Objectives
The purpose of this retrospective observational study was to evaluate the specificity of the new oral cytodiagnostic criteria and whether the new criteria predict change to oral epithelial dysplasia (OED) and cancerization for leukoplakia and oral lichen planus (OLP).
Study design
Fifty‐three cases of leukoplakia without OED and 126 cases of OLP were included in this study. Liquid‐based cytology (LBC) was performed just before biopsy. We evaluated the specificity of the new oral cytodiagnostic criteria and the rates of change to OED and cancerization for each cytodiagnosis in leukoplakia and OLP.
Results
One hundred and seventy patients were negative for intraepithelial lesion or malignancy (NILM), seven had low‐grade squamous intraepithelial lesions (LSILs), and two were indefinite for neoplasia (IFN). The specificity was 95% and the rates of OED change and cancerization in the observation period were 3.4% and 1.7%. In leukoplakia, there was a significant difference in the rates of change to OED and cancerization between negative for intraepithelial lesion or malignancy (NILM) and LSIL (odds ratio: 12.9; 95% CI: 1.72‐96.73).
Conclusions
The new oral cytodiagnostic criteria have high specificity for oral mucosal lesions. And, it was suggested that the cases diagnosed with LSIL using new criteria have a high possibility of change to OED or cancerization in leukoplakia.
The objective of this study was to determine the effect of zoledronic acid on mandibular bone quality in osteoporotic model mice. Zoledronic acid was administered to ovariectomized mice, and mandibular bone was harvested. Polished specimens were prepared, and the biological apatite (BAp) crystal alignment and changes in collagen fiber bundles in the alveolar and basal regions of the mandible were analyzed. It was found that ovariectomy increased BAp crystal alignment. The administration of zoledronic acid post-ovariectomy normalized BAp crystal alignment in the basal region of the mandible. However, BAp crystal alignment in the alveolar region decreased significantly. Ovariectomy decreased the diameters of collagen fiber bundles in both the alveolar and basal regions and significantly increased their lengths. The administration of zoledronic acid post-ovariectomy decreased both the diameters and lengths of collagen fiber bundles. These results showed that the microarchitecture of the mandibular bone changes to compensate for osteoporosis-induced loss of bone mass and adapts to the load environment resulting from mastication. Interestingly, they suggested that zoledronic acid severely reduces the bone quality of osteoporotic alveolar bone in a site-specific manner.
Bisphosphonate (BP) formulations are drugs that improve bone strength by suppressing osteoclast activation, preventing fractures of the vertebrae and the femoral head, but their side effects include osteonecrosis of the jaw (ONJ). In this case it is known as medication-related osteonecrosis of the jaw (MRONJ), and pathological and microbiological investigations have suggested that infection is one major causative factor. However, many points regarding the etiology of ONJ and its causative factors remain unclear. In this study, we administered BP to model mice and exposed their jaws to bacterial infection to produce a mouse model of BRONJ, and analyzed their bone structure, including an analysis of the quality of bone surrounding extraction cavities. We found that mice not exposed to bacterial infection did not develop ONJ, and that those mice exposed to bacterial infection that did develop ONJ exhibited abnormal collagen fiber arrangement and poor bioapatite crystal alignment. An analysis of areas of bone surrounding poorly healed extraction cavities also revealed that its quality was poor. These results showed that although BP use increases bone mineral density, it reduces the alignment of collagen fibers and decreases bone quality. Zoledronate (Zol) alone resulted in epithelial healing, but reduced bone quality. In addition, it was suggested that bacterial infection could develop into a condition similar to BRONJ.
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