa, 8(26.67%) for tongue, 2(6.67%) for floor of mouth SCC, 1(3.33%) involving lip, 1(3.33%) in Retromolar trigone. Clinically 2 (6.67%) patients had T1 cancer, 18 (54.54%) had T2, 6 (18.18%) had T3, 4(13.33%) had T4 tumor. Clinically Neck nodes were not palpable in 17 (56.67%) patients, 10 (33.33%) had N1 disease and 3 (10%) had N2 disease. T and N stage distributions for tongue/floor of mouth and gingival buccal complex cancers are summarized in the table and there were no statistically significant differences between the 2 groups. 19 (63.33%) had selective neck dissection (levels I–III), and 11 (36.67%) had comprehensive neck dissection. Well-differentiated tumors were encountered in 12 (40%) cases, moderately differentiated tumors in 16 (53.33%) cases, and poorly differentiated tumors in 2 (6.67%) cases. Bone was microscopically involved in 4 (13.33%) cases and mucosal margin of excision was less than 5 mm from the tumor in 2 (6.67%) cases. Cumulative hazard of local recurrence was not significantly affected by mandibular involvement. On histopathologic examination, positive nodes were seen in 6(20%) cases that included 3 (10%) with pN1 and the rest with pN2 disease. Adjuvant radiotherapy (56 to 64 Gy) was given to 13 (43.33%) patients. In carefully selected patients, marginal mandibulectomy in oral squamous cancer achieves good oncological outcome in terms of locoregional control and overall survival rates. [ABSTRACT FROM AUTHOR]

The aim of the study was to assess the involvement of submandibular gland in oral cancer patients undergoing neck dissection. This study reviewed the records and pathologic specimens of patients who were clinically and histopathologically diagnosed as having oral cavity squamous cell carcinoma, from the year 2018 to 2023. A total of 332 patients were included. These patients underwent surgery with primary tumor resection and neck dissection. Pathologic metastasis to submandibular gland was then evaluated. Histopathological data showed that submandibular gland was involved in only 10 cases. Out of these cases, involvement of level IA &B lymph nodes was found in 9 of the cases. Direct extension of primary tumor to submandibular gland was noted in advanced stages (stage IV). Most common primary site for involvement of SMG was buccal mucosa (six patients), with significant correlation with LVI, ENE, DOI and WPOI (p value < 0.05). This study demonstrates that the incidence of submandibular gland metastasis in oral cavity (SCC) is extremely rare. Its involvement is either through direct extension from a primary lesion or in advanced disease. Thus, patients with early-stage oral SCC with preoperative N0 neck, may be candidates for preservation of the submandibular gland. [ABSTRACT FROM AUTHOR]

Background and Purpose: The aims of our study are to evaluate the diagnostic performance and prognostic value of radiological lymph node (LN) characteristics in pN+ oral cavity squamous carcinoma (OSCC). Materials and Methods: pN+ OSCC treated between 2012 and 2020 were included. Preoperative imaging was reviewed by a single radiologist blinded to pathologic findings for the following nodal features: imaging‐positive LN (iN+), laterality and total number, and image‐identified extranodal extension (iENE). The sensitivity of iN+ for pN+ was calculated. The diagnostic performance of other nodal features was evaluated in the iN+ subgroup. The association of radiologic nodal features with overall survival (OS) was evaluated. Inter‐rater kappa for radiologic nodal features was assessed in 100 randomly selected cases. Results: Of 406 pN+ OSCC, 288 were iN+. The sensitivity of iN+ for pN+ was 71% overall, and improved to 89% for pN+ LN >1.5 cm. Within iN+, sensitivity/specificity for LN size (>3 cm), total LN number (>4), and ENE were 0.44/0.95, 0.57/0.84, and 0.27/0.96, respectively. Sensitivity of iENE was higher in the subset, with major (>2 mm) versus minor (≤2 mm) pENE (43% vs. 13%, p = 0.001). Reduced OS was observed in iN+ versus iN– (p = 0.006), iENE+ versus iENE– (p = 0.004), LN size >3 versus ≤3 cm (p < 0.001), and higher LN number (p < 0.001). Inter‐rater kappa for iN+, laterality, total LN number, and presence of iENE were 0.71, 0.57, 0.78, and 0.69, respectively. Conclusion: Our study shows that despite modest sensitivity of most radiological nodal features, the specificity of image‐identified nodal features is high and their prognostic values are retained in pN+ OSCC. Level of Evidence: 3 (retrospective review comparing cases and controls) Laryngoscope, 134:4947–4955, 2024 [ABSTRACT FROM AUTHOR]

Lymphoma is the most common tumor of hematopoietic origin in horses. The course of the disease and clinical signs vary greatly, depending on tumor location and extent. The aim of this report is to describe the occurrence of T-cell-rich oral large B-cell lymphoma with marked local infiltration in a 25-year-old Crioula mare. The mare showed an increase in volume on the right side of its face, dyspnea, anorexia, and progressive weight loss. The clinical assessment showed that the lesion was located in the rostral and caudal sinuses and was markedly invasive to adjacent structures. The autopsy revealed a yellow mass with a soft to firm consistency, infiltrating multiple bones in the skull, and extensively invading the hard palate and masseter muscle. Histologically the mass comprised an undifferentiated malignant neoplasm characterized by a densely cellular neoplasm composed of large CD20 + neoplastic B-lymphocytes admixed with sheets of small, CD3 + reactive T-lymphocytes supported by delicate fibrovascular stroma leading to the diagnosis of oral T-cell-rich large B-cell lymphoma. [ABSTRACT FROM AUTHOR]

Background: Metastatic tumors of the oro-facial tissuesare rare, with an incidence ranging between 1% and 8% of all oral malignant tumors. Generally reported with a peak of incidence in the 5–7th decades but possibly occurring at any age, metastases may represent the first sign of an occult cancer or manifest in patients with an already known history of a primary carcinoma, mostly from the lungs, kidney, prostate, and colon/rectum in males, and the uterus, breast, lung, and ovary in females. In the oro-facial tissues, the most involved sites are the oral mucosa, gingiva/jawbones, tongue, and salivary glands. Methods: A broad and deep literature review with a comprehensive analysis of the existing research on oro-facial metastases from renal-cell carcinoma (RCC) was conducted by searching the most used databases, with attention also paid to the clear-cell histological variant, which is the most frequent one. Results: Among the 156 analyzed studies, 206 cases of oro-facial metastases of renal cancer were found in patients with an average age of 60.9 years (145 males, 70.3%; 61 females, 29.6%). In almost 40% of the cases, metastasis represented the first clinical manifestation of the primary tumor, and 122 were histologically diagnosed as clear-cell renal-cell carcinoma (ccRCC) (59.2%). The tongue was involved in most of the cases (55 cases, 26.7%), followed by the gingiva (39 cases, 18.9%), mandible (35 cases, 16.9%), maxilla (23 cases, 11.1%), parotid gland (22 cases, 10.6%), buccal mucosa (11 cases, 5.3%), lips (7 cases, 3.3%), hard palate (6 cases, 2.8%), soft palate, masticatory space, and submandibular gland (2 cases, 0.9%), and lymph nodes, tonsils, and floor of the mouth (1 case, 0.4%). Among the 122 ccRCCs (84 males, 68.8%; 38 females, 31.1%), with an average age of 60.8 years and representing in 33.6% the first clinical manifestation, the tongue remained the most frequent site (31 cases, 25.4%), followed by the gingiva (21 cases, 17.2%), parotid gland (16 cases, 13.1%), mandibular bone (15 cases, 12.2%), maxillary bone (14 cases, 11.4%), buccal mucosa and lips (6 cases, 4.9%), hard palate (5 cases, 4%), submandibular gland and soft palate (2 cases, 1.6%), and lymph nodes, tonsils, oral floor, and masticatory space (1 case, 0.8%). The clinical presentation in soft tissues was mainly represented by a fast-growing exophytic mass, sometimes accompanied by pain, while in bone, it generally presented as radiolucent lesions with ill-defined borders and cortical erosion. Conclusions: The current comprehensive review collected data from the literature about the incidence, site of occurrence, age, sex, and survival of patients affected by oro-facial metastases from renal-cell carcinoma, with particular attention paid to the cases diagnosed as metastases from clear-cell renal-cell carcinoma, which is the most frequent histological variant. Clinical differential diagnosis is widely discussed to provide clinicians with all the useful information for an early diagnosis despite the effective difficulties in recognizing such rare and easily misdiagnosed lesionsTheir early identification represents a diagnostic challenge, especially when the clinical work-up is limited to the cervico–facial region. Nevertheless, early diagnosis and recently introduced adjuvant therapies may represent the key to better outcomes in such patients. Therefore, general guidelines about the clinical and radiological identification of oro-facial potentially malignant lesions should be part of the cultural background of any dentist.

Abstract Background Tooth loss significantly impacts oral function and overall health deterioration. Dental caries and periodontal disease are major contributors to tooth loss, emphasizing the critical need to prevent these conditions. Genetic studies have played a crucial role in deepening our understanding of the underlying mechanisms of these diseases. While large-scale genome-wide association studies (GWAS) on dental caries and periodontal disease have been conducted extensively, research focusing on Asian populations remains limited. Given substantial genetic and lifestyle variations across ethnicities, conducting studies across diverse populations is imperative. This study aimed to uncover new insights into the genetic mechanisms of these diseases, contributing to broader knowledge and potential targeted interventions. Methods We conducted a GWAS using genome data from 45,525 Japanese individuals, assessing their self-reported history of dental caries and periodontal disease. Additionally, we performed a meta-analysis by integrating our results with those from a previous large-scale GWAS predominantly involving European populations. Results While no new loci associated with periodontal disease were identified, we discovered two novel loci associated with dental caries. The lead variants of these loci were intron variant rs10974056 in GLIS3 and intron variant rs4801882 in SIGLEC5. Conclusion Our study findings are anticipated to advance understanding of the underlying mechanisms of dental caries and periodontal disease. Thes insights may inform better management strategies for patients affected by these conditions.

Archaea represent a separate domain of life, next to bacteria and eukarya. As components of the human microbiome, archaea have been associated with various diseases, including periodontitis, endodontic infections, small intestinal bacterial overgrowth, and urogenital tract infections. Archaea are generally considered nonpathogenic; the reasons are speculative because of limited knowledge and gene annotation challenges. Nevertheless, archaeal syntrophic principles that shape global microbial networks aid both archaea and potentially pathogenic bacteria. Evaluating archaea interactions remains challenging, requiring clinical studies on inflammatory potential and the effects of archaeal metabolism. Establishing a culture collection is crucial for investigating archaea functions within the human microbiome, which could improve health outcomes in infectious diseases. We summarize potential reasons for archaeal nonpathogenicity, assess the association with infectious diseases in humans, and discuss the necessary experimental steps to enable mechanistic studies involving archaea.

Background/purpose: Helicobacter pylori has been found to be related to periodontitis, and the oral cavity has been considered a reservoir for H. pylori gastritis infection. Thus, this study evaluated the effect of mouthwash containing poly l-Lysine and glycerol monolaurate on inhibiting H. pylori growth, biofilm formation, cell cytotoxicity, adhesion ability, cagA mRNA expression, and pro-inflammatory cytokines stimulated by H. pylori. Materials and methods: Nineteen H. pylori strains were isolated from the oral cavity. The effectiveness of mouthwash containing poly l-Lysine and glycerol monolaurate was examined for its ability to inhibit H. pylori growth and biofilm formation and was tested for cell viability in oral epithelial cells (H357), gastric adenocarcinoma cells (AGS), and periodontal ligament cells (PDL). Additionally, the mouthwash was tested for reducing cagA mRNA expression, adhesion ability to H357 and AGS cells, and pro-inflammatory cytokines stimulated with H. pylori in AGS and PDL cells. Results: The mouthwash containing poly l-Lysine and glycerol monolaurate could eradicate the biofilm by 14.9–19.9% after incubation at 5 min, and cell viability revealed 77.2, 79.8, and 100.0% for AGS, H357, and PDL cells, respectively. Moreover, the mouthwash containing poly l-Lysine and glycerol monolaurate could down-regulate cagA mRNA expression, reduce adhesion of H. pylori by approximately 9.5–47.8% for H357 cells and 24.5–62.9% for AGS cells, and decrease pro-inflammatory cytokines, especially interleukin-8, stimulated with H. pylori. Conclusion: Mouthwash containing poly l-Lysine and glycerol monolaurate could inhibit H. pylori growth and reduce their virulence expression. The mouthwash also revealed low cytotoxicity to oral and gastric cells.

Mucosal melanoma malignum (mMM) is a rare and aggressive malignancy that carries a poor prognosis. Most commonly, it develops on the mucous membranes in the head and neck region, and within the genitalia. Because of its anatomical location and absence of early symptoms, diagnosing mucosal melanoma malignum presents significant challenges. Consequently, the disease is usually diagnosed at an advanced stage. Dermoscopy is a helpful tool in the early diagnosis of mucosal melanoma malignum. Risk factors for mucosal melanoma malignum are poorly understood so far, but exposure to ultraviolet light is not known to increase the risk of developing the disease. The overall 5-year survival rate for mucosal melanoma ranges from 0% to 45%, with an average survival of 2 years. Early detection is crucial for favourable prognosis.

Abstract Background Clinical diagnosis of the masses of the oropharynx and the oral cavity is usually straightforward; however, deep extension of lesions should be assessed by imaging. Thirty patients with suspected masses in oral cavity and oropharynx were enrolled in the present study. Contrast-enhanced CT and MRI were used for imaging of all patients, and superficial ultrasound was used as screening (whether the mass was accessible to ultrasound or not). The aim of this study was to evaluate clinical impact of combined imaging modalities for assessment of intraoral and oropharyngeal masses. Results There was a statistically significant difference between CT and MRI regarding the detected tumor size, lymph node and adjacent structures. CT had a sensitivity of 77.78% and specificity of 75% in the detection of malignancy. A low apparent diffusion coefficient can detect malignancy with 61.11% sensitivity and 91.67% specificity. Conclusions The radiographic diagnosis of the oral cavity presents a complex challenge. According to the unique presentation of each patient, combined CT and MRI imaging will enhance the identification and characterization of lesions in the oral cavity and oropharynx. There is a secondary, limited role for ultrasonography.

Background: Tooth loss significantly impacts oral function and overall health deterioration. Dental caries and periodontal disease are major contributors to tooth loss, emphasizing the critical need to prevent these conditions. Genetic studies have played a crucial role in deepening our understanding of the underlying mechanisms of these diseases. While large-scale genome-wide association studies (GWAS) on dental caries and periodontal disease have been conducted extensively, research focusing on Asian populations remains limited. Given substantial genetic and lifestyle variations across ethnicities, conducting studies across diverse populations is imperative. This study aimed to uncover new insights into the genetic mechanisms of these diseases, contributing to broader knowledge and potential targeted interventions. Methods: We conducted a GWAS using genome data from 45,525 Japanese individuals, assessing their self-reported history of dental caries and periodontal disease. Additionally, we performed a meta-analysis by integrating our results with those from a previous large-scale GWAS predominantly involving European populations. Results: While no new loci associated with periodontal disease were identified, we discovered two novel loci associated with dental caries. The lead variants of these loci were intron variant rs10974056 in GLIS3 and intron variant rs4801882 in SIGLEC5. Conclusion: Our study findings are anticipated to advance understanding of the underlying mechanisms of dental caries and periodontal disease. Thes insights may inform better management strategies for patients affected by these conditions. [ABSTRACT FROM AUTHOR]

Nodular fasciitis is a rare but benign fibroblastic proliferation that typically presents as a solitary lesion with rapid growth and variable mitotic activity. The lesions usually occur on the extremities and occasionally in the head/neck region. Involvement of the buccal mucosa is extremely rare with only few reports in the literature; in this case report, we describe a 41 year old female who presented with a 6-month history of a stable intraoral lump at the junction of the upper and lower lip. Fine needle aspiration revealed an atypical spindle cell population with plump cells. The surgical excision demonstrated a well circumscribed tan-white firm nodule. Histologic examination revealed a spindle cell proliferation that grew in short, intersecting fascicles with focal storiform architecture. The lesion had a pushing border that was not overtly infiltrative and the stroma contained focal myxoid changes giving a "tissue culture" appearance to the cells. Immunohistochemical testing showed the tumor cells were vimentin (+), SMA (+), weakly Calponin (+), and desmin (-), cytokeratin (-), AE1/AE3 (-), S100 (-), ALK (-), STAT6 (-), and beta-catenin (-). Fluorescence in-situ hybridization (FISH) revealed a USP6 gene rearrangement with an atypical probe pattern. Next generation sequencing identified a novel SPTAN1::USP6 fusion gene confirming the diagnosis of buccal nodular fasciitis. Identification of the characteristic histologic features and USP6 gene rearrangements helped support the diagnosis. A review of the literature identified 25 cases of nodular fasciitis involving the buccal mucosa. The occurrence of this tumor in an unusual location may pose difficulties for diagnosis. [ABSTRACT FROM AUTHOR]

Sex steroid hormones (SSH) are extremely versatile molecules with a myriad of physiological functions. Next to their well-known role in sexual development and reproduction, SSH play active roles in practically every tissue in the human body, including the oral cavity. It has long been demonstrated that periodontal tissues express SSH receptors and therefore are responsive to the presence of SSH. Interestingly, SSH not only interact with the periodontal tissues but also with other tissues in the oral cavity such as dental enamel, pulp, cementum, oral mucosa, and salivary glands. Questions concerning the possible physiological functions of these receptors and their role in maintenance of oral health, remain unanswered. The purpose of this scoping review was to gather and summarize all the available evidence on the role of SSH in physiological processes in the oral cavity in humans. Two comprehensive literature searches were performed. References were screened and selected based on title, abstract and full text according to our inclusion criteria. Both searches yielded 18,992 results of which 73 were included. Results were divided into four categories: (1) Periodontium; (2) Dental structure; (3) Mucosa; and (4) Salivary glands. The interaction of these tissues with progestagens, androgens and estrogens are summarized. Sex steroid hormones are an overlooked yet fundamental factor in oral homeostasis. They play important roles in the development and function of the periodontium, dental structure, mucosa and salivary glands. Dentists and healthcare providers should consider these hormonal factors when assessing and treating oral health conditions. [ABSTRACT FROM AUTHOR]

Herpailurus yagouaroundi, popularly known as the jaguarundi cat, is a small cat with a wide territorial distribution. Understanding its morphological characteristics is of great importance for the evolution of scientific knowledge of the species and its eating habits. With that in mind, the objective was to describe the morphology of its oral cavity to contribute to future studies on its diet in captivity. Three specimens of H. yagouaroundi were used, and underwent the process of fixation in 10% formaldehyde, photodocumentation, preparation of histological slides for evaluation of lips, cheeks, hard palate, soft palate and tongue, for subsequent photomicrography. Macroscopically, the animal presented tactile hairs in the region of the cheek and close to the lips, the latter with a blackish color and smooth appearance, hard palate with wrinkles and palatine grooves full of palatine papillae, and soft palate with folds of the mucosa. The tongue had an elongated shape with different thicknesses in each region, at the apex of the tongue, filiform papillae were observed, including fungiform ones. At the base of the organ, vallate papillae, conical papillae, more delicate than the filiform ones, foliate papillae and marginal papillae were observed on the side of the tongue. Analyzing the literature, it was possible to prove that the jaguarundi cat has characteristics very similar to those of large cats. Evaluating the presence of a greater variety of lingual papillae, it is suggested that the eating habits of jaguarundi cats are more restricted and that they are more selective in their food. [ABSTRACT FROM AUTHOR]

Introduction. Oral lymphatic malformations are uncommon lesions. This study assessed the clinicopathological and sociodemographic features of oral lymphatic malformations in a Brazilian oral pathology service. Methods. Between 2000 and 2021, all oral lymphatic malformations diagnosed in a single oral pathology service were selected for the study. Clinical data, such as age, sex, site of the lesion, clinical presentation, diagnosis clinical, and the type of biopsy were recorded from the patient's clinical charts. Results. From 7554 oral lesions, 17 (0.22%) were oral lymphatic malformations. This lesion similarly affected both sexes, and the mean age of the patients was 16.5 years. The tongue was the most common site (n = 13; 76%). The mean size of the lesions was 17 mm. Oral lymphatic malformations were asymptomatic for 29% of the patients. Clinically, most lesions appeared as a reddish, sessile nodule, with a pebbly surface. In addition, the clinical and histopathological diagnoses agreed for most lesions (n = 11; 64%). The type of biopsy performed was excisional in 41% of lesions. Conclusions. In summary, oral lymphatic malformations present a low prevalence among the oral lesions diagnosed in an oral pathology service. Moreover, they affect equally both sexes, especially young patients, and usually appear as an asymptomatic or symptomatic nodular swelling on the tongue. [ABSTRACT FROM AUTHOR]

Purpose: The choice of surgical approach for floor of the mouth (FOM) cancer, particularly for intermediate-stage tumors (cT2–cT3), remains controversial. This study aims to evaluate a method considering mylohyoid muscle (MM) invasion as a determinant for surgical approach selection, utilizing magnetic resonance imaging (MRI) preoperatively and frozen section (FS) analysis intraoperatively. Methods: This observational retrospective cohort study analyzed patients undergoing surgical resection of cT2 and cT3 FOM squamous cell carcinoma (SCC) between January 2013 and June 2023. MM infiltration assessed by preoperative MRI determined the surgical approach: clear infiltration led to compartmental surgery (CS), while doubtful or absent infiltration led to transoral surgery (TOS). Conversion from TOS to CS occurred intraoperatively based on macroscopic evidence or positive FS. Data collected included demographic, clinical, surgical, and pathological variables. Survival analysis was conducted using Kaplan–Meier method. Results: Among 44 patients included, majority had cT2 tumors (59.1%). MM resection was necessary in 22.7% of cases. Overall survival (OS) and progression-free survival (PFS) did not significantly differ between TOS and CS groups. Radiological depth of invasion (rDOI) < 10 mm is correlated with MM preservation in 89% of cases, while rDOI > 10 mm is correlated with MM resection only in 23.8% of cases. Pathological depth of invasion (pDOI) discrepancies were observed in the two groups: in CS group is shown a higher pDOI (> 10 mm) confirmation (90%). Surgical complications and functional outcomes differed between TOS and CS groups. Conclusion: Considering MM invasion for surgical approach selection in cT2–cT3 FOM tumors appears oncologically safe, with better functional outcomes in muscle preservation. Preoperative MRI for MM assessment combined with intraoperative FS analysis provides reliable guidance for surgical decision-making. [ABSTRACT FROM AUTHOR]

The feeding habits and habitats of fish influence the morphology of the oral cavity. This study used gross anatomy, light microscopy, and scanning electron microscopy, in addition to morphometric analysis, to investigate the anatomical characteristics of the oral cavity roof in Pagrus pagrus and Boops boops, which have different dietary habits. The oral cavity roof appeared U‐shaped and divided into the palate and upper pharyngeal regions. The upper lip of P. pagrus was broad, while B. boops' upper lip was small and thin. Both species had a stratified squamous epithelium with an irregular shape and a folded surface. P. pagrus had a horseshoe‐shaped upper velum with a high middle part, and its surface resembled sea waves with obvious mucous‐secreting openings with cilia and many folds and grooves between them. B. boops's upper velum was thin and appeared as a triangle pouch with a pointed cranial apex. The palate in both species was narrow in the front and increased in width backward until it ended. The upper pharyngeal teeth in P. pagrus appeared as two patches, separated by a median longitudinal ridge and an anterior V‐shape separator. Meanwhile, in B. boops, they appeared as a ball patch on both sides and a separator ridge in the middle. Because P. pagrus fed on harder structures than B. boops, their feeding habits were reflected in the structure of the oral cavity roof. P. pagrus, a carnivorous species, had several rows of sharp upper jaw and upper pharyngeal teeth, thick spinous tubercles on oblique transverse ridges, and massive mucous glands. On the other hand, B. boops, an omnivorous species, had only one row of upper jaw teeth, a few upper pharyngeal teeth scattered on two oval patches, and thin filaments on the oblique transverse ridges. [ABSTRACT FROM AUTHOR]