The Impact of a Pandemic on a Military Oral and Maxillofacial Pathology Biopsy Service.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) and the resulting societal reaction presented new challenges to the medical community by limiting patient access to care in 2020 and 2021. The Navy Postgraduate Dental School (NPDS) oral and maxillofacial pathology biopsy service is dependent on in-office physician or dentist appointments and patient biopsies. The purpose of this study was to understand the regulatory and societal impacts of COVID-19 restrictions on biopsy service submissions by assessing NPDS biopsy submission quantities and disease distribution. MATERIALS AND METHODS: All NPDS oral and maxillofacial pathology biopsy submissions from calendar years 2015 to 2016 and 2019 to 2021 were evaluated, and patient demographics and biopsy diagnoses were recorded in a biopsy registry. Data collected included age, sex, biopsy site, and diagnosis. Data from 2015, 2016, and 2019 were defined as pre-COVID and 2020 and 2021 as COVID. Biopsy reports for each year were organized in quarters. Diagnoses were categorized as malignant, pre-malignant, or benign. Categorical and continuous data were evaluated and presented as counts with percentages and means or medians with standard deviations, respectively. Significant differences in proportions or means were assessed using chi-square analysis or Student t-test, respectively. Cases were aggregated by quarter and year and assessed for temporal trends using linear regression analysis. RESULTS: The study evaluated 9,351 biopsy submission reports. The annual pre-COVID count mean (± standard deviation) and yearly counts for 2020 and 2021 were 2,063 ± 33.3, 1,421, and 1,742, respectively. The mean (± standard deviation) percentage of diagnoses classified as malignant from pre-COVID, 2020, and 2021 were 2.46 ± 0.005%, 3.59%, and 3.04%, respectively. Case counts and representation as a percentage of all biopsy diagnoses for Human Papillomavirus (HPV)-associated squamous cell carcinoma increased significantly during COVID compared to pre-COVID years (P < .05). CONCLUSIONS: Overall, preventative COVID-19 health measures and protocols resulted in a reduction in biopsy submission frequency, particularly during the second quarter (April to June) of 2020. However, case counts for malignant biopsies remained consistent between pre-COVID and COVID time intervals, suggesting that the identification and analysis of cases requiring follow-on care were unaffected by COVID-19 protocols.

Oral and maxillofacial pathology: quality diagnostics for the present and the future.

The American Academy of Oral and Maxillofacial Pathology (AAOMP) has 619 members and 276 fellows. Oral and maxillofacial pathologists are uniquely qualified by training to combine expertise in histo-pathologic diagnosis, clinical diagnosis, and treatment. The majority of oral and maxillofacial pathologists are academicians, and optimal education of students of all types is a major focus of the specialty. Oral pathology is an important bridging specialty between dentistry and medicine, and strong links exist between it and pathology, otolaryngology, and dermatology, among others. Patient education is also important to the specialty, and information to assist patients is a critical part of the AAOMP Web site. In research and patient care, the main focus has been on oral cancer, and the specialty continues to emphasize that dentistry not lose sight of its role in combating malignancy. The organization has worked most recently to increase liaisons among both medical and dental sister organizations to improve the healthcare climate for all.

Historical perspective and nomenclature of potentially malignant or potentially premalignant oral epithelial lesions with emphasis on leukoplakia-some suggestions for modifications.

Of the potentially (pre)maligant oral epithelial lesions, leukoplakia is the most common. A brief overview of the various definitions of leukoplakia that have been used in the past is presented here. A proposal has been made to modify the current definition. Clinically, for decades, leukoplakias have been divided into homogeneous and nonhomogeneous leukoplakias and further into different subtypes. A proposal has been made to slightly rearrange these subtypes. Furthermore, attention has been paid to a number of keratotic lesions that have been reported in the literature. It is expected that the increasing knowledge on carcinogenesis, including various genetic aspects, will be reflected in the definition of oral potentially (pre)malignant lesions in the near future.

The future of oral pathology practice.

Oral and maxillofacial pathology (OMP) may be viewed as a specialty of dentistry, which addresses the diagnosis and treatment of diseases of the oral and perioral regions. Consensus definitions may be found in the accreditation standards for OMP as published by the American Dental Association, and in the Constitution and Bylaws of the American Academy of Oral and Maxillofacial Pathology (AAOMP). These sources describe roles for OMP in laboratory diagnosis (histopathology), and clinical practice. Eversole recognizes these divisions of OMP in his discussion of evidence-based practice, noting that oral medicine shares with OMP responsibilities in the care of patients with oral disease. Broadly viewed, all clinical disciplines and specialties of dentistry provide services in disease diagnosis and treatment. However, Eversole makes a distinction between the diagnostic and treatment services provided throughout dentistry, and those offered by OMP, excluding from OMP those primarily focused on dental caries, diseases of the periodontium, missing teeth and tooth structure, and dental misalignment. The focus of this essay addresses the future of OMP practice.

Second opinion oral pathology referrals in New Zealand.

Referral for a second opinion is an important aspect of pathology practice, which reduces the rate of diagnostic error and ensures consistency with diagnoses. The Oral Pathology Centre (OPC) is the only specialist oral diagnostic centre in New Zealand. OPC provides diagnostic services to dentists and dental specialists throughout New Zealand and acts as a referral centre for second opinions for oral pathology specimens that have been sent to anatomical pathologists. The aim of this study was to review second opinion referral cases sent to the OPC over a 15-year period and to assess the levels of concordance between the original and final diagnoses. The findings indicated that the majority of referred cases were odontogenic lesions, followed by connective tissue, epithelial and salivary lesions. The most prevalent diagnoses were ameloblastoma and keratocystic odontogenic tumour, followed by oral squamous cell carcinoma. Discordant diagnoses were recorded in 24% of cases. Diagnostic discrepancies were higher in odontogenic and salivary gland lesions, resulting in the change of diagnoses. Second opinion of oral pathology cases should be encouraged in view of the relative rarity of these lesions in general pathology laboratories and the rates of diagnostic discrepancy, particularly for odontogenic and salivary gland lesions.

[Pathology and problems in theoretical and practical dentistry]. / Obshchaia patologiia i problemy teorii i praktiki stomatologii.

Pathology is a science describing the common regularities of pathological processes underlying disease development. Today pathology is defined as a theoretical science, which is at the same time closely connected to clinical practice. This paper reviews the history of research activities of Laboratory of Pathology of Central Institute of Stomatology. New methods have always been used at the laboratory; today it is histochemistry, radioisotope method (specifically histoautoradiography), and electron microscopy (including cytochemistry). Many-year research activities of the laboratory confirm the significance and perspectiveness of basic studies in dentistry, which are of priority importance for the development of theoretical dentistry and for solving the pressing problems in clinical practice.

A vision for oral and maxillofacial pathology in Jamaica / Una visión de la patología oral y maxilofacial en Jamaica

Oral and maxillofacial pathology is an important bridging specialty between dentistry and medicine. This branch of dentistry is gaining special interest as a result of increasing number of oral cancer and microbial diseases. The advancements of medicine and basic medical sciences may help in directing the research in dentistry and oral and maxillofacial pathology. This paper highlights the new area and scope for oral and maxillofacial pathology in Jamaica.

La patología oral y maxilofacial es una especialidad importante que constituye un puente de enlace entre la medicina y la odontología. Esta rama de la odontología está ganando interés especial como resultado del aumento de número de casos cáncer bucal y enfermedades microbianas. Los avances de la medicina y las ciencias médicas básicas pueden ayudar a dirigir la investigación en odontología y patología oral y maxilofacial. Este trabajo pone de relieve la nueva área y el alcance de la patología oral y maxilofacial en Jamaica.

Púrpura trombocitopênica idiopática: importância do cirurgião-dentista no diagnóstico / Idiopathic thrombocytopenic purpura: importance of the dentist in this diagnosis

Esse trabalho descreve um caso de púrpura trombocitopênica idiopática (PTI) diagnosticado durante exame odontológico de rotina. A PTI é uma desordem caracterizada pela destruição anormal das plaquetas circulantes e geralmente apresenta manifestações bucais. Dessa forma, destacamos a importância de o cirurgião-dentista estar apto a reconhecer os sinais e sintomas da PTI, principalmente mudanças bucais que não têm origem dental, possibilitando tratamento imediato. Esta patologia quando não tratada, pode ser irreversível e fatal.