Lower Labial Mucosa Research Articles

ORAL SQUAMOUS CELL CARCINOMA IN A PATIENT WITH ORAL LICHENOID LESION (A CASE REPORT)

Oral squamous cell carcinoma represents more than 90% of all oral cancers. Ten percent of the cases are found on the buccal mucosa and the gingiva. The World Health Organization defines a premalignant or precancerous lesion as a morphologically altered tissue in which cancer is most likely to occur and includes oral leukoplakia, oral erythroplakia, and possibly oral lichen planus (OLP). The purpose of this study was to discuss the possibility of malignant transformation of OLP. The potency of OLP as a premalignant lesion is still an ongoing controversial discussion in literature. The report a case of oral squamous cell carcinoma located on the left buccal mucosa accompanied by oral lichenoid lesions on the right buccal mucosa, lower labial mucosa, and left buccal mucosa. These findings led to a possibility of malignant transformation of the oral lichenoid lesion. Unfortunately, biopsy on the lichenoid lesions was not performed. Therefore, a definitive diagnosis of OLP could not be established and the possibility of the lesions being dysplastic remained unclear. This study concluded that biopsy is mandatory to establish a definitive diagnosis of OLP and to investigate the possibility of dysplasia. It is necessary to perform examination of genetic alteration in dysplastic OLP in order to assess loss of heterzygosity (LOH), which may help to consider the risk of malignant transformation.

Mucocele in Pediatric Patients: Analysis of 36 Children

Mucoceles are common benign lesions of the oral cavity that develop following extravasation or retention of mucous material from major or minor salivary glands. Most series report a higher incidence of mucocele in young patients but no studies exist for this specific age group. The records of 104 patients presenting with mucocele who underwent surgery in the Oral Diseases Clinic of the Department of Dermatology of the University of São Paulo, Brazil, between 1991 and 2006, were reviewed. Of these, 36 (34.6%) were 15 years old or younger, the youngest being 2 years old. Twenty-six patients were girls, 10 were boys. Lesions were located on the lower labial mucosa (30 patients), tongue (three), floor of the mouth (one), buccal mucosa (one), and in one patient the location was unknown. Histopathology revealed an extravasation pattern in 35 patients and a retention pattern in one. Of the distinct subtypes of mucocele, tongue lesions (mucocele of the glands of Blandin-Nuhn) seem to be more prevalent and retention mucoceles seem to be very rare in children.

Glass embedded in labial mucosa for 20 years

Foreign bodies may be deposited in the oral cavity either by traumatic injury or iatrogenically. Among the commonly encountered iatrogenic foreign bodies are restorative materials like amalgam, obturation materials, broken instruments, needles, etc. Few reports of glass pieces embedded in the soft tissues of the mouth have been published. We report a case where glass pieces had been lodged in the lower labial mucosa for 20 years, with consequent peripheral reactive bone formation.

Analysis of residual saliva and minor salivary gland secretions

Residual saliva and minor salivary gland secretions are important for the maintenance of oral mucosal wetness. Salivary proteins and glycoproteins are the major components of the oral mucosal film, which functions as a moisture retainer and a protective barrier. Here, the correlations between the amounts of residual saliva and minor salivary gland secretions and their protein concentrations were investigated in 30 normal healthy individuals. The thickness of the mucosal film was measured at six mucosal surfaces and minor salivary gland secretion rate was measured at two mucosal surfaces. The thickness of residual saliva was determined by placing filter-paper strips against the mucosa at each site for 5 s and then measuring the volume electronically with a Periotron 8000 ® micro-moisture meter. The unstimulated rate of minor salivary gland secretion was measured for 30 s by the same method. Unstimulated whole salivary flow rate was measured with the spitting method. The total protein concentration of all salivary samples was measured by bicinchoninic acid assay. Before the experiment, the intra-/inter-examiner reliability of the method using the Periotron and the filter-paper strips was investigated. With a range of 0.4256–0.8846, the intraclass correlation coefficient, measured within and between examiners, was indicative of good reliability. The oral mucosal site with the thinnest coat of residual saliva was the anterior hard palate. Mucosal wetness on the hard palate and buccal mucosa showed significant positive correlations with the unstimulated whole salivary flow rate and significant negative correlations with the total protein concentration of residual saliva. Mucosal wetness on the upper and lower labial mucosa also showed significant negative correlations with the total protein concentration of residual saliva. Mucosal wetness on the soft palate was correlated with the minor salivary gland secretion rate ( r=0.477, P<0.01). Among the minor salivary glands, the secretion rate of soft palate glands in females showed a significant correlation with the unstimulated whole salivary flow rate ( r=0.563, P<0.05) and a significant negative correlation with its total protein concentration ( r=−0.525, P<0.05). These data suggested that oral mucosal wetness and minor salivary gland secretions could be influenced by various factors differently according to mucosal sites.

Superficial mucocele: Report of 4 cases

Four cases of the lesion first described as superficial mucocele by Eveson in 1988 are reported. All of the lesions developed in adult women; two of the women had concurrent oral lichen planus. The mucoceles were found on the soft palate, the buccal mucosa, and the upper and lower labial mucosa. The etiologic factors and pathogenesis of this lesion are discussed. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:469-72)

Toombak-associated oral mucosal lesions in Sudanese show a low prevalence of epithelial dysplasia.

Clinical (n = 281) and histopathological (n = 141) characteristics of toombak-associated oral mucosal lesions detected in an epidemiological study in northern Sudan in 1992/93 are described. The lesional site in the majority of toombak users was the anterior lower labial groove and the lower labial mucosa. 4 degrees (1-4) of clinical severity of lesions, similar to those used to characterise Swedish snuff-dipper's lesion, were applied. An association between the severity of mucosal lesions and a longer lifetime duration (> 10 years) of toombak use was found, but the severity was not related to the daily frequency of the habit. Parakeratosis, pale surface staining of the epithelium and basal cell hyperplasia were commonly observed, but epithelial dysplasia was infrequent (10/141). The most significant observation was a PAS-positive amorphous deposit between the lamina propria and the submucosa, found in 25/141 biopsies. The clinical and histopathological features of toombak lesions are closely similar to Swedish moist snuff-dipper's lesions and this may reflect the high alkalinity of these products, resulting in an alkaline burn on the oral mucosa following chronic exposure. The low prevalence of epithelial dysplasia implies a low risk of malignant transformation. Nevertheless, the high concentrations of tobacco-specific nitrosamines present in toombak, and the high prevalence of oral cancer in Sudan, mandate biopsy and careful histopathological analysis of any such lesions detected in habitues.

続発性貧血における口腔粘膜血行動態の研究

The pallor of the skin and oral mucosa that is associated with anemia is thought to be due to a decrease in hemoglobin in the super ficial blood vessels. However, there has been little systematic research on this subject.The authors of this paper used a tissue spectrum analyzer to measure the Lib (indicating hemoglobin concentration) and the Iso2 (indicating saturation). Experiments were conducted to determine the relationship between anemia and hemoglobin level in the oral mucosa, using the hemoglobin (Hb) value as the indicator.The following conclusions were reached.1. The areas of the oral mucosa which best correlate with the blood Hb level are the upper labial mucosa, lower labial mucosa, the back of the tongue, the sublingual surface, and the soft palate. The patients with secondary anemia showed reduced Lib levels (i. e. anemia) in all of these areas.2. Measurements of IHb were graded to appear in the following order, from highest to lowest: labial mucosa, tongue, and then soft palate.3. These measurements did not show a definite relationship between the IHb and the is in either patients with secondary anemia or in normal healthy people.4. It was conjectured that patients on dialysis would tend to show a somewhat higher IHb on the back of the tongue than in other areas.5. Sudden changes in blood volume, as in transfusions, surgery, etc., influence the oral mucosal hemodynamics. Reductions in the blood volume of thebody as a whole are accompanied by reductions in the blood volume of the oral mucosa. It was conjectured that the degree of this change in the oral mucosa would increase as the severity of anemia increased.6. Among the five parts of the oral mucosa which were investigated, the back of the tongue showed the lowest correlation with the true state of anemia.7. In order to determine the degree of anemia by hemodynamics of the oral mucosa, it is thought that the four parts (the upper and lower labial mucosas, the lower part of the tongue, and the soft palate) are the most reliable ones to observe.From the above, it was concluded that, in secondary anemia (patients on dialysis, those having blood dyscrasis, a malignant tumor of the oral cavity, etc.), there is a distinct correlation between the tissue hemoglobin concentration (IHb) in the mucous membranes of the oral cavity and the true degree of anemia. This could be considered a useful method for clinical diagnosis.

Substance-P-Like Immunoreactive Subepithelial Nerve Plexuses in the Labial Mucosa of the Mouse

Substance P (SP)-like immunoreactivity was examined in the lower labial mucosa of the mouse by using the whole-mount technique. The density and design of subepithelial nerve plexuses containing SP differed depending on portions of the lower labial mucosa.

Lupus band test in uninvolved oral mucosa in systemic lupus erythematosus.

In 42 patients with systemic lupus erythematosus, clinically normal oral mucosa was investigated with direct immunofluorescence technique for the presence of immunoglobulins G, A and M and complement factor C3 in the mucosal basement membrane zone (the lupus band test, LBT). Punch biopsies were performed in the posterior part of the hard palate (n = 39) or the lower labial mucosa (n = 3). The immunopathological observations were compared with clinical and serological data. The LBT was positive for IgM in 45% of the patients and trace amounts of IgM were found in another 19%. In 7 cases (17%) either IgG, IgA or C3 were found in addition to IgM and these patients all had a severe form of the disease, while the presence of IgM only was not correlated to clinical parameters.

Migration of Merkel cells in the labial mucous epithelium of adult rabbits following mental nerve resection

Merkel cells in the lower labial mucosa of adult rabbits were studied electron microscopically, 9, 21, 28, and 50 days after resection of the mental nerves. By day 9, nerve fibers were completely retracted from the epithelial layer of the mucosa. On and after day 21, Merkel cells were located not only in the basal layer but also in the prickle or more superficial cell layers. The ultrastructure of the migrating Merkel cells was unchanged, both as to the amount and location of the specific cored granules in the cytoplasm, until the cells reached the granular cell layer. The position of the migrating Merkel cells differed from cell to cell, and migration continued for at least 50 days. A remarkably large number of immature Merkel cells was observed in the basal and suprabasal cell layers of the denervated epithelium even by day 50. Therefore, the possibility of the reproduction of Merkel cells exists. The migrating Merkel cells, as well as the keratinocytes in the same cell layer, had degenerated drastically in the parakeratinized cell layer. This seems to indicate that the Merkel cells belong to the line of keratinocytes.

Intravascular papillary endothelial hyperplasia in the oral mucosa

An intraluminal reactive hyperplastic lesion from the lower labial mucosa of an adult male patient is described. It has been termed intravascular papillary endothelial hyperplasia and may have arisen in an organizing thrombosed vein. The importance of distinguishing it from a malignant vascular neoplasm is stressed, and the differential diagnosis is discussed.

Periodontal ligament thickness as related to age and mesiocclusal drifting of teeth:a histometric study.

THE EFFECT OF HYDROMASSAGE ON CAPILLARY STRENGTH Kozam, G. N.Y. State Dent. J., 39:551, November, 1973. Forty subjects in good general and periodontal health were tested by using a capillary resistometer to apply suction stress to tissue surfaces at —100, —200, and —300 millimeters of mercury for one minute. Petechiae in a 3 cm. diameter were counted. The test regions used were the antecubital skin of both arms and the lower labial mucosa. The first 4 weeks were used for pre-experimental baselines on the right side of both regions and pre-control baselines on the left. Patients were in­ structed to use a Water Pik spray to their right side areas for 4 minutes. When the hydromassage was used, a rapid decrease in the number of petechiae was demonstrated indicating an in­ creased capillary resistance to rupture to suction-stress tests by a physiologic mechanism. 100 Bergen St., Newark, New Jersey 07103. MASSIVE GINGIVAL HYPERPLASIA PRECEDING DENTAL ERUPTION IN I-CELL DISEASE Galili, D., Yatziv, S., and Russell, A. Oral Surg., 37:533, April, 1974. I-cell disease is a rare condition, found in infants, which is characterized by severe shortness of stature, early psychomotor retardation, congenital dislocation of the hip, inguinal hernia, and facial and skeletal anomalies. Hyperplasia of the gingiva is usually seen by 6-18 months along with variations in the facial configuration. Diagnosis is based on clinical signs and both enzymatic and tissue analyses. The tissue defects resemble those of the storage disorders, suggested to be of combined lipid and mucopolysaccharide metabolic groups, and culture of fibroblasts shows the cytoplasmic inclusion which are charac­ teristic of the disease. The disease probably represents the homozygous state of a recessive mutation, but the pathogene­ sis is not known. The reported case is that of a 12-month-old Arab boy, whose parents were first cousins, who presented with all of the aforementioned symptoms. The hyperplastic gingival tissues were firm, hard, and somewhat elastic, with no signs of inflammation. Radiographs showed the tissue to be com­ pletely covering otherwise erupted teeth. The posterior regions of the tissue occluded, while there was an open-bite an­ teriorly. The enlargement of the gingiva, combined with the normal size of the tongue reduced the volume of the oral cavity which interfered with breathing and feeding. Histologic examination revealed normal stratified squamous epithelium, with a slight elongation of the rete pegs, and an underlying connective tissue layer consisting of dense collagen and a slight chronic inflammatory cell infiltration. Department of Oral Di­ agnosis, Oral Medicine, and Roentgenology, The Hebrew Uni- versity-Hadassah School of Dental Medicine, P.O.B. 1172, Jerusalem, Israel. HEMORRHAGE AFTER ORAL SURGERY: A N ANALYSIS OF 103 CASES Jensen, P. S. Oral Surg., 37:2, January, 1974. A study was done of 103 patients consecutively treated for postoperative hemorrhage and a control group of 103 patients in the clinics who consecutively underwent the same treatment as the experimental group, but without developing postopera­ tive hemorrhage. The majority of the patients were in the 16- to 30-year old range, with a better than two to one (73:30) ratio of males to females. The most common site of bleeding problems was the lower third molar area, but after periodontal surgery, bleeding was more common from the maxilla. A statistically significant high frequency of earlier postsurgical bleeding episodes suggested that certain oral surgery patients have a tendency to postoperative hemorrhage without display­ ing hematologic values characteristic of any known hemor­ rhagic diathesis. In the remainder of the patients, bleeding was usually of local origin, with a high frequency of mucosal laceration, suggestive of inadequate surgical techniques. Dental Department, University Hospital, Blegdamsvej 9, DK 2100, Copenhagen, Denmark. PERIODONTAL DISEASE, BACTERIA, AND PULPAL

Punch-biopsy of minor salivary glands in the diagnosis of Sjögren's syndrome.

Abstract— The aim of the present investigation has been to examine whether the histopathologic changes in the minor salivary glands in patients with Sjögren's syndrome are of the same nature as the changes in the major salivary glands. Punch‐biopsies were taken from the lower labial mucosa in 14 patients; 12 of these had a verified Sjögren's syndrome. In 10 patients changes in accordance with those of a benign lymphoepithelial lesion were present in the minor salivary glands. The technique was found valuable in the diagnosis of general disorders with salivary gland involvement.

Strength of capillaries in oral mucous membranes.

The suction method was used to test the capillary resistance of oral mucous membranes. The labial mucosa was found to be suited to capillary resistance studies since it lacks both pigment and cornification, and the petechial hemorrhages are easily visualized. The minute vessels of the lower labial mucosa were significantly stronger at -50, -100, -200, -300 and -400 mm Hg than were those of the skin of the antecubital fossae. It is now possible to recognize subjects of high, low, and intermediate capillary resistance.

Treatment of oral histoplasmosis by local injection with nystatin.

As yet, no specific therapy for histoplasmosis has been developed clinically. The effective inhibitory nature of nystatin on Histoplasma capsulatum has been demonstrated both in vitro and in animals experimentally infected.1On this premise, we injected nystatin solution directly into oral lesions of histoplasmosis and observed the gradual but complete disappearance of the localized disease process. Report of a Case A 78-year-old man was admitted to the Cincinnati General Hospital on Sept. 13, 1955, with the history of firm blisters that had been appearing in his mouth since mid-July, 1955. There were no other subjective complaints. On physical examination, this elderly man appeared thin but not ill. Examination of the oral cavity revealed multiple, firm, nontender, mucosacovered nodules, which varied in size from 5 to 10 mm. in their greatest diameter. The lesions were distributed as follows: two nodules on the upper and one on the lower labial mucosa,