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International Journal of Oral Science Jun 2022The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists. The expert consensus was conducted to summarize the... (Review)
Review
The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists. The expert consensus was conducted to summarize the diagnostic work-up for difficult and complicated oral ulcers, based on factors such as detailed clinical medical history inquiry, histopathological examination, and ulceration-related systemic diseases screening. Not only it can provide a standardized procedure of oral ulceration, but also it can improve the diagnostic efficiency, in order to avoid misdiagnosis and missed diagnosis.
Topics: Consensus; Humans; Oral Ulcer
PubMed: 35650189
DOI: 10.1038/s41368-022-00178-0 -
Indian Pediatrics Jun 2022
Topics: Humans; Infant; Oral Ulcer; Tongue; Tongue Diseases
PubMed: 35695153
DOI: No ID Found -
European Annals of Otorhinolaryngology,... Dec 2014Osteoradionecrosis (ORN) is a severe, generally irreversible complication of radiotherapy due to failure of healing. The pentoxifylline-tocopherol combination decreases...
INTRODUCTION
Osteoradionecrosis (ORN) is a severe, generally irreversible complication of radiotherapy due to failure of healing. The pentoxifylline-tocopherol combination decreases the superficial fibrosis induced by radiotherapy. Potentiation by Clodronate (PENTOCLO) appears to be effective in ORN of the mandible. The objectives of this study were to evaluate the efficacy and safety of PENTOCLO to treat osteoradionecrosis of the mandible.
METHODS
Retrospective study of 27 patients with a mean age of 65±12 years, managed for ORN of the mandible secondary to irradiation for head and neck cancer, treated by the PENTOCLO protocol between January 2010 and March 2011. The primary endpoint was regression of exposed bone until complete healing. Assessment was both clinical (measurement of mucosal ulceration) and radiological (panoramic dental x-rays) before treatment, after antibiotic-corticosteroid combination therapy for one month (M1), and then after 3, 6, 12 months of PENTOCLO.
RESULTS
An improvement of mucosal ulceration was observed in 16/21 patients after 3 months and in 12/17 patients after 6 months of PENTOCLO. Healing was obtained in 16 patients. Median healing time was 82 days (range: 32-266), and was shorter after surgery and radiotherapy (49 days) and longer after chemoradiotherapy (169 days). Radiological healing was achieved later than clinical healing with improvement in 9 out of 20 patients at 3 months. The safety and efficacy of treatment were evaluated by intraoral clinical examination, and assessment of feeding, weight and analgesic consumption. No patient discontinued treatment because of adverse effects.
CONCLUSION
The PENTOCLO protocol achieved clinical and radiological regression of ORN with, in parallel, a reduction of the indications for major surgery. These preliminary results need to be confirmed by prospective studies comprising quality of life assessment.
Topics: Aged; Aged, 80 and over; Bone Density Conservation Agents; Clodronic Acid; Drug Combinations; Female; Head and Neck Neoplasms; Humans; Male; Mandibular Diseases; Middle Aged; Oral Ulcer; Osteoradionecrosis; Pentoxifylline; Radiography, Panoramic; Retrospective Studies; Tocopherols; Wound Healing
PubMed: 24993781
DOI: 10.1016/j.anorl.2013.11.006 -
Annals of the Royal College of Surgeons... Nov 2021Ulceration of the oral cavity is common and a frequent reason for referral to secondary and tertiary centres. Epstein-Barr virus (EBV)-related mucocutaneous ulceration,...
Ulceration of the oral cavity is common and a frequent reason for referral to secondary and tertiary centres. Epstein-Barr virus (EBV)-related mucocutaneous ulceration, however, is a rare cause of oral ulceration that has been described only recently. Histologically these lesions resemble lymphomas; however, their management and prognosis differ significantly. We present a case of EBV-induced oral ulceration and discuss the diagnosis and management of and available literature for the condition, which was treated successfully through conservative measures alone.
Topics: Adult; Biopsy; Epstein-Barr Virus Infections; Female; Herpesvirus 4, Human; Humans; Mouth Mucosa; Oral Ulcer
PubMed: 34436949
DOI: 10.1308/rcsann.2021.0051 -
Postgraduate Medical Journal Oct 2000Behçet's disease is a systemic vasculitis of unknown aetiology characteristically affecting venules. Onset is typically in young adults with recurrent oral and genital... (Review)
Review
Behçet's disease is a systemic vasculitis of unknown aetiology characteristically affecting venules. Onset is typically in young adults with recurrent oral and genital ulceration, uveitis, skin manifestations, arthritis, neurological involvement, and a tendency to thrombosis. It has a worldwide distribution but is prevalent in Japan, the Middle East, and some Mediterranean countries. International diagnostic criteria have been proposed, however diagnosis can be problematical, particularly if the typical ulcers are not obvious at presentation. Treatment is challenging, must be tailored to the pattern of organ involvement for each patient and often requires combination therapies.
Topics: Adult; Autoimmune Diseases; Behcet Syndrome; Brain Diseases; Diagnosis, Differential; Female; Genital Diseases, Female; Genital Diseases, Male; Humans; Infant; Infant, Newborn; Male; Oral Ulcer; Pregnancy; Skin Ulcer; Ulcer; Uveitis; Vasculitis; Venules
PubMed: 11009577
DOI: 10.1136/pmj.76.900.629 -
CMAJ : Canadian Medical Association... Oct 2023
Topics: Humans; Tattooing; Oral Ulcer
PubMed: 37844927
DOI: 10.1503/cmaj.230584-f -
Cancer Reports (Hoboken, N.J.) Aug 2021Oral and oropharyngeal cancer are significant health problems. They are both life-threatening conditions usually diagnosed at an advanced stage causing survival rates to... (Comparative Study)
Comparative Study
BACKGROUND
Oral and oropharyngeal cancer are significant health problems. They are both life-threatening conditions usually diagnosed at an advanced stage causing survival rates to decline.
AIM
To assess and compare practices, knowledge and attitude regarding oral and oropharyngeal cancer between dental and medical practitioners.
METHODS
A cross-sectional study was conducted to assess knowledge, attitude and practices of oral and oropharyngeal cancer among dental and medical practitioners at King Abdulaziz Medical City, Riyadh, Saudi Arabia. 360 participants were included in the study using a convenient sampling technique. Participants were approached in their clinics and printed self-administered questionnaire were handed over to them after signing a written consent form. Frequency distribution and Chi-Square test were used for the statistical analysis and the level of significance was set at P value of .05 or less.
RESULTS
A total of 174 participants responded. Assessment of oral and oropharyngeal cancer knowledge between dental practitioners and medical practitioners showed comparable results. Regarding practices, a significant difference was seen between medical practitioners and dental practitioners in determining the duration of intra-oral ulcer to consider urgent referral (P = .006) and in number of referrals made in relation to suspicious oral lesions (P = .002). Moreover, a significant difference (P = .006) was seen between medical practitioners and dental practitioners in determining the duration of intra-oral ulcer to consider urgent referral.
CONCLUSION
Medical and dental practitioners showed areas of differences in practice, attitude and knowledge of oral and oropharyngeal cancer that when addressed would lead to improved survival rates.
Topics: Clinical Competence; Cross-Sectional Studies; Dentists; Early Detection of Cancer; Female; General Practitioners; Humans; Male; Mouth Neoplasms; Neoplasm Staging; Oral Ulcer; Oropharyngeal Neoplasms; Referral and Consultation; Risk Factors; Saudi Arabia; Survival Rate
PubMed: 33660423
DOI: 10.1002/cnr2.1349 -
Journal of Oral Pathology & Medicine :... Aug 2022Oral erythroplakia has been classically considered as the potentially malignant disorder with the highest rate of malignant development into squamous cell carcinoma.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Oral erythroplakia has been classically considered as the potentially malignant disorder with the highest rate of malignant development into squamous cell carcinoma. This critical systematic review and meta-analysis aim to estimate the malignant development rate of oral erythroplakia and identify the associated risk factors.
METHODS
We performed a bibliographic search in PubMed, Scopus, Web of Science, Embase, and LILACS, with keywords "erythroplakia," "erythroplasia," "malignant transformation," "malignant development," "malignization," "carcinogenesis," "oral cancer," "oral squamous cell carcinoma," "mouth neoplasm," and "prognosis." Meta-analysis was conducted using a random-effects model.
RESULTS
Ten observational studies with 441 patients met the inclusion criteria, whose mean malignant development rate was 12.7% and with a mean follow-up period of patients of 6.66 years. In the initial biopsy, 42.8% of oral erythroplakia were already squamous cell carcinoma. The buccal mucosa was the most frequent location of oral erythroplakia, but the floor of the mouth was the most common site of malignant development. All patients who underwent malignant development showed epithelial dysplasia on the initial diagnostic biopsy.
CONCLUSION
Overall malignant development rate of OE in the meta-analysis was 19.9%. We could not associate any specific clinicopathological feature with the malignant development. The presence of epithelial dysplasia in the initial biopsy remains the worst prognostic factor. Further observational studies on OE are needed, with well-established diagnostic criteria and good clinical follow-up, in order to identify the true risk of malignant development of oral erythroplakia and the related risk factors.
Topics: Carcinoma in Situ; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Erythroplasia; Humans; Leukoplakia, Oral; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Oral Ulcer; Precancerous Conditions
PubMed: 35488780
DOI: 10.1111/jop.13304 -
Swiss Dental Journal 2017Pyostomatitis vegetans is a disease of the gingiva and the oral mucosa with noticeable, uncommon morphology. Clinical characteristics of this rare disease and...
Pyostomatitis vegetans is a disease of the gingiva and the oral mucosa with noticeable, uncommon morphology. Clinical characteristics of this rare disease and considerations regarding differential diagnosis are described. Pyostomatitis vegetans is frequently associated with chronic inflammatory bowel diseases and can, thus, give a diagnostic hint at an existing ulcerative colitis or Crohns disease. A therapy plan for pyostomatitis vegetans is presented, which led to remission using local treatment only. The follow-up examination after one year showed that the treatment outcome had remained stable. An unexpected clinical appearance of the gingiva with small, pale pink thickenings after therapy and at follow-up is portrayed.
Topics: Abscess; Administration, Topical; Adult; Betamethasone Valerate; Colitis; Diagnosis, Differential; Drug Therapy, Combination; Eosinophils; Gingivitis; Humans; Intestinal Mucosa; Male; Mouth Mucosa; Oral Ulcer; Plasma Cells; Stomatitis; Tacrolimus
PubMed: 28639684
DOI: No ID Found -
Head and Neck Pathology Dec 2017Pyoderma gangrenosum (PG) is a distinctive ulcerative skin disorder of unknown etiology, associated with an underlying systemic disease in up to 70% of cases. The... (Review)
Review
Pyoderma gangrenosum (PG) is a distinctive ulcerative skin disorder of unknown etiology, associated with an underlying systemic disease in up to 70% of cases. The condition is characterized by the appearance of one or more necrotic ulcers with a ragged undermined violaceous border and surrounding erythema. Lesions are often initiated by minor trauma. The condition can affect any anatomical site, however the head and neck are rarely involved. Although the oral cavity is subject to recurrent minor trauma through everyday activities such as mastication and oral hygiene, as well as during dental treatment, oral lesions appear to be extremely rare. In an effort to provide a detailed explanation of the oral manifestations of PG, a systematic search was conducted using medical databases. A total of 20 cases of PG with oral involvement were reported in the English and French literature. The objectives of this article are to present the pertinent diagnostic criteria and to discuss the differential diagnosis and therapeutic modalities.
Topics: Diagnosis, Differential; Humans; Oral Ulcer; Pyoderma Gangrenosum
PubMed: 28275955
DOI: 10.1007/s12105-017-0804-3