Tobacco smoking is a global problem associated with the occurrence of many systemic diseases and tumors. Oral cavity tumors are common tobacco-related cancers, and of all the anatomical structures that are exposed to the effects of smoking, the oral cavity remains the least-explored area. Changes that occur in the biology of oral epithelial keratinocytes under the influence of the components of tobacco smoke often go unnoticed, if they are asymptomatic. The proper functioning of the oral epithelium is determined by the proliferation and differentiation of the cells in keratinization -the process of programmed cell death, which extends through to the mechanisms of apoptosis. Due to incomplete knowledge of the impact of tobacco smoke on the biology of keratinocytes, an evaluation of the cell cycle was conducted and the apoptosis of oral epithelial keratinocytes was analyzed. The study involved 77 patients divided into four groups according to their intensity of smoking, ranging from 0 to 27 pack-years. There were no differences in the cell count between nonsmokers and smokers in the proper cell-cycle phases. The percentage of proliferating cells in the oral epithelium is about 11%. A reduction in the number of early-apoptotic cells (caspase positive/propidium iodide negative) and an increase in the number of late-apoptotic cells (caspase positive/annexin V positive/propidium iodide positive) were observed to occur with increasing pack-years. The present study demonstrates that smoking does not affect the oral keratinocyte cell cycle, but does modify the number of cells with early and late apoptotic features. An intensification of the impact of tobacco smoke components on the biology of the oral keratinocytes is clearly noticeable at approximately 6 pack-years. This indicates that the biology of the first organ exposed to tobacco smoke -the oral epithelium -is altered by tobacco smoking.
IntroductionDirect oral microscopy is a novel, non-invasive diagnostic technique that aids clinical examination of the oral cavity. The basic principles of this method derive from colposcopy and dermoscopy. The principle is to reveal precancerous lesions of oral mucosae in their subclinical phase in order to begin their treatment as early as possible and prevent malignant transformation. Oral lichen planus (OLP) is an autoimmune, inflammatory, chronic disease affecting oral mucous membranes. Buccal mucosae are most often affected.AimTo describe the in vivo picture of erosive OLP in direct oral microscopy in terms of the pattern and density of subepithelial blood vessels, surface texture, color, transparency and borders of the lesions. The study also demonstrates the utility of the method in the selection of the most appropriate biopsy site.Material and methodsA total of 30 patients with erosive OLP were examined. Clinical examination of the oral cavity with the naked eye was performed, followed by direct oral microscopy. The most appropriate biopsy sites based on both examinations were chosen for every individual and biopsies were taken for histopathological evaluation.ResultsBiopsies obtained based on direct oral microscopy revealed dysplasia in 16 patients (53.3%). Biopsies obtained based on clinical examination with the naked eye revealed dysplasia in 3 cases (10%).ConclusionsDirect oral microscopy makes it possible to obtain a repeated picture of erosive OLP and constitutes an alternative to the clinical examination with the naked eye in election of the most appropriate biopsy site. Thus, introduction of the most accurate and early therapy is possible.
A Ad dd dr re es ss s f fo or r c co or rr re es sp po on nd de en nc ce e: : Piotr Chomik DDS, Department of Oral and Maxillofacial Surgery, Medical University of Gdansk, 7 Smoluchowskiego St, Poland, phone Case report A b s t r a c tThe investigators wish to discuss the diagnostic difficulties, histology and immunohistochemical profile of a solitary fibrous tumor (SFT) based on the presented case, as well as previously reported cases within the oral cavity. A young woman was referred to the Department of Maxillofacial Surgery, Medical University of Gdansk, Poland, due to a considerable palpable mass within the hard palate. Pain and discomfort caused by the tumor's location were the main complaints. A clinical examination revealed a tumor of the right hard palate along the alveolar crest, measuring approximately 5 cm × 3 cm. Panoramic X-ray depicted a bone defect of the alveolar crest around tooth 17. Histological and immunohistochemical evaluation of the biopsy specimen and resected tumor established the diagnosis of SFT. This rare spindle cell neoplasm of mesenchymal origin is typical of serosal sites and approximately 80 cases within the head and neck region have been reported so far. The hard palate is one of the least frequent locations. Approximately 5-20% of lesions may present features of aggressiveness. The authors wish to emphasize that the diagnosis of SFT is challenging due to a relatively small number of cases reported in the literature, uncertain etiology of the tumor, as well as clinical and histological similarity to other, more frequently occurring benign neoplasms of mesenchymal origin, i.e. hemangiopericytoma, myofibroblastoma, schwannoma, neurofibroma, leiomyoma, as well as inflammatory disorders, especially nodular fasciitis. Radical excision of the tumor is mandatory for effective treatment due to the possibility of recurrence and malignant transformation after subradical resection.K Ke ey y w wo or rd ds s: : solitary fibrous tumor, oral cavity, hard palate, diagnosis.
IntroductionDirect oral microscopy constitutes a novel technique of in vivo oral mucosae examination. The basic principles of this method derive from colposcopy and dermoscopy. The main goal of direct oral microscopy is the earliest possible detection of oral precancerous lesions in order to implement their treatment as quickly as possible and prevent malignant transformation.AimTo establish a standard picture of healthy oral mucosae with direct oral microscopy applying standard colposcopic criteria in order to create a reference point for further diagnosis of precancerous lesions.Material and methodsThirty patients of both genders with clinically unaltered oral mucosae were examined. For every individual, clinical examination with the naked eye was performed, followed by direct oral microscopy with colposcopic assessment criteria. Oral mucosae at various sites (lip, cheek, floor of mouth, ventral and lateral sides of the tongue, alveolar ridge and soft palate) were examined.ResultsSubepithelial blood vessel patterns, mucosal surface, colour tone and transparency were described for healthy oral mucosae. Moreover, cases with clinically unaltered oral mucosae where direct oral microscopy revealed subclinical alterations were described.ConclusionsDirect oral microscopy with colposcopic assessment criteria enables establishment of a repeated picture of unaltered oral mucosae. The standard picture of healthy oral mucosae is an essential reference point for application of this technique to early diagnose potentially malignant oral mucosal lesions as well as apply their early treatment.
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