Retromolar Area Research Articles

Malignant Transformation of Oral Lichen Planus: A Peril of COVID-19 Pandemic

Oral Lichen Planus (OLP) is a chronic autoimmune inflammatory disease of the oral mucosa. The erosive variety of OLP is multifocal, ulcerative, and painful in nature. Patients with OLP have a higher risk of developing Oral Squamous Cell Carcinomas (OSCCs). Here, authors presents a case of 49-year-old female patient presented to the Department of Oral Medicine and Radiology with the chief complaint of burning sensation in the inner aspect of right cheek, since one year. A diffuse whitish area surrounded by erythematous area was present in the right buccal mucosa. Lesion was diagnosed primarily as erosive Lichen Planus (LP). She discontinued the medication and did not come for follow-up visits because of the Coronavirus Disease-2019 (COVID-19) pandemic. After 10 months, she came back with pain and a diffuse swelling with indurated margin in the same region involving right buccal vestibule and retromolar area. After incisional biopsy it was found that the lesion has progressed to squamous cell carcinoma, and the patient was referred to the Department of Oral Surgery where segmental mandibulectomy was done with placement of free fibula graft. The OLP is considered as a potentially malignant disorder and patient should be advised to avoid additional risk factors such as tobacco and alcohol and should be followed at minimum one year interval as prognosis and patient survival is directly related to stage and grade of cancer at its initial diagnosis.

Biomechanical Evaluation of a New Fixation Method for Stabilization of Sagittal Split Ramus Osteotomy After Mandibular Advancement

Study Design: Biomechanical in vitro study. Mandibular advancement after sagittal split ramus osteotomy (SSRO) is a common procedure in orthognathic surgery. Several fixation methods are used for stabilization of SSRO. Objective: The aim of this study was to compare a new fixation method (gridplate) with more contemporary applied methods of fixation. Material and Methods: In this study, 50 polyurethane hemimandibles with a prefabricated SSRO were used as specimens. All hemimandibles were advanced by 8 mm and divided into 5 groups with different fixation methods: (A) one 4-hole miniplate with 4 monocortical screws; (B) two 4-hole miniplates with 8 monocortical screws; (C) one 4-hole miniplate with 4 monocortical screws and 1 bicortical screw in the retromolar area (hybrid method); (D) 3 bicortical screws in an inverted-L pattern; and (E) one 8-hole gridplate with 8 monocortical screws. Loads in newtons were recorded at displacements of the mandibular incisive edge at 1 mm, 3 mm and 5 mm. Results: Fixation with 3 bicortical screws and the gridplate presented the most stability, followed by two 4-hole miniplates. Fixation with the hybrid method or the single miniplate showed the least stability. Conclusion: According to the results of this study, the 8-hole gridplate design appears a sufficient fixation method regarding stabilization of SSRO with larger mandibular advancement.

Mucoepidermoid Carcinoma: A Demographic and Histopathological Profile

Background: To find the frequency and clinico-pathological presentation of mucoepidermoid carcinoma (MEC).Materials and Methods:In this study, we included all the malignant salivary gland tumors. Among these the frequency of mucoepidermoid carcinoma was considered. Age, gender, histopathological grading and anatomical site of tumor were included in data analysis.Results:Out of 60 malignant salivary gland tumors reported to the histopathology department, 30 tumors were diagnosed as mucoepidermoid carcinomas. The patient’s age having mucoepidermoid carcinoma ranged from 6 to 88 years, mean age of 44.9±19.2SD. The male patients were 23 in number while female were 7. Out of 30 cases, 73.3% patients had tumor in parotid gland, while13.3% patients in submandibular gland . Other tumors were in palate, retromolar area, and in posterior 1/3rdof tongue (13.3%). According to histopathological grading 26.6% cases of MEC were of high grade, 26.6 % were intermediate grade and 36.6% were low grade.Conclusions:According to this study, the frequency of MEC was 50% among all salivary gland tumors. MEC was mostly found in parotid gland and histopathologically low grade type was the most common.

Relationship of natural occlusal plane with different anatomical landmarks.

To evaluate the parallelism of natural maxillary occlusal plane with inter-pupillary line and ala-tragus line, and to evaluate the anatomic relationship of natural mandibular occlusal plane with retromolar pad among dentate subjects. The cross-sectional study was conducted from September 2017 to February 2018 at Fatima Jinnah Dental College, Karachi, and comprised front and profile photographs of subjects aged 20-28 years while holding the camper's plane against the maxillary occlusal plane. The photographs were imported in a software and an interpupillary line was drawn and the angle with Camper's plane was measured. On both profile pictures, lines were drawn from base of the ala to the superior, middle and inferior points on the tragus. The angle between ala-tragus line and Camper's plane were measured. Intra-orally, height of the mandibular occlusal plane in relation to the retromolar pad was evaluated using a stainless steel scale. Data was analysed using SPSS 23. Of the 109 subjects with a mean age of 23.03±1.36 years, 76(69.72%) were females. Horizontal parallelism of occlusal plane with inter-pupillary line was observed with a mean angle of 1.17±1.27 degrees. The angle between the occlusal plane and the inferior ala-tragus line was 4.25 degrees on the right side, and 4.50 degrees on the left. Intraorally, mandibular occlusal plane coincided with the inferior 48(44%) and the middle third 48(44%) of the retromolar pad. Inter-pupillary line and retromolar pad area should be used as a guide in the determination of plane of occlusion. The ala-tragus line was not found to be a reliable guide.

Pleomorphic Adenoma of the Cheek. Case Report with Review

Pleomorphic adenoma (PA), also called benign mixed tumor, is the most common tumor of the salivary glands. About 70 % of these tumors occur in the parotid gland and an uncommon site are the minor salivary glands. The most common sites of PA of the minor salivary glands are the palate followed by lips and cheek. Other rare reported sites include the fauces, floor of the mouth, tongue, tonsil, pharynx, retromolar area and nasal cavity. Here we report a case of pleomorphic adenoma of minor salivary glands of the cheek in a 22-year-old male. The mass was removed by wide local excision with adequate margins, and the patient was followed for 1-year post operatively with no recurrence.

Occult Nodal Metastasis in Oral Cavity Cancers

Introduction: In squamous cell carcinoma (SCC) of the oral cavity, there is always a risk of occult metastasis to neck nodes in the clinically and radiologically negative neck (N0). Therefore, elective neck dissection (END) has ever been under discussion since the beginning of their routine use for the management of neck for oral carcinomas. The purpose of the current study is to identify the percentage of occult nodal metastasis to neck levels I-V in the cases of oral carcinoma who were treated for the N0 with END.Methods: Patients who were treated between June 2005 and May 2010 with END from neck levels I to V for the management of N0 with oral SCC had been identified from the database of Aga Khan University Hospital. Those who met the inclusion and exclusion criteria were included in the study. Data were analyzed using SPSS 16 software. Using descriptive statistics, the mean was computed for the quantitative variable (age). Frequencies and percentages were calculated for gender, site, tumor grade, and lymph node involvement for each neck level.Results: A total of 50 patients were included in the study. There were 38 males and 12 females. The mean age was 47 (range 25-72). The most common site of the tumor was buccal mucosa in 50% of the cases followed by tongue 20%, then floor of mouth 14%, dentoalveolar ridge 8%, retromolar area 4%, lip 2%, and hard palate 2%. Histopathological grading of tumors showed well-differentiated 28%, moderately differentiated 33%, and poorly differentiated 6%. Twenty-seven out of 50 patients were found positive for nodal metastasis on final postoperative histopathology. Neck node metastasis at level I was found in 22 patients, at level II in 16 patients, at level III in seven patients, and at level IV in two patients. The level V was found free of metastasis in all of the cases.Conclusion: The rate of occult metastatic disease to the neck nodes was similar to that found in the literature. Both early and advanced local disease is associated with a risk of occult metastasis. END for neck levels I-V is, therefore, recommended for the management of the N0 in all cases of oral SCCs. Spread to levels IV and V is rare and these levels should not be a part of routine END.

Diagnostic and Therapeutic Preventive Features of Sagittal Dentofacial Anomalies in Children

This article presents the specific features of clinical and radiological abnormalities in the mixed dentition.Individuality of such features is determined by the parameters of the maxillofacial region and the maxillarydimensions, in the form of late milk dentition abrasion, shape of the submaxillary retromolar area and theeruption level of the lower first and second multi-cuspid teeth according to the dental panoramic radiogram.All above was used as a basis for the assessment algorithm development for children with the dentofacialanomalies. Based on the results obtained, the recommendations has been proposed that allow to performindividual treatment for the children with this pathology.

SURGICAL TREATMENT OF GLANDULAR ODONTOGENIC CYST IN POSTERIOR REGION OF MANDIBLE

A 49-year-old male patient complained "I can’t chew on the swollen side" (according to patient information). The anamnesis revealed a slightly painful lesion with 5 years of evolution. The physical examination showed swelling, with both cortices expanding, approximately 3 cm, in a retromolar area on the right side of the mandible, covered by normal-looking mucosa. Imaging examination showed an intraosseous lesion with hypodense area associated to tooth 46 in retromolar region. Incisional biopsy followed by histopathological examination closed the diagnosis of glandular odontogenic cyst. The lesion was treated by enucleation followed by peripheral ostectomy. The 12-month follow-up showed no signs of recurrence at clinical examination, such as imaging tests. Although the glandular odontogenic cyst is a rare entity, it needs to be diagnosed and treated, since it may present an aggressive character to the gnathic bones. A 49-year-old male patient complained "I can’t chew on the swollen side" (according to patient information). The anamnesis revealed a slightly painful lesion with 5 years of evolution. The physical examination showed swelling, with both cortices expanding, approximately 3 cm, in a retromolar area on the right side of the mandible, covered by normal-looking mucosa. Imaging examination showed an intraosseous lesion with hypodense area associated to tooth 46 in retromolar region. Incisional biopsy followed by histopathological examination closed the diagnosis of glandular odontogenic cyst. The lesion was treated by enucleation followed by peripheral ostectomy. The 12-month follow-up showed no signs of recurrence at clinical examination, such as imaging tests. Although the glandular odontogenic cyst is a rare entity, it needs to be diagnosed and treated, since it may present an aggressive character to the gnathic bones.

LICHENOID MUCOSITIS DIAGNOSED IN CENTER OF REFERENCE IN ORAL LESIONS: A CASE REPORT

This study reports a case of a 56-year-old melanoderm woman who lives in the rural area of Nordestina, Brazil. The patient reported to have anemia and the use of ferrous sulfate and simvastatin. Also, the patient was a cigarette smoker for 17 years. During the intraoral examination nondetachable white lesions were observed in the right and left superior alveolar ridge, extending to vestibular, retromolar, and palatal areas. Nearby the second superior molar, the lesions showed irregular shape, contour, and well-defined limits. The clinical hypothesis was leukoplakia. After an incisional biopsy in the right inferior retromolar area, the histopathologic examination revealed an epithelium exhibiting hyperplasia, acanthosis, and hydropic degeneration of basal cells leading to the disappearance of the basal layer. The lamina propria exhibited moderate lymphocytic inflammatory infiltrate, in a juxtaposition, compatible with lichenoid mucositis. The patient has been in follow-up to identify the etiology of the lesions.

RECURRENT PYODERMA GANGRENOSUM IN THE ORAL CAVITY: A CASE REPORT

Pyoderma gangrenosum (PG) is a rare chronic neutrophilic dermatosis with a variable clinical presentation and uncommon oral involvement. A 40-year-old male patient sought out the stomatology service complaining of oral ulcers that did not heal. The oral lesions were painful, persistent to treatment after immunosuppressive therapy (IT), and debilitating leading to recurrent hospital admissions. The patient was diagnosed as having PG by the medical clinic and had been under treatment with IT for 12 years. Besides, the patient also had been diagnosed as having juvenile idiopathic arthritis. Clinical examination revealed multiple ulcers with a necrotic aspect, and erythematous and edematous borders in the retromolar area and on the left side of the soft palate. Treatment with multiple sessions of low-level laser therapy associated or not with the intralesional application of steroids was performed. After 11 sessions, there was an improvement of the ulcers’ clinical aspects. Currently, the patient is asymptomatic.

Prevalence of mucoepidermoid carcinoma among intraoral minor salivary gland tumors: A systematic review and meta-analysis.

This study aimed to synthetize and critically appraise available evidence regarding mucoepidermoid carcinoma (MEC) prevalence among intraoral minor salivary gland tumors (MiSGT). Five main electronic databases and three grey literature databases were searched. The risk of bias (RoB) was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Proportion meta-analyses were performed. From 1321 studies identified, 82 were included in qualitative synthesis and 80 in meta-analyses. Sixteen were classified as high, 33 as moderate, and 33 as low RoB. A total of 12774 MiSGT were found, of which overall MEC prevalence was 16.5% (95% Confidence Interval [95% CI]=14.8%-18.4%). Most MiSGT were found in the palate (n=7115), although MEC pooled prevalence in this anatomic location was only 13.6% (95% CI=11.7%-15.6%). The retromolar area presented the highest pooled prevalence (58.9%; 95% CI=47.0%-70.3%), followed by gingiva (28.8%; 95% CI=22.7%-35.4%) and tongue (27.2%; 95% CI=21.2%-33.6%). Regarding geographic location, Middle East presented the highest pooled prevalence (20.8%; 95% CI=14.8%-27.6%), followed by America (20.0%, 95% CI=17.2%-23%) and Europe (15.6%; 95% CI=9.2%-23.5%). Among MiSGT, the MEC overall prevalence was approximately 16.5%. Although most MiSGT were found in the palate, the retromolar area was proportionally more affected by MEC.

Distinct differences in hypoxic responses between human oral mucosa and skin fibroblasts in a 3D collagen matrix.

The differences between oral mucosa and skin wound healing involving hypoxic responses of fibroblasts are poorly elucidated. In this study, we aimed to study the different hypoxic responses between oral and skin fibroblasts embedded in a three-dimensional (3D) collagen matrix to address the early stage of wound healing. Primary oral mucosa fibroblasts (OMFs) obtained from the retromolar area and skin fibroblasts (SFs) obtained from the abdomen were cultured in the 3D 'floating model' under either 21%, 5% or 1% O2 for 2days. Cell viability under hypoxia was higher in the OMFs than in the SFs. Collagen gel contraction was suppressed under hypoxic conditions in both fibroblasts, consistent with the reduction of alpha smooth muscle actin expression, except for SFs under 1% O2. Subsequently, their gene expression profiles between 21 and 1% O2 concentrations were compared via microarray technology, and the expression profiles of the extracellular matrix (ECM)-associated proteins, including matrix metalloproteinases and collagens, were evaluated. The OMFs were more susceptible to 1% O2, and more of their genes were downregulated than the SFs'. Although the production and expression levels of ECM-associated proteins in both fibroblasts diminished under hypoxia, those levels in OMFs were significantly higher than those in SFs. In the case of single origin OMFs and SFs, our findings suggest that OMFs possess a higher baseline production capacity of several ECM-associated proteins than SFs, except type III collagen. The intrinsic hypoxic responses of OMFs may be attributed to a more favourable wound healing in oral mucosa.

Clinicopathological profile of squamous cell carcinoma presenting in Tertiary Care Hospital, Karachi.

Objectives: Oral Squamous cell carcinoma (OSCC) is the most common malignant tumor of the oral cavity. The study was done with the aim to determine the clinical pattern of OSCC seen in tertiary care hospital of Karachi, Pakistan. The frequency of neck metastasis in different staging of squamous cell carcinoma was also recorded. Study Design: Retrospective study. Setting: Department of Oral & Maxillofacial Surgery Liaquat College of Medicine and Dentistry. Period: June 2013- July 2016. Material & Methods: It included 35 males and 25 females which presented with different sites and stage of squamous cell carcinoma. Clinically patients were staged as stage I, stage II, stage III and stage IV and comprised of 3, 8, 30 & 19 patients respectively. Patients presented with cancer of buccal mucosa (31 patients), retromolar region (12 patients), maxillary alveolus (8 patients), tongue (2 patients), floor of mouth (4 patients) & lip (3 patients). Right side was most common, 48 patients as compare to left side, 12 patients while lip cancers was in upper lip in all patients including commissure. Results: Total 60 patients were included in the study with the male to female ratio of 1.4:1. No significant association was seen between age and gender of the patient (p-value 0.933). Majority of patients were male involving buccal mucosa (51.67%) as the most frequently involved site followed by retromolar area (20%) and tongue (13.3%). Mean age of patients included in the study was 50.87 ± 5.53. Conclusion: Most of the cases of OSCC were seen in older patients with increased number of cases involving buccal mucosa as their primary site. Majority of the tumors were classified as stage III followed by Stage IV, Stage II and stage 1 respectively.

Incidence of retromolar canal in Egyptian population using CBCT: a retrospective study

BackgroundMany studies have been done to investigate the incidence and the course of the retromolar canal (RMC) in different populations either osseous studies using cadavers or dry mandibles, panoramic studies, or cone beam computed tomography (CBCT) studies. The location of the RMC is in the retromolar area distal to the third mandibular molar. The retromolar area is considered an imperative site where many dental surgeries are being held.The aim of this study is to determine the incidence of RMC in the Egyptian population using CBCT and measure the distance between the RMF and neighboring anatomical landmarks to better allocate the RMC and RMF and avoid the complications.Two hundred and fourteen CBCT scans were examined to detect the presence of RMC. Their course was classified to 3 main types A, B, and C, and linear measurements were done from the retromolar foramen (RMF) to the 2nd and 3rd molars in anteroposterior direction and from the RMF to the mandibular foramen (MF) in anteroposterior and mediolateral directions.ResultsThe RMC was present in 24 scans from the 214 with 11.2% incidence rate. The most common type was found to be type A, and type C was the rarest. The RMC has no significant difference between males and females, unilateral and bilateral distribution, and right and left sides. The linear measurements from the RMF to the 2nd and 3rd molars are 14.70 ± 5.07 mm and 4.26 ± 4.21 mm, respectively, and from the RMF to the MF in anteroposterior and mediolateral directions are 15.69 ± 3.43 mm and 2.62 ± 1.60 mm, respectively.ConclusionsThe incidence rate of RMC in Egyptian population represents 11.2%. The use of CBCT is quite important in the evaluation of the retromolar area to visualize the presence of the RMC or RMF and avoid the complications occurring due to different dental surgical procedures performed in the aforementioned site.

Oral Fibrolipoma: A Report of Two Cases

Introduction: Lipoma is a benign neoplasm of the fat tissue. Although, lipoma represents as the most common soft tissue neoplasm, lipomas of the oral cavity are very rare. This neoplasm contains 0.1 - 0.5% of all benign tumors of the oral cavity. Case Presentation: We reported two cases of fibrolipomas; the first case was in a 36-year-old female as a swelling in retromolar pad area and the second one in a 71-year-old female as an exophytic mass in pterygomandibular raphe. Conclusions: The novelty of these reported cases of fibrolipomas is that they have been occurred in infrequent area such as retro molar pad area and pterygo mandibular raphe. The lesions were removed by electro cutter with no recurrence at the follow up sessions. Although fibrolipoma is pretty rare in the oral cavity, there are several lesions can also have similar clinical features. Therefore, the histopathological examination is recommended for the clinicians in order to accomplish the final diagnosis.

Incidence and Anatomical Properties of Retromolar Canal in an Iranian Population: A Cone-Beam Computed Tomography Study.

Objectives Retromolar canal (RC) is an anatomic structure, and due to increasing demand for surgical procedure in the retromolar area of the mandible, the identification of the retromolar canal has become an issue of clinical concern. It can innervate the third molar and some of the muscles around the posterior segment of the mandible, complicating surgical procedures in the retromolar area and root canal treatment of third molars. The aim of this study was to evaluate the incidence and anatomical properties of RC in a western Iranian population using cone-beam computed tomography (CBCT) images. Materials and Methods. Two hundred bilateral CBCT images were collected and screened in the three spatial planes for the presence of an RC. Anatomical properties and location of the RCs were assessed according to their course and distance from the surrounding structures. The relationship between the presence of RC and age, sex, side, and presence of second and third molars was also evaluated. Independent samples t-test, ANOVA, Tukey's post hoc test, paired t-test, ANOVA, Tukey's post hoc test, paired Results At least one RC was observed in 22% of the mandibles. Its bilateral incidence was 5.5%. Two major types of canals were detected, namely, type I, following a straight or curved course from the mandibular canal (MC) to the retromolar area (47.3%), and type II, coursing from the retromolar area to the radicular part of the third molar (52.7%). Regarding linear measurements, the mean RC diameter and the mean distance to the MC, second, and third molars were 0.68 ± 0.31, 13.7 ± 2.8, 15.3 ± 3.0, and 7.3 ± 2.3 mm, respectively. Conclusion Based on the results of this study, RC was found in 22% of the cases; thus, it should be considered as a normal anatomical variation in the Iranian population rather than a rare finding.

Neuroepithelial Structures of the Oral Soft Tissues Including the Juxtaoral Organ of Chievitz: A Literature Review and Audit of Diagnosed Cases

The juxtaoral organ of Chievitz (JOOC) is a part of microanatomy composed of bland epithelial islands closely associated with small nerves and usually described within the soft tissue on the lingual aspect of the posterior mandible. Similar structures are documented in the posterior tongue. There is a risk of misinterpretation as carcinoma showing perineural invasion. An audit was undertaken of diagnosed cases of the JOOC and similar neuroepithelial structures identified within the oral soft tissues of surgical specimens. Nineteen cases were identified. Epithelial islands ranged < 0.5–4 mm in maximum dimension and lay in close association with small nerves. Epithelial cells showed a squamoid appearance but were without keratinisation. There was no atypia and mitotic figures were not seen. In 53% of cases the epithelial cells showed cytoplasmic clearing, in 26% of cases there was brown pigment and in 11% of cases there were calcifications. In 53% of cases, these neuroepithelial structures lay within the soft tissue lingual to the mandible in the retromolar area, 26% of the structures were placed buccal to the mandible, 11% of the structures lay adjacent to the maxillary tuberosity and 11% of the structures were within the posterior tongue.

How to avoid iatrogenic lingual nerve injury in the retromolar area: an anatomical study of retromolar pad and lingual nerve.

This study aimed to investigate the relationship between the retromolar gland and pad, and the relationship between the LN and retromolar gland/pad to establish a new landmark for avoiding LN injury. Sixty-two lingual nerves from fresh-frozen cadavers were used for this study. The age of the specimens at the time of death ranged from 57 to 98 with a mean of 76.5years. The mucous incision was made into the medial border of the retromolar pad and the submucosal tissue depth of the initial incision was bluntly dissected to expose the lingual nerve. When the LN was identified, the mucosa overlying the retromolar pad was removed to expose the retromolar gland to confirm if the retromolar pad corresponds to the retromolar gland. On all sides, the lingual nerve was found to course medial to the retromolar pad and inferior to the inferior border of the superior pharyngeal constrictor muscle to enter the sublingual space via the pterygomandibular space. The retromolar pad corresponded to the retromolar gland on all sides. This demonstrated that the retromolar pad is an overlying mucosa of the retromolar gland. No LN was found to travel through the retromolar gland. We suggest that the retromolar pad can be used as a new landmark for avoiding iatrogenic LN injury.

Multiple oral verruciform xanthomas: A rare entity

Verruciform xanthoma (VX) is an uncommon benign lesion that can affect oral, genital mucosa, and rarely skin. The characteristic foam cells seen in papillary dermis are a hallmark for diagnosing this entity. A 42-year-old male, tobacco-chewer presented with asymptomatic white-circular plaques on the bilateral buccal mucosa and yellow papules on retromolar area which on histopathological evaluation showed parakeratotic epithelium with surface and deep invagination of columns of parakeratosis throughout the hyperplastic epidermis, few neutrophils in upper spinous layers, and uniform elongation of rete ridges. The rete ridges showed numerous lipid-laden CD 68-positive foam cells. Punch excision coupled with cryotherapy was done, which resulted in the complete resolution of lesions. We publish this uncommon benign entity for increased awareness among physicians to consider it as a differential of verrucous lesion in the mucosa. Our patient had two different morphology of lesions, both suggestive of VX with characteristic foam cells on histopathology.

Lichen planus: Oralne manifestacije, diferencijalna dijagnoza i terapija

Introduction: Some of the typical skin diseases, such as Pemphigus vulgaris, Pemphigoid mucosae oris, Erythema exudativum multiforme, Sclerodremia, Dermatitis herpetiformis-Duhring and Lichen planus, can cause swelling and irritation in mucous membranes of the oral cavity. Aim: The aim of the study was to precise diagnosis and treatment of oral Lichen planus manifestations. Methods: Analyzing the literature data and the experience of clinicians, the most common oral lichen planus manifestations were investigated. Results: This disease most commonly occurs in middle-aged patients (30-60 years) and is more common in women than in men. Oral Lichen planus is rarely seen in children. The disease presents in 0.5% to 2% of the population. Clinical history established the relation between oral Lichen planus and oral carcinoma, and therefore this disease should be considered a precancerous lesion. Conclusion: Dermatoses in the mouth are localized most often in the oral mucosa, both at the height of the occlusal line and in the mucous membrane of the retromolar area, but they can also occur in the mucous membranes of the tongue, the floor of the mouth and lips.