Background/purpose: Periapical lesions of endodontic origin are often diagnosed based on the clinical and radiological presentations that may be different from the histological diagnoses. The purpose of this study was to assess the concordance between the clinical diagnosis of these lesions and the histopathological diagnoses and to analyze their clinical and pathological features. Biopsies of periapical lesions of endodontic origin diagnosed in the histopathology laboratory between 2006 and 2017 were retrieved from the database and used to conduct this retrospective review. Clinical data were obtained, and tissue samples were re-evaluated. The overall agreement between the clinical and histological diagnoses was tested utilizing the Cohen kappa (k). A total of 317 periapical biopsy specimens were included in this study which consisted of 137 periapical granulomas, 174 periapical cysts, and six periapical scars. Generally there was weak overall agreement between the clinical and histological diagnoses of periapical granuloma and periapical cysts (Cohen kappa, k = 0.059). The findings of this study indicate that clinical/radiographic examinations are not able to preoperatively determine whether a periapical lesion is a cyst or a granuloma and highlights the importance of developing a reliable nonsurgical diagnostic method to differentiate periapical lesions.

Spindle cell lipoma (SCL) is a benign lipomatous neoplasm typically located in the posterior neck and back of older males. It presents as a well-circumscribed mass in the buccal mucosa, tongue, floor of the mouth or hard palate. There are only two case reports of SCL in the gingiva and alveolar ridge. Here, we report a case of SCL in the mandibular mucogingival junction of a 68-year-old male. Clinical, histopathological and immunohistochemical findings are presented. Although oral SCL is rare, it should be considered in the differential diagnosis of spindle cell neoplasms occurring in the oral cavity.

Salivary gland tumors (SGT) comprise 3% of all head and neck tumors, are mostly benign, and arise frequently in the parotid gland. Pleomorphic adenoma (PA) is the commonest SGT, representing 60‐70% of all benign parotid tumors. Clinically, parotid PA presents as irregular, lobulated, asymptomatic, slow‐growing preauricular mass, involving both superficial and deep lobes, and could grow to gigantic proportions. Histologically, PA has epithelial and mesenchymal elements in chondromyxoid matrix and is managed surgically. Based on a review of 43 cases reported in English literature since 1995, giant parotid PA is reported as large as 35 cm (diameter) and 7.3 kg (resected weight). Although rare, 10 cases of malignant transformation were reported in the review. Surgical management included extracapsular dissection (ECD), superficial parotidectomy, and total parotidectomy for benign tumors, and adjuvant radiation or chemotherapy for malignant tumors. We further present the case of a 36‐year‐old healthy male with slow‐growing and asymptomatic giant parotid PA, of 4‐year duration. The patient presented with firm, lobulated preauricular swelling, provisionally diagnosed as PA based on radiographic and cytological findings. The tumor was resected through ECD, and the patient had uneventful postoperative recovery and a 7‐year recurrence‐free follow‐up period. Histological examination revealed epimyoepithelial proliferation punctuated by chondromyxoid areas, with extensive squamous metaplasia and keratin cysts. To the best of knowledge from indexed literature, giant parotid PA is rarely reported in Saudi Arabia. In addition to its rarity, this case is reported for its benign nature despite atypical histological presentation, successful surgical management without complications, and long‐term recurrence‐free follow‐up. Based on this report, clinicians must be aware of atypical histological presentations associated with PA and plan suitable surgical management and follow‐up to avoid morbidity. Nevertheless, attempts must be made to diagnose and manage these lesions at an early stage and before they reach gigantic proportions.

Objectives We investigated the clinical anti-inflammatory and antimicrobial efficacy of Nigella Sativa oil compared with chlorhexidine in patients with gingivitis assessing clinical parameters and gingival IL-6 and IL-18 levels and supra-gingival plaque analysis to determine if Nigella Sativa oil is comparable in efficacy to chlorhexidine and if it could be used for treating gingivitis. Materials and Methods A double-blind, randomized clinical trial was conducted in patients having chronic generalized gingivitis. Patients were randomly assigned to Group 1: Nigella sativa oil (NS) (n = 18) or Group 2: chlorhexidine (CHX) (n = 19). GCF and plaque samples were collected on day 0 and day 15. Plaque index (PI), gingival index (GI), and gingival IL-6 and IL-18 levels were measured. Colony-forming units (CFU) were quantified from plaque cultures, and α-hemolytic streptococcus strains were identified. Results CHX and NS reduced PI and GI scores (p < 0.0001). NS was better at reducing gingival IL-6 (p = 0.0076) than CHX (p = 0.145). Neither NS (p = 0.284) or CHX (p = 0.418) reduced IL-18 levels. There was no difference in the post-intervention PI and GI scores and inflammatory cytokine levels between treatments. Both NS and CHX caused a significant reduction in the CFU (p < 0.0001) and a reduction of pathogenic bacteria; S. mitis, S. oralis, S. sanguinis, and S. parasanguinis in 50% of CHX patients (p = 0.1031) and 20% of NS patients (p = 0.7395). Conclusions NS demonstrated comparable efficacy to CHX at reducing clinical parameters. Clinical Relevance: NS may be an alternative therapeutic option in treating gingivitis.

Objective: Benign fibroosseous lesions (BFOLs) encompass a heterogenous collection of bone conditions characterized by replacing normal bone with fibro-collagenous tissue with osteoid or woven bone, and cementicles. Despite their clinical significance, the frequency of BFOLs in Saudi Arabia still needs to be assessed. Methods: This retrospective study investigated the frequency and demographics of BFOLs in Riyadh, Saudi Arabia, by retrieving all cases recorded between January 1984 and January 2013 from a single Oral Pathology Laboratory archive. Results: A total of 64 cases were classified as BFOLs, with a predominance in females (67.2 %) and a median age of 21.5 years. The most prevalent condition identified was fibrous dysplasia (45.31 %), followed by cemento-ossifying fibroma (26.56 %). There were significant sex differences between BFOLs, with a p-value of 0.03. FD was predominantly located in the maxilla (65.5 %), whereas COF was predominantly found in the mandible (82.3 %). Recurrence was observed in 17.2 % of patients with FD, in contrast to no reported recurrence in patients with COF. Conclusion: This study represents the first exploration of BFOL frequency and demographics in Riyadh, Saudi Arabia, highlighting the need for further investigations to comprehensively understand the nature of these lesions in our population.

This study aimed to evaluate the healing of furcation when repaired with Chitosan (CS) scaffold impregnated or not with Simvastatin (SIM) compared with CollaCote (CL) in goat premolar teeth. Root canal treatment was performed in 52 mandibular premolars followed by furcal perforation induction. The perforation was repaired with CL, CS, or CS with SIM after leaving it untreated for 4 weeks. White mineral trioxide aggregate was carried into the furcal site followed by a 2–3 mm resin-modified glass ionomer. The perforation was left untreated, and the access cavity was left open without coronal filling in the control group. The animals were sacrificed after one and three months. Block sections of the premolars were prepared and examined histologically to evaluate the inflammation and type of healing. Hard tissue formation was found in CL, CS, and CS/SIM groups in both periods. At one month, no significant differences were detected among the experimental groups, whereas at three months, CS without SIM showed significantly better performance compared to CL and CS/SIM groups (p = 0.040). Therefore, repairing furcal perforation with CS scaffolds shows desirable biological responses and healing characteristics in favor of bone regeneration at three months.