Oral lichen planus (OLP) is a chronic inflammatory disease, affecting approximately 0.5% to 2% of the global population. OLP can lead to long-term oral pain, reduced quality of life, with the potential for malignant transformation. Current treatment strategies focus on symptom management and reducing the risk of malignancy. Treatment of OLP is challenging and varies from patient to patient, especially in those who do not respond to corticosteroids. The effectiveness and safety of second-line and third-line treatment options in such cases are continually compared and evaluated, and recently, the application of Janus kinase inhibitors, micro ribonucleic acids, and mesenchymal stem cell-based therapies is being assessed. As a result, the ability of clinicians to select the most appropriate treatment modalities for each patient remains crucial. This review aims to evaluate the efficacy of recent treatment modalities and key considerations to assist clinicians in selecting effective and safe treatment strategies for OLP.

Purpose: Temporomandibular disorder (TMD) is a multifactorial condition influenced by biological, psychological, and social factors. Some patients perceive dental treatment as the cause of their TMD, which may impact symptom perception and treatment response. This study aims to compare the psychosocial and clinical characteristics of patients who attribute their TMD onset to prior dental treatment (DT group) with those who do not (NT group). Methods: A total of 250 patients diagnosed with TMD at Pusan National University Dental Hospital between January and October 2024 were included. Patients were classified into the DT group (n=92) if they attributed their symptoms to previous dental procedures, while the remaining NT group (n=158) consisted of patients with other primary complaints. Patients were additionally categorized into Generation X (1965-1980), Generation Y (1981-1999), and Generation Z (2000-2012). Clinical assessments were conducted following the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and psychosocial factors were evaluated using the Oral Behaviors Checklist (OBC), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-15 (PHQ-15). Results: The DT group had a significantly higher mean age (54.16±16.87 years) compared to the NT group (39.71±19.12 years, p<0.001). Psychological distress scores (PHQ-9, GAD-7, and PHQ-15) were significantly higher in the DT group, particularly among Generation X patients (p<0.05). Muscle-related pain was more prevalent in the DT group (75%) than in the NT group. Interestingly, OBC scores were higher in the NT group (p<0.05). Conclusions: Patients who attributed their TMD onset to dental treatment reported higher psychological distress and a greater prevalence of muscle-related pain, underscoring the need for a biopsychosocial approach to TMD management. Clinicians should consider the impact of patient perception on TMD symptoms and integrate psychological assessment and counseling to enhance treatment efficacy and patient adherence.

Purpose: This study aimed to identify reproducible locations for evaluating masseter muscle function by measuring its thickness using ultrasonography (US). The study focused on comparing two measurement locations: the thickest part of the masseter muscle during ultrasonographic scanning (TMUS) and the most prominent part during clenching (PMC). Methods: Forty healthy adults (20 males and 20 females) participated in the study. US images were obtained from both sides of the masseter muscle under resting and clenching conditions. Measurements were taken at the TMUS and PMC locations, and the clenching-to-resting (C/R) ratio was calculated. Intra- and inter-rater reliability were assessed using intraclass correlation coefficients (ICCs), and the agreement between the two locations was further analyzed using Bland-Altman (BA) plots. Results: The measurements at both TMUS and PMC showed high intra- and inter-rater agreement, with no significant difference in measurements between the two locations. However, the PMC location demonstrated slightly higher ICC values (0.94) compared to TMUS (0.91). The C/R ratio for PMC showed higher consistency (0.89) compared to TMUS (0.65). BA plots indicated that the agreement between TMUS and PMC was slightly better during clenching than at rest, with smaller mean differences in clenching (-0.06 mm) than resting (-0.13 mm). Additionally, the number of measurements outside the upper and lower limits was lower during clenching (10) than at rest (13). Conclusions: Both TMUS and PMC locations demonstrated reliable measurements, but the PMC location showed slightly better consistency across different muscle states. The findings suggest that PMC provides a more reproducible and standardized approach for masseter muscle assessment, making it a better choice for both clinical practice and research in evaluating masticatory function.

Foramen of Huschke (FH) is a congenital defect of the external auditory canal (EAC) that may persist into adulthood. Although rare, it can present with symptoms that overlap with temporomandibular disorders (TMDs), leading to potential misdiagnosis. This report describes two cases of patients who exhibited common TMDs symptoms, such as temporomandibular joint (TMJ) sounds during function. However, neither patient demonstrated additional signs or symptoms indicative of TMDs in a comprehensive TMDs evaluation. Consequently, they were referred to an otolaryngologist for further assessment to investigate non-TMD etiologies. Cone-beam computed tomography (CBCT), frequently used in dental practice, is effective in assessing osseous structures but is limited in detecting soft tissue abnomalities. To achieve a more comprehensive evaluation, temporal bone computed tomography (TBCT) was performed. TBCT revealed an osseous discontinuity without other underlying causes, along with soft tissue bulging at the affected site, confirming the presence of the FH in the EAC. Given the limitations of CBCT in soft tissue visualization, advanced imaging modalities like TBCT should be considered in cases of persistent TMJ-related symptoms to improve diagnostic accuracy. These cases highlight the importance of differential diagnosis when evaluating patients with symptoms suggestive of TMDs, as soft tissue bulging through the FH can generate TMJ sounds during function, potentially mimicking TMD. Clinicians should consider that non-TMDs etiologies, such as the FH, as possible contributors to similar symptomatology. Accurate assessment and appropriate imaging studies are crucial for ensuring an accurate diagnosis and optimal management.

Xerostomia or dry mouth is commonly associated with medications, head and neck radiation therapy, and Sjögren's syndrome. Studies report that it predominantly affects older adults and females; however, there is limited research focusing on the atypical and low-risk groups. This report presents a case of xerostomia in a 35-year-old male following a mandibular fracture (MF). Initial self-care attempts were insufficient, necessitating pharmacological intervention with pilocarpine, which improved both the salivary function and symptoms. This case highlights MF as a rare yet plausible cause of xerostomia, mediated by trauma-induced neural and physiological disruptions. The potential mechanisms include cranial nerve injury, autonomic dysfunction, psychological stress, and the effects of trauma-related medications. These findings emphasize the need to consider xerostomia in nontraditional populations, particularly in those with facial trauma, and call for further research to elucidate its underlying mechanisms and guide effective management strategies.