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Jeng PY, Chang MC, Chiang CP, Lee CF, Chen CF, Jeng JH. Oral soft tissue biopsy surgery: Current principles and key tissue stabilization techniques. J Dent Sci 2024; 19:11-20. [PMID: 38303868 PMCID: PMC10829751 DOI: 10.1016/j.jds.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/12/2023] [Indexed: 02/03/2024] Open
Abstract
There are different kinds of benign and malignant lesions in the oral cavity. Clinically, definite diagnosis can be confirmed only by doing adequate surgical biopsy and subsequent histopathological examination. Inadequate biopsy technique, unsuitable selection of the location for biopsy, inappropriate tissue handling and record of patients' information may lead to artifacts and misdiagnosis by the oral pathologists. Soft tissue stabilization is a challenge during oral surgery procedures. It needs the cooperation of operator, assistants, and patients to overcome the difficulty and ensure the successful outcome. In this article, we reviewed the procedures for clinical surgical biopsy, and raised three current tissue stabilization methods including fingers and gauze stabilization, stabilization with chalazion forceps and adapted instruments, and stabilization with retraction sutures. Moreover, some limitations were also presented. Clinician should examine the clinical characteristics of the oral lesion, the surrounding anatomical structures, and their own clinical experience and preference to select the appropriate tool. More understanding of these biopsy and tissue stabilization methods can effectively improve the biopsy procedures and obtain adequate tissues for histopathological examination and subsequent issue of an accurate pathological report.
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Affiliation(s)
- Po-Yuan Jeng
- Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Mei-Chi Chang
- Chang Gung University of Science and Technology, Kwei-Shan, Taoyuan, Taiwan
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Chun-Pin Chiang
- Department of Dentistry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Fang Lee
- Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Feng Chen
- Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jiiang-Huei Jeng
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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Lopes-Santos G, Peralta-Mamani M, Oliveira DT. Histological implications of high-power laser use in the oral soft tissue lesions: a systematic review. Lasers Med Sci 2023; 38:263. [PMID: 37952038 DOI: 10.1007/s10103-023-03923-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/26/2023] [Indexed: 11/14/2023]
Abstract
The objective of this study was to describe the histological artifacts caused by high-power laser use compared to cold scalpel surgery in oral soft tissue lesions. Clinical studies that evaluated and compared histological artifacts resulting from the use of high-power lasers and cold scalpels in oral soft tissue lesions biopsies were retrieved from seven databases and four grey literatures, up to July 2022. The risk of bias was investigated using the ROBINS-I tool. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Seven studies were eligible for qualitative analysis. Based on the results obtained, those four studies had a low risk of bias, and three studies had an unclear risk of bias. The certainty of the evidence was classified as low. Limited evidence showed that epithelial artifacts such as loss of intraepithelial and subepithelial adhesions, accompanied by pyknotic, fusiform, and/or hyperchromic nuclei, were more common when a high-power laser device was used. Four articles reported that the use of high-power lasers did not interfere with the histopathological diagnosis of oral soft tissue lesions. Due to the heterogeneity of the data, a meta-analysis was not performed. Compared to the use of cold scalpels, histological artifacts, particularly those observed in epithelial tissue, are more common when high-powered lasers are used in oral lesions biopsies. The eligibility criteria and adequate indications of high-power lasers in different oral soft tissue lesion treatments must be respected to avoid tissue artifacts that impair precise histopathological diagnosis.
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Affiliation(s)
- Gabriela Lopes-Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Mariela Peralta-Mamani
- Department of Surgery, Stomatology, Pathology and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
- Faculdade do Centro Oeste Paulista - FACOP, Piratininga, São Paulo, Brazil
| | - Denise Tostes Oliveira
- Department of Surgery, Stomatology, Pathology and Radiology, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
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Castejón-González AC, Reiter AM. Oral and Maxillofacial Tumor Management - From Biopsy to Surgical Removal. Vet Clin North Am Small Anim Pract 2021; 52:235-270. [PMID: 34838252 DOI: 10.1016/j.cvsm.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The main objective of oral and maxillofacial (OMF) tumor resection is to get local control of the disease. Many OMF tumors can be cured with wide or radical surgery, whereas others might only achieve temporary local control of the disease by removing infection and the source of pain, thereby improving the quality of life of the patient while keeping masticatory function. The standard of care on managing OMF tumors includes the diagnosis and identification of the local and distant extension of the disease to establish an appropriate treatment plan tailored for each patient. In this article, we provide a practical review of the current information related to staging, biopsy, and main surgical techniques for OMF tumor removal.
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Affiliation(s)
- Ana C Castejón-González
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA
| | - Alexander M Reiter
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
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Chaudhry K, Khatana S, Kaur A, Kumar S, Gigi PG, Aparna G. 2.5% EMLA Versus 2% Lignocaine with Adrenaline Injection in Small Oral Mucosal Biopsies: A Parallel Group Randomized Controlled Trial. J Maxillofac Oral Surg 2021; 20:619-627. [PMID: 34776695 DOI: 10.1007/s12663-020-01363-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 04/01/2020] [Indexed: 11/25/2022] Open
Abstract
Trial Design The study was designed as an open label randomized comparative parallel group design with a 1:1 allocation ratio. Methods All consecutive patients reporting for small biopsies (incisional or excisional) who gave written informed consent were included in the study between October 2018 and October 2019. They were randomized into two groups, Group A and Group B both receiving intervention in the form of 2.5% EMLA cream and 2% Lignocaine with 1:80,000 Adrenaline injection respectively, to anaesthetise tissue for small mucosal biopsies in the oral cavity. Results EMLA was found to be as effective as lignocaine infiltration with a completely painless application and higher satisfaction for overall comfort during procedure. The duration required to achieve anaesthesia was however more. A particular subgroup of pathology was found to be completely resistant to anaesthesia by EMLA. Conclusion We recommend the use of EMLA as a sole anaesthetic in small mucosal biopsies and shavings in all patients. We suggest it as a higher and first line recommendation for anaesthesia in needle phobic patients and children.
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Affiliation(s)
| | | | - Amanjot Kaur
- Department of Dentistry, AIIMS Jodhpur, Jodhpur, India
| | | | - P G Gigi
- Department of Dentistry, AIIMS Jodhpur, Jodhpur, India
| | - G Aparna
- Department of Dentistry, AIIMS Jodhpur, Jodhpur, India
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Lajolo C, Gioco G, Rupe C, Patini R, Rizzo I, Romeo U, Contaldo M, Cordaro M. Patient perception after oral biopsies: an observational outpatient study. Clin Oral Investig 2021; 25:5687-5697. [PMID: 33704571 DOI: 10.1007/s00784-021-03870-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/01/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the postoperative course in patients undergoing oral mucosal biopsies, considering clinical and patient's perception variables potentially correlated to poor healing. SUBJECTS AND METHODS Eighty patients underwent oral biopsies. All the variables connected with the surgery were recorded, and the harvested volume was calculated through image software (ImageJ, NIH, Betesda, USA). To evaluate the postoperative discomfort, the OHIP-14 and the numeric rating scale of pain (NRS) were administered at 6 h, 7 days and 21 days after biopsy. RESULTS Six hours after the biopsy, 22 (OHIP-14 ≥ 20) and 24 (NRS ≥ 4) patients experienced a troublesome or painful healing, respectively. A significant statistical correlation between poor healing and high scores of NRS and OHIP was detected (Pearson's correlation test p < 0.05). Higher values of OHIP-14 were correlated to the type of lesion (OR = 1.165; p < 0.05), whereas high values of NRS were correlated to the use of systemic drugs (p < 0.05). No surgical variable had a significant statistical correlation with any of the outcomes. CONCLUSIONS The clinical evaluation was correlated with the patient's perception of pain and discomfort. This finding could be suggestive of the fact that wound healing can be reliably monitored with the help of these tools. CLINICAL RELEVANCE Patient perception can be a predictor of the healing of biopsied tissues.
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Affiliation(s)
- C Lajolo
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - G Gioco
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - C Rupe
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy.
| | - R Patini
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - I Rizzo
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - U Romeo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - M Contaldo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via Luigi de Crecchio, 6, 80138, Naples, Italy
| | - M Cordaro
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS," School of Dentistry, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168, Rome, Italy
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Gambino A, Cabras M, Cafaro A, Broccoletti R, Carossa S, Hopper C, Chiusa L, El Haddad G, Porter SR, Arduino PG. In-vivo usefulness of optical coherence tomography in atrophic-erosive oral lichen planus: Comparison between histopathological and ultrastructural findings. J Photochem Photobiol B 2020; 211:112009. [PMID: 32862089 DOI: 10.1016/j.jphotobiol.2020.112009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/06/2020] [Accepted: 08/21/2020] [Indexed: 02/07/2023]
Abstract
Oral lichen planus (OLP) is a common premalignant chronic inflammatory disorder. Optical Coherence Tomography (OCT) provides a real-time, non-invasive, and in-situ optical signature using light of varying wavelengths to examine tissue. Aim of the present study was to assess the possible role of OCT as diagnostic tool for atrophic-erosive OLP by examining OCT scans of healthy buccal mucosa, and comparing their ultrastructural features with those of a buccal mucosa affected by atrophic-erosive OLP, using their histopathological counterparts as the gold standard. Through grayscale (enface scan) and an application in which the vascularization of the tissue is visible (dynamic scan), it was possible to distinguish the healthy from the lichenoid pattern from 20 controls (12 M; 8 F; mean age: 41.32 years) and 20 patients with histologically confirmed atrophic-erosive OLP (7 M; 13 F; mean age: 64.27 years). In detail, mean width of stratified squamous epithelium (EP) and lamina propria (LP) were evaluated. Among controls, EP and LP showed a mean width of 300 (±50) and of 600 (±50) μm respectively; among cases, disruption of membrane basement prevented from any measurement. Furthermore, a differential pattern of EP and LP emerged between the two groups: a light-grayish, hypo-reflective, homogeneous area of EP recurring in controls turned into a hyper-reflective, non-homogeneous area among cases. Dynamic scan showed a differential profile of LP vascularization, varying from a hypo-reflective red area with small blood vessels in the control group, to a hypo/hyper-reflective area, completely overrun by a denser, wider blood flow amid OLP cases. Although histopathological examination remains the gold standard for OLP diagnosis, OCT could be a potentially helpful tool for the clinician and the pathologist, since it allows analysis of the vascularization of the sample without adversely affecting histological processing.
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Affiliation(s)
- Alessio Gambino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy.
| | - Marco Cabras
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Adriana Cafaro
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Roberto Broccoletti
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Stefano Carossa
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Colin Hopper
- Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - Luigi Chiusa
- AOU Città della salute e della Scienza di Torino, Turin, Italy
| | - Giorgia El Haddad
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
| | - Stephen R Porter
- Department of Clinical Research, UCL Eastman Dental Institute, London, United Kingdom
| | - Paolo G Arduino
- Department of Surgical Sciences, Oral Medicine Section, CIR-Dental School, University of Turin, Italy
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Abstract
Squamous cell carcinoma makes up 90% of cases of oral cancer. However, a myriad of premalignant, inflammatory, and immune-based conditions can manifest as oral mucosal lesions. Biopsy of these lesions shares many of the principles of cutaneous lesions. Biopsy of oral mucosal lesions is a procedure that is safely performed in most cases in the outpatient ambulatory setting using local anesthesia. Special considerations should be taken depending on the presumed diagnosis based on physical examination. Its clinical relevance depends on a sound clinicopathologic assessment of the patient's condition. This article reviews specific considerations for biopsy of oral mucosal lesions.
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Affiliation(s)
- Rabie M Shanti
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Pennsylvania Health System, 3400 Civic Center Boulevard, 4th Floor, South Pavilion, Philadelphia, PA 19104, USA.
| | - Takako Tanaka
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, 240 South 40th Street, Philadelphia, PA 19104, USA
| | - David C Stanton
- Oral & Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA; Oral & Maxillofacial Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Oral & Maxillofacial Surgery, Perelman Center, 4th Floor, South Pavilion, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA
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8
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Palaia G, Impellizzeri A, Tenore G, Caporali F, Visca P, Del Vecchio A, Galluccio G, Polimeni A, Romeo U. Ex vivo histological analysis of the thermal effects created by a 445-nm diode laser in oral soft tissue biopsy. Clin Oral Investig 2019; 24:2645-2652. [PMID: 31734792 DOI: 10.1007/s00784-019-03123-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 10/14/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate, ex vivo, the histological effects of 445-nm diode laser (Eltech K-Laser srl, Treviso, Italy), during an oral soft tissue biopsy. MATERIALS AND METHODS Thirty samples from pig cadaver tongues were obtained, through five laser settings, in continuous and pulsed wave (CW and PW). Samples were divided into six groups of five pieces each. A control specimen was taken by a scalpel. All samples were examined with an optical microscope by a blinded pathologist. Thermal effects on epithelium and connective tissues were measured with LAS 4.8 software. Finally, a statistical evaluation was made using GraphPadPrism 7.0 software. RESULTS All specimens, except one, showed a damage lower than 1 mm. Readability was always optimal; there was a different thermal effect between epithelial and connective tissue and in CW and PW samples, confirmed by statistical analysis too. CONCLUSIONS A 445-nm diode laser creates a minimum thermal effect, that has no implications in the histological evaluation of benign lesions. In suspicious lesions, a safety margin of 1 mm, compared with a scalpel, is preferable. CLINICAL RELEVANCE A 445-nm diode laser has excellent surgical properties and can manage many arduous clinical cases, such as vascularized lesions. In the excision of suspected lesions, it is necessary to compare, case by case, clinical advantages to possible histological implications.
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Affiliation(s)
- Gaspare Palaia
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy.
| | - Alessandra Impellizzeri
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Gianluca Tenore
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Federico Caporali
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Paolo Visca
- Department of Cytology and Cellular Diagnostics, Regina Elena Institute, Rome, Italy
| | - Alessandro Del Vecchio
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Gabriella Galluccio
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
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Shah L, Fogden S, Majumdar A. Use of a chalazion clamp for intraoral biopsies: a technical note. Br J Oral Maxillofac Surg 2019; 58:105-106. [PMID: 31718917 DOI: 10.1016/j.bjoms.2019.10.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 10/15/2019] [Indexed: 11/24/2022]
Abstract
Oral biopsies are common diagnostic and therapeutic procedures in oral and maxillofacial surgical (OMFS) outpatient departments. The chalazion clamp is similar to a pair of forceps. One extension has a flat, solid, oval plate, the other, a ring-like structure that is used to clamp and retract soft tissues. We highlight the benefits of using this simple, widely-available tool during oral biopsies. We find that the clamp increases effectiveness and efficiency for the clinician and assistant. We recommend its use in daily OMFS practice.
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Affiliation(s)
- L Shah
- Milton Keynes University Hospital, UK.
| | - S Fogden
- Milton Keynes University Hospital, UK.
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10
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Garg N, Tanveer N, Gaur JH. Utility of WhatsApp as a Tool for Tele-oncopathology for Oral Lesions. Indian J Surg Oncol 2019; 10:446-50. [PMID: 31496588 DOI: 10.1007/s13193-019-00919-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022] Open
Abstract
Traditional telepathology techniques like whole slide imaging and robotic microscopy are too expensive to be used in developing countries. With the advent of smartphones with high-resolution cameras and faster internet services, it is now possible to send good-quality images to pathologist for diagnosis. To study the utility of WhatsApp image transfer in the histopathological diagnosis of common oral malignant and benign lesions. A total of 100 cases of oral biopsy were included in the study. These comprised of 58 cases of squamous cell carcinoma, 33 cases of oral leukoplakia, 3 cases of oral lichen planus and 6 cases of moderate to severe dysplasia. The conventional microscopy diagnosis made by glass slide viewing was taken as the gold standard and the concordance of the WhatsApp diagnosis with the gold standard was calculated for each category of diagnosis and also for all the 100 cases. The concordance rate for squamous cell carcinoma was 96.6%(56/58). For leukoplakia, there was 100%(33/33) concordance between the WhatsApp diagnosis and conventional microscopy. The concordance rates for dysplasia (4/6) and oral lichen planus (2/3) were 66.7% each. Hence, for all the categories taken together, the overall concordance rate was 95%. A concordance rate of 95% is very encouraging; however, for routine diagnostic use in telepathology, there is still a long way to go. With the availability of better smartphone cameras and faster internet, it will be possible to send better quality images in the future. The pathologists will also learn where to draw the line and ask for glass slides for final diagnosis.
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Palaia G, Tenore G, Tribolati L, Russo C, Gaimari G, Del Vecchio A, Romeo U. Evaluation of wound healing and postoperative pain after oral mucosa laser biopsy with the aid of compound with chlorhexidine and sodium hyaluronate: a randomized double blind clinical trial. Clin Oral Investig 2019; 23:3141-51. [PMID: 30374831 DOI: 10.1007/s00784-018-2735-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 10/23/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The aim of this study is to evaluate secondary intention healing process and postoperative pain of oral soft tissues after laser surgery with the use of a compound containing chlorhexidine and sodium hyaluronate. MATERIALS AND METHODS This double-blind, randomized clinical study included 56 patients affected by benign oral lesions and subjected to excisional biopsy with diode laser and randomly divided into three groups. Study group (SG) received 0.2% chlorhexidine digluconate and 0.2% sodium hyaluronate treatment; control group (CG) received 0.2% chlorhexidine digluconate; and placebo group (PG) followed the same protocol, taking a neutral solution having the same organoleptic characteristics. Wound healing was evaluated using percentage healing index (PHI). Numeric rating scale (NRS) was used to evaluate postoperative pain. RESULTS PHI (T1 = 7 days) was 67.25% for SG, 58.67% for CG, and 54.55% for PG. PHI (T2 = 14 days) was 94.35% for SG, 77.79% for CG, and 78.98% for PG. A statistically significant difference was between the groups for PHI at T2 p = 0.001. No difference was detectable for pain index. CONCLUSIONS A solution containing sodium hyaluronate and chlorhexidine is a good support to increase wound healing by secondary intention after laser biopsy, but no differences were in postoperative perception of pain. CLINICAL RELEVANCE The use of the tested solution can be recommended after laser oral biopsies, to achieve a healing without suture. About the postoperative pain, the compound has not showed the same results and did not have measurable effects.
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12
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Scotti F, Decani S, Sardella A, Iriti M, Varoni EM, Lodi G. Anti-inflammatory and wound healing effects of an essential oils-based bioadhesive gel after oral mucosa biopsies: preliminary results. Cell Mol Biol (Noisy-le-grand) 2018; 64:78-83. [PMID: 29981687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 06/08/2023]
Abstract
Post-operative management of patients receiving oral biopsy includes the control of edema, pain, infection, and re-epithelization at the surgical site. This clinical study investigates the topical use of a bioadhesive gel, containing essential oils, to promote wound healing and prevent post-operative pain and infection, avoiding the need for surgical suture and chlorhexidine applications. Ten patients, who needed to receive oral biopsies (≤6 mm in diameter) for the diagnosis of mucosal oral lesions, were enrolled. The bioadhesive gel successfully controlled the post-surgical pain; at 1-week follow-up visit, no signs of infection nor side effects were reported and the surgical sites were completely healed. The bioadhesive gel resulted in a very promising agent for the post-operative management of oral biopsy site, without the need for surgical suture and chlorhexidine applications.
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Affiliation(s)
- Federico Scotti
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milan, Italy
| | - Sem Decani
- ASST Santi Paolo e Carlo, Presidio Ospedaliero San Paolo, Via Beldiletto 1/3 20142, Milan, Italy
| | - Andrea Sardella
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milan, Italy
| | - Marcello Iriti
- Dipartimento di Scienze Agrarie e Ambientali, Università degli Studi di Milano, Milan, Italy
| | - Elena Maria Varoni
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Lodi
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, Milan, Italy
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Satheeshkumar PS, Mohan MP. Does multiple biopsies and implantation along the needle tract augment for increased local recurrence in head and neck neoplasms? Oral Oncol 2016; 63:e4-e5. [PMID: 27651021 DOI: 10.1016/j.oraloncology.2016.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 09/12/2016] [Indexed: 10/21/2022]
Affiliation(s)
- P S Satheeshkumar
- Maxillofacial Surgery and Diagnostic Sciences, Qassim University, Saudi Arabia.
| | - Minu P Mohan
- Prosthetic Dental Sciences, Qassim University, Saudi Arabia.
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14
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Abstract
Despite the many types of oral pathologic lesions found in infants and children, the most commonly encountered are benign soft tissue lesions. The clinical features, diagnostic criteria, and treatment algorithms of pathologies in the age group from birth to 18 years of age are summarized based on their prevalence in each given age distribution. Treatment modalities include both medical and surgical management.
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Affiliation(s)
- Alexandra Glickman
- Oral and Maxillofacial Surgery, New York University-Bellevue Hospital Center, New York, NY, USA
| | - Vasiliki Karlis
- Oral and Maxillofacial Surgery, New York University-Bellevue Hospital Center, New York, NY, USA.
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Abstract
Pathology is a science, which deals with the scientific study of structure and function of the body in disease. It involves both macroscopic and microscopic study of the tissue correlating it with the clinical and radiographic history, thus helping to arrive at an accurate diagnosis. Proper history and clinical description of the excised specimen has to be conveyed to the pathologist. More than proper surgical technique is required to facilitate the proper diagnosis of an oral biopsy specimen. The proper preparation of the tissue for microscopic analysis depends on steps taken by the surgeon, assistant, and histotechnician to reduce the inclusion of artifacts. This article particularly deals with various requirements for proper handling and transportation of specimens, important things which are to be communicated to pathologists, and various methods used to preserve the tissue for use in latest techniques.
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Affiliation(s)
- Nitul Jain
- Department of Oral Pathology, Eklavya Dental College and Hospital, Kotputli, Rajasthan India
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