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Histopathological parameters reported in microinvasive oral squamous cell carcinoma: a systematic review. 微创口腔鳞状细胞癌的组织病理学参数报告:一项系统综述。
IF 2.2 3区 医学 Pub Date : 2023-05-01 DOI: 10.4317/medoral.25675
C Saldivia-Siracusa, A-L Araújo, W-A González-Arriagada, F-J Nava, K-D Hunter, M-A Lopes, P-A Vargas, A-R Santos-Silva

Background: Microinvasive oral squamous cell carcinoma (OSCCmi) is an incipient stage of oral cancer. Through this systematic review, we aim to assess patterns of histopathological outcomes reported in OSCCmi cases.

Material and methods: An online search in major databases was performed without period restriction, and 2,024 publications in English, Spanish and Portuguese were obtained. After screening and eligibility, 4 studies were selected. The risk of bias was assessed using Joanna Briggs Institute Critical Appraisal Checklist. A descriptive synthesis was conducted.

Results: All 4 publications included were retrospective, reporting a total of 116 OSCCmi patients, with a male predominance (1.6:1) and a mean age of 55.9 years. The main parameters considered for microinvasion were tumor thickness (TT) (range 4-10mm) and depth of invasion (DOI) (range 0,02-5mm). Definition, cut-off values, and assessment of microscopic features were not standardized. Other relevant measures such as perineural or lymphovascular invasion and pattern of invasive front were barely described, and cytological/architectural characteristics were not discussed.

Conclusions: TT and DOI are currently the primary histopathological criteria used to define OSCCmi. Nonetheless, the outcomes of this systematic review showed the absence of standardized quantitative parameters to render the diagnosis of microinvasive OSCC. Therefore, additional studies aiming to standardize histopathological features to diagnose OSCCmi are paramount.

背景:微创口腔鳞状细胞癌(Microinvasive oral squamous cell carcinoma, OSCCmi)是一种早期的口腔癌。通过这一系统综述,我们旨在评估OSCCmi病例报告的组织病理学结果模式。材料和方法:在各大数据库中进行无时期限制的在线检索,获得英文、西班牙文和葡萄牙文出版物2024篇。经筛选合格后,入选4项研究。偏倚风险采用乔安娜布里格斯研究所关键评估清单进行评估。进行了描述性综合。结果:纳入的4篇文献均为回顾性研究,共报道了116例OSCCmi患者,男性占多数(1.6:1),平均年龄55.9岁。微侵袭的主要参数为肿瘤厚度(TT)(范围4-10mm)和浸润深度(DOI)(范围0.02 -5mm)。定义、临界值和微观特征评估没有标准化。其他相关措施,如神经周围或淋巴血管侵犯和侵犯前缘的模式几乎没有描述,细胞学/建筑学特征没有讨论。结论:TT和DOI是目前用于定义OSCCmi的主要组织病理学标准。尽管如此,本系统综述的结果显示缺乏标准化的定量参数来诊断微创OSCC。因此,旨在标准化组织病理学特征来诊断OSCCmi的进一步研究是至关重要的。
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引用次数: 1
Adverse reactions to the injection of face and neck aesthetic filling materials: a systematic review. 面部颈部美容填充材料注射不良反应的系统回顾。
IF 2.2 3区 医学 Pub Date : 2023-05-01 DOI: 10.4317/medoral.25713
R-A Machado, L-Q Oliveira, H Martelli-Júnior, F-R Pires, J-B Carvas, V-E Rogerio, V-D Rabelo, R-D Coletta

Background: Adverse reactions, caused during the inflammation and healing process, or even later, can be induced by the injection of dermal filler and can present a variety of clinical and histological characteristics. In this study we aimed to review the adverse reactions associated with the injection of aesthetic filling materials in the face and neck.

Material and methods: The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies published that mentioned adverse reactions in patients with aesthetic filling materials in the face or neck were included. Risk of bias was assessed using the Joanna Briggs Institute appraisal tool. After a 2-step selection process, 74 studies were included: 51 case reports, 18 serial cases, and five cohorts.

Results: A total of 303 patients from 20 countries were assessed. Lesions were more prevalent in the lip (18%), nasolabial folds (13%), cheeks (13%), chin (10%), submental (8%), glabella (7%), and forehead (6%). Histopathological analysis revealed a foreign body granuloma in 87.1% of the patients, 3% inflammatory granuloma, 3% lipogranuloma, 2.3% xanthelasma-like reaction, 1% fibrotic reaction, 0.7% amorphous tissues, 0.7% xanthelasma, 0.3% sclerosing lipogranuloma, 0.3% siliconoma, and 0.3% foreign body granuloma with scleromyxedema. In addition, two patients displayed keratoacanthoma and two others displayed sarcoidosis after cutaneous filling. The most commonly used materials were silicone fillers (19.7%), hyaluronic acid (15.5%), and hydroxyethyl methacrylate/ethyl methacrylate suspended in hyaluronic acid acrylic hydrogel (5.6%). All patients were treated, and only 12 had prolonged complications.

Conclusions: There is evidence that adverse reaction can be caused by different fillers in specific sites on the face. Although foreign body granuloma was the most common, other adverse lesions were diagnosed, exacerbating systemic diseases. In this way, we reinforce the importance of previous systemic evaluations and histopathological analyses for the correct diagnosis of lesions.

背景:注射真皮填充物可引起炎症和愈合过程中甚至之后的不良反应,并可表现出多种临床和组织学特征。在这项研究中,我们旨在回顾美容填充材料在面部和颈部注射相关的不良反应。材料和方法:根据系统评价和荟萃分析首选报告项目清单进行综述。已发表的研究中提到在面部或颈部使用美学填充材料的患者出现不良反应。使用乔安娜布里格斯研究所的评估工具评估偏倚风险。经过两步选择过程,纳入了74项研究:51例病例报告,18例系列病例和5个队列。结果:共评估了来自20个国家的303例患者。病变在唇部(18%)、鼻唇沟(13%)、脸颊(13%)、下巴(10%)、颏下(8%)、眉间(7%)和前额(6%)更为普遍。组织病理学分析显示:87.1%的患者为异物肉芽肿,3%为炎性肉芽肿,3%为脂肪肉芽肿,2.3%为黄原样反应,1%为纤维化反应,0.7%为无定形组织,0.7%为黄原肿,0.3%为硬化性脂肪肉芽肿,0.3%为硅瘤,0.3%为异物肉芽肿合并硬黏液水肿。此外,2例患者表现为角棘瘤,另外2例患者在皮肤填充后表现为结节病。最常用的材料是硅酮填充剂(19.7%)、透明质酸(15.5%)和悬浮在透明质酸丙烯酸凝胶中的甲基丙烯酸羟乙酯/甲基丙烯酸乙酯(5.6%)。所有患者都得到了治疗,只有12例出现了长期并发症。结论:有证据表明,不同的填充物可引起面部特定部位的不良反应。虽然异物肉芽肿是最常见的,但其他不良病变也被诊断出来,加重了全身性疾病。通过这种方式,我们强调了以前系统评估和组织病理学分析对正确诊断病变的重要性。
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引用次数: 2
Stafne's bone defect: a systematic review. 斯塔芬骨缺损:系统回顾。
IF 2.2 3区 医学 Pub Date : 2023-05-01 DOI: 10.4317/medoral.25676
A Soares, L Ferreira, C Calderipe, R Bologna-Molina, M Damian, M Martins, F Silveira, A-C Vasconcelos

Background: This systematic review integrated the available data published in the literature on Stafne's bone defect (SBD), considering the clinical, imaging and histopathological results.

Material and methods: An electronic search was undertaken in six databases. Eligibility criteria were: articles in English, Spanish, and Portuguese describing case reports or case series of SBD, reported up to September/2021. Risk of bias was assessed using the Joanna Briggs Institute tool.

Results: A total of 98 articles were retrieved, involving 465 individuals with SBD and were included for quantitative analysis. Mean age was 52.78 years (range: 11-89 years), with male predilection (n=374/80.85%). Radiographs were the most frequent imagiological exams (n=298/64.09%), followed by computed tomography (n=98/21.08%). SBD was more prevalent in the posterior mandible (n=361/93.77%) as a hypodense radiolucent lesion (n=250/77.40%). Mean size was 1.58 cm (range: 0.3-.8.0 cm). Two-hundred-and-two lesions (97.37%) were unilocular and 126 (91.97%) were classified as well-defined. Clinical symptoms were reported in 73 cases, while 68 cases (93.15%) were asymptomatic. Only 34 cases (12.32%) were submitted to histopathological examination. Mean follow-up time was 26.42 ±25.39 months.

Conclusions: SBD is more frequent in male patients in the fifth and sixth decade of life. Classic SBD is radiographically characterized as a single, unilocular and well-defined lesion in the posterior region of the jaw with a radiolucent/hypodense appearance.

背景:本系统综述综合考虑临床、影像学和组织病理学结果,综合了目前已发表的关于骨缺损(SBD)的文献资料。材料和方法:在六个数据库中进行电子检索。入选标准为:截至2021年9月报告的SBD病例报告或病例系列的英文、西班牙文和葡萄牙文文章。使用乔安娜布里格斯研究所的工具评估偏倚风险。结果:共检索到98篇文献,涉及465例SBD患者,并纳入定量分析。平均年龄52.78岁(范围:11 ~ 89岁),男性为主(n=374/80.85%)。影像学检查以x线片检查最多(n=298/64.09%),其次为计算机断层扫描检查(n=98/21.08%)。SBD以低密度放射性病变(n=250/77.40%)多见于后下颌骨(n=361/93.77%)。平均大小为1.58 cm (0.3- 0.8.0 cm)。222例(97.37%)为单眼病变,126例(91.97%)为定义良好病变。临床症状73例,无症状68例(93.15%)。仅有34例(12.32%)进行了组织病理学检查。平均随访26.42±25.39个月。结论:SBD多见于5、6岁男性患者。典型的SBD在x线上表现为单个、单眼和边界明确的病变,位于颌骨后区,呈放射性透光/低密度。
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引用次数: 0
Association of oral lichen planus with hepatic disorders and hepatocellular carcinoma: systematic review and meta-analysis. 口腔扁平苔藓与肝脏疾病和肝细胞癌的关系:系统评价和荟萃分析。
IF 2.2 3区 医学 Pub Date : 2023-05-01 DOI: 10.4317/medoral.25661
M-Á González-Moles, T de Porras-Carrique, P Ramos-García

Background: Oral lichen planus (OLP) is a prevalent autoimmune chronic inflammatory disease of unknown etiology. The importance of the association between hepatic disease and OLP lies in the fact that many of these disorders (HC, HB, cirrhosis, hepatic steatosis) behave as risk factors for hepatocellular carcinoma.

Material and methods: We searched PubMed, Embase, Web of Science, and Scopus for studies published before January 2022. We evaluated the quality of studies (Joanna Briggs Institute tool). We performed meta-analyses, investigated the heterogeneity between studies, and we also carried out subgroups, meta-regression, and small-study effects analyses. 146 studies (21,187 patients) were included in this study. Our study aims to evaluate current evidence on the prevalence and magnitude of association between hepatic diseases (especially those with risk of malignancy), hepatocellular carcinoma and OLP.

Results: Our results suggest that patients with OLP present a significant tendency to the development of hepatitis B (OR=1.62, 95%CI=1.01-2.40, p=0.02), hepatitis C (OR=4.09, 95%CI=2.77-6.03, p<0.001), cirrhosis (OR=5.58, 95%CI=1.83-16.96, p=0.002), hepatic steatosis (OR=5.71, 95%CI=0.97-33.60, p=0.05) and hepatocellular carcinoma (OR=3.10,95%CI=1.14-8.43, p=0.03).

Conclusions: Patients with OLP should be investigated to rule out the presence of hepatic disease, which can lead to hepatocellular carcinoma, allowing an early diagnosis that would help to a better approach to liver disease and a notable improvement in prognosis in terms of both progression and severity.

背景:口腔扁平苔藓(OLP)是一种常见的自身免疫性慢性炎症性疾病,病因不明。肝脏疾病和OLP之间关系的重要性在于,许多这些疾病(HC、HB、肝硬化、肝脂肪变性)都是肝细胞癌的危险因素。材料和方法:我们检索了PubMed、Embase、Web of Science和Scopus,检索了2022年1月之前发表的研究。我们评估研究的质量(乔安娜布里格斯研究所工具)。我们进行了荟萃分析,调查了研究之间的异质性,我们还进行了亚组、荟萃回归和小研究效应分析。146项研究(21,187例患者)纳入本研究。我们的研究旨在评估肝脏疾病(特别是那些有恶性肿瘤风险的疾病)、肝细胞癌和OLP之间的患病率和相关性的现有证据。结果:我们的研究结果表明,OLP患者目前乙型肝炎的一个重要发展趋势(或= 1.62,95% ci = 1.01 - -2.40, p = 0.02),丙型肝炎(或= 4.09,95% ci = 2.77 - -6.03, pConclusions: OLP患者应该调查排除肝脏疾病的存在,从而导致肝细胞癌,允许一个早期诊断,有助于更好的方法肝病和显著改善预后方面的进展和严重性。
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引用次数: 3
Pentoxifylline and tocopherol for the treatment of osteoradionecrosis of the jaws. A systematic review. 己酮茶碱和生育酚治疗颌骨放射性骨坏死。系统回顾。
IF 2.2 3区 医学 Pub Date : 2023-05-01 DOI: 10.4317/medoral.25729
M Arqueros-Lemus, D Mariño-Recabarren, S Niklander, R Martínez-Flores, V Moraga

Background: Osteoradionecrosis of the jaws (ORNJ) is a severe and challenging complication of head and neck radiation therapy. Despite its aggressiveness and controversy respect to its efficacy, surgical intervention remains the main treatment modality. Nevertheless, due to advances in the understanding of ORNJ physiopathology, new treatment alternatives such as the combination of pentoxifylline with tocopherol (PENTO) have emerged. The aim of this systematic review was to assess the reported efficacy of PENTO for the treatment of ORNJ.  Material and Methods: Studies were search using Pubmed, The Cochrane Library, Scopus, and Web of Science data bases following the PRISMA guidelines. Inclusion criteria were cohort, case series, randomized or non-randomized clinical studies published in English including human subjects who received PENTO as treatment for ORN of the jaws.  Results: Eleven articles met the inclusion criteria and were included for data analysis. All studies reported patients with complete mucosal coverage with no exposed bone (considered healthy) after PENTO treatment, ranging from 16.6% to 100% of the patients, depending on the study. Clinical improvement or disease stabilization was reported between 7.6% and 66.6% of studied individuals, while disease progression was seen in only 5 studies involving 7.6 - 32% of patients.

Conclusions: PENTO treatment achieved a complete disease control in a significant number of patients in all studies. However, there is no standardized protocol for administering the therapy. It is necessary to determine the pharmacological doses and to evaluate the benefits of adding antibiotics and clodronate. Good quality clinical trials are needed to develop a successful algorithm for the management of ORN of the jaws.

背景:颌骨放射性骨坏死(ORNJ)是头颈部放射治疗中一种严重且具有挑战性的并发症。尽管手术治疗具有侵略性,其疗效也存在争议,但手术仍然是主要的治疗方式。然而,由于对ORNJ生理病理认识的进步,出现了新的治疗方案,如己酮茶碱与生育酚(PENTO)的联合治疗。本系统综述的目的是评估已报道的PENTO治疗ORNJ的疗效。材料和方法:根据PRISMA指南,使用Pubmed、Cochrane图书馆、Scopus和Web of Science数据库进行研究检索。纳入标准为队列、病例系列、随机或非随机临床研究,包括接受PENTO治疗颌骨ORN的人类受试者。结果:11篇文章符合纳入标准,纳入数据分析。所有研究都报告了PENTO治疗后粘膜完全覆盖,无骨暴露(被认为是健康的)的患者,根据研究的不同,范围从16.6%到100%。7.6% - 66.6%的研究个体报告了临床改善或疾病稳定,而只有5项研究涉及7.6 - 32%的患者出现了疾病进展。结论:在所有研究中,PENTO治疗在相当数量的患者中实现了完全的疾病控制。然而,目前还没有标准化的治疗方案。有必要确定药理学剂量并评估添加抗生素和氯膦酸盐的益处。需要高质量的临床试验来开发一种成功的颌部ORN治疗算法。
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引用次数: 1
Efficacy of stem cells in bone rehabilitation in patients with alveolar bone atrophy: a systematic review. 干细胞在牙槽骨萎缩患者骨康复中的疗效:一项系统综述。
IF 2.2 3区 医学 Pub Date : 2023-05-01 DOI: 10.4317/medoral.25667
M Pérez-Leal, M Scanferla, M-C Carceller, N Flacco

Background: Biomedical engineering proposes the use of stem cells as a bone rehabilitation treatment in patients with alveolar bone defects. Many authors suggest that this innovative technique could represent the future of bone regeneration in dentistry. The present study systematically reviewed the efficacy of stem cells in bone regeneration in patients with alveolar bone atrophy.

Material and methods: The study was developed following the criteria of the PRISMA guideline (2020). The literature review was conducted in Pubmed, Medline Complete, and Scopus. The search algorithms used the following key words: stem cells, bone regeneration, and alveolar ridge augmentation. To assess the risk of bias, the CASPe methodology was used.

Results: Seven clinical trials in humans were included in this systematic review. In all the studies, the proposed objective of bone regeneration by using stem cells was achieved, although in a different way with different results. Although the authors of the analysed clinical trials achieved favourable results, they highlighted the presence of multiple limitations throughout bone regeneration treatments, such as scarce scientific literature on stem cells, a reduced number of follow-up studies, and a lack of a standardized international protocol.

Conclusions: Based on the analysed studies, it is concluded that the therapy proposed by tissue engineering through the use of stem cells to rehabilitate patients with bone atrophies can be considered effective. In addition, the need for further studies and standardization of protocols is highlighted.

背景:生物医学工程提出利用干细胞作为牙槽骨缺损患者的骨康复治疗。许多作者认为这种创新技术可能代表牙科骨再生的未来。本研究系统回顾了干细胞在牙槽骨萎缩患者骨再生中的作用。材料和方法:本研究是按照PRISMA指南(2020)的标准开发的。文献综述在Pubmed、Medline Complete和Scopus中进行。搜索算法使用以下关键词:干细胞、骨再生和牙槽嵴增强。为了评估偏倚风险,采用CASPe方法。结果:本系统综述纳入了7项人体临床试验。在所有的研究中,提出的利用干细胞进行骨再生的目标都实现了,尽管方法不同,结果也不同。尽管分析的临床试验的作者取得了有利的结果,但他们强调了整个骨再生治疗中存在的多重限制,例如干细胞的科学文献缺乏,后续研究的数量减少,以及缺乏标准化的国际协议。结论:通过对研究结果的分析,可以认为组织工程利用干细胞对骨萎缩患者进行康复治疗是有效的。此外,还强调了进一步研究和规范协议的必要性。
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引用次数: 0
Orthognathic surgery and aligners. A comparative assessment of periodontal health and quality of life in postsurgical orthodontic treatment with aligners versus traditional fixed appliances: a randomized controlled trial. 正颌手术和矫正器。正畸术后使用矫正器与传统固定矫治器对牙周健康和生活质量的比较评估:一项随机对照试验
IF 2.2 3区 医学 Pub Date : 2023-05-01 DOI: 10.4317/medoral.25555
P de Leyva, J-M Eslava, F Hernández-Alfaro, J Acero

Background: Removable clear aligners have become very popular in the last few decades, but they are still little used in the field of orthognathic surgery (OS). The objective of this study was to compare periodontal health and quality of life (QoL) associated to postsurgical orthodontic treatment.

Material and methods: Patients with dentofacial deformities undergoing OS were randomly allocated to receive postsurgical orthodontic treatment with either fixed orthodontic appliances or Invisalign. The main outcomes were periodontal health and QoL. Plaque index, probing depth and bleeding on probing were assessed as periodontal health indicators. QoL was assessed through the Orthognathic Quality of Life Questionnaire (OQLQ-22) and the Oral Health Impact Profile (OHIP-14). Data were analyzed before surgery and end of treatment. Total duration of treatment was also recorded.

Results: Twenty-eight patients were randomized, (16 women, 12 men). Periodontal assessment showed better outcomes for the Invisalign group: bleeding on probing (p=0.013), plaque index (p=0.001) and probing depth (p<0.001). The QoL questionnaires showed significant differences in favor of the Invisalign group: OHIP-14 (p=0.004) and OQLQ-22 (p=0.002). Total duration of treatment was similar in both groups (p=0.575).

Conclusions: Compared to traditional orthodontics with fixed appliances, patients managed with clear aligners after OS (surgery-first approach) had better periodontal health and QoL outcomes.

背景:在过去的几十年里,可移动的透明矫正器变得非常流行,但它们在正颌手术(OS)领域的应用仍然很少。本研究的目的是比较牙周健康和生活质量(QoL)与术后正畸治疗相关。材料和方法:随机选择行骨缺损手术的牙面畸形患者,分别使用固定矫治器和Invisalign进行术后正畸治疗。主要观察指标为牙周健康和生活质量。牙菌斑指数、探诊深度和探诊时出血作为牙周健康指标。生活质量通过正颌生活质量问卷(OQLQ-22)和口腔健康影响量表(OHIP-14)进行评估。分析术前和治疗结束时的数据。同时记录总治疗时间。结果:28例患者随机分组,其中女性16例,男性12例。牙周评估显示,Invisalign组有更好的结果:探诊出血(p=0.013),菌斑指数(p=0.001)和探诊深度(p)。结论:与传统的固定矫治器正畸相比,在手术先入路后使用透明矫正器的患者有更好的牙周健康和生活质量。
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引用次数: 0
Does preventive single dose of intravenous dexketoprofen reduce pain and swelling after orthognathic surgery? A prospective, randomized, double blind clinical trial. 预防性单次静脉注射右酮洛芬能减轻正颌手术后的疼痛和肿胀吗?一项前瞻性、随机、双盲临床试验。
IF 2.2 3区 医学 Pub Date : 2023-05-01 DOI: 10.4317/medoral.24852
Y-N Kaba, A-E Demirbas, N Kütük, D-G Canpolat, A Alkan

Background: The purpose of this study was to evaluate the effect of a single-dose intravenous dexketoprofen administration for preventive analgesia on postoperative pain and reducing swelling in double jaw surgery.

Material and methods: The authors designed a prospective, randomized, and double-blind cohort study. Patients who have Class III malocclusion were randomly divided in two groups. 50 mg intravenous dexketoprofen trometamol were administrated 30 minutes before incision in treatment group, while intravenous sterile saline was administrated 30 minutes before incision in placebo group. The primary predictor variable was treatment group. Primary outcomes were pain, swelling and 24-hour opioid intake. Patient- controlled analgesia with tramadol was given for management of postoperative pain. Other variables were demographic and operation related parameters. Visual analogue scale was used to evaluate postoperative pain. 3dMD Face System (3dMD, USA) was used to measure postoperative swelling. Data were analysed using two independent samples t test and Mann Whitney U test.

Results: The study sample was composed of 30 patients with a mean age of 20,63 years and 21 were female. Preemptive dexketoprofen administration decreased postoperative tramadol consumption by 25.9% compared to placebo group, and there was a statistically significant decrease in VAS scores (p<0,05). There was no statistically significant difference between the groups in terms of swelling (p>0,05).

Conclusions: Preventive administration of intravenous dexketoprofen provides adequate analgesic effect in the postoperative 24-hour period and reduces opioid consumption in orthognathic surgery.

背景:本研究的目的是评价单剂量静脉注射右酮洛芬预防镇痛对双颌手术术后疼痛和消肿的影响。材料和方法:作者设计了一项前瞻性、随机、双盲队列研究。III类错牙合患者随机分为两组。治疗组在切口前30分钟静脉给予右酮洛芬曲美他醇50 mg,安慰剂组在切口前30分钟静脉给予无菌生理盐水。主要预测变量为治疗组。主要结局是疼痛、肿胀和24小时阿片类药物摄入。术后疼痛给予曲马多患者自控镇痛。其他变量为人口统计和手术相关参数。采用视觉模拟评分法评价术后疼痛。3dMD面部系统(3dMD, USA)用于测量术后肿胀。数据分析采用两个独立样本t检验和Mann Whitney U检验。结果:研究样本由30例患者组成,平均年龄20岁,63岁,女性21例。与安慰剂组相比,预先给药右酮洛芬组术后曲马多用量减少25.9%,VAS评分降低有统计学意义(p0,05)。结论:预防性静脉注射右酮洛芬可在术后24小时内提供足够的镇痛效果,减少正颌手术中阿片类药物的消耗。
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引用次数: 2
Urban drinking and driving: comparison of electric scooter and bicycle related accidents in facial fracture patients. 城市酒驾:电动滑板车与自行车相关事故在面部骨折患者中的比较。
IF 2.2 3区 医学 Pub Date : 2023-05-01 DOI: 10.4317/medoral.25662
O Murros, T Puolakkainen, A Abio, H Thorén, J Snäll

Background: In recent years, electric scooters (e-scooter) have emerged as an alternative mode of urban transport due to their availability and effortless use. However, e-scooter-related trauma and injuries, especially to the head, have received wide media coverage and raised public concern about their safety. We aim to determine and compare clinically relevant variables, incidence, and severity between bicycle and e-scooter-related facial fractures and potential protective measures for injury prevention.

Material and methods: This retrospective study comprised all patients admitted to a tertiary trauma center with bicycle or e-scooter-related facial fractures between January 2019 and October 2020. Patient- and injury-related variables, including demographics, injury mechanisms, helmet use, influence of alcohol, types of facial injuries, types of other injuries, given treatment, and hospital stay, were collected, analysed, and compared between bicycle and e-scooter injuries.

Results: Altogether 169 patients with facial fractures, 124 bicycle-related injuries (73.4%) and 45 e-scooter-related injuries (26.6%) were included. Alcohol involvement was significantly higher in e-scooter patients (88.9%) than in bicycle patients (31.5%) (p<0.001). Driving under the influence of alcohol was associated with driving without a helmet in both groups (p<0.001). In multivariate analyses, e-scooter accidents were 18 times more likely to occur under the influence of alcohol (OR 17.85, p<0.001) and were more likely to involve collision with a stationary object (OR 3.81, p=0.028). E-scooter patients were significantly younger (OR 0.95, p<0.001) and had significantly more cranial fractures (OR 10.15, p=0.014) than bicycle patients.

Conclusions: Compared with patients in bicycle accidents, facial fracture patients injured in e-scooter accidents are younger, are more likely under the influence of alcohol, and sustain more severe craniofacial skeleton fractures. Our results for both groups of patients advocate stricter adherence to helmet and road safety legislation as well as public education for injury prevention.

背景:近年来,电动滑板车(e-scooter)因其可用性和使用方便而成为城市交通的一种替代方式。然而,与电动滑板车相关的创伤和伤害,特别是对头部的伤害,已经得到了媒体的广泛报道,并引起了公众对其安全性的关注。我们的目的是确定和比较与自行车和电动滑板车相关的面部骨折的临床相关变量、发生率和严重程度,以及预防伤害的潜在保护措施。材料和方法:本回顾性研究包括2019年1月至2020年10月期间在一家三级创伤中心收治的所有与自行车或电动滑板车相关的面部骨折患者。收集、分析和比较了与自行车和电动滑板车损伤相关的患者和损伤相关变量,包括人口统计学、损伤机制、头盔使用、酒精的影响、面部损伤类型、其他损伤类型、给予治疗和住院时间。结果:共纳入169例面部骨折,其中自行车相关损伤124例(73.4%),电动滑板车相关损伤45例(26.6%)。电动滑板车患者的酒精介入率(88.9%)明显高于自行车患者(31.5%)。(结论:与自行车事故患者相比,电动滑板车事故中面部骨折的患者年龄更小,更容易受到酒精的影响,并且发生更严重的颅面骨骼骨折。我们对两组患者的研究结果提倡更严格地遵守头盔和道路安全立法以及伤害预防的公共教育。
{"title":"Urban drinking and driving: comparison of electric scooter and bicycle related accidents in facial fracture patients.","authors":"O Murros,&nbsp;T Puolakkainen,&nbsp;A Abio,&nbsp;H Thorén,&nbsp;J Snäll","doi":"10.4317/medoral.25662","DOIUrl":"https://doi.org/10.4317/medoral.25662","url":null,"abstract":"<p><strong>Background: </strong>In recent years, electric scooters (e-scooter) have emerged as an alternative mode of urban transport due to their availability and effortless use. However, e-scooter-related trauma and injuries, especially to the head, have received wide media coverage and raised public concern about their safety. We aim to determine and compare clinically relevant variables, incidence, and severity between bicycle and e-scooter-related facial fractures and potential protective measures for injury prevention.</p><p><strong>Material and methods: </strong>This retrospective study comprised all patients admitted to a tertiary trauma center with bicycle or e-scooter-related facial fractures between January 2019 and October 2020. Patient- and injury-related variables, including demographics, injury mechanisms, helmet use, influence of alcohol, types of facial injuries, types of other injuries, given treatment, and hospital stay, were collected, analysed, and compared between bicycle and e-scooter injuries.</p><p><strong>Results: </strong>Altogether 169 patients with facial fractures, 124 bicycle-related injuries (73.4%) and 45 e-scooter-related injuries (26.6%) were included. Alcohol involvement was significantly higher in e-scooter patients (88.9%) than in bicycle patients (31.5%) (p<0.001). Driving under the influence of alcohol was associated with driving without a helmet in both groups (p<0.001). In multivariate analyses, e-scooter accidents were 18 times more likely to occur under the influence of alcohol (OR 17.85, p<0.001) and were more likely to involve collision with a stationary object (OR 3.81, p=0.028). E-scooter patients were significantly younger (OR 0.95, p<0.001) and had significantly more cranial fractures (OR 10.15, p=0.014) than bicycle patients.</p><p><strong>Conclusions: </strong>Compared with patients in bicycle accidents, facial fracture patients injured in e-scooter accidents are younger, are more likely under the influence of alcohol, and sustain more severe craniofacial skeleton fractures. Our results for both groups of patients advocate stricter adherence to helmet and road safety legislation as well as public education for injury prevention.</p>","PeriodicalId":18351,"journal":{"name":"Medicina oral, patologia oral y cirugia bucal","volume":"28 3","pages":"e238-e246"},"PeriodicalIF":2.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9444590","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: 3
Preoperative oral practices and incidence of postoperative complications in hospital medical-surgical procedures: A meta-analysis. 术前口腔习惯与医院内外科手术术后并发症的发生率:一项荟萃分析。
IF 2.2 3区 医学 Pub Date : 2023-05-01 DOI: 10.4317/medoral.25580
F Camus-Jansson, N Longueira-Diaz, B Salinas-Diaz, A Granic-Chinchón, W Cueto-Urbina, M Parra-Parra, S-A Lopez-de-Blanc
Background Oral decay prior to a hospital medical-surgical procedure is a risk factor for the development of postoperative complications. However, perioperative oral practices as a protective factor have not been studied. This review aims to evaluate the effectiveness of perioperative oral practices in the reduction of risk of developing postoperative complications in in-hospital medical surgical procedures. Material and Methods This review and meta-analysis was conducted according to Cochrane guidelines. Medline, Scopus, Scielo, and Cochrane were consulted. Articles of the previous 10 years concerning adult patients undergoing perioperative oral practices prior to hospital medical-surgical procedures, were included. Data of the type of perioperative oral practice, type of postoperative complication and measures of effect on the development of complications were extracted. Results Of a pool of 1470 articles, 13 were included for systematic review and 10 for meta-analysis. The most common perioperative oral procedures were focalized approach (FA), referred to only the elimination of infectious foci in the oral cavity and comprehensive approach (CA), referred to a integral approach of the patient's oral health, both of which were mainly performed in oncologic surgeries, both were effective in the reduction of postoperative complications (RR=0.48, [95% CI 0.36 - 0.63]). The most reported postoperative complication was postoperative pneumonia. Conclusions Perioperative oral management proved to be a protective factor against the development of postoperative complications. Key words:General surgery, surgical oncology, perioperative care, clinical protocols, dental care, postoperative complications.
背景:医院外科手术前的口腔腐烂是术后并发症发生的危险因素。然而,围手术期口腔实践作为保护因素的研究尚未见。本综述旨在评价围手术期口腔实践在降低院内外科手术术后并发症风险方面的有效性。材料和方法:本综述和荟萃分析按照Cochrane指南进行。咨询了Medline、Scopus、Scielo和Cochrane。纳入了过去10年关于住院内科-外科手术前接受围手术期口腔治疗的成年患者的文章。提取围手术期口腔练习类型、术后并发症类型及对并发症发生的影响措施等资料。结果:在1470篇文献中,13篇纳入系统评价,10篇纳入元分析。围手术期最常见的口腔手术是病灶入路(FA)和综合入路(CA),前者仅指消除口腔内的感染性病灶,后者是指综合考虑患者口腔健康的入路,这两种入路主要用于肿瘤手术,均能有效减少术后并发症(RR=0.48, [95% CI 0.36 - 0.63])。报道最多的术后并发症是术后肺炎。结论:围手术期口腔管理是预防术后并发症发生的保护因素。
{"title":"Preoperative oral practices and incidence of postoperative complications in hospital medical-surgical procedures: A meta-analysis.","authors":"F Camus-Jansson,&nbsp;N Longueira-Diaz,&nbsp;B Salinas-Diaz,&nbsp;A Granic-Chinchón,&nbsp;W Cueto-Urbina,&nbsp;M Parra-Parra,&nbsp;S-A Lopez-de-Blanc","doi":"10.4317/medoral.25580","DOIUrl":"https://doi.org/10.4317/medoral.25580","url":null,"abstract":"Background Oral decay prior to a hospital medical-surgical procedure is a risk factor for the development of postoperative complications. However, perioperative oral practices as a protective factor have not been studied. This review aims to evaluate the effectiveness of perioperative oral practices in the reduction of risk of developing postoperative complications in in-hospital medical surgical procedures. Material and Methods This review and meta-analysis was conducted according to Cochrane guidelines. Medline, Scopus, Scielo, and Cochrane were consulted. Articles of the previous 10 years concerning adult patients undergoing perioperative oral practices prior to hospital medical-surgical procedures, were included. Data of the type of perioperative oral practice, type of postoperative complication and measures of effect on the development of complications were extracted. Results Of a pool of 1470 articles, 13 were included for systematic review and 10 for meta-analysis. The most common perioperative oral procedures were focalized approach (FA), referred to only the elimination of infectious foci in the oral cavity and comprehensive approach (CA), referred to a integral approach of the patient's oral health, both of which were mainly performed in oncologic surgeries, both were effective in the reduction of postoperative complications (RR=0.48, [95% CI 0.36 - 0.63]). The most reported postoperative complication was postoperative pneumonia. Conclusions Perioperative oral management proved to be a protective factor against the development of postoperative complications. Key words:General surgery, surgical oncology, perioperative care, clinical protocols, dental care, postoperative complications.","PeriodicalId":18351,"journal":{"name":"Medicina oral, patologia oral y cirugia bucal","volume":"28 3","pages":"e217-e228"},"PeriodicalIF":2.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9805125","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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