From Short Circuit to Completed Circuit: Conductive Hydrogel Facilitating Oral Wound Healing.

The primary challenges posed by oral mucosal diseases are their high incidence and the difficulty in managing symptoms. Inspired by the ability of bioelectricity to activate cells, accelerate metabolism, and enhance immunity, a conductive polyacrylamide/sodium alginate crosslinked hydrogel composite containing reduced graphene oxide (PAA-SA@rGO) is developed. This composite possesses antibacterial, anti-inflammatory, and antioxidant properties, serving as a bridge to turn the "short circuit" of the injured site into a "completed circuit," thereby prompting fibroblasts in proximity to the wound site to secrete growth factors and expedite tissue regeneration. Simultaneously, the PAA-SA@rGO hydrogel effectively seals wounds to form a barrier, exhibits antibacterial and anti-inflammatory properties, and prevents foreign bacterial invasion. As the electric field of the wound is rebuilt and repaired by the PAA-SA@rGO hydrogel, a 5 × 5 mm2 wound in the full-thickness buccal mucosa of rats can be expeditiously mended within mere 7 days. The theoretical calculations indicate that the PAA-SA@rGO hydrogel can aggregate and express SOX2, PITX1, and PITX2 at the wound site, which has a promoting effect on rapid wound healing. Importantly, this PAA-SA@rGO hydrogel has a fast curative effect and only needs to be applied for the first three days, which significantly improves patient satisfaction during treatment.

Oral mucosal diseases and psychosocial factors: progress in related neurobiological mechanisms.

The aetiology of oral mucosal diseases, such as recurrent aphthous ulcer (RAU), oral lichen planus (OLP) and burning mouth syndrome (BMS), involves many factors, and it remains difficult for clinicians to effectively relieve disease symptoms and formulate coping strategies. With the rapid development of psychology, the role of mental and psychological factors in RAU, OLP and BMS has gradually attracted researchers attention, but the specific mechanism has not been completely determined. This narrative review describes the potential neurobiological mechanism of oral mucosal diseases and detailed psychological factors after introducing relevant research into psychological factors and oral mucosal diseases. Future research strategies and innovations needed to understand and treat oral mucosal diseases and psychological factors, as well as how to prevent oral mucosal diseases by regulation of the neuroendocrine system, are also discussed.

Potential Oral Health Benefits of Ginseng and Its Extracts.

This review discusses the effects of ginseng and its extracts in the treatment of dental caries, periodontal diseases, endodontic diseases, oral cancers, oral mucosal diseases, and some other dental associations. In the meantime, bioavailability and safety application of ginseng products are discussed. All of the articles reviewed were from PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Data, and VIP Chinese Science and Technology Periodicals Full-Text Database through November 2022, including full-text English or non-English publications. Ginseng and its extracts were shown to have beneficial effects on oral diseases, and further studies are needed to understand the mechanisms and confirm the effects in humans.

Clinical characteristics of oral chronic graft-versus-host disease according to the 2014 National Institutes of Health (USA) consensus criteria

Background: Chronic graft-versus-host disease (cGVHD) is a serious and common complication of allogeneic hematopoietic cell transplantation (alloHCT). The oral cavity is the second most common site affected by cGVHD. In 2014, the 2005 National Institutes of Health (NIH) consensus criteria were revised to address areas of controversy. The aim of this study was to evaluate the clinical characteristics of oral cGVHD using the 2014 NIH consensus criteria. Material and methods: The baseline data of oral manifestation of patients, who were diagnosed with oral cGVHD, in the first dental visit were analyzed (n=22). The oral mucosal disease was evaluated by NIH modified Oral Mucosa Rating Scale (OMRS) and Thongprasom sign score. The salivary gland disease and sclerotic disease were determined by the presence of signs and symptoms. The functional impact was assessed by the organ-specific severity score. Results: The median time from transplant to oral cGVHD diagnosis was 11.9 months. White striae with an erosive area was found in 72.7% of the patients. The mean ± SD of NIH modified OMRS was 6.1 ± 3.0. The most common and severely affected site of lichen planus-like features was buccal mucosa. Xerostomia, superficial mucocele and limited mouth opening were found in 18.2%, 9.1%, and 9.1%, respectively, of the patients. Almost all patients (90.9%) had partial limitation of oral intake. There were no significant differences in NIH modified OMRS or organ-specific severity score among the patient characteristic groups. Moreover, there was no association between the oral manifestations of cGVHD and the patient characteristics. Conclusions: The most common oral manifestation of cGVHD was white striae with an erosive area of oral mucosal disease, followed by xerostomia, superficial mucocele, and limited mouth opening. The 2014 NIH consensus criteria for diagnostic and severity assessment are informative and feasible in real-world practice. (AU)

Lichenoid lesions of the upper labial mucosa: a systematic review and a report of a new case with extensive follow-up.

OBJECTIVES: The paper reports the demographic characteristics of patients with lichenoid lesions affecting only the upper labial mucosa, with or without associated lesions in the maxillary anterior gingiva, alongside the lesions' clinical and histopathological features, treatment, follow-up and prognosis. Also, a new case with lengthy follow-up is presented. MATERIALS AND METHODS: A systematic review was performed in line with PRISMA guidelines. The literature search sources were PubMed, Scopus and Web of Science. RESULTS: In all, 26 patients (21 women, 5 men) were included in the review. 80.8% (n = 21) of the labial lesions were clinically erythematous and 19.2% (n = 5) were accompanied by white striations. The gingiva was affected in 46.2% of cases. All patients (100%, n = 24) reported symptoms. All of the lesions presented histological features of lichenoid inflammation. Granulomas were noted in 65.4% (n = 17) of the lesions. Topical corticosteroid was the most frequent therapy (89.5%, n = 17). CONCLUSIONS: Lichenoid lesions found solely in the upper labial mucosa, with or without adjacent gingival lesions, are rarely reported in the literature, and the reporting is often incomplete. A definitive aetiology could not be established for the lesions. Likewise, there is little information about this condition's long-term prognosis.

Antioxidant therapy for patients with oral lichen planus: A systematic review and meta-analysis.

Aims: This study aimed to systematically review the efficacy and safety of antioxidants for patients with Oral lichen planus (OLP). Methods: Databases, including PubMed, Web of Science, Cochrane Library, Embase, and Google Scholar, were searched up to 30 April 2022, for randomized controlled trials on the antioxidant therapy of OLP. The following endpoints were analyzed: pain score, clinical score, pain resolution rate, clinical resolution rate, and adverse effects. Results: A total of 19 studies met the inclusion criteria, and 17 studies with 704 patients were included in the meta-analysis. The findings showed that antioxidant therapy could significantly reduce the pain score [standardized mean difference -0.72 (-1.36, -0.07), P = 0.03, I2 = 87%, PI2 < 0.00001] and clinical score [SMD -2.06 (-3.06, -1.06), P < 0.0001, I2 = 94%, PI2 < 0.00001] of patients with OLP and improve the pain resolution rate [risk ratio (RR) 1.15 (1.01, 1.31), P = 0.04, I2 = 45%, PI2 = 0.09] and clinical resolution rate [RR 1.40 (1.10, 1.78), P = 0.006, I2 = 72%, PI2 = 0.002]. Conclusion: The study demonstrated that antioxidant therapy was beneficial for patients with OLP, and antioxidants might be used to treat OLP. Systematic Review Registration: https://clinicaltrials.gov/, identifier CRD4202233715.

[Research Updates: The Role of Interaction between Oral Microbiota, Immune Cells, and Epithelial Barrier in Oral Mucosal Homeostasis and Pathogenesis].

In a healthy state, the interaction between the oral microorganisms, mucosal immune cells and epithelial barrier can maintain the oral microecological stability. However, the oral microecology is disrupted under a diseased state and various pathogenic bacteria and their virulence factors and metabolites irritate the immune system, which causes direct or indirect damage to the epithelial barrier, promotes the pathogenesis and progression of oral mucosal diseases, and triggers immune inflammatory response or the irreversible transformation from inflammation into cancer. We herein reviewed the interaction between oral microorganisms, immune cells and epithelial barrier from two perspectives, the maintenance of the oral homeostasis and the pathogenesis of oral mucosal diseases. We intended to gain further understanding of the oral mucosal homeostasis and the mechanism of action of the pathogenesis and progression of oral mucosal diseases, and to provide thereby ideas and scientific and theoretical basis for developing new strategies for the diagnosis and treatment of oral mucosal diseases through re-establishing mucosal homeostasis.

Adverse drug reactions induced by hydroxychloroquine in the treatment of oral lichen planus: a report of 13 cases / 口腔疾病防治

Objective @# To analyze the adverse drug reaction（ADR） reports of hydroxychloroquine for clinical medication safety. @* Methods@#The ADR reports of hydroxychloroquine between May 2019 and May 2021 were analyzed. Age, reasons for drug use, time of ADR, combined drug use, and ADR outcomes were statistically analyzed. @*Results@# No severe ADR was reported. Patients over 60 years old accounted for 53.85% of the total cases, and the time of ADR appearance was significantly earlier among those under 60 years old. A total of 61.54% of ADRs were involved in multiple organs, and optic neurotoxicity was reported in 46.15% of cases. @*Conclusion@# In the treatment of oral lichen planus with hydroxychloroquine, adverse drug reactions should be monitored, and increased attention should be given to patients over 60 years old to ensure the safety of this medication.

Application status and prospects of topical drug therapy in oral mucosal diseases / 口腔疾病防治

@#Oral mucosal disease is a general term for a type of disease that mainly affects the oral mucosa and surrounding soft tissues. In the treatment of oral mucosal diseases, due to the particularity of the anatomical location, the use of topical administration is relatively simple and convenient; drugs can easily accumulate in the lesions, and at the same time, they can also avoid adverse reactions caused by systemic drug delivery. Topical administration has become an important and even preferred option for the treatment of oral mucosal diseases. There are various types of topically used drugs for oral mucosal diseases, such as glucocorticoids (triamcinolone acetonide), immunomodulatory drugs (tacrolimus), antiseptic drugs (chlorhexidine), pain relievers (lidocaine) and proprietary Chinese medicines (aloe vera gel). Among these drugs, although the most widely used liquid formulations such as gargles and sprays are easy to use, they are not conducive to local retention of drugs due to the particularity of the oral environment and function. Based on this, researchers have continuously improved the dosage form of the drug, and developed a series of semi-solid pharmaceutical preparations such as gels and ointments, some of which have exerted good curative effects in clinical work. In addition, although films, patches and other solid oral mucosal topical pharmaceutical preparations have few clinical applications, they have also been widely researched and described and are expected to become the mainstream dosage form in the future. In general, with the improvement of dosage forms, topical administration is playing an increasingly important role in the treatment of oral mucosal diseases. Therefore, combined with basic research and clinical reports, this article reviews the application of topical drug delivery in the treatment of oral mucosal diseases

Problem-based learning and case-based learning in dental education.

BACKGROUND: Numerous novel teaching methods have been developed in recent times for use in medical education. Of these methods, problem-based learning (PBL) and case-based learning (CBL) have attracted the most attention. We evaluated and compared the efficiency of these two teaching methods in dental education and discussed the importance of teachers to these courses. This study aims to evaluate the efficiency of PBL and CBL in dental education, and discuss the importance of teachers to the courses. METHODS: In this study, 28 students enrolled in a seven-year program at the College of Stomatology at Shanghai Jiao Tong University were chosen as participants. In the fourth year, PBL combined with independent learning was used to teach students the theory of oral mucosal diseases. During the internship, CBL was used to present specific cases. Both methods were carried out with group discussion. After the PBL course, teachers assessed its effect by the students' class performance, their ability to collect data, and group cooperation. After the CBL course, its effect was assessed by the students' ability in history-taking, diagnosis and antidiastole, and case analysis. In addition, the teachers' roles in both methods were assessed by both the students and the teachers themselves. Data was collected by questionnaire survey and statistically analyzed with SPSS Statistics 20. RESULTS: PBL significantly improved students' self-learning abilities in the theory course. CBL helped students make diagnoses and develop treatment plans for actual cases in the internship. Both students and teachers thought that teachers were indispensable to both PBL and CBL. There was no difference between student and teacher views. CONCLUSIONS: Although PBL and CBL have different focuses, their combination may enhance teaching effectiveness in dental education. Additionally, teachers play an important role in the application of both these teaching methods.

Therapeutic effect of curcumin on oral diseases: A literature review.

Curcumin (diferuloylmethane) is a polyphenol compound extracted from the rhizome of the plant Curcuma longa. It has the feature of being a yellow or orange pigment with a variety of biological properties, including anti-inflammation, antioxidation, anti-tumor, anti-bacteria, anti-fungus, and wound healing. Previous studies have reported the role of curcumin in treating different inflammatory diseases and tumors in vitro and in vivo. Recently, it has been demonstrated that curcumin has therapeutic benefits in oral mucosal diseases, periodontal diseases, and mouth neoplasms. In this review, we will focus on the therapeutic effects of curcumin on oral diseases.

Intraoral human herpes viruses detectable by PCR in majority of patients.

OBJECTIVES: To identify factors which influence the intraoral prevalence of human herpes viruses (HHVs) using mucosal swabs, saliva samples and qPCR analysis. METHODOLOGY: In this cross-sectional observational study, matched saliva and oral swabs were collected from a total of 115 subjects: 70 immunocompetent subjects with no mucosal abnormalities, 22 with mucosal abnormalities and 23 therapeutically immunocompromised individuals. Extracted DNA was analysed by multiplex qPCR for detection and quantification of HHVs 1-6. RESULTS: At least one human herpes virus was detected in 77.1% of immunocompetent individuals with no mucosal abnormalities, with EBV the most commonly detected at 61.4%. HHV-6 was detected in 17.1%, HSV-1 in 4.3% and CMV in 1.1%. Detection was higher in saliva than in oral swabs. There was no detection of HSV-2 or VZV. Neither presence of oral mucosal abnormality nor therapeutic immunocompromise was related to increased detection of human herpes virus. CONCLUSION: Commensal detection rates of EBV are high, and caution in clinical correlation of positive detection is warranted. Commensal CMV rates are low, and detection is likely to be clinically relevant. This study presents a comprehensive commensal detection rate of HHVs 1-6 by qPCR in saliva and swabs.

Countermeasure and opportunistic screening systems for oral cancer.

OBJECTIVES: Tokyo Dental College started oral cancer screening in cooperation with a local dental association in 1992. Reveal the usefulness of Countermeasure and Opportunistic Screening Systems for Oral Cancer. The actual results of countermeasure and opportunistic oral cancer screening systems are reported. MATERIALS AND METHODS: Countermeasure screening for the public was performed in each region, and opportunistic screening was performed in a general dental clinic of a cooperating physician. RESULTS: In countermeasure screening, 19,721 persons were checked from 1992 to 2018; the gender ratio was 1:3. The close examination rate was 4.45%. The detection rates of oral cancer and oral potentially malignant disorders were 0.13% and 1.85%, respectively. In opportunistic screening, 29,912 persons were checked from 2006 to 2018; the gender ratio was 2:3. The close examination rate was 2.33%. The detection rates of oral cancer and oral potentially malignant disorders were 0.08% and 2.15%, respectively. The close examination rate was significantly lower in opportunistic screening than in countermeasure screening. The oral cancer detection rates and the positive predictive value for cancer were equivalent. In addition, the detection rate of oral potentially malignant disorders was significantly higher in opportunistic screening than in countermeasure screening. CONCLUSION: Oral cancer detection rates were equivalent between countermeasure and opportunistic screenings, and opportunistic screening were more effective on number of participants and the close examination rate, and the detection rate of oral potentially malignant disorders.

Research progress on the role of T helper cells 17 and interleukin 17 in oral mucosal diseases / 口腔疾病防治

@#T helper 17 (Th17) cells are a new type of CD4+ T helper cell. They participate in the immune and inflammatory response by secreting specific interleukin-17 (IL-17). In oral mucosal diseases, oral lichen planus (OLP), recurrent aphthous ulcer (RAU) and Behcet′s disease (BD) are associated with Th17 cells and IL-17. There were 17 kinds of proteins in the saliva of patients with OLP that could upregulate the expression of Th17 cells and induce the secretion of IL-17. IL-17 can stimulate epithelial cells, endothelial cells and fibroblasts to produce a variety of cytokines, such as IL-6, IL-8, granulocyte macrophage colony-stimulating factor and cell adhesion molecule-1, leading to the production and aggravation of inflammation. Th17/Tc17 cell-targeted therapy can significantly improve the clinical symptoms of OLP patients′ mucosa and skin. IL-17 can stimulate oral keratinocytes through the IL-17RA or IL-17RE receptor and produce proinflammatory effects in RAU. Th17 cells in the peripheral blood of BD patients are significantly increased, while Treg cells are significantly decreased.

Health-related quality of life and its associated predictors in patients with oral lichen planus: a cross-sectional study.

OBJECTIVES: To investigate levels of quality of life (QoL) and determine associated predictors in patients with oral lichen planus (OLP). MATERIALS AND METHODS: A total of 300 patients with OLP at one tertiary Oral Medicine clinic in the UK were recruited in a cross-sectional study from January 2018 to July 2019. The 15-item Chronic Oral Mucosal Disease Questionnaire (COMDQ-15) and 14-item Oral Health Impact Profile (OHIP-14) were used to assess the level of QoL related to OLP. A number of potential determinants were considered, including patient demographics, treatment, the severity of oral symptoms, the clinical activity of the disease, and the patient psychological status, which were measured using the pain-Numerical Rating Scale, the Oral Disease Severity Score, the Hospital Anxiety and Depression Scale, and the 10-item Perceived Stress Scale. Multivariate linear regression was employed to identify independent determinants associated with overall and aspects of QoL. RESULTS: On multivariate analyses, after adjusting for confounding variables, the QoL levels in patients with OLP were significantly associated with levels of oral pain, anxiety, stress and use of topical corticosteroids. The COMDQ-15 instrument performed better than OHIP-14 at capturing the association between QoL and pain and disease activity in patients with OLP. CONCLUSION: Clinicians should expect reduced QoL in OLP patients with high pain levels, high anxiety levels, high perceived stress and use of topical corticosteroids. The COMDQ-15 is best suited to measure QoL in this population.

Relationship between the immunohistological examination and fluorescence visualization of oral squamous cell carcinoma.

Disorders of the oral mucosa are considered easy to diagnose since they can be visualized and examined directly. A change in the color of the oral mucosa reflects histopathological changes and is an important diagnostic parameter. However, the subjective perception of color varies. To determine the extent of resection for oral mucosa conditions, it is necessary to digitize the color and perform objective assessments. In recent years, fluorescence visualization devices and analysis software that measure tissue luminance G have been employed for the identification of oral mucosa diseases. Fluorescence visualization is presumably based on the decrease in epithelial flavin adenine dinucleotide content and luminance G values due to the destruction of collagen cross-links [fluorescence visualization loss (FVL)]. However, cases with differences between luminance values and histopathological presentation exist. Therefore, additional factors may affect fluorescence visualization. The present study used a portable, non-contact oral mucosa fluorescence visualization device for luminance measurements in seven patients with oral squamous cell carcinoma. Furthermore, Picro-Sirius Red and immunohistochemical staining were performed for CK13, CK17, Ki67, p53 and E-cadherin in the FVL(+) (lesion) and FVL(-) (resection stump) areas to elucidate the principle of fluorescence visualization. Fluorescence was significantly lower in the FVL(+) than in the FVL(-) areas, and the mean luminance G value was 56. The Picro-Sirius Red stain revealed collagen destruction in the FVL(+) areas but no collagen disruption in the FVL(-) areas. CK13 was negative in the FVL(+) and positive in the FVL(-) areas, whereas the opposite pattern was observed for CK17. In the FVL(+) area, p53 staining was positive. E-cadherin expression was enhanced in the FVL(-) areas and reduced in the FVL(+) areas. Furthermore, the luminance G value tended to be lower in cases with weaker E-cadherin staining. The aforementioned results suggest that decreased E-cadherin expression may be a factor that regulates fluorescence visualization.

Histological, Immunological, and Genetic Analysis of Feline Chronic Gingivostomatitis.

Feline chronic gingivostomatitis (FCGS) is an immune-mediated inflammatory condition affecting the oral mucosa that results in substantial pain and suffering. The goal of this study was to complete an in-depth immunohistochemistry analysis of affected FCGS mucosa, to perform and compare immune cell phenotypes in the blood of FCGS and healthy controls cats, and to determine a transcriptomic profile of the affected and normal oral mucosa of FCGS cats. We hypothesized that cats with FCGS would have circulating activated CD8+ T cells and that tissues would be infiltrated with activated B and T cells with a highly proinflammatory transcriptome. We found that oral mucosal tissues from cats with FCGS have high tissue infiltration of B cells and that T cells include both CD4+ and CD8+ lymphocytes. Cells positive for CD25 (IL2 receptor, indicative of lymphocyte activation) and FOXP3 (indicative of regulatory T cells) were scattered throughout the mucosa. Compared to healthy individuals, cats with FCGS had high circulating CD8+ effector memory cells with a concurrent decrease in central memory cells and evidence of circulating activated CD8+ T cells (CD25+, CD62L-). Gene expression in the affected tissues was enriched for genes associated with T-cell signaling, cell adhesion molecules, leukocyte migration, inflammatory signaling pathways, extracellular matrix-receptor interactions, cytokine-cytokine receptor interactions, and natural killer cell-mediated cytotoxicity, among others. These data are essential to understand disease pathogenesis, to inform mechanism of action studies for future and current therapies, and to help select prognostic biomarkers and potency assays for stem cell treatment of FCGS.

Prevalence of Oral Mucosal Diseases in Older Adults in Mainland China: A Meta-Analysis of Observational Studies.

Oral mucosal disease (OMD) is a public health challenge globally, but the epidemiological findings in older adults have been inconsistent in China. Thus, this meta-analysis was carried out to explore the prevalence of OMD and its moderating factors in this population. An electronic literature search was conducted of both international (PubMed, PsycINFO, and EMBASE) and Chinese (China National Knowledge Infrastructure and WanFang) databases from inception to November 1, 2019. The Der-Simonian and Laird random effects model was used to synthesize the prevalence of OMD and its 95% confidence intervals (95% CI). Twenty-four studies covering 23,653 older adults were included. The pooled prevalence of OMD was 23% (95% confidence interval: 17.9%-29.0%) Subgroup analyses and meta-analysis revealed that the prevalence of OMD was significantly associated with the reporting sampling, year of publication, and survey (all p values <0.05). This meta-analysis found that the prevalence of OMD among older adults in mainland China was significantly high. Early detection and effective intervention of OMD in older adults have public health and clinical importance.

Development and validation of a short version of Chronic Oral Mucosal Disease Questionnaire (COMDQ-15).

BACKGROUND: The adoption of the Chronic Oral Mucosal Disease Questionnaire (COMDQ) into clinical practice has been low, despite its rigorous development process. A potential limitation of the COMDQ is the high response burden to patients. Therefore, the aim of the present study was to develop and validate a short version of the 26-item COMDQ. METHODS: The COMDQ data of 520 patients with chronic oral mucosal diseases were randomly divided into two subsamples. Descriptive item analysis and exploratory factor analysis (EFA) were performed using data from the first subsample for item reduction and development of the shortened COMDQ. The resulting short version was then validated using confirmatory factor analysis (CFA) on the other subsample. Internal consistency reliability of the short-form COMDQ was assessed using Cronbach's alpha. Criterion validity of this new scale was examined against its original version. RESULTS: Based upon item analysis, 11 items were dropped. EFA results on the remaining 15 items extracted four factors consistent with the original COMDQ, and CFA results displayed acceptable goodness-of-fit indices of this factor structure on different sample. The COMDQ-15 was then created. Cronbach's alpha of four subscale scores ranged from 0.7 to 0.91, indicating good internal consistency reliability of the COMDQ-15. Correlations between total and subscale scores of the COMDQ-15 and its parent scale were high, supporting good criterion validity of this shortened scale. CONCLUSION: The COMDQ-15 is a brief, valid and reliable instrument that can give an overview of the patient's quality of life related to their chronic oral mucosal conditions.