Common Oral Lesions Research Articles

Yenidoğanlarda Sık Görülen Oral Lezyonlar ve Tedavileri

Yenidoğanlarda Sık Görülen Oral Lezyonlar ve Tedavileri

Micro-marsupialization as a conservative therapeutic approach for management of pediatric oral mucoceles

Background: Alteration of minor salivary glands due to a mucous accumulation is known as mucocele. It is considered to be a common oral mucosa lesion in pediatric and adolescents. The invasive conventional surgical technique, including surgical excision of the mucocele with the affected minor salivary gland, is not preferred especially in large lesion and in pediatric patients. Objective: This research aims to study the efficacy of micro-marsupialization as a new conservative technique for management of oral mucoceles in pediatric patients. Patients and methods: A prospective study was carried out using the clinical records of patients under 12 years old. The patient's age was ranged between 6 and 12 years old with a mean of 9.83 years. Twelve patients were included; they were suffering from mucocele and were treated using conservative micro-marsupialization as a solo treatment via draining the mucus out of the mucoceles to reduce its size and allowing subsequent healing. All children were recalled for clinical evaluation after 1 week, 1, and 3 months. Patients and methods: Out of the 12 children, seven (58.3%) children were complaining of lower lip mucoceles with 100% success, while the other five (41.7%) children were complaining of oral ranula, the micro-marsupialization technique showed 80% of successful results plus one recurrent case after 1 month of the technique that was treated by conventional marsupialization with packing. Results: Micro-marsupialization has proved to be a simple technique, the best choice management for pediatric mucoceles. It is rapid to perform, noninvasive, painless, requires only surface anesthesia, effective, low recurrence, well-tolerated by children, and can be easily performed by dental general practitioner in daycare outpatient departments safely.

A Review on Common Oral Mucosal Lesions Associated with Pediatric Patients

Pediatric oral pathology deals with the conditions causing or resulting from morbid anatomic or functional changes in the structures of the mouth in the pediatrics. Children and adolescents exhibit a wide spectrum of oral lesions including hard and soft tissue lesions of the oral maxillofacial region. Oral pathoses in children are often missed since obtaining detailed history and performing thorough clinical examination and more difficult in comparison with an adult. Oral lesions in children include mucosal conditions, developmental anomalies, neoplastic, reactive or inflammatory lesions. Thus this review article provides a brief note on the oral lesions commonly dealt with pediatric patients.

Periodontal health status, oral mucosal lesions, and adverse oral habits among rubber factory workers of Bahadurgarh, Haryana, India

Objective: The objective of this study was to assess the prevalence of periodontal disease, oral mucosal lesions, and tobacco usage among rubber factory workers of Bahadurgarh, Haryana, India. Materials and Methods: A descriptive cross-sectional study was conducted on a total sample size of 3290 workers with an age group of 19–60 years old. Tobacco-related habits, periodontal health, and oral mucosal lesions were recorded using the modified World Health Organization pro forma (1997). Descriptive statistics, Pearson Chi-square, and one-way analysis of variance were used. Results: Higher tobacco usage frequency (78.28%) in both forms smoking and smokeless was found. The prevalence of periodontal disease and oral mucosal lesions was 87.4% and 41.24%, respectively, among the study population. The most common oral mucosal lesion found was leukoplakia (10.13%), followed by oral submucous fibrosis (4.67%) among the 50–60 years age group. The most commonly involved site in the present study for the occurrence of oral mucosal lesions is buccal mucosa (30.5%), followed by vestibular region (22.3%), tongue (16.1%), labial mucosa (10.3%), and palate (9.7%), whereas floor of mouth (6.4%) and commissures (4.7%) were the least involved. Conclusions: The findings of this study provided an insight into the periodontal health status, adverse oral habits, and the prevalence of oral mucosal lesions of factory workers, which may be useful in planning oral health programs and free services for tobacco cessation and dental treatment, especially to this industrial sector.

Quantification of mast cells in reactive oral lesions – A clue to the morphologic diversity

OBJECTIVE: Inflammatory fibrous hyperplasia (IFH), pyogenic granuloma (PG), peripheral ossifying fibroma (POF), and peripheral giant cell granuloma (PGCG) are common oral soft-tissue reactive lesions that correspond to excessive connective tissue proliferation as a reaction to trauma or irritational factors local to the oral cavity. These lesions have specific differences in their histopathologic appearances and behavior in spite of having common etiologic factors. Mast cells (MCs) are immune-regulatory cells that have an important role to play in oral inflammation and have also been associated with tissue remodeling and fibrosis in various disorders. METHODOLOGY: MCs were stained with toluidine blue in cases of IFH (20), PG (20), PGCG (20), and POF (20) along with normal gingiva tissue as control (5) for quantification and comparison among them. RESULTS: The mast cell count was low in normal mucosa but a progressive increase was seen from PGCG to IFH to POF with maximum mast cells were evident in PG. There was a significant difference noted in the MC counts between the normal mucosa and the oral reactive lesions (P CONCLUSION: MCs emerged as significant players in the pathogenesis and histopathologic diversity of oral reactive lesions by their effects on fibroblasts and endothelial cells.

A combined two wavelenght laser treatment of prosthesis-related fibrous hyperplasia - Report of a clinical case

Purposes: Prosthesis-related Fibrous Hyperplasia, also many times referred as epulis fissuratum, is one of the most common benign oral soft tissue lesion, that appears due to chronic trauma, usually caused by a poorly adapted prosthesis. It is more common in the anterior region of the maxilla, being an exophytic lesion, which affects mainly elderly and female patients. Our aim is to present the usefulness of Er:YAG and Nd:YAG lasers in the surgical treatment of an Prosthesis-related Fibrous Hyperplasia (PRFH). Case report: The present paper reports a clinical case of two PRFH located in the maxillary vestibulum mucosa and in the palate in a 56-year-old female, caused by a poorly adapted prosthesis. For excision of the lesions in the vestibule and palate we used Er:YAG Laser (2940nm) and ND:YAG (1064nm), respectively. In the postoperative period, the patient did not report any discommodity, and presented a good tissue healing. Histological examination revealed the presence of Fibrous Hyperplasia. Conclusions: Elimination of PRFH is the treatment of choice with the confection of a new prosthesis. The two lesions were correctly eliminated, with the use of an Er:YAG and Nd:YAG lasers, with excellent recover and without recurrence.

Oral mucosal lesions and risk factors in elderly dental patients.

Background. The aim of this study was to determine the prevalence of oral lesions in terms of sex, age, educational status, medication use, systemic diseases, the duration of denture use and tobacco or alcohol use. Methods. A total of 709 voluntary patients (375 males and 334 females), aged ≥60 years, were interviewed by one investigator for demographic data, systemic diseases, tobacco or alcohol use, denture use and the duration of denture use. Results. The majority of the participants (87.6%) had one or more oral mucosal lesions. The prevalence of oral mucosal lesions was 46.3% in males and 41.3% in females (P=0.76). The most common oral mucosal lesion was a sublingual varicosity in both males and females. A statistically significant difference was observed between the three age groups (60–64, 65–69, and ≥70 years) with regard to the prevalence of oral mucosal lesions (P=0.02). There was a significant relationship between the presence of systemic diseases and oral mucosal lesions (P=0.01). There was also a significant relationship between denture use and oral mucosal lesions (P=0.001). Smoking and a history of smoking were also significant predictive factors for oral mucosal lesions (OR: 3.385, P=0.045). Conclusion. Although the majority of oral mucosal lesions detected in the present study were benign, there were some patients with premalignant and malignant lesions. Therefore, periodic oral examinations for detection of precancerous and cancerous lesions are important, especially in the elderly, smokers and denture users.

A clinicopathologic analysis of epulides from a subpopulation of Northern Nigeria

Context: Epulides are common oral lesions of the gingivae. Descriptive studies on epulides from a previously unreported Nigerian population are desirable. Aims: The aim of the study was to describe the characteristics of epulides from a subpopulation in the Northern Nigerian state of Sokoto. Settings and Design: This is a retrospective study of patients histologically diagnosed with epulis and treated at the Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital. Methods: A 10-year (2007–2017) review of histologically diagnosed oral and maxillofacial lesion was used for this study. Data on age, gender, site and histological diagnosis were retrieved from the hospital records and classified into two groups: fibrous lesions and haemorrhagic lesions, reflecting their clinical presentations. Statistical Analysis Done: Data were summarised using frequency distribution and mean and standard deviation (SD). Comparisons were done with Chi-square test and t-test. Statistical significance was set at P ≤ 0.05. Results: A total number of 28 gingival epulides out of a total of 644 lesions that were diagnosed were included in the study. Epulis consisted of 15 (53.6%) fibrous epulides and 13 (46.4%) vascular epulides. There were 20 (71.4%) females and 8 (28.6%) males (female:male = 2.5:1). The average age of study participants was 29.4 years ± 16.4 SD. The mean age of fibrous epulides was 22.73 ± 14.7 years, which was significantly lower than the mean age of vascular epulides (37.1 ± 15.4) (P = 0.018). The most common epulides observed were pyogenic granuloma (PG), (35.7%) followed by fibroepithelial hyperplasia (14.3%) and peripheral ossifying fibroma (10.7%). Conclusions: The most common epulis in this study was PG. It is desirable for the clinician to have a good knowledge of the frequency and distribution of epulides when establishing a diagnosis and formulating a treatment plan.

Ultrasonographic evaluation of maxillofacial swelling in a pediatric patient with Xeroderma pigmentosum

Background/Aim: Xeroderma pigmentosum (XP) is an autosomal recessive skin disease. Affected patients have skin problems, oral mucosa and neurologic symptoms. In these patients, erythematous, hyperpigmented or malignant skin lesions may occur in the sun-exposed areas. Leukoplakia, erythroplakia, and squamous cell carcinoma of the tip of the tongue and lips are common oral lesions associated with XP. Case report: Treatment of the disease included protection from ultraviolet radiation, topical application to treat actinic keratitis, and multidisciplinary approaches by physicians. Conclusions: Even though USG in dentistry is not very common, it is a non-invasive, cost-effective, readily available and repeatable diagnostic imaging method. Thus, USG should take place as a routine diagnostic tool in dentistry, especially for patients who are medically compromised.

Epidemiology of oral mucosal lesions in Slovenia.

BackgroundAmong the diseases of oral mucosa, malignant tumors are the most dangerous, but not the most common lesions that might appear in the oral cavity. Since most of the studies are focused on the detection of cancer in the oral cavity, we were interested in detecting the frequency of benign changes of the oral mucosa in Slovene population. Oral mucosal lesions are important pointer of oral health and quality of life, especially in elderly. The prevalence of oral mucosal lesions, together with information on the risk habits associated with oral health, such as tobacco and alcohol use, can help in planning future oral health studies and screening programs.Patients and methodsSurvey upon oral mucosal lesions was conducted during the national project for oral cancer screening in spring 2017 in the Slovenia in which more than 50% of dentists participated and 2395 patients (904 men and 1491 women) were included.ResultsClinical examination, which was conducted according to the WHO standards revealed that 645 patients (27%) had oral mucosal lesions. The ten most common oral lesions detected were fibroma, gingivitis, Fordyce spots, white coated tongue, cheek biting, linea alba, denture stomatitis, geographic tongue, recurrent aphthous ulcerations and lichen planus.ConclusionsOverall, these epidemiological data suggest need for specific health policies for prevention, diagnosis and treatment of oral mucosal lesions.

Common Oral Lesions in Hospitalized Patients and Physicians' Opinion About the Role of A Dentist in the Hospital

Common Oral Lesions in Hospitalized Patients and Physicians' Opinion About the Role of A Dentist in the Hospital

Case report on management of oral mucocele in two paediatric patients using cryosurgery and surgical excision.

Mucoceles are considered to be the most common oral lesion, with an approximate prevalence of around 2.4 cases per 1,000 people. The exact prevalence in children is not reported, but they are thought to occur more frequently in younger individuals when compared to adults. The age old treatment for mucocele involves surgical excision, which is associated with mental trauma and discomfort to the patient. Other treatment options that can be considered include cryosurgery, CO2 laser ablation, micro marsupialization, intralesional corticosteroid injection, marsupialization and electrocautery. Cryosurgery is the procedure where there is deliberate destruction of tissue by freezing, using liquid nitrogen. This treatment is well received by patients, as minimal or no local anesthesia is used, relative lack of discomfort, no bleeding and minimal to no scarring after healing. This paper discuses two cases of oral mucocele treated via surgical excision and cryosurgery.

Wandering rash of tongue: Case report with review

Functions like swallowing, speech, mastication and speaking are performed by the most sensitive part of oral cavity-tongue. Wandering rash is also known as geographic tongue, erythema migrans, annulus migrans and benign migratory glossitis. Though geographic tongue is common oral lesion of dorsal tongue but sometimes it may be left undiagnosed. It is an asymptomatic condition which presents as a map like red and white lesions with raised white borders. This paper present case of geographic tongue in an adult and discuss about the need of treatment and various modalities available for treatment.

Management of chronic traumatic ulcer mimicking oral squamous cell carcinoma on the tongue

Background: Traumatic ulcers represent the most common oral mucosal lesions that can be differentiated from oral squamous cell carcinoma (OSCC) by their clinical appearance. From a clinical perspective, OSCC may resemble a chronic traumatic ulcer (CTU) because the base of the CTU that is healing is filled with reddish-pink granulated tissue, similar to that in OSCC. Purpose: The aim of this case report is to provide information about the oral management of a CTU case that imitates OSCC. Case: A 30-year old female presented with a major, painful, non-healing ulcer located on the right lateral of the tongue for the previous two months. Approximately two years before, she had experienced a similar lesion on the tongue. Intra oral examination showed a 10mm x 5mm yellowish ulcer with a fibrous center, erythematous irregular-induration margin and concave yellow base. The 15th, 44th and 47th teeth were sharp and on occlusion caused trauma to the right lateral border of the tongue. Case management: Based on the clinical features, the lesion was imitating OSCC. After a case history review, clinical examination and appropriate investigation, the patient was diagnosed as suffering from a chronic traumatic ulcer. The primary treatment of traumatic ulcers involves eliminating etiological factors. As pharmacological therapy, a mixture of triamcinolone acetonide and 1mg dexamethasone tablet was administered in addition to folic acid and vitamin B12. Conclusion: Clinical presentation of traumatic lesions varies significantly and may, at times, be ambigous. It is important to immediately establish a correct diagnosis and implement prompt treatment of CTU lesions because they play a role at the oral carcinogenesis promotion stage.

Effect of 0.5% Chitosan mouthwash on recurrent aphthous stomatitis: a randomized double-blind crossover clinical trial.

BackgroundRecurrent aphthous stomatitis (RAS) is one of the most common painful oral lesions of which there is no certain treatment.ObjectiveThe aim of this study was to determine the effect of Chitosan mouthwash 0.5% on RAS.MethodsThis randomized double-blind crossover clinical trial was conducted at a dental school in Babol, Iran, from 2015 to 2016. Twenty patients with a history of minor aphthous stomatitis were entered into this study. All patients were initially monitored in the first episode without treatment, and then were randomly treated in three other episodes with Chitosan, Triamcinolone or Biogel mouthwashes. The ulcer size and pain intensity by using visual analogous score (VAS) were recorded in each episode. Data were analyzed by ANOVA and Tukey test. We used SPSS version 20 to analyze data.ResultsThe mean ulcer size on the fifth day (p=0.026, p=0.042, respectively) and VAS on the third and fifth days (p=0.011, p=0.013, respectively) were significantly less in Triamcinolone and Chitosan groups than Biogel and the no treatment episode. There were no significant differences between Chitosan and Triamcinolone groups in the average ulcer size and pain intensity in all the examination days.ConclusionsChitosan mouthwash is effective on pain relief and reducing ulcer size of minor aphthous stomatitis and this effect is almost the same as Triamcinolone mouthwash.Clinical trial registrationThe study was registered and approved by Iranian Registry of Clinical Trials (http://www.irct.ir) with IRCT ID: IRCT2015030718753N2.FundingThe study was funded by Deputy of Research and Technology of Babol University of Medical Sciences (ref. no.: 9133625).

Incidence of reactive hyperplastic lesions in the oral cavity: a 10 year retrospective study in Santa Catarina, Brazil

IntroductionReactive hyperplastic lesions develop in response to a chronic injury simulating an exuberant tissue repair response. They represent some of the most common oral lesions including inflammatory fibrous hyperplasia, oral pyogenic granuloma, giant cell fibroma, peripheral ossifying fibroma, and peripheral giant cell lesions. ObjectiveThe incidence of those lesions was investigated in an oral pathology service, and the clinical characteristics, associated etiological factors, concordance between the clinical and histopathological diagnostic was determined. MethodsA total of 2400 patient records were screened from 2006 to 2016. Clinical features were recorded from biopsy reports and patients’ files. ResultsA total of 534 cases of reactive hyperplastic lesions were retrieved and retrospectively studied, representing 22.25% of all diagnoses. The most frequent lesion was inflammatory fibrous hyperplasia (72.09%), followed by oral pyogenic granuloma (11.79%), giant cell fibroma (7.30%), peripheral ossifying fibroma (5.24%), and peripheral giant cell lesions (3.55%). Females were predominantly affected (74.19%), the gingiva and alveolar ridge were the predominant anatomical site (32.89%), and chronic traumatism was presented as the main etiological factor. The age widely ranges from the 1st decade of life to the 7th. Clinically, the reactive hyperplastic lesions consisted of small lesions (0.5–2cm) and shared a strong likeness in color to the oral mucosa. The concordance between the clinical and histopathological diagnostic was high (82.5%). ConclusionReactive hyperplastic lesions had a high incidence among oral pathologies. The understanding of their clinical features helps to achieve a clearer clinical and etiological diagnosis, and the knowledge of factors related to their development. This may contribute to adequate treatment and positive prognosis.

Assessment of Pizotifen efficacy in the management of recurrent aphthus stomatitis - A double blind trial -

Recurrent aphthus ulceration (RAU) is one of the most common and troublesome oral lesions, as they are extremely painful and recurrent, no single preparation is uniformly effective in the treatment of this condition.A double blind cross-over trial assessed the value of pizotifen in reducing the severity of pain, duration and frequency of ulcers in a group of recurrent aphthus ulcer patients. Active & placebo preparation were used for a period of 4 weeks each; 42 patients completed the use of both preparations.20 patients out of 28 patients on pizotifen therapy experienced a decrease in the severity of pain as well as decrease in the duration of each attack, where as 18 patients in the same group reported reduction in the frequency of the disease.Pizotifen reduced pain severity, duration and frequency of oral ulcerations in the examined group

Case report on management of oral mucocele in paediatric patients using cryosurgery and surgical excision

Mucoceles are considered to be the most common oral lesion, with an approximate prevalence of around 2.4 cases per 1,000 people.

Oral candidiasis as clinical manifestation of HIV/AIDS infection in Airlangga University hospital patients

The purpose of this study was to determine the characteristics of HIV/AIDS patients with oral candidiasis as its clinical manifestation at Airlangga University Hospital Surabaya. This is a descriptive analytic research with cross-sectional design using Chi-Square statistic test. Samples of this study consist of 34 patients using total sampling methods. Those patients were all HIV/AIDS infected patients with oral candidiasis clinical manifestations, who were admitted to Airlangga University Hospital Surabaya from January 2016 to September 2017. Results showed that mostly HIV/AIDS patients with oral candidiasis are male (79.4%), old age (40-75years) total amounted to 58.8%, heterosexual as main risk factor (70%), clinical stadium mostly in stage IV (61.8%), 26% of patients with chronic diarrhea and 56% with pulmonary TB, clinical stages of patients have a significant relation to the incidence of oral candidiasis infection (p=0.024). The most common oral lesions found in people with HIV are Candidiasis. The best management is through routine dental examination and dental precautions to maintain health and achieve a better quality of life.

Prevalence of oral mucosal lesions in patients attending college of dentistry – Basrah University

Background: The aim of study was to find out the prevalence of oral mucosallesions in patients who are attending the oral diagnosis department of the Collegeof Dentistry – Basrah University and compare it with the prevalence rates ofthese lesions in other parts of Iraq.Materials and Method: Oral examination of 2318 outpatients, 1202 females (51.8%)and 1116 males (48.2%). The patient's age ranged between 9-74 years. All thepatients of this study referred to oral diagnosis department, College of Dentistry,Basrah University seeking for dental treatment (from October 2010-May 2011).Results: Among the 2318 patients, only 206 patients (8.8%) had oral lesions. 115males had oral lesion constituted 4.9% of total examined patients, while 91females had oral lesion constituted 3.9%. The age range of the patients wasbetween 9-74 years.Oral lesions were more prevalent among males (4.9%) than females (3.9%), andthere was significant statistical difference between males and females. Orallesions were classified according to the following 4 categories: ulcerated lesions(3.84%), benign lesions (2.93%) ,white lesions (1.12%) and candidiasis (0.99%),The most common oral lesion of the studied populations were the ulceratedlesions, which diagnosed in (3.8%).There were a significant statistical differencebetween males and females in the traumatic ulcer, lichen planus, pyogenicgranuloma and peripheral giant cell granuloma.Conclusions: This study has provided information about the epidemiologic aspects oforal mucosal lesions that may prove valuable in planning of future oral healthstudies.