Segmental odontomaxillary dysplasia (SOD) is a rare and unusual nonhereditary developmental disorder that affects one side of the maxilla, impacting the hard tissue, soft tissue, and dentition in the affected area. It most frequently presents with enlargement of the gingival and osseous tissue of the affected side and hypodontia of the involved quadrant. Cutaneous irregularities of the impacted area are also common. We report a case of SOD arising in the right maxilla of a three-year-old female. Our report and review of the literature highlight the clinical, radiographic, and histopathologic characteristics of SOD, as well as the management of patients and the proposed etiologies of its pathogenesis.

Introduction Idiopathic gingival papillokeratosis with crypt formation (IGPCF) is an uncommon condition of unknown etiology, characterized by keratotic plaques in the upper labial attached gingiva of young patients. No treatment is required, although periodic follow-up is recommended as some lesions persist. Despite the limited number of published cases, the diagnosis of IGPCF is highly suggestive based on the distinctive clinical features, and biopsy is usually unnecessary. We aim to report seven additional patients with IGPCF from Brazil and the United States. Material and Methods Seven IGPCF cases were retrieved from the archives of the Oral Pathology Laboratories from the Federal University of Rio de Janeiro, Brazil, and Texas A&M University, USA, between 2017 and 2023. Results Six patients were male, and one patient was female, with an average age of 15.8 years (ranging from 12 to 21). All patients presented with asymptomatic bilateral papillary white plaques located exclusively in the attached anterior gingiva with a duration ranging from 4 to 12 months. Six cases presented in the maxillary labial gingiva, whereas a single case was located in the mandibular labial gingiva. Clinically, the lesions appeared as well-demarcated symmetric white plaques with an irregular surface, stopping abruptly at the mucogingival junction. Incisional biopsies were performed on six patients with exuberant lesions, while an exclusively clinical diagnosis was established in a single patient with discrete plaques. Microscopic analysis revealed gingival mucosa showing overlying parakeratosis with papillary architecture and multifocal epithelial crypt-like invaginations with parakeratin plugging. Mild pseudoepitheliomatous hyperplasia was noticed, with no signs of epithelial atypia. Conclusion Clinicians should be aware of IGPCF and differentiate it from other papillary keratotic oral lesions. Reporting additional cases may provide further characterization of this unusual entity and improve understanding as it relates to etiology and prognosis.

Introduction Foreign body gingivitis (FBG) is an inflammatory reaction associated with the presence of foreign material in the gingival tissues. Si is the element most prevalent in the foreign particles and is typically found in nature as SiO2 (silica). Silica is a major component of toothpaste, pumice, polishing paste, and carborundum. We have previously reported a significant association between the presence of foreign particles and epithelial dysplasia. Herein, we aim to evaluate the clinical and histologic features of additional gingival lesions of FBG with significant epithelial changes to better characterize the histologic spectrum of the host response and epithelial findings. Materials and Methods Fourteen gingival lesions showing FBG and significant epithelial changes were retrieved from the archives of the Texas A&M Oral Pathology Services. Clinical records and deidentified microscopic slides were reviewed. Results Both sexes were affected equally, with an average age of 68.7 years. There was a strong predilection for the posterior gingiva (92.9% of cases), and the lesions were clinically suspected to be leukoplakia, proliferative verrucous leukoplakia, or dysplasia in the majority of cases. Microscopically, the predominant inflammatory cell type was lymphocytes followed by plasma cells, and the pattern of inflammation was lichenoid in 64.2%. A verrucous architecture was seen in 57.1% of the cases and varying degrees of dysplasia in 71.4 %. Conclusion Although the effects of silica microparticles in oral tissues are poorly understood, they have been shown to cause significant changes such as silicosis and carcinoma in the lung. Given the recent increase in the prevalence of gingival carcinomas and the wide use of nano- and microparticles in dental and household products, the biological effects of these particles in oral epithelium need to be better elucidated. Further documentation and evidence are needed, and pathologists should evaluate and document all gingival premalignant lesions for foreign material.

Multispectral autofluorescence lifetime imaging (maFLIM) can be used to clinically image a plurality of metabolic and biochemical autofluorescence biomarkers of oral epithelial dysplasia and cancer. This study tested the hypothesis that maFLIM-derived autofluorescence biomarkers can be used in machine-learning (ML) models to discriminate dysplastic and cancerous from healthy oral tissue. Clinical widefield maFLIM endoscopy imaging of cancerous and dysplastic oral lesions was performed at two clinical centers. Endoscopic maFLIM images from 34 patients acquired at one of the clinical centers were used to optimize ML models for automated discrimination of dysplastic and cancerous from healthy oral tissue. A computer-aided detection system was developed and applied to a set of endoscopic maFLIM images from 23 patients acquired at the other clinical center, and its performance was quantified in terms of the area under the receiver operating characteristic curve (ROC-AUC). Discrimination of dysplastic and cancerous from healthy oral tissue was achieved with an ROC-AUC of 0.81. This study demonstrates the capabilities of widefield maFLIM endoscopy to clinically image autofluorescence biomarkers that can be used in ML models to discriminate dysplastic and cancerous from healthy oral tissue. Widefield maFLIM endoscopy thus holds potential for automated in situ detection of oral dysplasia and cancer.

Materials and Methods:10 cases each of AEP, IPH and PSCC were retrieved from the University of Florida, Oral Pathology Biopsy Service archive and stained with Anti-KMT6/EZH2 antibody.The cases were reviewed and the extent and pattern of EZH2 expression were assessed.The results were analyzed for statistical significance using Fischer's exact test.Results:The pattern and intensity of EZH2 expression in AEP and PSCC demonstrated statistically significant differences when compared to IPH (p=0.002).In addition, the basal cell layer showed EZH2 expression in all the cases of AEP (100%) and PSCC (100%) but only 3 out of 10 (30%) in IPH (p=0.000),comparable to normal oral epithelial control tissue. Conclusion:EZH2 expression in AEP is more similar to malignant processes than benign lesions.The pattern of basal cell layer expression of EZH2 could be a potential prognostic indicator of malignant transformation risk in oral AEP lesions.A subsequent study by our group to assess EZH2 expression with respect to clinical outcome in AEP lesions is ongoing.

ObjectiveCanalicular adenoma (CA) is an uncommon but unique benign tumor of salivary gland origin. It is the third most common benign tumor of minor salivary glands, representing less than 1% of all salivary neoplasms. A systematic review is presented of reported cases of CA, to determine trends in presentation, diagnostic features, treatment, and patient outcome.MethodsSearches of specific databases, as reported, were carried out to identify papers reporting CA. The variables were patient symptoms, tumor location, histopathological findings, demographics, treatment, follow-up, and recurrence.Results430 cases were identified; the most common location was in the upper lip (66.3%), followed by hard palate (14.5%). The most common clinical presentation was a nodule (46.5%), followed by asymptomatic (29.5%), and discomfort (28.7%). CA was most frequently seen in females (64%). The average age was 66.3 years. 97% of cases were treated surgically. The average follow-up was 136.3 months, and recurrence was reported in 3% of the cases.ConclusionCA shows a strong predilection for the upper lip. CAs are frequently asymptomatic, but the principal symptom was pressure.

Aims To immunohistochemically evaluate the cytokeratin ( CK ) pattern of expression in localized juvenile spongiotic gingival hyperplasia ( LJSGH ) as compared with the gingival epithelium ( GE ). Methods and results Ten cases of LJSGH were semiquantitatively evaluated for the immunohistochemical pattern of CK 1/10, CK 4, CK 8/18, and CK 19. GE controls were taken from 10 cases of reactive gingival fibroepithelial hyperplasia. GE s showed mean positivity rates of 80% for both CK 1/10 and CK 4, and 5% for both CK 8/18 and CK 19. LJSGH s showed mean positivity rates of 65% for CK 19, 60% for CK 8/18, 30% for CK 4, and 5% for CK 1/10. The differences between LJSGH s and GE s were statistically significant ( P < 0.01). Conclusions The LJSGH pattern of CK expression is reminiscent of the profile described in the literature for the junctional epithelium ( JE ). Possibly, JE exteriorized from the gingival sulcus would be more prone to irritation from a variety of sources, resulting in inflammation and hyperplasia, with the subsequent development of LJSGH .

Using saliva for disease diagnostics and health surveillance is a promising approach as collecting saliva is relatively easy and non-invasive. Over the past two decades, using salivary biomarkers specifically for early cancer detection has attracted much research interest, especially for cancers occurring in the oral cavity and oropharynx, for which the five-year survival rate (62%) is still one of the lowest among all major human cancers. More than 90% of oral cancers are oral squamous cell carcinoma (OSCC) and the standard method for detection is through a comprehensive clinical examination by oral healthcare professionals. Despite the fact that the oral cavity is easily accessible, most OSCCs are not diagnosed until an advanced stage, which is believed to be the major reason for the low survival rate, and points to the urgent need for clinical diagnostic aids for early detection of OSCC. Thus, much research effort has been dedicated to investigating potential salivary biomarkers for OSCC, and more than 100 such biomarkers have been reported in the literature. However, some important issues and challenges have emerged that require solutions and further research in order to find reliable OSCC salivary biomarkers for clinical use. This review article provides an up-to-date list of potential OSCC salivary biomarkers reported as of the fall of 2013, and discusses those emerging issues. By raising the awareness of these issues on the part of both researchers and clinicians, it is hoped that reliable, specific and sensitive salivary biomarkers may be found soon-and not only biomarkers for early OSCC detection but also for detecting other types of cancers or even for monitoring non-cancerous disease activity.

Optical imaging techniques using a variety of contrast mechanisms are under evaluation for early detection of epithelial precancer; however, tradeoffs in field of view (FOV) and resolution may limit their application. Therefore, we present a multiscale multimodal optical imaging system combining macroscopic biochemical imaging of fluorescence lifetime imaging (FLIM) with subcellular morphologic imaging of reflectance confocal microscopy (RCM). The FLIM module images a 16 x 16 mm(2) tissue area with 62.5 mu m lateral and 320 ps temporal resolution to guide cellular imaging of suspicious regions. Subsequently, coregistered RCM images are acquired at 7 Hz with 400 mu m diameter FOV, <1 mu m lateral and 3.5 mu m axial resolution. FLIM-RCM imaging was performed on a tissue phantom, normal porcine buccal mucosa, and a hamster cheek pouch model of oral carcinogenesis. While FLIM is sensitive to biochemical and macroscopic architectural changes in tissue, RCM provides images of cell nuclear morphology, all key indicators of precancer progression. (C) The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

Fluorescence lifetime imaging (FLIM) offers a noninvasive approach for characterizing the biochemical composition of biological tissue. There has been an increasing interest in the application of multispectral FLIM for medical diagnosis. Central to the clinical translation of FLIM technology is the development of compact and high-speed endoscopy systems. Unfortunately, the predominant multispectral FLIM approaches suffer from limitations that impede the development of endoscopy systems that are suitable for in vivo tissue imaging. We present a compact wide-field time-gated FLIM flexible endoscope capable of continuous lifetime imaging of up to three fluorescence emission bands simultaneously. This endoscope design will facilitate the evaluation of FLIM for in vivo applications.