Lesions Of Oral Cavity Research Articles

Outcome of Treatment in Verrucous Carcinoma of Oral Cavity: A Tertiary Rural Hospital Experience.

Verrucous carcinoma of oral cavity is a highly well differentiated variant of squamous cell carcinoma with a low potential for invasion and metastasis. It is prevalent in the tobacco quid chewing population in our region. In this observational study, we reviewed the medical case records of 58 patients treated for oral verrucous carcinoma staged T2 to T4a. All patients underwent wide excision of tumour which included marginal mandibulectomy in 22 and hemimandibulectomy in 23 patients along with neck dissection saving the accessory nerve and internal jugular vein. 5 patients were found to have bone involvement along the alveolar sockets. 11 patients had other associated premalignant lesions in oral cavity. Only 2 patients had lymph node metastasis without extra nodal spread in submandibular region. With a mean follow up of 6years and minimum follow up of 1year, 3 patients had local recurrence. All these 3 patients had bone involvement and 2 of them had lymph node metastasis on histopathological examination. 3 patients who had associated premalignant lesions developed second primary in oral cavity after 3years. In our experience, verrucous carcinoma has good prognosis when treated by surgery. Bone involvement along alveolar sockets and associated oral premalignant lesions adversely affect the outcome. There was no difference in the outcome between selective and modified radical neck dissection. Therefore selective neck dissection (supraomohyoid) would be adequate in treating these patients. Adjuvant radiotherapy can be reserved for T4a lesions or for positive margins.

Workplace based Potentially Malignant Oral Lesions Screening among Tobacco Consuming Migrant Construction Site Workers in Chennai, South India: A Pilot Study.

Context:Vulnerable population groups such as migrant workers are identified as emerging high-risk groups for oral cancer owing to the high prevalence of smokeless tobacco consumption. Premature deaths due to oral cancer can be prevented by screening the population with high tobacco consumption practices and detecting early reversible stages of oral mucosal cavity lesions and facilitating linkages for further care.Aim:To assess prevalence of potentially malignant oral mucosal cavity lesions among tobacco consuming migrant construction workers in sub-urban Chennai, India.Settings and Designs:A workplace based cross-sectional study design.Materials and Methods:A cross-sectional study was conducted at workplaces i.e., construction sites for screening potentially malignant oral mucosal cavity lesions among migrant workers across 23 construction sites of Chennai during September 2019 - February 2020. An onsite, group health education session was provided about the harms of tobacco use to the migrants.Statistical Analysis Used:Data entered in MS Excel was analysed using SPSS and multivariate analysis was performed.Results:Among 640 migrants included in the study, 411 (64.2%) were less than 30 years of age, 623 (97.4%) were from north-eastern states of India such as West Bengal, Bihar, Rajasthan, Uttar Pradesh, Jharkhand. A considerable size (272, 42.5%) could not read or write and 355 (55.4%) earn a monthly income of less than ten thousand rupees. Current tobacco users were 619 (96.7%), smokeless tobacco users (463, 72.34%), smokers (206, 32.2%) and dual users (52,8.12%). Inflammatory mucosal lesions in the oral cavity were 70.97% and more among smokeless tobacco users comparable to 22.58% among tobacco smokers and was significantly associated with up to 20 years of tobacco consumption.Conclusions:Prevalence of Potentially malignant oral lesions among smokeless tobacco using interstate migrant construction site workers is very high and need urgent interventions.

Evaluation of Alteration in Oral Microbial Flora Pre- and Postradiation Therapy in Patients with Head and Neck Cancer.

ABSTRACTIntroduction:For decades now, head and neck cancer (HNC) remains to be one of the deadliest; per se the treatment for the same has been evolving for the past years. Radiation therapy (RT) has been one among the various treatment modalities adopted to treat HNC. The fact that RT can affect the quality of life in these patients cannot be denied. In patients with HNC, these can bring about a wide array of lesions in oral cavity and its associated structures as these areas are invariably affected due to exposure to radiation as such. These include alteration in salivary parameters, changes in microbial flora, and occurrence of radiation caries.Aim:In our study we aimed at assessing the alteration in oral microbial flora inclusive of Streptococcus mutans and Lactobacillus colony count before and after RT.Materials and Methods:Saliva and plaque samples were collected from patients with HNC, who were prescribed to undergo intensity-modulated radiation therapy (IMRT) amounting to a mean radiation dosage of 60 Gy units. The aforementioned samples were collected at three different intervals, before, immediately after, and 6 months after RT. The samples were cultured in selective media in three different dilutions (1:10, 1:100, and 1:1000). Following with colony counting is carried out using a standardized colony counter.Conclusion:The results showed a significant alteration in microbial flora pre- and post-RT. Individual parameters do not show a single stand in causing these changes. Moreover, these changes seem to have earned a multifactorial contribution.

Epistaxis in Pregnancy - A Rare Case Report

Introduction: Pyogenic granuloma is a benign lesion of unknown etiology that occurs in the skin and mucous membrane. It has been reported as a common lesion in oral cavity and less commonly in nasal cavity. Although its etiology is unclear, pyogenic granuloma is commonly associated with pregnancy, oral contraceptives and trauma. Case: A 22 year old female patient with 7 months of amenorrhoea came to ENT opd with complaints of epistaxis and swelling in left nasal cavity ultimately diagnosed as pyogenic granuloma. The patient was treated with endoscopic excision of nasal mass under general anesthesia. The management of pregnant female with such lesion was challenging, so we had to operate her. Even radiation exposure was a risk while radioimaging before surgery. Conclusion: Pyogenic granuloma is rapidly growing lesion that should be considered in the differential diagnosis of gravid patient with oral and nasal mass. Early excision of mass helped in avoidance of further complications such as fetal distress, low birth weight and reduces maternal mortality and morbidity.

The role of Helicobacter pylori in development of lesion in oral cavity

Background/Aim: to examine the connection of H. Pylori in saliva and biopsy material with oral lesions. Material and Methods: Sixty patients with dyspeptic complaints were followed up at the Clinic for Gastroenterology at University Medical Clinical Centre in Skopje, divided into two groups: first group consisted of 30 patients without presence of H. pylori, and the second group with 30 subjects and presence of H. pylori. The presence or absence of H. pylori has been ascertained after endoscopic examination-gastroscopy, and implemented urease test (CLO-test). All patients were clinically followed in order to determinate mouth burning, recurrent aphthous stomatitis (RAS), acid taste and lingual papillary hyperplasia according to Cohen and Proctor. The presence of H. pylori in saliva has been ascertained before endoscopic examination, after chewing Orbit gum without sugar for 1 min using by Pronto dry test. Determination of H. pylori in biopsy material has been ascertained by rapid urease test (RUT). Results: At 30 patients with dyspeptic complaints and presence of Helicobacter pylori, 16 patients (53,33%) had lingual papillary hyperplasia, acid taste, burning mouth and recurrent aphthous stomatitis (RAS). At 4 patients (13,33%) was confirmed acid taste, and also at 4 patients (13,33%) burning mouth. At 2 patients (6,67%) was confirmed lingual papillary hyperplasia, burning mouth, and recurrent aphthous stomatitis (RAS). At the same time, at 2 patients (6,67%) was confirmed burning mouth, and recurrent aphthous stomatitis (RAS), until at 1 patient (3,33%) lingual papillary hyperplasia, as at 1 patient (3,33%) lingual papillary hyperplasia and acid taste. At patients without presence of Helicobacter pylori but with dyspeptic complaints, was confirmed burning mouth in 14 patients (46,67%), lingual papillary hyperplasia, burning mouth, and acid taste in 7 patients (23,33%); in 3 patients (10,00) lingual papillary hyperplasia, burning mouth, and in 2 patients (6,67%) was confirmed recurrent aphthous stomatitis (RAS). Acid taste was registered in 2 patients (6,67%), and also lingual papillary hyperplasia in 2 patients (6,67%). There was a significant differences in clinical aspect between the patients with and without presence of H. pylori, for p< 0,01(p= 0,002); Pearson Chi-square= 20,10 i and p<0,05(p= 0,01). Conclusions: H. pylori in saliva and biopsy material detected with CLO test are reason for oral lesions at patients with dyspeptic complaints who have the presence of H. pylori.

Occurrence site of canine oral lesions: a retrospective study of 659 cases

Many types of tumorous and tumour-like lesions occur in the oral cavity of dogs. Even benign neoplasia often represents great inconvenience due to potential restrictions of therapeutic surgical approach in this area. Whereas in human medicine, there are statistical data describing areas of the oral cavity, that are more prevalent for development of particular neoplasia, in veterinary medicine, these data are not yet available. The aim of this study was to evaluate the prevalence of tumours in dogs with oral neoplasia, the occurrence site of the most common neoplastic lesions in the canine oral cavity, as well as the effect of age and sex on the prevalence of these lesions. In this study we investigated oral tumorous lesions from 659 dogs, out of which 352 lesions were diagnosed as tumours and 307 as tumour-like lesions. The most common tumours encountered were melanoma (42%, n = 148), squamous cell carcinoma (16%, n = 57) and canine acanthomatous ameloblastoma (10%, n = 35). The median age of dogs with oral neoplasia was 9.9 years, with the range of 0.2 to 17.5 years. There was no significant association between sex and the type of oral lesion (tumorous and tumour-like). Melanoma was most commonly present in the caudal maxillary region, squamous cell carcinoma on the mouth floor, canine acanthomatous ameloblastoma in the area of the rostral mandible, plasmacytoma on the tongue, osteosarcoma was most often diagnosed in the caudal parts of oral cavity and fibrosarcoma did not have a specific site of occurrence.

Smoking, alcohol consumption and human papillomavirus infection as risk factors for oral cavity and oropharyngeal tumors in Serbia - a pilot study

Background/Aim. The oral cavity and oropharyngeal cancers are among the most common cancers worldwide with the multifactorial etiology. The aim of this study was to determine the major risk factors among patients with oral cavity and oropharyngeal tumors in Serbia. Methods. A total of 63 patients with biopsy proven malignant (33 patients) or benign (30 patients) oral cavity or oropharyngeal lesions were included in this study. The data about gender, age, smoking habits and alcohol consumption were obtained from the routine medical files. The detection and genotyping of human papillomavirus (HPV) was done in paraffin embedded tissue samples using in situ hybridization. Results. Malignant lesions were more frequent in men, smokers and patients who consume alcohol with a statistically significant difference compared to the patients with benign lesions. The prevalence of HPV infection was higher in patients with malignant lesions compared to patients with benign lesions, but without statistically significant difference. High risk genotypes were detected only in patients with malignant lesions of tonsils and base tongue cancer, while low risk types were demonstrated in patients with benign lesions with a highly statistically significant difference. Conclusion. The results point to the significant association of tobacco smoking, alcohol consumption and high risk HPV genotypes as risk factors for oral cavity and oropharyngeal carcinomas in Serbian patients.

Non-healing ulcer of tongue: The most commonest yet the most camouflaged lesion of oral cavity

Non-healing ulcer of tongue: The most commonest yet the most camouflaged lesion of oral cavity

Artificial intelligence: In modern dentistry

Artificial intelligence (AI) is the ability of a digital computer or computer-controlled robot to perform tasks commonly associated with intelligent beings. There is marked increase in evolution of AI from the last decade, which has been showing tremendous improvement and dentistry is no exception. AI has its importance in dentistry, especially in oral medicine and radiology, which includes patient diagnosis, storage of patient data, and the assessment of genetic information which will provide improved healthcare for patients. Regardless of many improvements and advances, AI is still in its teething stage, but its potential is boundless. This article reviews on how this technology is tremendously utilized for easy and early diagnosis, proper treatment of lesions of oral cavity, advanced breakthroughs in image recognition techniques, screening of suspicious premalignant, and malignant changes of oral cavity with satisfying outcome. A thorough knowledge regarding the adaptation of technology will not only help in better and precise patient care but also reducing the work burden of the clinician.

Knowledge assessment among the fourth and fifth year students on the potentially malignant lesions of oral cavity

Background/Aim: Potentially malignant oral lesions (PMOL) are lesions that have an increased risk of malignant transformation concerning healthy oral mucosa. This research aimed to assess the knowledge of students of final years of study on the potentially malignant lesions of the oral cavity. Material and Methods: 120 students of the fourth and fifth years of study participated in this research,60 respondents were fourth-year students, 60 respondents were fifth-year students. All of the respondents signed informed consent.According to the type of research, this is a cross-sectional study which was conducted by completing a 15-item questionnaire. The results were statistically analyzed and processed in the SPSS Statistics 21.0 program. Results: The results indicate that during the clinical examination the fourth and fifth-year students examine the oral mucosa as well. 61% of the students find themselves poorly informed on the PMOL. In the fourth year of study, only 5,5% of students responded that they were well informed, while in the fifth year that number totaled 28,5%. When knowledge self-assessment is concerned the difference has shown itself to be statistically significant between the fourth and fifth-year students. When asked what knowledge on the prevention of oral cancer they expect to receive during their studies, 78% of the students expected more knowledge than at that moment - 36% of which were fifth-year students, and 42% were fourth-year students. Conclusions: Even though the oral cavity is easily accessible to examination, the discovery of oral cancer occurs quite late. Ours, as well as results of other studies, impose the need for better theoretical and practical education of the students.

A study on the pattern of oral cavity involvement in various dermatoses at tertiary care center

Introduction: Oral mucosa is in direct continuity with the skin externally and with the mucosa of oropharynx and nasopharynx internally. Dermatological diseases may involve the mucosa which can be an early predictor of any underlying disease. Materials and Methods: The present study was a cross-sectional observational study, conducted between May and October 2018 after institutional ethical clearance. Patients presenting with dermatoses involving oral cavity alone or with other sites belonging to all age groups and either sexes were included. Cutaneous, oral cavity, and systemic examination was done along with other relevant investigations which were required, and detailed examination was noted in a prestructured pro forma. Results: Out of 52 cases of oral cavity lesions, 55.76% were female and 40.38% were in 19–40 years of age group. Complaints of pain and burning sensation in the oral cavity were present in 48.07% of cases. Majority of patients (55.76%) had lesions over lips and buccal mucosa. Lichen planus was the most common clinical diagnosis seen in 40.38% of cases followed by herpes labialis in 17.30% of cases. Other mucosal sites involved were genital mucosa in 11.53%, followed by conjunctiva in 1.92% of patients. Hypertension was seen in 11.53% of cases. Discussion: Various dermatological disorders of diverse etiologies involve oral cavity. Any symptom or sign in the oral cavity should not be neglected because that can be an early predictor of any underlying disease. Routine intraoral examination should be incorporated in all dermatosis as the oral manifestations can represent preliminary signs or can coexist with the diseases. Conclusions: Thus, prompt diagnosis and management can minimize disease progression and improve the quality of life of an individual. Limitation: Small sample size was the limitation of our study.

Assessment of awareness of human papillomavirus infection impact on oral cavity among patients.

IntroductionHuman papillomavirus (HPV) is responsible for oral cavity lesions such as squamous papilloma, multiform epithelial hyperplasia, condylomata acuminata, giant cell fibroids or squamous cell carcinoma.AimTo assess the patients’ awareness of HPV infection’s impact on oral health.Material and methodsThis was a prospective study of dental patients who were treated in the Department of Oral Surgery at the Medical University of Gdańsk (Gdańsk, Poland) from January to February 2019. Inclusion criteria were as follows: Polish-speaking patients over 18 years old. Exclusion criteria were as follows: people with limited Polish language knowledge and under 18 years old. Participation was voluntary based on the written consent. Descriptive and bivariate statistics were computed and the p-value was set at ≤ 0.05.ResultsThree hundred and sixty-three people (58.13%: females; 41.87%: males; mean age 21 years, range: 18–65) were included in the study. Women were more aware what HPV was (p = 0.011), the fact that HPV infection could be latent (p = 0.018), responsible for the oral cancer (p = 0.032), there was an HPV vaccine (p < 0.001), and how to prevent infection (p < 0.001); relationship between age and the fact that HPV infection may be responsible for the oral cancer (p = 0.007), HPV infection methods (p < 0.001), characteristics of the lesions caused by the HPV on the mucous membrane (p < 0.001), and how to prevent infection (p = 0.044).ConclusionsOur study suggests that patients’ awareness of the influence of HPV infections on oral health is limited. Therefore, more attention should be paid to the education of the patients and to prevention programs.

Erythema Multiforme versus Herpes Simplex Virus, what is the diagnosis? A review and a case report.

One of the commonly encountered lesions in oral cavity is oral ulceration. They arise from various etiology, being associated with discomfort or pain, rarely results in complications and scarring. The nonspecific clinical presentation of oral ulceration in the oral cavity, will made their diagnosis crucial, however a detailed patient history, comprehensive clinical examination together with background knowledge of possible causes will lead to correct diagnosis and subsequent treatment, moreover distinguishing between erythema multiforme (EM) and herpes simples viral infection (HSV) when there is only oral involvement is of a great importance as the treatment of EM is contra indicated for HSV.

Prevalência e caracterização das lesões orais na Clínica de Estomatologia da Policlínica Piquet Carneiro – Estudo Retrospectivo de 12 anos

Objetivo: avaliar a prevalência dos principais tipos de lesões submetidas à biópsia e identificar o perfil dos pacientes atendidos no ambulatório de Estomatologia da Policlínica Piquet Carneiro (PPC/UERJ, Rio de Janeiro) no período compreendido entre 2000 e 2012. Material e Métodos: estudo transversal e retrospectivo em que prontuários de 2078 pacientes foram avaliados e dados referentes às doenças, idade, gênero, cor da pele e localização anatômica das lesões foram coletados e analisados de forma descritiva. Resultados: 69% dos pacientes (1441 casos) obtiveram o diagnóstico conclusivo através de exame histopatológico, ao passo que 31% (637 casos) obtiveram um laudo histopatológico descritivo. Dos casos com diagnóstico histopatológico conclusivo, 58% eram mulheres, 31% homens e em 11% o sexo não foi informado. A média de idade da população estudada foi de 50,63 anos e em 58% dos casos os pacientes eram leucodermas. O maior número de lesões foram as do grupo dos processos proliferativos não-neoplásicos, sendo a hiperplasia fibrosa inflamatória (30,1%) a mais prevalente. Conclusão: o perfil epidemiológico do paciente atendido no período estudado foi composto predominantemente por mulheres com mais de 50 anos de idade e a lesão oral mais prevalente foi a hiperplasia fibrosa inflamatória. Este estudo reforça a importância do papel da análise histopatológica como método auxiliar de diagnóstico e que possibilita a elaboração de estratégias específicas para prevenção e detecção precoce das doenças orais mais frequentes na população.

EPIDEMIOLOGIC EVALUATION OF ORAL LESIONS BIOPSIED IN STOMATOLOGY SERVICE IN POPULATION OF 7 CITIES

Objective Dental specialty centers (DSC) in Brazil are secondary care units associated with the public health system that offer care directed to the specialty of stomatology, among other areas. The present study aimed to evaluate epidemiologic data of lesions biopsied in DSC responsible for clinical care in 7 cities in its state. Study Design This is a retrospective, observational, quantitative study. Information related to age, sex, anatomic location of the lesion, diagnostic hypothesis, type of biopsy, and histopathologic conclusion were collected from the health unit's database with the aid of a data collection instrument. Biopsy procedures performed between the period from May 10, 2013, to April 5, 2018, were considered. Absolute frequency and chi-square test were used for statistical analysis. Results One hundred ninety-four biopsy procedures were performed in 187 patients. The age ranged from 5 to 87 years. Male sex was represented by 66 individuals (35.2%), while female sex was represented by 120 individuals (64.1%). Conclusions Clinical care in the area of stomatology offered to population of 7 cities by the CEO presents fundamental importance in the diagnosis and treatment of oral cavity lesions.

Natural course of diffuse large B cell lymphoma\u2014a manifestation in buccal mucosa

BackgroundTransformation and progression of lymphoma after treatment is well known; however, since the advent of chemotherapy and radiotherapy, progression in untreated lymphoma is seldom seen. We present a case which was misdiagnosed and treated as abdominal tuberculosis later presented with progression and involvement of oral cavity.Case presentationA 41-year-old male who presented with urinary symptoms and abdominal pain was diagnosed as abdominal tuberculosis and treated. Two years later, he presented with B symptoms and oral cavity lesion that was diagnosed as diffuse large B cell lymphoma. The patient was treated with R-CHOP chemotherapy with complete regression of the lesion.ConclusionInvolvement of extranodal sites in predominantly nodal disease does occur; however, involvement of oral cavity is rare. Though primary extranodal lymphoma is reported to occur in oral cavity and oropharynx, natural progression in untreated disease is seldom documented.

Pigmented Lesions of Oral Cavity―A Short Review

Pigmentation of oral mucosa occurs due to accumulation of pigments and thereby leading to colour change. Pigmented lesions of oral cavity can be physiologic or pathologic. The pigments causing discolouration can be either from external sources (exogenous) or internal sources(endogenous). Certain drugs can also cause pigmentation of the oral mucosa. Benign and malignant tumours of melanocytic origin can also be pigmented in nature. Endocrine diseases (adrenal) can also cause pigmentation. Diagnosing pigmented lesions requires thorough knowledge of various causes and proper diagnosis is important for planning the treatment.

Mucocutaneous Histoplasmosis in immunocompetent adult patients

Introduction: Histoplasmosis is a fungal infection caused by the agent Histoplasma capsulatum,a dimorphic fungus. The spectrum of illness ranges from subclinical infection to progressive disseminated disease. The major bulk of histoplasma infections are asymptomatic or pulmonary histoplasmosis. In immune compromised patients it can cause disseminated infections involving different organs of the body. In immune competent individuals it may cause isolated adrenal histoplasmosis.&#x0D; Material and methods: A retrospective study was done to look for mucocutaneous histoplasmosis. The excised tissue samples were cultured and only culture confirmed cases were included in the study.&#x0D; Result: Here, we present five cases of primary mucocutaneous histoplasmosis in immune competent individuals in a tertiary care centre in India. These patients had no other co-morbidities and had only isolated lesions in oral cavity or penis.The tissue on excision was cultured and showed growth of Histoplasma capsulatum. All the patients improved with treatment. There are limited cases of mucocutaneous ulcerated lesions caused by Histoplasma capsulatum in immune competent people in published literature.&#x0D; Conclusion: This study emphasizes the necessity of a vigilant look out and clinical suspicion of fungal causes like histoplasma in chronic non healing ulcers which should be confirmed by the laboratory investigations. Accurate diagnosis helps in specific management of these cases.&#x0D; Bangladesh Journal of Medical Science Vol.19(1) 2020 p.94-97

Oral Cavity Lesions

This chapter presents a systematic approach to the diagnosis and management of the most common oral cavity lesions. Oral cavity lesions are broadly categorized based on etiology and are further characterized according to clinical features such as location, shape, size, associated symptoms, and duration. Some of these conditions present with pathognomonic signs and symptoms, whereas others may present nonspecific features, making clinical diagnosis challenging. Formulating a differential diagnosis requires taking a thorough history and performing a detailed physical examination, often along with investigative studies and tests. Management protocols differ according to the specific condition, ranging from observation alone to medication-based and/or surgical therapy. This review 32 figures, 6 tables, and 53 references. Key Words: hematologic malignancy, immune-mediated disease, mucosal melanoma, oral anatomy, oral cancer, oral examination, oral infections, oral manifestations, oral mucosal disease, oral precancerous lesions, salivary gland disease

A clinical study on precancerous lesions of oral cavity in patients attending dental hospital, Telangana

Background: Aim of the retrospective study is to determine the type and frequency of the precancerous lesions of the oral cavity and to assess their sex, age distribution among the patients.Methods: Study was conducted based on year-wise data collected during 2015 to 2018 of all the patients with precancerous lesions of oral cavity.Results: The total number of patients was 1247, out of which 803 (64.39%) were males and 444 (35.60%) were females. Most common precancerous lesion is oral submucous fibrosis (70.24%) followed by oral lichen planus (19.08%), leukoplakia (8.98%), erythroplakia (1.68%).Conclusions: We observed marked geographical variation in the incidences of various precancerous lesions. Mostly males are affected by precancerous lesions than females.