Search Results (235)

This pilot study sought to evaluate and compare the performance of an automated method, developed using a neural network trained at the University of Palermo, with a traditional manual method for assessing capillary morphology in the oral mucosa. The analysis was conducted using videocapillaroscopy, a non-invasive imaging technique that allows for detailed visualization and quantification of microvascular structures. Three key parameters were examined: capillary caliber, length, and density. Measurements were taken across ten patients in four distinct anatomical sites within the oral cavity: the right buccal mucosa, left buccal mucosa, lower labial mucosa, and upper labial mucosa. The primary objective was to determine whether the automated method could serve as a reliable and efficient alternative to the manual approach, particularly in clinical and research settings where precision and reproducibility are paramount. The findings revealed that the automated method consistently produced higher values for capillary caliber and length compared to the manual method, suggesting a systematic overestimation of these parameters. This discrepancy may be attributed to the way the neural network identifies and processes capillary structures, potentially including more complex or tortuous segments that the manual method might overlook or exclude. In contrast, the two methods showed good agreement in the assessment of capillary density, with no significant differences observed. This indicates that the automated method performs well in quantifying capillary density, a critical parameter in microvascular studies. In conclusion, while the automated method shows promise as a faster and more efficient alternative to manual measurements, its systematic overestimation of certain parameters underscores the importance of continued development and validation. The availability of a non-operator-dependent, rapid, repeatable, and thus objective method represents a significant step forward in the assessment of microcirculation. However, careful consideration must be given to the limitations and potential biases of these tools to ensure their reliability and applicability in both research and clinical practice. Full article

Periodontitis is a prevalent oral condition worldwide. Azithromycin, a conventional lipophilic drug for periodontal treatment, often causes systemic side effects when administered orally. To address this, azithromycin-loaded nano-emulgels were developed using olive oil as a carrier within a xanthan gum aqueous gel phase. This oil-in-aqueous gel emulsion was actuated into a foam for localized drug delivery in gingival and periodontal disease. The solubility of azithromycin in various vehicles was tested, with olive oil showing the best solubility (0.347 mg/mL). Thermodynamic stability testing identified viable nano-formulations, with encapsulation efficiencies ranging from 98 to 100%. These formulations exhibited rapid drug release within 2–8 h. Muco-adhesion studies and ex vivo permeability tests on porcine buccal mucosa highlighted the beneficial properties of xanthan gum for local drug retention within the oral cavity. Antimicrobial efficiency was assessed using minimum inhibitory concentrations against various oral pathogens, where the formulation with equal surfactant and co-surfactant ratios showed the most potent antibacterial activity, ranging from 0.390 to 1.56 µg/mL. This was supported by the shear-thinning, muco-adhesive, and drug-retentive properties of the xanthan gel base. The study also examined the influence of the oil phase with xanthan gum gel on foam texture, rheology, and stability, demonstrating a promising prototype for periodontitis treatment. Full article

In pathology laboratories, several volatile organic compounds (VOCs) are used, such as formaldehyde, ethanol, and xylene. These substances are recognized as genotoxic and cytotoxic, which is why their handling poses risks to human health. The buccal micronucleus (MN) cytome assay is a non-invasive, useful, and simple method to detect these effects in exposed individuals. The aim of the study was to evaluate the risk of genotoxicity and cytotoxicity of VOCs in pathology professionals of S. Miguel Island, Azores, Portugal. The study comprised two groups: exposed workers (n = 21) from the three laboratories of S. Miguel, and a reference group (n = 50), randomly chosen from other hospital services without known exposure to VOCs. The exfoliated buccal cells were auto-sampled by all the participants using a cytobrush. The samples were processed in ThinPrep^®, stained with modified Feulgen with Fast Green, and visualized for MN and other nuclear anomalies (ONAs), such as karyorrhexis, pyknotic, and karyolytic cells. Results showed that VOCs have a predictive significance for MN frequency, leading to the conclusion that their exposure is an increased risk factor for the health of these professionals, approximately four times greater than in the control group. Full article

Background/Objectives: Vascular anomalies represent a complex group of conditions including vascular malformations and haemangiomas. Haemangiomas are benign tumours that have an endothelial origin. In contrast, vascular malformations are characterized by the abnormal dilation of vessels without proliferation. Depending on the extension of the disease, there is a higher risk of life-threatening haemorrhages that may occur during simple dental procedures. The aim of this case report is to present the interdisciplinary treatment for patients with venous malformation and to discuss the possible dental management of these patients. Methods: A 66-year-old male patient with an extensive venous malformation of the head and neck was referred for a tooth extraction. The venous malformation involved lips, buccal mucosa, tongue, and floor of the oral cavity. Its proximity to the tooth requiring extraction was associated with a high risk of severe bleeding. Results: Prior to the treatment, CBCT and CT scans were performed to confirm the extensions of the lesion and visualise its margins. Considering the possible risks related with venous malformation, the procedure consisted of tooth removal in a hospital setting with control over severe bleeding complications. Conclusions: The presence of an extensive vascular malformation in the head and neck region is burdened with a higher risk of haemorrhages during simple dental procedures. The radiological and clinical planning enables the choice of an accurate treatment strategy to avoid possible difficulties. In cases where such complications cannot be avoided, it is important to perform the treatment in a hospital setting with the cooperation of maxillofacial surgeons. Full article

Background/Objectives: Oral cancer is a significant global public health concern. Understanding the prevalence and associated risk factors of oral lesions is essential for developing effective preventive strategies. This study aimed to assess the prevalence and risk factors of oral lesions submitted for biopsy in a Portuguese subpopulation. A retrospective cross-sectional analysis was conducted using data from patients who sought dental care at the Egas Moniz Dental Clinic (EMDC) in the Lisbon metropolitan area. Methods: Data analysis was performed on a sample of 264 patients who attended the EMDC between October 2016 and December 2019 to ascertain the presence of oral lesions, their different types, and their correlation with potential risk factors. The analysis included all patients who underwent biopsy, and their pathology reports were reviewed. Results: The prevalence of oral lesions was 10.3%, affecting 58.7% females and 41.3% males, with a mean age of 55 years. The most frequently biopsied site was the buccal mucosa (23.5%). Non-neoplastic lesions accounted for 75.0% of cases, while mesenchymal lesions were the most common neoplastic category (58.5%). The most prevalent diagnosis was fibroepithelial hyperplasia (36.7%). A statistically significant association was observed between neoplastic lesions and statin use, as well as between both neoplastic and non-neoplastic lesions and the use of antidiabetic medications. Conclusions: Oral lesions are prevalent, with non-neoplastic lesions being the most frequent. Understanding their nature, prevalence, and associated risk factors is crucial for early and accurate diagnosis, aiding in disease prevention and management. Full article

Purpose: The objective of this research was to compare the pain-reducing effects of two topical anesthetic agents, 10% atomized lidocaine spray and an EMLA, cream before needle injection applied at different time intervals using parameters of visual analog scale (VAS) score and heart rate (HR). Methods: The randomized split-mouth study included 30 patients (17 boys, 13 girls) aged 8.22 ± 1.8 years. The application of atomized lidocaine spray or cream was randomly used in the maxillary second premolar region. The parameters were measured prior to and following each needle insertion after being applied for 10, 30, 60, and 120 sec. Paired t-test and independent t-test were used for statistic analyses. Results: Compared with the first applications (10 s), atomized lidocaine and EMLA cream applications significantly decreased scores of VAS at the 30 and 120 s applications, respectively. Despite atomized lidocaine showing an early effect compared with EMLA, there were no significant differences in VAS scores between the atomized lidocaine and EMLA cream at the 60 and 120 s measurements. Although HR significantly increased at first anesthetic administration with the atomized lidocaine spray, HR significantly decreased at 30 and 120 s administrations. Conclusions: Atomized 10% lidocaine-based topical anesthetics significantly reduced pain more rapidly and better than EMLA from needle pricks in the buccal mucosa. Therefore, atomized lidocaine topical anesthesia could be used as a substitute for EMLA cream prior to buccal anesthetic administration. On the other hand, further comprehensive studies are required to explore the effects of several doses of atomized lidocaine in various areas of the oral cavity. Full article

The buccal fat pad and buccal mucosa are anatomical structures closely related to palatal clefts which can provide additional tissues for defect reconstruction which is crucial for practitioners aiming to lessen the need for additional corrective surgeries in patients with cleft palates and to lower the rates of residual palatal fistulae. Objectives: Aims to explore the recent scientific data available on the applications and outcomes of two surgical techniques involving the buccal fat pad and buccal mucosal flap in primary and secondary palatoplasty. Methods: The analyzed articles published between 2020 and 2025 from PubMed, Web of Science, and Scopus. The search strategy included terms related to buccal fat pad flaps, buccal mucosal flaps, and cleft palate repair. Results: After performing the search, including eligible articles and removing duplicates, 15 articles were included in this review. Eight studies explored the effectiveness of buccal fat pad or buccal mucosal flap during primary palatoplasty and seven studies for secondary palatoplasty. The articles included in this review provide insights on the usefulness of buccal fat pad flaps and buccal mucosal flaps in primary and secondary palatoplasty. Conclusions: The buccal fat pad and buccal mucosal flaps are highly effective in secondary palatoplasty, particularly for velopharyngeal dysfunction and fistula closure. In primary palatoplasty, the buccal fat pad flap aids mucosal healing, reduces complications, and improves speech, while the buccal mucosal flap is beneficial for wide palatal defects. Full article

Background/Objectives: Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disorder with a recognized potential for malignant transformation. While histopathological examination remains the diagnostic gold standard, mucoscopy has emerged as a valuable non-invasive tool for assessing striae patterns, vascular features, and pigmentary alterations. This study aimed to evaluate the mucoscopic characteristics of OLP across different oral mucosal sites and to compare them with other inflammatory oral conditions, assessing their diagnostic relevance. Methods: A retrospective comparative study was conducted on 106 patients, including 33 with histopathologically confirmed OLP and 73 with other inflammatory oral conditions (pemphigus vulgaris, chronic cheilitis, hyperplastic oral candidiasis, leukoplakia, squamous cell carcinoma, pachyonychia congenita, morsicatio buccarum). Mucoscopic evaluation focused on the buccal mucosa, vermilion, and lingual mucosa. Features assessed included background color, white striae patterns, vascular morphology, the presence of erosions, and other features like blunting of the lingual papillae and scales on the vermilion. Statistical analysis was carried out using SPSS 29.0. Results: Reticular striae were highly specific to OLP, particularly on the buccal mucosa (90.9%, p < 0.001). Leukoplakia-like lesions were most prevalent on the lingual mucosa and significantly associated with dotted (p = 0.027) and looped vessels (p = 0.002). Erosions correlated significantly with both dotted (p < 0.001) and linear vessels (p = 0.011), especially in lingual and vermilion lesions. In comparison, control group lesions displayed significantly more globular structures (p < 0.001), veil-like patterns (p < 0.001), and diffuse vascular distributions (p = 0.018), particularly in cheilitis and candidiasis cases. Conclusions: Mucoscopy reveals distinct site-specific patterns in OLP, supporting its role as a non-invasive diagnostic aid. Comparative analysis highlights its utility in differentiating OLP from other inflammatory oral conditions and in identifying lesions with features suggestive of malignant potential. These findings support the integration of mucoscopy into routine clinical practice and warrant further validation through larger, prospective studies. Full article

Background: Oral ulcerative mucositis (OUM) is a painful, inflammatory mucosa lesion that impairs quality of life. Despite available treatments, effective agents that promote faster healing and modulate inflammation are still needed. Oxytocin (OT), a neuropeptide with anti-inflammatory and antioxidant properties, may aid wound healing by regulating the remodeling of the extracellular matrix (ECM). This study investigates the effects of OT on oral ulcer healing in rats, focusing on its modulation of the MMP-2/TIMP-2 pathway. Methods: Acetic acid 70% was used as the oral mucosal ulcer inducer. Thirty-six Wistar albino rats were divided into control, oral ulcer + saline, and oral ulcer + OT (intraperitoneally for 15 days) groups. Histopathological, biochemical, and molecular analyses were performed. Buccal mucosa tissue was examined for TNF-α, TIMP-2, and MMP-2 levels via ELISA, while oxidative stress markers and pentraxin-3 (PTX3) were also assessed. Results: OT significantly preserved epithelial integrity and reduced fibrosis compared to the saline group (p < 0.001). TNF-α, MMP-2, PTX3, and malondialdehyde levels were significantly lower, while TIMP-2 levels were elevated in the OT-treated group (p < 0.01). Histopathological analysis confirmed reduced inflammation and enhanced tissue organization. Conclusions: OT accelerates oral ulcer healing by modulating inflammation, oxidative stress, and ECM remodeling via the MMP-2/TIMP-2 pathway. These findings highlight its potential as a therapeutic agent for managing mucosal injuries. Further clinical studies are warranted. Full article

Background and Clinical Significance: Renal cell carcinoma (RCC) is the third most common cancer that metastasizes to the oral and maxillofacial region following breast and lung cancers. Metastatic involvement in the oral cavity is rare and can present as a diagnostic challenge due to non-specific clinical features that mimic other benign or malignant conditions. The limited information available regarding oral metastasis of RCC highlights the importance of recognizing this uncommon presentation. Case Presentation: A 50-year-old female presented with a painful swelling in the buccal and palatal mucosa of the right maxilla that progressively enlarged over several months. Initially, this lesion was diagnosed clinically as a pyogenic granuloma. However, given the lesion’s continued growth and unusual presentation, a biopsy was performed. Histopathological examination confirmed the lesion as metastatic renal clear-cell carcinoma (ccRCC), with immunohistochemical analysis verifying the renal origin. Further diagnostic tests, including a computed tomography (CT) urogram, chest CT, and bone scintigraphy, revealed additional metastases in the left adrenal gland, lungs, and bone. Conclusions: This case is notable because the oral lesion was the first visible sign of RCC, making it a rare presentation of metastatic RCC. This underscores the importance of thorough history taking, detailed clinical evaluations, and considering rare metastatic conditions in the differential diagnosis of oral swellings. Additionally, this case reinforces the significance of routine cancer screenings for early detection of undiagnosed cancer. We also updated a previous literature review of metastatic RCC to the head and neck region, covering cases until 2023. Full article

Background: While various techniques for the surgical correction of urethral strictures exist, data on their trends and perioperative outcomes are limited. Methods: Data from the German Nationwide Inpatient Data (GRAND) registry (2005–2023) were used to estimate the trends, baseline characteristics, and perioperative outcomes of the surgical techniques for urethral stricture correction. Results: A total of 500,937 patients underwent surgery. Internal urethrotomy was the most frequently performed procedure (n = 413,095, 82%), followed by urethral dilatation (n = 39,619, 8%), meatoplasty (n = 30,774, 6%), urethroplasty with buccal mucosa (n = 12,351, 2%), urethral excision with primary anastomosis (n = 3428, 0.7%), urethroplasty with preputial skin (n = 1585, 0.3%), and drug-coated balloon dilatation (n = 85, <0.1%). In recent years, internal urethrotomy declined; urethroplasty was relatively stable, and drug-coated balloon dilatation emerged as a promising treatment modality. Internal urethrotomy and urethral dilatation were predominantly performed in older patients (median age of 71 years), while urethroplasty was performed in younger (56 years). Preputial skin urethroplasty had a shorter hospital stay compared to buccal mucosa (−0.4 days, p = 0.02), with no significant differences in transfusion or sepsis rates. Conclusions: Internal urethrotomy remains the most frequently used technique despite declining utilization. Preputial skin urethroplasty presents similar perioperative outcomes compared to buccal mucosa urethroplasty. Full article

Oral fungal homeostasis is closely related to the state of human health, and its composition is influenced by various factors. At present, the effects of long-term soil heavy metal exposure on the oral fungi of local populations have not been adequately studied. In this study, we used inductively coupled plasma–mass spectrometry (ICP-MS) to detect heavy metals in agricultural soils from two areas in Gansu Province, northwestern China. ITS amplicon sequencing was used to analyze the community composition of oral buccal mucosa fungi from local village residents. Simultaneously, the functional annotation of fungi was performed using FUNGuild, and co-occurrence networks were constructed to analyze the interactions of different functional fungi. The results showed that the species diversity of the oral fungi of local populations in the soil heavy metal exposure group was lower than that of the control population. The relative abundance of Apiotrichum and Cutaneotrichosporon was higher in the exposure group than in the control group. In addition, Cutaneotrichosporon is an Animal Pathogen, which may lead to an increased probability of disease in the exposure group. Meanwhile, there were significant differences in the co-occurrence network structure between the two groups. The control group had a larger and more stable network than the exposure group. Eight keystone taxa were observed in the network of the control group, while none were observed in that of the exposure group. In conclusion, heavy metal exposure may increase the risk of diseases associated with Apiotrichum and Cutaneotrichosporon infection in the local populations. It can also lead to the loss of keystone taxa and the reduced stability of the oral fungal network. The above results illustrated that heavy metal exposure impairs oral fungal interactions in the population. This study extends our understanding of the biodiversity of oral fungi in the population and provides new insights for further studies on the factors influencing oral fungal homeostasis. Full article

Background/Objectives: Oral leukoplakia (OLK) is an oral mucosal lesion classified in the oral potentially malignant disorder group and is associated with an increased risk of malignant transformation (MT). The aim of this study was to compare the clinical and histopathological features of two OLK groups, a group of smokers and a group of non-smokers. Methods: In this retrospective study, a cohort of 154 patients with OLK was divided into two groups based on the presence of smoking as a major risk factor. OLK diagnoses were established via clinical and histopathological examination. Results: Females were more abundant in the non-smoking group than in the smoking group, where males were more abundant (p < 0.001). The average age of the smokers was lower than that of the non-smokers (p = 0.003). In the smokers, the buccal mucosa was most frequently affected, while in the non-smokers, the gums and the tongue were primarily involved (p = 0.016). In female smokers, involvement of the buccal area and multiple-site involvement were statistically significantly more frequently observed compared to that in female non-smokers (p = 0.006). Non-dysplastic lesions were predominant in both groups, with severe dysplasia observed more frequently in the non-smokers than in the smokers. MT was higher in the non-smoker group compared to that in the smoker group. Conclusions: OLK in smokers is different from OLK in non-smokers concerning female gender involvement, site location, the number of lesions, and the MT rate. Full article

Background and Clinical Significance: Lipomas, benign tumors composed of adipose tissue, are recognized as one of the two most common fat-containing soft tissue tumors, underscoring their relative prevalence among benign tumors in children. Despite their prominence, lipomas rarely occur before 20 years of age, highlighting a discrepancy between their commonality and the age at which they typically manifest. This case report focuses on a 11-year-old patient who noticed the presence of an intraoral mass, which prompted further investigation, ultimately leading to the diagnosis of a lipoma located on the palate. Following our diagnosis, we searched for similar cases; however, the relevant literature was rather limited. There was a case report of a 4-year-old patient who presented with a lipoma on her tongue and a case report of a 6-year-old patient who presented with a lipoma on the buccal mucosa. Case Presentation: The young patient came with his parents to the Department of Oral Medicine and Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, and reported the presence of a growth in the middle of the upper jaw. A tumor, of approximately 1 cm diameter, was observed in the middle of the palate, on the border between the hard and soft palate. The surrounding mucosa appeared normal, which is critical in differentiating the tumor from more aggressive pathological entities. It was characterized by a soft and slippery consistency. The patient was referred to a cone beam computed tomography (CBCT) examination to investigate if there was any bone involvement. Based on clinical and radiographical findings, a biopsy was carried out. The tumor was initially excised in its entirety and the base was electrocauterized to avoid placing sutures. The histopathological examination that followed suggested the presence of an intraoral lipoma since lobules of mature adipose tissue in lamina propria and fatty tissue in close proximity to mucinous salivary glands were noticed. Conclusions: The development of lipomas in young patients can be attributed to a multitude of factors that interplay with one another, emphasizing the need for a comprehensive understanding of these growths. Additionally, underlying conditions such as diabetes mellitus, hypercholesterolemia, and obesity also play a crucial role, highlighting the interconnected nature of metabolic disorders and lipoma formation. The surgical approaches for the removal of oral lipomas primarily revolve around complete surgical excision, which is considered the mainstay treatment for these benign tumors. Full article

Autoimmune blistering diseases (AIBDs) involve autoantibodies targeting proteins in the epidermal/epithelial desmosome (pemphigus) or basement membrane zone (pemphigoid). Despite widespread antigen distribution, lesions exhibit a scattered involvement pattern. This study maps the frequency/severity of AIBD lesions on various body parts and investigates whether differential antigen expression contributes to specific predilection sites. We analyzed affected sites presenting blisters/erosions, erythematous/urticarial lesions, and mucosal lesions in bullous pemphigoid (BP-cohort 1, n = 65; BP-cohort 2, n = 119), pemphigus vulgaris (PV, n = 67), and pemphigus foliaceus (PF, n = 20) patients. To assess antigen expression, we conducted indirect immunofluorescence (IF) staining of 11 AIBD antigens from 13 anatomical sites of 10 body donors without AIBD. In BP, blisters/erosions and erythematous/urticarial lesions predominantly affected arms and legs, while PV/PF patients exhibited frequent involvement of buccal mucosa and back, respectively. IF staining identified significant regional differences in BP180, BP230, and integrin β4 expression, although these variations did not correlate with a higher lesion frequency/severity. Other antigens showed consistent expression across all regions. Our findings suggest that predilection sites for BP and PV/PF are largely unaffected by regional variations in antigen expression but may be influenced by factors like microbiota, mechanical stress, sunlight exposure, local immunity, or genetics. Full article