Actinic cheilosis: early intervention prevents malignant transformation.

Potentially malignant disorders (PMD) have a high risk of malignant transformation. Habits such as tobacco and alcohol use predispose to PMD and subsequently to an oral carcinoma. Oral squamous cell carcinoma (OSCC) can occur even without the usage of tobacco. Occupational exposure to actinic rays may predispose to the development of OSCC in the lip. People who are involved in farming or those exposed to an environmental background radiation, such as ultraviolet rays, develop a PMD called actinic cheilosis. A high proportion of patients with actinic cheilosis develop an oral carcinoma when not diagnosed and treated in early stages. This case depicts the clinical and histological changes in a 61-year-old Indian man with actinic cheilosis.

Necrotising sialometaplasia at multiple sites: a therapeutic challenge to oral physicians.

Necrotising sialometaplasia is a rare, benign and self-limiting inflammatory lesion that commonly involves minor salivary glands. Its clinical appearance, signs and symptoms very often mimic a carcinomatous lesion, thus creating a diagnostic dilemma for the clinician. Necrotising sialometaplasia being an important differential for an apparent carcinoma should be excluded histologically prior to radical therapy. It commonly occurs on the palatal mucosa following a palatal infiltration anaesthesia. The patient reports to the dentist with a sudden onset of painful ulcerations that rapidly increase in size. This case report describes the occurrence of necrotising sialometaplasia in a 46-year-old man with an unusual clinical presentation at multiple sites in the oral cavity. The importance of history taking, thorough clinical examination and careful histopathological examination in diagnosing necrotising sialometaplasia is highlighted in this paper.

Medication-related osteonecrosis of the jaw: a dentist's nightmare.

Medication-related osteonecrosis of the jaw (MRONJ) is a complication in patients who are on anti-bone resorptive drugs. These drugs are prescribed for patients with multiple myeloma, osteoporosis, metastatic carcinoma and Paget's disease. Common anti-bone resorptive drugs such as bisphosphonate and monoclonal antibodies such as denosumab are prescribed for these patients to prevent bone resorption. Although very effective in preventing bone resorption, a complication arising from these groups of drugs is the development of osteomyelitis of the jaw. This medication-related osteonecrosis occurs only in the jaw bones. It could mimic a metastatic jaw tumour when a patient reports to the dental surgeon with pain and swelling in the jaw. This case report describes MRONJ in a 50-year-old Indian woman. This possible painful drug-induced complication of jaw bones can be prevented if proper medical history is taken and management protocol is followed in these patients.