The Impact of a Pandemic on a Military Oral and Maxillofacial Pathology Biopsy Service.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) and the resulting societal reaction presented new challenges to the medical community by limiting patient access to care in 2020 and 2021. The Navy Postgraduate Dental School (NPDS) oral and maxillofacial pathology biopsy service is dependent on in-office physician or dentist appointments and patient biopsies. The purpose of this study was to understand the regulatory and societal impacts of COVID-19 restrictions on biopsy service submissions by assessing NPDS biopsy submission quantities and disease distribution. MATERIALS AND METHODS: All NPDS oral and maxillofacial pathology biopsy submissions from calendar years 2015 to 2016 and 2019 to 2021 were evaluated, and patient demographics and biopsy diagnoses were recorded in a biopsy registry. Data collected included age, sex, biopsy site, and diagnosis. Data from 2015, 2016, and 2019 were defined as pre-COVID and 2020 and 2021 as COVID. Biopsy reports for each year were organized in quarters. Diagnoses were categorized as malignant, pre-malignant, or benign. Categorical and continuous data were evaluated and presented as counts with percentages and means or medians with standard deviations, respectively. Significant differences in proportions or means were assessed using chi-square analysis or Student t-test, respectively. Cases were aggregated by quarter and year and assessed for temporal trends using linear regression analysis. RESULTS: The study evaluated 9,351 biopsy submission reports. The annual pre-COVID count mean (± standard deviation) and yearly counts for 2020 and 2021 were 2,063 ± 33.3, 1,421, and 1,742, respectively. The mean (± standard deviation) percentage of diagnoses classified as malignant from pre-COVID, 2020, and 2021 were 2.46 ± 0.005%, 3.59%, and 3.04%, respectively. Case counts and representation as a percentage of all biopsy diagnoses for Human Papillomavirus (HPV)-associated squamous cell carcinoma increased significantly during COVID compared to pre-COVID years (P < .05). CONCLUSIONS: Overall, preventative COVID-19 health measures and protocols resulted in a reduction in biopsy submission frequency, particularly during the second quarter (April to June) of 2020. However, case counts for malignant biopsies remained consistent between pre-COVID and COVID time intervals, suggesting that the identification and analysis of cases requiring follow-on care were unaffected by COVID-19 protocols.

Historical perspective and nomenclature of potentially malignant or potentially premalignant oral epithelial lesions with emphasis on leukoplakia-some suggestions for modifications.

Of the potentially (pre)maligant oral epithelial lesions, leukoplakia is the most common. A brief overview of the various definitions of leukoplakia that have been used in the past is presented here. A proposal has been made to modify the current definition. Clinically, for decades, leukoplakias have been divided into homogeneous and nonhomogeneous leukoplakias and further into different subtypes. A proposal has been made to slightly rearrange these subtypes. Furthermore, attention has been paid to a number of keratotic lesions that have been reported in the literature. It is expected that the increasing knowledge on carcinogenesis, including various genetic aspects, will be reflected in the definition of oral potentially (pre)malignant lesions in the near future.

Second opinion oral pathology referrals in New Zealand.

Referral for a second opinion is an important aspect of pathology practice, which reduces the rate of diagnostic error and ensures consistency with diagnoses. The Oral Pathology Centre (OPC) is the only specialist oral diagnostic centre in New Zealand. OPC provides diagnostic services to dentists and dental specialists throughout New Zealand and acts as a referral centre for second opinions for oral pathology specimens that have been sent to anatomical pathologists. The aim of this study was to review second opinion referral cases sent to the OPC over a 15-year period and to assess the levels of concordance between the original and final diagnoses. The findings indicated that the majority of referred cases were odontogenic lesions, followed by connective tissue, epithelial and salivary lesions. The most prevalent diagnoses were ameloblastoma and keratocystic odontogenic tumour, followed by oral squamous cell carcinoma. Discordant diagnoses were recorded in 24% of cases. Diagnostic discrepancies were higher in odontogenic and salivary gland lesions, resulting in the change of diagnoses. Second opinion of oral pathology cases should be encouraged in view of the relative rarity of these lesions in general pathology laboratories and the rates of diagnostic discrepancy, particularly for odontogenic and salivary gland lesions.

A vision for oral and maxillofacial pathology in Jamaica / Una visión de la patología oral y maxilofacial en Jamaica

Oral and maxillofacial pathology is an important bridging specialty between dentistry and medicine. This branch of dentistry is gaining special interest as a result of increasing number of oral cancer and microbial diseases. The advancements of medicine and basic medical sciences may help in directing the research in dentistry and oral and maxillofacial pathology. This paper highlights the new area and scope for oral and maxillofacial pathology in Jamaica.

La patología oral y maxilofacial es una especialidad importante que constituye un puente de enlace entre la medicina y la odontología. Esta rama de la odontología está ganando interés especial como resultado del aumento de número de casos cáncer bucal y enfermedades microbianas. Los avances de la medicina y las ciencias médicas básicas pueden ayudar a dirigir la investigación en odontología y patología oral y maxilofacial. Este trabajo pone de relieve la nueva área y el alcance de la patología oral y maxilofacial en Jamaica.

Púrpura trombocitopênica idiopática: importância do cirurgião-dentista no diagnóstico / Idiopathic thrombocytopenic purpura: importance of the dentist in this diagnosis

Esse trabalho descreve um caso de púrpura trombocitopênica idiopática (PTI) diagnosticado durante exame odontológico de rotina. A PTI é uma desordem caracterizada pela destruição anormal das plaquetas circulantes e geralmente apresenta manifestações bucais. Dessa forma, destacamos a importância de o cirurgião-dentista estar apto a reconhecer os sinais e sintomas da PTI, principalmente mudanças bucais que não têm origem dental, possibilitando tratamento imediato. Esta patologia quando não tratada, pode ser irreversível e fatal.

Oral and maxillofacial pathology: quality diagnostics for the present and the future.

The American Academy of Oral and Maxillofacial Pathology (AAOMP) has 619 members and 276 fellows. Oral and maxillofacial pathologists are uniquely qualified by training to combine expertise in histo-pathologic diagnosis, clinical diagnosis, and treatment. The majority of oral and maxillofacial pathologists are academicians, and optimal education of students of all types is a major focus of the specialty. Oral pathology is an important bridging specialty between dentistry and medicine, and strong links exist between it and pathology, otolaryngology, and dermatology, among others. Patient education is also important to the specialty, and information to assist patients is a critical part of the AAOMP Web site. In research and patient care, the main focus has been on oral cancer, and the specialty continues to emphasize that dentistry not lose sight of its role in combating malignancy. The organization has worked most recently to increase liaisons among both medical and dental sister organizations to improve the healthcare climate for all.

The future of oral pathology practice.

Oral and maxillofacial pathology (OMP) may be viewed as a specialty of dentistry, which addresses the diagnosis and treatment of diseases of the oral and perioral regions. Consensus definitions may be found in the accreditation standards for OMP as published by the American Dental Association, and in the Constitution and Bylaws of the American Academy of Oral and Maxillofacial Pathology (AAOMP). These sources describe roles for OMP in laboratory diagnosis (histopathology), and clinical practice. Eversole recognizes these divisions of OMP in his discussion of evidence-based practice, noting that oral medicine shares with OMP responsibilities in the care of patients with oral disease. Broadly viewed, all clinical disciplines and specialties of dentistry provide services in disease diagnosis and treatment. However, Eversole makes a distinction between the diagnostic and treatment services provided throughout dentistry, and those offered by OMP, excluding from OMP those primarily focused on dental caries, diseases of the periodontium, missing teeth and tooth structure, and dental misalignment. The focus of this essay addresses the future of OMP practice.

Efecto de los tratamientos antirretrovirales en las manifestaciones orales de los pacientes VIH+ / Effects of antiretoviral treatments on oral manifestations in HIV+ patients

El presente trabajo es un estudio para valorar el efecto de los tratamientos antirretrovirales en pacientes seropositivos al VIH, visitados en el dispensario de enfermedades infecciosas del Hospital Vall D´Hebron de Barcelona. Se visitaron 90 pacientes, 51 varones (56,7%) y 39 mujeres (43,3%), siendo la edad media de los pacientes de 36,2 años con una desviación de ±17,8 años y una moda de 35 años. Las visitas fueron realizadas desde enero a diciembre del año 1999. Estos pacientes recibían tratamiento antirretroviral de uno o más fármacos y algunos de ellos (32,2% ) estaban sometidos a tratamiento antirretroviral de alta actividad (TAAA). Asimismo, en estos pacientes se valoró el recuento de CD4 y carga viral de forma bimodal, al inicio del proceso y en el momento de la visita. La exploración de la cavidad oral se realizó en este momento, buscando las lesiones asociadas al Sida según la clasificación de Pindborg y cols., de 1989. La patología más prevalente encontrada en este estudio fue la sensación de boca seca o xerostomía en un 47,8%, seguida por orden de frecuencia de policaries (34,4%) y candidiasis eritematosa (31,1%). Otras manifestaciones orales son muy poco frecuentes, en comparación con los resultados de otros autores en la etapa previa a la utilización de los inhibidores de la proteasa (IP). Así, por ejemplo, se observó un solo caso de leucoplasia vellosa, tan característica antes del año 1996 (AU)

We evaluate the effects of antiretroviral treatments in HIV seropositive patients, who were seen in the Clinic for Infectious Diseases in the Vall D´Hebron Hospital, Barcelona. 90 patients were seen, 51 males (56.7%) and 39 females (43.3%), the mean age of the patients was 36.2 years with a deviation of ±17.8, and a mode of 35 years. The visits were carried out between January and December 1999. These patients were receiving antiretroviral treatment with one or more drugs and some of them (32.2%) were subjected to high activity antiretroviral treatment (HAART). Also, in these patients the CD4 count and bimodal viral load was measured, at the start of the disease process and at the time of visit. Theoral cavity was examined at this time, in search of lesions associated with AIDS according to the classification by Pindborg et al, 1989. The most prevalent pathology found in this study was the sensation of dry mouth or xerostomia in 47.8%, followed by, in order of frequency, multiple caries (34.4%) and erythematous candidiasis (31.1%). Other oral manifestations are very rare, in comparison with the results of other authors in the time before the use of protease inhibitors (PI). There is, for example, only one case of leukoplakia, so characteristic before 1996 (AU)

Prevalencia de lesiones mucosas en población anciana de la Región de Murcia / Prevalence of oral mucosal lesions in elderly people in Murcia

Introducción: El estudio de la prevalencia de la patología oral es importante, tanto para conocer el estado de salud como las necesidades de tratamiento. En este trabajo se valora la presencia de las lesiones mucosas orales en mayores de 65 años en pacientes institucionalizados y no institucionalizados de la Región de Murcia . Pacientes y método: Se estudio una muestra representativa de ancianos de la región de Murcia igual o mayor de 65 años en total 385 sujetos; tasa de participación 46%. Se diagnosticaron las lesiones mucosas en base a los criterios establecidos por la OMS Resultados: La prevalencia de las lesiones orales fue de 17,8% (no institucionalizado) y 14,2% institucionalizado. La lesión más frecuente asociada fue la ulcera traumática seguida de lengua geográfica y candidiasis protésica. Conclusión: Realizar programas de prevención y diagnostico de lesiones de mucosa oral. Además en los casos que se establezcan tratarlas adecuadamente (AU)

Background: Oral prevalence studies are important to know the state of health and the needs of treatment. The aim of the study was to determine the oral health status in a group of Murcia individuals 65 years of age or older Patients and Methods: A sample of 385 representative Murcia subjects older than 65 years old were (response rate 46%) Oral mucosal lesions were gathered according World Health Organization. Results: The prevalence of oral lesions was17,8% (non-institutionalised) and 14,2 (institutionalised). The most common lesion was traumatic ulcer followed geographic tongue and denture stomatitis. Conclusions: That oral mucosal lesions are common in elderly people in Murcia, suggesting the necessity for improved standards of prevention, and diagnostic and opportune treatment of these lesions (AU)

Valoración clínica de proliferaciones de tejido duro en la cavidad bucal / Clínical evaluafion of hard tissue proliferations in the mouth

Objetivos: En este trabajo se ha realizado un estudio de las proliferaciones de tejido duro presentes en la cavidad bucal. Diseño del estudio: Se realizó en una muestra de 530 individuos centroamericanos, 179 hombres y 154 mujeres, determinando la frecuencia de estas formaciones en función de laedad, el sexo y la raza, así como de su localización en el maxilar. Resultados: Se observó que el 38 por ciento de la muestra total presentaba proliferación de tejido duro en la cavidad bucal. De estos 206 casos, 158 (el 80 por ciento) se sitúan en el maxilar superior y 48 (el 20 por ciento) de los casos en el maxilar inferior o mandíbula. De ellos, 52 fueron hombres (25 por ciento) y 154 mujeres (75 por ciento). Esta proliferación tiene la mayor incidencia en la raza negra, en personas universitarias y con profesiones liberales. Predominan el torus palatino y el torus mandibular bilateral. Conclusiones: Existe una alta incidencia en la población centroamericana de proliferación de tejido duro en la cavidad oral, siendo suficiente para su detección un estudio clínico-radiológico (AU)

[Pathology and problems in theoretical and practical dentistry]. / Obshchaia patologiia i problemy teorii i praktiki stomatologii.

Pathology is a science describing the common regularities of pathological processes underlying disease development. Today pathology is defined as a theoretical science, which is at the same time closely connected to clinical practice. This paper reviews the history of research activities of Laboratory of Pathology of Central Institute of Stomatology. New methods have always been used at the laboratory; today it is histochemistry, radioisotope method (specifically histoautoradiography), and electron microscopy (including cytochemistry). Many-year research activities of the laboratory confirm the significance and perspectiveness of basic studies in dentistry, which are of priority importance for the development of theoretical dentistry and for solving the pressing problems in clinical practice.

Alteraciones digestivas frecuentes en niños con trastorno psicomotor / Frequents digestives alterations in children with psicomotrical trouble

La calidad de vida de los niños que padecen trastorno psicomotor puede estar directamente afectada por la presencia de diversas patologías que se suman a su enfermedad de base. Estas alteraciones pueden ser de carácter sensitivo motor, cognitivo y conductual. A nivel del tracto digestivo son frecuentes las patologías bucales de diverso orden, los trastornos deglutorios faríngeos y esofágicos, las alteraciones en el tono del cardias y del píloro, el vaciado gástrico lento, el reflujo gastroesofágico, la gastritis y el estreñimiento. Estas alteraciones, diversas en su expresión e intensidad, afectan en grado variable la conducta alimentaria y su calidad de vida total. El riesgo de padecer malnutrición es elevado en este grupo de pacientes. Por ello es importante la detección precoz de estos trastornos para aplicar a tiempo un tratamiento adecuado. La interacción de un equipo interdisciplinar y la aplicación de una terapia reeducativa es de suma trascendencia (AU)

Patología de cavidad oral: maxilares y gládulas salivales: estudio restrospectivo Hospital de Clínicas, Departamento de Patología y Maxilo Facial: años 1984-1993 / Oral pathology: maxillan and salivary glands retrospective study at in Department of maxillofacial pathology at Hospital de Clinicas 1984-1993

Se describen los resultados del estudio longitudinal, retrospectivo, analitico de la casuistica de patologia de cavidad oral, maxilares y glandulas saliales en los años 1984 a 1994 correlacionandose los archivos de los departamentos de anatomia patologica y maxilo facial, del hospital de clinicas de la ciudad de La Paz, estableciendose el porcentaje de su presentación, en base a diferentes variables y sobre todo a su tipificacion histologica.