Relationship between Tumor Diameters and Antoni Classification for Schwannoma of the Lower Lip.

Schwannoma is an uncommon benign tumor in the oral and maxillofacial region, and development of schwannoma in the lower lip is rare. Herein, we present the case of a 68-year-old woman who visited Nihon University Itabashi Hospital complaining of a painless mass in the lower lip. The lesion was surgically resected under local anesthesia. On histopathological examination, the resected specimen was a mixture of Antoni types A and B schwannoma. No recurrence has been seen over a postoperative follow-up period of 58 months. In the schwannoma of the lower lip, the mean tumor volume was compared for type A and the mixed type, which tended to be larger in the mixed type. No previous reports have described the relationship between the size of schwannoma in the lower lip and Antoni classification. Therefore, this report discusses the possibility of a relationship between tumor size and Antoni classification for schwannomas in the lower lip.

A combination of phototherapy modalities for extensive lip lesions in a patient with SARS-CoV-2 infection.

Many oral signs and symptoms related to the novel coronavirus disease (COVID-19) have been reported; however, both prevalence and etiology are still undetermined. Since the clinical features of the oral lesions seen in COVID-19 are highly heterogeneous and the treatments differ considerably in the literature, the present study aimed to report a clinical case in which a combination of antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) was used for extensive lip lesions in a patient suffering from COVID-19. Within 4 days and without any systemic drug administration, after two sessions of aPDT and one session of PBMT, the lip lesions were completely healed, and the patient recovered her orofacial functions satisfactorily. According to the current case report and taking into consideration the evident lack of information about many aspects of COVID-19 infection, this combination of phototherapy modalities seems to be a promising tool for managing COVID-19-related lip lesions; however, more studies are necessary.

Hyaluronic acid and platelet-rich plasma, a new therapeutic alternative for scleroderma patients: a prospective open-label study.

BACKGROUND: Systemic sclerosis is a systemic connective tissue disease characterized by endothelium damage, fibrosis, and subsequent atrophy of the skin. Perioral fibrosis produces a characteristic microstomia together with microcheilia, both of which cause severe difficulties and affects patients' daily life, such as eating and oral hygiene. Since there are no effective and specific therapies, we have aimed at evaluating the response to filler injections of hyaluronic acid together with platelet-rich plasma. METHODS: Ten female patients aged between 18 and 70 were included in this study. Each patient was treated with three filler injections of hyaluronic acid and platelet-rich plasma at an interval of 15 to 20 days. Follow-up check-ups were recorded 1, 3, and 24 months after the end of the treatment. During the therapy and the subsequent follow-up, we evaluated the mouth's opening, freedom of movement of the lips, and skin elasticity. RESULTS: After the treatment, patients had achieved good results already after the first injection and the improvement was maintained in the following months, up to 2 years. In particular, 8 (80%) patients showed a greater mouth's opening and increased upper lip's thickness during 1-month follow-up and maintained these results after 2 years (maximum mouth's opening T0 47.61; T3 49.23; T4 48.60 p <  0.0001. Upper lip's thickness T0 4.20; T3 4.75; T4 4.45 p <  0.0001). Moreover, distance between upper and lower incisors (T0 27.05; T3 29.03; T4 28.14 p < 0.0001), inter-commissural distance (T0 49.12; T3 51.44; T4 50.31: p < 0.0001), and lower lip's thickness (T0 3.80; T3 4.85, 5.10; T4 4.25; p < 0.0001) were increased in all of patients in 1-month follow-up, keeping these benefits after 24 months and having a significant increase of skin elasticity 1 month after the end of therapy. CONCLUSIONS: Our study demonstrates that filler injections of hyaluronic acid and platelet-rich plasma represent an efficient local therapeutic alternative for patients affected by scleroderma. The treatment has significantly improved patients' quality of living.

Oral exfoliative cytology and corrosion of metal piercings. Tissue implications.

OBJECTIVES: A group of adolescents with oral piercings was studied to determine the presence of metallic particles in cells exfoliated from the mucosa surrounding their metal oral piercings and the association between such particles and the metal jewelry, and to evaluate subsequent tissue implications. MATERIALS AND METHODS: Sixteen teenage patients who had tongue and/or lip piercings were included. The clinical features of the oral mucosa and lip skin were evaluated. Exfoliative cytology was performed in the area surrounding the piercing. The surface of used and unused jewelry was studied by scanning electron microscopy and energy dispersive X-ray analysis. RESULTS: Hyperplastic, leukoedematous, and lichenoid lesions were observed in the mucosa, as well as lesions associated with metallosis of the lip skin. Cytological smears showed the presence of particles inside the epithelial cells; the particles were found to contain aluminum, tungsten, and molybdenum. In one case requiring surgical removal of the piercing, histological examination of the tissue associated with the piece of jewelry showed the presence particles containing aluminum, iron, and tin inside multinucleated giant cells. Although surface finish defects were observed on both unused and used piercing jewelry, they were more evident on the used pieces. CONCLUSIONS: Ion particles are released from the metal piercings and could have been adjuvant factors in the development of the observed lesions. Cells exfoliated from the oral mucosa surrounding metal piercings may serve as bioindicators of corrosion processes. CLINICAL RELEVANCE: We propose the use of exfoliative cytology to monitor corrosion processes and for routine clinical follow up.

Successful treatment of isolated oral lichen planus on lower lip with traditional Chinese medicine and topical wet dressing: A case report.

RATIONALE: Biopsy is very important for the diagnosis of oral lichen planus (OLP) on the lips. Traditional Chinese medicine (TCM) can be used to coordinate the whole body, soften and eliminate swellings and masses, and regulate the functions of qi and blood. Therefore, TCM could be an effective and safe treatment for OLP. Wet dressing is particularly important for the treatment of lip diseases. We report on a rare case of OLP on the lower lip. PATIENT CONCERNS: A 38-year-old female patient presenting with a history of recurrent erosion, bleeding, and pain on her lower lip for 10 years. DIAGNOSES: Erosive OLP of the lower lip. INTERVENTIONS: The patient was treated for 4 months using TCM comprising "Qingwen Jiedu Kouyankang granules," total Paeonia glucosides, and a combination of hormones and anti-inflammatory agents applied locally using a wet dressing. OUTCOMES: Lip erosion was improved remarkably after 1 month, and there was no recurrence or aggravation of the condition. The duration of the follow-up period was 5 months. LESSONS: The therapeutics used here were effective and safe for the treatment of OLP and could improve the quality of life in patients with lip erosion. The therapeutics provide new insight into the treatment of OLP on the lip.

Melkersson-Rosenthal Syndrome: A Case Report With a Psychosomatic Perspective.

Context • The Melkersson-Rosenthal syndrome (MRS) is a rare condition characterized by a triad of symptoms: (1) recurrent and/or persistent orofacial swelling, (2) recurrent facial paralysis, and (3) a fissured tongue. Although various contributing factors have been suggested, the etiology and mechanisms of the syndrome have not been fully elucidated. Objective • The aim of the current study was to examine for the first time some psychosomatic aspects of the syndrome and to evaluate the benefits of a brief psychotherapeutic process in which the research team worked to reintegrate the complex bio-psycho-social functioning of the patient. Design • The research team performed a case study. Setting • The study took place at the outpatient clinic for psychiatric services of the Alto Minho Local Health Unit (Viana do Castelo, Portugal). Participant • The participant was a 26-y-old woman suffering from MRS who received services at the clinic for depression. Her clinical history revealed that significant life events had acted as triggers for her syndrome, both at the start and during several exacerbations of her symptoms. Intervention • The intervention consisted of 15 weekly sessions focused on insight promotion. Outcome Measures • The case study measured changes in the patient's condition through her verbal self-reports about her physical and mental state, and the research team's clinical evaluation. Results • The treatment allowed remission of her depression and diminished the frequency of her relapses of MRS. Conclusions • The current case study offers the first report that describes how significant affective phenomena can act as triggers in the MRS. It also opens the possibility of providing psychiatric and psychological therapeutic interventions to help prevent relapses and exacerbations of that syndrome.

The effect of hippophae rhamnoides extract on oral mucositis induced in rats with methotrexate.

OBJECTIVE:: To investigate the effect of HRE (Hippophae rhamnoides extract) on oral mucositis induced in rats with MTX. MATERIAL AND METHODS:: Experimental animals were divided into groups as healthy (HG), HRE+MTX (HMTX), and control group, which received MTX (MTXC). HMTX group received 50 mg/kg HRE while MTXC and HG groups received equivolume distilled water with gavage once a day. After one hour of HRE and distilled water administration, HMTX and MTXC groups received a single dose of oral MTX 5 mg/ kg. This procedure was repeated for one month. RESULTS:: The levels of MDA, IL-1ß, and TNF-α were found to be significantly higher in the cheek, lower lip, and tongue tissue of the animals receiving MTX, compared with HG and HMTX groups; however, these parameters were lower in the cheek and low lip tissue, and a milder damage ocurred in these tissues, compared with the tongue tissue in MTXC group. No histopathologic damage was observed in the cheek, lower lip, and tongue tissues of the rats treated with HRE. CONCLUSION:: This findings indicate that HRE as a natural product is an important advantage compared with synthetic drugs for prophylaxis of oral mucositis developed due to MTX.

The effect of hippophae rhamnoides extract on oral mucositis induced in rats with methotrexate

ABSTRACT Objective: To investigate the effect of HRE (Hippophae rhamnoides extract) on oral mucositis induced in rats with MTX. Material and Methods: Experimental animals were divided into groups as healthy (HG), HRE+MTX (HMTX), and control group, which received MTX (MTXC). HMTX group received 50 mg/kg HRE while MTXC and HG groups received equivolume distilled water with gavage once a day. After one hour of HRE and distilled water administration, HMTX and MTXC groups received a single dose of oral MTX 5 mg/ kg. This procedure was repeated for one month. Results: The levels of MDA, IL-1β, and TNF-α were found to be significantly higher in the cheek, lower lip, and tongue tissue of the animals receiving MTX, compared with HG and HMTX groups; however, these parameters were lower in the cheek and low lip tissue, and a milder damage ocurred in these tissues, compared with the tongue tissue in MTXC group. No histopathologic damage was observed in the cheek, lower lip, and tongue tissues of the rats treated with HRE. Conclusion: This findings indicate that HRE as a natural product is an important advantage compared with synthetic drugs for prophylaxis of oral mucositis developed due to MTX.

Lábio duplo bilabial / Bilabial double lip

O lábio duplo é uma entidade rara, com poucos relatos, que geralmente afeta o lábio superior, sendo de fácil diagnóstico clínico. Pode ter origem congênita ou adquirida. O tratamento cirúrgico é indicado por queixa estética ou funcional, de simples execução. Este relato refere-se a um caso de lábio duplo bilabial em paciente do sexo masculino de 14 anos, em que foi realizada correção cirúrgica por motivação estética do paciente, com ótimo resultado dos pontos de vista estético e funcional.

There are few published reports on double lip, a rare entity that usually affects the upper lip, and that is easily diagnosed clinically. It may be congenital or acquired. Surgical treatment is indicated for aesthetic or functional complaints, and is simple to implement. This report describes a case of bilabial double lip in a 14-year-old male patient, in whom surgical correction was carried out for aesthetic reasons, with excellent aesthetic and functional results.

[An infant with yellow spots in the mouth]. / Een zuigeling met gele plekjes in de mond.

A 3-days-old infant was seen with jaundice and yellow spots in the oral mucosa . The jaundice was treated with phototherapy, after which the lesions became white. The spots appeared on the mucosa of the lower lip; their diameter was approximately 1 mm. The diagnosis Fordyce's spots was made.

Treatment of skeletal class II division 1 malocclusion with mandibular deficiency using myofunctional appliances in growing individuals.

Class II division 1 malocclusion is the most common malocclusion seen in day-to-day practice. The majority of the patients with class II division 1 malocclusions have the presence of underlying skeletal discrepancy between maxilla and mandible. The treatment of skeletal class II division 1 depends upon the age of the patient, growth potential, severity of malocclusion, and compliance of patient with treatment. Myofunctional appliance can be successfully used to treat growing patients with class II division 1 malocclusion having retrusive mandible. This article presents a discussion on treatment of class II division 1 due to mandibular deficiency with growth modification approach using myofunctional appliances and a series of three case reports of treatment of skeletal class II division 1 malocclusion using myofunctional appliance followed by fixed mechanotherapy.

High-power diode laser use on Fordyce granule excision: a case report.

BACKGROUND: Fordyce granules are conventionally considered to be a developmental oral lesion with a higher incidence in men. OBJECTIVE: To report a clinical case of surgical lip Fordyce granule excision in a 19-year-old male. METHODS: Fordyce granules were excised using a high-power diode laser (gallium arsenide [GaAs], Diode Vision®, MDL, 10 Dental Laser Unit, GmbH, Lower Saxony, Germany) with wavelength emission at 980 ± 10 nm, in a continuous wave mode, pulse width of 0.5 µs, fiber optic delivery system of 400 µm in diameter, at 2.5 W. Subsequently, low-intensity laser therapy was applied (gallium-aluminum-arsenide [GaAlAs], at 670 nm, 50 mW, at 4 J/cm(2); Dentoflex®, São Paulo, Brazil] in order to stimulate a faster wound tissue-healing process and less postoperative pain and inflammation. CONCLUSION: The excellent esthetic result demonstrated the effectiveness of both high- and low-intensity laser therapy on the excision of Fordyce granules.

Relapse of anterior open bites treated with orthodontic appliances with and without orofacial myofunctional therapy.

INTRODUCTION: Closure and long-term retention of anterior open bites are significant concerns for orthodontists and their patients. In this study, we investigated the efficacy of orofacial myofunctional therapy (OMT) for maintaining closure of open bites in conjunction with orthodontic treatment. METHODS: The sample included 76 subjects with dental anterior open bites referred for OMT before, during, or after relapse of orthodontic treatment. The experimental cohort consisted of 27 subjects who received OMT and orthodontic treatment or retreatment. The control cohort comprised 49 subjects who had a history of orthodontic treatment with open-bite relapse. Overbite was evaluated by an OMT professional or orthodontist 2 months to 23 years after removal of the fixed appliances. Measurements were compared with t tests. RESULTS: Overbite relapse means were 0.5 mm (range, 0.0-4.0 mm) in the experimental group and 3.4 mm (range, 1.0-7.0 mm) in the control group, a difference that was clinically and statistically significant (P <0.0001). CONCLUSIONS: This study demonstrated that OMT in conjunction with orthodontic treatment was highly effective in maintaining closure of anterior open bites compared with orthodontic treatment alone.

Surgical correction and MR imaging of double lip in Ascher syndrome: record of a case and a review of the literature.

A double-lip is an infrequent anomaly which may occur either isolated or as a component of Ascher's syndrome. Apart from a deformity that may interfere with speech and mastication, surgery may be indicated for cosmetic reasons. We present a case of a male patient with an acquired double lip and blepharochalasis. In order to make the differential diagnosis a magnetic resonance imaging (MRI) was performed. The mass was removed by a transverse elliptical incision under local anesthesia. No post-operative problems occurred and the cosmetic result was good.

Erupción de pápulas foliculares y comedones localizados en el abdomen y en el labio superior / Eruption of follicular papules and comedones localizad on the abdomen and upper lip

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Perioral soft-tissue rejuvenation techniques to enhance esthetic restorative dentistry.

Every practitioner has the obligation to offer his or her patients the latest advances in their profession. Dentistry has made a shift over the past 50 years from caries restoration and prosthetic replacement to preventative and esthetic rejuvenation. Related dental specialties have also blossomed with new procedures and an expanded scope of practice. This shift has also included more comprehensive care and treatment of the oral and maxillofacial region. Modern esthetic dentists realize the facial soft tissues serve as a frame for their restorative artwork. Contemporary oral and maxillofacial surgery includes cosmetic facial surgery. Procedures for such surgery are taught in oral and maxillofacial surgery residency programs, are part of the oral and maxillofacial surgery board exams, and are covered by oral and maxillofacial surgery malpractice companies. Esthetic dentists should understand facial aging, as well as the basic procedures available for facial rejuvenation by the oral and maxillofacial surgeon. Contemporary esthetic dentistry goes beyond the oral cavity, and the smile is truly enhanced by simultaneous facial rejuvenation. This article discusses the process of perioral facial aging and various cosmetic facial surgery options.

Carcinoma de células de Merkel de labio / Merkel Cell Carcinoma of the Lip

Paciente de 83 años, insuficiente renal crónica en hemodiálisis que consultó por lesión tumoral, bilobulada, ulcerada de un año de evolución en labio inferior, la cual fue extirpada. La histopatología demostró nidos tumorales epiteliales con atipía, alto índice mitótico y focos necróticos.El estudio inmunohistoquímico fue positivo para neuroenolasa específica y neurofilamentos, compatible con el diagnóstico de Carcinoma de Células de Merkel. El paciente rechazó otras terapias coadyuvantes y falleció un año después por descompensación de su estado de base.Se presenta una revisión bibliográfica de esta infrecuente patología con sólo 13 casos publicados en la literatura médica. (AU)

Suspected hypovitaminosis A in a colony of captive green anoles (Anolis carolinensis).

In a colony of 18 green anoles (Anolis carolinensis), 3 animals experienced focally thickened lips, ulcerative cheilitis, lethargy, depression, and weight loss over a 5-month period. In addition to crickets fed fresh fruit and leafy green vegetables, the diet of the green anoles consisted of a supply of mealworms that had been dusted with a commercial liquid vitamin supplement. The history, clinical findings, and histopathologic lesions were suggestive of hypovitaminosis A, which is known to cause squamous metaplasia of the mucus secreting glands and epithelial surfaces in many species.