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In this chapter, we briefly review some aspects of the biology and physiology of oral melanocytes, the function of melanin in the oral epithelium, and the features of several different oral mucosal melanin hyperpigmentations, including physiological hyperpigmentation, tobacco-related melanosis, human immunodeficiency virus (HIV)-associated melanosis, melanotic maculae, naevomelanocytic naevus, and oral mucosal melanoma