Cysts of the jaws: A multicentre study.

OBJECTIVES: To determine the relative frequency, demographic and pathologic profiles of patients diagnosed with cysts of the jaws. MATERIALS AND METHODS: Biopsy records of the participating institutions from 2000 to 2020 were reviewed for lesions diagnosed in the cyst category. Demographic data, the location of the cysts and pathologic diagnoses were collected. Data were analyzed by appropriate statistics using IBM SPSS software version 28.0. RESULTS: From 148,353 accessioned cases, 25,628 cases (17.28%) were diagnosed in the cyst category. Mean age of the patients ± SD = 42.62 ± 19.36 years. Paediatric patients (aged ≤ 16 years) accounted for 9.63%, while geriatric patients (aged ≥ 65) comprised 14.22% of all the patients. The male-to-female ratio was 1.27:1. The majority of the lesions were encountered in the mandible. The most prevalent cyst was radicular cyst followed by dentigerous cyst and odontogenic keratocyst. In the paediatric group, dentigerous cyst was the most prevalent, whereas in the geriatric group, radicular cyst was the most common. CONCLUSIONS: In general, the results of this study are in accordance with previous studies. This study provides an invaluable database for clinicians when formulating clinical differential diagnoses as well as for pathologists in rendering the final diagnosis.

Intraosseous jaw lesions: A 25-year experience.

Context: Jaw bones can be afflicted by to a diverse group of lesions ranging from developmental, reactive/inflammatory, cystic lesions to tumors and tumor-like lesions. Objectives: The objective of this study is to determine the relative frequency, demographic and pathologic profiles of patients with intraosseous jaw lesions from Thailand. Subjects and Methods: Biopsy records from 1995 to 2019 were reviewed. Age, gender and location of the lesions were collected from the biopsy records. Data were analyzed by appropriate statistics using the IBM SPSS software version 22.0. Results: From 23,344 accessioned cases, 7382 cases (31.62%) were encountered within the jaw bones. Age of the participants ranged from 1 to 96 years with the mean ± standard deviation = 36.05 ± 17.80 years. Pediatric participants (aged ≤16 years) comprised 13.80% of all the participants, whereas the geriatric ones (aged ≥65 years) accounted for 7.55%. The male-to-female ratio was 0.89:1. The majority of lesions were observed in the mandible. The most prevalent intra-osseous jaw lesion was radicular cyst followed by dentigerous cyst and ameloblastoma. The most common malignant tumor was osteosarcoma followed by ameloblastic carcinoma and lymphoma. Among the pediatric participants, dentigerous cyst was the most prevalent jaw lesion, while that in the geriatric participants was radicular cyst. Conclusions: This is the largest study on intra-osseous jaw lesions encompassing several pathological entities ever conducted from Thailand. It thus provides an invaluable database for clinicians to formulate a differential diagnosis as well as for the pathologists to render the final diagnosis. The results of this study are in accordance with previous studies in general.

Pigmented Oral Lesions: A Multicenter Study.

OBJECTIVES: The aim of this study was to determine the prevalence and clinical features of pigmented oral lesions from Thailand. MATERIALS AND METHODS: Biopsy records of the Department of Oral Pathology, Chulalongkorn University, Department of Oral Diagnosis, KhonKaen University, Department of Oral Biology and Oral Diagnostic Sciences, Chiangmai University, Department of Stomatology, Prince of Songkla University, and Rangsit University were reviewed for oral pigmented lesions diagnosed during 1999 to 2019. Demographic data were culled from the biopsy records. Ages of the patients were subdivided into 10-year intervals. Locations of the lesions were classified as gingiva, labial/buccal mucosa, palate, floor of the mouth, tongue, as well as the combination of sites. Data were analyzed by descriptive statistics using SPSS version 20.0. RESULTS: Of the 47,175 accessioned cases, 241 cases (0.51%) were diagnosed in the category of pigmented oral lesions. The age of the patients ranged from 1 month to 88 years with the mean ± standard deviation = 38.74 ± 20.96 years. Regarding gender, 172 patients (71.37%) with pigmented lesions were females, while 69 patients (28.63%) were males. The female-to-male ratio was 2.49:1. The majority of the pigmented lesions were encountered at the gingiva (29.88%) followed by labial/buccal mucosa (26.97%), palate (14.94%), lip (10.79%), alveolar mucosa (9.54%), and others (7.88%), respectively. The three most common pigmented oral lesions in the present study were nevus (39.83%), followed by melanotic macule (28.63%) and amalgam tattoo (17.43%), respectively. CONCLUSIONS: The most common pigmented oral lesion in the present study is nevus. Demographic data of the patients in the present study are in accordance with previous studies with minor differences. Even though pigmented lesions of the oral cavity constitute a small portion of the oral pathology biopsies, accurate diagnosis is important since there is an overlap in clinical appearance of benign pigmented lesions and melanoma.

Human Papillomavirus 16 and 18 Infection in Oral Cancer in Thailand: A Multicenter Study.

OBJECTIVES: To identify the prevalence of high-risk human papillomavirus (HPV) genotypes 16 and 18 among patients with oral squamous cell carcinoma (OSCC) in Thailand and investigate the associations of p16 expression and HPV16/18 with the demographic, clinicopathologic, and risk parameters. MATERIALS AND METHODS: A total of 403 formalin-fixed paraffin-embedded OSCC specimens from four centers in four regions were obtained. p16 expression was evaluated by immunohistochemistry. The detection of HPV16/18 DNA was performed by polymerase chain reaction.  Results: Of all, 172 specimens (42.7%) were presented with amplifiable extracted DNA. Among these, 62.8% were positive for p16, 8.1% were positive for HPV16/18, and 5.8% were positive for both methods. Of all HPV-positive specimens, HPV18 was detected in 57.1%; HPV16 in 14.3%; and HPV16 and 18 (co-infection) in 28.6%. The prevalence of HPV16/18 varied between centers, with the highest rate in the northern center (20.0%). There was no significant correlation between p16 expression and HPV16/18. There were no significant associations of p16 expression and/or HPV16/18 with all variables. CONCLUSIONS: The prevalence of HPV16/18 infection in OSCC geographically varied in Thailand, with the highest rate in the northern region. Poor correlation between p16 and HPV16/18 suggests p16 not be used as a surrogate marker for HPV-positive OSCC.
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A Multicenter Study of Tongue Lesions from Thailand.

OBJECTIVE: Tongue lesions constitute a considerable proportion of the oral lesions. Previous studies on tongue lesions were based on clinical studies. There has been a scarcity of the studies which are based on histopathological examination. This study aimed to determine the prevalence, demographic, and pathologic features of tongue lesions from Thailand. MATERIALS AND METHODS: Biopsy records of the participating institutions were reviewed for lesions on the tongue diagnosed during 1998 to 2017. Demographic data were collected from the biopsy records. Locations were arbitrarily classified as dorsal, lateral, and ventral surfaces, tip of the tongue, and the combination of sites. Lesions of the tongue were classified as reactive/inflammatory, developmental, immune-mediated, cystic, benign, premalignant, malignant, infectious, and miscellaneous categories. STATISTICAL ANALYSIS: Data were analyzed by descriptive statistics using SPSS version 20.0. RESULTS: Of the 44,188 accessioned cases, 2,153 cases (4.87%) were diagnosed from the tongue. The age of the patients ranged from 3 to 93 years with the mean ± standard deviation = 45.26 ± 20.48 years. The female-to-male ratio was 1.49:1. The majority of the tongue lesions were encountered at the lateral border of the tongue (47.66%). Most of the tongue lesions in the present study (53.74%) fell into the reactive/inflammatory category. Irritation fibroma was the most prevalent lesion (18.99%) followed by squamous cell carcinoma (16.91%), and mucus extravasation phenomenon (14.26%), respectively. CONCLUSIONS: This study offers new perspective into the study of tongue lesions apart from the clinically based studies. It also demonstrates the difference between the pediatric and the elderly patients. This study provides invaluable database for clinicians when formulating the clinical diagnosis of tongue lesions.

Oral cancer: A multicenter study

Background: To determine the prevalence and clinicopathologic features of the oral cancer patients. Material and Methods: Biopsy records of the participating institutions were reviewed for oral cancer cases diagnosed from 2005 to 2014. Demographic data and site of the lesions were collected. Sites of the lesion were subdivided into lip, tongue, floor of the mouth, gingiva, alveolar mucosa, palate, buccal/labial mucosa, maxilla and mandible. Oral cancer was subdivided into 7 categories: epithelial tumors, salivary gland tumors, hematologic tumors, bone tumors, mesenchymal tumors, odontogenic tumors, and others. Data were analyzed by descriptive statistics using SPSS software version 17.0. Results: Of the 474,851 accessioned cases, 6,151 cases (1.30%) were diagnosed in the category of oral cancer. The mean age of the patients was 58.37±15.77 years. A total of 4,238 cases (68.90%) were diagnosed in males, whereas 1911 cases (31.07%) were diagnosed in females. The male-to-female ratio was 2.22:1. The sites of predilection for oral cancer were tongue, labial/buccal mucosa, gingiva, palate, and alveolar mucosa, respectively. The three most common oral cancer in the descending order of frequency were squamous cell carcinoma, non-Hodgkin lymphoma and mucoepidermoid carcinoma. Conclusions: Although the prevalence of oral cancer is not high compared to other entities, oral cancer pose significant mortality and morbidity in the patients, especially when discovered late in the course of the disease. This study highlights some anatomical locations where oral cancers are frequently encountered. As a result, clinicians should pay attention to not only teeth, but oral mucosa especially in the high prevalence area as well since early detection of precancerous lesions or cancers in the early stage increase the chance of patient being cured and greatly reduce the mortality and morbidity. This study also shows some differences between pediatric and elderly oral cancer patients as well as between Asian and non-Asian oral cancer patients (AU)

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Expression of C-X-C motif chemokine receptors 4 and 7 in salivary gland neoplasms.

OBJECTIVES: Chemokine receptors have been shown to overexpress in several cancer types. Binding of chemokines to their cognate chemokine receptors on tumor cells can promote tumor growth, angiogenesis and metastasis. The purposes of this study was to examine the expression of chemokine receptors, CXCR4 and CXCR7, in salivary gland neoplasms and its association with pathologic characteristics. DESIGN: Sixty-two cases of salivary gland neoplasms, including 25 mucoepidermoid carcinomas (MEC), 18 adenoid cystic carcinomas (ACC), 14 pleomorphic adenomas (PA) and 5 polymorphous low-grade adenocarcinoma (PLGA) were investigated for CXCR4 and CXCR7 expression immunohistochemically. The immunoreactivity was categorized as low expression or high expression group, based on whether the positive staining was below or higher than 50% of the neoplastic cells, respectively. RESULTS: The majority of MECs, ACCs and PLGAs showed high CXCR4 and CXCR7 expression, whereas most PAs showed high CXCR4 but low CXCR7 expression. The levels of CXCR4 and CXCR7 expression were significantly correlated. In MECs, the expression of both chemokine receptors was localized to squamous cells, intermediate cells and glandular epithelial cells, whereas mucous cells and clear cells were negative. In ACCs and PAs, their immunoreactivity was more intense in ductal cells than myoepithelial cells. Most neoplastic myoepithelial cells in PAs did not express CXCR7, while those in ACCs showed strong CXCR7 expression. The increased CXCR4 expression was significantly associated with advanced pathologic grade of MECs (P=0.03). CONCLUSION: Overexpression of CXCR4 and CXCR7 is common in the 4 salivary gland neoplasms investigated. CXCR4 may play a role in the progression of MECs.

Dentofacial Deformity Caused by Bulky Osteochondroma: Report of an Unusual Case and the Importance of Cone Beam Computed Tomography.

INTRODUCTION: Osteochondroma of mandibular condyle is a rare benign tumor. CASE REPORT: This case report described clinical, radiographic features, differential diagnosis, histopathologic correlation and treatment of condylar osteochondroma. CONCLUSION: Conebeam computed tomography (CBCT) is an alternative modality to CT or MRI that should be performed in all cases of suspected osteochondroma of the mandibular condyle.

A multicenter study of oral malignant tumors from Thailand.

BACKGROUND: Oral malignant tumors in Thailand have not been extensively studied. Hence the following study was conducted. AIMS: To determine the prevalence and clinicopathologic data of the oral malignant tumors from Thailand. SUBJECTS AND METHODS: Biopsy records of the Oral Pathology Department, Chulalongkorn University; Department of Oral Biology and Diagnostic Sciences, Chiang Mai University; Department of Oral Diagnosis, Khon Kaen University and Department of Stomatology, Prince of Songkla University, were reviewed for lesions diagnosed in the category of oral malignant tumors from 2005-2014. Demographic data and site of the lesions were collected. STATISTICAL ANALYSIS USED: Data were analyzed by descriptive statistics using SPSS software version 17.0. RESULTS: Of the 22,639 accessioned cases, 1411 cases (6.23%) were diagnosed as oral malignant tumors. The mean age of the patients was 59.13 ± 17.32 years. A total of 651 cases (46.14%) were diagnosed in males, whereas 759 cases (53.79%) were diagnosed in females. The male-to-female ratio was 0.86:1. The sites of predilection for oral malignant tumors were the gingiva, followed by tongue and alveolar mucosa. The three most common oral malignant tumors in the descending order of frequency were squamous cell carcinoma, non-Hodgkin lymphoma and mucoepidermoid carcinoma. CONCLUSIONS: This study provides extensive data on the oral malignant tumors from several university biopsy services located in virtually all parts of Thailand. The data from the present study show some similarities with previous studies; however, differences such as gender and site of predilection still exist.

Geriatric oral lesions: A multicentric study.

AIM: To carry out an oral biopsy survey in geriatric patients from the participating institutions. METHODS: The biopsy records of the participating institutions were reviewed for oral lesions from patients aged 65 years and older diagnosed from 2003 to 2012. Demographic data and the site of the lesions were collected. Histopathological diagnoses were categorized into two categories: non-neoplastic lesions (reactive/inflammatory lesion, cyst, allergic/immunologic disorders, potentially malignant disorders, infection and others) and neoplastic lesions (benign and malignant tumors). Data were analyzed by appropriate statistics using stata11. RESULTS: Of the 76,045 accessioned cases, 11,346 cases (14.92%) were in geriatric patients. The mean age of the patients was 72.98 ± 6.25 years. A total of 5010 cases (44.16%) were diagnosed in males, whereas 6336 cases (55.84%) were diagnosed in females. The male-to-female ratio was 0.79:1. Non-neoplastic lesions outnumbered the neoplastic counterpart. The five most prevalent oral lesions in the geriatric population in the present study in descending order of frequency were squamous cell carcinoma, focal fibrous hyperplasia (irritation fibroma), radicular cyst, osteomyelitis and epithelial dysplasia, respectively. The site of predilection was labial/buccal mucosa, followed by gingiva, mandibular bone, tongue and maxillary bone, respectively. CONCLUSIONS: The geriatric oral lesions from the present study showed a similar trend with studies based on histopathological data, but different from the studies based on clinical data. This study also shed more light on potentially malignant disorders, as well as benign and malignant tumors.

Lower eyelid complications associated with transconjunctival versus subciliary approaches to orbital floor fractures.

PURPOSE: The aim of this study was to compare the frequencies of lower eyelid complications after subciliary versus transconjunctival approaches to orbital floor fractures. MATERIALS AND METHODS: The investigators implemented a retrospective cohort study and enrolled a sample composed of subjects who had orbital floor repair. The predictor variable was surgical approach, classified as subciliary or transconjunctival. The primary outcome variable was postoperative lower eyelid complications (ectropion, entropion, and eyelid retraction). Other variables were demographic, anatomic, or time to surgery. Descriptive and bivariate statistics were computed. Statistical significance was set at P ≤ 0.05. RESULTS: The study samples were composed of 346 patients (98 [28.3%] females; 225 [65%] underwent a subciliary approach) with a mean age of 42.7 ± 21.1 years. The subciliary approach was significantly linked to the higher rates of ectropion and the lower rates of entropion at 7 days and 6 months postoperatively. There was no statistically significant difference in the frequency of eyelid retraction between both groups. CONCLUSIONS: In the setting of orbital floor fractures, these results suggest that the use of the subciliary approach increases the frequency of ectropion, while the transconjunctival approach increases the frequency of entropion. The authors decline to comment on what the better surgical approach to the orbital floor fractures is. The selection should be based on an individual patient basis and surgeon's preference.

Factors associated with postrhinoplasty mucous cyst in cleft lip patients.

PURPOSE: The purpose of this study was to identify risk factors associated with postrhinoplasty mucous cyst (PMC) among adult cleft patients undergoing rhinoplasty. PMC has been reported sporadically in the literature. Its aetiology is uncertain. The purpose of this study was to determine whether three factors, (1) patient age, (2) surgical trauma, and/or (3) use of a nasal septal cartilage graft (NSCG), were risk factors for PMC. METHODS: We organized a retrospective, single-center study and enrolled cleft rhinoplasty patients treated between January 2003 and December 2008. The predictor variables included age at surgery, use of a NSCG, and length of surgery. The primary outcome was presence of PMC. Other study variables included demographic, surgical, and postoperative data. Appropriate descriptive and univariate statistics were calculated, and P < 0.05 was regarded as indicative of statistical significance. RESULTS: The sample comprised 314 cleft rhinoplasty patients (118 females; 37.6 %) with a mean age of 14.9 ± 10.7 years (range 0-65). Three patients had a PMC after secondary cleft rhinoplasty. Average time to disease was 26 ± 19.3 months after surgery (range 12-48). There was no significant association between the presence of the PMC and the three predictor variables-patient's age, NSCG transplantation, and protracted surgery (P > 0.05). CONCLUSIONS: These study findings suggest that young age, use of a NSCG, and protracted surgery are not risk factors for PMC. The prevalence of PMC is greater for cleft patients after rhinosurgery than for noncleft patients.

Factors affecting scientific productivity of German oral-maxillofacial surgery training centers: a retrospective cohort study.

PURPOSE: To identify factors associated with scientific productivity (SP) of German oral-maxillofacial surgery (OMFS) training centers. MATERIALS AND METHODS: This retrospective cohort study was composed of a set of data from German OMFS training centers. A total of eight predictor variables were grouped into demographic, structural, and personal categories. The outcome variables were average publications in 2013 per senior staff, and percentage of OMFS trainees with >1 publications. Descriptive and univariate statistics were computed using P < 0.05. RESULTS: The sample included outputs from 62 OMFS departments (34 [54.8 %] university-based; 46 [74.2 %] in large cities). Average publications were 2.4 ± 3 per senior staff (range, 0-27), and 160 trainees (31.7 %) published >1 papers. The number of publications and productive trainees was not linked to department name and number of female senior staffs, but publication count was significantly increased when the hospital was in a metropolis (P = 0.018) or university-based (P < 0.0001), the OMFS' chairperson and >3 staffs within the department had a postdoctoral degree (German "Habilitation") (P = 0.013 and <0.0001), and the chairperson had h-index >10 or the first/last authorship in 2013 (P < 0.0001). Female senior surgeons were less scientifically productive than the male ones (P = 0.01). CONCLUSION: SP of German OMFS training centers is greatly different across the country and influenced by city size, university base, educational backgrounds, and research activities of chairpersons and senior staffs. This helps students, trainees, and young surgeons to reach the career choice that is personally appropriate. The involved organizations may need to encourage research output of less productive surgeons/centers. Increasing postdoctoral-qualified staffs will increase SP of the department.

An analysis of microvessel density in salivary gland tumours: a single centre study.

BACKGROUNDS: Microvessel density (MVD) can be used for determining neoplastic neovascularisation. Tumour angiogenesis correlates with prognosis of cancers in many organs. The aims of this study were to evaluate MVD as demonstrated by CD31 and CD105 in salivary gland tumours (SGTs), and to correlate the MVD results with clinicopathological characteristics of the tumours. MATERIALS AND METHODS: Using a retrospective cohort study design, we enrolled SGTs patients at the Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand, over the 22-year period. The predictor variables included demographic, anatomic and histopathological parameters. The outcome measure was average CD31-MVD and CD105-MVD counted by the "hot spot" method. Descriptive, uni- and bivariate statistics were computed, and P <0.05 was considered statistically significant. RESULTS: The study sample consisted of 43 subjects with a mean age of 39.6 ± 17.8 years (range, 9-82), including 26 females (60.5%), diagnosed with SGTs. In this cohort, 58.1% of the cases were benign, and 83.7% were minor SGTs. There was a significant correlation between CD31-MVD and CD105-MVD (r = 0.8, P < 0.001), but mean CD31-MVD and CD105-MVD were 17.7 ± 9.3 and 12.8 ± 7.4, respectively (P = 0.009). Age, gender and tumour site were not individually associated with significant differences between CD31-MVD and CD105-MVD. Tumours with myoepithelial cells had lower MVD than those without myoepithelial cells (P = 0.04 for CD31; P = 0.03 for CD105). Only CD105-MVD showed statistical difference between benign and malignant SGTs (P = 0.01). CONCLUSIONS: These results suggest that MVD in SGTs can be demonstrated by CD31 and CD105. Despite a strong correlation, CD31-MVD is always higher than CD105-MVD and cannot differentiate between benign and malignant SGTs. The presence of myoepithelial cells within SGTs affects the MVD analysis using either CD31 or CD105, while age, gender and tumour location do not.