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Orbital blowout fractures: manifestations and missed diagnoses in 207 surgically treated patients. 眼眶爆裂性骨折:207 例手术治疗患者的表现和漏诊。
IF 2.2 3区 医学 Pub Date : 2024-04-14 DOI: 10.4317/medoral.26559
M. Nikunen, R. Nikkilä, J. Snäll
BACKGROUNDWe aimed to retrospectively measure the incidence of missed orbital blowout fracture diagnosis in primary examinations of patients with surgically treated fractures, to identify the causes of the diagnostic oversight, and to describe the clinical manifestations of the fractures.MATERIAL AND METHODSA retrospective cohort of all patients with unilateral orbital blowout fractures who underwent subsequent surgical fracture reduction at the Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, from January 2011 to July 2021, was gathered. Demographics, fracture type, associated injuries, clinical manifestations, reconstruction indication, diagnostic delay, and causes of fractures were analysed. For statistical analysis, Fisher's exact test, unpaired t-test, and the Wilcoxon Rank Sum were used. Significance was set at P˂0.05.RESULTSFracture diagnosis was missed in 26 (13%) of 207 patients: in 40% of patients aged under 18 years and in 10% of patients aged 18 years or over (P=0.005). Suboptimal eye examination was found in 62% of patients with missed fracture and in 13% of those with timely diagnosis (P<0.001). Adjusted odds ratios for missed diagnosis in patients aged under 18 years versus patients aged 18 years and over was 9.3 (95% CI 2.4-35) and in patients with suboptimal versus sufficient eye examination 13.6 (95% CI 5.1-37). More common clinical manifestations in patients aged under 18 years were diplopia or restricted eye movements (P=0.005), pain in eye movements (P=0.010), nausea and/or vomiting (P<0.001), and bradycardia (P=0.014); periorbital haematoma was rarer (P<0.001). Suboptimal eye examination was involved in 62% and misinterpretation of computed tomography images in 50% of missed fractures, together explaining 85% of cases.CONCLUSIONSOrbital blowout fractures are often missed in primary examination, especially in children and adolescents, who also present with subtler clinical manifestations. While the diagnosis can be difficult, appropriate clinical and radiological examination will reveal most cases.
背景我们的目的是回顾性地测量经手术治疗的骨折患者初诊时眼眶爆裂性骨折漏诊的发生率,找出诊断疏忽的原因,并描述骨折的临床表现。材料与方法我们收集了2011年1月至2021年7月期间在赫尔辛基大学医院口腔颌面部疾病科接受后续手术骨折复位的所有单侧眼眶爆裂性骨折患者的回顾性队列。对人口统计学、骨折类型、相关损伤、临床表现、重建指征、诊断延迟和骨折原因进行了分析。统计分析采用费雪精确检验、非配对 t 检验和 Wilcoxon 秩和。结果207例患者中有26例(13%)漏诊骨折:18岁以下患者漏诊40%,18岁以上患者漏诊10%(P=0.005)。62%的漏诊骨折患者和13%的及时诊断患者的眼部检查结果不理想(P<0.001)。18岁以下患者与18岁及以上患者的漏诊调整几率比为9.3(95% CI 2.4-35),眼部检查不达标患者与眼部检查达标患者的漏诊调整几率比为13.6(95% CI 5.1-37)。18 岁以下患者更常见的临床表现是复视或眼球运动受限(P=0.005)、眼球运动疼痛(P=0.010)、恶心和/或呕吐(P<0.001)以及心动过缓(P=0.014);眶周血肿较少见(P<0.001)。62%的漏诊病例与眼部检查不当有关,50%的漏诊病例与计算机断层扫描图像误读有关,两者合计可解释85%的病例。虽然诊断可能比较困难,但适当的临床和放射学检查可发现大多数病例。
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引用次数: 0
Accuracy in osteotomy drilling using a new universal and disposable drill-stop device for dental implant drills: an in vitro study using a bovine rib model. 使用新型通用一次性牙科种植钻钻头止钻装置进行截骨钻孔的准确性:使用牛肋骨模型进行的体外研究。
IF 2.2 3区 医学 Pub Date : 2024-04-14 DOI: 10.4317/medoral.26495
F. Camacho-Alonso, M. Pérez-Sayáns, J. Pato-Mourelo, J-E Martínez-Martínez
BACKGROUNDThis study aimed to evaluate the surgical accuracy of a new universal disposable stop system for implant drills (FCA Universal Drill Stop).MATERIAL AND METHODSA total of 60 bovine ribs were included in this in vitro study. The ribs were randomized into three study groups (n=20 ribs per group). In each study group (Group1: drills without stop or control group, Group 2: prefabricated drills with stop or gold standard group, and Group 3: drills with FCA Universal Drill Stop) a total of 100 osteotomies were performed with implant drills in each group, following the drilling sequence for the placement of a dental implant of 10 mm length and 4 mm diameter. The accuracy of the depth of the osteotomies was quantified clinically (with periodontal probe) and radiologically, using ImageJ version 1.48v software.RESULTSThe order of highest to lowest accuracy (clinical and radiological) in the depth of osteotomies was: FCA Universal Drill Stop> prefabricated drills with a stop>drills without stop, with statistically significant differences being observed between both systems with stop with respect to the control group, although not between them.CONCLUSIONSThe new universal disposable stop system for implant drills, offers similar accuracy to prefabricated drills with stop, with both systems being much more accurate than implant drills without stop. Although this experimental evaluation showed favourable results, further clinical studies are necessary.
背景本研究旨在评估用于种植钻的新型一次性通用止钻系统(FCA 通用止钻器)的手术准确性。这些肋骨被随机分为三个研究组(每组 20 根肋骨)。每个研究组(第一组:不带止动器的钻头或对照组;第二组:带止动器的预制钻头或金标准组;第三组:带 FCA 通用钻头止动器的钻头)都使用种植钻头进行了总共 100 次截骨,按照钻孔顺序植入了长度为 10 毫米、直径为 4 毫米的种植体。结果截骨深度的准确性(临床和放射学)从高到低的顺序为:FCA通用钻止器>首选钻止器>FCA通用钻止器:结论新型一次性通用种植体钻止动环系统的准确性与带止动环的预制钻相似,两种系统的准确性都远高于不带止动环的种植体钻。尽管实验评估结果良好,但仍有必要开展进一步的临床研究。
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引用次数: 0
Early complications and quality of life in patients with immediately loaded implant-supported maxillary partial rehabilitations: A prospective cohort study. 即刻加载种植体支持的上颌部分修复患者的早期并发症和生活质量:前瞻性队列研究。
IF 2.2 3区 医学 Pub Date : 2024-03-01 DOI: 10.4317/medoral.26158
A Sánchez-Torres, M Moragón-Rodríguez, A Agirre-Vitores, I Cercadillo-Ibarguren, R Figueiredo, E Valmaseda-Castellón

Background: Immediate loading of dental implants is considered an excellent option to reestablish function and aesthetics in a short period of time, thereby reducing the psychological impact of edentulism. The aim of this study was to describe the incidence of complications in immediately loaded implant-supported single or partial maxillary provisional rehabilitations; to assess changes in patient quality of life (QoL); to evaluate patient overall satisfaction; and to determine whether the occurrence of complications affects these outcomes.

Material and methods: Patients requiring partial rehabilitation with implants in the maxilla were included in a prospective cohort study. In all cases, implant-based restoration with an immediate loading protocol was indicated. A provisional restoration was placed within 72 hours after implant placement. Patient QoL was measured at the first appointment and just before placing the final restoration, using two validated questionnaires. All mechanical and biological complications occurring up until placement of the final restoration were documented. A descriptive and bivariate analysis of the data was performed.

Results: Thirty-five patients with 40 prostheses supported by 60 implants were analyzed. Three implant failures were observed, yielding a 95% survival rate. Five provisional prosthesis fractures and two prosthetic screw loosenings were recorded in four patients. A significant reduction in OHIP-14 score was observed. Likewise, significant differences were found in the results of the QoLFAST-10, with a mean difference in score of 7.3 between the initial and final evaluation.

Conclusions: Patients receiving immediately loaded implant-supported single or partial maxillary provisional rehabilitations seem to have a low risk of developing early mechanical (13.3%) or biological complications (5%). These patients appear to experience significant improvement in QoL and report excellent overall satisfaction with the treatment received - though the occurrence of complications seems to affect these outcomes.

背景:即刻植入种植体被认为是在短时间内重建功能和美观的极佳选择,从而减少缺牙带来的心理影响。本研究旨在描述即刻加载种植体支持的单颗或部分上颌临时修复中并发症的发生率;评估患者生活质量(QoL)的变化;评价患者的总体满意度;并确定并发症的发生是否会影响这些结果:一项前瞻性队列研究纳入了需要使用种植体对上颌骨进行部分修复的患者。在所有病例中,均采用了种植体即刻加载修复方案。种植体植入后 72 小时内植入临时修复体。在首次就诊时和最终修复体植入前,使用两份经过验证的问卷对患者的生活质量进行了测量。在植入最终修复体之前发生的所有机械和生物并发症都被记录在案。对数据进行了描述性和双变量分析:对 35 名患者的 40 个修复体和 60 个种植体进行了分析。观察到三个种植体失败,存活率为 95%。4名患者中有5例临时假体骨折,2例假体螺丝松动。观察发现,OHIP-14评分明显下降。同样,QoLFAST-10的结果也有明显差异,初次评估和最终评估的平均得分相差7.3分:结论:接受即刻加载种植体支持的单颗或部分上颌临时修复的患者发生早期机械并发症(13.3%)或生物并发症(5%)的风险较低。尽管并发症的发生似乎会影响这些结果,但这些患者的生活质量似乎得到了明显改善,并对所接受的治疗表示非常满意。
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引用次数: 0
The evaluation of nasolacrimal duct injury in Le Fort I osteotomy patients. 评估 Le Fort I 截骨术患者的鼻泪管损伤。
IF 2.2 3区 医学 Pub Date : 2024-03-01 DOI: 10.4317/medoral.26167
Y-N Kaba, A-E Demirbas, C Topan, C Yılmaz-Asan, N Ersu

Background: Although Le Fort I surgeries are safe and successful procedures; nasolacrimal duct injuries may be observed due to these surgeries. The study aimed to investigate the prevalence of nasolacrimal duct injury in Le Fort I osteotomy patients.

Material and methods: The authors conducted a retrospective cohort study consisting of patients who underwent Le Fort I osteotomies between 2017 and 2021 in the Erciyes University Faculty of Dentistry. The primary predictor variables were the distance of the nasolacrimal canal to the outer cortex of the maxilla and the nasal floor, as well as the superior-inferior level of the superiorly positioned screw inserted in the maxilla aperture region relative to the nasolacrimal canal. The outcome variable was the presence of a nasolacrimal duct injury. Mann Whitney U test was used for quantitative variables between the two groups. A Pearson chi-squared analysis was used to compare categorical data. A p-value <0.05 was considered statistically significant.

Results: A total of 290 nasolacrimal canals were evaluated in 145 patients, 87 females, and 58 males. The mean age was 23.47± 6.67. There was a statistically significant relationship between screw level and nasolacrimal canal perforation (p<0,001). The distance between the most anterior border of the nasolacrimal canal and the outer cortical of the maxilla was significantly less in the perforation group (p<0,001). The fixation screw was significantly closer to the nasolacrimal canal in the perforation group (p<0,001).

Conclusions: In Le Fort I surgery, nasolacrimal duct injury may occur during screw fixation to the aperture region. Superiorly positioned fixation screws in the aperture region may damage the nasolacrimal canal. In patients where the nasolacrimal canal is close to the outer cortex, care should be taken when applying the fixation screws to the aperture region to avoid damaging the canal.

背景:尽管 Le Fort I 截骨手术是安全且成功的手术,但仍有可能发生鼻泪管损伤。本研究旨在调查 Le Fort I 截骨术患者鼻泪管损伤的发生率:作者开展了一项回顾性队列研究,研究对象包括2017年至2021年间在埃尔希耶斯大学牙科学院接受Le Fort I截骨术的患者。主要预测变量是鼻泪管到上颌骨外皮质和鼻底的距离,以及插入上颌骨孔区的上位螺钉相对于鼻泪管的上下水平。结果变量为是否出现鼻泪管损伤。两组之间的定量变量采用曼-惠特尼U检验。皮尔逊卡方分析用于比较分类数据。A p值 结果:共对 145 名患者的 290 个鼻泪管进行了评估,其中女性 87 人,男性 58 人。平均年龄为 23.47±6.67 岁。螺钉水平与鼻泪管穿孔之间存在统计学意义上的显著关系(p 结论:在 Le Fort I 手术中,将螺钉固定在孔区时可能会造成鼻泪管损伤。在孔区位置靠上的固定螺钉可能会损伤鼻泪管。对于鼻泪管靠近外皮层的患者,在孔区使用固定螺钉时应小心谨慎,避免损伤鼻泪管。
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引用次数: 0
Coronectomy of impacted mandibular third molars: a clinical and radiological retrospective case series study with 2-9 years of follow-up. 影响下颌第三磨牙的冠状切除术:临床和放射学回顾性病例系列研究,随访 2-9 年。
IF 2.2 3区 医学 Pub Date : 2024-03-01 DOI: 10.4317/medoral.26159
J-C Bernabeu-Mira, D Peñarrocha-Oltra, M Peñarrocha-Diago

Background: Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated with a high risk of IAN injury, and which were treated with the coronectomy technique.

Material and methods: A retrospective case series evaluated the outcomes of coronectomies of impacted mandibular third molars. The inclusion criteria were: available preoperative, immediate postoperative and two-year panoramic radiographs, preoperative cone-beam computed tomography (CBCT), and a complete case history. The clinical evaluation comprised intraoperative complications (mobilized fragments of root and damage to adjacent structures), short-term complications (sensory alterations and postoperative infection), and long-term complications (infection or oral exposure). The IAN position with respect to the roots, root shape, eruption status, third molar position, radicular-complex migration and bone above roots were radiographically evaluated as well.

Results: Approximately a total of 2000 mandibular third molars were removed from 2011 to 2022. Of these, 39 molars in 34 patients were partially extracted using the coronectomy technique. The mean age was 36 years (range 22-77), and the mean follow-up was 28 months (range 24-84). There were two short-term postoperative infections. One of them was resolved through reintervention to remove the roots after antibiotic treatment, while the other required hospital admission and removal of the roots. One case of short-term transient lingual paresthesia was also recorded. Two long-term oral exposures were detected, and the root fragments had to be extracted. There were no permanent sensory alterations.

Conclusions: In our case series of 39 impacted mandibular molars in intimate contact with the IAN and treated with the coronectomy technique, the number of complications was low (two infections and a single case of transient lingual paresthesia), and no permanent sensory alterations were observed. Prospective studies, especially randomized clinical trials, are needed to compare this technique with conventional extraction.

背景:受撞击的下颌第三磨牙偶尔会与下牙槽神经(IAN)密切相关。有人认为冠状切除术是防止下牙槽神经损伤的一种很好的替代方法。本研究评估了下颌第三磨牙撞击的临床和放射学结果,这些下颌第三磨牙的放射学表现与下牙槽神经损伤的高风险有关,并采用冠状切除术进行了治疗:一项回顾性病例系列研究评估了下颌第三磨牙冠状切除术的疗效。纳入标准包括:术前、术后即刻和两年的全景X光片、术前锥束计算机断层扫描(CBCT)以及完整的病史。临床评估包括术中并发症(移动的牙根碎片和邻近结构损伤)、短期并发症(感觉改变和术后感染)和长期并发症(感染或口腔暴露)。此外,还对IAN相对于牙根的位置、牙根形状、萌出状态、第三磨牙位置、根尖复合体移位和牙根上方的骨质进行了放射学评估:从 2011 年到 2022 年,共拔除了约 2000 颗下颌第三磨牙。其中,34 名患者的 39 颗臼齿采用冠切术进行了部分拔除。平均年龄为 36 岁(22-77 岁不等),平均随访时间为 28 个月(24-84 个月不等)。术后有两次短期感染。其中一例在抗生素治疗后通过再次手术切除牙根得到了解决,另一例则需要入院并切除牙根。此外,还记录了一例短期短暂的舌麻痹。发现了两例长期口腔暴露,必须拔除牙根碎片。没有永久性的感觉改变:在我们的病例系列中,有 39 颗下颌磨牙与 IAN 紧密接触,并采用牙冠切除术进行治疗,并发症较少(两例感染和一例短暂的舌麻痹),也没有观察到永久性的感觉改变。需要进行前瞻性研究,特别是随机临床试验,以比较该技术与传统拔牙术。
{"title":"Coronectomy of impacted mandibular third molars: a clinical and radiological retrospective case series study with 2-9 years of follow-up.","authors":"J-C Bernabeu-Mira, D Peñarrocha-Oltra, M Peñarrocha-Diago","doi":"10.4317/medoral.26159","DOIUrl":"10.4317/medoral.26159","url":null,"abstract":"<p><strong>Background: </strong>Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated with a high risk of IAN injury, and which were treated with the coronectomy technique.</p><p><strong>Material and methods: </strong>A retrospective case series evaluated the outcomes of coronectomies of impacted mandibular third molars. The inclusion criteria were: available preoperative, immediate postoperative and two-year panoramic radiographs, preoperative cone-beam computed tomography (CBCT), and a complete case history. The clinical evaluation comprised intraoperative complications (mobilized fragments of root and damage to adjacent structures), short-term complications (sensory alterations and postoperative infection), and long-term complications (infection or oral exposure). The IAN position with respect to the roots, root shape, eruption status, third molar position, radicular-complex migration and bone above roots were radiographically evaluated as well.</p><p><strong>Results: </strong>Approximately a total of 2000 mandibular third molars were removed from 2011 to 2022. Of these, 39 molars in 34 patients were partially extracted using the coronectomy technique. The mean age was 36 years (range 22-77), and the mean follow-up was 28 months (range 24-84). There were two short-term postoperative infections. One of them was resolved through reintervention to remove the roots after antibiotic treatment, while the other required hospital admission and removal of the roots. One case of short-term transient lingual paresthesia was also recorded. Two long-term oral exposures were detected, and the root fragments had to be extracted. There were no permanent sensory alterations.</p><p><strong>Conclusions: </strong>In our case series of 39 impacted mandibular molars in intimate contact with the IAN and treated with the coronectomy technique, the number of complications was low (two infections and a single case of transient lingual paresthesia), and no permanent sensory alterations were observed. Prospective studies, especially randomized clinical trials, are needed to compare this technique with conventional extraction.</p>","PeriodicalId":18351,"journal":{"name":"Medicina oral, patologia oral y cirugia bucal","volume":" ","pages":"e180-e186"},"PeriodicalIF":2.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10945869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10444469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiological, clinical, and prognostic analysis of oral squamous cell carcinoma diagnosed and treated in a single hospital in Galicia (Spain): a retrospective study with 5-year follow-up. 加利西亚(西班牙)一家医院诊断和治疗的口腔鳞状细胞癌的流行病学、临床和预后分析:一项为期 5 年的回顾性研究。
IF 2.2 3区 医学 Pub Date : 2024-01-01 DOI: 10.4317/medoral.26047
I Amezaga-Fernandez, J-M Aguirre-Urizar, J-M Suárez-Peñaranda, C Chamorro-Petronacci, I Lafuente-Ibáñez de Mendoza, X Marichalar-Mendia, A Blanco-Carrión, J Antúnez-López, A García-García

Background: Oral cancer is a common neoplasm worldwide, mostly corresponding to squamous cell carcinoma (OSCC). Unfortunately, its overall prognosis remains poor, with no improvement in recent decades. In this study, we have analysed the epidemiological, clinical, and prognostic characteristics of OSCC on patients of a specific Spanish region (Galicia), in order to improve its prognosis and apply effective preventive and early diagnosis measures.

Material and methods: We retrospectively analysed 243 cases of OSCC, diagnosed and treated in a single hospital centre in Galicia between 2010 and 2015 (minimum of 5 years of evolution). Overall and specific survival were calculated (Kaplan-Meier) and associated variables were identified (log rank test and Cox regression).

Results: The mean age of the patients was 67 years, with the majority being male (69.5%), smokers (45.9%) and alcohol consumers (58.6%), who lived in non-urban areas (79.4%). Cases diagnosed at advanced stages entailed the 48.1% of the sample, and 38.7% of cases relapsed. The 5-year overall and disease-specific survival rates were 39.9% and 46.1%, respectively. Patients who consumed tobacco and alcohol had a worse prognosis. OSCC cases referred to hospital by specialist dentists had a better prognosis, as those who were previously diagnosed with an oral potentially malignant oral disorder (OPMD) or received dental care during OSCC treatment.

Conclusions: In view of these findings, we conclude that OSCC in Galicia (Spain) still has a very poor overall prognosis, which is mainly related to the advanced age of the patients and the late diagnosis. Our study highlights the better survival of OSCC in relation to the referring health professional, the presence of a previous OPMD and the dental care after diagnosis. This demonstrates the importance of dentistry as a health profession involved in the early diagnosis and multidisciplinary management of this malignant neoplasm.

背景:口腔癌是全球常见的肿瘤,主要是鳞状细胞癌(OSCC)。不幸的是,其总体预后仍然很差,近几十年来没有任何改善。在这项研究中,我们分析了西班牙一个特定地区(加利西亚)OSCC 患者的流行病学、临床和预后特征,以改善其预后并采取有效的预防和早期诊断措施:我们回顾性分析了 2010 年至 2015 年期间在加利西亚一家医院中心诊断和治疗的 243 例 OSCC 病例(病程至少 5 年)。我们计算了总生存率和特定生存率(卡普兰-梅耶尔),并确定了相关变量(对数秩检验和考克斯回归):患者的平均年龄为 67 岁,大多数为男性(69.5%)、吸烟者(45.9%)和饮酒者(58.6%),居住在非城市地区(79.4%)。在样本中,48.1%的病例诊断为晚期,38.7%的病例复发。5年总生存率和疾病特异性生存率分别为39.9%和46.1%。吸烟和饮酒的患者预后较差。由专科牙医转诊到医院的OSCC病例预后较好,因为那些曾被诊断为口腔潜在恶性口腔疾病(OPMD)或在OSCC治疗期间接受过牙科治疗的患者预后较好:鉴于这些发现,我们得出结论:加利西亚(西班牙)的OSCC总体预后仍然很差,这主要与患者年龄偏大和诊断较晚有关。我们的研究强调,OSCC 较好的存活率与转诊医疗专业人员、既往是否患有 OPMD 以及诊断后的牙科护理有关。这表明牙科作为一种医疗专业,在这种恶性肿瘤的早期诊断和多学科治疗中的重要性。
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引用次数: 0
Evaluation of the efficacy of hydroxyl radical (OH˙) release for disinfection of the air and surfaces in the dental clinic: an in vitro study. 评价羟基自由基 (OH˙) 释放对牙科诊所空气和表面消毒的功效:一项体外研究。
IF 2.2 3区 医学 Pub Date : 2024-01-01 DOI: 10.4317/medoral.26157
A Paños-Crespo, J Toledano-Serrabona, M-Á Sánchez-Garcés, C Gay-Escoda

Background: Concerning about the quality of room air has increased exponentially. Specially in dental clinics where diary practice is characterized by the important generation of aerosols.

Material and methods: An in vitro model was used in which samples were collected from the surfaces and room air of a dental clinic before and after the use of an OH˙ radical generator.

Results: A total of 1260 samples were collected for bacteriological analysis and 14 samples for the detection of SARS-CoV-2. Following OH˙ treatment, the tested surface samples showed a decrease in the number of colony forming units (CFUs) of 76.9% in TSA culture medium. The circulating room air samples in turn showed a decrease in CFUs of 66.7% in Sabouraud medium and 71.4% in Mannitol agar medium. No presence of SARS-CoV-2 was observed on the surface of the face shield.

Conclusions: The disinfectant technology based on the use of hydroxyl radicals (OH˙) is effective in reducing the presence of moulds and yeasts and Staphylococcus in the air, and in reducing total aerobic bacteria on the tested surfaces.

背景介绍人们对室内空气质量的关注急剧增加。特别是在牙科诊所,因为牙科诊所的特点是会产生大量气溶胶:材料和方法:采用体外模型,在使用 OH˙自由基发生器前后从牙科诊所的表面和室内空气中采集样本:结果:共采集了 1260 份样本进行细菌分析,14 份样本进行 SARS-CoV-2 检测。经 OH˙处理后,被测表面样本在 TSA 培养基中的菌落形成单位(CFU)数量减少了 76.9%。室内循环空气样本在沙保鲁培养基中的菌落形成单位数减少了 66.7%,在甘露醇琼脂培养基中减少了 71.4%。在面罩表面没有观察到 SARS-CoV-2 的存在:结论:使用羟基自由基(OH˙)的消毒技术能有效减少空气中的霉菌、酵母菌和葡萄球菌,并减少测试表面的需氧细菌总数。
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引用次数: 0
Clinical practice guideline of the Spanish society of oral surgery for dental care in patients with oral cancer. 西班牙口腔外科协会关于口腔癌患者牙科治疗的临床实践指南。
IF 2.2 3区 医学 Pub Date : 2024-01-01 DOI: 10.4317/medoral.26064
M Baus-Domínguez, M Rizo-Gorrita, C Herráez-Galindo, S Bakkali, Í Fernández-Figares-Conde, M-Á Serrera-Figallo, A Gutiérrez-Corrales, C Vázquez-Pachón, J Alberdi-Navarro, A Uribarri-Etxebarría, L Bagán-Debón, M Sánchez-Garcés

Background: Oral cancer is the sixteenth most common malignant neoplasm worldwide, with a high mortality rate, greater than 50% at five years, and high morbidity. The effect of oncological treatment in the oral cavity is broad and has multiple levels, therefore knowing these effects and preventing them is essential for avoiding an increase in the oral pathology related with oncological therapy, maintaining the quality of life of the patient, and improving the efficacy of the treatment itself.

Material and methods: A group of experts belonging to the fields of Dentistry, Maxillofacial Surgery and Oncology of the University of Seville and the Virgen del Rocío University Hospital of Seville in collaboration with the University of Valencia, University of Barcelona, and University of the Basque Country, developed this Clinical Practice Guideline for the proper clinical management of patients diagnosed with oral cancer. The clinical questions were formulated in PICO format. The databases consulted were Medline/PubMed and Embase/Elsevier. The systematic reviews published on the topic were identified on Tripdatabase, Cochrane Library and CRD (Centre for Reviews and Dissemination). The recommendations were prepared based on the GRADE methodology.

Results: Various recommendations were defined, derived from the 21 PICO questions, referring to prevention, treatment and care for alterations arising from the pathology of oral cancer itself and its treatment.

Conclusions: The preparation of this clinical practice guideline allows recommendations to be generated based on the scientific evidence available, on dentistry actions in patients with oral cancer and undergoing oncological treatment, which may be of use to the multidisciplinary team treating this type of patient.

背景:口腔癌是全球第 16 位最常见的恶性肿瘤,死亡率高,五年内死亡率超过 50%,发病率也很高。肿瘤治疗对口腔的影响是广泛的、多层次的,因此,了解这些影响并加以预防,对于避免与肿瘤治疗相关的口腔病变增加、保持患者的生活质量以及提高治疗本身的疗效至关重要:由塞维利亚大学牙科、颌面外科和肿瘤科以及塞维利亚 Virgen del Rocío 大学医院的专家组成的小组与巴伦西亚大学、巴塞罗那大学和巴斯克大学合作,共同制定了本临床实践指南,用于对确诊为口腔癌的患者进行正确的临床治疗。临床问题以 PICO 格式提出。查阅的数据库包括 Medline/PubMed 和 Embase/Elsevier。在 Tripdatabase、Cochrane Library 和 CRD(文献综述与传播中心)上找到了已发表的有关该主题的系统综述。根据 GRADE 方法提出建议:从 21 个 PICO 问题中得出了各种建议,涉及口腔癌病理改变的预防、治疗和护理及其治疗:通过编写该临床实践指南,可以根据现有的科学证据,就口腔癌患者和接受肿瘤治疗的患者的牙科治疗提出建议,这些建议可能对治疗这类患者的多学科团队有用。
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引用次数: 0
Clinical practice guideline of the spanish society of oral surgery for oral surgery in patients with coagulation disorders. 西班牙口腔外科学会关于凝血障碍患者口腔手术的临床实践指南。
IF 2.2 3区 医学 Pub Date : 2024-01-01 DOI: 10.4317/medoral.26063
J Valenzuela-Mencia, M-Á Serrera-Figallo, D Torres-Lagares, G Machuca-Portillo, E Sánchez-Fernández, E Valmaseda-Castellón, M Peñarrocha-Diago, N Fernández-Mosteirín, J-M Somoza-Martin, A Pérez-Jardón, C-M Chamorro-Petronacci, A García-García

Background: The number of patients treated with coagulation disorders, and more specifically with anticoagulant therapy, has increased worldwide in recent years due to increased life expectancy in developed countries. The protocols for managing this type of patient in oral surgery has varied over recent years, especially after the appearance of new direct-acting oral anticoagulants (DOACs). The assessment of risk of bleeding in this type of patient when undergoing a surgical procedure continues to be a controversial issue for patients, dentists and general practitioners. The objective of this document is to offer recommendations, based on evidence, for decision making for patients with coagulopathies who require dental surgical intervention.

Material and methods: Based on the indications of the "Preparation of Clinical Practice guidelines in the National Health System. Methodological manual", we gathered a group of experts who agreed on 15 PICO questions based on managing patients with coagulation disorders in dental surgical procedures, such as fitting of implants or dental extractions.

Results: The 15 PICO questions were answered based on the available evidence, being limited in most cases due to the lack of a control group. Two of the PICO questions were answered by the experts with a grade C recommendation, while the rest were answered with grade D.

Conclusions: The results of this review highlight the need to undertake well designed clinical trials with control groups and with a representative sample size.

背景:近年来,由于发达国家人均寿命的延长,全世界接受凝血功能障碍治疗,特别是接受抗凝治疗的患者人数有所增加。近年来,管理口腔外科这类患者的方案各不相同,尤其是在新型直接作用口服抗凝剂(DOAC)出现之后。对于患者、牙医和全科医生来说,如何评估这类患者在接受外科手术时的出血风险仍然是一个有争议的问题。本文件的目的是根据证据为需要接受牙科手术治疗的凝血功能障碍患者提供决策建议:根据 "国家卫生系统临床实践指南的编写。方法手册",我们召集了一批专家,就牙科外科手术(如安装种植体或拔牙)中凝血功能障碍患者的管理问题商定了 15 个 PICO 问题:15 个 PICO 问题是根据现有证据回答的,但由于缺乏对照组,大多数情况下回答的证据有限。专家们对其中两个 PICO 问题的回答是 C 级建议,而对其他问题的回答是 D 级建议:本综述的结果突出表明,有必要开展精心设计的临床试验,并设立对照组和具有代表性的样本量。
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引用次数: 0
Lymphomas affecting the submandibular glands. 影响颌下腺的淋巴瘤。
IF 2.2 3区 医学 Pub Date : 2024-01-01 DOI: 10.4317/medoral.26065
G-R Araújo, A-L Morais-Perdigão, C-V Lopez-de-Cáceres, O-P Almeida, P-A Vargas, E-M Roman-Tager, B-A Andrade, C-D Soares, C-C Ramos, M-M Andrade, A-D Sales, H-A Pontes

Background: Lymphomas affecting the submandibular glands are very uncommon and few reports are currently available in the literature. Therefore, the aim of the current study is to describe the clinical and microscopic features of an original series of lymphomas affecting the submandibular glands.

Material and methods: The pathology files of two institutions were searched for lymphoma cases affecting the submandibular glands. The original hematoxylin and eosin, and immunohistochemical slides were revised by a pathologist for diagnosis confirmation following the revised 4th edition of the World Health Organization classification of tumours of haematopoietic and lymphoid tissues. Clinical data regarding age, sex, clinical manifestation, treatment, follow-up and status at last appointment were retrieved from the patients' medical charts.

Results: During the period investigated, 16 cases were included in the study. Females predominated (10:6) with a mean age of 57.8 years-old. Tumors usually presented as asymptomatic swellings. MALT lymphoma represented the most common subtype, followed by diffuse large B cell lymphoma and follicular lymphoma. Three patients died, one of them affected by plasmablastic lymphoma, one by DLBCL and one by MALT lymphoma.

Conclusions: Low-grade B cell lymphomas predominate in the submandibular glands, but DLBCL and other subtypes may also be rarely diagnosed in this salivary gland.

背景:影响颌下腺的淋巴瘤非常罕见,目前文献中鲜有报道。因此,本研究旨在描述一系列原始颌下腺淋巴瘤的临床和显微特征:材料和方法:检索了两家机构的病理档案,以寻找累及颌下腺的淋巴瘤病例。病理学家根据世界卫生组织第四版造血和淋巴组织肿瘤分类修订版对原始苏木精、伊红和免疫组化切片进行了修订,以确认诊断。有关年龄、性别、临床表现、治疗、随访和最后一次就诊时的状况等临床数据均来自患者的病历:在调查期间,共有 16 例患者纳入研究。女性占多数(10:6),平均年龄为 57.8 岁。肿瘤通常表现为无症状肿物。MALT 淋巴瘤是最常见的亚型,其次是弥漫大 B 细胞淋巴瘤和滤泡淋巴瘤。3名患者死亡,其中1人死于浆细胞淋巴瘤,1人死于DLBCL,1人死于MALT淋巴瘤:结论:低级别B细胞淋巴瘤主要发生在颌下腺,但DLBCL和其他亚型淋巴瘤也极少在该唾液腺中确诊。
{"title":"Lymphomas affecting the submandibular glands.","authors":"G-R Araújo, A-L Morais-Perdigão, C-V Lopez-de-Cáceres, O-P Almeida, P-A Vargas, E-M Roman-Tager, B-A Andrade, C-D Soares, C-C Ramos, M-M Andrade, A-D Sales, H-A Pontes","doi":"10.4317/medoral.26065","DOIUrl":"10.4317/medoral.26065","url":null,"abstract":"<p><strong>Background: </strong>Lymphomas affecting the submandibular glands are very uncommon and few reports are currently available in the literature. Therefore, the aim of the current study is to describe the clinical and microscopic features of an original series of lymphomas affecting the submandibular glands.</p><p><strong>Material and methods: </strong>The pathology files of two institutions were searched for lymphoma cases affecting the submandibular glands. The original hematoxylin and eosin, and immunohistochemical slides were revised by a pathologist for diagnosis confirmation following the revised 4th edition of the World Health Organization classification of tumours of haematopoietic and lymphoid tissues. Clinical data regarding age, sex, clinical manifestation, treatment, follow-up and status at last appointment were retrieved from the patients' medical charts.</p><p><strong>Results: </strong>During the period investigated, 16 cases were included in the study. Females predominated (10:6) with a mean age of 57.8 years-old. Tumors usually presented as asymptomatic swellings. MALT lymphoma represented the most common subtype, followed by diffuse large B cell lymphoma and follicular lymphoma. Three patients died, one of them affected by plasmablastic lymphoma, one by DLBCL and one by MALT lymphoma.</p><p><strong>Conclusions: </strong>Low-grade B cell lymphomas predominate in the submandibular glands, but DLBCL and other subtypes may also be rarely diagnosed in this salivary gland.</p>","PeriodicalId":18351,"journal":{"name":"Medicina oral, patologia oral y cirugia bucal","volume":" ","pages":"e78-e86"},"PeriodicalIF":2.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9835644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Medicina oral, patologia oral y cirugia bucal
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