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Methods: All trainees within the British Isles were sent anonline questionnaire and allowed access to an existing ePortfolio.Two trainee focus groups were conducted to help design the oralmedicine ePortfolio template. Qualitative and quantitative datawould be collected from both questionnaires and focus groups.Quantitative data would be presented using descriptive statistics,and qualitative results would be processed using the “contentanalysis” method.

Results: Of all trainees, 61% (11 of 18) responded to thequestionnaire; 72.7% (8 of 11) thought the specialty requiresstandardized portfolios. Dominant themes from qualitative datawere identified. Beneficial themes included practical benefits(e.g., remote access, less paperwork) and workforce benefits(e.g., national standardization of training). Negative themesincluded concerns about ePortfolio limiting trainer input anddissatisfaction with requirement for trainees to self-fund theePortfolio. Suggestions from the trainees about the design ofthe ePortfolio included an emphasis on practicality and simplicityand a requirement for a voluntary pilot study to further refinethe ePortfolio before full implementation. Evidence of deeperlearning and reflective practice were demonstrated by the traineesattending the focus groups.

Conclusions: The results of this action research projectsuggest that there is a strong desire among oral medicine traineeswithin the British Isles to implement an ePortfolio. The focusgroup setting appeared to be successful in producing a pragmaticdesign for the oral medicine ePortfolio and in promoting deeperlearning and reflective practice within the participating trainees.

OI0293 SALIVARY EXOSOMES: COMPARISON BE-TWEEN METHODS OF ISOLATION Marilena Vered,Ayelet Zlotogorski-Hurvitz, Gavriel Chaushu, Tuula Salo,Dan Dayan, Department of Oral Pathology and Oral Medi-cine, Tel Aviv University, Tel Aviv, Israel

Objectives: Exosomes are nanoparticles (30-100 nm)secreted by most cell types. It was the aim of our study to isolatefor the first time salivary exosomes using a chemically basedagent (Exoquick (EQ)-TC; Systems Biosciences, CA, USA) andto compare their characteristics to those isolated by ultracentri-fugation (UC).

Methods: Whole saliva (5-10 mL) from healthy individualswas collected under standardized conditions, kept at 4�C, andcentrifuged (3000 g for 15 minutes), and the supernatant wasfrozen (�70�C) until further use. Exosomal precipitates (ppt)obtained by EQ were termed EQppt, and those resulting from UC(120 000 g for 3 hours) were termed UCppt. EQ was added tosaliva in a ratio of 1:2, incubated overnight at 4�C followed bycentrifugation (5000 g for 30 minutes). Exosomes isolated withEQ were characterized by ELISA and Western blotting moleculartests for assessment of the exosomal markers CD63, CD9, andCD8 and compared with those isolated by UC. Morphologically,the comparison was done by atomic force microscopy (AFM) andelectron microscopy (EM).

Results: All the tests were done using a saliva volume of0.5 mL. EQppt was considerably larger than UCppt. ELISA testsfound no significant differences in the concentrations of theexosomal markers in EQppt when compared with UCppt. Usingthe same markers, Western blotting showed thinner bands inEQppt than UCppt. Examination with AFM found that EQpptcontained only a few single particles of exosomal size alongsidewith aggregates of varying size, unlike in UCppt. EM of EQpptshowed only a few particles with classical exosomal size and

bilayered morphology together with aggregates and debris ofother biologic precipitates. UCppt showed purer exosomes almostwithout debris or aggregates.

Conclusions: Although isolation of exosomes by EQ isquicker and easier, it provides an impure precipitation whencompared with exosomes isolated by UC.

OI0306 DOES NARROW BAND IMAGING ADD VALUEIN ORAL MEDICINE? Giulia Otaviani, Margherita Gobbo,Marta D’Ambros, Serena Zacchigna, Roberto Di Lenarda,Matteo Biassotto, Dental Science Department, Division ofOral Medicine and Pathology, Trieste, Italy

Objectives: The study of angiogenesis, an early and keyevent in carcinogenesis, could improve early detection of malig-nant/premalignant oral lesions. Narrow band imaging (NBI) is anoptical technique that is used both to perform objective examina-tion of the oral cavity, with the aid of different grades of magni-fication, and to visualize intrapapillary capillary loops (IPCLs)through a 415-nm light source. The aim of this study was (1) todefine the sensitivity and specificity of NBI in detecting dysplasticand neoplastic lesions and (2) to evaluate its learning curve.

Methods: The NBI-guided technique was used to photo-graph and biopsy 91 white, red, or white-red oral lesions afterdetecting IPCL abnormalities. Lesions were classified by an expertblind rater (main rater) and by 17 students (nonexpert raters) afteradequate instructions, according to Takano’s IPCL classification.Lesions were classified into mild/moderate/severe dysplasia orneoplasia. Histopathologic retrievals were used as a referencestandard. Dysplastic oral lesions were induced in 40 mice. Lesionswere analyzed according to IPCL classification and biopsied.Comparison between histopathologic retrievals and clinicallydetermined grade of dysplasia (mild/moderate/severe dysplasia orneoplasia) was performed. Kendall W was used to compare clin-ical/histologic findings and expert/nonexpert evaluations.

Results: In the clinical study, the concordance between themain rater and reference standard was 72.5%; the k coefficient ofthe main rater was 0.74 (95% CI). Nonexpert raters had 21.7%concordance with the reference standard and 26.8% with the mainrater. NBI examination found 57% to 96% sensibility and 85% to99% specificity, depending on grades of dysplasia. The highestvalues were found in neoplasia detection. In the animal study,sensitivity and specificity of NBI-guided grading were 95.7% and98.5%, respectively.

Conclusions: Our findings support (1) that high sensitivity/specificity can be obtained both in patients and in mice and (2)that NBI has a steep learning curve. We can hypothesize that NBIcould be of great help in the early detection of oral lesions,performing guided biopsies and follow-up of suspicious oral le-sions, although guidelines and education courses could help inrendering it more reproducible.

OI0317 EPIDEMIOLOGIC, CLINICAL, AND RADIO-GRAPHIC EVALUATION OF JAW LESIONS JulianePiragine Araujo, Celso Augusto Lemos Junior, Decio SantosPinto Junior, Gustavo Henrique Campos Rodrigues, FabioAbreu Alves, Stomatology, Dentistry School, São Paulo Uni-versity, São Paulo, Brazil

Objectives: This study evaluated the prevalence and theclinical and radiographic features of jaw lesions in a singleinstitution.

Methods: A prospective study of descriptive characterevaluated clinical and radiographic features of all lesions arising

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in the jaws between May and December 2013 in the StomatologyDepartment, School of Dentistry, São Paulo University. Theimaging examinations and biopsy were performed according toeach lesion diagnosis indication. The data were reported throughthe absolute and relative frequency of categorical variables.

Results: A total of 64 patients, 32 male and 32 female, witha mean age of 33 years (� 18; range, 8-77) had 65 lesions. Themost frequent symptoms were swelling and pain. A biopsy wasindicated in 47 lesions, and in the other 17 the diagnosis wasdone by clinical and radiographic features. The anterior maxillaregion and the body of the mandible were the main affected sites.Despite the diagnosis, 10 cases were periapical cyst, 8 simplebone cyst, 6 osseous dysplasia, 5 dentigerous cyst, 3 calcifyingcystic odontogenic tumor, 3 ameloblastomas, 2 keratocysticodontogenic tumor, 2 condensing osteitis, 2 odontomas, 2nasopalatine duct cyst, and a case each of mucoepidermoid car-cinoma, hypercementosis, maxillary sinus hypoplasia, multiplemyeloma, osteosarcoma, bone exostoses, sclerotic bone, andfibrous dysplasia. Surgical treatment was performed in 39 casesand in 17 cases was only expectant. At the time of this report, 8cases remained waiting for the biopsy or anatomopathologicanalysis.

Conclusions: These preliminary results showed that odon-togenic cyst and tumors were the most prevalent lesions. Inter-estingly, in about 30% of the jaw lesions only clinical andradiographic features performed the diagnosis.

OI0318 HEALING OF ORAL ULCERS BY POLYMER-BASED MUCOADHESIVE Ines Velez, Diagnostic Sciences,Nova Southeastern University, Fort Lauderdale, FL, USA

Objectives: This double-blinded pilot study was to evaluateMuGard (carbomer-homopolymer) as a mucoadhesive (1) topromote healing of oral lichen planus ulcerations, (2) to decreaseerythema, and (3) to decrease pain.

Methods: Patients who had ulceration due to their erosivelichen planus (n ¼ 10) were followed for severity changes andcompared with a placebo group (n ¼ 10). Measures included oralmucositis assessment scale (OMAS) and visual analog scale(VAS) for pain, measured at rest, speaking, and swallowing, (1) atbaseline (before randomization and before treatments began) and(2) repeated on days 2, 7, and 14 after initiation of treatment.After baseline evaluation, patients were randomly assigned to theactive or placebo cohort. Participants were assigned a blinded IDnumber and supplied with either the MuGard or the placebo.After clinical evaluations, the code was broken to allow for sta-tistical analysis. No adverse incidents were reported. The initialOMAS and VAS scores of the 2 groups were compared using thenonparametric Mann-Whitney test to determine if the 2 groupswere statistically similar before treatments began. Each group wascompared with its own baseline values using the Friedman test, awithin-group measure. The final values were compared statisti-cally, using the Mann-Whitney test.

Results: The randomization process was successful informing 2 statistically similar groups. One-way repeated-mea-sures analysis of variance found statistically significant changesfrom baseline for the MuGard participants with respect tomucositis and pain. No significant changes occurred in the pla-cebo group. Changes in pain are associated with changes in ulcersbut not with changes in erythema.

Conclusions: The copolymer MuGard is effective in pro-moting the healing of oral erosive lichen planus ulcers and in

decreasing pain. Clinical trials with larger sample sizes arenecessary to validate the effectiveness of this therapy.

Funding sources: Nova Southeastern University.

OI0341 UTILIZATION OF COMPOUND PRESCRIPTIONMEDICATIONS IN AN ORAL MEDICINE PRACTICEShannon Stock, Katherine Rubino, Arthur Margolis, IrenaThomas, Sook-Bin Woo, Nathaniel Treister, Mathematics andComputer Science, College of the Holy Cross, Boston,MA, USA

Objectives: For many oral medicine conditions, the use ofintensive topical therapies that act directly at the affected siteprovides greater efficacy and fewer side effects than systemicallydelivered medications. The efficacy of these treatments, combinedwith the need for patient-specific customizations, such as vectorof delivery and dose, has resulted in drug compounding playingan important role in the practice of oral medicine. The objectiveof this study was to characterize the utilization and costs asso-ciated with the use of compounded medications in an academichospital-based oral medicine practice.

Methods: This was a retrospective analysis of outpatientstreated at the Center for Oral Disease at Brigham and Women’sHospital (Boston, MA, USA) from November 2006 throughNovember 2011. Patient prescription and payment informationwere obtained from the pharmacy’s patient database. Variablesincluded medication, number of refills filled, prescription cost, andpayment contributions from insurance and patients. An electronicmedical record review was conducted to obtain patient de-mographic data and diagnosis as well as the prescribing provider.

Results: A total of 510 prescriptions corresponding to 423unique patients were filled during the study period. Nearly 93% ofprescriptions were for management of neuropathic conditions ormucosal diseases. Four medications composed the majority (474 of510; 93%) of prescriptions filled. Approximately half were for clo-nazepam 0.5mgper 5mLof solution, followed by tacrolimus 0.5mgper 5 mL of solution (29%), clobetasol 0.05% solution (10%), andketoprofen 20% cream (7%). Nearly all prescriptions filled (94%)were at least partially paid for by insurance. The median cost perprescription was $167 (range, $10-$809). The median out-of-pocketcost (including copays) paid by patients was $25 (range, $0-$550).A median of 1 fill was obtained for each prescription (range, 1-28).

Conclusions: Compound medications provide an affordableand flexible treatment option for patients being treated for avariety of oral diseases, especially those involving neuropathicand mucosal conditions.

OI0444 BIOMARKERS IN ORAL CHRONIC GRAFT-VS-HOST DISEASE Ana Carolina F. Motta, Robert J. Soiffer,Qian Zhan, Allison Larson, George F. Murphy, NathanielS. Treister, Department of Oral Diagnosis, São Paulo Uni-versity, São Paulo, Brazil

Objectives: Chronic graft-vs-host disease (cGVHD) is aserious complication of allogeneic hematopoietic stem celltransplant and the leading cause of nonrelapse mortality. There isgreat interest in identifying cGVHD biomarkers for diagnosis andevaluating disease activity. As the oral cavity is one of the mostfrequently affected sites, we investigated the specificity ofimmunopathologic features of oral mucosal cGVHD and the ef-fect of topical therapy on biomarker expression.

Methods: Biopsies of oral cGVHD (n ¼ 17) werecompared with oral acute GVHD (aGVHD; n ¼ 3), oral lichen