Oral Surgery Oral Medicine Oral Pathology Oral Radiology最新文献

{"title":"Diversity within: a systematic review of intratumor heterogeneity in head and neck squamous cell carcinoma.","authors":"Vivek Nayyar, Beryl Rachel J, Sachendra Kumar, Siva Kumar N, Rewa Malhotra, Harpreet Singh, Debnath Pal, Varun Surya, Deepika Mishra","doi":"10.1016/j.oooo.2026.08.023","DOIUrl":"https://doi.org/10.1016/j.oooo.2026.08.023","url":null,"abstract":"<p><strong>Objective: </strong>Head and neck squamous cell carcinoma (HNSCC), is a common, morbid, and frequently lethal malignancy with complex molecular landscapes that influence treatment outcomes and resistance. This systematic review aimed to evaluate the frequency and nature of intratumor heterogeneity (ITH) across multiple tumor regions.</p><p><strong>Design: </strong>We systematically reviewed and screened studies on HNSCC intratumor heterogeneity. Mutation and heterogeneity rates were extracted, quality-assessed, and analyzed to classify genes by heterogeneity levels.</p><p><strong>Results: </strong>We identified five eligible studies, analyzing 59 reported cases; after correcting for a partially overlapping patient cohort shared between 2 of the included studies, 57 unique cases were analyzed. Among them, 51 cases (89.5%) exhibited significant spatial heterogeneity, while only 6 cases (10.5%) showed mutational homogeneity. The most frequently mutated gene was TP53 (85.96%), which also showed the lowest ITH (34.69%), suggesting clonal origin. Other commonly mutated genes included TGFBR2, NOTCH1, CDKN2A, and EGFR. Notably, KRAS, NRAS, and BRAF genes associated with the MAPK and PI3K pathways exhibited 100% heterogeneity, implying subclonal and late-arising mutations. EGFR mutations, which are commonly targeted in several other malignancies, were observed in 30.43% of cases, with a heterogeneity rate of 64.29%.</p><p><strong>Conclusion: </strong>Understanding ITH is key to precision oncology, improving personalized treatment and outcomes in HNSCC, though larger studies are needed to confirm its prognostic and therapeutic relevance.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing reproducibility among observers for low-, standard-, and high-dose protocols of CBCT assessing anatomical landmarks and pathology related to third molars: An ex vivo study.","authors":"Elias Rezai, Louise Hauge Matzen, Laurits Kaaber, Lars Schropp","doi":"10.1016/j.oooo.2026.08.014","DOIUrl":"https://doi.org/10.1016/j.oooo.2026.08.014","url":null,"abstract":"<p><strong>Objective: </strong>To assess the reliability of low-dose(LD) cone-beam computed tomography (CBCT) protocols for radiographic assessment of third molars, including anatomical structures and related pathology, compared with standard-dose(SD) and high-dose(HD) protocols across three CBCT units.</p><p><strong>Materials and methods: </strong>This ex vivo study included 25 teeth from nine anonymized human skulls, each with one to four impacted third molars. Each tooth was scanned using HD, SD, and LD protocols on three CBCT units. Radiographic parameters were assessed by multiple observers, and inter- and intra-observer agreement was statistically analysed.</p><p><strong>Results: </strong>Inter-observer agreement varied substantially across diagnostic parameters, CBCT units, and dose protocols, with κ values generally ranging from moderate to almost perfect agreement. Pronounced variability among observer pairs was observed for certain parameters within the same protocol and unit. No consistent reduction in reproducibility was observed when lowering the dose from HD to SD to LD. Intra-observer reproducibility was generally high.</p><p><strong>Conclusion: </strong>Reproducibility in the assessment of third molars was primarily influenced by the diagnostic parameter and the observer rather than by CBCT dose level or unit. Lowering dose did not result in a consistent change in reproducibility. These findings indicate that LD protocols may provide sufficient reproducibility for third molar-related assessments.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomics features of diffusion kurtosis imaging and dynamic contrast enhanced-MRI for predicting aggressive pathological characteristics of oral and oropharyngeal squamous cell carcinoma.","authors":"Lingjie Yang, Riyu Han, Abuduxukuer Aili, Xing Wu, Yun Su, Yu Wang, Guangzi Shi, Lu Yang, Longfeng Yang, Xiaohui Duan, Fang Zhang","doi":"10.1016/j.oooo.2026.08.016","DOIUrl":"https://doi.org/10.1016/j.oooo.2026.08.016","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of radiomics features derived from diffusion kurtosis imaging and dynamic contrast-enhanced MRI for aggressive pathological characteristics of oral and oropharyngeal squamous cell carcinoma (SCC).</p><p><strong>Study design: </strong>This prospective single-center study enrolled 157 patients with pathologically confirmed oral and oropharyngeal SCC, randomly divided into a training set (n = 109) and an internal validation set (n = 48). Additionally, a temporal validation cohort comprising 18 consecutive patients enrolled from November 2022 to September 2023 was utilized to further evaluate the model's robustness. Radiomics features were extracted from 15 parameter maps. Least absolute shrinkage and selection operator (LASSO) regression was used for feature selection, and logistic regression models were constructed.</p><p><strong>Results: </strong>For T stage prediction, the combined DKI and DCE model achieved AUC values of 0.930 in the training set and 0.818 in the internal validation set. For lymph node metastasis (LNM) prediction, the combined model yielded AUC values of 0.978 and 0.854, respectively. In the temporal validation cohort, the combined model maintained favorable predictive performance, with AUCs of 0.900 for T stage and 0.800 for LNM.</p><p><strong>Conclusions: </strong>Radiomics models based on combined diffusion kurtosis imaging and dynamic contrast-enhanced MRI demonstrated favorable predictive performance for T stage and LNM in oral and oropharyngeal SCC. The successful validation in a temporal cohort suggests the potential clinical utility of these models as noninvasive decision-support tools.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Minimally invasive transcrestal sinus floor elevation: a 10-year cohort study\".","authors":"M Shalini, Vatsala Gupta, Parag J Ratnakar, Gaurav, Fayaz Ahamed","doi":"10.1016/j.oooo.2026.07.024","DOIUrl":"https://doi.org/10.1016/j.oooo.2026.07.024","url":null,"abstract":"","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing, testing, and validating a clinical decision support tool to improve the quality of intraoral dental radiographs.","authors":"Jay Patel, Mustafa Badi, Ritwik Katiyar, Jie Yang, Marisol Tellez, Lucia Cevidanes","doi":"10.1016/j.oooo.2026.08.018","DOIUrl":"https://doi.org/10.1016/j.oooo.2026.08.018","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to develop, test, and clinically validate an AI-driven Clinical Decision Support Tool (CDST) to enhance dental radiographic quality, with the goal of reducing retakes and improving diagnosis.</p><p><strong>Study design: </strong>About 188,684 radiographs from 16,703 patients (2020-2024) were manually labeled. Two enhancement strategies were developed: (1) generalized and (2) localized enhancements. For generalized enhancement, two further approaches were developed, including traditional algorithms with the BSRGAN model, and a custom AI pipeline integrating the lighting enhancement-net and enhancement U-net with BSRGAN to remove artifacts, correct exposure, reduce noise, blurriness, and improve sharpness. Localized enhancement involved an ensemble YOLO v8.2 segmentation model followed by LaMa inpainting to remove artifacts. Performance was evaluated on test sets using standard metrics. A panel of dental experts reviewed the original and enhanced radiographs to assess diagnostic quality.</p><p><strong>Results: </strong>The YOLO model achieved 92% accuracy, while LaMa achieved 96%. Expert evaluation of 1,500 radiographs indicated that 81% were improved, 15% were unchanged, and 3% showed reduced diagnostic quality, with statistically significant differences (P < .05).</p><p><strong>Conclusions: </strong>This AI-driven, expert-validated CDST enhances global and localized radiographic quality, potentially reducing retakes, lowering radiation exposure, and improving diagnostic reliability.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of intercellular bridges quantified by machine learning in oral squamous cell carcinoma: a retrospective study.","authors":"Atsuya Ishiyama, Kunio Yoshizawa, Junya Furukawa, Malek Abdelghafaar, Zhenyang Zhu, Toru Odate, Zhenfei Wang, Naoki Oishi, Akinori Moroi, Masahiro Toyoura, Koichiro Ueki","doi":"10.1016/j.oooo.2026.08.020","DOIUrl":"https://doi.org/10.1016/j.oooo.2026.08.020","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the intercellular bridges in oral squamous cell carcinoma (OSCC) using artificial intelligence (AI) and to evaluate their independent prognostic value for recurrence-free survival (RFS).</p><p><strong>Study design: </strong>Whole-slide images from 103 primary OSCC patients were analyzed. Swin-WNet automatically segmented intercellular bridges, cytoplasm, and nuclei at the tumor surface (ROI-S), center, and invasive front to calculate area ratios. ROC, Kaplan-Meier, and multivariate Cox regression analyses identified prognostic factors.</p><p><strong>Results: </strong>Cytoplasm-based ratios exhibited slightly higher predictive accuracies (AUC: 0.77-0.79) than nucleus-based ratios. A low cytoplasm-based ROI-S ratio predicted significantly higher recurrence rates (P < .001). Multivariate analysis identified the cytoplasm-based ROI-S ratio (HR: 2.98, P = .019), depth of invasion (DOI; HR: 2.93, P = .011), and Yamamoto-Kohama classification (HR: 2.54, P = .014) as independent RFS predictors.</p><p><strong>Conclusions: </strong>AI-driven quantification of the cytoplasm-based intercellular bridge ratio at the tumor surface has the potential to serve as a novel, objective, and independent predictor of OSCC recurrence. Integrating this cytological metric with macroscopic parameters (DOI, invasion patterns) may contribute to a comprehensive, multispatial prognostic system. Further prospective studies are required to validate these findings.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor regarding \"Minimally invasive transcrestal sinus floor elevation: a 10-year cohort study\".","authors":"Federico Garola, Jaime Andrés Fiol, Julio César García, Eduardo David Piemonte","doi":"10.1016/j.oooo.2026.08.021","DOIUrl":"https://doi.org/10.1016/j.oooo.2026.08.021","url":null,"abstract":"","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proliferative verrucous leukoplakia: a Brazilian multicenter study of 40 cases with exploratory assessment of contemporary diagnostic criteria.","authors":"Rafael Aguiar de Sousa, José Alcides Almeida de Arruda, Giovanna Ribeiro Souto, Sandra Beatriz Chaves Tarquinio, Ricardo Alves Mesquita, Victor Zanetti Drumond, Beatriz Lages Diniz Pereira, Mathias Ponche Barbosa, Bruno Augusto Benevenuto de Andrade, Jefferson R Tenório, Marcela Ferreira Abrahão Ribeiro, Paulo Eduardo Alencar de Souza, Martinho Campolina Rebello Horta, Maria Cássia Ferreira de Aguiar","doi":"10.1016/j.oooo.2026.08.015","DOIUrl":"https://doi.org/10.1016/j.oooo.2026.08.015","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinicodemographic and histopathological features of proliferative verrucous leukoplakia (PVL) in a multicenter cohort and assess the availability of variables required for retrospective application of contemporary diagnostic criteria.</p><p><strong>Study design: </strong>This retrospective multicenter study included 40 patients with PVL from four Brazilian referral centers. All cases met a clinicopathological case definition based on the World Health Organization description of PVL. Clinicodemographic, histopathological, and follow-up data were analyzed descriptively. Medical records were reviewed for documentation of variables required by diagnostic criteria.</p><p><strong>Results: </strong>Most patients were female (85%); median age was 70 years. The gingiva/alveolar mucosa/retromolar area and buccal mucosa were the most frequent sites (55% each). At least two lesions were documented in 90% of patients, including three or more lesions in 72.5%. Nonhomogeneous morphology was documented in 47.5%. During a median follow-up of 3.8 years, recurrence occurred in 75% and malignant transformation in 22.5%. Patients underwent a median of two biopsies, showing findings ranging from hyperkeratosis to invasive squamous cell carcinoma. All variables required for retrospective application were documented in 24 cases (60%); at least one required variable was undocumented in 16 (40%).</p><p><strong>Conclusion: </strong>PVL exhibits marked clinicopathological heterogeneity and substantial malignant potential. Prospective documentation is essential for applying diagnostic criteria, improving comparability across studies, and guiding surveillance.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labial, perioral, and oral molluscum contagiosum in pediatric patients: a multi-institutional case series and literature review.","authors":"José Alcides Almeida de Arruda, Mariana Villarroel-Dorrego, Angelo Meneses, Cislenyt González-Vielma, Jeaneth López-Labady, Oriana Pinto-Laya, Magdalena Asinari, Gerardo Gilligan, Leonardo Amaral Dos Reis, Gerhilde Callou Sampaio, Lucas Guimarães Abreu, Victor Zanetti Drumond, Ricardo Santiago Gomez, Felipe Paiva Fonseca, Ricardo Alves Mesquita, Bruno Augusto Benevenuto de Andrade","doi":"10.1016/j.oooo.2026.08.017","DOIUrl":"https://doi.org/10.1016/j.oooo.2026.08.017","url":null,"abstract":"<p><strong>Objective: </strong>To describe clinicopathological features, differential diagnosis, and management of pediatric labial, perioral, and oral molluscum contagiosum (MC) in light of the available literature.</p><p><strong>Study design: </strong>The present multi-institutional case series included pediatric patients from Venezuela, Brazil, Argentina, and the Dominican Republic. Four databases were searched for pediatric cases involving labial, perioral, and oral sites. Data were analyzed descriptively.</p><p><strong>Results: </strong>Four girls and two boys six to 15 years of age were included. All were asymptomatic. The lesions were solitary or multiple and mainly involved the lips and perioral skin; one patient had intraoral involvement. Differential diagnoses included verruca vulgaris, focal fibrous hyperplasia, and mucocele. Histopathologically, the lesions exhibited a lobulated epithelial proliferation with crater-like invaginations and keratinocytes containing Henderson-Paterson bodies. Management included excisional biopsy, topical cantharidin for cutaneous lesions, and observation or spontaneous regression; five cases had no recurrence. The search yielded 576 records and identified six studies comprising six cases. These included three boys and three girls aged eight months to 17 years. All had labial and/or perioral involvement; two had intraoral lesions.</p><p><strong>Conclusion: </strong>Pediatric labial, perioral, and oral MC is rare. Recognition of its clinicopathological spectrum may prevent misdiagnosis and support individualized conservative management.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postdischarge radiation exposure from I-131-treated thyroid cancer patients: implications for dental practice.","authors":"Emine Tuna Akdoğan, Enes Malik Pınarbaşı, Sinem Coşkun, Nami Yeyin, Ghada ALMisned, Huseyin Ozan Tekin, Mustafa Demir","doi":"10.1016/j.oooo.2026.08.009","DOIUrl":"https://doi.org/10.1016/j.oooo.2026.08.009","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated, for the first time, the radiation exposure of dentists examining thyroid cancer patients following radioactive iodine (RAI) therapy.</p><p><strong>Study design: </strong>External dose-rate measurements were performed at distances of 5-100 cm in 93 differentiated thyroid carcinoma (DTC) patients between Days 1 and 7 after discharge. Patients were classified according to administered RAI activity as Group I (1110-2775 MBq, n = 31) and Group II (3700-7400 MBq, n = 62). Measurements were obtained in the anterior oblique position with patients seated upright to simulate dental examination conditions.</p><p><strong>Results: </strong>In Group I, the cumulative radiation dose potentially received by a dentist was 461.75 µSv on Day 1 after discharge, decreasing to 112 µSv and 92 µSv on Days 2 and 3, respectively. In Group II, cumulative doses on Days 1-4 after discharge were 1148 µSv, 447 µSv, 73 µSv, and 37 µSv, respectively.</p><p><strong>Conclusions: </strong>The findings indicate that patients receiving <3700 MBq RAI may safely undergo dental examination approximately 24-26 hours after discharge with appropriate radiation protection precautions, whereas dental treatment in patients receiving ≥3700 MBq RAI should preferably be postponed for at least 48 hours to maintain occupational exposure below the 1 mSv public dose limit.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149289568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}