Management of Lobular Capillary Hemangioma Using Diode Laser: A Case Report.

This case report focuses on the clinical development of a 32-year-old female patient's lobular capillary hemangioma and provides valuable insights into the atypical nature of this tumor. Low-level laser therapy (LLLT) that follows diode laser intervention can be regarded as a novel and evidence-based approach to therapeutic management. The application of a diode laser causes the vascular elements that comprise the bulk of the lesion to coagulate, which in turn causes the lesion's size to decrease. The biological processes that lead to quick tissue regeneration are also activated by LLLT. The suggested therapeutic approach ensures that the patient will heal in the best possible way while also optimizing their comfort and safety. It extends beyond the mere removal of wounds. The case report demonstrates how well dual laser therapy works to lessen common postoperative issues that are commonly seen in traditional surgical therapies for lobular capillary hemangioma such as excessive bleeding and infection. The precise application of the diode laser minimizes damage to surrounding tissues, thereby enhancing the healing process. Additionally, following surgery, LLLT helps reduce pain and inflammation, which improves patient outcomes. The potential of diode laser and LLLT therapies for treating vascular lesions, including lobular capillary hemangioma, is evidenced by their therapeutic advantages. This encourages wider clinical applications and field research. The presented case report offers valuable clinical significance by highlighting an innovative therapeutic approach for lobular capillary hemangioma, a vascular lesion that can present challenges in management.

Diagnosis and Management of Riga-Fede Disease: A Case Series.

In this case series, we present four unique cases of Riga-Fede disease (RFD), a rare disorder characterized by mucosal trauma as a result of repetitive tongue protrusion against the incisors, leading to the development of a large oral mass/ulceration. Due to the rapid development and growth of these lesions mimicking malignancy, it is important for the general and pediatric otolaryngologist to correctly diagnose and treat this benign disorder. This series highlights the variable clinical presentations, along with comorbidities of RFD, as well as the importance of interdisciplinary care between the pediatric otolaryngologist and pediatric dentist in its management. Laryngoscope, 2024.

Exploring the prevalence and risk factors of benign and premalignant oral lesions in an adult population from Northern Spain: a pilot study.

OBJECTIVE: The goal was to identify the lifestyle risk factors associated with benign and potentially malignant oral disorders. METHOD AND MATERIALS: The study enrolled first-time patients from the Oral Pathology Section, volunteers from Oviedo, and first-time patients from the University of Oviedo dental clinic. Patients underwent a survey that included sociodemographic information, lifestyle habits, and medical history. A comprehensive examination of the oral mucosa was conducted. Univariate and multivariate logistic regression were conducted using R software. RESULTS: Among the 183 participants, the most prevalent lesions were varicose veins (43.20%), cheek/lip biting (34.97%), and coated tongue (33.33%). Among the oral potentially malignant disorders (16.39%) were oral lichen planus (12.64%) and leukoplakia (3.33%). Tobacco was associated with melanotic pigmentation (OR 3.87, P = .001) and coated tongue (OR 5.90, P = .001). Longer intervals since the last check-up were associated with traumatic keratosis (OR 2.95, P = .031). Age and heavy smoking were found to have higher risk of developing an oral potentially malignant disorder (OR 1.04, P = .035, and OR 7.35, P = .028, respectively). CONCLUSIONS: These data should be considered when organizing public health programs focused on the detection and screening of heavy smokers. It is also important to strengthen the oral pathology units in universities as reference centers for students to acquire the necessary knowledge for their diagnosis and treatment, while simultaneously promoting awareness of this risk factor for oral precancer among the general population.

A case of oral tuberculous ulcer and literature review.

Our purpose is to clearly diagnose the tongue and back tuberculosis ulcer through detailed medical history collection combined with examination, so as to provide certain experience for the diagnosis and treatment of oral tuberculosis.

Median Rhomboid Glossitis: A Developmental Disorder Involving the Central Part of the Tongue.

Median rhomboid glossitis (MRG), also known as posterior midline atrophic candidiasis, is a developmental disorder of the oral cavity. It usually involves the central part of the dorsum surface of the tongue. It is a papillary atrophy that is generally well-defined and symmetrical in presentation. It is usually a painless lesion, but some patients may complain of mild itching and irritation in that region. This lesion is more predominant in males than females. It has been widely argued that this lesion is not a developmental disorder but a clinical manifestation of a fungal etiology. This article presents a case report of a 55-year-old woman who reported to the oral medicine department in a tertiary care center in Wardha, India, with the chief complaint of an oval-shaped, discolored area on the dorsum of her tongue since birth. This article also emphasizes the role of a dental practitioner in diagnosing the lesion and appropriate patient education regarding the condition.

The development of an online serious game for oral diagnosis and treatment planning: evaluation of knowledge acquisition and retention.

BACKGROUND: While serious games seem to be supportive in healthcare education, none of them had been designed to develop competence in diagnosis and treatment planning of oral lesions. Therefore, this research aimed to develop an online simulation-based serious game for training diagnosis and treatment planning of oral lesions (SimOL) and to evaluate its educational impact in terms of knowledge improvement and retention. METHODS: As a mandatory task in an oral lesion course, all 28 students were required to participate in SimOL activities. Participants were instructed to complete a pre-knowledge assessment following a one-week washout period prior to the game activity. Subsequent to the game completion, they were tasked to complete a post-knowledge assessment I (Full score = 15) and satisfaction questionnaire. A post-knowledge assessment II was administered a week later to evaluate knowledge retention. RESULTS: The findings demonstrated a significant increase in the assessment scores after interacting with the game (P < 0.001), where the pre- and immediate post-knowledge assessment scores were 8.00 (SD = 2.11) and 11.71 (SD = 2.39), respectively. The game also exhibited a positive impact on knowledge retention, as there was no significant difference between the scores of post-knowledge assessment I and II (P > 0.05). Additionally, students perceived the game as positively in all aspects, although the entertainment aspect achieved a slightly lower score of 3.70 (SD = 0.21), in comparison to the usefulness and ease of use with a score of 4.02 (SD = 0.11) and 4.02 (SD = 0.16), respectively. CONCLUSION: SimOL demonstrated its potential as an effective learning tool for improving and retaining knowledge for diagnosis and treatment planning of oral lesions. The game was perceived positively by dental students in all aspects, however further improvements should prioritize the enhancement of entertaining components.

Peculiar Histological Features of Oral Intravascular Papillary Endothelial Hyperplasia.

A 55-year-old male patient with single and well-circumscribed nodule in the lower lip. Accurate diagnosis is based only on histopathological examination using hematoxylin and eosin and immunohistochemical approach, which a large, organized thrombus within the dilated lumen of a poorly demarcated vein, associated with papillary projections of endothelial proliferation occupying vascular spaces. The final diagnosis was intravascular papillary endothelial hyperplasia (IPEH) associated with a thrombus. Oral IPEH is rare and has historically been difficult to diagnose due to its resemblance to other oral lesions. However, the distinctive histological features of oral IPEH associated with a thrombus now allow for its diagnosis through hematoxylin and eosin staining alone, without the need for additional techniques. Therefore, it is crucial for pathologists to be familiar with these unique morphological features to accurately diagnose oral IPEH and differentiate it from more common benign, malignant, or reactive vascular lesions in the oral cavity.

Concurrent Perioperative Diagnosis of HIV in a Patient With Plunging Ranula: A Case Report.

Oral manifestations may be the earliest indicators of HIV infection as it has strong association with oral candidiasis, hairy leukoplakia, linear gingival erythema, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis, Kaposi sarcoma, and lymphoma. Other conditions such as diffuse infiltrative lymphocytosis syndrome, benign lymphoepithelial cyst, and salivary gland neoplasm have also been reported in HIV patients. Ranulas are caused by salivary leakage from the sublingual gland as a result of ductal obstruction or trauma. At the present time, there is no clear evidence of a link between plunging ranula and HIV. The authors described a case of plunging ranula of the right floor of the mouth with a concurrent perioperative diagnosis of HIV. Surgical excision of ranula and associated salivary glands via submandibular and intraoral approach was successfully done with no recurrence over a period of one year. This case also highlights the importance of taking a thorough clinical history from patients and always practicing universal precautions, especially during surgical interventions.

Aspectos clínicos, epidemiológicos e histopatológicos de pacientes con lesiones en la mucosa bucal / Clinical, epidemiological, histological and pathological aspects of patients with lesions in the oral mucosa i: en

Introducción: Las lesiones en la mucosa bucal constituyen un grupo heterogéneo de alteraciones, de cuyo diagnóstico temprano depende el pronóstico y el tratamiento. Objetivo: Caracterizar a pacientes con lesiones en la mucosa bucal según variables clínicas, epidemiológicas e histopatológicas. Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo de 23 pacientes con lesiones en la mucosa bucal pertenecientes a los consultorios médicos de la familia del reparto Vista Alegre, quienes fueron asistidos en la consulta de estomatología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba desde septiembre del 2021 hasta junio del 2022. Resultados: En la serie predominaron el sexo femenino, el grupo etario de 60 y más años, la estomatitis subprótesis como lesión más frecuente (39,1 %) y los traumatismos crónicos como factores de riesgo (65,2 %); asimismo, en los pacientes remitidos al nivel secundario de atención hubo coincidencia entre los diagnósticos clínico e histopatológico (76,9 % ). Conclusiones: De la valoración clínica, epidemiológica e histopatológica de estas lesiones y de la preparación de los especialistas sobre el tema dependerá el diagnóstico definitivo.

Introduction: Lesions in the oral mucosa constitute a heterogeneous group of disorders which prognosis and treatment depend on the early diagnosis. Objective: To characterize patients with lesions in the oral mucosa according to clinical, epidemiological, histological and pathological variables. Methods: A descriptive, longitudinal and prospective study of 23 patients with lesions in the oral mucosa was carried out. They belonged to the family doctor offices from Vista Alegre neighborhood and were assisted in the Stomatology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba from September, 2021 to June, 2022. Results: In the series there was a prevalence of the female sex, the 60 years and over age group, subprosthesis stomatitis as more frequent lesion (39.1%) and chronic traumatisms as risk factors (65.2%); also, in patients referred to the secondary care level there was coincidence between the clinical, histological and pathological diagnoses (76.9%). Conclusions: The final diagnosis will depend on the clinical, epidemiological, histological and pathological valuation of these lesions and on the preparation of the specialists on the topic.

Prevalence of Oral Mucosal Lesions among Tobacco Consumers: Cross-Sectional Study.

Introduction: Different lesions of mucosa can arise in people with a habit of tobacco usage. An assessment of prevalence of such lesions among tobacco consumers was done through this study. Materials and Methods: A total of 1000 persons were included in this cross-sectional survey. Individuals with a habit of tobacco usage in any form were included in the study. Demographic data were recorded for each study participant. Furthermore, all the participants were examined for associated oral lesions through toluene blue staining method. Results: Types of tobacco consumption reported were for bidi, cigarette, hookah, gutkha, zarda, pan masala, and supari. Different types of associated lesions that were observed included tobacco pouch keratosis, leukoplakia, smoker's melanosis, erythroplakia, erythroleukoplakia, squamous cell carcinoma, sub-mucous fibrosis, and lichen planus in descending order. The oral sites involved were buccal mucosa, labial mucosa, floor of the mouth, gingiva, palate, and tongue in descending order. Conclusion: Various types of oral lesions can arise due to tobacco usage in different forms. The most common change observed is pouch keratosis in chewers and leukoplakia in smokers.

Peripheral calcifying odontogenic cyst: a case report and comprehensive review of 60 years of literature.

Peripheral Calcifying Odontogenic Cyst (PCOC) is the extraosseous form of calcifying odontogenic cyst that is limited to peripheral soft tissue without bony involvement. This case report presents a case of PCOC manifested as a progressive growth of gingival mass in a young male treated with excisional biopsy. Histological examination confirmed diagnosis of PCOC with presence of characteristic ghost cells and sporadic calcifications. No recurrence of the lesion and no complication were noted at three-year follow-up. Review of available literature on PCOC noted a predilection of occurrence in the mandible (61%) and in the anterior area of the jaws (58%). Mean age of patients was 41.7 ± SD25.43 (7-83) and 95% CI [33.6, 49.8] yrs. Mean size of the lesions was 1.38 ± SD1.1 (0.5-4.3) and 95% CI [0.93, 1.83] cm. Gender distribution was noted to be 51.3% male and 48.7% female.

Cytological features of oral malignant lymphoma in scraping liquid-based cytology: Cases of plasmablastic lymphoma and anaplastic lymphoma kinase-positive anaplastic large cell lymphoma.

The main purpose of cytological examination in the oral region is to screen for squamous cell carcinoma or intraepithelial neoplasms; thus, the background tends to be considered a deterrent for microscopy. From this perspective, liquid-based cytology (LBC) is favorable for preparing clear samples with few backgrounds. However, background hemocytes are sometimes of critical importance in the diagnosis. We report two cases of oral malignant lymphoma, plasmablastic lymphoma, and anaplastic large cell lymphoma in which careful observation of the background in scraping LBC sample contributed to the early diagnosis. Atypical lymphoid cells were observed only in a very small part of the LBC samples from the presented patients; however, cytological findings, such as large lymphoid cells with outstanding nucleoli, large mitotic cells, or intermediate-to-large lymphoid cells with pleomorphic nuclei were sufficient for obtaining a cytological diagnosis of malignant lymphoma. Although the number and cell size of leukocytes in LBC with Papanicolaou staining were significantly different from those in air-dried conventional smears with Romanovsky staining, which are commonly preferred for the discrimination of hemocytes, the corresponding cytological features could be observed. Therefore, attention should be paid to the background as well as squamous epithelium to prepare for such unexpected cases. The LBC examination with Papanicolaou staining alone can suggest the possibility of malignant lymphoma.

The Oral Lesion in the COVID-19 Patient: Is It True Oral Manifestation or Not?

Objective: Many previously reported publications mentioned that oral lesion in COVID-19 patients was varied. The term oral manifestations refer to pathognomonic features that are found consistently with a specific cause and effect. In this context, the oral manifestation of COVID-19 was inconclusive. This systematic review aimed to analyse previously reported publications related to oral lesions in COVID-19 patients to define as oral manifestations or not. The PRISMA guidelines were implemented in this review. Methods: All umbrella reviews, systematic reviews, systematic reviews and meta-analyses, comprehensive reviews, and original and non-original studies were included. Twenty-one of systematic review, 32 original studies and 68 non-original studies reported the oral lesion in COVID-19 patients. Results: Most of the publications mentioned that ulcers, macular, pseudomembranes and crusts were frequent oral lesions. The reported oral lesions in COVID-19 patients did not show any pathognomonic features and might be unrelated directly to COVID-19 infections, however, more likely due to gender, age, underlying diseases, and medication. Conclusion: The oral lesions found in previous studies do not have pathognomonic features and are inconsistent. Therefore, the reported oral lesion, in present time, cannot be defined as an oral manifestation.

Odynophagia as the first symptom of monkeypox infection.

A 50-year-old patient with confirmed monkeypox infection presented with odynophagia and nocturnal dyspnea. Clinically, there was a lesion on the tongue without any skin lesions and fibrinous plaques on the right tonsil with asymmetry of the palatoglossal arch. Due to a suggested abscess in the CT scan, a tonsillectomy à chaud was performed. By pan-orthopox-specific polymerase chain reaction (PCR) the monkeypox infection was also confirmed in the tonsil tissue. Isolated oral findings may represent a monkeypox infection and should be considered as a currently important differential diagnosis, especially for patients at risks.

Multiple-Drugs-Related Osteonecrosis of the Jaw in a Patient Affected by Multiple Myeloma: A Case Report.

A 60-year-old woman suffering from multiple myeloma (MM) was treated with zoledronic acid (bisphosphonate), dexamethasone (corticosteroid), bortezomib (a chemotherapeutic agent), and lenalidomide (thalidomide analog) for about a year and with lenalidomide alone as maintenance therapy for almost two years and developed stage three medication-related osteonecrosis of the jaws (MRONJ) in the upper left dental arch approximately two weeks after tooth extraction, which was treated with a medical nonoperative conservative approach until reversion to stage one. The present case report describing the development of multi-drug-related osteonecrosis of the jaws during the pharmacologic MM maintenance phase draws attention to the complex multidisciplinary and multistage management of MM subjects and also that during disease remission, crucially involving oral healthcare providers for MRONJ prevention and pharmacovigilance. To prevent similar cases, cancer patient management should ensure proper dental care not only before starting but also throughout therapy duration and ensure continuous interdisciplinary consensus between oncologists and dentists. Moreover, also considering the independent negative and potentially synergistic effect on bone metabolism and mucosal healing processes of employed medicaments, additionally combined with the cumulative one of previous intravenous bisphosphonates, further studies should highlight the polypharmacy effect and hopefully aid in patient-specific MRONJ risk assessment in cancer patients.

Palliative oral care in terminal cancer patients: Integrated review.

BACKGROUND: Palliative care (PC) aims to improve quality of life in patients and its families against life threatening diseases, through suffering's prevention and relief. It is the duty of the dental surgeon to possess the knowledge needed to treat a patient with little life span, in order to establish an adequate treatment plan for each situation. AIM: To synthesize the published evidence on oral conditions, impact, management and challenges in managing oral conditions among palliative patients. METHODS: Articles were selected from PubMed and Scopus electronic platforms, using a research strategy with diverse descriptors related to "palliative care", "cancer" and "oral health". The article's selection was done in two phases. The first one was performed by the main researcher through the reading of the abstracts. In the second phase two researchers selected eligible articles after reading in full those previous selected. Data was tabulated and analyzed, obtaining information about what is found in literature related to this subject and what is necessary to be approached in future researches about PC. RESULTS: As results, the total of 15 articles were eligible, being one a qualitative analysis, 13 (92.8%) clinical trials and one observational study. Of the 15 articles, 8 (53.4%) involved questionnaires, while the rest involved: one systematic review about oral care in a hospital environment, 2 oral exams and oral sample collection, one investigation of terminal patient's (TP) oral assessment records, 2 collection of oral samples and their respective analysis and one treatment of the observed oral complications. CONCLUSION: It can be concluded that the oral manifestations in oncologic patients in terminal stage are, oral candidiasis, dry mouth, dysphagia, dysgeusia, oral mucositis and orofacial pain. Determining a protocol for the care of these and other complications of cancer - or cancer therapy - based on scientific evidence with the latest cutting-edge research results is of fundamental importance for the multidisciplinary team that works in the care of patients in PC. To prevent complications and its needed to initial the dentist as early as possible as a multidisciplinary member. It has been suggested palliative care protocol based on the up to date literature available for some frequent oral complications in TP with cancer. Other complications in terminal patients and their treatments still need to have further studying.

Ulceration and a White Lesion of the Tongue in a Male HIV Positive Patient: A Journey on the Avenue of Differential Diagnoses in Search of a Solution.

Oral lesions are early indicator of immunosuppression, leading to HIV new diagnoses. The type of oral lesions can reveal opportunistic diseases that are correlated with the severity of immune depletion. Highly active antiretroviral therapy decreases the incidence of opportunistic oral infections, whereas a large variety of lesions are frequently experienced in people with HIV. Overlapping pathogenic mechanisms and multiple contributing etiologies are related to unusual, atypical oral lesions that are challenging in the clinical practice. We present a rare case of eosinophilic granuloma of the tongue in an older male HIV patient with severe immunosuppression due to the failure of antiretroviral treatment. Differential diagnoses considered squamous carcinoma, lymphoma, viral, fungal or bacterial infections and autoimmune disorders, as well as the influence of HIV immune disfunctions or the influence of cannabidiol use. The histopathologic and immunohistochemistry examination clarified the inflammatory reactive benign substrate of the lesion, although future survey of the oral lesions is essential.

[Odynophagia as the first symptom of monkeypox infection]. / Odynophagie als erstes Symptom bei Affenpocken-Infektion.

A 50-year-old patient with confirmed monkeypox infection presented with odynophagia and nocturnal dyspnea. Clinically, there was a lesion on the tongue without any skin lesions and fibrinous plaques on the right tonsil with asymmetry of the palatoglossal arch. Due to a suggested abscess in the CT scan, a tonsillectomy à chaud was performed. By pan-orthopox-specific polymerase chain reaction (PCR) the monkeypox infection was also confirmed in the tonsil tissue. Isolated oral findings may represent a monkeypox infection and should be considered as a currently important differential diagnosis, especially for patients at risks.

Mucocutaneous diseases with manifestations in the head and neck region: 24 years of experience in a Dermatology service

Background: This study aimed to evaluate the clinicopathological features of mucocutaneous diseases with manifestation in the head and neck region. Material and methods: A retrospective analysis of a dermatology reference center database was carried out. Over 24 years. Clinicopathological data were collected from medical records and the data was analyzed by descriptive statistics. Results: A total of 11.538 medical records were analyzed, being 152 cases of mucocutaneous diseases with manifestations in the head and neck region. Cutaneous lupus erythematosus was the most prevalent diagnosis (66.4%). Face (44.1%), females (79.6%), and patients with 45 years mean age were the most common features. In the oral cavity, the most affected region was the buccal mucosa (37.5%). Conclusions: Mucocutaneous diseases with head and neck manifestation were rare in the sample analyzed (1.3%), with cutaneous lupus erythematosus and lichen planus being the most common lesions in this region. (AU)

Can Oral TB develop in susceptible individuals after an oral surgical procedure? 3 case reports.

As opposed to the popular assumption, there have been an increase in the cases of Oral Tuberculosis as of late. Owing to increased drug resistance, there has been a change in the disease pattern leading to an upsurge in the Extra-pulmonary Oral Tuberculosis. According to the WHO, Diagnosis is the first step in the control of TB; but due to the lack of pathognomonic signs associated with Oral Tuberculosis and the rarity of these lesions, diagnosis is often difficult. So, to enable a timely diagnosis, we point out the occurrence of such lesions in the post-operative refractory lesions in susceptible individuals. However, a thorough search of literature did not yield any conclusive results. In this paper we present the clinical, radiographic and histopathological findings of three cases between the ages of 5 and 50 years old who were diagnosed of Oral Tuberculosis. These patients have undergone a recent oral surgical procedure prior to the development of Oral TB lesions. More research is required to increase the awareness of the pattern of this disease and to enable a quicker diagnosis so that the overall morbidity and mortality is reduced.