Mandibular Alveolar Mucosa Research Articles

Peripheral Ameloblastoma Associated with Peripheral Giant Cell Granuloma in the Mandibular Alveolar Mucosa

Peripheral Ameloblastoma Associated with Peripheral Giant Cell Granuloma in the Mandibular Alveolar Mucosa

Predictors of Locoregional Recurrence in Oral Squamous Cell Carcinoma

Introduction: Lip and oral cavity cancer is the third and fifth most frequent cancer for men & women respectively in Bangladesh. Locoregional recurrence after primary surgery is common for oral cancer due to aggressive local invasion and metastasis. The objective of this study was to analyze the predictors of locoregional failure in a tertiary center hospital. Materials and Methods: A prospective cohort study was designed to analyze the presence of recurrences of OSCC patients after surgery. The purposive sampling technique was used to include patients in the study. Excision of the primary tumor was done with neck dissection followed by reconstruction with local or regional flap. The variables considered were demographic information, site, TNM stage at diagnosis, margin status, lymph node metastasis, perineural invasion, recurrence, and the adjuvant therapy used for disease control. Patients were followed up by hospital revisits or phone calls and necessary information was collected through a standardized data collection sheet. Results: A total of 39 patients were included for data analysis. The male to female ratio was 1:2 and the most common primary site was mandibular alveolar mucosa (31%). Nearly 90% of patients were admitted with stage ׀׀׀ or ׀ᴠ lesions and tumor margin was positive in 21% of cases. Lymph node metastasis and perineural invasion were identified in 64% and 23% of cases respectively. Recurrence developed in 14 patients (36%) during the average follow-up of 13 months. Recurrences were more common in females (42%) and Postoperative histopathology showed a positive margin, perineural invasion, and N3 neck node. Univariate logistic regression analysis for locoregional recurrence showed no significant association between the variables and recurrence. Patients with clinically palpable lymph node, grade 2 lesion, presence of perineural invasion, presence of co-morbidity, patients who did not receive any adjuvant therapy, and patients who had metastatic neck node showed an increased odds ratio (OR>1). Conclusion: The clinicopathologic and treatment-related factors of recurrence in OSCC were explored in this study. Although no significant association was identified between the variables and recurrence of lesions, a high recurrence rate was observed in a shorter span of the follow-up period. Update Dent. Coll. j: 2022; 12 (1): 12-16

A comparative study on the effectiveness of application of different types of biological matrixes on mandibular alveolar mucosa lesion healing

Periodontal diseases is one of the most relevant and important problem in modern dentistry due to their increasing prevalence in population, association with the occurrence of focus of chronic infection, progressive development and irreversibility which, in case of severe damage of periodontal tissues, eventually leads to a loss of the number of teeth. All of the named factors eventually lead to the development of irreversible inflammatory-dystrophic and destructive changes in periodontal tissues. During the recent years the method of guided tissue regeneration that uses membranes is being successfully used for the treatment of periodontal diseases.A comparative study on the mandibular alveolar mucosa lesion healing during application of different types of biological matrixes containing decellularized amniotic membrane, decellularized amniotic membrane in combination with platelet-rich plasma (PRP) growth factors, and decellularized amniotic membrane in combination with PRP growth factors and hyaluronic acid was performed. The study proved the acceleration of the processes of wound area reduction. Under experimental conditions, the wound healing lasted from day 3 to day 5 of the study; however, the rate of reduction of the wound area was slower, which indicates an alterative stage of the acute inflammatory process. During days 5 – 7 (stage of regeneration, the 2nd phase of wound process) the wound area reduced rapidly and by day14 a complete epithelization of the surgical wound was observed in all groups using decellularized amniotic membrane. In the group using the combination of PRP growth factors and hyaluronic acid the epithelization of wound was already observed on the day5. In the control group healing occurres with scar formation.

Clinical pathologic conference case: An older woman with a painless, deep, and indurated ulcer on her mandibular alveolar mucosa

Clinical pathologic conference case: An older woman with a painless, deep, and indurated ulcer on her mandibular alveolar mucosa

Measurement of mucosal thickness in denture-bearing area of edentulous mandible.

Background:The thickness of the alveolar mucosa influences the probability of the occurrence of denture-induced irritations. Thick denture-supporting tissues offer relief from mucosal tenderness and ulcers; however, the uniformity of the thickness across the entire mandibular alveolar mucosa cannot be accurately determined in edentulous patients. This study aimed to assess the mucosal thickness of the denture-bearing area in the edentulous mandible.Methods:Twenty-seven edentulous patients underwent cone-beam computed tomography scanning, wherein the patients wore a record base to retract soft tissues away from the alveolar mucosa. The measured regions were the central incisor (IC), lateral incisor (IL), canine (Ca), first premolar (P1), second premolar (P2), first molar (M1), and second molar (M2) regions. The thickness was measured in the alveolar ridge crest (T), buccal (B1–B4), and lingual (L1–L4) alveolar ridge mucosa. The average thickness of the mucosa at buccal sides (B) and lingual sides (L) were also assessed.Results:The differences in the mucosal thickness between the left and right sides were not significant. In the Ca–M2 regions, T was the thickest, and L3 was the thinnest of all the measured points in the same regions. L was significantly less than B in posterior regions (P < 0.01). On the other hand, M2 at L4 was thinnest of all the measured regions from Ca to M2 (P < 0.01), and was thicker than IC, IL, P1, and P2 at B2.Conclusions:Since the mucosal thickness of denture-bearing area in the edentulous mandible is not uniform; the tissue surface of the denture base or custom tray should be selectively relieved, which may reduce the risk of denture-induced irritations.

Application of diode laser for the management of oral verrucous carcinoma mimicking Candidiasis

Oral verrucous carcinoma (OVC) is a variant of oral squamous cell carcinoma which shows a local invasive pattern without any distant metastases. Accurate diagnosis of OVC depends on a careful association between clinical and histological features of the lesion. This paper reports a case of OVC over mandibular alveolar mucosa, mimicking Candidiasis. Use of diode laser for the management of the lesion is also described.

Oral verrucous carcinoma arising from lichen planus and esophageal squamous cell carcinoma in a patient with hepatitis C virus-related liver cirrhosis-hyperinsulinemia and malignant transformation: A case report

Oral lichen planus (OLP) is a potentially malignant disorder associated with an increased risk of oral cancer. In Japan, the association of OLP with hepatitis C virus (HCV) infection is well documented. In the present study, a case of oral verrucous carcinoma arising from OLP coexisting vulvo-vaginal-gingival syndrome and esophageal squamous cell carcinoma (SCC) in a patient with HCV-related liver cirrhosis is reported. A 71-year old, non-smoking Japanese woman presented with lesions of OLP affecting the bilateral buccal mucosa, tongue, gingival, palate, oral floor and lower lip. Ten years later, an exophytic mass developed in the mandibular alveolar mucosa, the right buccal mucosa and the right lower lip. Pathological diagnosis confirmed the presence of verrucous carcinoma. However, she developed esophageal rather than oral cancer. The oral cancer was resected surgically three times and the patients underwent radiotherapy. The esophageal cancer was removed by endoscopic submucosal dissection. The risk of carcinogenesis increased as hyperinsulinemia continued. The results suggested that it is necessary to monitor for malignant changes in patients with OLP lesions and HCV infection. In addition, treatment requires the cooperation of various medical specialists, as well as an oral surgeon.

Treatment of Lymphangioma with CO2 Laser in the Mandibular Alveolar Mucosa

In this case report, treatment of lymphangioma (a red-purple vesicular apperance, nonulcerated lesion, located on the gingiva of the mandibular alveolar bone) with CO2 laser on a 63-year-old female patient and 2 years clinical outcome is presented. Lymphangiomas are hemorrhagic, rare, benign hamartomatous tumors of lymphatic system have a marked predilection for the head, neck and oral cavity. Lymphangiomas are congenital lesions and an often present at or around the time of birth (60%). Among the dental laser systems, CO2 laser is the most suitable instrument for the treatment of soft tissue pathologies because of its affinity for water-based tissues. The absorbed energy causes vaporization of the intra- and extracellular fluid and destruction of the cell membranes. A major advantage of the 10.600 nm wavelength CO2 laser is its ability to seal blood vessels during surgery and to make the excision of vascular lesions with its hemostatic effect. CO2 laser application (focused CO2 laser beam, 10.600 nm) was performed in a separate operation room at 3 watt (W), continous wave (CW) with 90 degree angle tip under local anesthesia. The mouth was protected from reflection of the laser by wet gauzes. The wound formed by laser was left open to secondary epithelization. Excessive bleeding was not observed during the procedure. The wound formed by laser was left open to secondary epithelization. Neither sutures nor dressings were used after surgery. Only paracetamol and chlorhexidine digluconate mouthwash were prescribed during the postoperative period. There was no postsurgical complaints from the patient. CO2 laser worked well while making the excision with its hemostatic effect. No recurrence was seen in the two years follow-up period. CO2 laser therapy can be used as a primary alternative method in the treatment of lymphangiomas. It can be safely used and recurrence may be less than conventional excision with scalpel. However, long-term clinical follow-up is neccessary for the recurrence of the lesion. CO2 laser treatment can be used safely in the treatment of lymphangiomas.

Osteolipoma of the oral and pharyngeal region: report of a case and review of the literature

Osteolipoma is an uncommon phenomenon that rarely occurs in the oral and pharyngeal region. A 68-year-old man presented with a 4-year history of a relatively small painless mass in the right mandibular alveolar mucosa adjacent to the premolar teeth. The lesion was easily excised and histologically confirmed to be an osteolipoma. Ten cases of oral and pharyngeal osteolipoma have appeared in the English literature thus far. In addition to reporting a new case of osteolipoma arising in the oral cavity in this article, the literature is reviewed accordingly.

Oral inflammatory myofibroblastic tumor demonstrating ALK, p53, MDM2, CDK4, pRb, and Ki-67 immunoreactivity in an elderly patient

Inflammatory myofibroblastic tumor (IMT) is a controversial lesion composed of myofibroblasts, accompanied by varying numbers of inflammatory cells. Various pathogenetic factors have been proposed (ie, reactive, infectious, autoimmune, and neoplastic) but the etiology of most IMTs remains unknown. Here we review the literature of oral IMTs, detailing the demographic profile of these rare lesions. Moreover, we present an unusual case of IMT arising from the mandibular alveolar mucosa of an 82-year-old female. Microscopic examination revealed plump spindle cells set in a myxoid vascular stroma admixed with inflammatory cells. Numerous large ganglion cell-like cells were seen, some exhibiting emperipolesis of neutrophils. Ultrastructurally, prominent myofibroblasts with abundant rough endoplasmic reticulum were noted. Tumor cells were immunoreactive for vimentin, smooth muscle actin, and KP1 (CD68), and negative for desmin, S-100, and EBV-LMP. The lesion was excised without margins and the patient has manifested no evidence of disease at an 18-month recall. In an attempt to further delineate the potential neoplastic nature of this lesion, we assessed the immunohistochemical expression of various markers that have been linked to neoplastic transformation. The recorded positivity for ALK, p53, MDM2, CDK4, pRb, and Ki-67, despite the absence of bcl-2 reactivity, strongly favors the neoplastic origin of the studied tumor.

Inflammatory myofibroblastic tumor of the oral cavity: review of the literature and presentation of an ALK-positive case

Inflammatory myofibroblastic tumor (IMT) is a controversial lesion composed of myofibroblastic spindle cells accompanied by varying numbers of inflammatory cells. Although various pathogenetic (ie, reactive, infectious, autoimmune, and neoplastic) factors have been implicated, the etiology of most IMTs remains unknown. Here, we present a case of IMT arising from the mandibular alveolar mucosa of an 82-year-old female. The lesion presented as a 5 × 5 cm round pedunculated painless mass of 2 months' duration, associated with a superficial resorptive defect of the mandible. The lesion was surgically removed and, on histopathologic examination, appeared to be composed of plump spindle cells set in a myxoid vascular stroma admixed with an inflammatory component consisting primarily of neutrophils and lymphocytes. Numerous large “ganglion cell–like” cells were dispersed throughout the lesion. Only occasional mitotic figures were encountered, in the absence of cytologic atypia. Ultrastucturally, prominent myofibroblastic features were seen. Immunohistochemical analysis revealed that the spindle and ganglion-like cells were diffusely positive for vimentin, smooth muscle actin, and anaplastic lymphoma kinase (ALK), focally positive for CD68, and negative for desmin, bcl-2 and EBV-LMP. No evidence of recurrence has been noted at a 12-month follow-up. Including our patient, only 14 cases of oral IMT have been described in the literature. Patients' age ranged from 2 to 82 years with a mean of 35 years, and a 1.6:1 female predilection was noted. The buccal mucosa was the most commonly affected site (50%), followed by the mandible (21%). None of the reported cases of oral IMT recurred or metastasized. The present case is the second reported ALK-positive oral IMT, which points to a potential neoplastic origin. Significant differences in the clinical behavior and immunohistochemical and genetic profile of lesions diagnosed as IMT may indicate that the term has been used to describe lesions with similar histology but variable etiopathogenesis and prognosis.

A microscopic focus of traumatic neuroma with intralesional glandular structures: An incidental finding

A 50-year-old man received radiation therapy and chemotherapy for squamous cell carcinoma of the right floor of the mouth. Histologic examinations of surgical materials revealed the presence of benign ductal epithelial structures containing mucinous material within a small traumatic neuroma of the mandibular alveolar mucosa. Presumably, the residual salivary ducts of the sublingual glands may become incorporated during the development of a traumatic neuroma secondary to the destruction of tissue. Our search of the literature has failed to reveal a similar recorded occurrence.