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BJU International Aug 2023To describe outcomes of oral mucosal graft ureteroplasty (OMGU) and ileal ureter replacement (IUR) and determine the relative merits of both procedures. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To describe outcomes of oral mucosal graft ureteroplasty (OMGU) and ileal ureter replacement (IUR) and determine the relative merits of both procedures.
METHODS
Databases (including PubMed, Embase and Cochrane) were interrogated for eligible trials that assessed outcomes of OMGU or IUR from 2000 to 30 July 2022. The variables analysed were reconstruction success rates, stricture length, hospital stays, perioperative complications and long-term complications.
RESULTS
A total of 23 single-arm studies were included. The pooled reconstruction success rates for OMGU and IUR were 94.9% (95% confidence interval [CI] 91.0%-97.7%) and 85.8% (95% CI 81.0%-90.0%), respectively. Stricture length of patients in the OMGU and IUR groups were 3.73 (95% CI 3.17-4.28) and 11.55 (95% CI 9.82-13.29) cm, respectively. The maximal stricture length repaired by OMGU was 8 cm. The hospital stays were 5.85 (95% CI 3.88-7.82) and 11.55 (95% CI 6.93-16.17) days in the OMGU and IUR groups, respectively. The incidences of low-grade postoperative complications were 13.6% (95% CI 6.9%-20.3%) and 27.3% (95% CI 19.5%-35.1%), high-grade postoperative complications were 4.6% (95% CI 1.8I-8.5%) and 13.0% (95% CI 9.4%-17.1%), and long-term complications (occurred at > 3months) were 9.0% (95% CI 1.7%-20.0%) and 35.4% (95% CI 25.8%-45.6%) in the OMGU and IUR groups, respectively.
CONCLUSION
An OMGU is an effective, minimally invasive, and safe alternative to IUR for the management of long ureteric strictures. OMGU was the preferred treatment for long ureteric strictures, especially obstructed ureter segments of ≤8 cm.
Topics: Humans; Ureter; Constriction, Pathologic; Treatment Outcome; Ureteral Obstruction; Mouth Mucosa; Postoperative Complications
PubMed: 36815226
DOI: 10.1111/bju.15994 -
Pathology Feb 2024Oral epithelial dysplasia is a histologically diagnosed potentially premalignant disorder of the oral mucosa, which carries a risk of malignant transformation to... (Review)
Review
Oral epithelial dysplasia is a histologically diagnosed potentially premalignant disorder of the oral mucosa, which carries a risk of malignant transformation to squamous cell carcinoma. The diagnosis and grading of oral epithelial dysplasia is challenging, with cases often referred to specialist oral and maxillofacial pathology centres for second opinion. Even still there is poor inter-examiner and intra-examiner agreement in a diagnosis. There are a total of 28 features of oral epithelial dysplasia listed in the 5th edition of World Health Organization classification of tumours of the head and neck. Each of these features is poorly defined and subjective in its interpretation. Moreover, how these features contribute to dysplasia grading and risk stratification is even less well defined. This article discusses each of the features of oral epithelial dysplasia with examples and provides an overview of the common mimics, including the normal histological features of the oral mucosa which may mimic atypia. This article also highlights the paucity of evidence defining these features while offering suggested definitions. Ideally, these definitions will be refined, and the most important features identified to simplify the diagnosis of oral epithelial dysplasia. Digital whole slide images of the figures in this paper can be found at: https://www.pathogenesis.co.uk/r/demystifying-dysplasia-histology-dataset.
Topics: Humans; Mouth Neoplasms; Hyperplasia; Precancerous Conditions; Carcinoma, Squamous Cell; Mouth Mucosa; Cell Transformation, Neoplastic
PubMed: 38030478
DOI: 10.1016/j.pathol.2023.10.002 -
American Journal of Physiology. Cell... Jun 2020Both skin and oral mucosa are characterized by the presence of keratinized epithelium in direct apposition to an underlying collagen-dense connective tissue. Despite... (Review)
Review
Both skin and oral mucosa are characterized by the presence of keratinized epithelium in direct apposition to an underlying collagen-dense connective tissue. Despite significant overlap in structure and physiological function, skin and the oral mucosa exhibit significantly different healing profiles in response to injury. The oral mucosa has a propensity for rapid restoration of barrier function with minimal underlying fibrosis, but in contrast, skin is associated with slower healing and scar formation. Modulators of cell function, matricellular proteins have been shown to play significant roles in cutaneous healing, but their role in restoration of the oral mucosa is poorly defined. As will be discussed in this review, over the last 12 years our research group has been actively investigating the role of the profibrotic matricellular protein periostin in tissue homeostasis and fibrosis, as well as healing, in both skin and gingiva. In the skin, periostin is highly expressed in fibrotic scars and is upregulated during cutaneous wound repair, where it facilitates myofibroblast differentiation. In contrast, in gingival healing, periostin regulates extracellular matrix synthesis but does not appear to be associated with the transition of mesenchymal cells to a contractile phenotype. The significance of these findings will be discussed, with a focus on periostin as a potential therapeutic to augment healing of soft tissues or suppress fibrosis.
Topics: Animals; Cell Adhesion Molecules; Extracellular Matrix; Fibrosis; Humans; Mouth Mucosa; Organ Specificity; Phenotype; Signal Transduction; Skin; Skin Aging; Wound Healing
PubMed: 32267719
DOI: 10.1152/ajpcell.00035.2020 -
La Revue Du Praticien Oct 2019Benign pathologies of the oral mucosa. An overview of some common benign oral diseases whose diagnostic orientation begins and is based primarily on a precise clinical... (Review)
Review
Benign pathologies of the oral mucosa. An overview of some common benign oral diseases whose diagnostic orientation begins and is based primarily on a precise clinical analysis. Canker sores and benign traumatic ulcers must not make a novice carcinoma go unnoticed. Apart from bacterial stomatitis of dental origin, the most common infectious stomatitis is viral with herpes and papilloma, mycotic with acute and chronic forms. Oral dryness and glossodynia are two common situations that are difficult to manage.
Topics: Communicable Diseases; Humans; Mouth Diseases; Mouth Mucosa; Stomatitis, Aphthous
PubMed: 32237646
DOI: No ID Found -
Drug Design, Development and Therapy 2021Recurrent aphthous stomatitis (RAS) is a disease marked by painful oral lesions on the buccal and labial mucosa or tongue. Drug delivery systems (DDS) for RAS include... (Review)
Review
Recurrent aphthous stomatitis (RAS) is a disease marked by painful oral lesions on the buccal and labial mucosa or tongue. Drug delivery systems (DDS) for RAS include topical forms that manage wound healing, cover the ulcer, and relieve the associated pain. DDS targeting the oral mucosa face a major challenge, especially the short residence times in the mouth due to the effect of "saliva wash-out", which continually removes the drug. The objective of this review is to study the development of preparation forms and delivery systems of various types and preparations that have been used for RAS management from 1965 until February 2020. There are 20 types of DDS for RAS which were discussed in 62 articles. The preparations were classified into 4 preparation forms: liquid, semi-solid, solid, and miscellaneous. In addition, the ultimate DDS for RAS preparations is the semi-solid forms (41.94%), which include 5 types of DDS are gel, paste, patch, cream, and ointment. This preparation was developed into new preparation form (11.29%), such as adhesive alginates, dentifrice, OraDisc, membranes, bioresorbable plates, pellicles, and gelosomes. Generally, the mucosal drug delivery system is the method of choice in RAS treatment because the ulcer is commonly located in the oral mucosa. In conclusion, these preparations are designed to improve drug delivery and drug activity for the treatment of RAS ulcers. Moreover, almost all of these DDS are topical preparations that use various types of mucoadhesive polymers to increase both residence time in the oral mucosa and pain relief in RAS treatment.
Topics: Animals; Drug Delivery Systems; Humans; Mouth Mucosa; Stomatitis, Aphthous; Tongue
PubMed: 34616142
DOI: 10.2147/DDDT.S328371 -
International Journal of Dermatology Nov 2022Eosinophilic ulcer of the oral mucosa is a benign, reactive, self-limited lesion. Its pathogenesis is unclear, and it clinically manifests as a punched-out ulcer with... (Review)
Review
Eosinophilic ulcer of the oral mucosa is a benign, reactive, self-limited lesion. Its pathogenesis is unclear, and it clinically manifests as a punched-out ulcer with surrounding indurated border, raising suspicion for a possible malignancy. On histology, an acute and chronic dense inflammatory infiltrate can be appreciated, which can extend to the deep underlying tissue (including skeletal muscle). Eosinophils are especially conspicuous on hematoxylin and eosin staining and might play an important role in the development of the ulcer. Removal of possible triggers followed by monitoring and possible biopsy are among the initial recommendations. Most lesions heal spontaneously without the need for intervention. This review aims at assisting dermatologists to easily recognize this entity, avoiding unnecessary interventions and apprehension.
Topics: Eosine Yellowish-(YS); Eosinophilia; Hematoxylin; Humans; Mouth Mucosa; Oral Ulcer; Ulcer
PubMed: 34812492
DOI: 10.1111/ijd.15986 -
International Journal of Dermatology Apr 2022
Topics: Administration, Oral; Humans; Larva Migrans; Mouth Mucosa
PubMed: 34242402
DOI: 10.1111/ijd.15765 -
Gerodontology Dec 2022Oral bisphosphonates are widely used in the treatment of bone resorptive diseases. There is an evidence that oral bisphosphonates can exert adverse effects on the oral... (Review)
Review
BACKGROUND
Oral bisphosphonates are widely used in the treatment of bone resorptive diseases. There is an evidence that oral bisphosphonates can exert adverse effects on the oral mucosa independently of their effects on the jaw bones.
OBJECTIVE
To systematically map the literature on adverse effects of oral bisphosphonates on the oral mucosa of adults with bone resorptive diseases.
DESIGN
Scoping review of the literature, including different study designs.
METHODS
Systematic searches of the PubMed, LILACS, Google Scholar and EMBASE databases were conducted. Two independent reviewers screened titles and abstracts according to predetermined criteria.
RESULTS
The search retrieved 26 unique articles, comprising 22 case reports, one case series and three reviews describing a total of 56 cases of oral adverse events related to oral bisphosphonates. 88% of the reported cases were female suffering from comorbidities other than metabolic bone diseases. The improper use of the oral bisphosphonate was the most suspected cause of the adverse effect on the oral mucosa. Its management mainly involved withdrawal of the medication.
CONCLUSION
Adverse effects on the oral mucosa can develop from using oral bisphosphonates. Standardised registration of these adverse effects in university clinics and private practises could provide additional information about their occurrence and severity.
Topics: Female; Humans; Male; Mouth Mucosa; Diphosphonates; Bone Density Conservation Agents
PubMed: 34725854
DOI: 10.1111/ger.12590 -
Archives of Oral Biology Sep 2019The present review provides information about which molecules appear to be the main fluorophores in skin and oral mucosa, together with their clinical applications. (Review)
Review
OBJECTIVES
The present review provides information about which molecules appear to be the main fluorophores in skin and oral mucosa, together with their clinical applications.
DESIGN
The MEDLINE database was searched, using "oral mucosa AND fluorophores", "skin AND fluorophores", "epidermal AND fluorophores", "dermal AND fluorophores" and "cutaneous AND fluorophores" as entry terms. We searched the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The level of evidence in the studies was assessed using the Classification of the Oxford Centre for Evidence-based Medicine (CEBM) Levels for Diagnosis.
RESULTS
Five papers and 17 were primarily focused on description of fluorophores in oral mucosa and skin Evidence exists that fluorophores of oral mucosa and skin are mainly proteins such as collagen, elastin, keratin and tryptophan. Other possible fluorophores identified are: porphyrins, advanced glycation end products, flavins, lipopigment, nicotinamide adenine dinucleotide, flavin adenine dinucleotide, pheomelanin, eumelanin and components of lipofuscin. Clinical applications of oral mucosal autofluorescence (AF) are related to management of malignant and potentially malignant lesions. In the skin, AF has been used for acne assessment, diagnosis of sweat-gland pathologies, glycemic control and management of malignant lesions and as a marker for skin aging.
CONCLUSION
Fluorophores stimulated through AF devices are implied in different physiologic and pathologic processes. AF seems to be useful for several clinical applications, especially in skin department. Because most of the studies show a low level of evidence, further studies are necessary in such a promising and fascinating field.
Topics: Fluorescence; Humans; Mouth Mucosa; Skin
PubMed: 31299549
DOI: 10.1016/j.archoralbio.2019.07.001 -
Oral Surgery, Oral Medicine, Oral... Aug 2022This study evaluated and compared the expression of secreted protein acidic and rich in cysteine (SPARC) in epithelial cells and fibroblasts of oral leukoplakia (OL) and...
OBJECTIVE
This study evaluated and compared the expression of secreted protein acidic and rich in cysteine (SPARC) in epithelial cells and fibroblasts of oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) using normal oral mucosa as a control.
STUDY DESIGN
The expression of SPARC was determined in samples of normal oral mucosa (n = 12), OL without dysplasia (n = 31), OL with dysplasia (n = 54), and OSCC (n = 69) using immunohistochemistry. The percentage of positive cells in epithelial cells and fibroblasts was independently evaluated.
RESULTS
Epithelial SPARC was found in 33.3%, 35.5%, 25.9%, and 66.7% of normal oral mucosa, OL without dysplasia, OL with dysplasia, and OSCC, respectively. Fibroblast SPARC was found in 50.0%, 29.0%, 46.3%, and 84.1% of normal oral mucosa, OL without dysplasia, OL with dysplasia, and OSCC, respectively. OSCC had higher epithelial and fibroblast SPARC expression than normal oral mucosa, OL without dysplasia, and OL with dysplasia (P < .05). No significant differences were observed in epithelial and fibroblast SPARC among normal oral mucosa or OL with and without dysplasia.
CONCLUSION
Overexpression of epithelial and fibroblast SPARC was observed in OSCC but not in OL, suggesting that SPARC is involved in the late stage of oral carcinogenesis.
Topics: Fibroblasts; Humans; Leukoplakia, Oral; Mouth Mucosa; Mouth Neoplasms; Osteonectin; Squamous Cell Carcinoma of Head and Neck
PubMed: 35165061
DOI: 10.1016/j.oooo.2021.10.019