A. Alves, Dayrine Silveira de Paula, Lia Vila Real Lima, T. Dantas, M. Mota, F. Sousa, Paulo Goberlânio Barros Silva
Background This study aimed to analyze whether immunohistochemistry (IHC) is more sensitive than hematoxylin-eosin (H&E) staining for identifying perineural invasion (PNI) or lymphovascular invasion (LVI) in oral squamous cell carcinoma (OSCC). Material and Methods In this systematic review and meta-analysis (Prospective Register of Systematic Reviews – CRD 42021256515), data were obtained from six databases (PubMed, Scopus, LILACS, Web of Science, EBSCO, LIVIVO, Embase) and the grey literature. Cross-sectional observational studies of the diagnostic sensitivity of IHC for PNI and LVI were included. Studies were selected in two phases: first collection and reference retrieval. The Quality Assessment of Diagnostic Accuracy Studies-2 tool assessed study quality, while the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach assessed evidence quality. The meta-analysis (random effects model) was performed using MedCalc 18.2.1 software (MedCalc®) (p<0.05). Results Four studies (560 patients with 295 biopsies) were analyzed. The combined sensitivity was 76% (95% confidence interval [CI], 44.30–97.19%) and specificity was 42% (95% CI, 23.40–62.02%). The positive predictive value (PPV) and negative predictive value (NPV) were 61% (95% CI, 49.78–71.53%) and 70% (95% CI, 37.63–94.43%). The overall accuracy was 58% (95% CI, 45.17–70.65%). The risk of bias was low, and GRADE analysis showed a very low certainty of evidence. Conclusions Our data suggest that IHC staining to highlight PNI/LVI may be useful in cases in which H&E analysis results in a negative decrease in the prevalence of false-negative cases and underestimated treatment. Key words:Mouth neoplasms, neoplasm invasiveness, blood vessels, peripheral nerves.
{"title":"Is immunohistochemistry more sensitive than hematoxylin-eosin staining for identifying perineural or lymphovascular invasion in oral squamous cell carcinoma? A systematic review and meta-analysis","authors":"A. Alves, Dayrine Silveira de Paula, Lia Vila Real Lima, T. Dantas, M. Mota, F. Sousa, Paulo Goberlânio Barros Silva","doi":"10.4317/medoral.25114","DOIUrl":"https://doi.org/10.4317/medoral.25114","url":null,"abstract":"Background This study aimed to analyze whether immunohistochemistry (IHC) is more sensitive than hematoxylin-eosin (H&E) staining for identifying perineural invasion (PNI) or lymphovascular invasion (LVI) in oral squamous cell carcinoma (OSCC). Material and Methods In this systematic review and meta-analysis (Prospective Register of Systematic Reviews – CRD 42021256515), data were obtained from six databases (PubMed, Scopus, LILACS, Web of Science, EBSCO, LIVIVO, Embase) and the grey literature. Cross-sectional observational studies of the diagnostic sensitivity of IHC for PNI and LVI were included. Studies were selected in two phases: first collection and reference retrieval. The Quality Assessment of Diagnostic Accuracy Studies-2 tool assessed study quality, while the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach assessed evidence quality. The meta-analysis (random effects model) was performed using MedCalc 18.2.1 software (MedCalc®) (p<0.05). Results Four studies (560 patients with 295 biopsies) were analyzed. The combined sensitivity was 76% (95% confidence interval [CI], 44.30–97.19%) and specificity was 42% (95% CI, 23.40–62.02%). The positive predictive value (PPV) and negative predictive value (NPV) were 61% (95% CI, 49.78–71.53%) and 70% (95% CI, 37.63–94.43%). The overall accuracy was 58% (95% CI, 45.17–70.65%). The risk of bias was low, and GRADE analysis showed a very low certainty of evidence. Conclusions Our data suggest that IHC staining to highlight PNI/LVI may be useful in cases in which H&E analysis results in a negative decrease in the prevalence of false-negative cases and underestimated treatment. Key words:Mouth neoplasms, neoplasm invasiveness, blood vessels, peripheral nerves.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"62 1","pages":"e238 - e247"},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84268454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Infante-Cossio, Macarena Fernandez-Mayoralas-Gomez, L. González-Pérez, Rafael Martínez-de-Fuentes, Á. Rollón-Mayordomo, E. Torres-Carranza
Background The coronavirus pandemic has impacted health systems worldwide, with Spain being one of the most affected countries. However, little is known about the extent to which the effects of staying home, social distancing, and quarantine measures have influenced the epidemiology of patients with maxillofacial trauma. The aim of this study was to analyze the impact of the coronavirus pandemic on the incidence, demographic patterns, and characteristics of maxillofacial fractures in the largest hospital in southern Spain. Material and Methods Data from patients who underwent surgery for maxillofacial fractures during the first year of the pandemic between 16 March 2020 and 14 March 2021 (pandemic group) were retrospectively compared with a control group during the equivalent period of the previous year (pre-pandemic group). The incidence was compared by weeks and by lockdown periods of the population. Demographic information, aetioloy, fracture characteristics, treatment performed, and days of preoperative stay were evaluated. Descriptive and bivariate statistics were calculated (p<0.05). Results During the first year of the pandemic, there was a 35.2% reduction in maxillofacial fractures (n=59) compared to the pre-pandemic year (n=91, p=0.040). A significant drop was detected during the total home lockdown period of the population (p=0.028). In the pandemic group, there was a reduction in fractures due to interpersonal aggressions, an increase in panfacial fractures, a significant increase in other non-facial injuries associated with polytrauma (p=0.037), a higher number of open reduction procedures with internal fixation, and a significantly longer mean preoperative stay (p=0.016). Conclusions The first pandemic year was associated with a decline in the frequency of maxillofacial trauma and a change in the pattern and characteristics of fractures. Inter-annual epidemiological knowledge of maxillofacial fractures may be useful for more efficient planning of resource allocation and surgical practice strategy during future coronavirus outbreaks and population lockdowns. Key words:SARS-CoV-2, coronavirus infection, pandemic, maxillofacial trauma, Spain.
{"title":"Impact of the coronavirus pandemic on maxillofacial trauma: A retrospective study in southern Spain","authors":"P. Infante-Cossio, Macarena Fernandez-Mayoralas-Gomez, L. González-Pérez, Rafael Martínez-de-Fuentes, Á. Rollón-Mayordomo, E. Torres-Carranza","doi":"10.4317/medoral.25063","DOIUrl":"https://doi.org/10.4317/medoral.25063","url":null,"abstract":"Background The coronavirus pandemic has impacted health systems worldwide, with Spain being one of the most affected countries. However, little is known about the extent to which the effects of staying home, social distancing, and quarantine measures have influenced the epidemiology of patients with maxillofacial trauma. The aim of this study was to analyze the impact of the coronavirus pandemic on the incidence, demographic patterns, and characteristics of maxillofacial fractures in the largest hospital in southern Spain. Material and Methods Data from patients who underwent surgery for maxillofacial fractures during the first year of the pandemic between 16 March 2020 and 14 March 2021 (pandemic group) were retrospectively compared with a control group during the equivalent period of the previous year (pre-pandemic group). The incidence was compared by weeks and by lockdown periods of the population. Demographic information, aetioloy, fracture characteristics, treatment performed, and days of preoperative stay were evaluated. Descriptive and bivariate statistics were calculated (p<0.05). Results During the first year of the pandemic, there was a 35.2% reduction in maxillofacial fractures (n=59) compared to the pre-pandemic year (n=91, p=0.040). A significant drop was detected during the total home lockdown period of the population (p=0.028). In the pandemic group, there was a reduction in fractures due to interpersonal aggressions, an increase in panfacial fractures, a significant increase in other non-facial injuries associated with polytrauma (p=0.037), a higher number of open reduction procedures with internal fixation, and a significantly longer mean preoperative stay (p=0.016). Conclusions The first pandemic year was associated with a decline in the frequency of maxillofacial trauma and a change in the pattern and characteristics of fractures. Inter-annual epidemiological knowledge of maxillofacial fractures may be useful for more efficient planning of resource allocation and surgical practice strategy during future coronavirus outbreaks and population lockdowns. Key words:SARS-CoV-2, coronavirus infection, pandemic, maxillofacial trauma, Spain.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"36 1","pages":"e223 - e229"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76333116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
María Otero, N. Oishi, F. Martínez, M. T. Ballester, J. Basterra
Background The healthcare practice of dentistry, as well as medicine, is framed within a legal environment. Patients have the right to know all the information related to any action performed on them and dental or medical doctors are obliged to obtain their patient’s prior written informed consent (IC) before undertaking any healthcare procedures. Material and Methods Here we reviewed the legality and jurisprudence in Spain regarding IC. We also used INFLESZ text readability analysis software to analyse a sample of official Spanish informed consent documents (ICDs) from different surgical and interventional procedures related to dentistry and oral cavity interventions. Results It is a mistake to confound IC with ICDs. This error prevents physicians from considering the former as a care process in which the patient’s authorisation signature is the last link in a chain formed, almost in its entirety, by the informative process and deliberation alongside the patient. Multiple factors can influence communication between practitioners and their patients. Importantly, treatment adherence is greater when patients feel involved and autonomous in shared decision-making and when the circumstances of their lives are adequately considered. We concluded that although the ICDs we analysed conformed to the requirements set out in international law, they were somewhat difficult to read according to the reading habits of the general Spanish population. Conclusions Knowledge about the legality of IC helps professionals to understand the problems that may arise from their non-compliance. This is because the omission or defective fulfilment of IC obligations is the origin of legal responsibility for medical practitioners. In this sense, to date, there have been more convictions for defective ICs than for malpractice. The information provided in ICs should include the risks, benefits, and treatment alternatives and must be tailored to the needs and capabilities of the patient to enable autonomous decision-making. Key words:Informed consent, legality of informed consent, principle of autonomy, defensive medicine, satisfactive medicine, health law, stomatology, oral surgery, dentistry.
{"title":"Informed consent in dentistry and medicine in Spain: Practical considerations and legality","authors":"María Otero, N. Oishi, F. Martínez, M. T. Ballester, J. Basterra","doi":"10.4317/medoral.25265","DOIUrl":"https://doi.org/10.4317/medoral.25265","url":null,"abstract":"Background The healthcare practice of dentistry, as well as medicine, is framed within a legal environment. Patients have the right to know all the information related to any action performed on them and dental or medical doctors are obliged to obtain their patient’s prior written informed consent (IC) before undertaking any healthcare procedures. Material and Methods Here we reviewed the legality and jurisprudence in Spain regarding IC. We also used INFLESZ text readability analysis software to analyse a sample of official Spanish informed consent documents (ICDs) from different surgical and interventional procedures related to dentistry and oral cavity interventions. Results It is a mistake to confound IC with ICDs. This error prevents physicians from considering the former as a care process in which the patient’s authorisation signature is the last link in a chain formed, almost in its entirety, by the informative process and deliberation alongside the patient. Multiple factors can influence communication between practitioners and their patients. Importantly, treatment adherence is greater when patients feel involved and autonomous in shared decision-making and when the circumstances of their lives are adequately considered. We concluded that although the ICDs we analysed conformed to the requirements set out in international law, they were somewhat difficult to read according to the reading habits of the general Spanish population. Conclusions Knowledge about the legality of IC helps professionals to understand the problems that may arise from their non-compliance. This is because the omission or defective fulfilment of IC obligations is the origin of legal responsibility for medical practitioners. In this sense, to date, there have been more convictions for defective ICs than for malpractice. The information provided in ICs should include the risks, benefits, and treatment alternatives and must be tailored to the needs and capabilities of the patient to enable autonomous decision-making. Key words:Informed consent, legality of informed consent, principle of autonomy, defensive medicine, satisfactive medicine, health law, stomatology, oral surgery, dentistry.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"38 2","pages":"e294 - e300"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72612770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the editor: Triclosan in patients with inflammatory bowel disease","authors":"Juan-Francisco Peña-Cardelles","doi":"10.4317/medoral.25407","DOIUrl":"https://doi.org/10.4317/medoral.25407","url":null,"abstract":"","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"1 1","pages":"e442 - e443"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83108251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. García-De-La-Fuente, Irene Lafuente-Ibáñez-de-Mendoza, M. Lartitegui-Sebastián, X. Marichalar-Mendia, María-Ángeles Echebarria-Goikouria, J. Aguirre‐Urizar
Background Parkinson's disease (PD) is one of the leading neurological disorders, affecting more than 6 million people worldwide. These patients present motor and non-motor symptoms, including oral pathology. The objective of this research is to determine the oral health of patients diagnosed with PD, in order to stablish a specific preventive oral health programme. Material and Methods Case-control study on 104 PD and 106 control patients. The pre-designed clinical protocol included a complete oral examination on general aspects, standardised epidemiological index for caries, periodontal disease and edentulism, analysis of oral hygiene, presence of mucous/ salivary/ functional disorder, and dental treatments. Results A higher number of PD patients consumed daily sweets (p<0.004) and antidepressant drugs (p<0.004). Patients with PD practised less interdental hygiene (p<0.023). The mean plaque index was higher in PD (p<0.003). Drooling (p<0.001), xerostomia (p<0.001), hyposialia (p<0.001), dysphagia (p<0.001), hypogeusia/dysgeusia (p<0.025) and chewing difficulty (p<0.006) were more common in PD. Conclusions Oral disorders are frequent in PD. A good knowledge of these alterations will allow us design a specific preventive protocol. Some oral alterations may be a sign of diagnostic alert or progression of PD. Key words:Parkinson's disease, oral health, dysgeusia, dysphagia, drooling.
{"title":"Facts and controversies regarding oral health in Parkinson's disease: A case-control study in Spanish patients","authors":"A. García-De-La-Fuente, Irene Lafuente-Ibáñez-de-Mendoza, M. Lartitegui-Sebastián, X. Marichalar-Mendia, María-Ángeles Echebarria-Goikouria, J. Aguirre‐Urizar","doi":"10.4317/medoral.25348","DOIUrl":"https://doi.org/10.4317/medoral.25348","url":null,"abstract":"Background Parkinson's disease (PD) is one of the leading neurological disorders, affecting more than 6 million people worldwide. These patients present motor and non-motor symptoms, including oral pathology. The objective of this research is to determine the oral health of patients diagnosed with PD, in order to stablish a specific preventive oral health programme. Material and Methods Case-control study on 104 PD and 106 control patients. The pre-designed clinical protocol included a complete oral examination on general aspects, standardised epidemiological index for caries, periodontal disease and edentulism, analysis of oral hygiene, presence of mucous/ salivary/ functional disorder, and dental treatments. Results A higher number of PD patients consumed daily sweets (p<0.004) and antidepressant drugs (p<0.004). Patients with PD practised less interdental hygiene (p<0.023). The mean plaque index was higher in PD (p<0.003). Drooling (p<0.001), xerostomia (p<0.001), hyposialia (p<0.001), dysphagia (p<0.001), hypogeusia/dysgeusia (p<0.025) and chewing difficulty (p<0.006) were more common in PD. Conclusions Oral disorders are frequent in PD. A good knowledge of these alterations will allow us design a specific preventive protocol. Some oral alterations may be a sign of diagnostic alert or progression of PD. Key words:Parkinson's disease, oral health, dysgeusia, dysphagia, drooling.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"125 1","pages":"e419 - e425"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78558654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Corona Virus Disease-2019 (COVID-19) is perhaps the disastrous medical emergencies that has ever hit globally with multiple strains. Amongst various sequelae, mucormycosis may be considered as the most debilitating one. Post COVID-19 mucormycosis is formally regarded as corona virus disease associated mucormycosis (CAM). The aim of the current paper is to present twelve cases of CAM with unique clinical presentation with a detailed histopathological correlation of the gingival biopsied material. Material and Methods Twelve cases of CAM were included in the study who presented initially with non-purulent swelling of the gingiva. The clinic-demographic data pertaining to age, gender, location, laterality and presence of co-morbidities was collected along with histopathological examination of biopsied specimen. Results The patients ranged from 31-65 years (mean age 47.33 years). There was a male predominance. Clearly, maxillary right gingiva was mostly affected and all cases presented with non purulent, non tender swelling of the gingiva. The incisional biopsy from the gingiva consistently showed pseudoepitheliomatous hyperplasia of the surface epithelium along with vacuolar degeneration, extensive stromal edema, massive mixed inflammatory reaction, congested blood vessels, hemorrhage and abundant multinucleated giant cells. Potassium hydroxide (10% KOH) mount served no additional diagnostic advantage. After two initial biopsies any suspected case of CAM with these features was treated with appropriate antifungal therapy and conservative excision. Conclusions Gingival swelling with aforementioned histopathological features resembling post COVID-19 histological alterations could be alarming early signs of CAM and are candidate of prompt antifungal therapy rather than repeat biopsy for confirmation. Key words:CAM, COVID-19, giant cells, gingiva, mucormycosis.
{"title":"Histopathological analysis of soft tissue changes in gingival biopsied specimen from patients with underlying corona virus disease associated mucormycosis (CAM)","authors":"Deepak Pandiar, P. Ramani, R. Krishnan, Dinesh Y","doi":"10.4317/medoral.25050","DOIUrl":"https://doi.org/10.4317/medoral.25050","url":null,"abstract":"Background Corona Virus Disease-2019 (COVID-19) is perhaps the disastrous medical emergencies that has ever hit globally with multiple strains. Amongst various sequelae, mucormycosis may be considered as the most debilitating one. Post COVID-19 mucormycosis is formally regarded as corona virus disease associated mucormycosis (CAM). The aim of the current paper is to present twelve cases of CAM with unique clinical presentation with a detailed histopathological correlation of the gingival biopsied material. Material and Methods Twelve cases of CAM were included in the study who presented initially with non-purulent swelling of the gingiva. The clinic-demographic data pertaining to age, gender, location, laterality and presence of co-morbidities was collected along with histopathological examination of biopsied specimen. Results The patients ranged from 31-65 years (mean age 47.33 years). There was a male predominance. Clearly, maxillary right gingiva was mostly affected and all cases presented with non purulent, non tender swelling of the gingiva. The incisional biopsy from the gingiva consistently showed pseudoepitheliomatous hyperplasia of the surface epithelium along with vacuolar degeneration, extensive stromal edema, massive mixed inflammatory reaction, congested blood vessels, hemorrhage and abundant multinucleated giant cells. Potassium hydroxide (10% KOH) mount served no additional diagnostic advantage. After two initial biopsies any suspected case of CAM with these features was treated with appropriate antifungal therapy and conservative excision. Conclusions Gingival swelling with aforementioned histopathological features resembling post COVID-19 histological alterations could be alarming early signs of CAM and are candidate of prompt antifungal therapy rather than repeat biopsy for confirmation. Key words:CAM, COVID-19, giant cells, gingiva, mucormycosis.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"69 1","pages":"e216 - e222"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77680780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. E. Rodríguez-Fuentes, M. Pérez‐Sayáns, Luis Chauca-Bajaña, G. Barbeito-Castiñeiras, María Luisa Pérez del Molino-Bernal, R. López-López
Background Oral mucositis is one of the most common side effects in cancer patients receiving systemic antineoplastics. However, the underlying biological mechanisms leading to this condition are still unclear. For this reason, it has been hypothesised that systemic antineoplastics may cause an imbalance on the oral microbiota that subsequently triggers oral mucosa damage. Material and Methods A systematic review was performed following the PRISMA protocol and the PICO question established was: patients diagnosed with cancer, who are candidates for receiving systemic antineoplastics (P=Patients), that undergo oral microbiome determinations (I=Intervention), before and after systemic antineoplastics administration (C=Comparison), to analyse changes in the oral microbiome composition (O=Outcome). The bibliographic search was carried out in PubMed and other scientific repositories. Results Out of 166 obtained articles, only 5 met eligibility criteria. Acute myeloid leukaemia (AML) was the most frequent type of cancer (40 %) among the participants. Only one of the studies included a control group of healthy subjects. Heterogeneity in the protocols and approaches of the included studies hindered a detailed comparison of the outcomes. However, it was stated that a decrease in bacteria α diversity is often associated with oral mucositis. On the other hand, fungal diversity was not associated with oral mucositis although α diversity was lower at baseline on patients developing oral candidiasis. Conclusions There is insufficient scientific evidence of oral microbiological changes in patients undergoing systemic antineoplastics. Further investigations ought to be carried out to identify microorganisms that might play a key role in the pathogenesis of oral mucosa damage in patients undergoing systemic antineoplastics. Key words:Stomatitis, antineoplastic agents, neoplasms, microbiota, immunotherapy.
{"title":"Oral microbiome and systemic antineoplastics in cancer treatment: A systematic review","authors":"M. E. Rodríguez-Fuentes, M. Pérez‐Sayáns, Luis Chauca-Bajaña, G. Barbeito-Castiñeiras, María Luisa Pérez del Molino-Bernal, R. López-López","doi":"10.4317/medoral.25121","DOIUrl":"https://doi.org/10.4317/medoral.25121","url":null,"abstract":"Background Oral mucositis is one of the most common side effects in cancer patients receiving systemic antineoplastics. However, the underlying biological mechanisms leading to this condition are still unclear. For this reason, it has been hypothesised that systemic antineoplastics may cause an imbalance on the oral microbiota that subsequently triggers oral mucosa damage. Material and Methods A systematic review was performed following the PRISMA protocol and the PICO question established was: patients diagnosed with cancer, who are candidates for receiving systemic antineoplastics (P=Patients), that undergo oral microbiome determinations (I=Intervention), before and after systemic antineoplastics administration (C=Comparison), to analyse changes in the oral microbiome composition (O=Outcome). The bibliographic search was carried out in PubMed and other scientific repositories. Results Out of 166 obtained articles, only 5 met eligibility criteria. Acute myeloid leukaemia (AML) was the most frequent type of cancer (40 %) among the participants. Only one of the studies included a control group of healthy subjects. Heterogeneity in the protocols and approaches of the included studies hindered a detailed comparison of the outcomes. However, it was stated that a decrease in bacteria α diversity is often associated with oral mucositis. On the other hand, fungal diversity was not associated with oral mucositis although α diversity was lower at baseline on patients developing oral candidiasis. Conclusions There is insufficient scientific evidence of oral microbiological changes in patients undergoing systemic antineoplastics. Further investigations ought to be carried out to identify microorganisms that might play a key role in the pathogenesis of oral mucosa damage in patients undergoing systemic antineoplastics. Key words:Stomatitis, antineoplastic agents, neoplasms, microbiota, immunotherapy.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"23 1","pages":"e248 - e256"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85720481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kevin Barrios-Garay, J. Toledano-Serrabona, C. Gay-Escoda, M. Sánchez-Garcés
Background The aim of the present systematic review was to evaluate the clinical effect of vitamin C on bone healing after bone fracture or bone reconstruction procedures. Material and Methods In October 2020, Cochrane Library, Scopus and PubMed-Medline databases were searched without restrictions to identify animal and human studies that fulfilled the eligibility criteria. Outcome measures were bone healing time, bone gain (mm), bone density and adverse events. The risk of bias assessment of the selected studies was evaluated by means of Cochrane Collaboration’s Tool for randomized clinical trials, while randomized clinical animal trials were assessed according to SYRCLE’s tool. Additionally, quality of reporting animal studies were assessed according to ARRIVE guidelines. Results Out of the 248 articles that yielded the initial search, 11 papers about the effect of ascorbic acid on bone healing were selected. In most of the animal studies, vitamin C seemed to accelerate bone formation owing to an enhanced osteoblastic proliferation and differentiation and its antioxidant function when pro-oxidant substances were added. It was not possible to observe this phenomenon in human studies. Conclusions Although additional well-performed animal and human studies are required, vitamin C seems to accelerate bone regeneration without adverse events. However, it is not possible to recommend a specific dose or route of administration of vitamin C to improve the bone healing process in humans as there was great heterogeneity among the included studies. Key words:Vitamin C, Fracture healing, Bone regeneration, Bone mineral density, Implants.
{"title":"Clinical effect of vitamin C supplementation on bone healing: A systematic review","authors":"Kevin Barrios-Garay, J. Toledano-Serrabona, C. Gay-Escoda, M. Sánchez-Garcés","doi":"10.4317/medoral.24944","DOIUrl":"https://doi.org/10.4317/medoral.24944","url":null,"abstract":"Background The aim of the present systematic review was to evaluate the clinical effect of vitamin C on bone healing after bone fracture or bone reconstruction procedures. Material and Methods In October 2020, Cochrane Library, Scopus and PubMed-Medline databases were searched without restrictions to identify animal and human studies that fulfilled the eligibility criteria. Outcome measures were bone healing time, bone gain (mm), bone density and adverse events. The risk of bias assessment of the selected studies was evaluated by means of Cochrane Collaboration’s Tool for randomized clinical trials, while randomized clinical animal trials were assessed according to SYRCLE’s tool. Additionally, quality of reporting animal studies were assessed according to ARRIVE guidelines. Results Out of the 248 articles that yielded the initial search, 11 papers about the effect of ascorbic acid on bone healing were selected. In most of the animal studies, vitamin C seemed to accelerate bone formation owing to an enhanced osteoblastic proliferation and differentiation and its antioxidant function when pro-oxidant substances were added. It was not possible to observe this phenomenon in human studies. Conclusions Although additional well-performed animal and human studies are required, vitamin C seems to accelerate bone regeneration without adverse events. However, it is not possible to recommend a specific dose or route of administration of vitamin C to improve the bone healing process in humans as there was great heterogeneity among the included studies. Key words:Vitamin C, Fracture healing, Bone regeneration, Bone mineral density, Implants.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"32 1","pages":"e205 - e215"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72661299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. V. R. Louredo, P. Vargas, Maria Eduarda Pérez-de-Oliveira, M. Lopes, L. P. Kowalski, M. Curado
Background Lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC) represent a major health problem in the global scenario. In South America, the highest incidence rates are seen in Brazil. Therefore, the epidemiological and clinical profile and survival outcomes of lip, oral cavity, and oropharyngeal SCC was studied in São Paulo State, Brazil. Material and Methods The clinicopathological data of 12,099 patients with lip, oral cavity, and oropharyngeal SCC were obtained from hospital cancer registries of the Fundação Oncocentro de São Paulo, Brazil (2010–2015). Survival rates and other analyses were performed using SPSS software. Results A clear male predominance was observed, particularly for patients with oropharyngeal SCC (88.3%). The average age of patients was higher for lip cases (65 ± 13.5 years) compared to other sites. The schooling level was low for most patients, especially in lip cases (87.9%). Most of the patients with oral cavity (71.8%) and oropharyngeal (86.3%) SCC had advanced-stage (III–IV) disease. However, the majority of lip cases (83.3%) were at an early stage (I–II). Surgical excision was the main treatment for lip (72%) and oral cavity SCC (23.5%), and chemoradiotherapy was the main treatment for oropharyngeal SCC (40.2%). The 5-year overall survival (OS) for patients with lip, oral cavity, and oropharyngeal SCC were 66.3, 30.9, and 22.6%, respectively. Multivariate analysis revealed that the determinants of OS were different for lip, oral cavity, and oropharyngeal SCC, except for those at the clinical stage, which was an independent predictor for all sites. Conclusions OS-independent determinants varied according to the affected site. Oral cavity and oropharyngeal SCC presented worse survival rates than those for lip SCC. Key words:Squamous cell carcinoma of head and neck, lip neoplasms, mouth neoplasms, oropharyngeal neoplasms, survival analysis.
背景唇、口腔和口咽鳞状细胞癌(SCC)在全球范围内是一个主要的健康问题。在南美洲，巴西的发病率最高。因此，在巴西圣保罗州研究了唇、口腔和口咽鳞状细胞癌的流行病学、临床概况和生存结果。材料和方法从巴西圣保罗肿瘤中心基金会(funda o Oncocentro de saul Paulo)的医院肿瘤登记处(2010-2015)获得12099例唇、口腔和口咽鳞状细胞癌患者的临床病理资料。生存率等分析采用SPSS软件进行。结果男性明显占优势，尤其是口咽部鳞状细胞癌(88.3%)。唇部患者的平均年龄(65±13.5岁)高于其他部位。大多数患者的受教育程度较低，尤其是唇部病例(87.9%)。口腔鳞状细胞癌(71.8%)和口咽鳞状细胞癌(86.3%)多数为晚期(III-IV)。然而，大多数唇部病例(83.3%)处于早期(I-II期)。手术切除是唇部(72%)和口腔(23.5%)鳞状细胞癌的主要治疗方法，放化疗是口咽部鳞状细胞癌的主要治疗方法(40.2%)。唇部、口腔和口咽部SCC患者的5年总生存率(OS)分别为66.3、30.9%和22.6%。多因素分析显示，除了临床阶段是所有部位的独立预测因子外，唇部、口腔和口咽部SCC的OS决定因素各不相同。结论与os无关的决定因素因受累部位而异。口腔和口咽鳞状细胞癌的生存率低于唇部鳞状细胞癌。关键词:头颈部鳞状细胞癌，唇部肿瘤，口腔肿瘤，口咽肿瘤，生存分析
{"title":"Epidemiology and survival outcomes of lip, oral cavity, and oropharyngeal squamous cell carcinoma in a southeast Brazilian population","authors":"B. V. R. Louredo, P. Vargas, Maria Eduarda Pérez-de-Oliveira, M. Lopes, L. P. Kowalski, M. Curado","doi":"10.4317/medoral.25147","DOIUrl":"https://doi.org/10.4317/medoral.25147","url":null,"abstract":"Background Lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC) represent a major health problem in the global scenario. In South America, the highest incidence rates are seen in Brazil. Therefore, the epidemiological and clinical profile and survival outcomes of lip, oral cavity, and oropharyngeal SCC was studied in São Paulo State, Brazil. Material and Methods The clinicopathological data of 12,099 patients with lip, oral cavity, and oropharyngeal SCC were obtained from hospital cancer registries of the Fundação Oncocentro de São Paulo, Brazil (2010–2015). Survival rates and other analyses were performed using SPSS software. Results A clear male predominance was observed, particularly for patients with oropharyngeal SCC (88.3%). The average age of patients was higher for lip cases (65 ± 13.5 years) compared to other sites. The schooling level was low for most patients, especially in lip cases (87.9%). Most of the patients with oral cavity (71.8%) and oropharyngeal (86.3%) SCC had advanced-stage (III–IV) disease. However, the majority of lip cases (83.3%) were at an early stage (I–II). Surgical excision was the main treatment for lip (72%) and oral cavity SCC (23.5%), and chemoradiotherapy was the main treatment for oropharyngeal SCC (40.2%). The 5-year overall survival (OS) for patients with lip, oral cavity, and oropharyngeal SCC were 66.3, 30.9, and 22.6%, respectively. Multivariate analysis revealed that the determinants of OS were different for lip, oral cavity, and oropharyngeal SCC, except for those at the clinical stage, which was an independent predictor for all sites. Conclusions OS-independent determinants varied according to the affected site. Oral cavity and oropharyngeal SCC presented worse survival rates than those for lip SCC. Key words:Squamous cell carcinoma of head and neck, lip neoplasms, mouth neoplasms, oropharyngeal neoplasms, survival analysis.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"191 1","pages":"e274 - e284"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72744743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Ramos, Adriano Referino da Silva Sobrinho, L. Ribeiro, A. V. Martins-de-Barros, H. Mauricio, Stefânia Jerônimo Ferreira, M. V. Carvalho
Background Oral and oropharyngeal cancer (OPC) is an important cause of morbidity and mortality worldwide. Populations in situations of social vulnerability tend to have higher incidences of cancer, a higher proportion of late diagnosis, greater difficulties in accessing health services, and, consequently, worse prognosis. The aim of this study was to evaluate the relationship between race/skin color and OPC prognosis in Brazil. Material and Methods This is a cross-sectional epidemiological study using OPC data from the National Cancer Institute between the years 2000 and 2019. The selected variables were: gender, race/skin color, age, education, smoking and alcohol consumption, stage of the disease and disease status at the end of the 1st treatment. Results 154,214 cases were recorded. Black men, in the 6th decade of life, were the most affected population. Blacks had a lower level of education when compared to non-blacks (p<0.001). Blacks were more exposed to smoking and alcohol consumption (p<0.001). At the time of diagnosis, the black population was at the most advanced stage when compared to non-blacks (p<0.001). At the end of the 1st treatment, more black patients had disease in progression, as well as more black patients died (p<0.001). Conclusions Blacks had a worse prognosis for OPC in Brazil. Despite the limitations, these results are important to elucidate the scenario of health disparities in relation to the race/skin color of the Brazilian population. Key words:Head and neck, oncology, cancer, oral cavity, oropharynx.
{"title":"Racial disparity and prognosis in patients with mouth and oropharynx cancer in Brazil","authors":"L. Ramos, Adriano Referino da Silva Sobrinho, L. Ribeiro, A. V. Martins-de-Barros, H. Mauricio, Stefânia Jerônimo Ferreira, M. V. Carvalho","doi":"10.4317/medoral.25334","DOIUrl":"https://doi.org/10.4317/medoral.25334","url":null,"abstract":"Background Oral and oropharyngeal cancer (OPC) is an important cause of morbidity and mortality worldwide. Populations in situations of social vulnerability tend to have higher incidences of cancer, a higher proportion of late diagnosis, greater difficulties in accessing health services, and, consequently, worse prognosis. The aim of this study was to evaluate the relationship between race/skin color and OPC prognosis in Brazil. Material and Methods This is a cross-sectional epidemiological study using OPC data from the National Cancer Institute between the years 2000 and 2019. The selected variables were: gender, race/skin color, age, education, smoking and alcohol consumption, stage of the disease and disease status at the end of the 1st treatment. Results 154,214 cases were recorded. Black men, in the 6th decade of life, were the most affected population. Blacks had a lower level of education when compared to non-blacks (p<0.001). Blacks were more exposed to smoking and alcohol consumption (p<0.001). At the time of diagnosis, the black population was at the most advanced stage when compared to non-blacks (p<0.001). At the end of the 1st treatment, more black patients had disease in progression, as well as more black patients died (p<0.001). Conclusions Blacks had a worse prognosis for OPC in Brazil. Despite the limitations, these results are important to elucidate the scenario of health disparities in relation to the race/skin color of the Brazilian population. Key words:Head and neck, oncology, cancer, oral cavity, oropharynx.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"40 1","pages":"e392 - e396"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82459813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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