Multivariate analysis of oral mucosal ulcers during orthodontic treatment

BACKGROUND Orthodontic treatment can easily cause local soft tissue reactions in the oral cavity of patients under mechanical stress,leading to oral mucosal ulcers and affecting their quality of life.At present,only limited literature has explored the factors leading to oral ulcers in orthodontic treatment,and these research results are still controversial.AIM To investigate the current status and related factors of oral mucosal ulcers during orthodontic treatment,aiming to provide a valuable reference for preventing this disease in clinical practice.METHODS A total of 587 patients who underwent orthodontic treatment at the Peking University School of Stomatology and Hospital of Stomatology between 2020 and 2022 were selected and allocated to an observation or control group according to the incidence of oral mucosal ulcers during orthodontic therapy.A questionnaire survey was constructed to collect patient data,including basic information,lifestyle and eating habits,treatment details,mental factors,and trace element levels,and a comparative analysis of this data was performed between the two groups.RESULTS A logistic regression model with oral ulcers as the dependent variable was established.The regression results showed that age(≥60 years:odds ratio[OR]:6.820;95%confidence interval[CI]:2.226–20.893),smoking history(smoking:OR:4.434;95%CI:2.527–7.782),toothbrush hardness(hard:OR:2.804;95%CI:1.746–4.505),dietary temperature(hot diet:OR:1.399;95%CI:1.220–1.722),treatment course(>1 year:OR:3.830;95%CI:2.203–6.659),and tooth brushing frequency(>1 time per day:OR:0.228;95%CI:0.138–0.377)were independent factors for oral mucosal ulcers(P<0.05).Furthermore,Zn level(OR:0.945;95%CI:0.927–0.964)was a protective factor against oral ulcers,while the SAS(OR:1.284;95%CI:1.197–1.378)and SDS(OR:1.322;95%CI:1.231–1.419)scores were risk factors.CONCLUSION Age≥60 years,smoking history,hard toothbrush,hot diet,treatment course for>1 year,tooth brushing frequency of≤1 time per day,and mental anxiety are independent risk factors for oral mucosal ulcers.Therefore,these factors should receive clinical attention and be incorporated into the development and optimization of preventive strategies for reducing oral ulcer incidence.

Unraveling brain aging through the lens of oral microbiota

The oral cavity is a complex physiological community encompassing a wide range of microorganisms.Dysbiosis of oral microbiota can lead to various oral infectious diseases,such as periodontitis and tooth decay,and even affect systemic health,including brain aging and neurodegenerative diseases.Recent studies have highlighted how oral microbes might be involved in brain aging and neurodegeneration,indicating potential avenues for intervention strategies.In this review,we summarize clinical evidence demonstrating a link between oral microbes/oral infectious diseases and brain aging/neurodegenerative diseases,and dissect potential mechanisms by which oral microbes contribute to brain aging and neurodegeneration.We also highlight advances in therapeutic development grounded in the realm of oral microbes,with the goal of advancing brain health and promoting healthy aging.

History and evolution of the use of oral mucosa for urethral reconstruction

We report here the history and evolution of the use of oral mucosa in reconstructive urethral surgery since it was first used for urethroplasty in 1894.Since that time,many authors have contributed to develop,improve and popularize the use of oral mucosa as a substitute material.Paediatric urologists should be considered pioneers on the use of oral mucosa as they used it to repair primary and failed hypospadias.The use of oral mucosa to repair penile and bulbar urethral strictures was described,for the first time,in 1993.Important evolutions in the technique for harvesting oral mucosa from the cheek were reported in 1996.Today,oral mucosa is considered the gold standard material for any type of anterior urethroplasty in a one-or two-stage repair due to its biological and structural characteristics that make it a highly versatile that is adaptable to any environment required by the reconstructive urethral surgery.As the future approaches,tissue engineering techniques will provide patients with new materials originating from the oral epithelial mucosal cells,which are cultured and expanded into a scaffold.However,the path to reach this ambitious objective is still long and many difficulties must be overcome along the way.

The mucosal immune system in the oral cavity——an orchestra of T cell diversity

The mucosal immune system defends against a vast array of pathogens, yet it exhibits limited responses to commensal microorganisms under healthy conditions. The oral-pharyngeal cavity, the gateway for both the gastrointestinal and respiratory tracts, is composed of complex anatomical structures and is constantly challenged by antigens from air and food. The mucosal immune system of the oral-pharyngeal cavity must prevent pathogen entry while maintaining immune homeostasis, which is achieved via a range of mechanisms that are similar or different to those utilized by the gastrointestinal immune system. In this review, we summarize the features of the mucosal immune system,focusing on T cell subsets and their functions. We also discuss our current understanding of the oral-pharyngeal mucosal immune system.

Micronuclei in Nasal Mucosa, Oral Mucosa and Lymphocytes in Students Exposed to Formaldehyde Vapor in Anatomy Class

The frequency of micronuclei (MN) in cells of the nasal mucosa, oral mucosa and in lym-phocytes was evaluated for 25 students in anatomy classes exposed to formaldehyde (FA) overan 8-week period. Each student served as his or her own control. The time-weighted averageconcentration (TWA) of fOrmaldehyde in anatomical laboratories and in students' dormitorieswas 0. 508 ± 0. 299 mg/m3 and 0. 012 ± 0. 0025mg/m3, respectively. A higher frequency ofmicronuclei was observed in nasal and oral exfoliative cells after formaldehyde exposure (3. 85± 1. 48 vs 1 .20± 0. 676 and 0. 857 ± 0. 558 vs 0. 568 ± 0. 317, paired-t test: P< 0. 001and P < 0. 01, respectively). No significant increase in the frequency of lymphocyte micronu-clei was found after formaldehyde exposure (P >0. 05 ). The present study shows that nasalmucosa cel1s exposed through respiration are the chief target of FA-induced genotoxic effects

Bacterial-killing Effect of Atmospheric Pressure Non-equilibrium Plasma Jet and Oral Mucosa Response

Recently, plasma sterilization has attracted increasing attention in dental community ibr the atmospheric pressure non-equilibrium plasma jet （APNPs）, which is driven by a kilohertz pulsed DC power, may be applied to the dental and oral diseases. However, it is still in doubt whether APNPs can effectively kill pathogenic bacteria in the oral cavity and produce no harmful effects on normal oral tissues, especially on normal mucosa. The aim of this study was to evaluate the bacterial-killing effect of APNPs in the biofilms containing a single breed of bacteria （Porphyromonas gingivalis, Pg.）, and the pathological changes of the oral mucosa after treatment by APNPs. P.g. was incubated to form the biofilms in vitro, and the samples were divided into three groups randomly： group A （blank control）; group B in which the biofilms were treated by APNPs （the setting of the equipment： 10 kHz, 1600 ns and 8 kV）; group C in which the biofilms were exposed only to a gas jet without ignition of the plasma. Each group had three samples and each sample was processed for up to 5 min. The biofilms were then fluorescently stained, observed and photographed under a laser scanning confocal microscope. In the animal experiment, six male Japanese white rabbits were divided into two groups randomly （n=3 in each group） in terms of the different post-treatment time （1-day group and 5-day group）. The buccal mucosa of the left side and the mucosa of the ventral surface of the tongue were treated by APNPs for 10 min in the same way as the bacterial biofilm experiment in each rabbit, and the corresponding mucosa of the other sides served as normal control. The clinical manifestations of the oral mucosa were observed and recorded every day. The rabbits were sacrificed one or five day（s） after APNPs treatment. The oral mucosa were harvested and prepared to haematoxylin and eosin-stained sections. Clinical observation and histopathological scores were used to assess mucosal changes. The results showed the obvious P.g. biofilms were formed at 10 days, and most of the bacteria in groups A and C were alive under a laser scanning confocal microscope, but the bacteria in the group B were almost all dead. In animal experiment, no ulcers, anabrosis and oral mucositis were found in both the 1-day and 5-day groups. The aver- age mucous membrane irritation index was -0.83 and -0.67 in the 1-day and 5-day groups, respectively, suggesting that no intense mucosal membrane irritation responses occurred. It was concluded that APNPs could effectively kill Pg. in the biofilms and did not cause any pathological changes in the normal mucosa, suggesting that the plasma jet （APNPs） may be applied to oral diseases as a novel sterilization device in the future.

Urothelial or oral mucosa cells for tissue-engineered urethroplasty: A critical revision of the clinical outcome

Objective:To report the clinical outcome of urethral reconstruction by cultured urothelial or oral mucosa cells for tissue-engineered urethroplasty.Methods:We systematically searched for studies reporting the use of tissue-engineered techniques for hypospadias and urethral stricture repair in humans in PubMed and Embase(OvidSP)through January,1990 to June,2018.We excluded studies based on titles that clearly were not related to the subject,studies in which tissue-engineered biomaterial were used only in laboratory or experimental animals,and in the absence of autologous cultured epithelial cells.Studies were also excluded if they were not published in English,had no disease background and adequate follow-up.Finally,we search all relevant abstract presented at two of the main urological meetings in the last 10 years:European Association of Urology(EAU)and American Urological Association(AUA).Results:A total of six articles,reporting the clinical use of tissue-engineered techniques in humans,were fully reviewed in our review.The epithelial cells were harvested from the urethra(10 patients),the bladder(11 patients)and the mouth(104 patients).The tissue-engineered grafts were used in children for primary hypospadias repair in 16 cases,and in adults for posterior and anterior urethral strictures repair in 109 cases.Tissue-engineered grafts were showed working better in children for primary hypospadias repair than in adults for urethral strictures repair.Conclusion:One hundred and twenty-five patients received tissue-engineered urethroplasty using cultured epithelial cells for primary hypospadias or urethral strictures repair.The studies demonstrate a high degree of heterogeneity respect to epithelial cells(from urethra,bladder,and mouth),type of scaffold,etiology,site of urethral stricture,number of patients,follow-up and outcomes.

Characteristics of benign lymphoadenosis of oral mucosa

AIM: To investigate the pathological characteristics and carcinogenesis mechanism of benign lymphoadenosis of oral mucosa (BLOM).METHODS: The expressions of Ki-67, CD34 and apoptosis were evaluated by immunohistochemical SP staining in 64 paraffin-embedded tissue samples. Of them, 9 were from BLOM with dysplasia, 15 from BLOM without dysplasia,15 from oral squamous cell carcinoma (OSCC), 15 from oral precancerosis, and 10 from normal tissues. Cell proliferation, apoptosis and angiogenesis of tissue samples were also analyzed.RESULTS: The expression of Ki-67 in BLOM with dysplasia,oral precancerosis and OSCC was significantly higher than in BLOM without dysplasia and normal mucosa. The microvascular density (MVD) in BLOM with and without dysplasia, oral precancerosis, and OSCC was significantly higher than in normal mucosa. Apoptosis in BLOM and oral precancerosis was significantly higher than in OSCC and normal mucosa.CONCLUSION: Benign lymphoadenosis of oral mucosa has potentialities of cancerization.

Development of a mouse model of arecoline-induced oral mucosal fibrosis

Objective: To develop a BALB/c mouse model of oral submucous fibrosis(OSF)induced by arecoline and to exhibit an accumulation of collagen and angiogenesis changes.Methods: BALB/c mice were randomly assigned to either the control(distilled water) or experimental group(arecoline)(n = 40). Eight mice from each group were sacrificed every 4 weeks since 8 weeks post treatment. Changes in histopathologic features, levels of collagen type Ⅰ and collagen type Ⅲ, and angiogenesis were measured.Results: In the 8th week, epithelium atrophy, collagen cumulation and micrangium pathologic changes in the lamina propria were observed in the oral mucosa. In the 20th week, hyaline degeneration of the connective tissues was observed on the tongue and palate mucosa. The angiogenesis and collagen type Ⅰ changed significantly as the diseases advanced(P < 0.05); however, collagen type Ⅲ was not statistically different.Conclusions: An OSF model involving mice can be rapidly induced by drinking a highdose of arecoline. OSF angiogenic changes in mice primarily decrease and collagen accumulation is mainly collagen type Ⅰ.

Novel oral-targeted therapies for mucosal healing in ulcerative colitis

Ulcerative colitis(UC), a chronic, relapsing, remitting disease of the colon and rectum, is characterized by inflammatory ulceration of the mucosa. Current UC therapy relies on controlling acute episodes and preventing relapse. To predict modifications in the natural course of UC, mucosal healing(MH) has emerged as a major treatment goal. Endoscopic evaluation is considered the gold standard for assessing MH, which can be achieved by conventional drugs and biologics in many, but not all, patients. Consequently, interest is focusing on the development of new substances for UC therapy, and new oral agents are in the pipeline. This review will focus on the ability of newly developed oral drugs to induce and maintain MH in UC patients.

Clinical and impression cytology findings of amniotic membrane and oral mucosal membrane transplantation for the management of socket contracture

AIM:To investigate and compare the cytopathological and clinical effects of amniotic membrane transplantation(AMT)and oral mucosal membrane transplantation(OMMT)in socket contraction.METHODS:Twelve patients who could not be fitted with ocular prosthesis due to socket contracture were included in this study.Seven patients underwent AMT and 5 patients underwent OMMT.Thirteen patients who had healthy sockets were included as control group.Depth of inferior fornix,degree of inflammation,extent of the socket contracture and socket volume were measured in the preoperative period and at sixth and twelfth weeks postoperatively.Impression cytology of conjunctival fornices and tear transforming growth factor beta-1(TGFβ1)levels were determined.RESULTS:In the AMT group,socket volume and lower fornix depth values were significantly higher(P=0.030and P=0.004 respectively)and inflammation levels and impression cytology stages(P=0.037 and P=0.022respectively)were significantly lower in postoperative period compared to preoperative period.In the OMMT group,no statistical differences were found in terms of clinical parameters,inflammation levels and impression cytology stages of preoperative versus postoperative values.Preoperative tear TGFβ1 levels were higher in AMT and OMMT groups compared to the control group(25.5 ng/mL,26.3 ng/mL and 21.7 ng/mL respectively).Decreased tear TGFβ1 levels were observed in both the AMT and OMMT groups postoperatively(median decrease value=2.1 ng/mL and 2.7 ng/mL respectively).CONCLUSION:AMT is associated with postoperative improvement in inferior fornix depth,socket volume,inflammation and impression cytology levels and may bea more proper alternative method than OMMT in the management of socket contracture.

Intragastric surgery using laparoscopy and oral endoscopy for gastric submucosal tumors

We review the techniques and outcomes of the intragastric resection for gastric submucosal tumors(GSTs) using laparoscope and oral endoscope. In the literature, the mean operation time, intraoperative blood loss, pathological size of the tumor and postoperative hospital stay were 134 min, minimal, 31 mm and 6.4 d, respectively. There were no particular perioperative complications during the follow-up period(mean: 121.3 mo). Intragastric surgery using laparoscopy and oral endoscopy can be considerably beneficial for patients with GSTs locating in the upper third of the stomach between 2-5 cm in diameter and < 8 cm2 in crosssectional area and located in the upper third of the stomach.

Assessment of Nutritional Status of Clinical Patients by Determining Normal Range of Oral Mucosal Apoptosis and Proliferation Rate

The normal range of oral mucosal cell apoptosis and proliferation rate through a larger sample of non-malnourished crowd was investigated,and the nutritional status of clinical patients was assessed.Of 194 clinical patients selected according to 'NRS2002' guidance,there were 167 non-malnourished patients and 27 malnourished cases,respectively.Twelve patients with toxic reactions of grade III after postoperative chemotherapy (POC) were chosen.The oral mucosal epithelial apoptosis and proliferation rate were measured by using flow cytometry.The statistical significance was processed by using unpaired t-test.The results showed that there was no significant difference in gender,age and body weight between malnourished and non-malnourished groups.The normal range of oral mucosal epithelial apoptosis and the proliferation rate was (27.50±1.50)% and (15.12±1.68)% in non-malnourished patients,and that was (19.90±4.14)% and (6.66±5.83)% in the malnourished patients,respectively.It is concluded that the normal range of oral mucosa cell apoptosis and proliferation rate is achieved,which can not be influenced by gender,age,weight and other factors,and could be used as a sensitive and accurate index to assess the nutritional status of clinical patients.

Role of Protein Kinase C<i>δ</i>-Mediated Spleen Tyrosine Kinase (Syk) Phosphorylation on Ser in the Amplification of Oral Mucosal Inflammatory Responses to <i>Porphyromonas gingivalis</i>

The signaling events underlying oral mucosal inflammatory responses to P. gingivalis and its key endotoxin, lipopolysaccharide (LPS), relay primarily on the LPS engagement of Toll-like receptor-4 (TLR4), and the activation of IκB-kinase complex (IKK) and mitogen-activated protein kinases (MAPKs that exert their control over transcription factors implicated in the regulation of iNOS and COX-2 proinflammatory genes expression). Since spleen tyrosine kinase (Syk) has emerged recently as a major amplifier in the production of proinflammatory mediators, we investigated the process of recruitment and interaction of Syk with TLR4 in salivary gland acinar cells in response to P. gingivalis LPS. Our findings revealed that stimulation of the acinar cells with the LPS leads to protein kinase Cδ (PKCδ)-mediated phosphorylation of Syk on Ser which results in its localization with the membrane associated TLR4 complex and the activation through phosphorylation on Tyr. Further, our results support the involvement of Syk in the amplification of transcription factors involved in the assembly and expression of transcription complexes associated with the induction in COX-2 and iNOS genes. Therefore, our data suggest that PKCδ is a primary linchpin affecting the Syk recruitment to the membrane localized TLR4, and hence affects the efficiency of the kinase activation and the magnitude of oral mucosal inflammatory response to P. gingivalis.

Exfoliative Cytology of Oral Mucosa Epithelium: Cytochemical Study and Morphologic Analysis of Patients with Type 2 Diabetes

Background: Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia. An association between diabetes mellitus and periodontal disease has been reported. However, few comprehensive reports have examined the impact of chronic hyperglycemia on oral mucosal epithelial cells. This study clarified the effect of diabetes on oral mucosal epithelium cells. Methods: Cells from 44 patients with type 2 diabetes and 10 healthy controls were collected from the buccal mucosa, gingiva, and lateral margin of the tongue by exfoliation. Samples were subjected to Papanicolaou staining;immunochemical staining using anti-AGE antibody, anti-Ki-67 antibody, and anti-p53 antibody;and lectin chemical staining. Furthermore, the nuclear area and cytoplasmic area were measured, and the nuclear/cytoplasm ratio was calculated. Results: A chromatin condensation-like substance was found in samples from some diabetic patients. In AGE staining, positive cells were found in both groups, although the rate of positive cells tended to be higher in diabetic patients. No positive findings were found for Ki-67 and p53 antibodies. PNA and RCA120 showed differences in staining between diabetic patients and controls. The nuclear area was significantly expanded in diabetic patients (P < 0.05). There was no significant difference between groups in the cytoplasmic area. The nuclear/cytoplasm ratio was significantly increased in diabetic patients (P Conclusion: These findings suggest that in patients with persistent hyperglycemia, changes in the sugar chain terminal of the cell surface may influence mucosal epithelial cell differentiation. The appearance of chromatin-like substances may be an indicator of the need for better management of type 2 diabetes.

Effects of quercetin on hyper-proliferation of gastric mucosal cells in rats treated with chronic oral ethanol through the reactive oxygen species-nitric oxide pathway

AIM： To investigate the effect of quercetin （3,3,4,5, 7-pentahydroxy flavone）, a major flavonoid in human diet, on hyper-proliferation of gastric mucosal cells in rats treated with chronic oral ethanol. METHODS： Forty male Sprague-Dawley rats, weighing 200-250 g, were randomly divided into control group （tap wateradlibitum）, ethanol treatment group （6 mL/L ethanol）, quercetin treatment group （intragastric gavage with 100 mg/kg of quercetin per day）, and ethanol plus quercetin treatment group （quercetin and 6 mL/L ethanol）. Expression levels of proliferating cell nuclear antigen （PCNA）and Cyclin D1 were detected by Western blot to assay gastric mucosal cell proliferation in rats. To demonstrate the influence of quercetin on the production of extra-cellular reactive oxygen species/ nitrogen species （ROS/RNS） in rats, changes in levels of thiobarbituric acid reactive substance （TBARS）, protein carbonyl, nitrite and nitrate （NOx） and nitrotyrosine （NT） were determined. The activity of inducible nitric oxide synthase （NOS） including iNOS and nNOS was also detected by Western blot.RESULTS：Compared to control animals, cell proliferation in the gastric mucosa of animals subjected to ethanol treatment for 7 days was significant increased （increased to 290% for PCNA density P 〈 0.05, increased to 150 for Cyclin D1 density P 〈 0.05 and 21.6 ± 0.8 vs 42.3 ± 0.7 for PCNA positive cells per view field）, accompanied by an increase in ROS generation （1.298 ± 0.135 μmol vs 1.772 ± 0.078 μmol for TBARS P 〈 0.05; 4.36 ± 0.39 μmol vs 7.48 ± 0.40 μmol for carbonyl contents P 〈 0.05） and decrease in NO generation （11.334 ± 0.467 μmol vs 7.978 ± 0.334 μmol P 〈 0.01 for NOx; 8.986 ± 1.351 μmol vs 6.854 ± 0.460 μmol for nitrotyrosine P 〈 0.01） and nNOS activity （decreased to 43% P 〈 0.05）. This function was abolished by the co-administration of quercetin. CONCLUSION： The antioxidant action of quercetin relies, in part, on its ability to stimulate nNOS and enhance production of NO that would interact with endogenously produced reactive oxygen to inhibit hyper-proliferation of gastric mucosal cells in rats treated with chronic oral ethanol.

Assessment of delayed bleeding after endoscopic submucosal dissection of early-stage gastrointestinal tumors in patients receiving direct oral anticoagulants

Delayed bleeding is a major and serious adverse event of endoscopic submucosal dissection(ESD)for early-stage gastrointestinal tumors.The rate of post-ESD bleeding for gastric cancer is higher(around 5%-8%)than that for esophagus,duodenum and colon cancer(around 2%-4%).Although investigations into the risk factors for post-ESD bleeding have identified several procedure-,lesion-,physician-and patient-related factors,use of antithrombotic drugs,especially anticoagulants[direct oral anticoagulants(DOACs)and warfarin],is thought to be the biggest risk factor for post-ESD bleeding.In fact,the post-ESD bleeding rate in patients receiving DOACs is 8.7%-20.8%,which is higher than that in patients not receiving anticoagulants.However,because clinical guidelines for management of ESD in patients receiving DOACs differ among countries,it is necessary for endoscopists to identify ways to prevent post-ESD delayed bleeding in clinical practice.Given that the pharmacokinetics(e.g.,plasma DOAC level at both trough and T_(max))and pharmacodynamics(e.g.,anti-factor Xa activity)of DOACs are related to risk of major bleeding,plasma DOAC level and anti-FXa activity may be useful parameters for monitoring the anti-coagulate effect and identifying DOAC patients at higher risk of post-ESD bleeding.

STUDY OF ESTROGEN RECEPTOR AND PROGESTERONE RECEPTOR IN SQUAMOUS CELL CARCINOMA TISSUE OF ORAL MUCOSA

By means of the enzyme linked affinity histothemical method, 45 cases of squamous cell carcinoma(SCC) of the oral mucosa and 15 cases of the approximately normal oral mucosal tissue were detected for estrogen receptor(ER) and progesterone receptor(PR). The results indicated that In the SCC tissue of the oral mucosa there were 5 cases of ER+ and PR- and 32 cases of both ER+ and PR+. Thirty-seven cases, the summation of the above two items, were considered as receptor(+),therefore the rate of the receptor(+) being 82.22%. ER+ and PR+ were cd related to the sex and age of patients, the neck lymph nodes' metastasizing or not and affected parts of the tumor, while they were related to the differentiation degree of the tumor. The rate of receptor(+) decreased with the decrease of the differentiation degree of the tumor. By X2 test a remarkable difference between grade Ⅰand grade Ⅲ of SCC of the oral mucosa was shown. It is suggested that SCC of the oral mucosa may probobly be hormone dependent tumor. The authors consider that the SCC detection for ER and PR could not only be one of the indices of biologic characteristics for that tumor but also as bases of anti-hormone treatment.

ORAL TRANSMUCOSAL BACK PERMEATION OF ALFENTANIL IN DOGS──A NOVEL METHOD TO DETERMINE BLOOD ALFENTANIL CONCENTRATION

This study explores a novel noninvasive method for monitoring blood alfentanil concentrations using a dog model. Alfentanil which 'back', permeated across the oral mucosa from the systemic circulation was collected from the oral mucosal surface and quantitated. The levels of the 'back' permeated alfentanil were found to closely reflect real time serum alfentanil concentrations. With further work, this finding may lead to a novel noninvasive method for monitoring real time serum alfentanil concentrations in its clinical applications.

P^（53） PROTEIN OVEREXPRESSION IN PREMALIGNANT AND MALIGNANT LESIONS OF ORAL MUCOSA：IMMUNOHISTOCHEMICAL OBSERVATION

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