Diagnosis Of Oral Mucosal Diseases Research Articles

Optical coherence tomography: Promising imaging technique for the diagnosis of oral mucosal diseases.

This review aims to summarize the latest application of optical coherence tomography (OCT) in oral mucosal diseases, promoting an accurate and earlier diagnosis of such disorders, which are difficult to be differentiated. References on the application of OCT in oral mucosal diseases were mainly obtained from PubMed, Embase, Web of Science and Scopus databases, using the keywords: "optical coherence tomography and 'oral mucosa/oral cancers/oral potentially malignant diseases/oral lichen planus/oral leukoplakia/oral erythroplakia/discoid lupus erythematosus/oral autoimmune bullous diseases/oral ulcers/erythema multiforme/oral mucositis'". It is found that OCT is showing a promising application potential in the early detection, diagnosis, differential diagnosis, monitoring of oral cancer and oral dysplastic lesions, as well as the delineation of tumor margins. OCT is also playing an increasingly important role in the diagnosis of oral potentially malignant disorders, oral mucosal bullous diseases, oral ulcerative diseases, erythema multiforme, and the early detection of oral mucositis. Optical coherence tomography, as a novel optical technique featured by real-time, noninvasive, dynamic and high-resolution imaging, is of great use to serve as an adjunct tool for the diagnosis, differential diagnosis, monitoring and therapy evaluation of oral mucosal diseases.

Machine Learning Analysis of Gaze Data for Enhanced Precision in Diagnosing Oral Mucosal Diseases.

The diagnosis of oral mucosal diseases is a significant challenge due to their diverse differential characteristics. Risk assessment of lesions by visual examination is a complex process due to the lack of definitive guidelines. This study aimed to improve this process by creating a diagnostic algorithm using gaze data acquired during oral mucosal disease examinations. A total of 78 dentists were included in this study. Tobii Pro Nano® (Tobii Technology) was used to acquire gaze data during clinical photographic visual examinations. Advanced analysis tools such as support vector machines and heatmaps were used to visualize the gazing tendencies of a group of skilled oral surgeons, focusing on the number of gazes per region and the gazing time ratios. The preliminary findings showed the possibility of visualizing gazing tendencies and identifying areas of importance for diagnosis. The classification of intraoral photographs based on gross features revealed the existence of an optimal examination method for each category and diagnostically significant areas. This novel approach to analyzing gaze data has the potential to refine diagnostic techniques and increase both accuracy and efficiency.

Oral mucosal disease recognition based on dynamic self-attention and feature discriminant loss.

To develop a dynamic self-attention and feature discrimination loss function (DSDF) model for identifying oral mucosal diseases presented to solve the problems of data imbalance, complex image background, and high similarity and difference of visual characteristics among different types of lesion areas. In DSDF, dynamic self-attention network can fully mine the context information between adjacent areas, improve the visual representation of the network, and promote the network model to learn and locate the image area of interest. Then, the feature discrimination loss function is used to constrain the diversity of channel characteristics, so as to enhance the feature discrimination ability of local similar areas. The experimental results show that the recognition accuracy of the proposed method for oral mucosal disease is the highest at 91.16%, and is about 6% ahead of other advanced methods. In addition, DSDF has recall of 90.87% and F1 of 90.60%. Convolutional neural networks can effectively capture the visual features of the oral mucosal disease lesions, and the distinguished visual features of different oral lesions can be extracted better using dynamic self-attention and feature discrimination loss function, which is conducive to the auxiliary diagnosis of oral mucosal diseases.

Prevalence and determinants of oral potentially malignant disorders in rural areas of South India.

Oral potentially malignant disorders are associated with a risk of undergoing malignant transformation and a concomitant increase in morbidity and mortality. Moreover, epidemiological studies, especially from rural areas, are important in assessing their prevalence and the identification of determinants of these disorders so that preventive strategies can be employed in tackling them. Cross-sectional descriptive study was conducted based on guidelines of the World Health Organization's Guide Epidemiology and Diagnosis of Oral Mucosal Disease and Conditions 1995 in rural areas of south India. Prevalence of oral potentially malignant disorders (OPMDs) in the studied population was 13.28%, with oral submucous fibrosis (OSMF) accounting to 6.21% and erythroplakia at 1.3%. Regression analysis revealed, age 40-54 years (odds ratio [OR] = 3.8, confidence interval [CI] at 95%-1.5-4.0, P < 0.05), lower socioeconomic groups (OR = 2.1, CI at 95%-1.4-3.1, P < 0.05), habits (OR = 3.2, CI at 95%-1.9-3.8, P < 0.05), smoke form of tobacco-beedi (OR = 2.5, CI at 95%-1.6-2.8, P < 0.05), smokeless form of tobacco-areca nut lime and leaf and tobacco (OR = 3.1, CI at 95%-1.9-3.4, P < 0.05) to be the possible determinants for OPMDs. The overall prevalence of OPMDs in the studied population was 13.28%. The most common OPMDs were OSMF. Identified determinants were age, socioeconomic group, ethnicity, diet, body mass index, and associated harmful habits.

Application of medical magnifying loupes in diagnosis of oral mucosal diseases.

: To evaluate the application of medical magnifying loupes in diagnosis of oral mucosal diseases. Twenty-four patients with plaque-type oral lichen planus or homogeneous oral leukoplakia were inspected by naked eyes or assistance with magnifying loupes. Histopathological results were used as the gold standard to evaluate the sensitivity, specificity and accuracy of the two methods in clinical diagnosis. Questionnaires were used to evaluate the subjective effect of magnifying loupes on the diagnosis efficiency of oral mucosal diseases and to explore the most suitable parameters for application. The sensitivity, specificity and accuracy of medical magnifying loupes for the identification of plaque-type oral lichen planus and homogeneous oral leukoplakia were 94.74%, 100.00% and 95.83%, respectively, which were significantly higher than those of naked eye inspection (89.47%, 80.00% and 87.50%). The effective rate of magnifying loupes assisted diagnosis was 91.76% according to physicians' subjective evaluation. The most suitable parameters were 3.5 times magnification and working distance. The medical magnifying loupes can effectively improve the efficiency of the inspection and diagnosis of oral mucosal diseases, and have the characteristics of convenience and real-time. The recommended clinical parameters are 3.5 times magnification and working distance.

Technologies for early diagnosis of oral mucosal diseases

Expert evaluation of minimally invasive techniques in the diagnostic algorithm of pathological processes of the oral mucosa. Fluorescence stomatoscopy of the oral mucosa of 1520 patients aged 18-65 years with analysis of color code of optical images was carried out. The nature of the disease was established by liquid cytology. PCR diagnostics was performed to detect oral-potential disorders provoked by human papillomavirus and Epstein-Barr virus. Analysis of optical images of the normal and pathologically affected oral mucosa allows determining the possibilities of the technique to detect a hidden pathological process at the preclinical level. The results of liquid cytology in each case confirm the nature and depth of the pathological process. PCR diagnostics determines the presence of risk factors (Epstein-Barr virus, human papilloma virus 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59), contributing to the malignant transformation. A comprehensive examination of the oral mucosa using clinical-laboratory methods of visualizing pathological processes contributes to their early diagnosis, reduces the risk of advanced cases of oncopathology and allows extending life expectancy.

Diagnostic capabilities of a dentist in detecting neoplasms of the oral mucosa

Differential diagnosis of inflammatory diseases, precancerous and early diagnosis of oral mucosal cancer remains relevant both in dentistry and Oncology. The detection rate of advanced forms of oral mucosal cancer is still high. Unfortunately, the diagnosis of oral mucosal diseases is often limited to visual examination, which is subjective in nature, data is difficult to document and subsequently analyze, which leads to both hypo- and hyperdiagnosis of precancerous and cancer. Materials and methods. The article presents the results of the analysis of outpatient records of 78 patients referred to the Samara regional clinical oncological dispensary in the period from 2014 to 2019 with various pathological formations of the oral mucosa. In the control group (41 patients) — the examination was limited to a survey, examination and palpation. In the main group (37 people) — autofluorescence stomatoscopy was added to the standard methods. Re- sults. It was found that complaints were made more often by patients with inflammatory diseases of the OSR. Tumor formations were more often localized on the tongue and had a predominantly exophytic form of growth. After histological examination, signs of inflammation were more often confirmed in the control group — 39 vs 13.5% in the main group, while signs of pre-cancer and cancer were more often detected in the main group —86.5 vs 61% in the control group (p=0.007). The color glow in the main group correlated with the histological examination data. Conclusions. The use of fluorescence stomatoscopy in addition to traditional methods of examination made it possible to reliably and cost-effectively make a differential diagnosis between inflammation, pre- cancerous and cancer, which is important for the appointment of an invasive biopsy procedure and early diagnosis of OSR cancer, or to limit conservative therapy with subsequent dynamic follow-up by a dentist in an outpatient setting. The analysis of the obtained data indicates the need to im- prove the examination algorithms with the inclusion of fluorescent diagnostic methods.

Immunological methods for the diagnosis of oral mucosal diseases

Immunological methods, which have been widely used in autoimmune blistering diseases (AIBDs) of the oral mucosa, can also be adopted as auxiliary diagnostic tools in oral lichen planus (OLP) and discoid lupus erythematosus (DLE). AIBDs, characterized by autoantibodies against structural proteins of keratinocytes or the basement membrane zone, clinically present as blisters and erosions of the oral mucosa. When atypical lesions occur, OLP or DLE may be confused with AIBDs. The improvement of diagnostic accuracy is necessary due to the significant differences in treatment and prognosis among these diseases. A variety of immunological methods are used for qualitative and quantitative detection of target antigens and autoantibodies. These methods can evaluate efficacy of treatment, monitor diseases and guide treatment decisions. In this review, we discuss the application of immunofluorescence, biochemical tests, and protein microarrays for AIBDs, OLP and DLE, as well as the differential diagnostic methods using immunological tests.

Evaluation of the Prevalence of Oral Mucosal Lesions in a Population of Eastern Coast of South India.

Objective/Aim:The aim of this study is to measure the association between oral mucosal lesions (OMLs) and habit of tobacco and alcohol in the population of Guntur city, Andhra Pradesh, South India.Material and Method:A cross-sectional study was conducted on 300 participants in Guntur city with the habit of tobacco and alcohol consumption in various forms who were selected by stratified cluster random sampling technique. Guntur city was divided into four zones, that is, North, East, South, and West; and two administrative wards were randomly selected from each zone as clusters. Information was obtained by interviewing the participant regarding various tobacco-related habits followed by standardized clinical examination in the field. Clinical data were collected using a modified 1980 WHO Pro forma where the basis for diagnosis was established as per the criteria provided by the epidemiology guide for the diagnosis of oral mucosal diseases (WHO). Statistical tests such as Pearson Chi-square were exercised to test the significance, using SPSS version 19.0 with 0.05 as cutoff level of significance.Results:Overall oral soft-tissue lesions were found in 42.4% of the study participants including nicotinic stomatitis, tobacco pouch keratosis, smokers melanosis, mild keratosis of the palate, and chewer's mucosa. In this study, nicotinic stomatitis was found to be the most common soft-tissue lesion among men, while leukoplakia was found to be the most common premalignant lesion with the prevalence being 5.7%. While oral submucous fibrosis was found to be the most common premalignant condition among women. It was found that 13.2% of illiterates (53) were having leukoplakia. In the present study, the lower labial mucosa and buccal mucosa were found to be the most common sites of occurrence of leukoplakia and oral submucous fibrosis.Conclusion:This study gives information on the association of OML in smokers, chewers, alcoholics, and those with mixed habits. This study highlighted six habit-related OML which included potentially malignant disorders such as leukoplakia and oral submucous fibrosis. Future case–control or cohort studies for individual lesions and with larger sample size are necessary to evaluate the risk for OML including potentially malignant conditions and oral cancer resulting from smoking and chewing habits.

Prevalence of Oral Lesions in the Elderly.

Geriatric dentistry refers to dealing with oral diseases including prevention and treatment in old individuals. The aim of this investigation was to examine the types and frequency of oral lesions in the elderly. The study involved 75 elderly persons. The clinical diagnosis was established by correlating the aetiological factor associated with the lesion and by systematic examination of the oral mucosa and classifying those alterations according to the epidemiological guidelines for the diagnosis of oral mucosal diseases. During the clinical examination, the following elements were analysed: features of the lesion, anatomical location, extension, aetiological factors or related factors, dental status, alcohol, tobacco, trauma, use of prosthesis and if such were well adapted. Sixty lesions were diagnosed in 75 patients. These were classified according to clinical, histopathological and microbiological diagnosis and were distributed into 15 different clinical entities. The more prevalent pathologies were inflammatory, reactive and associated with long-term use of prostheses or ill-adapted prostheses, since 67% of the patients with lesions were using prostheses. Of the lesions related to prosthesis use, denture stomatitis was the most common one, representing 20 cases (33.3%). The second most frequent lesion was erythematous candidiasis (10%). The other most frequent lesions in this study were lingua plicata, xerostomia and pseudomembranous candidiasis. Oral and perioral tissues undergo different functional and structural changes with ageing. The role of the dentist and stomatologist includes the management of systemic, nutritional and pharmacological oral manifestations in order to establish an early diagnosis and subsequent accurate treatment.

Raman spectral properties of squamous cell carcinoma of oral tissues and cells

Early diagnosis is the key of the improved survival rates of oral cancer. Raman spectroscopy is sensitive to the early changes of molecular composition and structure that occur in benign lesion during carcinogenesis. In this study, in situ Raman analysis provided distinct spectra that can be used to discriminate between normal and malignant tissues, as well as normal and cancer cells. The biochemical variations between different groups were analyzed by the characteristic bands by comparing the normalized mean spectra. Spectral profiles of normal, malignant conditions show pronounced differences between one another, and multiple Raman markers associated with DNA and protein vibrational modes have been identified that exhibit excellent discrimination power for cancer sample identification. Statistical analyses of the Raman data and classification using principal component analysis (PCA) are shown to be effective for the Raman spectral diagnosis of oral mucosal diseases. The results indicate that the biomolecular differences between normal and malignant conditions are more obviously at the cellular level. This technique could provide a research foundation for the Raman spectral diagnosis of oral mucosal diseases.

Clinical recommendations for oral cancer screening

To address the benefits and limitations of oral cancer screening and the use of adjunctive screening aids to visualise and detect potentially malignant and malignant oral lesions. Squamous cell carcinomas of the lips and cancers of the oropharynx (including the posterior one-third of the base of the tongue and the tonsils were excluded. A specially convened expert panel evaluated the available evidence which was derived from a systematic search of Medline and the Cochrane Library. Further details about the search are available in a supplement to the published article available on the Journal of the America Dental Association's website (http://jada.ada.org/cgi/content/full/141/5/509). Qualitative synthesis of the data was performed by the panel. Where consensus could not be reached majority voting was employed. Recommendations were reviewed by internal and external scientific experts and organisations. After review recommendations were revised where appropriate and the ADA Council on Scientific Affairs approved the final clinical recommendations. No information provided in article. The key recommendations were all classified as level D being based on grade IV evidence or extrapolated from grade I, II or III evidence using a system based on Shekelle et al.(1) The main recommendations can be summarised as:1) Clinicians should remain alert for signs of potentially malignant lesions or early-stage cancers in all patients while performing routine visual and tactile examinations, particularly for patients who use tobacco or who are heavy consumers of alcohol. 2) For seemingly innocuous lesions, clinicians should follow up in seven to 14 days to confirm persistence after removing any possible cause to reduce the potential for false-positive screening results. 3) For lesions that raise suspicion of cancer or for lesions that persist after removal of a possible cause, clinicians should communicate the potential benefits and risks of early diagnosis. Considerations include the following: a) that even suspicious lesions identified during the course of a routine visual and tactile examination may represent false positives; b) that clinical confirmation (a second opinion) can be sought from a dental or medical care provider with advanced training and experience in diagnosis of oral mucosal disease so as to reduce the potential for a false positive or false negative oral cancer screening result; c) that a malignancy or non-malignancy can be confirmed only via microscopic examination that requires a surgical biopsy; d) that a decision to pursue a biopsy to confirm the presence or absence of malignancy should be made in the context of informed consent. 4) Although transepithelial cytology has validity in identifying disaggregated dysplastic cells, the panel suggests surgical biopsy for definitive diagnosis. In all, 15 separate research recommendations were made ranging from determining the prevalence of potentially malignant oral mucosal lesions in the United States to whether the use of adjunctive devices improves patient education and adherence to follow-up care.

Pathological diagnosis of oral maxillofacial diseases: Part I. Pathological diagnosis of oral mucosal diseases

口腔黏膜由上皮、固有层构成,部分区域的口腔黏膜有黏膜下层.虽然口腔黏膜结构上并不复杂,但由于口腔黏膜病种类繁多,许多疾病的病理表现有重叠,给口腔黏膜病的病理诊断带来了较多困难.口腔黏膜病往往与类似或相同

Accuracy of Referrals to a Specialist Oral Medicine Unit by General Medical and Dental Practitioners and the Educational Implications

In this study we investigated the accuracy of diagnoses of oral mucosal diseases made by family physicians (without a dental degree), other categories of physicians, and general dental practitioners prior to referring patients to a university oral medicine unit. Over a three-year period, we compared the diagnoses proposed in referral letters with the definitive histological diagnoses made by the specialist unit. Only 305 of 678 (45 percent) of the referral letters included a clinical diagnosis. Eighty-six patients (86/305, 28 percent) were referred by general dental practitioners (GDPs) who had graduated in dentistry; seventy-six (76/305, 25 percent) were sent by GDPs who had graduated in medicine with a postgraduate degree in dentistry; and 143 (143/305, 47 percent) were referred by other categories of physicians. More than 50 percent of the referring professionals were not able to make a clinical diagnosis of oral mucosal diseases. Only 40 percent of the provisional diagnoses (122/305) coincided with the diagnosis made at the specialist unit. The proportion of correct diagnoses was 40 percent for GDPs who had graduated in dentistry, 33 percent for other categories of physicians, and 27 percent for GDPs who had graduated in medicine with a postgraduate degree in dentistry. These findings suggest that Italian dental and medical practitioners have limited knowledge in the field of oral medicine. Consequently, there is a need for better education in the diagnosis and treatment of oral diseases and for improvement in total oral health training.

The prevalence of oral mucosal lesions in U.S. adults: Data from the Third National Health and Nutrition Examination Survey, 1988–1994

Most reports of oral lesion prevalence are based on studies of atypical populations. There are no published studies on oral mucosal lesion prevalence in U.S. adults that are based on a national probability sample. The Third National Health and Nutrition Examination Survey, or NHANES III, employed a complex, multistage sample of 33,994 civilian, noninstitutionalized people from 19,528 households. Dentist examiners were trained to recognize, classify and record in a standardized manner the clinical characteristics of each of the 48 conditions of interest to include diagnosis, size, location, surface morphology, color consistency, pain, duration and history using procedures based on the World Health Organization's Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases. Examinations were performed on 17,235 people aged 17 years and older, of whom 4,801 (27.9 percent) had a total of 6,003 lesions. Denture-related lesions (stomatitis, hyperplasia, ulcers, inflammation and angular cheilitis) composed 8.4 percent and tobacco-related lesions (smokeless tobacco-related and nicotinic stomatitis) composed 4.7 percent of all lesions. Discounting denture-related lesions, amalgam tattoos were the most prevalent lesions (3.30 percent), followed closely by cheek/lip bites (3.05 percent) and frictional white lesions (2.67 percent). Smokeless-tobacco users (odds ratio, or OR, = 3.90) and removable denture wearers (OR = 3.57) had the highest odds of having a lesion. Lesion prevalences differed significantly by age, sex, race/ethnicity, denture wearing and tobacco use. When lesion-specific prevalences are cited in the literature, they should be stratified by covariates known to be associated with them.

The prevalence of oral mucosal lesions in a population in Ljubljana, Slovenia

The purpose of the present study was to evaluate the prevalence of oral mucosal lesions and conditions in a population in Ljubljana, capital of Slovenia. A total 1609 subjects represented the study population in the survey about the periodontal treatment needs in a population in Ljubljana, conducted from 1983 to 1987. Ten years later the same 1609 subjects were invited to the second examination. Altogether, 555 (34.5%) of the invited subjects in the age range 25-75 years came for an interview and clinical examination at the Department of Oral Medicine and Periodontology of the Dental Clinic in Ljubljana. Oral mucosal lesions and conditions were evaluated according to the WHO Guide to Epidemiology and Diagnosis of Oral Mucosal Diseases and Conditions. The results showed the presence of one or more mucosal lesions in 61.6% of the population. Fordyce's condition was observed the most frequently (49.7%) followed by: fissured tongue (21.1%), varices (16.2%), history of herpes labialis (16.0%), history of recurrent aphthae (9.7%), denture stomatitis (4.3%), leukoplakia (3.1%), cheek biting (2.7%), lichen planus (2.3%), frictional keratosis (2.2%), geographic tongue (2.2%), geographic and fissured tongue together (1.1%), mucocele (0.9%), smoker's palate (0.5%) and angular chelitis (0.4%). In the population examined, no oral malignancies were observed. Mucosal lesions like whitish lesions, denture related lesions, fissured tongue, varices and mucocele were more prevalent with increasing age. Tobacco-related lesions (leukoplakia and smoker's palate together) were significantly more prevalent among men than among women (P<0.05), while lichen planus, denture stomatitis and herpes labialis occurred more frequently in the female population.

The Oral Mucosal Punch Biopsy: Indications and Technique

The indications for advantages and disadvantages of the punch biopsy technique in the diagnosis of oral mucosal disease are discussed. The punch biopsy is recommended for use by the general practitioner as a simple, fast, inexpensive, and safe procedure for the diagnosis of oral mucosal lesions.

Direct immunofluorescence in the diagnosis of oral mucosal diseases

Direct immunofluorescence is an important technique in establishing the diagnosis of a variety of diseases. It has become a useful adjunct to the diagnosis of oral mucosal diseases, yet many practitioners find the field confusing. This paper summarises the published findings and presents a table for ready reference for clinicians.

成人集団検診における口腔粘膜疾患診査の試み Ｉ 診査の方法の検討

The purpose of the present study was to evaluate the procedures recommended by WHO (World Health Organization) for examination and recording via a mass screening of oral mucosal diseases in adults. WHO procedures have defined a criteria for these diseases (A method). As a comparison to the WHO method, alternatively mass screening of oral mucosa was also conducted in a way that is characterised by the description of the detected symptoms of oral mucosa (B method). This evaluation was achieved through the analysis of the precision level of a general dental practicioner (GP) of the coincident rate, sensitivity, specificity, false positive rate and false negative rate of the diagnosis. The precision level was calculated by comparison of the results of the detection by a GP to that of an oral surgeon (SP) fully experienced in the diagnosis of oral mucosal disease. One hundredeighty five people (21 women, 164 men, mean age 33.4 ranged from 18 to 63 years) who work in manufacturing establishments were examined for oral mucosa. Out of 185 persons 113 were examined and reported on using the WHO method (A method). The remaining 72 were examined and reported on using the B method. Prior to the screening the examiners were a SP and a GP who had one day training and were calibrated according to the WHO guide (1980). The following results were obtained. 1) The coincident rate between the diagnosis by the GP and the SP was 82.3% using the WHO method (A method). and 29.2% using the B method. Sensitivity was 47.6% in A method and 27.7% in B method. was 88.3% using the A method. and 15.4% using the B method. The false positive rate was 52.4% with the A method. and 77.2% with the B method. The false negative rate was 11.7% with the A method, and 81.0% with the B method. 2) Out of 185 people 27 cases (14.6%) were detected as having oral mucosal diseases: leukoplakia (3.8%), lichen planus (0.5%), leukoedema (2.7%), leukokeratosis nicotina palatini (3.2%), and others (4.3%).These results showed that the WHO procedures clearly surpassed the B method and were useful for mass screening of oral mucosal diseases in adults. In the A method a low value of sensitivity compared to specificity suggested that the training and calibration of a GP should be taken into account and improved.

Allopurinol-amplified lichenoid reactions of the oral mucosa

Three cases of oral lichenoid reaction linked with the administration of allopurinol are presented. Withdrawal of the drug resulted in considerable clinical improvement in one case and complete resolution of the ulcerative lesions in the other two cases. The consideration of drug-induced reactions in the differential diagnosis of oral mucosal diseases has been emphasized.