Oral Pathologic Lesions Research Articles

ÇOCUKLARDA GÖRÜLEN KİSTLER: VAKA SERİSİ

There can be a wide variety and prevalence of oral pathological conditions in children that can differ from adults in terms of symptoms and clinical course. This case presentation aims to raise awareness about the importance of early diagnosis and treatment of oral pathological lesions in pediatric patients. In three patients, two boys and one girl aged between 10 and 14, diagnosed with the radicular cyst, odontogenic keratocyst, and odontogenic myxoma, treatments such as marsupialization, enucleation, and enucleation with the associated impacted tooth were performed based on the size and type of the lesions. Postoperative follow-up of the patients is ongoing. Knowing pediatric oral lesions is crucial for accurate and differential diagnosis. When determining the treatment approach for these lesions in children, factors such as ongoing maxillofacial development, high osteogenic activity, and potential cooperation issues should be taken into consideration.

The prevalence of oral and maxillofacial pathologic lesions in pathology centers of Zanjan (Iran) over a 5-years period (2014-2020)

Background and objectives: The oral and maxillofacial region is exposed to many harmful agents and can be affected by a wide range of reactive, infectious, cystic, precancerous, and neoplastic lesions. This study aimed to determine the prevalence of oral and maxillofacial pathological lesions in pathology laboratories in Zanjan. 
 Method: This retrospective descriptive study was conducted in the period 2014 -2020 by referring to the hospitals and laboratories with pathologists in Zanjan. Information about patients with histopathological lesions of oral and maxillofacial region was extracted, and studied in terms of age, gender, location and histopathological type of lesion. Finally, the collected data were entered into SPSS software version 22 and statistically analyzed (P <0.05).
 Results: A total of 176 histopathological lesions were investigated. Of them, 120 cases (58%) were female and 74 (42%) were male. The mean age of the patients was 39.4 years. The most prevalent lesion was periapical cyst (14.8%).In terms of tissue involved, the most lesions were related to soft tissue (67%) and in terms of anatomical location, the most lesions were gingival mucosal lesions (35.2%).
 Conclusion: The prevalence of pathological lesions was higher in females than in males. Soft tissue lesions were more than hard tissue lesions. Gingival mucosal lesions were the most prevalent and lesions of the floor of the mouth and nasal vestibule lesions were the least prevalent ones. Given the histopathologic nature of lesions, periapical cyst was the most prevalent lesion.

An insight into perceptions of general pathologists about the need for oral pathology services: An observational study.

The objective of this study was to identify the degree of perception of oral pathology as a specialty among the general pathologists and the need of utilizing oral pathologists in assisting to identify oral lesions in diagnostic challenges. A questionnaire-based survey was conducted among qualified general pathologists to collect the data. The survey items focused on various aspects, including the analysis of oral pathology as a specialty, the importance of employing oral pathologists for identifying oral lesions in diagnostic challenges, and the difficulties encountered in managing such lesions. The data collected was analyzed using descriptive and inferential statistics. For comparing the relationship between work experience and the referral of odontogenic cysts and tumors cases, a Chi-square test was employed. A significance level of p ⩽ 0.05 was deemed as statistically significant. Two hundred and fifty general pathologists responded to the questionnaire. Two hundred and thirty two (92.8%) participants showed awareness of oral pathology as a specialty. For the diagnosis of oral, jaws, and salivary glands pathologic lesions, the majority 198 (79.2%) respondents believed that oral pathologists are required for the diagnosis. Regarding the referrals of lesions to oral pathologists, 137 (54.8%), participants did not refer. In terms of training in oral pathology, all of the participants agreed that they would undertake short-term posting in oral pathology. For challenging cases, all the general pathologists believed that oral pathologists should be part of the team. The general pathologists recognized oral pathology as a specialty and feel the need for an oral pathologist opinion in diagnosis. However, most of the general pathologists did not refer the complex cases to oral pathologists. Therefore, it is of paramount importance to encourage oral pathologists and their hiring at histopathology laboratories that are diagnosing complex head and neck cases.

A retrospective analysis of oral and maxillofacial pathological lesions in a group of Egyptian children over 21\xa0years

ObjectivesThe goal of the current study was to evaluate the relative frequency of oral and maxillofacial pathological lesions among Egyptian children.Materials and methodsRecords of biopsies submitted to the department of oral and maxillofacial pathology from the year 1999 to 2019 were retrieved and reassessed for all cases under the age of 18 years. Information on age, sex, location of the lesion, and the histopathologic diagnosis was analyzed.ResultsOver the course of twenty-one years, 1108 specimens were analyzed where reactive soft tissue lesions, which accounted for 397 (35.8%) of all cases ranked the highest presented category, followed by inflammatory odontogenic cysts, which accounted for 213 cases (19.2%). With 208 cases, the inflammatory radicular cyst was on the top of the most common 20 lesions, followed by pyogenic granuloma (160 cases). Malignancy was found in 19 cases, with soft tissue tumors (10 cases) being the most common, followed by salivary gland (5 cases) and bone pathologies (4 cases).ConclusionsThe frequency of oral and maxillofacial pathological lesions among Egyptian children increased over the years but remained consistent with global trends.Clinical relevanceThis is the first study evaluating the relative frequency of oral and maxillofacial pathological lesions among Egyptian children and provides an insight into the most commonly encountered pediatric pathologies. This may aid in the understanding of the most prevalent oral lesions that impact the pediatric population, as well as providing the key to early detection of lesions.

Oral Pathological Lesions in the Aegean Region: A 30-Year Retrospective Study

Oral Pathological Lesions in the Aegean Region: A 30-Year Retrospective Study

A Histopathology-based Assessment of Biological Behavior in Oral Hyalinizing Extraosseous Lesions by Differential Stains

The assessment of hyalinization to determine aggressive behavior in oral pathological lesions is a scarcely researched field that requires further exploration. The current study aims to predict the biological behavior of oral hyalinizing extraosseous lesions (OHEOL) by employing four differential stains with clinicopathologic correlation. The study was performed on retrospectively diagnosed formalin-fixed paraffin-embedded cases of salivary gland tumors (SGTs) (n = 13), benign soft tissue (BST) lesions (n = 24), and oral submucous fibrosis (OSMF) (n = 53). The hematoxylin and eosin-stained sections were analyzed for the severity of hyalinization (SOH). Differential stains periodic acid Schiff (PAS), Alcian blue, safranin O, and picrosirius red with polarizing microscopy were used to assess the components of hyalinized tissue. The SOH was correlated with differential staining characteristics and clinicopathologic features to analyze possible correlation with aggressive potential in BST, advancement of disease in OSMF, and recurrence in SGT. Intensity of picrosirius red stain significantly correlated with SOH of SGTs (p = 0.044). The intensity of PAS stain (p = 0.040), picrosirius red polarizing greenish-yellow color (p = 0.002), and pattern of distribution of picrosirius red (p = 0.023) significantly correlated with recurrence of SGTs. The intensity of differential stains increased with the SOH in BST lesions indicating their correlation with SOH. The intensity (p = 0.008) and pattern (p = 0.010) of Alcian blue staining and intensity of safranin O stain (p = 0.003) significantly correlated with SOH in OSMF. Picrosirius red polarizing color reddish and yellowish red (p = 0.002) significantly correlated with SOH distinguishing early and advanced OSMF. Picrosirius red and PAS stains are reliable indicators of SOH and recurrence potential in SGT. Alcian blue, safranin O, and picrosirius red polarizing colors enable detection of SOH and accurately distinguish early from advanced OSMF. SOH can be considered as a histological predictor of aggressive biologic behavior in OHEOL. These findings will result in appropriate management protocols.

Spectrum of Histopathological Diagnosis of Oral Lesions in a Tertiary Care Hospital at Miraj in Maharashtra State, India

Introduction: Oral cavity is a common site for many types of benign, precancerous conditions and malignant tumours as well as development of congenital and acquired lesions. Oral cancers are the most common type of cancer in Indian men and actually accounted for 40% of all forms of cancers due to tobacco addiction, representing 4% of total body cancers. In Indian females, 2% of all cancers are of oral cavity. The knowledge of aetiological factors for the development of oral cancers can make the disease preventable. Aim: To study histopathological spectrum of various oral lesions. Materials and Methods: This was a prospective observational study done, during the period from November 2013 to June 2017, 150 cases of oral lesions were studied at a tertiary care hospital in Miraj. All the cases were studied and histopathological diagnosis was correlated with clinical findings. The Microsoft Excel 2010 sheet was filled as per case proforma of patients. Analysis was done manually like age wise, gender wise, site wise and sex wise distribution based on the Excel sheet data. Results: The age of study population ranged from 6-80 years. Most oral cavity lesions were found in the age group 51-60 years of age group with 46/150 (30.67%) cases. Male to female ratio was 1.78:1. Malignant epithelial tumours of oral cavity comprised 100/150 cases (66.67% cases). Amongst malignant tumours, Squamous Cell Carcinoma (SCC) comprised 92/100 cases (92% cases). There was history of addiction in 96/100 cases (96% cases) with 52/100 cases as tobacco chewers (52% cases). 4/100 cases did not have history of addiction (4% cases). Conclusion: The clinical examination of the oral pathological lesions does not lead to appropriate diagnosis. The clinical diagnosis must be supplemented by ‘gold standard’ histopathological examination for confirming the malignant tendency of oral lesions.

Evaluation of oral pathologic lesions in elderly patients in Isfahan, Iran, 1989-2018 years

Objective: One of the most important alterations in elderly is the destruction and loss of teeth and oral mucosal lesions. The aim of this study was to determine the frequency of biopsed pathologic lesions in elderly registered in the pathology department of Isfahan University of Medical Sciences during 1989 to 2018 years. Material and Methods: This crosssectional descriptive-analytic study was performed on pathologic lesions in elderly archived in Faculty of Dentistry, Isfahan University of Medical Sciences. In this study, all archived information of elderly over 65 years including gender, age, location of lesion, clinical diagnosis, pathology diagnosis, and diagnosis year were evaluated in last three decades, and were analyzed statistically. Results: The age range of elderly patients was 65 to 90 years with a mean of 72.8 ± 4.9. The highest frequency for location of lesions was related to mandibular vestibule (21.1%). The most clinical diagnosed lesions were squamous cell carcinoma (24.5%) and Epulis Fissuratum (13.4%). The highest pathologic diagnosed lesions were related to reactive lesions group (35.6%). The squamous cell carcinoma malignancies and other malignancies were increased significantly in elderly patients with high age. Conclusion: According to the considerable frequency of oral lesions in elderly and increased frequency of squamous cell carcinoma and other malignancies, attention to oral lesions in elderly and periodic examinations are important to early diagnosis and treatment. KEYWORDS Pathology; Biopsy; Elderly; Oral lesions; Isfahan.

Prevalence of odontogenic cysts and its associated factors in South Indian population.

Background:Odontogenic cysts (OCs) constitute a major part of oral pathological lesions, but little is known about their distribution patterns in various populations.Aims:The aim was to determine the prevalence and factors associated with the cases of histopathologically diagnosed OCs that report to our institution and to analyze the factors associated with the presence of OCs and to study the biologic behavior of different types of cysts.Materials and Methods:A cross-sectional study was performed on 596 oral and maxillofacial specimens during 2013–2017. Out of these, the cases which were histopathologically proven as OCs were separated and data were collected and analyzed regarding the age, gender, primary symptom, site, radiographic feature, histopathologic diagnosis, treatment given, recurrences and associated conditions if any.Results:Of the 596 cases included in the study, 67 (11.2%) had a histopathological diagnosis of OCs. 41 cases were inflammatory cysts and 26 developmental cysts. 28 cases (41.8%) were reported as periapical cysts, 10 cases (14.9%) were odontogenic keratocysts (OKCs), 9 cases (13.4%) were dentigerous cysts, 8 cases (11.9%) were inflamed cyst wall, 5 cases (7.5%) each of residual cyst and developmental OCs and one case (1.5%) each of orthokeratinized OC and calcifying OC.Conclusion:This study showed that the prevalence of OCs was similar to other reported studies. Periapical cysts were the most common cysts reported, followed by OKCs showing that the latter were more frequent than dentigerous cysts.

Clinical Diagnostic Accuracy of Oral and Maxillofacial Pathologic Lesions by Dental Specialty

Clinical Diagnostic Accuracy of Oral and Maxillofacial Pathologic Lesions by Dental Specialty

Clinical and histological diagnosis of oral pathologic lesions, any concordance?

Abstract Introduction: Histopathology examination is employed to confirm or rule out presumptive clinical diagnosis and there are different types and techniques of obtaining the specimen used for the examination. Histopathologic examination though regarded as the gold standard for diagnosis of oral pathologic lesions has also been reported to have varying rates of misdiagnosis depending on the technique or type. Objective: This study aims to examine the concordance between clinical and histopathological diagnosis as well as partial biopsy technique and surgical specimen of oral lesions. Methods: This was a cross-sectional retrospective study that utilized the data obtained from the case notes and histology record of 433 patients that had biopsy done between 2006 and 2016. Information on patients’ age, gender, type of biopsy, presumptive clinical diagnosis and histopathologic diagnosis were obtained. Concordance between presumptive clinical and histopathologic diagnosis (incisional and final surgical specimen as the case may apply) and rate of misdiagnosis were assessed. Results: Excisional biopsies were more often used for benign lesions while incisional biopsy with or without surgical specimen were more often used for malignant lesions. Benign lesions were more frequently diagnosed than malignant lesions. The presumptive clinical diagnosis was erroneous for 40.3% and 22.1% of lesions following incisional histopathology and surgical specimen histopathology report respectively. Lesions that were subjected to both incisional and surgical specimen biopsies had a misdiagnosis rate of 11.2%. Conclusion: Incisional biopsy and post-surgical specimen histopathology investigation are important tools in the effective management of oral pathologic lesions.

Making sense of medieval mouths: Investigating sex differences of dental pathological lesions in a late medieval Italian community.

Bioarchaeological investigations of sex-based differences in the prevalence of dental pathological lesions, particularly caries, have drawn considerable attention, and out of this work, two dominant models have emerged. Traditionally, the first model interprets sex-related patterns in caries as a product of gendered differences in diet. A more recent model interprets a generally higher propensity for caries prevalence in females in light of reproductive ecology. To test the hypothesis that females have higher risk of caries in accordance with reproductive ecology, we examined and analyzed caries prevalence and other potentially synergistic oral pathological lesions in a late medieval (A.D. 1300-1500) Italian archaeological sample. We examined sex- and age-related prevalence in caries and other oral pathological lesions in a late medieval Italian skeletal assemblage excavated from Villamagna consisting of 38 females and 37 males (n = 1,534 teeth). We examined age- and sex-related patterns in six dental traits: antemortem tooth loss, caries, calculus, periapical inflammation, tooth wear, and periodontitis. Significant age-related increases in antemortem tooth loss, caries, calculus, and tooth wear were observed in both males and females. However, there was a lack of expected sex differences in oral pathological lesions, with instead older males exhibiting significantly more antemortem tooth loss and corrected caries than females. Results are discussed in relation to the ethnohistoric context of medieval rural dietary practices as well as biomedical salivary literature, which suggest that dietary changes throughout the life course may have facilitated trade-offs that buffered females from higher rates of dental pathological lesions.

Chromatographic estimation of tetracycline in saliva

Tetracyclines have been widely used in dentistry, especially in treatment of periodontal diseases and other oral pathological lesions. They are effective in treatment because their concentration in the gingival crevice is 2-10 times that in serum. In addition, several studies have demonstrated that tetracyclines at a low gingival crevicular fluid concentration (2-4 mg/ml) are very effective against many periodontal pathogens. Tetracyclines are an extensively used group of antibiotic medicines. Clinical pharmacology of tetracycline in saliva was not clear until the time of this research achieving on normal subjects or patients required tetracycline treatment. The evaluation was achieved by using suitable method (efficient, low cost, and reproducible). The purpose of this study is the determination of the tetracycline concentration in saliva. The obtained results from HPLC method recorded saliva concentration of tetracycline ranged fom 0.08 to 0.23 μg. / ml. The HPLC method provided successful methods for monitoring the tetracycline in saliva with a detection limit reached to 0.05 ng/ml. Since the saliva is considered as the first line of immune system in the oral cavity, so it is important to suggest further study to know the therapeutic effect of tetracycline through saliva against certain oral lesions

Rare case of bilateral complex odontoma associated with mandibular bicuspids

Among oral pathologic lesions, odontomas are the most common odontogenic tumor of the jaws and generally asymptomatic. They are mostly diagnosed as a result of routine radiographic investigation. In this report, we describe a very rare occurrence of bilateral complex odontoma in the region of the mandibular second premolar. Conservative surgical procedure was planned, and removal of the odontomas was carried out through the socket after extraction of the deciduous second molars, and the diagnosis was confirmed with a histopathological study.

Nature of Hard Tissues in Oral Pathological Lesions -Using Modified Gallego's Stain.

Histological stains are dyes that bind to various tissues. Special stains form an integral part of routine histopathology as an adjunct to Haematoxylin and Eosin (H&E), and give meaningful diagnostic information of the tissues available. By using routine histological procedure like H&E alone, it is difficult to differentiate the various hard tissues present in the oral pathological lesions. Modified Gallego's stain can be used as one of the differential stain for these hard tissues. To differentiate various hard tissues of teeth and to identify the presence of hard tissue components in different oral pathological lesions using Modified Gallego's stain under light microscope. A total sample of 20 cases, amongst which 10 were human extracted teeth and 10 oral pathological lesions were included. From 10 human extracted teeth, five ground sections and five decalcified sections were prepared. From pathological lesions, two slides of each lesion were prepared. All the sections were stained with Modified Gallego's stain and viewed under light microscopy. In properly stained slides, cementum stained red, dentin and bone stained green and enamel stained pink in colour. Modified Gallego's stain can be used as a differential stain for various hard tissues in oral pathological lesions and also for ground sections for which histochemical stains are very rare.

Pediatric Benign Soft Tissue Oral and Maxillofacial Pathology.

Despite the many types of oral pathologic lesions found in infants and children, the most commonly encountered are benign soft tissue lesions. The clinical features, diagnostic criteria, and treatment algorithms of pathologies in the age group from birth to 18 years of age are summarized based on their prevalence in each given age distribution. Treatment modalities include both medical and surgical management.

Frequency of Oral Anatomic Variations and Mucosal Lesions Among a Defined Group of Elderly Dental Patients in Iran

histopathologically. Data were analyzed by the Chi-square test and logistic regression by means of the SPSS software version 18. Results: Out of the 129 elderly participants, aged between 60-87 years (mean: 66.71 ± 6.21), males constituted 58.1% (n = 75) of patients and female were 41.9% (n = 54). Normal variations of oral mucosa were observed in 62% (n = 80) of patients, while 44.2% (n = 57) had oral mucosal lesions. Normal variations were significantly associated with smoking (OR = 1.2), while denture wearers were at higher risk of oral pathological lesions (OR = 1.5). Meanwhile, the frequency of normal variations in men was 1.3 folds higher than that of women (P = 0.04). Conclusions: The frequency of normal variations and oral lesions among elderly dental patients is high, and this is significantly associated with smoking, denture wearing and male sex.

Oraland Maxillofacial Lesions in an Elderly Population in Shiraz, Iran

Background: Aging causes many changes in human physiology, increasing the risk of pathologic conditions in elderly populations. Different studies have shown higher frequency of oral and maxillofacial lesions in older people. Knowing the prevalence and distribution of these lesions can help dentists in screening these patients. Objectives: This study aimed to evaluate the frequency and distribution of oral pathologic lesions among patients referred to Oral Pathology Department of Shiraz Dental School. Patients and Methods: By referring to archives of Oral Pathology Department of Shiraz University of Medical Sciences, the histopathological reports of all 231 patients aged 60 years or over were reviewed. The data were described and analyzed using SPSS software. Chi-square test was performed and a P value less than 0.05 was considered significant. Results: The most prevalent lesion was oral lichen planus (21.6%), followed by inflammatory fibrous hyperplasia (15.8%) and squamous cell carcinoma (7.6%). There was a statistically significant difference between men and women in the occurrence of odontogenic cysts and dermatologic diseases. (P = 0.018 and 0.002, respectively;chi-square = 5.63 and 9.47, respectively). Moreover, non-neoplastic lesions were the most prevalent group of lesions in this study. Conclusions: High frequency of life-threatening oral conditions among elderly populations makes it essential for dentists to pay special attention to the most frequent lesions and help enhance the life quality of elderlies by early diagnosis and management of these diseases.

Oral health and liver function in children and adolescents with cirrhosis of the liver.

IntroductionPeople with cirrhosis of the liver are predisposed to developing oral lesions. The occurrence and type of lesion depend on the degree of liver function impairment and its type, and on the severity and duration of systemic diseases. In children, the age at which the early symptoms of liver disease are experienced is also of great importance.AimTo assess the prevalence of oral pathological lesions in children and adolescents with cirrhosis of the liver, and their correlation with the degree of liver function impairment.Material and methodsClinical and laboratory results of liver function tests (Model of End-Stage Liver Disease/Score of Paediatric End-Stage Liver Disease, Child-Pugh score) were assessed in 35 patients with cirrhosis of the liver. The average age of the patients was 10.7 ±4.74 years. All patients also had their oral cavities examined (mucosa, gingiva – GI, hygiene – PLI, teeth – dmft/dmfs and DMFt/DMFs, DDE Index and Candida spp. presence) and this was then correlated to the degree of liver function impairment.ResultsAccording to the Child-Pugh scale, 16 patients were class A and 19 were class B/C. Jaundice during the first 3 years of life occurred in 9 patients. Mucosal lesions were found in 26 out of 35 patients (74%), including 10 out of 16 (63%) in Child-Pugh group A, and 16 out of 19 (84%) in group B/C (NS – non significant). Oral candidiasis occurred more often in class B/C than in class A (47.4% vs. 12.5%; p < 0.05). The GI index (Gingival Index) and PLI index (Dental Plaque Index) did not differ between the groups (A vs. B/C) but correlated in the whole group (R = 0.58) as well as in subgroups A (R = 0.65) and B/C (R = 0.59). Dmft/dmfs and DMFt/DMFs indexes did not differ between groups A and B/C, and neither did the DMFt/DMFs in patients with/without enamel defects.ConclusionsOral mucosal lesions are commonly found in children with cirrhosis of the liver. Advanced liver disease promotes oral candidiasis. Severity of gingivitis correlates with the presence of dental plaque.

Odontogenic cysts: a retrospective study of 1227 cases in an Iranian population from 1987 to 2007

Odontogenic cysts constitute a major part of oral pathological lesions, but little is known about their distribution patterns in various populations. In this retrospective study, patient records from the archive of the Department of Oral and Maxillofacial Pathology at the Faculty of Dentistry affiliated to the Tehran University of Medical Sciences were reviewed. Cases diagnosed as odontogenic cyst from 1987 to 2007 were selected and histopathologically re-evaluated to confirm the diagnosis. Patients' demographic information (age and sex) and location of the lesion were recorded and analyzed using descriptive statistics. From a total of 8529 files reviewed, the diagnosis of odontogenic cyst was confirmed in 1227 cases (14.4%). The overall male to female ratio was 1.33:1. The patients' age ranged from 3 to 84 years with a mean of 28 years. 49% of cysts were found in maxilla and 50.4% in mandible. Radicular cyst was the most common type followed by dentigerous cyst, odontogenic keratocyst, residual cyst and paradental cyst. Lateral periodontal cyst, eruption cyst, glandular odontogenic cyst and gingival cyst of adults were also reported. The distribution pattern of odontogenic cysts in Iran is relatively similar to that in other parts of the world. The importance of complete clinical reports for final diagnosis of these lesions and routine follow-up examinations is emphasized.