The apparent diffusion coefficient (ADC) values with diffusion-weighted MRI (DWI) can be used to differentiate and characterize benign and malignant head and neck lesions. We described two cases of glandular odontogenic cyst with DWI: Case 1: glandular odontogenic cyst of the left side of the maxilla in a 73-year-old male; Case 2: glandular odontogenic cyst of the left side of the mandible in a 57-year-old female. The two cases of glandular odontogenic cysts were defined as a well-defined unilocular lesion on panoramic radiography, and T1-weighted image, T2-weighted image, and DWI of the lesions showed high-, high-, and high-signal intensity area than surrounding muscle, respectively. The ADC values of Case 1 and Case 2 were 1.61 x 10(-3) and 2.40 x 10(-3) mm(2) s(-1), respectively. The ADC values with DWI can be an effective technique for the quantitative evaluation of the glandular odontogenic cyst.

Background/Aim:Hyalinizing clear-cell carcinoma (HCCC) is a rare malignant tumor of the minor salivary glands characterized by nests of clear cells within a hyalinized stroma. Its diagnosis remains challenging due to its histological similarity to other neoplasms, and the recent recognition of distinct molecular features, such as Ewing sarcoma breakpoint region 1 (EWSR1)-activating transcription factor 1 (ATF1) fusion. This report describes a rare case of HCCC arising from the tongue with confirmed EWSR1-ATF1 fusion. Case Report:A 54-year-old man presented with a painless mass on the right lateral border of the tongue. Clinical examination revealed an elastic hard tumor measuring 18×15×8 mm. Biopsy under local anesthesia revealed a malignant clear-cell neoplasm. The lesion was completely excised under general anesthesia 2 weeks later. Histopathology showed nests of clear cells with polygonal nuclei in a hyalinized stroma. Immunohistochemistry demonstrated positivity for cytokeratin AE1/AE3, p63 protein and cytokeratin 7, and negativity for cytokeratin 20, α-smooth muscle actin, S-100 protein, vimentin, and cluster of differentiation 10. Periodic acid-Schiff staining was positive, with no diastase sensitivity. Fluorescence in situ hybridization revealed EWSR1 rearrangement, confirmed by reverse transcription-polymerase chain reaction as an EWSR1-ATF1 fusion. Perifocal stroma showed marked hyalinization. These findings support a diagnosis of HCCC with hyalinization. The patient remained disease-free 5 years after surgery. Conclusion:This case highlights the diagnostic importance of integrating histopathology, immunoprofiling, and molecular analysis in patients with rare salivary gland tumors and underscores the favorable outcomes of complete surgical resection for HCCC of the tongue.

The aim of this study was performed to investigate the salivary gland SPECT/CT of parotid glands in patients with lymphoepithelial sialadenitis including preliminary study on clinical and pathological features. The study was performed in 5 patients with lymphoepithelial sialadenitis who underwent salivary gland SPECT/CT. Correlation between maximum standardized uptake value (SUV) at ratio of pre- to post-stimulation and clinicopathological parameters in lymphoepithelial sialadenitis were performed by Pearson correlation coefficient. The maximum SUV of 10 parotid glands in 5 patients with lymphoepithelial sialadenitis using salivary gland SPECT/CT was 23.8 ± 16.9 at pre-stimulation, 10.5 ± 5.1 at post-stimulation, and 2.06 ± 0.66 at ratio of pre- to post-stimulation. Furthermore, the maximum SUV at ratio of pre- to post-stimulation was significantly correlated with Saxon test score (r = 0.637, p = 0.048). The salivary gland SPECT/CT can be useful in clinical practice for the quantitative management of parotids in patients with lymphoepithelial sialadenitis.

To radiographically and histologically evaluate bone formation following alveolar ridge preservation (ARP) using octacalcium phosphate collagen composite (OCP/Col). A total of 42 patients (48 sites) completed the study. The primary comparison was performed between an OCP/Col-treated molar group (OCP-M) and an atelocollagen-treated molar control group (Control-M). In addition, an OCP/Col-treated incisor–premolar group (OCP-IP) was included as an exploratory subgroup to assess tooth-type effects. Alveolar bone dimensional changes were assessed using cone-beam computed tomography (CBCT) immediately after ARP and at 6 months. Guided hard tissue biopsies were performed to quantify the proportions of mature bone and residual granules. Changes in buccal bone height were + 0.7 mm (± 2.2) in the OCP-M group, − 0.6 mm (± 0.7) in the Control-M group, and + 3.7 mm (± 3.9) in the OCP-IP group. The difference between the OCP-M and Control-M groups was significant (p = 0.041), as was that between the OCP-IP and OCP-M groups (p = 0.038). Histologically, the proportion of mature bone in the alveolar crest region was significantly higher in the OCP-M group (38.14

Most oral malignant tumors are primary, and the incidence of oral metastatic tumors is low at 1

Sialolithiasis-a condition that most commonly affects the salivary glands, especially the submandibular gland-arises from the formation of calcified masses (sialoliths) within the salivary ducts. Although the morphology of sialoliths is diverse, reports of those containing bone are exceedingly rare, with only one documented case to date. Herein, we describe an unusual case of submandibular sialolithiasis with histologically confirmed bone formation. A 50-year-old Japanese woman presented with swelling and pain in the right submandibular region. Computed tomography showed a well-defined calcified lesion, and T2-weighted magnetic resonance imaging revealed a high-signal-intensity area posterior to the calcification within the gland. Under a clinical diagnosis of submandibular sialolithiasis with sialadenitis, surgical excision of the submandibular gland was performed. Gross examination of the excised gland revealed a 20 & times; 13 mm sialolith with a pale brown core surrounded by concentric lamellar structures. Histopathological assessment confirmed bone formation within the lamellar portions of the sialolith and lamellar calcification deposited around the bone tissues. The bone mass consisted of various morphologies and maturation stages, including mature bone with osteocytes, immature woven bone, bone lacking osteocytes, and bone becoming acellular during ossification. These bone tissues were not in contact with the ductal epithelium or fibrous connective tissue. The surrounding submandibular gland exhibited chronic obstructive sialadenitis with lymphoplasmacytic infiltration. Pathological ossification may occur as degenerative or necrotic tissue transforms into bone, potentially involving local mesenchymal stromal cells; however, the exact process leading to bone formation in these rare cases cannot be confirmed until more material becomes available.

Sjögren’s syndrome causes dryness of the eyes and mouth due to destruction of glandular tissue. Single-photon emission computed tomography/computed tomography (SPECT/CT) is used to evaluate salivary gland function. This study aimed to quantitatively evaluate the stage of Sjögren’s syndrome using SPECT/CT maximum standardized uptake value (SUVmax) by comparing the SUVmax with the Saxon test, magnetic resonance (MR) sialography stage, and histopathological grade. This study was conducted in 29 patients with Sjögren’s syndrome who underwent the Saxon test, MR sialography, SPECT/CT, and histopathological examination. We compared the SPECT/CT SUVmax with the Saxon test, MR sialography stage, and histopathological grade to determine the stage of Sjögren’s syndrome. We then calculated the cutoff value of SUVmax at pre-stimulation for the parotid glands in the early and late stages of Sjögren’s syndrome. The SUVmax for > 2 g per 2 min by the Saxon test was higher than that for ≤ 2 g per 2 min. The SUVmax for MR sialography stages 0–1 was higher than that for stages 2–4. The SUVmax for histopathological grades 0–2 was higher than that for grades 3–4. The cutoff value for early and late Sjögren’s syndrome was 20.55 (sensitivity, 0.85; specificity, 0.67). SPECT/CT is a highly suitable modality for quantitatively evaluating the stage of Sjögren’s syndrome. Especially, the pre-stimulation SUVmax of the parotid glands serves as a valuable indicator for assessing Sjögren’s syndrome stage and predicting prognosis.

Glandular odontogenic cysts (GOC) are relatively rare, and require differentiation from radicular cysts, dentigerous cysts, and central mucoepidermoid carcinoma of jawbone. We conducted clinical, histopathological, and immunohistochemical analysis to elucidate the relationship between the clinical behavior and histopathological features, as well as the origin of tissues and factors related to the development of GOC. Thirty specimens from 29 patients (19 males, 11 females; mean age 51.8, range 18–85 years) diagnosed histopathologically with GOC were studied. By location site, mandibular molar region was most common (17 cysts), followed by maxillary anterior region (5), maxillary molar region (4), and mandibular anterior region (4). All cases were clinically asymptomatic and were detected incidentally on X-ray examination. In the X-ray findings, all cases showed unilocular, well-defined radiolucencies, with a long diameter ranging from 9 to 36 mm. Histopathologically, eosinophilic cuboidal cells and microcysts were found in all cases, apocrine snouting was observed in 27 (90

Objectives: Perforation of the pulp floor prior to tooth replantation promotes tertiary dentin formation and reduces bonelike tissue formation in the pulp cavity. However, the mechanisms remain largely unclear. This study aimed to elucidate the effects of this method on macrophage dynamics and angiogenesis in dental pulp. Methods: The bilateral maxillary first molars of TetOP-H2B-GFP mice were extracted. The left molar was immediately replanted, serving as the control group (CG), whereas the pulp floor of the right molar was perforated using a tungsten carbide bur prior to tooth replantation, serving as the experimental group (EG). Immunohistochemical analysis of F4/80, CD206, erythroblast transformation-specific-related gene (ERG), and GFP was performed on days 3, 5, and 7. Results: The F4/80-positive area in the coronal pulp of the CG on days 3 and 7 was larger than that of the EG. The area of CD206 positivity, a specific marker of M2 macrophages, in the coronal pulp of the EG on day 7 was larger than that of the CG. The number of cells positive for ERG, a transcription factor expressed in vascular endothelial cells, in the coronal pulp of the EG on days 5 and 7 was higher than that of the CG. GFP-positive cells were distributed around the pulp floor on day 5 of the EG. Conclusions: This study demonstrates that perforation of the pulp chamber floor prior to tooth replantation induces early revascularization and vascular stabilization as well as promoting M2 macrophage polarization in the coronal pulp.

Near-infrared photoimmunotherapy (NIR-PIT) is a novel cancer therapy based on a monoclonal antibody (mAb) conjugated to a photosensitizer (IR700Dye). The conjugate can be activated by near-infrared light irradiation, causing necrotic cell death with high selectivity. In this study, we investigated NIR-PIT using a small protein mimetic (6-7 kDa, Affibody) which has more rapid clearance and better tissue penetration than mAbs for epidermal growth factor receptor (EGFR)-positive salivary gland cancer (SGC). The level of EGFR expression was examined in vitro using immunocytochemistry and Western blotting. Cell viability was analyzed using the alamarBlue assay. In vivo, the volume of EGFR-positive tumors treated with NIR-PIT using the EGFR Affibody-IR700Dye conjugate was followed for 43 days. It was found that NIR-PIT using the EGFR Affibody-IR700Dye conjugate induced the selective destruction of EGFR-positive SGC cells and restricted the progression of EGFR-positive tumors. We expect that NIR-PIT using the EGFR Affibody-IR700Dye conjugate can efficiently treat EGFR-positive SGC and preserve normal salivary function.

Intravascular papillary endothelial hyperplasia (IPEH) is a benign non-neoplastic lesion histopathologically characterized by papillary proliferation of endothelial cells in dilated vascular lumen, and occurrence in the oral region is relatively rare. In this study, we performed clinical, histopathological, and immunohistochemical evaluations in 13 cases of oral IPEH, and examined the pathogenetic mechanism, pathophysiology, and differentiation from other vascular anomalies. The upper lip was the most common lesion site (5 cases), followed by the lower lip (3 cases) and the tongue (2 cases). The most common clinical diagnosis was hemangioma in 7 cases, followed by benign tumor in 4 cases. On gross examination, the tumor was dark red or mucosal color, similar to a hemangioma, and the surface was smooth, elastic and soft. Histological classification was mixed form in 11 cases and pure form in 2 cases. In immunohistochemical staining, CD31 was expressed in the cytoplasm and on cell membrane of vascular endothelial cells in all 13 cases; ERG was expressed in the nuclei of vascular endothelial cells in all 13 cases; alpha-SMA was expressed on cell membrane of smooth muscle cells in the blood vessel wall in all 13 cases; CD105 was expressed in the cytoplasm of vascular endothelial cells in 10 of 13 cases; and VEGF-A was expressed in the cytoplasm of vascular endothelial cells in all 13 cases. D2-40 was expressed in the cytoplasm and on cell membrane of endothelial cells within the papillary structures in only 2 cases, but Glut-1 expression was not detected in any of the cases. IPEH was easily differentiated from angiosarcoma, Kaposi's sarcoma, mucous cyst, and pyogenic granuloma. The pathogenetic mechanism of this disease suggested by this study is that thrombus formation induces a hypoxia and low glucose state at the lesion site, and VEGF produced by endothelial cells stimulates reactive proliferation of the endothelial cells to form IPEH.

Hyperplastic dental follicles (HDFs) represent odontogenic hamartomatous lesions originating from the pericoronal tissues and are often associated with impacted or embedded teeth. These lesions may occasionally feature unique calcifying bodies, known as calcifying whorled nodules (CWNs), characterized by stromal cells arranged in a whorled or spiral fashion. CWNs are typically observed in multiple calcifying hyperplastic dental follicles or regional odontodysplasia. In our study, we examined 40 cases of HDFs, including nine instances with characteristics of CWNs, referred to as calcifying hyperplastic dental follicles (CHDFs), which are infrequently accompanied by odontodysplasia. The median ages of the HDFs and CHDFs were 16 (ranging from 3 to 66) and 15 (ranging from 11 to 50) years, respectively. The lower third molars were the most frequently affected by HDSFs and CHDFs, followed by the upper canines. A histological examination was conducted on all 40 cases, with an immunohistochemical analysis performed on 21 of them. Among the cases with CWN, nine affected a single embedded tooth, with one exception. CWNs exhibited diverse calcifications featuring sparse or entirely deposited psammoma bodies, and some displayed dentinoid formation. Immunohistochemically, the stromal cells of HDFs were frequently positive for CD56 and nestin. By contrast, CWNs were negative for CD56 but positive for nestin as well as hairy and enhancer split 1 (HES1), with a few dentin sialoprotein (DSP)-positive calcified bodies. Our results revealed that hamartomatous CHDFs can impact multiple and single-embedded teeth. CWNs composed of nestin and HES1-positive ectomesenchymal cells demonstrated the potential to differentiate into odontoblasts and contribute to dentin matrix formation under the influence of HES1. This study is the first report documenting odontoblastic differentiation in HDFs. The rare occurrence of HDFs and CHDFs contributes to limited comprehension. To prevent misdiagnosis, a better understanding of these conditions is necessary.

Papillary thyroid carcinoma is the most common pathological type of thyroid cancer. Lymph node metastasis in patients with papillary thyroid carcinoma is common. We report a case of cervical lymph node metastasis of papillary thyroid carcinoma in a patient with maxillary gingival squamous cell carcinoma. A 77-year-old man presented with swelling and pain on the left side of the maxilla. Maxillary gingival squamous cell carcinoma without cervical lymph node metastasis was suspected from the CT images of the lesion in addition to panoramic radiography. A partial biopsy of the maxillary region was performed. Histopathological diagnosis was well to moderately differentiated squamous cell carcinoma. Chemoradiotherapy (CDDP: 400 mg and external radiation: 60 Gy) was performed for the maxillary tumor, and post-chemoradiotherapy outcomes were good for the maxillary tumor. However, contrast-enhanced CT taken 4 months after the primary treatment showed increase of the superior internal jugular node with heterogeneous enhancement and the mid internal jugular node with homogeneous enhancement and flecks of calcification on the left side of the neck. Cervical lymph node metastasis of the left maxillary gingival carcinoma after chemoradiotherapy was suspected from the CT images. Neck dissection was performed. Histopathological diagnosis was cervical lymph node metastasis of the left maxillary gingival squamous cell carcinoma and papillary carcinoma of the thyroid.

Abstract Background Adenocarcinoma not otherwise specified (NOS) is an uncommon malignant minor salivary gland tumor. We report gallium-67 SPECT/CT and diffusion-weighted MRI (DWI) in the palatal tumor, especially a rare case with adenocarcinoma NOS. Case presentation An 85-year-old female patient presented with swelling on the palate within 3 months. DWI and apparent diffusion coefficient (ADC) maps indicated high and low signal intensities on the lesion, respectively. ADC value of the lesion was 0.58 × 10–3 mm2s−1. Gallium-67 SPECT/CT showed increased uptake on the lesion and no metastasis. The maximum SUV for the palatal lesion was 7.36. Histopathological diagnosis by a biopsy was adenocarcinoma NOS. Conclusion The gallium-67 SPECT/CT and DWI should be effective for assessment of the palatal tumor.

BackgroundBreast carcinoma is a common tumor in women, but it rarely metastasizes to the oral region. Case presentationAn 83-year-old woman presented with numbness and pain on the right side of the mandible. The patient's medical history included breast cancer that was treated with surgery. Panoramic radiograph showed a radiolucency with ill-defined margin in the right mandible. CT images showed an osteolytic lesion with cortical bone destruction in the right mandible. Histopathological diagnosis was invasive ductal carcinoma. ConclusionDental practitioner should be aware that metastatic tumor of the mandible may occur in the patient with breast cancer.

In recent years, bacterial DNA in formalin-fixed paraffin-embedded (FFPE) samples has been recognized as a valuable bioresource for microbiota studies. This study aimed to examine the effect of the FFPE process on microbiota profiling to evaluate whether FFPE samples could serve as an alternative bioresource to fresh samples in oral microbiota studies. Fresh saliva was collected from nine subjects. The pellets obtained by centrifuging the collected saliva were fixed in formalin, then dehydrated and embedded in paraffin to prepare FFPE samples. The abundance of the hypervariable regions V1-9, V1-2, and V3-4 of the 16S rRNA gene in fresh and FFPE samples was relatively compared. In addition, microbiota profiling was performed to compare the results between the two sample types. The results showed that the FFPE process resulted in a certain degree of fragmentation of the 16S rRNA gene. However, the V1-2 region was relatively well-preserved compared to the V1-9 and V3-4 regions, suggesting that short regions are suitable targets for oral microbiota analysis. Importantly, there were no significant differences in alpha and beta diversity of microbiota between fresh and FFPE samples, and microbiota profiles were similar between the two sample types, suggesting that FFPE samples could be a valuable bioresource for oral microbiota studies.

Purpose: The aim of this study was to evaluate the accuracy of intraoral ultrasonography (US) for gingival squamous cell carcinoma (SCC) thickness and bone invasion compared with computed tomography (CT). Materials and Methods: This study assessed eight gingival squamous cell carcinoma patients who underwent US and CT at our hospital from April 2021 to November 2021. Grayscale and color Doppler US were performed using a liner 14 MHz transducer. Computed tomography imaging was undergone with a 16-multidetector CT scanner using the oral and maxillofacial protocol. The relationship between US and CT on tumor thickness of gingival SCC was assessed by Pearson's rank correlation test. A p value lower than 0.05 was considered as statistically significant. Results: Presence or absence of bone invasion was consistent in CT and US. We plotted tumor thickness of gingival SCC and observed a significant correlation between tumor thickness using CT and US. Conclusion: We showed the usefulness of to evaluate of tumor thickness and bone invasion using intraoral US is useful with gingival SCC.

Objectives: Shortening the root of a mouse molar prior to tooth replantation results in early revascu-larization in the pulp cavity and activation of the dental pulp quiescent stem cells. This study aimed to validate the effects of pulp chamber floor perforation on pulpal healing after tooth replantation as a strategy to promote early revascularization into the pulp.Methods: The maxillary first molars of three-week-old Crlj:CD1 mice were extracted and repositioned into the original socket: the left teeth were immediately replanted (control group: CG), whereas the floor of the pulp chamber of the right teeth was perforated with a tungsten carbide bur before tooth replantation (experimental group: EG). The samples were collected from three days to eight weeks postoperatively. In addition to the TUNEL assay, immunohistochemistry for Nestin, CK14, and Ki-67 was conducted. Results: In the EG, early revascularization occurred with a decrease in apoptosis and an increase in cell proliferation, facilitating pulpal healing, compared with the CG. The rate of Nestin-positive perimeter in the distal root significantly increased on days 5 and 14 and the amount of Nestin-positive hard tissue increased on day 14. However, on day 7, the number of epithelial cell rests of Malassez in the EG significantly decreased, making the EG susceptible to ankylosis at the floor.Conclusions: Intentionally perforating the floor of the pulp chamber provides a route for early revas-cularization, resulting in better pulpal healing after tooth replantation.(c) 2023 Japanese Association for Oral Biology. Published by Elsevier B.V. All rights reserved.