Cancer stem cells (CSCs) represent a subpopulation of cancer cells that are believed to initiate and drive cancer progression. In animal models, xenotransplanted CSCs have demonstrated the ability to produce tumors. Since their initial isolation in blood cancers, CSCs have been identified in various solid human cancers, including oral squamous cell carcinoma (OSCC). In addition to their tumorigenic properties, dysregulated stem-cell-related signaling pathways—Wnt family member (Wnt), neurogenic locus notch homolog protein (Notch), and hedgehog—have been shown to endow CSCs with characteristics like self-renewal, phenotypic plasticity, and chemoresistance, contributing to recurrence and treatment failure. Consequently, CSCs have become targets for new therapeutic agents, with some currently in different phases of clinical trials. Notably, small molecule inhibitors of the hedgehog signaling pathway, such as vismodegib and glasdegib, have been approved for the treatment of basal cell carcinoma and acute myeloid leukemia, respectively. Other strategies for eradicating CSCs include natural compounds, nano-drug delivery systems, targeting mitochondria and the CSC microenvironment, autophagy, hyperthermia, and immunotherapy. Despite the extensive documentation of CSCs in OSCC since its first demonstration in head and neck (HN) SCC in 2007, none of these novel pharmacological approaches have yet entered clinical trials for OSCC patients. This narrative review summarizes the in vivo and in vitro evidence of CSCs and CSC-related signaling pathways in OSCC, highlighting their role in promoting chemoresistance and immunotherapy resistance. Additionally, it addresses methodological challenges and discusses future research directions to improve experimental systems and advance CSC studies.

Background: In Indonesia, cultural practices such as betel quid chewing, smoking, and alcohol consumption are prevalent. These practices are known risk factors for oral cancer and may influence the salivary profile, which is essential for maintaining oral health. Purpose: To compare the salivary profiles of individuals with and without risk factors for oral cancer. Methods: The study included 49 individuals identified as having risk factors for oral cancer. Unstimulated saliva samples were collected. Various parameters were measured, including salivary pH, flow rate (FR), thickness, color, turbidity, and the levels of IL-1β and IL-8. Data were analyzed using Chi-square and t-tests. Results: A significant difference was found in salivary IL-1β levels between the two groups (p = 0.009), with higher levels observed in individuals with oral cancer risk factors. Notably, the salivary IL-1β concentrations showed significant differences between the smoking group (p = 0.021; OR = 2.94) and the alcohol-drinking group (p = 0.007; OR = 4.96) compared to the control group. However, no significant differences were observed between the groups in terms of salivary viscosity, color, turbidity, flow rate, acidity, or IL-8 levels (p > 0.05). Conclusion: Individuals with risk factors for oral cancer exhibit distinct salivary IL-1β profiles compared to those without such risk factors, particularly those who practice alcohol drinking.

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 adult- and juvenile -onset SLE patients varied depending on the disease severity and treatment received.

Background: Oral potentially malignant disorder (OPMD) is a lesion with a high potential to turn into oral squamous cell carcinoma (OSCC). The discovery of OPMD lesions precedes most cases of OSCC. Sensitive and specific biomarkers can help in the early detection of high-risk patients, one of which is CD8+, part of the cytotoxic T lymphocytes, which have a role in eliminating cancer cells. Several studies use infiltration density and CD8+ T cells' activity as biomarkers in malignancy. This study aims to observe the expression of CD8+ in OPMD lesions and correlate with risk factors Method: Twelve paraffin blocks samples consist of OPMD lesions. One oral lichen planus (OLP) as the positive control. Samples were stained using HE to observe the degree of dysplasia and immunohistochemistry to observe the expression of CD8+ T cells. Observation of results using a microscope with 100x magnification to select the field of view and 400x magnification to count the number of positive CD8+ T cells with a cut-off point of 500 cells from a total of 5 fields of view and determined by weak intensity (

Background: Oral cancer is one of the most causes of morbidity and mortality due to malignancy in Indonesia. This problem usually occurs because the cancer is found late in its development. Oral Potentially Malignant Disorders (OPMD) can be detected and treated as early as possible to prevent their transformation into oral cancer by dentists with a good knowledge and attitude about OPMD. Aim: To describe the knowledge and attitudes of dentists in Indonesia regarding OPMD. Method: Descriptive observational study with a cross-sectional design using an online questionnaire (google form) consisting of 47 questions about knowledge and attitude to 167 dentists in Indonesia. The knowledge was categorized into high, moderate, and low levels. The attitude was categorized into good, moderate, and low levels. Results: This study collects data from 167 people according to the inclusion criteria, consisting of 124 women and 43 men, of whom were aged 20-29 years (58 people), 30-49 years (97 people), and >50 years (12 people). A total of 121 respondents have a high level of knowledge and 46 respondents in the moderate category meanwhile, 124 respondents have good attitude categories, 42 respondents in the moderate categories, and one respondent in the low one. Conclusion: The dentist in Indonesia has a high level of knowledge with an average score of 18.86+0.23 and a good level of attitude with an average score of 15+0.18.

Background: Candida–related lesions can present as denture sore mouth intraorally and cheilitis angular extra orally. Some predisposing factors include ill-fitting dentures, malnutrition, and poor oral hygiene. Objective: To determine the proper diagnosis and management of sore mouth dentures and cheilitis angular in patients with ill-fitting dentures and bad oral hygiene.  Case report: A 59-year-old male patient presented with a burning sensation on the hard palate and sores at the corners of the lips, which were aggravated by the meal and opening of the mouth. No history of systemic diseases was found. Extra-orally erythema fissure lesions were found surrounded by multiple white areas at the corners of the lips bilaterally and were painful. Intra-oral examination showed erythema macular lesions that extend to the gingiva and palate mucosa that contact the denture base. Nystatin oral suspension combined with fluconazole, and multivitamins as supportive therapy. Educational suggestions such as the replacement of dentures and improve oral hygiene conditions were given. Conclusion: Denture sore mouth and cheilitis angular in this case are caused by Candida albicans related to the insufficient denture and poor oral hygiene. Management for this case by providing causative treatment with single or combine antifungal drugs along with proper communication, instructions, and education regarding the diseases.