ABSTRACT Background Methotrexate (MTX) remains the cornerstone therapy for rheumatoid arthritis (RA); however, adverse events such as oral mucositis are underreported in real‐world settings. The aim of this study was to examine the prevalence, severity, patient self‐management, and involvement of healthcare providers in MTX‐induced oral mucositis among RA outpatients. Methods A questionnaire‐based study was conducted between October and December 2024, targeting patients with RA receiving MTX who visited community pharmacies. Patients aged ≥ 20 years were asked to complete an 18‐item questionnaire assessing the incidence, severity (graded by the Common Terminology Criteria for Adverse Events v5.0), timing, management, and impact of oral mucositis, as well as communication with physicians, dentists, and pharmacists. Results Among the 101 valid responses, 26.7% of the patients experienced oral mucositis, and 41.6% reported either mucositis or oral discomfort. Of those with mucositis, 64% had grade ≥ 2 severity, and 63% implemented some form of countermeasure—most commonly the use of mouthwash or over‐the‐counter medications. However, 37% of the patients did not take any action; only 55.6% consulted healthcare professionals, mainly physicians or dentists, whereas none consulted a pharmacist. Communication gaps between patients and dental care professionals were noted. Conclusion These findings suggest a higher prevalence of MTX‐induced oral mucositis than that previously reported in randomized controlled trials. Despite its clinical impact, the management of MTX‐induced oral mucositis remains inconsistent, with many patients not seeking support. Enhanced interprofessional collaboration and proactive patient education, especially involving pharmacists and dentists, are essential for the continuity of MTX therapy in RA and improving adverse event monitoring.

ABSTRACT We report a case of metastatic colon adenocarcinoma discovered following the diagnosis of maxillary gingival carcinoma. The patient underwent a systemic workup for suspected adenocarcinoma of the maxillary gingiva, which revealed sigmoid colon cancer with metastases in other organs. Subsequently, the patient underwent surgery for the primary sigmoid colon cancer and the metastatic maxillary gingival tumor, followed by postoperative adjuvant chemotherapy. After the treatment was initiated, disease control was achieved in the sigmoid colon and metastatic sites. Particularly, the maxillary gingival tumor had completely resolved and had no substantial impact on oral intake. Rectal cancer with metastases in other organs is generally associated with a poor prognosis. As treatment for metastatic lesions is often initiated after resection of the primary tumor, there is a risk of progression at metastatic sites. Thus, early and aggressive therapeutic intervention should be considered, especially when metastases are located in the oral cavity, because tumor progression may impair oral intake.

ABSTRACT Background Peripheral ossifying fibroma (POF) is a reactive gingival lesion, typically under 20 mm. Giant POFs exceeding 50 mm in the mandible are extremely rare. This report details a rare case of a giant POF. Case Presentation A 55‐year‐old woman presented with a chief complaint of dysarthria and dysphagia due to a progressively enlarging mass in the left mandible. A mass over 50 mm in size occupied the oral cavity. Imaging revealed a well‐defined calcified lesion within the tumor. The tumor was excised en bloc. Conclusion Histopathological examination confirmed POF. The patient has had no recurrence at the 13‐month follow‐up. This case highlights the importance of considering POF in the differential diagnosis of large oral masses, especially when they cause functional impairment.

ABSTRACT Aim Perioperative oral management (POM) reduces the risk of postoperative complications. We previously conducted a randomized controlled feasibility study using povidone iodine (PVP‐I) or cetylpyridinium chloride (CPC) and found that perioperative self‐care with CPC mouthwash may support antibiotic‐induced changes in the oral flora. In this subanalysis, the effects of mouthwashes on postoperative systemic inflammatory reactions were analyzed. Methods This subanalysis was conducted on 78 patients undergoing general anesthesia (38 with PVP‐I group and 40 with CPC group). White blood cell (WBC) counts, serum CRP levels, and postoperative fever were employed as postoperative inflammatory markers, and a comparison was made between the groups. We collected bacteria from the dorsal surface of the tongue, and the total bacterial count, operational taxonomic unit (OTU) counts, and Shannon Index were analyzed. Results In comparing postoperative inflammatory indices between PVP‐I and CPC groups, median CRP was significantly lower in the CPC group than in the PVP‐I group (3.7 mg/dL vs. 6.3 mg/dL, p = 0.038). Univariate analysis identified significant associations between high CRP levels (≥ 5 mg/dL) and surgical site (OR = 0.62, 95% CI: 0.44–0.88, p = 0.008), surgical time (OR = 1.00, CI: 1.00–1.01, p = 0.047), and intervention product (OR = 0.39, 95% CI: 0.16–0.97, p = 0.043). In the multiple logistic regression analysis, the intervention product remained significantly associated with high CRP (OR = 0.30, 95% CI: 0.10–0.91, p = 0.034). In addition, the low CRP in the CPC group was associated with lower OTU and Shannon Index. Conclusion CPC rather than PVP‐I in POM has a significant positive effect on systemic inflammation (CRP level) and on the richness and evenness of the bacterial community on the surface of the tongue. These findings suggest that CPC rather than PVP‐I might be useful in POM. Trial Registration: UMIN000030919. Registered January 21, 2018.

ABSTRACT Objective Oral potentially malignant disorders (OPMDs) are defined as clinical conditions that carry the risk of cancer development in the oral cavity. Regardless of their cancerous nature, the mechanism of malignant transformation is unknown and there are no indicators to predict the risk of malignant transformation. In order to manage OPMDs appropriately, indicators that are useful for predicting their prognosis are required. The purpose of this study was to examine the expression of YAP1, p53, and Ki‐67 in OPMDs and explore their potential as biomarkers to predict the risk of malignant transformation. Methods Immunohistochemical staining for YAP1, p53, and Ki‐67 was performed in 70 cases with a confirmed diagnosis of OPMDs. The staining status was evaluated by multiplying the positive cell occupancy score by the staining intensity score. We statistically investigated the association between malignant transformation of OPMDs and clinicopathologic features and staining grade. Results No significant differences were observed between malignant transformation and clinicopathological features of OPMDs. However, YAP1 ( p = 0.003) and p53 ( p = 0.013) were expressed higher in malignant transformation cases than in non‐malignant transformation cases. Moreover, Ki‐67 showed a tendency to be highly expressed in malignant transformation cases ( p = 0.161). Conclusions The cancer‐related factors YAP1 and p53 were found to be potentially upregulated in cases of malignant transformation of OPMDs. Therefore, YAP1 and p53 may be biomarkers to predict malignant transformation of OPMDs, and patients with OPMDs with high expression of YAP1 and p53 are at high risk of malignant transformation and require careful follow‐up.

ABSTRACT Aim This study examined the effectiveness of human demineralized bone matrix (DBM) as a scaffold material in bone regenerative medicine using cultured periosteal cells (CPCs). Methods A bone defect created in the parietal region of eight‐week‐old nude rats served as the graft bed. A polylactic acid resin dish shell was used as a covering material, and DBM (with (+) or without (−) CPC) was grafted at the site. Deproteinized bovine bone (DBB) was used in the control group. Four weeks later, the grafted site was sampled for micro‐computed tomography and histological observations. The osteoblastic induction effect of DBM was evaluated by co‐culturing with CPCs. Results The DBM‐CPC (+) group demonstrated a significantly larger new bone volume than the DBM‐CPC (−) group. New bone formation with a distinct lining of alkaline phosphatase (ALP)‐positive cells was observed in the DBM graft area, regardless of cell administration. However, the staining intensity and thickness tended to be higher in the DBM‐CPC (+) group. Cells positive for tartrate‐resistant acid phosphatase were more concentrated in areas close to the existing bone in the DBM‐CPC (−) group and throughout the newly formed bone area in the DBM‐CPC (+) group. Only slight bone conduction was observed adjacent to existing bone in the DBB graft group, with no new bone formation. The emergence of ALP‐positive cells was confirmed in CPC co‐cultured with DBM. Conclusions These findings demonstrate the bone inductive effect of DBM and indicate the effectiveness of DBM as a cell transplantation carrier in bone regeneration cell therapy.

ABSTRACTOral lymphoepithelial cyst (LEC) with sebaceous gland differentiation and buccal fistula is extremely rare. A 55‐year‐old woman presented with a 25 mm × 25 mm mass in the right buccal mucosa and a fistula near the angle of the mouth. CT showed continuity between the mass and the fistula. Cystectomy and fistulectomy were performed. Histopathology confirmed LEC with lymphoid follicles and sebaceous glands. We report a rare case of oral LEC with sebaceous gland differentiation and buccal fistula. No recurrence was observed 2 years postoperatively.

ABSTRACTBackgroundCentipedes are arthropods that are primarily nocturnal. Bites occur frequently on summer nights and, in rare cases, can lead to severe systemic complications, including anaphylactic shock, so caution is required. We report a case of herpes zoster triggered by a centipede bite.Case PresentationAn 83‐year‐old man visited the hospital 3 days after a centipede bite, complaining of oral pain and difficulty eating. Small blisters were found on the right buccal mucosa, tongue edge, and palate, and he was diagnosed with herpes zoster. He was admitted to a negative pressure room, where he was administered antiviral drugs and fluid replacement, and specialized oral care was provided. His symptoms improved, and he was discharged on the 10th day of hospitalization.ConclusionIn particular, patients taking immunosuppressants or those with underlying immune‐related diseases must be particularly aware of the risk of serious complications after a centipede bite.

ABSTRACTBackgroundTo report the efficacy of a nerve‐sparing surgery for mandibular MRONJ in oldest‐old patients.Case PresentationTwo oldest‐old patients with Stage 2 MRONJ underwent a nerve‐sparing marginal mandibulectomy. This technique corresponds to the “edge and nerve preservation with removal of infection” (EGRI) method. In both cases, surgical wounds healed successfully without recurrence, preserving mandibular integrity.ConclusionThis nerve‐sparing approach is effective for local disease control, though postoperative neurosensory disturbance remains a complication.