Hard Palate

We constructed amplicon libraries from sponge samples that span the V4-V5 16S rRNA region (Supplementary Methods). Supplementary Table S1 describes the 16S-specific primers and the sequencing adaptors for paired-end sequencing on the Illumina MiSeq platform (Illumina Inc., San Diego, CA, USA) using 2 × 250 cycles. V3-V5 pyrosequencing reads (250 nt in length) from a publicly available oral microbiome study (The Human Microbiome Project Consortium, 2012b (link)) represent samples from nine sites in the human mouth and pharynx (subgingival plaque, supragingival plaque, buccal mucosa, keratinized gingiva, tongue dorsum, hard palate, saliva, palatine tonsils and throat).

For dataset A1, A2, A3, and B1, the primary sample materials were collected from the COpenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC₂₀₁₀) mother-child cohort, following 700 children and their families from pregnancy into childhood, as previously described in detail [33 (link)]. In this study, we used fecal samples collected at ages 1 week (n = 95), 1 month (n = 361), and 1 year (n = 622); vaginal swabs collected at week 36 of pregnancy (n = 670); and hypopharyngeal aspirates (n = 144) collected at acute wheezy episodes in children with persistent wheeze aged 1–3 years, using a soft suction catheter passed through the nose. DNA was extracted using MoBio PowerSoil kits on an EpMotion 5075, amplified using a two-step PCR reaction with forward and reverse 16S V4 primers, and sequenced using 250bp paired-end sequencing on an Illumina MiSeq. A full description of the laboratory workflow and the bioinformatics pipeline is available in the Additional file 13.
To examine effects in smaller datasets, we subset datasets A1, A2, and A3 into 16 (small) and 50 samples (medium) by random sampling with recorded random seeds, resulting in datasets A1s–A3s and A1m–A3m. Additionally, we created a simulated dataset A4 by independent resampling of all OTUs across samples, without replacement, of dataset A3.
Additionally, for dataset B2, we used public data from the Human Microbiome Project [34 (link)], testing separation ability between the tongue dorsum (n = 316) and hard palate (n = 301) 16S V3-5 samples (http://hmpdacc.org/HMQCP/). For dataset B3, we used data from Pop et al. [35 (link)], downloaded from Bioconductor (http://bioconductor.org/packages/release/data/experiment/html/msd16s.html), testing separation between age groups 0–6 months (n = 112), 6–12 months (n = 308), 12–18 months (n = 173), 18–24 months (n = 146), and 24–60 months (n = 253).
To reduce sparsity of dataset B3, chimeras were rechecked using USEARCH v7.0.1090 [36 (link)] against the gold database [37 (link)], and 3624 chimeras (listed in Additional file 14: Table S2) were removed from the OTU table. Since a phylogenetic tree file was not published along with the OTU table and sample metadata from this paper, we built one using the supplied reference sequences as described in the “Bioinformatics” section of the Additional file 13. Due to issues with TMM normalization of this dataset (see the “Results” section), we agglomerated similar OTUs to reduce the sparsity as a sensitivity analysis. This was achieved by computing pairwise phylogenetic distances using the tree and grouping together all OTUs who were closer to each other than the 0.001 quantile of the distance distribution, see Additional file 1: Table S1. The OTUs were merged with the merge_taxa function in the R package phyloseq [38 (link)], using the OTU with the highest sum of counts as archetype.

It has been reported that the scanning of fetal hard palate was completed by the axial transverse views method, but this method has high requirements on fetal position and only focuses on the hard palate. In order to more easily display the complete structure of the palate [5 (link)], based on the characteristics of the ultrasonic beam and the fetal oral anatomy, we designed “sequential sector-scan through oral fissure” scanning method (Fig. 2) [6 ]. First, adjust the direction of the beam according to the position of the fetal, so that the beam is directly in front of the fetal face, If the fetal position is poor, the sound beam can be adjusted to the side front. The acoustic beam was placed on the superior margin of the submaxilla parallel to the lower alveolar ridge plane through the oral fissure (Fig. 2, cross-Sect. 1). Then, the probe that pivoted from the superior margin of the submaxilla slightly tilted to head side, and soft palate (Fig. 2: cross-Sect. 2), hard palate (Fig. 2: cross-Sect. 3) and upper alveolar ridge (Fig. 2: cross-section of 4)will be displayed in sequence. The integrity of the palate was observed by dynamic sequential sector scanning.Fig. 2

Scanning method design of SSTOF. 1/2/3/4 respectively represent continuous sequence sections. The evaluation was based on the dynamic scanning video, and the still picture was only the schematic diagram of the four anatomical marks captured in the vide

- Case series
The cases of oral PMC diagnosed at the Oral Pathology Laboratory of the School of Dentistry, Federal University of Rio de Janeiro were obtained by reviewing the Institution's files for the period between 1958 and 2021. The study was approved by the Ethics Committee of the local Institution (No. 54005021.7.0000.5257). The patient's identity remained anonymous according to the ethical principles of the Declaration of Helsinki.
The following data were collected from the records of individuals: sex, age, skin color, occupation, time of evolution of the lesion, symptomatology, clinical aspects, anatomical location, and clinical differential diagnosis. For anatomical location and differential diagnosis, the unit of analysis was not the number of individuals, since each individual evaluated could have been affected at more than one anatomical site and the clinician may have formulated more than one diagnostic hypothesis. All cases were referred by dentists.
All cases of oral PCM from the period under study were included, and those with incomplete data were excluded. After selection of the cases, 5-mm thick sections were cut from the paraffin blocks, stained with hematoxylin-eosin (H&E), and re-examined under light microscopy by two lecturers of Oral and Maxillofacial Pathology (B.A.B.A.; M.J.R.) for diagnostic confirmation. Yeasts were identified after staining the tissue sections with the Grocott-Gomori methenamine silver.
- Literature review
Electronic searches were conducted in PubMed, Embase, Scopus, Web of Science, Latin American and Caribbean Center on Health Sciences Information (LILACS), and Brazilian Library of Dentistry (BBO) in February 21, 2022 and updated in July 6, 2022. The following combination of terms was used: (paracoccidioidomycosis OR “South American blastomycosis” OR “paracoccidioidal granuloma” OR “Lobo disease” OR “Lutz-Splendore-Almeida disease”) AND (“alveolar process” OR “alveolar ridge” OR “buccal mucosa” OR “buccal mucosal” OR “floor of the mouth” OR gingiva OR gingivae OR “hard palate” OR jaw OR jaws OR lip OR lips OR mandible OR mandibles OR maxilla OR maxillae OR mouth OR oral OR “oral cavity” OR “oral mucosa” OR “oral mucosae” OR oropharynges OR oropharynx OR palate OR perioral OR “soft palate” OR tongue OR tonsil OR tonsils). References that were duplicated across databases were found and eliminated with a command of the EndNote software (End Note® Online, Clarivate Analytics, Canada).
Inclusion criteria were retrospective studies and case series in which at least 10 cases of oral PCM had been included, without restriction of year of publication, language, or geographical region. Exclusion criteria were histopathological, immunohistochemical or molecular studies, in vitro studies (e.g., microbiological assays), and letters to the editor/comments/expert opinions, unless any of these types of publication provided sufficient and detailed clinicodemographic aspects about oral PCM cases.
An author (J.A.A.A.) read the included articles and extracted all data from the studies. A second author (B.A.B.A.) double-checked these data. If the authors disagreed, they discussed until the disagreement was resolved. For unresolved cases, another author (L.G.A.) was consulted. The following data were extracted from the articles included in the literature review: author(s) and year of publication, country, number of cases reported, individuals’ sex and age, anatomical location, evolution time, and treatment.
- Data analysis
Data were tabulated in Microsoft Office Excel 2019 (Microsoft® software, Redmond, WA, USA) and analyzed descriptively using GraphPad Prism version 8.0.0 for Windows (GraphPad software, San Diego, CA, USA).