Dental implants for patients with oral mucosal diseases: A narrative review and clinical guidance.

Oral mucosal diseases are a group of conditions that affect the oral mucosa with variable severity and include recurrent aphthous stomatitis (RAS), oral lichen planus (OLP), pemphigus vulgaris (PV), mucous membrane pemphigoid (MMP), and systemic lupus erythematosus (SLE). These may manifest clinically as painful oral ulcerations, reticulations and/or erosions, with differences between each. Management protocols often include initial topical and/or systemic corticosteroid (CS) therapy to control the patient's acute symptoms, followed by CS-sparing agents for long-term maintenance therapy. Patients with oral mucosal diseases often require dental implants to replace missing teeth. However, data on potential complications and success rates for these cases is still lacking. Considering the steady increase in the incidence of immune-related systemic conditions in the general population globally, dentists are expected to have the needed knowledge and ability to safely place dental implants in this group of patients. Therefore, this review aims to discuss the underlying pathogeneses of common oral mucosal diseases, clinical presentations, best practice approaches, and recommendations for the placement of dental implants in patients with similar conditions.

Oral changes associated with kolanut use: a report of 2 cases.

INTRODUCTION: Contact stomatitis (CS) is an inflammatory reaction of the oral mucosa induced by contact with an irritant, such as menthol and cinnamon compounds. We are reporting 2 cases of CS related to the use of kolanut, a caffeine-containing nut of evergreen trees. CASE DESCRIPTION: Case 1 was a 22-year-old man with history of chewing kolanut for the past 10 years; he presented with a grayish-white, velvety, leukoplakia-like plaque with ill-defined borders in the mandibular anterior facial vestibule and extending to the lower labial mucosa. The patient had never consumed tobacco products or alcohol before. Histopathologic analysis revealed hyperparakeratosis with otherwise normal epithelium. The patient continued kolanut consumption with persistent oral changes. Case 2 was a 29-year-old man with history of chewing kolanut for the past 2 years; he presented with extensive, diffuse, white, leukoplakia-like plaques on the anterior maxillary and all mandibular gingiva and vestibule, with epithelial desquamation and erosive patches. The patient reported smoking 30 cigarettes per day for the last 11 year. Following cessation of kolanut use, the leukoplakia-like lesion resolved with persistent erythema. CONCLUSIONS: This is the first report of histopathologic characterization of CS associated with the use of kolanut, which is believed to be reactive in nature with unknown premalignant potential.