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Head and Neck Pathology Mar 2019Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient... (Review)
Review
Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient history is critical in assessing ulcerative oral lesions and should include a complete medical and medication history; whether an inciting or triggering trauma, condition, or medication can be identified; the length of time the lesion has been present; the frequency of episodes in recurrent cases; the presence or absence of pain; and the growth of the lesion over time. For multiple or recurrent lesions the presence or history of ulcers on the skin, genital areas, or eyes should be evaluated along with any accompanying systemic symptoms such as fever, arthritis, or other signs of underlying systemic disease. Biopsy may be indicated in many ulcerative lesions of the oral cavity although some are more suitable for clinical diagnosis. Neoplastic ulcerated lesions are notorious in the oral cavity for their ability to mimic benign ulcerative lesions, highlighting the essential nature of biopsy to establish a diagnosis in cases that are not clinically identifiable or do not respond as expected to treatment. Adjunctive tests may be required for final diagnosis of some ulcerated lesions especially autoimmune lesions. Laboratory tests or evaluation to rule out systemic disease may be also required for recurrent or severe ulcerations especially when accompanied by other symptoms. This discussion will describe the clinical and histopathologic characteristics of a variety of ulcerated lesions found in the oral cavity.
Topics: Humans; Mouth Mucosa; Oral Ulcer
PubMed: 30701449
DOI: 10.1007/s12105-018-0981-8 -
Medicina Clinica Sep 2023Recurrent aphthous stomatitis (RAS) is the most common clinical disease of the oral mucosa. Its prevalence in the general population varies between 5 and 25%, with its... (Review)
Review
Recurrent aphthous stomatitis (RAS) is the most common clinical disease of the oral mucosa. Its prevalence in the general population varies between 5 and 25%, with its peak appearance in the second decade of life. So far, the etiopathogenesis is not clear. In genetically predisposed patients, the effect of certain triggering factors would initiate the proinflammatory cytokine cascade directed against certain regions of the oral mucosa. Ulcers are round or oval with well-defined erythematous margins and a shallow ulcerated center covered with a gray or yellowish fibrinous pseudomembrane. The ulcers may reappear at intervals of a few days and months. Given the appearance of periodic thrush in the oral mucosa, the first thing to do is to make a correct differential diagnosis, rule out associated systemic diseases and assess treatable causes before reaching the diagnosis of RAS. At present, there is no curative treatment.
Topics: Humans; Stomatitis, Aphthous; Ulcer; Mouth Mucosa; Diagnosis, Differential; Recurrence
PubMed: 37357066
DOI: 10.1016/j.medcli.2023.05.007 -
Head and Neck Pathology Mar 2019Human papillomaviruses (HPVs) are causative of a group of clinically papillary lesions. The HPV-related lesions of the oral cavity include squamous papilloma, condyloma... (Review)
Review
Human papillomaviruses (HPVs) are causative of a group of clinically papillary lesions. The HPV-related lesions of the oral cavity include squamous papilloma, condyloma acuminatum, verruca vulgaris, and multifocal epithelial hyperplasia. Benign entities, such as verruciform xanthoma or giant cell fibroma, as well as malignancies, such as papillary squamous cell carcinoma and verrucous carcinoma, may be considered in the clinical and/or histologic differential diagnoses of these lesions. Mechanisms of infection, epidemiology, clinical presentations, histologic features, and differential diagnoses of the HPV-related oral pathologies are discussed. Current concepts of viral transmission, especially as pertaining to lesions in pediatric patients, and the impacts of HPV vaccination are reviewed.
Topics: Humans; Mouth Diseases; Mouth Mucosa; Papillomavirus Infections
PubMed: 30693456
DOI: 10.1007/s12105-019-01003-7 -
Head and Neck Pathology Mar 2019Black and brown pigmentation of the oral mucosa can occur due to a multitude of non-neoplastic causes. Endogenous or exogenous pigments may be responsible for oral... (Review)
Review
Black and brown pigmentation of the oral mucosa can occur due to a multitude of non-neoplastic causes. Endogenous or exogenous pigments may be responsible for oral discoloration which can range from innocuous to life-threatening in nature. Physiologic, reactive, and idiopathic melanin production seen in smoker's melanosis, drug-related discolorations, melanotic macule, melanoacanthoma and systemic diseases are presented. Exogenous sources of pigmentation such as amalgam tattoo and black hairy tongue are also discussed. Determining the significance of mucosal pigmented lesions may represent a diagnostic challenge for clinicians. Biopsy is indicated whenever the source of pigmentation cannot be definitively identified based on the clinical presentation.
Topics: Humans; Mouth Diseases; Mouth Mucosa; Pigmentation; Pigmentation Disorders
PubMed: 30671761
DOI: 10.1007/s12105-018-0980-9 -
International Journal of Molecular... Jul 2021The oral mucosa, which is the lining tissue of the oral cavity, is a gateway to the body and it offers first-line protection against potential pathogens, exogenous... (Review)
Review
The oral mucosa, which is the lining tissue of the oral cavity, is a gateway to the body and it offers first-line protection against potential pathogens, exogenous chemicals, airborne allergens, etc. by means of its physical and microbiological-immune barrier functions. For this reason, oral mucosa is considered as a mirror to the health of the individual as well as a guard or early warning system. It is organized in two main components: a physical barrier, which consists of stratified epithelial cells and cell-cell junctions, and a microbiological-immune barrier that keeps the internal environment in a condition of homeostasis. Different factors, including microorganism, saliva, proteins and immune components, have been considered to play a critical role in disruption of oral epithelial barrier. Altered mucosal structure and barrier functions results in oral pathologies as well as systemic diseases. About 700 kinds of microorganisms exist in the human mouth, constituting the oral microbiota, which plays a significant role on the induction, training and function of the host immune system. The immune system maintains the symbiotic relationship of the host with this microbiota. Crosstalk between the oral microbiota and immune system includes various interactions in homeostasis and disease. In this review, after reviewing briefly the physical barriers of oral mucosa, the fundamentals of oral microbiome and oral mucosal immunity in regard to their barrier properties will be addressed. Furthermore, their importance in development of new diagnostic, prophylactic and therapeutic strategies for certain diseases as well as in the application for personalized medicine will be discussed.
Topics: Animals; Homeostasis; Humans; Immunity, Mucosal; Microbiota; Mouth Mucosa
PubMed: 34360589
DOI: 10.3390/ijms22157821 -
The Medical Clinics of North America Nov 2014Patients often present to their physician with complaints of dental and/or oral pain. It is important for physicians to understand the complexities of oral anatomy and... (Review)
Review
Patients often present to their physician with complaints of dental and/or oral pain. It is important for physicians to understand the complexities of oral anatomy and how to perform a basic clinical examination of this area to evaluate and potentially manage patients with these complaints. This article discusses anatomic structures of the oral cavity and systematic clinical examination of this area.
Topics: Dentition; Diagnosis, Oral; Humans; Mouth; Mouth Mucosa; Pharynx; Primary Health Care; Salivary Glands
PubMed: 25443674
DOI: 10.1016/j.mcna.2014.08.001 -
Biomolecules Aug 2021Wound healing is an essential process to restore tissue integrity after trauma. Large skin wounds such as burns often heal with hypertrophic scarring and contractures,... (Review)
Review
Wound healing is an essential process to restore tissue integrity after trauma. Large skin wounds such as burns often heal with hypertrophic scarring and contractures, resulting in disfigurements and reduced joint mobility. Such adverse healing outcomes are less common in the oral mucosa, which generally heals faster compared to skin. Several studies have identified differences between oral and skin wound healing. Most of these studies however focus only on a single stage of wound healing or a single cell type. The aim of this review is to provide an extensive overview of wound healing in skin versus oral mucosa during all stages of wound healing and including all cell types and molecules involved in the process and also taking into account environmental specific factors such as exposure to saliva and the microbiome. Next to intrinsic properties of resident cells and differential expression of cytokines and growth factors, multiple external factors have been identified that contribute to oral wound healing. It can be concluded that faster wound closure, the presence of saliva, a more rapid immune response, and increased extracellular matrix remodeling all contribute to the superior wound healing and reduced scar formation in oral mucosa, compared to skin.
Topics: Animals; Cytokines; Extracellular Matrix; Fibroblasts; Gene Expression Regulation; Humans; Intercellular Signaling Peptides and Proteins; Keratinocytes; Macrophages; Microbiota; Mouth Mucosa; Neutrophils; Organ Specificity; Saliva; Signal Transduction; Skin; Wound Healing
PubMed: 34439831
DOI: 10.3390/biom11081165 -
Science Immunology Jan 2020The oral mucosa is a primary barrier site and a portal for entry of microbes, food, and airborne particles into the gastrointestinal tract. Nonetheless, mucosal immunity... (Review)
Review
The oral mucosa is a primary barrier site and a portal for entry of microbes, food, and airborne particles into the gastrointestinal tract. Nonetheless, mucosal immunity at this barrier remains understudied compared with other anatomical barrier sites. Here, we review basic aspects of oral mucosal histology, the oral microbiome, and common and clinically significant diseases that present at oral mucosal barriers. We particularly focus on the role of interleukin-17 (IL-17)/T helper 17 (T17) responses in protective immunity and inflammation in the oral mucosa. IL-17/T17 responses are highly relevant to maintaining barrier integrity and preventing pathogenic infections by the oral commensal fungus On the other hand, aberrant IL-17/T17 responses are implicated in driving the pathogenesis of periodontitis and consequent bone and tooth loss. We discuss distinct IL-17-secreting T cell subsets, emphasizing their regulation and function in oropharyngeal candidiasis and periodontitis.
Topics: Animals; Host-Pathogen Interactions; Humans; Immunity, Mucosal; Interleukin-17; Microbiota; Mouth Diseases; Mouth Mucosa; Th17 Cells
PubMed: 31901072
DOI: 10.1126/sciimmunol.aau4594 -
International Journal of Environmental... Dec 2022Burning Mouth Syndrome (BMS) is a complex chronic neuropathic orofacial pain disorder characterized by a generalized or localized intraoral burning, dysesthetic... (Review)
Review
Burning Mouth Syndrome (BMS) is a complex chronic neuropathic orofacial pain disorder characterized by a generalized or localized intraoral burning, dysesthetic sensation or pain of the oral mucosa, recurring daily for more than 2 h per day for more than 3 months, without any evidence of specific mucosal lesions and/or laboratory findings [...].
Topics: Humans; Burning Mouth Syndrome; Causality; Mouth Mucosa; Neuralgia
PubMed: 36613002
DOI: 10.3390/ijerph20010682 -
Mucosal Immunology Nov 2021Oral mucosal disease (OMD), which is also called soft tissue oral disease, is described as a series of disorders or conditions affecting the mucosa and soft tissue in... (Review)
Review
Oral mucosal disease (OMD), which is also called soft tissue oral disease, is described as a series of disorders or conditions affecting the mucosa and soft tissue in the oral cavity. Its etiology is unclear, but emerging evidence has implicated the influence of the composition of the oral mucosa and saliva-resident microbiota. In turn, this dysbiosis effects the immune response balance and epithelial barrier function, followed by the occurrence and progression of OMD. In addition, oral microbial dysbiosis is diverse in different types of diseases and different disease progressions, suggesting that key causal pathogens may exist in various oral pathologies. This narrative literature review primarily discusses the most recent findings focusing on how microbial dysbiosis communicates with mucosal adaptive immune cells and the epithelial barrier in the context of five representative OMDs, including oral candidiasis (OC), oral lichen planus (OLP), recurrent aphthous ulcer (RAU), oral leukoplakia (OLK), and oral squamous cell carcinoma (OSCC), to provide new insight into the pathogenetic mechanisms of OMDs.
Topics: Animals; Biodiversity; Cell Communication; Disease Susceptibility; Dysbiosis; Homeostasis; Host Microbial Interactions; Host-Pathogen Interactions; Humans; Immune System; Immunity, Mucosal; Microbial Interactions; Microbiota; Mouth Mucosa; Signal Transduction
PubMed: 34040155
DOI: 10.1038/s41385-021-00413-7