Scalloped border as a possible diagnostic aid for differentiating jaw lesions: A pictorial essay.

Purpose: The aim of this study was to introduce a category of jaw lesions comprising cysts and tumors associated with scalloped borders. Materials and Methods: General search engines and specialized databases including Google Scholar, PubMed, PubMed Central, and Scopus, as well as an authoritative textbook, were used to find relevant studies by using keywords such as "jaw lesion," "jaw disease," "scalloping," "scalloped border," "scalloped margin," "irregular border," and "irregular margin." Out of 289 articles, 252 records were removed because they were duplicates, did not have a relevant title, or did not mention the frequency of findings described using the term "scalloped border." Finally, 37 closely related articles were chosen. Results: According to the relevant literature, scalloped borders are found most frequently in ameloblastoma, followed by simple bone cyst, central giant cell granuloma, odontogenic keratocyst, and glandular odontogenic cyst. Conclusion: The lesions most frequently reported to have scalloped borders are ameloblastoma, central giant cell granuloma, odontogenic keratocyst, simple bone cyst, and glandular odontogenic cyst.

Sublingual varicosity as a possible indicator of hypertension.

Oral varices are a common acquired vascular malformation that might be associated with several heart diseases. The aim of this study was to investigate whether an association exists between the severity of sublingual varices and stage of hypertension. Oral examinations were conducted, and the sublingual varicosity of 151 patients was categorized as grade 0, 1, or 2 based on severity. The blood pressure of the patients was measured and classified as normal, prehypertension, stage 1 hypertension, or stage 2 hypertension according to the guidelines of the National Heart, Lung, and Blood Institute. Pearson chi-square test, linear-by-linear association, and logistic regression were used for data analysis. Of 151 patients, 91 (60.3%) had sublingual varices, with 68 (45.0%) having grade 1 varicosity and 23 (15.2%) having grade 2. Sublingual varices were seen most frequently (84.4%) in patients older than 60 years. The frequency of hypertension (stage 1 or 2) among the sample was found to be 24.5%. The Pearson chi-square test showed a positive correlation between hypertension and sublingual varicosity (P < 0.0001; γ = 0.499). Logistic regression showed that the risk of hypertension in patients with grades 1 and 2 sublingual varicosity was 2.53 and 7.57 times greater, respectively, than that in patients with grade 0. In addition, sublingual varicosity (grade 1 or 2) was 2.32 times more frequent in men than in women (P = 0.022; 95% CI = 1.12-4.79) and 3.55 times more frequent in smokers than in nonsmokers (P = 0.003; 95% CI = 1.01-1.06). Therefore, sublingual varicosity may be a sign of hypertension.

Frequency of oral Lichen Planus among hypothyroid patients / Frequência de Líquen Plano oral em pacientes com hipotireoidismo

Objective: Recent investigations have suggested a correlation between thyroid diseases, particularly hypothyroidism (HT), and oral lichen planus (OLP). Objective: This study aimed to assess the frequency of OLP in HT patients. Material and Methods: This analytical descriptive study evaluated 100 HT patients including 94 females and 6 males, who were selected by convenience sampling. The subjects were clinically examined for OLP. The mean age of patients was 42.49±1.29 years. Also, 100 age- and sex-matched healthy controls were examined. The data were analyzed using chi-square test and Fisher's exact test via SPSS. Results: Of all, 14 (14%) HT patients (12 females and 2 males) had OLP while only one case of OLP was found in the control group. The difference between the two groups in the frequency of OLP was significant (P=0.001). The odds ratio (OR) of developing OLP was calculated to be 16.11 in HT patients. Reticular form was the most common type of OLP in patients (50%). The buccal mucosa was the most common site of involvement (92.85%). The mean age of patients with OLP was 42.93±1.29 years with a median of 46±1.29 years in HT group. Conclusion: The frequency of OLP was significantly higher in HT patients such that HT patients had higher odds of developing OLP by 16 folds. (AU)

Objetivo: Investigações recentes sugeriram uma correlação entre doenças da tireoide, particularmente hipotireoidismo (HT), e líquen plano oral (LPO). Objetivo: Este estudo teve como objetivo avaliar a frequência de LPO em pacientes com HT. Material e Métodos: Este estudo descritivo analítico avaliou 100 pacientes com HT, incluindo 94 mulheres e 6 homens, selecionados por amostragem por conveniência. Os indivíduos foram examinados clinicamente para LPO. A média de idade dos pacientes foi de 42,49 ± 1,29 anos. Além disso, foram examinados 100 controles saudáveis pareados por idade e gênero. Os dados foram analisados usando o teste do qui-quadrado e o teste exato de Fisher via SPSS. Resultados: De todos, 14 (14%) pacientes com HT (12 mulheres e 2 homens) tiveram LPO, enquanto apenas um caso de LPO foi encontrado no grupo controle. A diferença entre os dois grupos na frequência de LPO foi significativa (P = 0,001). A razão de probabilidade de desenvolvimento de LPO foi calculado em 16,11 em pacientes com HT. A forma reticular foi o tipo mais comum de LPO nos pacientes (50%). A mucosa bucal foi o local de acometimento mais comum (92,85%). A média de idade dos pacientes com LPO foi de 42,93 ± 1,29 anos, com mediana de 46 ± 1,29 anos no grupo HT. Conclusão: A frequência de LPO foi significativamente maior em pacientes com HT, de modo que os pacientes com HT tinham maior chance de desenvolver LPO em 16 vezes. (AU)

Dental extraction and full mouth root canal therapy in a patient with atypical odontalgia: Report of invasive malpractice / Extração dentária e terapia de canal radicular total em um paciente com odontalgia atípica: relato de terapia invasiva por erro diagnóstico

Atypical odontalgia is a pain disorder featured by constant pain without any obvious dental pathology. We report a 38-year-old man having chronic orofacial pain in the past two years. The pain was first located in the left maxillary premolar-molar region, but spread to the contra lateral mandible, occipital region, head and shoulders over time. The pain was described as dull and continuous with the intensity of #6 (VAS), and not relieved even after root canal therapy of all teeth and extraction of wisdom teeth . Some comorbid conditions such as TMJ problems and involvement of masticatory muscles were also reported. Finally, the diagnosis of atypical odontalgia was established due to lack of evidence for any organic pathology on clinical and paraclinical investigations, and a combination therapy including fluoxetine and clonazepam was started. Dental practitioners should consider AO when confronting toothache without any reasonable organic cause and avoid unnecessary dental procedures (AU)

A odontalgia atípica (OA) é um distúrbio doloroso caracterizado por uma dor constante sem qualquer patologia dentária óbvia. Relatamos um homem de 38 anos com dor orofacial crônica nos últimos dois anos. A dor foi inicialmente localizada na região pré-molar-molar superior esquerdo, mas se espalhou para o lado oposto da mandíbula, região occipital, cabeça e ombros ao longo do tempo. A dor foi descrita como maçante e contínua com a intensidade de # 6 (EVA), e não aliviada mesmo após tratamento de canal de todos os dentes e extração dos dentes do siso. Algumas comorbidades como problemas de ATM e envolvimento dos músculos mastigatórios também foram relatadas. Finalmente, o diagnóstico de odontalgia atípica foi estabelecido devido à falta de evidência para qualquer patologia sistêmica nas investigações clínicas e exames complementares, e uma terapia combinada incluindo fluoxetina e clonazepam foi iniciada. Os dentistas devem considerar OA ao enfrentar uma dor de dente sem qualquer causa sistêmica razoável e evitar procedimentos odontológicos desnecessários (AU)

Assessment of oral health- related quality of life in patients with lichen planus during the course of treatment, using "Chronic Oral Mucosal Disease Questionnaire" / Avaliação da qualidade de vida relacionada à saúde bucal em pacientes com líquen plano durante o curso do tratamento, utilizando o "Questionário de Doença Oral Crônica

Objective: The aim of this study was to assess the oral health related quality of life in patients with oral lichen planus, using a Chronic Oral Mucosal Diseases Questionnaire (COMDQ) during a course of standard medical treatment. Material and Methods: In this experimental study, fifteen patients with oral lichen planus were entered the study and the COMDQ (a self-reported questionnaire assessing different aspects of quality of life in individuals with chronic oral mucosal diseases), was used to assess the level of "Pain and functional limitation", "Medication and treatment", "Social emotional" and "Patient support" during the course of standard treatment. A data collection form including demographic information, type and location of the lesions, patients' symptoms and level of healing process was completed. Patients were evaluated weekly during four weeks of treatment and COMDQ scores were documented. Data were analyzed, using ANOVA and Friedman statistical tests. Results:The mean score of the COMDQ questionnaire in lichen planus patients who completed the course of treatment, showed significant improvement (p < 0.001) after each week of therapy. Oral symptoms and the healing process of oral lesions showed improvement without any statistically significant changes among different weeks of therapy. "Pain and functional limitation", "Medication and treatment" and "Patient Support" improved significantly during the treatment period (p<001); however, the "Social and emotional" aspect did not show significant changes over the course of medical management. Conclusion: Oral health-related quality of life in patients with oral lichen planus improved significantly during the course of medical treatment. (AU)

Objetivo: O objetivo deste estudo foi avaliar a qualidade de vida relaciona à saúde oral em pacientes com líquen plano oral, utilizando o questionário de Doença oral crônica (Chronic Oral Mucosal Diseases Questionnaire -COMDQ) durante o curso de tratamento médico convencional. Material e Métodos: Neste estudo, foram incluídos quinze pacientes com líquen plano oral e o COMDQ (Um questionário de auto-avaliação que abrange diversos aspectos da qualidade de vida dos indivíduos com doenças orais crônicas) foi utilizado para avaliar o nível de "dor e limitação funciononal", "medicação e tratamento, "habilidades sócio-emocionais" e "suporte do paciente" durante o curso do tratamento. Também foram coletados dados como informações geográficas, tipo e local das lesões, sintomas dos pacientes e se a cicatrização das lesões foi completa. Os pacientes foram avaliados semanalmente durante 4 semanas e os escores do COMDQ foram documentados. Os dados foram analisados utilizando os testes estatísticos de ANOVA e Friedman. Resultados: O escore médio do questionário COMDQ em pacientes com líquen plano que completaram o tratamento, demonstrou melhora significativa (p < 0,001) após cada semana de tratamento. Sintomas orais e o processo de cicatrização das lesões orais mostrou melhoras entre as diferentes semanas de tratamento, porém sem significância estatística. "Dor e limitação functional, "Medicação e tratamento"e "suporte do paciente" aumentaram significativamente durante o período de tratamento (p < 0,001); No entanto, "habilidades sócio-emocionais" não apresentou alterações significantes durante o curso do manejo clínico. Conclusão: Qualidade de vida relacionada à saúde oral em pacientes com líquen plano melhora significativamente no decorrer do tratamento médico. (AU)

Common conditions associated with displacement of the inferior alveolar nerve canal: A radiographic diagnostic aid.

PURPOSE: This study reviewed the common conditions associated with displacement of inferior alveolar nerve canal. MATERIALS AND METHODS: General search engines and specialized databases including Google Scholar, Pub Med, Pub Med Central, Science Direct, and Scopus were used to find relevant studies by using keywords such as "mandibular canal", "alveolar canal", "inferior alveolar nerve canal", "inferior dental canal", "inferior mandibular canal" and "displacement". RESULTS: About 120 articles were found, of which approximately 70 were broadly relevant to the topic. We ultimately included 37 articles that were closely related to the topic of interest. When the data were compiled, the following 8 lesions were found to have a relationship with displacement of mandibular canal: radicular/residual cysts, dentigerous cyst, odontogenic keratocyst, aneurysmal bone cyst, ameloblastoma, central giant cell granuloma, fibrous dysplasis, and cementossifying fibroma. CONCLUSION: When clinicians encounter a lesion associated with displaced mandibular canal, they should first consider these entities in the differential diagnosis. This review would help dentists make more accurate diagnoses and develop better treatment plans according to patients' radiographs.

Common conditions associated with mandibular canal widening: A literature review.

PURPOSE: The aim of this study was to review the common conditions associated with mandibular canal widening. MATERIALS AND METHODS: General search engines and specialized databases including Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus were used to find relevant studies by using the following keywords: "mandibular canal," "alveolar canal," "inferior alveolar nerve canal," "inferior dental canal," "inferior mandibular canal," "widening," "enlargement," "distension," "expansion," and "dilation." RESULTS: In total, 130 articles were found, of which 80 were broadly relevant to the topic. We ultimately included 38 articles that were closely related to the topic of interest. When the data were compiled, the following 7 lesions were found to have a relationship with mandibular canal widening: non-Hodgkin lymphoma, osteosarcoma, schwannoma, neurofibroma, vascular malformation/hemangioma, multiple endocrine neoplasia syndromes, and perineural spreading or invasion. CONCLUSION: When clinicians encounter a lesion associated with mandibular canal widening, they should immediately consider these entities in the differential diagnosis. Doing so will help dentists make more accurate diagnoses and develop better treatment plans based on patients' radiographs.

Oral White Lesions: An Updated Clinical Diagnostic Decision Tree.

Diagnosis of oral white lesions might be quite challenging. This review article aimed to introduce a decision tree for oral white lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as "mouth disease", "oral keratosis", "oral leukokeratosis", and "oral leukoplakia". Related English-language articles published since 2000 to 2017, including reviews, meta-analyses, and original papers (randomized or nonrandomized clinical trials; prospective or retrospective cohort studies), case reports, and case series about oral diseases were appraised. Upon compilation of data, oral white lesions were categorized into two major groups according to their nature of development: Congenital or acquired lesions and four subgroups: Lesions which can be scraped off or not and lesions with the special pattern or not. In total, more than 20 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

Intraosseous migration of second premolar below the inferior alveolar nerve canal: Case report.

Migration is a kind of eruption abnormality where a tooth grows far from its original site of development. Anomalies in dental eruptions are referred to as ectopia, which might be encountered in several regions around the oral cavity. The incidence of mandibular second premolar impaction has been estimated to be 2.1-2.7%. The frequency of its intraosseous distal migration is 0.25%. We report a case of extremely distally intraosseous migration of mandibular second premolar, which was found in a routine radiography. A 28-year-old woman who attended a dental clinic to treat teeth caries was noticed to have her lower second premolar located horizontally in the homolateral mandibular angle below the inferior alveolar nerve canal on a panoramic view. As the patient was asymptomatic, she was advised to take follow-up radiographs to rule out any cystic/neoplastic changes. Taking a panoramic radiograph in patients with missing mandibular premolars should be considered, because in rare cases migration or transmigration of these teeth may happen.

Head and Neck Lymphoma in an Iranian Population.

INTRODUCTION: This study is aimed to assess the prevalence and characteristics of head and neck lymphoma in a defined group of an Iranian population. MATERIALS AND METHODS: In this retrospective study, 126,450 biopsy reports from two referral Pathology Departments, (Tehran, the capital of Iran) were evaluated. In cases with head and neck lymphoma, other variables such as age, sex, specific location of lesions, and histopathological findings were recorded. Descriptive statistics were used to measure the prevalence and characteristics of head and neck lymphoma by means of SPSS soft ware, version 18. RESULTS: In total, 513 (0.4%) cases had head and neck lymphoma (46.9% male, 27.1% female) with a mean age of 46±6.2. Of the total lesions, 200 (0.15%) were Hodgkin lymphoma and 313 (0.25%) were non-Hodgkin lymphoma. Nodular sclerosis was the most common (62.5%) histopathological subtype among Hodgkin lymphoma. In non-Hodgkin lymphoma, diffuse large B-cell lymphoma (62.3%) had the highest frequency. In Hodgkin disease, classic Hodgkin lymphocytic rich, mixed cellularity, and lymphocyte depletion were only seen in the neck compartment. Bone involvement was only found in Hodgkin nodular lymphocytic predominant variation. In non-Hodgkin lymphoma, the tongue, palate, and vestibular mucosa were affected only by diffuse large B-cell lymphoma. Jaw bones were only involved with diffuse large B-cell lymphoma compared to other bony structures. T-cell lymphoma and mucosal associated lymphoid tissue lymphoma were also found. CONCLUSION: Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma especially in the tongue, palate, vestibular mucosa, and jaw bones.

Peripheral Exophytic Oral Lesions: A Clinical Decision Tree.

Diagnosis of peripheral oral exophytic lesions might be quite challenging. This review article aimed to introduce a decision tree for oral exophytic lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of keywords such as "oral soft tissue lesion," "oral tumor like lesion," "oral mucosal enlargement," and "oral exophytic lesion." Related English-language articles published since 1988 to 2016 in both medical and dental journals were appraised. Upon compilation of data, peripheral oral exophytic lesions were categorized into two major groups according to their surface texture: smooth (mesenchymal or nonsquamous epithelium-originated) and rough (squamous epithelium-originated). Lesions with smooth surface were also categorized into three subgroups according to their general frequency: reactive hyperplastic lesions/inflammatory hyperplasia, salivary gland lesions (nonneoplastic and neoplastic), and mesenchymal lesions (benign and malignant neoplasms). In addition, lesions with rough surface were summarized in six more common lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.

Death Rate of Dental Anaesthesia.

Death was the most important side effect of anaesthesia in dentistry. In this article we reviewed more than 20 studies with adequate data focusing on death associated with dental procedures since 1955 and found 218 deaths out of 71,435,282 patients (3 deaths per 1,000,000 persons) with the mortality rate of 1:327,684. In addition, mortality rate per million has dropped to half (6.2 per 1,000,000 vs. 3 per 1,000,000) since 1955 till the last report in 2012 without any sex predilection. In children, most cases died in the age of two to five years. Hypoxia was the most common cause of death, and cardiovascular, respiratory, and endocrine disorders, hepatic cirrhosis, septicaemia, and bacterial endocarditis were the most frequent underlying systemic disease in deceased patients. Although rare death following general anaesthesia in dentistry, is a critical side effect mostly seen in patients with compromised health condition. Therefore, appropriate case selection in regard with patients' general health status as well as standard technical and equipment conditions are mandatory to diminish the risk of death during dental anaesthesia.

Herbs in Oral Mucositis.

Oral mucositis is an inflammatory mucosal destruction as a result of chemotherapy and/or radiation therapy, which in severe cases can impair patients' quality of life. Moreover, mucosal infection and/or systemic involvement due to compromised immunity leads to delay or discontinuation of the treatment. Many strategies and agents have been suggested for the management of this condition. Because of their lower side effects compared to chemical drugs, general interest in evaluating therapeutic effects of herbs has been increased intensively. Herbal plants apply their effect through different mechanisms of action: antioxidant, analgesic, anti-inflammatory, antifungal, antiseptic, and anticarcinogenic activity. Recently, various natural agents in plants have been noticed in mucositis, which may improve the symptoms through different interventions. The purpose of this review is to focus on the preventive or therapeutic use of herbal medicine to alleviate oral mucositis.

Frequency of craniofacial pain in patients with ischemic heart disease.

BACKGROUND: Referred craniofacial pain of cardiac origin might be the only symptom of ischemic heart accidents. This study aimed to determine the frequency of craniofacial pain in patients with ischemic heart disease. MATERIAL AND METHODS: This cross-sectional study was accomplished on 296 patients who met the criteria of having ischemic heart disease. Data regarding demographics, medical history and referred craniofacial pain were recorded in data forms. In addition, patients underwent oral examination to preclude any source of dental origin. Chi-square test, Student's t-test and backward regression model were used to analyze the data by means of SPSS software version 21. P<0.05 was considered significant. RESULTS: A total of 296 patients were studied comprising of 211 men (71%) and 85 women (29%) with the mean age of 55.8. Craniofacial pain was experienced by 53 patients out of 296, 35 (66%) of whom were male and 18 (34%) were female. None of the patients experienced craniofacial pain solely. The most common sites of craniofacial pain were occipital and posterior neck (52.8%), head (43.3%), throat and anterior neck (41.5%) respectively. We found no relationship between craniofacial pain of cardiac origin with age, diabetes, hypertension, and family history. On the other hand, there was a significant relationship between hyperlipidemia and smoking with craniofacial pain of cardiac origin. CONCLUSIONS: Radiating pain to face and head can be expected quite commonly during a cardiac ischemic event. Dental practitioners should be thoroughly aware of this symptomatology to prevent misdirected dental treatment and delay of medical care. Key words:Craniofacial pain, ischemic heart disease, myocardial infarction, angina pectoris, referred pain.

Head and Neck Lymphoma in an Iranian Population.

INTRODUCTION: This study is aimed to assess the prevalence and characteristics of head and neck lymphoma in a defined group of an Iranian population. MATERIALS AND METHODS: In this retrospective study, 126,450 biopsy reports from two referral Pathology Departments, (Tehran, the capital of Iran) were evaluated. In cases with head and neck lymphoma, other variables such as age, sex, specific location of lesions, and histopathological findings were recorded. Descriptive statistics were used to measure the prevalence and characteristics of head and neck lymphoma by means of SPSS soft ware, version 18. RESULTS: In total, 513 (0.4%) cases had head and neck lymphoma (46.9% male, 27.1% female) with a mean age of 46±6.2. Of the total lesions, 200 (0.15%) were Hodgkin lymphoma and 313 (0.25%) were non-Hodgkin lymphoma. Nodular sclerosis was the most common (62.5%) histopathological subtype among Hodgkin lymphoma. In non-Hodgkin lymphoma, diffuse large B-cell lymphoma (62.3%) had the highest frequency. In Hodgkin disease, classic Hodgkin lymphocytic rich, mixed cellularity, and lymphocyte depletion were only seen in the neck compartment. Bone involvement was only found in Hodgkin nodular lymphocytic predominant variation. In non-Hodgkin lymphoma, the tongue, palate, and vestibular mucosa were affected only by diffuse large B-cell lymphoma. Jaw bones were only involved with diffuse large B-cell lymphoma compared to other bony structures. T-cell lymphoma and mucosal associated lymphoid tissue lymphoma were also found. CONCLUSION: Diffuse large B-cell lymphoma is the most common subtype of non-Hodgkin lymphoma especially in the tongue, palate, vestibular mucosa, and jaw bones.

Review of common conditions associated with periodontal ligament widening.

PURPOSE: The aim of this article is to review a group of lesions associated with periodontal ligament (PDL) widening. MATERIALS AND METHODS: An electronic search was performed using specialized databases such as Google Scholar, PubMed, PubMed Central, Science Direct, and Scopus to find relevant studies by using keywords such as "periodontium", "periodontal ligament", "periodontal ligament space", "widened periodontal ligament", and "periodontal ligament widening". RESULTS: Out of nearly 200 articles, about 60 were broadly relevant to the topic. Ultimately, 47 articles closely related to the topic of interest were reviewed. When the relevant data were compiled, the following 10 entities were identified: occlusal/orthodontic trauma, periodontal disease/periodontitis, pulpo-periapical lesions, osteosarcoma, chondrosarcoma, non-Hodgkin lymphoma, progressive systemic sclerosis, radiation-induced bone defect, bisphosphonate-related osteonecrosis, and osteomyelitis. CONCLUSION: Although PDL widening may be encountered by many dentists during their routine daily procedures, the clinician should consider some serious related conditions as well.

Diagnostic Features of Common Oral Ulcerative Lesions: An Updated Decision Tree.

Diagnosis of oral ulcerative lesions might be quite challenging. This narrative review article aims to introduce an updated decision tree for diagnosing oral ulcerative lesions on the basis of their diagnostic features. Various general search engines and specialized databases including PubMed, PubMed Central, Medline Plus, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as "oral ulcer," "stomatitis," and "mouth diseases." Thereafter, English-language articles published since 1983 to 2015 in both medical and dental journals including reviews, meta-analyses, original papers, and case reports were appraised. Upon compilation of the relevant data, oral ulcerative lesions were categorized into three major groups: acute, chronic, and recurrent ulcers and into five subgroups: solitary acute, multiple acute, solitary chronic, multiple chronic, and solitary/multiple recurrent, based on the number and duration of lesions. In total, 29 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by stepwise progression.

Jaw lesions associated with impacted tooth: A radiographic diagnostic guide.

This review article aimed to introduce a category of jaw lesions associated with impacted tooth. General search engines and specialized databases such as Google Scholar, PubMed, PubMed Central, MedLine Plus, Science Direct, Scopus, and well-recognized textbooks were used to find relevant studies using keywords such as "jaw lesion", "jaw disease", "impacted tooth", and "unerupted tooth". More than 250 articles were found, of which approximately 80 were broadly relevant to the topic. We ultimately included 47 articles that were closely related to the topic of interest. When the relevant data were compiled, the following 10 lesions were identified as having a relationship with impacted tooth: dentigerous cysts, calcifying odontogenic cysts, unicystic (mural) ameloblastomas, ameloblastomas, ameloblastic fibromas, adenomatoid odontogenic tumors, keratocystic odontogenic tumors, calcifying epithelial odontogenic tumors, ameloblastic fibro-odontomas, and odontomas. When clinicians encounter a lesion associated with an impacted tooth, they should first consider these entities in the differential diagnosis. This will help dental practitioners make more accurate diagnoses and develop better treatment plans based on patients' radiographs.

Multifocal epithelial hyperplasia: a forgotten condition in the elderly.

Multifocal epithelial hyperplasia (MEH), also known as focal epithelial hyperplasia and Heck disease, is a relatively rare condition caused by the human papillomavirus. This case report describes a 92-year-old man who presented with multiple, asymptomatic, circumscribed, soft, flattened papules in different sizes on the retrocommissure of his lower lip. The lesions were of 2 months' duration and had the same coloration as the adjacent normal mucosa. Histopathologic examination showed orthokeratinized stratified squamous epithelium with acanthosis, some areas of club-shaped rete ridges, and a few superficial epithelial cells with koilocytic changes and a mitosoid-like appearance. A diagnosis of MEH was established. Although MEH tends to occur in the first 2 decades of life, it can be encountered in elderly patients as well.

Squamous Cell Carcinoma as the Most Common Lesion of the Tongue in Iranians: a 22-Year Retrospective Study.

The tongue has been globally considered as an indicator of general health for millennia. This study aimed to determine the prevalence and distribution of tongue lesions in an Iranian population. In this retrospective study, data from 6,435 oral biopsy reports over a 22-year period (1992-2014) were retrieved from archives of Oral and Maxillofacial Pathology Department, Shahid Beheshti Dental School, Tehran, Iran. These reports were analyzed according to age, sex, type of lesion and location. Prevalence of tongue lesions were reported as percentages. Out of total oral lesions, 238 (3.7%) were found in the tongue, with the incidence peak (42%) being between 41-60 years. Men constituted 53% and women 47%of patients. The youngest patient was a 3-year-old girl with pyogenic granuloma and the oldest one was a 93-year-old man with squamous cell carcinoma (SCC). SCC was the most common (25%) lesion generally found in the lateral border of the tongue with a male predilection. The second and third most prevalent lesions of the tongue were benign keratosis (frictional keratosis) (13.4%) and leukoplakia (13%).White-red lesions (38.6%) were the most frequent subgroup followed by neoplastic lesions (28%). Moreover, irritation fibroma, non-specific ulcers, squamous papilloma, and hemangioma were found as the most frequent lesions in their related subgroups.Given the high rate of SCC of the tongue in Iranian patients, this area should be examined more carefully by dental practitioners and physicians.