As a novel anti-tumor therapeutic approach, immune-checkpoint inhibitors (ICIs) have significantly improved the prognosis of many patients with advanced malignancies. However, with increasing clinical application, immune-related adverse events (irAEs) induced by ICIs have become more frequent, involving various organ systems throughout the body and drawing extensive attention from clinical researchers. To date, studies and summaries focusing on oral irAEs remain relatively limited. This article summaries on the clinicopathological features and current management of oral irAEs, aiming to provide insights for clinical diagnosis, treatment and related research on such conditions.

Oral lichen planus (OLP) is a chronic T cell-mediated autoimmune disorder of the oral mucosa. This review delineates the immunopathological mechanisms underlying OLP, focusing on the core pathway that progresses from an imbalance in CD4⁺ T-cell subsets to CD8⁺ T-cell-mediated tissue injury, a process further corroborated by pharmacological evidence. Studies have revealed heterogeneous infiltration patterns of CD4⁺ T-cell subsets (e.g., Th1, Th2, Th17, Treg) within the lesions of OLP patients, which closely correlate with clinical presentation and disease severity. Consequently, precise immunophenotyping of CD4⁺ T-cell infiltration holds promise for informing future individualized therapeutic strategies for OLP.

Recurrent aphthous ulcer (RAU) is a prevalent oral mucosal disorder characterized by painful, recurrent round or oval-shaped ulcers. Treatment aims to reduce recurrence frequency, alleviate pain, and accelerate healing. Local therapy is the mainstay, among which adhesive oral mucosal drug delivery systems are promising for targeted and prolonged drug action. This review summarizes advances in such systems for RAU treatment, including flexible films, patches, and microneedle patches. It analyzes the design strategies and advantages of these systems, and points out their shortcomings, with the aim of providing ideas and inspiration for further research.

Photodynamic therapy (PDT) is a new type of antibacterial method. This technology works by generating cytotoxic reactive oxygen species to destroy the DNA and cell membranes of pathogenic bacteria, achieving the purpose of treatment. Due to its advantages of being less likely to develop drug resistance and having low toxicity and minimal invasiveness, in recent years, a large number of scholars have conducted a series of studies on the effectiveness of PDT as an adjuvant treatment for periodontitis. This article reviews the research progress of PDT in the adjunctive treatment of periodontitis, including its working principle, mechanism of action, clinical efficacy and application in special populations, as well as innovative applications such as the development of new photosensitizers, optimized nanodelivery systems, improvement of therapeutic devices, implementation of individualized treatment strategies and application of up-conversion nanoparticles, offering new ideas for the treatment of periodontitis.

Objective: To assess regional differences in HIV/AIDS-related knowledge, attitudes toward patients with HIV/AIDS, and factors associated with treatment willingness among dentists in Xinjiang and the Beijing-Tianjin-Hebei region. Material and Methods: A cross-sectional questionnaire survey was conducted, including demographic characteristics, HIV/AIDS-related knowledge, attitudes, and treatment willingness towards patients with HIV/AIDS. Chi-square tests were used for group comparisons, and logistic regression was performed to identify factors influencing treatment willingness. Results: A total of 479 valid questionnaires were collected, including 165 males (34.4%) and 314 females (65.5%). Overall, 79.3% of dentists could correctly answer at least 10 questions among the 12 questions related to HIV/AIDS knowledge. A total of 43.2% expressed willingness to treat patients with HIV/AIDS, which was higher in Xinjiang than in the Beijing-Tianjin-Hebei region (48.5% vs. 36.1%). Moreover, 32.6% had prior experience treating patients with HIV/AIDS, which was also the higher proportion in Xinjiang (44.9%) compared with the Beijing-Tianjin-Hebei region (16.1%) (P<0.05). Dentists with previous treatment experience were more likely to provide treatments again than those without such experience (OR=3.517, 95% CI: 1.810-6.832, P=0.001). Conclusions: Dentists in Xinjiang showed higher willingness to treat patients with HIV/AIDS than those in the Beijing-Tianjin-Hebei region, despite comparable levels of HIV/AIDS-related knowledge. These findings highlight the need for region-specific continuing education strategies that strengthen clinical exposure to improve equitable oral care for patients with HIV/AIDS in China.

Objective: To report a case of histoplasma capsulatum with granulomatous hyperplasia occurring in labial-buccal and gingiva mucosa. Diagnosis and Treatment: This case involves a middle-aged male patient presenting with granulomatous hyperplasia of the gingiva and labial-buccal mucosa. The diagnosis of Histoplasma capsulatum infection was confirmed by pathological examination, fungal culture, and assisted by pathogenic microorganism nucleic acid high-throughput sequencing. After excluding fungal infections of the lungs and other organs, a treatment regimen was formulated including oral itraconazole capsules for 6 weeks combined with local antifungal therapy. Results: Five weeks after treatment, the granulomatous ulcers of the patient’s gingiva and lips healed completely. Fungal culture results were negative, which met the criteria for drug withdrawal, with no recurrence during follow-up. Conclusions: For oral granulomatous ulcers that are persistent and unresponsive to conventional treatment, especially in patients with a history of fungal exposure or local immune disorders, the possibility of orofacial Histoplasma capsulatum infection should be considered.

Objective: This case report presents the treatment process of a case of oral submucous fibrosis (OSF) using Compound Danshen Dripping Pills combined with Compound Betamethasone, aiming to provide clinical experience for the treatment of OSF. Diagnosis and treatment: After a clear diagnosis and informed consent from the patient, the patient underwent local blocking therapy with Compound Betamethasone for oral mucosal lesions, accompanied by oral administration of Compound Danshen Dripping Pills. Results: After 8 weeks of treatment, good clinical effects were achieved. Conclusions: The combination of Compound Danshen Pills and Compound Betamethasone Injection can exert a synergistic effect, which not only exerts an anti-inflammatory effect but also improves local microvascular microcirculation, leading to more effective symptom relief.

Objective: This case report describes the diagnosis and treatment process of a patient with mucous membrane pemphigoid (MMP) involving both oral and ocular regions, aiming to explore the multidisciplinary collaborative diagnosis and treatment strategy and the clinical outcomes of a stepped, individualized treatment regimen for high-risk MMP. Diagnosis and Treatments: The patient visited the Ophthalmology Department due to ‘congestion in both eyes and blurred vision’. He was advised to consult the Department of Oral Mucosa to rule out mucous membrane pemphigoid. A review of the medical history revealed that the patient developed gingival hyperemia two years ago, which did not receive treatment. The diagnosis of MMP was confirmed based on clinical examination, histopathology, and direct immunofluorescence. Treatment involved a stepped regimen of systemic glucocorticoids combined with immunosuppressants, underpinned by multidisciplinary management involving departments of oral medicine, ophthalmology, and endocrinology. Results: After 13 months of treatment, the oral lesions completely resolved, active ocular inflammation was effectively controlled, and symblepharon stabilized without progression. The systemic glucocorticoid dosage was successfully reduced to a maintenance dose of 6mg/d, creating conditions for subsequent ocular surgery. Conclusions: For high-risk MMP, early and accurate diagnosis is the prerequisite. An individualized, stepwise treatment strategy centered on systemic immunosuppression, with participation from multiple disciplines, is crucial for disease control, prevention of scar formation, and improvement of patient prognosis.

Objective: This case report described the diagnosis and treatment process of trigeminal herpes zoster complicated with Ramsay-Hunt syndrome. It aimed to provide a reference for the diagnosis and treatment of similar patients. Diagnosis and Treatment: The patient was elderly and presented with left trigeminal herpes zoster combined with Ramsay-Hunt syndrome at the initial visit. After a clear diagnosis, he was advised to be hospitalized. In addition to symptomatic treatment by the stomatology department, traditional Chinese medicine acupuncture was combined to treat facial paralysis, and multidisciplinary diagnosis and treatment were promptly performed. Results: Favorable effects were observed after 7 days treatment and 1-month follow-up. Conclusions: For oral mucosal diseases presenting with severe symptoms and systemic manifestations, hospitalization enables the implementation of multidisciplinary collaborative diagnosis and treatment, which confers notable clinical advantages.

Objective: This case reported the diagnosis and treatment for oral lichenoid lesions of chronic graft-versus-host disease, aiming to explore its clinical characteristics and individualized treatment strategies. Diagnosis and Treatment: After bone marrow transplantation, the patient developed white reticular striae in the oral mucosa accompanied by refractory large atrophic and erosive lesions. To avoid the impact of systemic medication on the underlying disease and hepatorenal function, we developed and implemented an individualized and staged topical treatment strategy. Results: Through multi-stage local comprehensive treatment, the atrophic and erosive lesions healed, the white reticular striae relieved significantly, and the pain alleviated completely. Conclusions: Oral lichenoid lesions of chronic graft-versus-host disease is a potential malignant oral disease. This case indicated that for patients with systemic diseases and complex medication regimen, an individualized treatment strategy with primarily topical therapy could effectively promote the healing of the lesions with safety, which has important clinical reference significance.

Objective: To explore the multidisciplinary collaborative management protocol and long-term prognosis of multiple oral erythroleukoplakia. Diagnosis and Treatment: A 69-year-old female patient with multiple oral erythroleukoplakia underwent standardized diagnosis, treatment, and follow-up for 7 years. Comprehensive examinations including pathological biopsy, non-invasive detection technologies were performed to dynamically monitor disease progression. A multidisciplinary team (MDT) comprising specialists from the Department of Oral Mucosal Diseases, Department of Oral and Maxillofacial Surgery, and Department of Pathology collaborated to dynamically adjust treatment strategies based on lesion risk stratification, balancing lesion control, functional preservation, and the patient’s quality of life. Results: The patient experienced a complex clinical course characterized by improvement, recurrence, development of new lesions, and eventual stabilization. Following multidisciplinary collaboration and individualized treatment, long-term stable control of oral erythroleukoplakia was achieved without malignant transformation, oral function and the patient’s quality of life were maximally preserved. Notably, the patient underwent local perfusion chemotherapy with mitomycin due to bladder cancer in the later stage, and the oral leukoplakia disappeared accidentally. Conclusions: Close and regular follow-up, MDT, and risk-stratified management are crucial for improving the prognosis of patients with oral erythroleukoplakia. This study provides a reference for the clinical management of complex oral potentially malignant disorders(OPMDs). The disappearance of oral leukoplakia after chemotherapy provides new ideas for drug treatment.

Objective: This article reports a case of severe pemphigus vulgaris with severe osteoporosis treated with rituximab combined with glucocorticoids, providing a reference for the treatment of such patients. Diagnosis and Treatment: The patient was contraindicated for long-term high-dose glucocorticoid therapy due to severe osteoporosis. After systematic evaluation during hospitalization, a personalized treatment regimen was established for intravenous rituximab combined with oral glucocorticoids. Results: After treatment, the oral mucosa and skin lesions were significantly improved, and the glucocorticoid was rapidly reduced while the disease was effectively controlled. Conclusions: For mucosal-predominant pemphigus, particularly in patients with contraindications to long-term glucocorticoid use, the combination therapy of rituximab and glucocorticoids demonstrates favorable efficacy and safety, while enabling rapid tapering of glucocorticoids.

The hierarchical progressive teaching model respects the objective laws of clinical competence formation. By scientifically designing teaching steps, reasonably matching teaching methods, and accurately implementing evaluation feedback, it helps to systematically improve the quality of clinical teaching for oral mucosal diseases. This article aims to explore the theoretical basis, implementation path, and application strategies of the layered and progressive teaching model in clinical teaching of oral mucosal diseases at Peking University School of Stomatology, in order to provide reference for the reform of clinical teaching of oral mucosal diseases.