Genetics and Molecular Mechanisms in Oral Squamous Cell Carcinoma: A Narrative Review

Oral squamous-cell carcinoma (OSCC) is the most common form of oral cancer, accounting for over 90% of malignancies in the oral cavity. Its pathogenesis is driven by a complex interplay of genetic alterations, transcriptomic dysregulation, epigenetic modifications, environmental exposures, and tumor microenvironment dynamics. Despite advances in therapy, OSCC remains associated with poor survival due to late diagnosis, therapeutic resistance, and tumor heterogeneity. This narrative review explores genetic determinants and molecular mechanisms underlying OSCC, focusing on recurrent mutations, deregulated pathways, epigenetic control, gene expression changes, insights from cell models, and potential biomarkers for diagnosis and therapy. We integrate findings from the recent literature to provide a comprehensive overview of the current state of research and emerging trends in OSCC genetics.