Oral Surgery Oral Medicine Oral Pathology Oral Radiology最新文献

{"title":"Oral angioleiomyomas: a case series and review of the literature.","authors":"Justin Bubola, Grace Bradley, Iona Leong, Deepika Chugh, Marco Magalhaes","doi":"10.1016/j.oooo.2025.04.097","DOIUrl":"https://doi.org/10.1016/j.oooo.2025.04.097","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize the clinical and microscopic features of oral angioleiomyomas (ALMs).</p><p><strong>Study design: </strong>A retrospective search of our diagnostic oral pathology biopsy service archives was performed for ALMs diagnosed between 1989 and 2024. Additionally, a review of the literature was performed using PubMed.</p><p><strong>Results: </strong>There were 38 tumors in 29 males and 9 females, with a mean age of 56.8 years. The most common site of involvement was the lips, followed by the palate and buccal mucosa. While the majority of tumors were blue or purple, the color of 8 tumors was pink or normal; therefore, they were not clinically suspected to represent vascular lesions. The most common clinical impression was of a salivary gland lesion. Histologically, the venous subtype was the most frequent, followed by the solid and cavernous subtypes. Adipocytic differentiation was noted in 55.3% of tumors.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this is the largest series of oral ALMs reported in the literature. We found that oral ALMs commonly exhibit adipocytic differentiation. It is important for pathologists to be aware of this phenomenon in order to avoid erroneous classification as angiomyolipoma. Unlike angiomyolipoma, ALMs are not known to be associated with tuberous sclerosis.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133360","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":"Clinical pathologic correlation case 5: “Tooth Sleuth”","authors":"Kittiphoj Tikkhanarak DDS ,&nbsp;Kathleen M. Schultz DMD","doi":"10.1016/j.oooo.2025.01.724","DOIUrl":"10.1016/j.oooo.2025.01.724","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Clinical Presentation&lt;/h3&gt;&lt;div&gt;A 6-year-old female presented to the Cohen Children's Medical Center for routine dental examination. Her medical history was significant for attention deficit disorder (ADHD), speech delay and sensory processing disorder. She was not taking any medications and did not have any allergies. She was asymptomatic at the time of the visit. A panoramic bite-wing radiograph was taken and attention was directed to a well circumscribed intracoronal radiolucency associated with unerupted right maxillary first permanent molar (tooth #3) (Figure 1). At a follow up visit 4 months later, the lesion exhibited significant radiographic progression of the resorptive process of coronal dentin, without periapical pathology or clinical symptoms (Figure 2). A clinical examination was performed and the partially erupted tooth exhibited focal enamel dehiscence with soft tissue accumulation at the mesial aspect of the crown. The remainder of the oral mucosa and dentition was otherwise within normal limits.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Differential Diagnosis&lt;/h3&gt;&lt;div&gt;The differential diagnoses for radiolucent defect within the dentin of the crown of an unerupted tooth include pre-eruptive intracoronal resorption (PEIR), molar-incisor hypomineralization (MIH), regional odontodysplasia (ROD), dental caries, and Turner's tooth.&lt;/div&gt;&lt;div&gt;The most plausible diagnosis in this case is pre-eruptive intracoronal resorption (PEIR). PEIR is characterized by a well-defined radiolucent defect located just beneath the dentin-enamel junction of unerupted teeth.&lt;sup&gt;1,2&lt;/sup&gt; The etiology of PEIR remains unclear, but it is generally identified as an incidental finding on radiographs and is often asymptomatic.&lt;sup&gt;3,4&lt;/sup&gt; Progressive resorption can be identified over time, necessitating timely treatment. There is no known predisposing risk factor for PEIR.&lt;sup&gt;3&lt;/sup&gt; In this case, the defect was identified through routine radiographic examination in an asymptomatic patient, consistent with the typical presentation of PEIR.&lt;/div&gt;&lt;div&gt;Molar-incisor hypomineralization (MIH) is another potential diagnosis. MIH is a developmental defect that affects the mineralization of enamel, primarily involving the first permanent molars and/or incisors.&lt;sup&gt;5&lt;/sup&gt; MIH is a chronologic enamel hypoplasia, and can be associated with an environmental insult at birth or within the first year of life, such as a diagnosed systemic medical condition, traumatic birth or childhood illnesses.&lt;sup&gt;6&lt;/sup&gt; It is typically associated with enamel breakdown and structural weakness which occurs after eruption.&lt;sup&gt;7&lt;/sup&gt; The severity of the enamel hypoplasia can range from focal discoloration of the crown to complete breakdown of the enamel and underlying dentin&lt;sup&gt;6&lt;/sup&gt;. The enamel hypoplasia predisposes the tooth to caries which can accelerate the breakdown process. The severity of the enamel hypoplasia is often correlated with patient symptoms such as temperature sensitivity.&lt;sup&gt;","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 6","pages":"Pages e172-e175"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863961","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":"Clinical pathologic conference case 6: nonhealing extraction site","authors":"Kathleen E. Higgins DDS MS ,&nbsp;Blaire Bowers Ersteniuk DDS, MS ,&nbsp;Aaron Yancoskie DDS","doi":"10.1016/j.oooo.2025.01.725","DOIUrl":"10.1016/j.oooo.2025.01.725","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Clinical Presentation&lt;/h3&gt;&lt;div&gt;A 42-year-old male presents for a 5 week follow up appointment after extraction and bone graft of tooth #31. The area appeared to be healing normally at the 2 week postoperative appointment. The patient reported no significant medical history and a remote social history of smoking cigarettes.&lt;/div&gt;&lt;div&gt;At the initial appointment the patient reported pain for 4 weeks associated with tooth #31. Periapical radiograph (Figure 1) demonstrates a periapical radiolucency associated with the distal root and a radiolucency at the furcation. Clinical exam revealed a probing depth of greater than 7 mm on the facial/lingual aspect extending into the furcation and mobility of the tooth.&lt;/div&gt;&lt;div&gt;At the 5 week follow up appointment the patient reported a nonhealing extraction site and pain. Periapical radiograph (Figure 2) demonstrated a soft tissue enlargement with small radiopacities scattered in the soft tissue and residual extraction site. Clinical exam revealed an exophytic and ulcerated soft tissue mass in the area of #31 (Figure 3). Incisional biopsy of the soft tissue mass was performed at this appointment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Differential Diagnosis&lt;/h3&gt;&lt;div&gt;Prior to considering the postextraction clinical scenario, it is appropriate to comment on the pre-extraction presentation. Critical features to consider include the patient's report of pain along with the radiographic findings of an absence of caries, evidence of fracture or bone loss pattern associated with chronic periodontitis. Additionally, there is a loss of the lamina dura and asymmetrical widening of the periodontal ligament space. These findings, when considered in aggregate, raise the index of suspicion for malignancy. This will be discussed further as the overall postextraction differential diagnosis is considered.&lt;/div&gt;&lt;div&gt;This patient is presenting with an ulcerated soft tissue mass. Such a finding in the oral cavity could represent a long list of both reactive and neoplastic entities, in this case that list becomes shortened when taking into account the corresponding radiographic features.&lt;/div&gt;&lt;div&gt;Developing the differential diagnosis in this case it is important to consider the volume of bone observed radiographically at 5-weeks postextraction (Figure 2). Araújo and colleagues cite 3 months as the earliest point at which bone is observable on radiograph following exodontia,&lt;sup&gt;1&lt;/sup&gt; suggesting that the bone present in this case is abnormal. This provides 2 possibilities for the presence of bone: (1) the bone graft placed at the time of extraction was not resorbed, or (2) the graft was resorbed, and the visible bone present at 5 weeks is neoplastic in origin.&lt;/div&gt;&lt;div&gt;Considering the first possibility, the bone graft may have failed due to any number of local factors including microbial colonization at the site. Hence, the radiographic bone could be the original graft material with the soft tissue mass representing an epulis granulomatosa","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 6","pages":"Pages e175-e177"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863962","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":"Clinical pathologic correlation Case 1: child with diffuse gingival hypertrophy","authors":"Christel M. Haberland DDS, MS ,&nbsp;Molly D. Cohen DMD","doi":"10.1016/j.oooo.2025.01.720","DOIUrl":"10.1016/j.oooo.2025.01.720","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Clinical Presentation&lt;/h3&gt;&lt;div&gt;14-year-old African American male presents with a past medical history of asthma, multiple skin lesions (atopic dermatitis, pruritus, prurigo nodularis, and keloids), and possible acromegaly (concern for large hands and feet) (Figure 1). The skin lesions were being treated with dupilumab and triamcinolone injections. He has a history of skin rashes and itching. He is constantly picking at the skin lesions, and they heal with hyperpigmentation and scarring. He also has keloids that have resulted from minor injuries. His endocrinology workup for large hands and feet found that his lab work and bone age x-rays were unremarkable. For the past year and a half, he has had gingival hypertrophy. The lesions started at the maxillary facial gingiva interproximally and progressed to cover his maxillary and mandibular teeth facially, palatally, and lingually (Figures 2 and 3) He was referred to OMFS, who diagnosed it as puberty gingivitis and planned a gingivectomy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Differential Diagnosis&lt;/h3&gt;&lt;div&gt;Given the patient's history of skin lesions and gingival enlargement, the differential diagnosis includes drug-related gingival hyperplasia, Crohn disease, leukemia, diabetes mellitus, granulomatosis with polyangiitis, and sarcoidosis.&lt;/div&gt;&lt;div&gt;Drug-related gingival hyperplasia should be considered in a patient with a history of prurigo nodularis (PN). PN is a chronic inflammatory skin disease characterized by symmetrical, hyperkeratotic, intensely pruritic nodules.&lt;sup&gt;1&lt;/sup&gt; Its exact pathogenesis is unknown, but neural and immune dysregulation are believed to play a role.&lt;sup&gt;1&lt;/sup&gt; Because of this, treatment may include systemic immunomodulating agents such as cyclosporine, a known trigger of gingival hyperplasia.&lt;sup&gt;1&lt;/sup&gt; Therefore, a thorough investigation of the patient's medication history is warranted.&lt;/div&gt;&lt;div&gt;The presentation of PN in this patient raised suspicion of a possible systemic condition. Prurigo nodularis is reported to be associated with numerous systemic conditions including Crohn disease, hematologic malignancies, diabetes mellitus, human immunodeficiency virus, hepatitis C, Celiac disease, thyroid disease, end-stage renal disease, chronic obstructive pulmonary disease, cardiovascular disease, and several psychiatric conditions.&lt;sup&gt;2&lt;/sup&gt; Of these, Crohn disease, hematologic malignancies, and diabetes mellitus may also exhibit gingival hypertrophy and are considered in this patient's differential diagnosis.&lt;/div&gt;&lt;div&gt;Crohn disease (CD) is a chronic granulomatous disease which may affect any portion of the gastrointestinal tract from mouth to anus.&lt;sup&gt;3&lt;/sup&gt; Oral manifestations are frequently reported and include swelling of oral and perioral tissues, mucosal tags, linear ulcers, aphthous-like ulcers, mucosal cobblestoning, and pyostomatitis vegetans.&lt;sup&gt;3,4&lt;/sup&gt; Gingival lesions are noted in the form of gingival edema, erythema, and hyperplasia.&lt;sup&gt;4&lt;/sup&gt; CD can devel","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 6","pages":"Pages e160-e162"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864966","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":"Society Page","authors":"","doi":"10.1016/S2212-4403(25)00812-0","DOIUrl":"10.1016/S2212-4403(25)00812-0","url":null,"abstract":"","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 6","pages":"Page A5"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865220","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":"Clinical pathology correlation case 4: right-sided sinonasal mass associated with ocular proptosis","authors":"Sara Albastoni BDS, MS ,&nbsp;Moni Ahmadian DMD ,&nbsp;Bart Singer MD","doi":"10.1016/j.oooo.2025.01.723","DOIUrl":"10.1016/j.oooo.2025.01.723","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Clinical Presentation&lt;/h3&gt;&lt;div&gt;An 11-year-old male patient presented with a right-sided facial asymmetry and proptosis of the right eye with associated vision loss and neuropathy. Review of his health history was otherwise unremarkable. Computed tomography (CT) scan of the head revealed a well-demarcated, expansile, heterogeneous radiodense mass with central lucent zone that obliterated the right nasal cavity and ethmoid sinus spaces (Figure 1). While impinging on the optic nerve, the lesion displaced the globe of the right eye, deviated the nasal septum, and displaced the sphenoid bone posteriorly.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Differential Diagnosis&lt;/h3&gt;&lt;div&gt;The differential diagnosis for sinonasal conditions associated with ocular proptosis is broad and includes a range of reactive processes along with benign and malignant neoplastic conditions arising in both soft tissues and hard tissues.&lt;sup&gt;1&lt;/sup&gt; Since this lesion demonstrates radiodensity comparable to those of the hard tissues, primary intraosseous pathologic conditions are favored in the differential diagnostic considerations with notable exception of sinonasal meningioma.&lt;/div&gt;&lt;div&gt;Meningioma is a tumor of possible meningiothelial cell origin that represents 24%-30% of all intracranial neoplasms.&lt;sup&gt;2&lt;/sup&gt; It arises across a broad age range with rare occurrence in children and an overall female predilection.&lt;sup&gt;3&lt;/sup&gt; Primary extracranial meningiomas are relatively rare representing less than 1% of all cases which mostly occur in the orbit, middle ear, soft tissues, skin, and sinonasal tract.&lt;sup&gt;3,4&lt;/sup&gt; Clinical manifestations of sinonasal meningiomas are nonspecific including nasal obstruction, epistaxis, nasal discharge, proptosis, facial pain and deformity.&lt;sup&gt;2,3&lt;/sup&gt; On CT imaging, sinonasal meningioma presents as a homogenously enhancing mass associated with hyperostosis of the surrounding bone. While it generally demonstrates soft tissue density, speckled opacifications may also be observed especially in the psammomatoid variant of this tumor.&lt;sup&gt;3-5&lt;/sup&gt; The present case demonstrates a heterogeneous radiodensity comparable to that of hard tissues and therefore meningioma is not considered a likely diagnostic consideration.&lt;/div&gt;&lt;div&gt;Osteomas are the most common primary bone tumors of the craniofacial skeleton which may arise in paranasal sinuses, maxilla, mandible, mastoid air cells, external auditory canal, and the cranial vault.&lt;sup&gt;6&lt;/sup&gt; While the exact pathogenesis of osteomas remain largely elusive, possible traumatic, infectious, and developmental etiologies have been suggested.&lt;sup&gt;6,7&lt;/sup&gt; In the paranasal sinuses, osteomas show a propensity for frontal and ethmoid sinuses.&lt;sup&gt;6&lt;/sup&gt; Arising across a broad age range, most sinonasal osteomas are diagnosed in 5th-6th decades of life.&lt;sup&gt;7,8&lt;/sup&gt; While most tumors are asymptomatic and incidentally discovered on imaging studies, depending on their location, sinonasal osteomas may induce symptoms such as h","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 6","pages":"Pages e169-e172"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863960","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":"Information for Readers","authors":"","doi":"10.1016/S2212-4403(25)00813-2","DOIUrl":"10.1016/S2212-4403(25)00813-2","url":null,"abstract":"","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 6","pages":"Page A6"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865221","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":"Clinical pathologic correlation case 3: right facial swelling after tooth extraction","authors":"King Chong Chan DMD, MS ,&nbsp;Allison Lee DDS, MS","doi":"10.1016/j.oooo.2025.01.722","DOIUrl":"10.1016/j.oooo.2025.01.722","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Clinical Presentation&lt;/h3&gt;&lt;div&gt;A 23-year-old man with a diagnosis of Hermansky-Pudlak syndrome presented to the emergency clinic, complaining of pain and swelling after a tooth extraction. Clinically, a painful swelling was identified to affect the right-side of the face. Panoramic imaging showed a diffuse asymmetric change in the cancellous and cortical bone pattern, extending from the mandibular right third molar region, mesially, crossing the midline, to the mandibular left canine region (Figure 1). The bone pattern alteration consisted of large and wide marrow spaces, bordered by remodeled cancellous bone trabeculae and admixed with multiple pinpoint radiolucent locules and multiple nutrient channel-like tubules; the latter was evident as channel-shaped discontinuities along the inferior mandibular cortex. Immediately adjacent to the affected region of the right mandibular body, the right mandibular foramen, right inferior alveolar canal, and right mental foramen were asymmetrically enlarged. Despite the bone pattern alteration, the normal anatomic shape and structure of the mandible was maintained and remained bilaterally symmetric to the unaffected left-side.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Differential Diagnosis&lt;/h3&gt;&lt;div&gt;Hermansky-Pudlak syndrome (HPS) is an autosomal recessive disorder that is associated with oculocutaneous albinism, bleeding diathesis, granulomatous colitis and, in certain subtypes, highly penetrant pulmonary fibrosis.&lt;sup&gt;1&lt;/sup&gt; Currently, 11 recognized subtypes of HPS are linked to various mutations affecting the biogenesis or function of lysosome-related organelles.&lt;sup&gt;2&lt;/sup&gt; Although these subtypes exhibit a range of clinical manifestations, none have been reported to cause jaw lesions akin to the current case. Nonetheless, patients with HPS may experience gingival bleeding, and prolonged bleeding following tooth extractions due to their bleeding diathesis. Therefore, it is essential to take appropriate precautions when treating patients with HPS.&lt;sup&gt;2&lt;/sup&gt;&lt;/div&gt;&lt;div&gt;The differential for a relatively ill-defined noncorticated radiolucency in the posterior mandible is quite broad, but is suggestive of a locally aggressive lesion, malignancy, or a vascular lesion, which may mimic aggressive or malignant entities. Given the lesion's location within the tooth-bearing region of the jaws, both odontogenic and nonodontogenic entities should be considered. The differential diagnosis includes odontogenic myxoma, central giant cell granuloma, osteosarcoma, malignant peripheral nerve sheath tumor, and an intraosseous arteriovenous malformation.&lt;/div&gt;&lt;div&gt;Odontogenic myxomas are rare benign odontogenic tumors that have a predilection for the posterior mandible and are predominantly found in young adults, with an average age between 25 and 30 years.&lt;sup&gt;3,4&lt;/sup&gt; Odontogenic myxomas are often associated with painless expansion and appear as a unilocular or multilocular radiolucency that may displace or cause resorption of teeth","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 6","pages":"Pages e167-e169"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863959","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":"Clinicopathologic correlation case 2: multifocal, symptomatic oral mucosal lesions","authors":"Spencer Roark DDS ,&nbsp;Vikki Noonan DMD, DMSc","doi":"10.1016/j.oooo.2025.01.721","DOIUrl":"10.1016/j.oooo.2025.01.721","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Clinical Presentation&lt;/h3&gt;&lt;div&gt;A 25-year-old otherwise healthy female presented for evaluation of mildly painful, multifocal, episodic oral mucosal lesions. The lesions had been present for several months, and predominantly involved the tongue, buccal mucosa, and soft palatal mucosa. Despite efforts to expedite resolution with topical 0.05% clobetasol gel, a multivalent mouthwash, and 2 regimens of systemic prednisone under the care of her physician, the lesions continued to wax and wane. Upon further inquiry, she noted hair loss around the temples and also endorsed a recent history of an enigmatic, pruritic dermal rash that since resolved. Clinical evaluation revealed superficial white patches of the anterior and posterior dorsolateral and ventral tongue as well as several areas of erythematous mucosa surrounded by yellow-white borders of the bilateral buccal mucosa and soft palate extending to the hard and soft palate junction. (Figures 1, 2a, and 2b). The remainder of the oral mucosa was generally moist, pink, and of uniform contour and consistency.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Differential Diagnosis&lt;/h3&gt;&lt;div&gt;The differential diagnosis for white and erythematous lesions affecting multiple sites within the oral cavity is broad and comprises a variety of disorders ranging from immune-mediated conditions to infectious diseases. Considerations in the differential diagnosis include contact hypersensitivity stomatitis, benign migratory stomatitis (geographic stomatitis), lichenoid mucositis, candidiasis, oral hairy leukoplakia, and syphilis.&lt;/div&gt;&lt;div&gt;Contact hypersensitivity stomatitis is a mucosal allergic hypersensitivity reaction to contactants characterized by variably symptomatic white, erythematous, or mixed red and white macular lesions or plaques involving the oral mucosa. This represents a type IV hypersensitivity reaction and is caused by a variety of inciting agents including flavorings found in mouthwashes, dentifrices, and candies/chewing gum, among others.&lt;sup&gt;1,2&lt;/sup&gt; Although any mucosal site may be affected, the maxillary labial mucosa is frequently involved. In some instances, a temporal relationship exists between the onset of symptoms and exposition to the inciting agent; however, the underlying cause may not be readily identified. Although the possibility of a contact hypersensitivity reaction could not be entirely excluded in this case, topical corticosteroids are often helpful in expediting resolution, and as the patient endorsed breakthrough symptomatic lesions despite management with topical and systemic corticosteroids, this possibility seems less likely.&lt;/div&gt;&lt;div&gt;Benign migratory stomatitis (geographic stomatitis) is a chronic relapsing/recurring immune-mediated condition of unknown etiology that occurs in roughly 1% to 3% of the population. Although the etiopathogenesis is uncertain, predisposing factors include atopy (patients often endorse a history of environmental allergies, asthma, eczema, and food sensitivities) ","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"139 6","pages":"Pages e163-e167"},"PeriodicalIF":2.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864967","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":"LED-based low-level light therapy for oral mucositis in cancer patients: a systematic review and GRADE analysis.","authors":"Betsy Joseph, Matti Mauramo, Timo Sorsa, Sukumaran Anil, Tuomas Waltimo","doi":"10.1016/j.oooo.2025.04.095","DOIUrl":"https://doi.org/10.1016/j.oooo.2025.04.095","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to evaluate the efficacy of light-emitting diode (LED) therapy in reducing oral mucositis (OM) severity, pain, and healing time in cancer patients and compare it to standard care or sham light.</p><p><strong>Materials and methods: </strong>A comprehensive search of major databases was conducted using relevant MeSH terms and keywords. Two authors independently screened studies meeting the eligibility criteria. The Cochrane Risk-of-Bias tool for randomized controlled trials (RoB-2) and the Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-I) were used to assess the methodological quality of included studies. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>The review included five studies (256 participants). Four studies reported significant improvements in OM severity and pain with LED therapy while only one study suggested improved healing time. The risk of bias was moderate among the included studies. Due to heterogeneous data, a meta-analysis could not be performed. The GRADE assessment indicated low certainty of evidence, highlighting the need for further clinical research.</p><p><strong>Conclusion: </strong>LED therapy may effectively manage cancer therapy-induced OM by reducing patient-reported pain and OM duration. However, the low certainty of evidence warrants more well-designed, longitudinal studies with larger sample sizes to confirm these findings and establish optimal treatment protocols.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144184","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}