Tartar-control toothpaste as a possible contributory factor in the onset of superficial mucocele: a case report

Diagnostic challenges of superficial mucoceles: An update

A superficial mucocele is a unique variant of a mucocele of the oral cavity that was described by Eveson for the first time in 1988. It occurs due to subepithelial extravasation of sialomucin at the epithelial-connective tissue interface and is related to damage of the minor salivary gland ducts. Clinically, they appear as small, asymptomatic, clear, tense vesicles with a predilection for the soft palate, retromolar pads, and posterior buccal mucosa. They are reported to occur more frequently in women than in men. Before Eveson endeavoured to describe these rather peculiar lesions, they were often misdiagnosed as vesiculobullous lesions such as bullous lichen planus, mucous membrane pemphigoid, and the like. It is incumbent on the present-day pathologist to be cognizant of the presence of these entities as it could present a formidable diagnostic challenge otherwise. This review gives an updated account on the etiology, prevalence, clinical features, differential diagnosis, and management of superficial mucoceles.

Multiple superficial mucoceles concomitant with oral lichen planus: a case series

Superficial mucoceles are a relatively rare variant of common mucoceles and have an unclear etiology. Clinically, they are small, translucent, subepithelial vesicles affecting the oral mucosa in the retromolar region, the lower labial and buccal regions, and the bilateral soft palate. Superficial mucocele is easily misdiagnosed as pemphigoid, bullous lichen planus, herpes lesion, or venous lake when it is concomitant with oral lichen planus (OLP) or lichenoid disorders on the basis of the initial impression. An inflammatory mechanism related to OLP has been hypothesized to induce the development of superficial mucoceles. It is essential to be familiar with this entity. This report presents 9 cases of multiple superficial mucoceles that occurred sequentially concomitant with OLP and with consistent clinical and histopathologic features. Relevant studies reported in the literature are also reviewed to provide additional clarification of the etiology, clinicopathologic characteristics, and differential diagnosis.

The classic caries clinical trial: constraints and opportunities

The history of clinical trials would include events in 1747 on board the Salisbury, a British Navy vessel at sea with 12 seamen critically ill with scurvy. Involving these 12 sailors in a study, an officer on board by the name of Lind evaluated six potential treatments for scurvy, and rapidly reached the conclusion that daily consumption of citrus fruits returned the men fit for duty in approximately six days (Bull, 1959). The concept of experimental randomization was first developed by Sir R.A. Fisher (1925, 1926), and the method was introduced to medical research via a study of tuberculosis treatment by Amberson and co-workers (1931), who randomized 24 TB patients into two groups, one to receive the experimental therapy, the other serving as the control. Amberson et al. also incorporated the concept of blinding into their study. Sir Austin Bradford Hill codified and built on the principles of scientific experimentation developed by Fisher, and introduced the use of random numbers in the allocation of patients in the British Medical Research Council (1948) study of the effect of streptomycin in the treatment of tuberculosis (Daniels and Hill, 1952; Hill, 1952). The first applications of clinical trial methodology for testing interventions on dental, oral, and maxillofacial diseases and conditions are more difficult to determine. For dental caries prevention, however, Chilton and Fertig (1958) and Slack and Martin (1964) were certainly among the early caries clinical trial pioneers. As clinical trials have come into the mainstream of clinical research in medicine and dentistry, a great deal of developmental work has focused on their methodological enhancement. The most successful of these efforts have come from fruitful, ongoing collaborations among clinician investigators, biostatisticians, data management specialists, biomedical ethicists, and others with an academic interest in clinical trial design and utilization. During the past 25 years, the emergence of systematic reviews and the evidence-based medicine (EBM) movement have also contributed significantly to the increasing reliance on randomized clinical trial outcomes for the advancement of better clinical practice (Richards et al., 1997; Straus and Sackett, 1998; www.cochrane.org/cochrane/ccbroch.htm#BDL, 2002).

Recurrent multiple superficial mucocele on the palate: Histopathology and laser vaporization

A 55-year-old Japanese woman presented with recurrent multiple vesicles on the soft palate. Some vesicles ruptured spontaneously but soon recurred, and the patient felt mild pain and discomfort. Histopathologically, intraepithelial mucocele with mucus retention in the salivary ducts was observed. The lesion was successfully treated with Nd: YAG Contact Laser. There has been no recurrence for 3 years.