Dental public health

Dental public health is concerned with preventing oral disease, promoting oral health, and improving the quality of life through the organized efforts of society. Oral diseases including dental caries, periodontal disease, oral neoplasms, and dentofacial trauma are common, have a significant impact on individuals and wider society, and are largely preventable. While the prevalence and severity of these most common and costly dental diseases have fallen in most developed countries, oral health inequalities exist in relation to socioeconomic status, ethnicity, or region. The links between oral and general health indicate that strategies to improve both sets of problems and reduce inequalities should be integrated within the framework advocated by the Commission for the Social Determinants of Health. Of particular relevance to oral health are increasing the availability of fluoride and ensuring universal access to quality dental services. Factors influencing oral health in the future include tighter financial pressures, changes in disease prevalence, the deprofessionalization of dentistry, the role of consumerism in oral health, and the need for a better evidence base.

Ultrasound-guided FNA Efficiency in Diagnosing of Metastatic Nodes of Oral Squamous Cell Carcinoma; Article Review

Oral cancer comprises a group of neoplasms affecting any fields of the oral cavity, pharyngeal regions and salivary glands. However, this term tends to be used interchangeably with oral squamous cell carcinoma (OSCC), which represents the most common of all oral neoplasms. It is estimated that more than 90% of all oral neoplasms are OSCC. Oral SCC prefers to spread through the lymphatic system than the bloodstream, and in this region tongue tumors have the greatest potential for neck metastases.Primary tumor’s histopathologic features like depth of invasion, thickness, growth pattern, differentiation, lymphovascular or vascular invasion have a limited prognostic value for nodal disease. cervical lymph node status accurate assessment in HNSCC patients is critical issue because of its influences on prognosis and treatment decisions, USgFNAC proved widely accepted not only because of safety and availability in diagnosis but also it is repeatable, minimally invasive and cost-effectiveness.

Immunohistochemical evaluation of suspected oral malignant melanoma in cats

Oral malignant melanoma (OMM) is considered the third most common oral malignant neoplasm in cats, but its variable morphology and frequent lack of melanin pigment make it a diagnostic challenge. Twenty-two cases of cats with malignant oral neoplasms that were diagnosed as OMM or listed OMM as a suspected differential diagnosis on the biopsy report were examined using an immunohistochemistry (IHC) panel for S100, melan-A, PNL2, laminin, CD34, and pan-cytokeratin. Although OMM was suspected ( n = 14) or previously diagnosed ( n = 8), only 2 cases were immunohistochemically confirmed as OMM. Seven cases were classified as soft tissue sarcoma based on positive expression of CD34 or laminin, and one was classified as carcinoma based on positive expression of pan-cytokeratin. The majority of cases ( n = 12) were categorized as unclassified malignant neoplasms because they did not express melan-A, PNL2, laminin, CD34, or pan-cytokeratin; however, a proportion of these did express S100 ( n = 7). Long-term prognosis of all 22 cats was poor, with a median survival time of 87 days (range = 2–249 days). Cases with longer survival times (>100 days) were treated with surgery, radiation therapy, or a combination. For feline oral malignant neoplasms thought to be OMM, routine use of IHC is required for an accurate diagnosis.

Only a Plate? Nine-Year Follow-Up After Partial Mandibulectomy and Reconstruction With Titanium Plate

Background: Oral squamous cell carcinoma is the main malignancy of the oral cavity; floor of the mouth and the lateral border of the tongue being the most affected sites. This kind of oral neoplasms may require mandibular resection and reconstruction. Treatment options for such mandibular defects include bone grafts, free flaps, and reconstruction plates. Today, the commonly used treatment method is vascularized fibula flaps due to its many advantages when compared to other methods. However, it is a complex procedure and demands much of both practitioners and the patient. Case Presentation: In this report, we present a case of oral squamous cell carcinoma of the gingiva of the mandible which was treated with a partial mandibulectomy and resection. Because of the patients age and fragility an immediate mandibular reconstruction with a pre-shaped reconstruction plate, without hard or soft tissue transfer, was performed. Yearly controls showed pleasing results both aesthetically and functionally and the patient showed no plate-related complications up until the patient’s death, 9 years later. Conclusion: With this case, we would like to illustrate that using reconstruction plates only may be a viable option in selected cases for continuity defects of the mandible, specifically in fragile patients less suitable for more demanding surgical interventions.

Occurrence of oral neoplasms and dysplastic lesions: retrospective study of a pathology service over a 19-years period

INTRODUCTION: The epidemiological survey of the maxillofacial pathologies is of fundamental importance to prevention and treatment of these lesions. OBJECTIVE: The aim of the present study was to collect and analyze histopathological reports of biopsies sent to the Pathology Department, School of Dentistry from EBMSP. METHODS: A retrospective study of biopsies realized from 2001 to 2019 was conducted and the diagnoses of oral neoplasms and epithelial dysplasias were collected and analyzed. Data related to sex and age of the patients, location of the lesions, and clinical and histopathological diagnosis were recovered. RESULTS: From the total of 3.068 biopsies received in this period, the oral neoplasms corresponded to 7,31% of this total. Patients of the female sex (55,3%) and individuals between 25 and 64 years of age (60,3%) were most affected by neoplasms. The most common diagnosis among benign neoplasms was the ameloblastoma (20,3%) and the squamous cells carcinoma (67,2%) was the most frequent diagnosis in the group of malignant neoplasms. The anatomical location most affected by the neoplasms was the jaw (36,7%). The epithelial dysplasias corresponded to 3,8% of the sample, with a higher occurrence in the male sex (50,8%) and the age group between 25 and 64 years (61%); the anatomical location most affected was the palate (22,8%), and the mild epithelial dysplasia (68,6%) was the most common diagnosis. CONCLUSION: The present study highlights the importance of the epidemiological surveys to prevention and treatment of the maxillofacial lesions and emphasizes the necessity of the appropriate filling out of biopsies files.

Mandibular Metastasis of a Recurrent Poorly Differentiated Urothelial Bladder Carcinoma

Metastatic lesions to the oral cavity are uncommon; they represent between 1 and 3% of all malignant oral neoplasms. In this article, we report a rare case of metastatic urothelial bladder carcinoma in the mandible detected on oral radiographic images and confirmed with multiple imaging modalities. A 67-year-old woman presented to our clinic suffering from pain in the right side of the mandible with a mild swelling. Panoramic radiograph revealed an ill-defined relatively radiolucent lesion in the right mandibular premolar-canine region presenting with permeative changes. Cone-beam computed tomography showed a relatively hypodense lesion with demineralization, interruption of the buccal cortices, and slight thickening and sclerosis of the buccal cortical bone. The patient was referred for further evaluation including additional advanced imaging radiographic techniques (MRI and PET scan) and clinical and histopathological examinations that lead to a final diagnosis of metastatic lesion from an underlying urothelial bladder carcinoma.

Clinical profile of the patients with oral squamous cell carcinoma: a tertiary institutional study

<p class="abstract"><strong>Background:</strong> Oral cancer consists of a group of neoplasms affecting any region of the oral cavity. This term is commonly used interchangeably with oral squamous cell carcinoma (OSCC), representing the most frequent of all oral neoplasms. Factors affecting the development of the oral squamous cell carcinoma are tobacco use, alcohol consumption, low socio-economic status, poor hygiene, poor diet, viral infection like HPV, ill-fitting dentures, jagged teeth.</p><p class="abstract"><strong>Methods:</strong> An institution based retrospective observational study was conducted in the department of ENT, GMC Jammu, including the records of the patients with oral squamous cell carcinoma admitted from June 2016 to July 2019. 80 patients of oral carcinoma were included in the study.</p><p class="abstract"><strong>Results:</strong> Male to female ratio was 5.1:1. Mean age of presentation was 49.2±4.1 with most of the cases presenting in the 6^th decade. 27 (33.75%) patients had history of chewing tobacco alone, 17 (21%) had smoking with chewing tobacco and 10 (12.5 %) smoking with alcohol. 52% patients presented with growth of tongue (52%) followed by buccal mucosa (17.5%) and other sites. Histopathological grading of OSCC showed predominance of well differentiated cancer in 44 cases (55%).</p><p class="abstract"><strong>Conclusions:</strong> Cases of OSCC are increasing day by day in young generation due to increasing exposure to the risk habits which are easily accessible to them.</p>

Gingiva-derived Mesenchymal Stem Cells and Their Potential Applications in Oral and Maxillofacial Diseases

Background: Stem cells are undifferentiated cells with multilineage differentiation potential. They can be collected from bone marrow, fat, amniotic fluid, and teeth. Stem cell-based therapies have been widely used to treat multiple diseases, such as cardiac disease, and hematological disorders. The cells may also be beneficial for controlling the disease course and promoting tissue regeneration in oral and maxillofacial diseases. Oral-derived gingival mesenchymal stem cells are easy to access and the donor sites heal rapidly without a scar. Such characteristics demonstrate the beneficial role of GMSCs in oral and maxillofacial diseases. Objective: We summarize the features of GMSCs, including their self-renewal, multipotent differentiation, immunomodulation, and anti-inflammation properties. We also discuss their applications in oral and maxillofacial disease treatment and tissue regeneration. Conclusion: GMSCs are easily harvestable adult stem cells with outstanding proliferation, differentiation, and immunomodulation characteristics. A growing body of evidence indicates that GMSCs have strong potential use in accelerating wound healing and promoting the regeneration of bone defects, periodontium, oral neoplasms, salivary glands, peri-implantitis, and nerves. Moreover, alginate, polylactic acid and polycaprolactone can be used as biodegradable scaffolds for GMSC encapsulation. Various growth factors can be applied to the corresponding scaffolds to obtain the desired GMSC differentiation and phenotypes. Three-dimensional spheroid culture systems could optimize GMSC properties and improve the performance of the cells in tissue engineering. The immunomodulatory property of GMSCs in controlling oral and maxillofacial inflammation needs further research.