Tori are reactive or developmental localized overgrowths of alveolar bone that are not cancerous. A thin, weakly vascularized mucosa surrounds a densely cortical, low-density mass of bone marrow known as tori or exostosis. Tori are more frequently observed in middle age. Both the maxilla (torus palatinus) and the mandible (torus mandibularis) exhibit tori. Difficulty in speaking and other issues are common obstacles associated with tori. Tori range in diameter from a few millimeters to several centimeters. Surgical excision of tori is the mainstay of treatment for large tori obstructing speech, mastication, or tongue position. The following case study includes a 36-year-old male patient with an association of mandibular canine and premolar regions with bony outgrowth.

OBJECTIVE: Several factors such as unavailability of specialists, dental phobia, and financial difficulties may lead to a delay between receiving an oral radiology report and consulting a dentist. The primary aim of this study was to distinguish between high-risk and low-risk oral lesions according to the radiologist\'s reports of cone beam computed tomography (CBCT) images. Such a facility may be employed by dentist or his/her assistant to make the patient aware of the severity and the grade of the oral lesion and referral for immediate treatment or other follow-up care.
METHODS: A total number of 1134 CBCT radiography reports owned by Shiraz University of Medical Sciences were collected. The severity level of each sample was specified by three experts, and an annotation was carried out accordingly. After preprocessing the data, a deep learning model, referred to as CNN-LSTM, was developed, which aims to detect the degree of severity of the problem based on analysis of the radiologist\'s report. Unlike traditional models which usually use a simple collection of words, the proposed deep model uses words embedded in dense vector representations, which empowers it to effectively capture semantic similarities.
RESULTS: The results indicated that the proposed model outperformed its counterparts in terms of precision, recall, and F1 criteria. This suggests its potential as a reliable tool for early estimation of the severity of oral lesions.
CONCLUSIONS: This study shows the effectiveness of deep learning in the analysis of textual reports and accurately distinguishing between high-risk and low-risk lesions. Employing the proposed model which can Provide timely warnings about the need for follow-up and prompt treatment can shield the patient from the risks associated with delays.
CONCLUSIONS: Our collaboratively collected and expert-annotated dataset serves as a valuable resource for exploratory research. The results demonstrate the pivotal role of our deep learning model could play in assessing the severity of oral lesions in dental reports.

Systemic lupus erythematosus (SLE) is an autoimmune disease with various oral manifestations, including ulceration, white keratotic plaques, oral discoid lupus erythematosus, oral lichen planus (OLP)-like lesions, non-specific erythema, purpura, petechiae, and cheilitis, which resemble lesions of other systemic diseases. Recognizing the oral manifestation of SLE is essential for comprehensive patient management. This study reports 4 cases of SLE with various oral lesions, underlying conditions and diagnostic methods.In September 2019, 2 adult SLE patients and 2 juvenile SLE patients were consulted at the Oral Medicine Clinic. The assessment of systemic diseases was conducted by the Internal Medicine and Pediatrics resident, whereas the Oral Medicine resident performed the intraoral examinations. The medical history, clinical findings and laboratory results were analyzed to establish the diagnosis.The first patient was a 38-year-old female presenting with multiple white keratotic plaques throughout the mucosa, an OLP-like lesion on the right buccal mucosa, petechiae on the hard palate, and petechiae and purpura on the upper and lower extremities. The second case was a 24-year-old female with a malar rash and multiple ulcerations on the vermilion zone, an OLP-like lesion on the left buccal mucosa, and a palatal ulcer. The third and fourth cases were 16-year-old females with a prominent butterfly rash. The patients presented with acute pseudomembranous candidiasis, an aphthous-like ulcer and keratotic plaques. They received antimicrobial therapy for the intraoral lesions and showed promising results.The oral lesions in adultand juvenile-onset SLE patients varied depending on the disease severity and treatment received.

UNASSIGNED: Cowden syndrome (CS) is a rare genetic disorder associated with PTEN gene mutations. It is characterized by macrocephaly, specific mucocutaneous features, and a predisposition to benign and malignant tumors. Cases of CS primarily presenting with oral clinical manifestations are relatively uncommon.
UNASSIGNED: We report the case of a 41-year-old male proband who presented with bilateral commissural and lingual externally projecting symmetric lesions for over two years. The proband also exhibited other features, including macrocephaly, communication difficulties, and obesity. Similar oral clinical manifestations were observed in family members. Whole exome sequencing analysis revealed PTEN gene mutations associated with CS in both the proband and his younger brother. This case serves as a reminder to be aware of the diverse presentations of CS in oral clinical practice and highlights the importance of genetic testing for guiding diagnosis and treatment.
UNASSIGNED: There are few reported cases of CS primarily presenting with oral lesions. This finding contributes to further understanding of certain aspects of the pathogenesis of CS and enhances awareness of CS cases primarily exhibiting oral clinical manifestations.

Pemphigus vulgaris (PV) is a chronic autoimmune mucocutaneous blistering disease. Autoantibodies are directed against desmogleins, leading to the formation of intraepithelial bullae. PV, as with other autoimmune mucocutaneous disorders of the oral cavity, presents diagnostic and therapeutic challenges. Approximately 50-70% of cases present first with oral lesions. The lesions commonly start as vesicles or bullae that rapidly rupture, leading to erosions and ulcerations. The palatal, gingival, buccal, and labial mucosa are the most commonly affected sites. Oral PV can mimic several other diseases that cause mucosal erosions and/or ulcerations, including erythema multiforme (EM). EM is an acute, immune-mediated, self-limited hypersensitivity condition primarily associated with herpes simplex infection. Oral lesions can be variable, but a very characteristic presentation with labial hemorrhagic erosions, ulcerations and crusting is commonly seen. In this case series, we present six cases of PV: one male patient and five female patients whose ages ranged from 34 to 65 years old. All patients presented with hemorrhage and crusting of the lips in addition to multiple intraoral erosions and ulcerations. Three patients presented with oral and skin lesions. All patients underwent biopsies, and a diagnosis of PV was confirmed. All patients were treated with steroids (topical and systemic) and variable steroid-sparing agents. This case series emphasizes that oral PV may be misdiagnosed as EM in a subgroup of patients who present with persistent lip hemorrhage and crusting. Therefore, a comprehensive history, clinical examination and incisional biopsies should be considered in such patients.

BACKGROUND: Psoriasis is a common cutaneous disease; however, information about psoriasis-related oral mucosal lesions is scarce in the literature.
METHODS: We report a case of a 73-year-old male patient with cutaneous and oral palatal alterations. An incisional biopsy of these lesions revealed psoriasis.
CONCLUSIONS: The current case highlights the importance of a systematic examination of the oral cavity in psoriasis patients for the appropriate diagnosis and management on the control of these lesions.

Oral manifestations in patients with COVID-19 have already been reported in the literature. Determining whether the oral manifestations in these cases are directly related to SARS-CoV-2 infection or not has been challenging for both clinicians and researchers, although at present it has not been possible to prove. There are several possible causes for the development of the oral lesions in patients with COVID-19, among them are, opportunistic infections, drug reactions, iatrogenic and those directly related to viral infection. The present work describes the main characteristics of 10 severe COVID-19 hospitalized patients with oral manifestations. By analyzing the characteristics of the reported patients, and what is published in the literature, we conclude that for this series of cases the manifestations are not directly related to SARS-CoV-2, however, it is a possibility that should be considered for all patients.

BACKGROUND: Behçet\'s disease (BD) is a rare chronic auto-inflammatory systemic disease with non-specific oral manifestations, categorised as generalised variable vessel vasculitis that requires an interdisciplinary approach to diagnose due to its phenotypic heterogeneity. Whilst the oral lesions that reoccur in BD underpin the complex diagnostic process, the crucial role of dental professionals is highlighted in a case report summarised herein. We present a case of a 47-year-old male referred to the Oral Medicine Department by a rheumatologist after previous hospitalization for thrombosis of the iliac vein and inferior vena cava. He had elevated inflammatory C-reactive protein biomarker and an increased erythrocyte sedimentation rate. Recurrent episodes of folliculitis, oral and genital ulcers were reported. Clinical examination revealed multiple ulcerations in the oral mucosa. The complementary, histopathological analysis performed to rule out other disorders, based on excisional biopsy, showed non-keratinised stratified squamous epithelium with areas of exocytosis and ulceration. The connective tissue presented an intense mixed inflammatory infiltrate, congested blood vessels, haemorrhage, vasculitis, and HLA-B genotyping identified the expression of HLA-B15, further supporting the BD diagnosis. Treatment was initiated with colchicine, prednisolone, and weekly subcutaneous administration of methotrexate and resulted in the complete remission of oral lesions and no recurrence of other manifestations.
CONCLUSIONS: This BD case report emphasizes the importance of a multidisciplinary approach in diagnosing BD, including the use of histopathological assessment and genetic profiling. It highlights the significance of thorough intraoral assessment and referral to a multidisciplinary team for diagnosis. The oral manifestations of BD as the primary symptoms often indicate underlying major systemic pathologies. The authors stress the need for a structured diagnostic algorithm to facilitate timely and effective management of BD.

UNASSIGNED: Pain management becomes important in the treatment of oral mucosal diseases since it can impair the quality of life. Photobiomodulation (PBM) as an alternative therapy, has potency in reducing pain through several mechanisms targeting peripheral nerves in the target tissue.
UNASSIGNED: To discuss the effectiveness of PBM in the management of four cases of oral mucosal diseases.
UNASSIGNED: Four patients, two females and two males, with an age ranging from 24 to 63 years came to the Oral Medicine Department complaining of painful lesions in their oral cavity. Three cases showed ulceration of the oral mucosa and had been diagnosed with recurrent aphthous stomatitis, recalcitrant chronic ulcer, and non-specific chronic sialadenitis. One patient who complained of intense pain and swelling on the right side of the face was diagnosed with post-herpetic neuralgia (PHN).
UNASSIGNED: PBM was administered in all four cases (976 nm diode laser, three cases with spot size 0.01 cm2, fluency 10 J/cm2, and one case with spot size 0.5 cm2; fluency 3 J/cm2). Visual analog scale (VAS) control was performed before and after the PBM at each visit. The recorded VAS results show a reduction in pain that started at the post-laser time, with VAS before PBM ranging from 5 to 7 and after PBM ranging from 0 to 4. Three patients were given triamcinolone acetonide 0.1%, chlorhexidine gluconate 0.2% mouthwash, petroleum jelly, and multivitamins. One patient was given mefenamic acid and multivitamins.
UNASSIGNED: PBM can be a useful adjunctive treatment to relieve the pain of oral mucosal diseases due to its ability to reduce pain intensity.

Mpox virus infection (MPXV) has recently been recognized as a public health emergency by the World Health Organization. While several studies have described the clinical characteristics of MPXV-oral lesions, there remains a dearth of information regarding the histological and ultrastructural oral findings. A 24-year-old HIV-positive man presented with a shallow ulcer, covered by a fibrinoid membrane, and surrounded by an erythematous halo in the hard and soft palate. The clinical appearance of the lesion raised suspicion of a viral infection; thus, the diagnosis was based on histological and electronic microscopy findings and confirmed by RT-PCR testing in the skin specimen. This case report aims to offer comprehensive insights into the clinical, histopathological, and ultrastructural features of oral lesions caused by MPXV in an individual with HIV. This report provides valuable information about the characteristics of MPXV infection in the oral mucosa, particularly in people living with HIV.