As the field of oral pathology has evolved, the nomenclature and classification of oral mucosal diseases with a remarkable risk of malignant transformation have undergone several modifications. In 2005, the World Health Organization (WHO) introduced the concept of oral potentially malignant disorders (OPMDs) as an alternative to the terms for oral precancerous lesions and precancerous conditions. In the consensus report by the WHO Collaborating Center for Oral Cancer of 2021, OPMD is defined as "any oral mucosal abnormality that is associated with a statistically increased risk of developing oral cancer."This definition encompasses a range of conditions, in-cluding oral leukoplakia, oral submucous fibrosis, proliferative verrucous leukoplakia, oral lichen planus, and other lesions. In light of the complex etiology, unclear pathogenesis, and carcinogenesis of OPMDs, early and precise diagnosis and treatment can contribute to the secondary prevention of oral cancer. For this reason, this review, which aims to provide a basis for the precise clinical diagnosis of OPMDs, was performed. Its aim was achieved by reviewing the historical evolution and research progress of the nomenclature, classification, and histopathological diagnostic criteria of OPMDs.
Humans ; Mouth Neoplasms/diagnosis* ; Precancerous Conditions/diagnosis* ; Leukoplakia, Oral/diagnosis* ; Lichen Planus, Oral/pathology* ; Oral Submucous Fibrosis/pathology* ; Mouth Mucosa/pathology* ; World Health Organization

Oral lichen planus (OLP) is a chronic and inflammatory oral mucosal disease that commonly affects middle-aged females. Most OLP cases might exhibit such symptom as pain, roughness and other discomfort, and more severe forms may show a high risk of developing oral cancer. Active preventive measure, precise diagnosis and standard therapeutic approach play a vital role in the management and prevention of OLP. This guideline is a revision on the base of trial in 2012, which mainly covers the following 8 aspects: etiology and medical records, clinical manifestations, pathological manifestations, diagnosis, differential diagnosis, laboratory examination, disease treatment and prevention, aiming at providing scientific evidence and guidance for the dental clinicians in diagnose and treatment of OLP.
Diagnosis, Differential ; Female ; Humans ; Lichen Planus, Oral/therapy* ; Middle Aged ; Mouth Neoplasms

Report of the fourth national oral health survey showed that the prevalence of gingivitis and periodontitis stayed at a high level in Chinese population and the periodontitis was the most common cause of tooth loss in Chinese adults. Therefore, the examination of periodontal health status, disease condition and risk assessment are particularly important. The Society of Periodontology of the Chinese Stomatological Association organized experts of related disciplines to formulate the standard of basic periodontal examination and evaluation during oral diagnosis and treatment, aiming to emphasize the necessity and importance of periodontal health and to improve dental clinicians' abilities in understanding, diagnosis and treatment planning of periodontal disease. As a national and professional standard, it will play an important and practically significant role in conservation of natural teeth and improvement of people's oral health in China.
Adult ; China ; Diagnosis, Oral ; Gingivitis ; Humans ; Periodontal Diseases/therapy* ; Reference Standards

Background: Oral lichen planus is an idiopathic autoimmune inflammatory condition and oral lichenoid reactions are lesions that resemble oral lichen planus clinically and histopathologically, but develop secondary to various underlying causes. Oral lichenoid reactions have been reported to be caused by contact allergy to dental materials. This study aims to describe the characteristics of patients with a clinical and/or histopathological diagnosis of oral lichen planus who underwent patch testing in Hospital Kuala Lumpur, Malaysia. Methods: This is a 5-year retrospective study of patients who had oral lichen planus and had undergone patch testing at the Department of Dermatology, Hospital Kuala Lumpur, Malaysia between January 2015 and Cecember 2019. Patch tests were performed with European Baseline Series and relevant extended series, which include dental and metal series as well as patients’ own products. Patch test results were recorded according to the International Contact Dermatitis Research Group recommendation. Results: There were 41 patients with oral lichen planus who underwent patch test. The median age was 56 (range 21 to 73) with 70.7% of patients being female. There were 29 (70.7%) patients who developed at least one positive reaction. The most frequent sensitizing allergens were nickel sulfate (34.1%), gold(I)sodium thiosulphate dihydrate (22.0%), fragrance mix I (19.5%), cobalt chloride (14.6%), Peru balsam (12.2%) and sodium tetrachloropalladate (II) hydrate (12.2%). Current relevance was recorded in 16 patients (39.0%) and of these patients, 12 of them had positive patch test reactions to allergens found in dental materials such as dental fillings, dental implants, orthodontic braces, dentures and dental crowns. Conclusion Contact sensitization was detected in about 70% of our patients with oral lichen planus. The most common sensitizing allergen was nickel sulfate. Current relevance was found mainly towards dental materials.
Lichen Planus, Oral--diagnosis ; Dermatitis, Allergic Contact ; Department of Dermatology, Hospital Kuala Lumpur (Malaysia)

The application of artificial intelligence in medicine has gradually received attention along with its development. Many studies have shown that machine learning has a wide range of applications in stomatology, especially in the clinical diagnosis and treatment of maxillofacial cysts and tumors. This article reviews the application of machine learning in maxillofacial cyst and tumor to provide a new method for the diagnosis of oral and maxillofacial diseases.
Artificial Intelligence ; Cysts/diagnosis* ; Humans ; Machine Learning ; Oral Medicine

PURPOSE: The prevalence of supernumerary teeth has been reported to be between 0.1% and 3.8%. The aim of this study was to determine the prevalence, clinical significance, and associated pathologies of fourth molars based on a retrospective study and a literature review. MATERIALS AND METHODS: A 5-year retrospective prevalence study was conducted at the Department of Oral Diagnosis and Dentomaxillofacial Radiology of Okayama University Hospital, Okayama, Japan. The study involved extracting data from the digital records of patients from January 1, 2013 through December 31, 2017. The sampling frame included all patients who had panoramic radiographs, cone-beam computed tomography (CT), and multislice CT images during the period under review. RESULTS: A total of 26,721 cases were reviewed and 87 fourth molars were identified. The prevalence of fourth molars in the 5-year study at Okayama was calculated as 0.32%. The mean age of patients with a fourth molar was 30.43 years, and the male-to-female ratio was 1:0.98. The vast majority of cases were in the maxilla (92%) and had normal shapes (89.7%); furthermore, 82.8% of cases were unerupted. CONCLUSION: The prevalence of fourth molars in the study population was found to be 0.32%, and fourth molars occurred with approximately equal frequency in males and females. Fourth molars were more common in the maxilla and were predominantly unerupted and small.
Cone-Beam Computed Tomography ; Cross-Sectional Studies ; Diagnosis, Oral ; Female ; Humans ; Japan ; Male ; Maxilla ; Odontogenic Cysts ; Odontoma ; Pathology ; Prevalence ; Retrospective Studies ; Tooth, Supernumerary

At the department of prosthodontics, the elderly patients with severely atrophied alveolar ridge who have been wearing complete dentures for a long period frequently visit the clinic. In general, the open-mouth impression technique for manufacturing a mandibular complete denture to secure primary support on buccal shelf area has been prevalent. In addition, for securing retention and stability of mandibular denture, we should consider diagnosis, oral function, denture border, occlusal plane, teeth arrangement, and patient training, etc.. But in edentulous patients with severe alveolar bone atrophy, it may hardly secure retention and stability of mandibular complete denture. To promote these, some of clinicians are making an attempt manufacturing the mandibular complete dentures using closed-mouth impression technique based on several reports that compare various impression techniques including open-mouth and closed-mouth impression technique. This case report suggests closed-mouth impression technique may promote retention and stability of mandibular complete denture and compares between the two impression techniques clinically.
Aged ; Alveolar Bone Loss ; Alveolar Process ; Dental Occlusion ; Denture, Complete ; Dentures ; Diagnosis, Oral ; Humans ; Jaw, Edentulous ; Prosthodontics ; Tooth

BACKGROUND AND OBJECTIVES: Cancer of the oral cavity is a disease of the head and neck that is difficult to treat. Periodic observation and biopsy are important for its early diagnosis once a premalignant lesion in the oral cavity is confirmed. The purpose of this study was to determine the importance of early excisional biopsy by investigating the histological features of oral leukoplakia and the rate of malignant change in the oral cavity. SUBJECTS AND METHOD: A total of 327 patients who underwent punch biopsy of oral cavity from January 2011 to December 2017 were reviewed retrospectively for the presence of initial gross lesions and for their biopsy results. The histological findings of 6 initial gross lesion groups were compared. Additional excisional biopsies were performed in the seven oral cavity subsites. RESULTS: There were 33 cases of oral leukoplakia. The punch biopsies of 3 of these cases (9.1%) showed malignancy. Additional excisional biopsies were performed in 6 cases, 4 of which were malignant (66.7%). Additional excisional biopsies of the tongue were performed in 14 cases (9.0%), 5 of which (35.7%) were malignant. The rate of atypia in leukoplakia (9.1%) was higher than in other atypia groups. Additional excisional biopsies were performed in 3 cases (100%) of atypia of leukoplakia, all of which were assessed to be malignant. CONCLUSION: For tongue leukoplakia, performing an early excisional biopsy rather than an incisional biopsy is recommendable. Moreover, additional excisional biopsies are needed when the initial biopsy is suggestive of hyperkeratosis, parakeratosis, or atypia.
Biopsy ; Early Diagnosis ; Head ; Humans ; Leukoplakia ; Leukoplakia, Oral ; Methods ; Mouth ; Neck ; Parakeratosis ; Retrospective Studies ; Tongue

Central odontogenic fibroma (COF) is defined as a fibroblastic odontogenic tumor characterized by varying density of the tooth epithelium. It is an extremely rare benign neoplasm that occurs in the maxilla and the mandible; only a few reports of COF are available in the literature. Diagnosis of the lesion based only on the radiological features of COF is difficult due to variation in the findings regarding this condition. This report describes 2 clinical cases of middle-aged women with COF. Clinical examination revealed palatal mucosal depression; additionally, oral examination, as well as panoramic radiographs, intraoral radiographs, and computed tomography scans, revealed severe root resorption. This report highlights the clinical and radiological imaging features of COF, with the goal of enabling straightforward differential diagnosis of the lesion by the clinician and thereby appropriate treatment of the patient.
Depression ; Diagnosis ; Diagnosis, Differential ; Diagnosis, Oral ; Epithelium ; Female ; Fibroblasts ; Fibroma ; Humans ; Mandible ; Maxilla ; Odontogenic Tumors ; Root Resorption ; Tooth

Clear cell odontogenic carcinoma (CCOC), a rare tumor in the head and neck region, displays comparable properties with other tumors clinically and pathologically. In consequence, an incorrect diagnosis may be established. A 51-year-old male patient who was admitted to the Department of Oral and Maxillofacial Surgery at Pusan National University Dental Hospital was initially diagnosed with ameloblastoma via incisional biopsy. However, the excised mass of the patient was observed to manifest histopathological characteristics of ameloblastic carcinoma. The lesion was ultimately diagnosed as clear cell odontogenic carcinoma by the Department of Oral Pathology of Pusan National Dental University. Therefore, segmental mandibulectomy and bilateral neck dissection were performed, followed by reconstruction with fibula free flap and reconstruction plate. Concomitant chemotherapy radiotherapy was not necessary. The patient has been followed up, and no recurrence has occurred 6 months after surgery.
Ameloblastoma ; Ameloblasts ; Biopsy ; Busan ; Diagnosis ; Diagnostic Errors ; Drug Therapy ; Fibula ; Free Tissue Flaps ; Head ; Humans ; Male ; Mandibular Osteotomy ; Middle Aged ; Neck ; Neck Dissection ; Pathology, Oral ; Radiotherapy ; Recurrence ; Surgery, Oral