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Predictors of health-related quality of life in Serbian patients with head and neck cancer 塞尔维亚头颈癌患者健康相关生活质量的预测因素
Pub Date : 2022-04-03 DOI: 10.4317/medoral.25274
Miloš Čanković, M. Tešić, M. Jevtić, D. Stevanović, M. Jovanovic, Dejan Kostić, J. Antic, Sanja Krejović Trivić
Background The aim of this study was to identify predictors of the Health-Related Quality of Life (HRQoL) in patients with head and neck cancers (HNCs). Material and Methods In total, 345 patients with HNCs were interviewed. A self-report questionnaire was administered to collect data about demographic characteristics, health status, smoking, alcohol consumption habits, and HRQoL. It were used the EORTC Instruments - Quality of Life Questionnaire-Core 30-questions (QLQ-C30), Quality of Life Questionnaire - Head and Neck Module 35-questions (QLQ-H&N 35) and OHIP-14 instrument for HRQoL assessments. Clinical information and treatment data were collected from medical records. Results Five groups of HRQoL predictors were identified: demographic, socioeconomic, behavioral, psychophysical, and clinical/treatment. These HRQoL predictors had a strong (i.e., age, level of social support and social contact, level of education, depression, fatigue, presence of gastrostomy, comorbidities, and use of pain medications and supplements), a moderate (i.e., marital status, smoking, sexuality problems, time since diagnosis, presence of tracheostomy, and side effects outcomes of radio and chemotherapy) and a small impact (i.e., employment/financial difficulties, tumor site and stage, and surgical procedure). Conclusions Study identified nineteen predictors that had significant, moderate and small impact on the HRQoL of patients with HNCs. Some of the predictors, like levels of social support and social contact, depression, and comorbidities could be targets for innervations to improve HRQoL. Key words:Quality of Life, oral health, combined modality therapy, treatment outcome.
本研究的目的是确定头颈癌(HNCs)患者与健康相关的生活质量(HRQoL)的预测因素。材料与方法对345例HNCs患者进行访谈。采用自我报告问卷收集有关人口统计学特征、健康状况、吸烟、饮酒习惯和HRQoL的数据。采用EORTC仪器-生活质量问卷-核心30题(QLQ-C30)、生活质量问卷-头颈模块35题(QLQ-H&N 35)和OHIP-14量表进行HRQoL评估。临床信息和治疗数据从医疗记录中收集。结果确定了5组HRQoL预测因子:人口学、社会经济、行为、心理物理和临床/治疗。这些HRQoL预测因子具有强影响(如年龄、社会支持和社会接触水平、教育水平、抑郁、疲劳、是否有胃造口术、合并症、是否使用止痛药和补充剂)、中等影响(如婚姻状况、吸烟、性问题、诊断后的时间、是否有气管造口术、放疗和化疗的副作用结果)和小影响(如就业/经济困难、肿瘤部位和分期、手术方式)。研究确定了19个对HNCs患者HRQoL有显著、中等和小影响的预测因子。一些预测因素,如社会支持和社会接触水平、抑郁和合并症,可能是神经干预改善HRQoL的目标。关键词:生活质量;口腔健康;综合治疗;
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引用次数: 2
Clinical manifestations of head and neck cancer in pediatric patients, an analysis of 253 cases in a single Brazilian center 儿科患者头颈癌的临床表现:巴西单一中心253例病例分析
Pub Date : 2022-04-03 DOI: 10.4317/medoral.25255
L. P. A. Arboleda, Maria Eduarda Pérez-de-Oliveira, I. Hoffmann, I. Cardinalli, K. Gallagher, A. Santos-Silva, Regina Maria Holanda de Mendonça
Background Pediatric head and neck cancer (PHNC) is rare and its nonspecific clinical manifestations may often lead to delayed diagnosis. We aimed to describe the signs, symptoms, and clinicopathological characteristics of PHNC. Material and Methods Medical records were retrospectively reviewed for all PHNC cases diagnosed from 1986 to 2016 affecting patients aged 19-years and younger from a tertiary referral center in Brazil. Demographic variables, anatomical site of primary tumors, histopathological diagnoses, signs and symptoms, and patterns of misdiagnosis were collected and interpreted by statistical and descriptive analysis. Results A total of 253 PHNC cases were included. The mean age was 9.3 years and male patients were more frequently affected (60.9%). Burkitt lymphoma (23.7%), nasopharyngeal carcinoma (15.8%), and rhabdomyosarcoma (15.4%) were the most common cancer types. The nasopharynx (28.9%), cervical/lymph node region (25.3%), and craniofacial bones (8.3%) were the predominant anatomical sites. Tumor/swelling (68.4%), was the clinical finding often presented. The univariable analysis showed association between tumor histology and clinical variables such as sex (p=0.022), age (p<0.0001), anatomical location (p<0.0001) tumor/swelling (p=0.034), pain (p=0.031), systemic/general manifestations (p=0.004), nasal/breathing alterations (p=0.012), orbital/ocular alterations (p<0.0001). Misdiagnosis such as tonsillitis, otitis, and abscess were frequent. Conclusions Although the clinical findings of PHNC are often unspecific, this study provided signs and symptoms with significant correlations between tumor histology. The suspicion of malignancy should be considered when the main signs and symptoms reported here appear and persist, in order to conduct a timely diagnosis. Key words:Head and neck, cancer, children, adolescent, signs, symptoms.
背景:小儿头颈癌(PHNC)是一种罕见的疾病,其非特异性临床表现往往导致诊断延误。我们旨在描述PHNC的体征、症状和临床病理特征。材料和方法回顾性分析1986年至2016年巴西一家三级转诊中心诊断的所有年龄在19岁及以下的PHNC病例的医疗记录。收集人口统计学变量、原发肿瘤解剖部位、组织病理学诊断、体征和症状以及误诊模式,并通过统计和描述性分析进行解释。结果共纳入PHNC 253例。平均年龄9.3岁,男性发病较多(60.9%)。伯基特淋巴瘤(23.7%)、鼻咽癌(15.8%)和横纹肌肉瘤(15.4%)是最常见的癌症类型。鼻咽部(28.9%)、颈部/淋巴结区(25.3%)和颅面骨(8.3%)是主要解剖部位。肿瘤/肿胀(68.4%)是常见的临床表现。单变量分析显示,肿瘤组织学与性别(p=0.022)、年龄(p<0.0001)、解剖位置(p<0.0001)、肿瘤/肿胀(p=0.034)、疼痛(p=0.031)、全身/全身表现(p=0.004)、鼻腔/呼吸改变(p=0.012)、眼眶/眼部改变(p<0.0001)等临床变量相关。扁桃体炎、中耳炎、脓肿等误诊较多。结论:虽然PHNC的临床表现往往不具有特异性,但本研究提供了与肿瘤组织学有显著相关性的体征和症状。当本文报道的主要体征和症状出现并持续时,应考虑是否为恶性肿瘤,以便及时诊断。关键词:头颈部,癌症,儿童,青少年,体征,症状
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引用次数: 0
Oral conditions and salivary analysis in HIV-uninfected subjects using preexposure prophylaxis 使用暴露前预防的hiv未感染者的口腔状况和唾液分析
Pub Date : 2022-04-03 DOI: 10.4317/medoral.25140
N. Macedo, G. Baggio, I. Henn, J. Santos, T. Batista, S. Ignácio, P. Souza, L. Azevedo-Alanis
Background New prevention strategies have been advocated to control the progression of HIV/AIDS, such as preexposure prophylaxis (PrEP). The aim of this study is to evaluate the potential changes in the oral and salivary conditions of HIV-uninfected subjects using PrEP. Material and Methods Subjects were evaluated before beginning the medication (T0), at the first follow-up (T1), and at the second follow-up (T2). Xerostomia, presence of untreated cavitated caries, oral hygiene habits, taste, gingival and plaque index, stimulated salivary flow rate (SSFR), and salivary concentrations of calcium, glucose, urea, and total proteins were evaluated. Data obtained were analyzed using statistical tests (p<0.05). Results Forty-seven participants (41 men; 6 women) were evaluated at T0. Thirty (28 men; 2 women) and 17 men were reassessed at T1 and T2, respectively. There was no difference between the SSFR and oral and salivary conditions between T0, T1, and T2 (p>0.05), except for the salivary calcium concentration, that increased at T2 compared to T1 (p=0.02). There was significant difference between taste and xerostomia at T1 (p=0.017), and the need to drink to swallow at T2 (p=0.015). There was significant correlation between the reported amount of saliva and taste (p=0.039, r=-0.378) at T1. Conclusions The prolonged use of PrEP seems to be associated with reports of dry mouth and worsening of taste, possibly associated with increased salivary calcium concentration. Key words:Antiretroviral agents, pre-exposure prophylaxis, saliva, oral health.
背景暴露前预防(PrEP)等新的预防策略已被提倡以控制HIV/AIDS的进展。本研究的目的是评估使用PrEP对未感染hiv的受试者口腔和唾液状况的潜在变化。材料和方法在开始用药前(T0)、第一次随访(T1)和第二次随访(T2)对受试者进行评估。评估口腔干燥、是否存在未经治疗的空腔性龋齿、口腔卫生习惯、味觉、牙龈和菌斑指数、刺激唾液流速(SSFR)、唾液钙、葡萄糖、尿素和总蛋白浓度。对所得数据进行统计学分析(p0.05),除T2时唾液钙浓度较T1升高外(p=0.02)。T1时味觉和口干的差异有统计学意义(p=0.017), T2时需要喝水吞咽的差异有统计学意义(p=0.015)。在T1时,报告的唾液量与味觉之间存在显著相关(p=0.039, r=-0.378)。结论长期使用PrEP可能与口干和味觉恶化的报告有关,可能与唾液钙浓度升高有关。关键词:抗逆转录病毒药物;暴露前预防;唾液;
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引用次数: 2
Reliability of the pre-operative imaging to assess neck nodal involvement in oral cancer patients, a single-center study 术前影像学评估口腔癌患者颈部淋巴结受累的可靠性,一项单中心研究
Pub Date : 2022-02-20 DOI: 10.4317/medoral.25228
Antti L Pakkanen, E. Marttila, S. Apajalahti, J. Snäll, T. Wilkman
Background Primary sites for the metastasis of oral cancer are the cervical lymph nodes. Although there has been considerable technical advancement in the radiological imaging, capability to recognize all metastatic lymph nodes pre-operatively has remained as a challenge. Thus elective neck dissection (END) has remained as reliable practice to treat cervical lymph nodes. This study evaluated the accuracy of pre-operative imaging in pre-operative diagnostics of cervical lymph node status using computed tomography or magnetic resonance imaging in patients with oral squamous cell carcinoma (OSCC). We have also considered the reasons for the difficulties to recognise metastatic nodes in cervical area. Material and Methods Patient charts of patients who had had elective neck dissection as a treatment for primary OSCC in the Department of Oral and Maxillofacial Surgery, Helsinki University Hospital between 2016 and 2017 were assessed retrospectively. The outcome variable was post-operatively histologically confirmed lymph node metastasis in the neck area. The primary predictor variable was radiologically confirmed metastasis in the neck area. The explanatory variables were age, sex, pT-class, imaging modality, delay and location of the tumour. Descriptive statistics, sensitivity, specificity and Youden-J index were computed. Results Eighty-three patients were included in the study. The sensitivity to detect pathological lymph nodes was 44.8%, and the specificity for the examination was 87.0%. 19.3% of cN0 patients had metastasis in the cervical nodes, whereas of the cN+ patients 8.4% were actually pN0. Patients having cN0, the largest neck metastasis was over 10 mm in 12.5%, whereas cN1-3 patients the corresponding rate was 45.5%. The computational threshold to diagnose a metastatic node was 7 mm. Conclusions Especially small metastases are difficult to diagnose. Limitations of radiological diagnostics must be considered when treating OSCC. Key words:Oral cancer, Metastasis, CT, MRI, Neck dissection.
口腔癌转移的原发部位是颈部淋巴结。尽管放射成像技术已经取得了相当大的进步,但术前识别所有转移性淋巴结的能力仍然是一个挑战。因此,选择性颈部清扫术(END)仍然是治疗颈部淋巴结的可靠方法。本研究评估术前影像学在口腔鳞状细胞癌(OSCC)患者术前使用计算机断层扫描或磁共振成像诊断颈部淋巴结状态的准确性。我们也考虑了难以识别宫颈转移淋巴结的原因。材料与方法回顾性分析2016 - 2017年赫尔辛基大学医院口腔颌面外科择期颈部清扫术治疗原发性OSCC的患者资料。结果变量为术后组织学证实的颈部淋巴结转移。主要预测变量是放射学证实的颈部转移。解释变量为年龄、性别、ct分级、成像方式、肿瘤的延迟和位置。计算描述性统计、敏感性、特异性和Youden-J指数。结果83例患者纳入研究。检查病理淋巴结的敏感性为44.8%,特异性为87.0%。cN0患者中有19.3%发生宫颈淋巴结转移,而cN+患者中有8.4%发生pN0。cN0患者中,最大颈部转移超过10 mm的占12.5%,而cN1-3患者的相应比例为45.5%。诊断转移淋巴结的计算阈值为7mm。结论尤其是小转移灶难以诊断。在治疗OSCC时必须考虑放射诊断的局限性。关键词:口腔癌,转移,CT, MRI,颈部清扫。
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引用次数: 2
Investigation of the prevalence of impacted third molars and the effects of eruption level and angulation on caries development by panoramic radiographs 全景x线片调查第三磨牙阻生率及出牙水平和出牙角度对龋发育的影响
Pub Date : 2022-02-20 DOI: 10.4317/medoral.25013
Handan Yıldırım, Mediha Büyükgöze-Dindar
Background This study is aimed to determine the prevalence of impacted third molars and to investigate the effects of their eruption level and angulation on caries formation in the distal of the adjacent tooth. Material and Methods This cross-sectional study was conducted on panoramic radiographs of 38481 patients who were admitted to the Trakya University, Faculty of Dentistry. The panoramic radiographs of 7998 patients with at least one impacted third molar were included. Third molars were classified according to Winter’s classification and Pell and Gregory’s classification. The frequency of caries in partially impacted third molars and adjacent second molars was determined. The chi-square tests were used to determine potential associations between the third molars' level of eruption, angulation, and caries development. Results The study group consisted of 4423 females (55.3%) and 3575 males (44.7%) with a mean age of 36.3±13.4 years. The prevalence of the third molar impaction rate was 23%. The impaction pattern of partially erupted third molars was characterized by an eruption level of A with the vertical position in both jaws. Partially erupted and vertically placed maxillary third molars in the level of position A caused more caries in the adjacent tooth and mesioangularly located partially erupted mandibular third molars were associated with more caries in the adjacent tooth. Conclusions The angulation and eruption level of partially erupted third molars should be carefully examined. The prophylactic extraction of vertically and mesioangularly located third molars, especially with an eruption level of position A can be suggested to eliminate the related complications and risk of caries. Key words:Dental caries, digital radiography, impacted tooth, panoramic radiography, third molar.
本研究旨在了解第三磨牙阻生的发生率,并探讨其出牙水平和出牙角度对邻牙远端龋形成的影响。材料与方法本研究对Trakya大学牙科学院收治的38481例患者的全景x线片进行了横断面研究。包括7998例至少有一颗阻生第三磨牙的患者的全景x线片。第三磨牙按Winter的分类和Pell和Gregory的分类进行分类。测定部分阻生的第三磨牙和相邻的第二磨牙的龋率。卡方检验用于确定第三磨牙的出牙水平、成角和龋齿发展之间的潜在关联。结果研究组女性4423人(55.3%),男性3575人(44.7%),平均年龄(36.3±13.4)岁。第三磨牙嵌塞率为23%。部分萌出的第三磨牙嵌塞模式的特点是萌出水平为A,双颌垂直位置。在A位水平部分萌出且垂直放置的上颌第三磨牙对邻牙的龋病发生率较高,而在中角位置部分萌出的下颌第三磨牙对邻牙的龋病发生率较高。结论对部分萌出的第三磨牙,应仔细检查其成角和萌出程度。建议预防性拔除垂直和中角位置的第三磨牙,特别是A位置的第三磨牙,以消除相关并发症和龋齿的风险。关键词:龋齿,数字摄影,阻生牙,全景摄影,第三磨牙。
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引用次数: 3
Prognostic importance of DNA from human papillomavirus in patients with oral squamous cell carcinoma 人乳头瘤病毒DNA对口腔鳞状细胞癌患者预后的重要性
Pub Date : 2022-02-20 DOI: 10.4317/medoral.25092
Elizabeth Pérez-Islas, A. García-Carrancá, E. Acosta-Gío, N. Reynoso-Noverón, H. Maldonado-Martínez, M. Guido-Jiménez, N. Sobrevilla-Moreno, M. Granados-García, Wendy Pérez-Báez, D. Vilar-Compte
Background Survival of patients with oral squamous cell carcinoma (OSCC) is generally low, with the likelihood of locoregional recurrence or disease progression (LR/DP). Knowledge of prognostic factors for survival is key to achieving an understanding and increased survival. The present study aimed to identify prognostic factors for patients with OSCC, especially the presence of DNA from human papillomavirus (HPV). Material and Methods Retrospective cohort study including 119 patients with OSCC treated at the National Cancer Institute in Mexico City (2009-2013). Clinical information was obtained from patient records including LR/DP. Formalin-fixed, paraffin-embedded tissues were obtained and used for detecting DNA from different types of HPV. Potential prognostic factors for Overall Survival (OS) were analyzed using the Cox proportional hazards model. Results After model adjustment, factors associated with longer OS were a pre-treatment platelet count above 400,000/mm3 (HR=0.09, p=0.026) and response to primary treatment (HR=0.26, p=0.001). HPV DNA was present in 23 (19.3%) of the patients and importantly, type 16 found in 19 of them. Although survival of HPV-positive patients was longer, difference was not significant. However, among patients with LR/DP, HPV positivity was significantly associated with increased survival (HR=0.23, p=0.034). Importantly, survival was significantly different for HPV-positive patients with LR/DP > 6 months (HR=0.20, p=0.002), had higher absolute lymphocyte count at start of treatment (HR=0.50, p=0.028) or had local rescue treatment (HR=0.24, p=0.019). Conclusions Although HPV positivity was not associated with a longer OS of OSCC patients, a better prognosis was significantly associated with HPV positivity and recurring or progressing disease, particularly with HPV type 16. Key words:HPV, human papillomavirus, HPV-16, oral squamous cell carcinoma, oral cancer, survival, locoregional recurrence, disease progression.
口腔鳞状细胞癌(OSCC)患者的生存率普遍较低,伴有局部复发或疾病进展(LR/DP)的可能性。了解影响生存的预后因素是了解和提高生存率的关键。本研究旨在确定OSCC患者的预后因素,特别是人乳头瘤病毒(HPV) DNA的存在。材料与方法回顾性队列研究,包括2009-2013年在墨西哥城国家癌症研究所治疗的119例OSCC患者。临床信息来自患者记录,包括LR/DP。获得福尔马林固定、石蜡包埋的组织,用于检测不同类型HPV的DNA。使用Cox比例风险模型分析总生存期(OS)的潜在预后因素。结果经模型调整后,与延长生存期相关的因素是治疗前血小板计数高于400,000/mm3 (HR=0.09, p=0.026)和对初级治疗的反应(HR=0.26, p=0.001)。23例(19.3%)患者存在HPV DNA,重要的是,其中19例发现16型。虽然hpv阳性患者的生存时间更长,但差异不显著。然而,在LR/DP患者中,HPV阳性与生存率增加显著相关(HR=0.23, p=0.034)。重要的是,hpv阳性的LR/DP患者6个月生存率有显著差异(HR=0.20, p=0.002),治疗开始时淋巴细胞绝对计数较高(HR=0.50, p=0.028)或局部抢救治疗(HR=0.24, p=0.019)。结论:尽管HPV阳性与OSCC患者较长的生存期无关,但较好的预后与HPV阳性和复发或进展性疾病显著相关,特别是与HPV 16型相关。关键词:HPV,人乳头瘤病毒,HPV-16,口腔鳞状细胞癌,口腔癌,生存,局部复发,疾病进展
{"title":"Prognostic importance of DNA from human papillomavirus in patients with oral squamous cell carcinoma","authors":"Elizabeth Pérez-Islas, A. García-Carrancá, E. Acosta-Gío, N. Reynoso-Noverón, H. Maldonado-Martínez, M. Guido-Jiménez, N. Sobrevilla-Moreno, M. Granados-García, Wendy Pérez-Báez, D. Vilar-Compte","doi":"10.4317/medoral.25092","DOIUrl":"https://doi.org/10.4317/medoral.25092","url":null,"abstract":"Background Survival of patients with oral squamous cell carcinoma (OSCC) is generally low, with the likelihood of locoregional recurrence or disease progression (LR/DP). Knowledge of prognostic factors for survival is key to achieving an understanding and increased survival. The present study aimed to identify prognostic factors for patients with OSCC, especially the presence of DNA from human papillomavirus (HPV). Material and Methods Retrospective cohort study including 119 patients with OSCC treated at the National Cancer Institute in Mexico City (2009-2013). Clinical information was obtained from patient records including LR/DP. Formalin-fixed, paraffin-embedded tissues were obtained and used for detecting DNA from different types of HPV. Potential prognostic factors for Overall Survival (OS) were analyzed using the Cox proportional hazards model. Results After model adjustment, factors associated with longer OS were a pre-treatment platelet count above 400,000/mm3 (HR=0.09, p=0.026) and response to primary treatment (HR=0.26, p=0.001). HPV DNA was present in 23 (19.3%) of the patients and importantly, type 16 found in 19 of them. Although survival of HPV-positive patients was longer, difference was not significant. However, among patients with LR/DP, HPV positivity was significantly associated with increased survival (HR=0.23, p=0.034). Importantly, survival was significantly different for HPV-positive patients with LR/DP > 6 months (HR=0.20, p=0.002), had higher absolute lymphocyte count at start of treatment (HR=0.50, p=0.028) or had local rescue treatment (HR=0.24, p=0.019). Conclusions Although HPV positivity was not associated with a longer OS of OSCC patients, a better prognosis was significantly associated with HPV positivity and recurring or progressing disease, particularly with HPV type 16. Key words:HPV, human papillomavirus, HPV-16, oral squamous cell carcinoma, oral cancer, survival, locoregional recurrence, disease progression.","PeriodicalId":18367,"journal":{"name":"Medicina Oral, Patología Oral y Cirugía Bucal","volume":"1 1","pages":"e150 - e158"},"PeriodicalIF":0.0,"publicationDate":"2022-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83708752","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}
引用次数: 1
Can cystic lesions of the jaws be considered as the cause of mandibular asymmetry? 颌骨囊性病变可以被认为是下颌不对称的原因吗?
Pub Date : 2022-02-20 DOI: 10.4317/medoral.25134
Mevlude Polat, O. Odabaşı
Background The aim of this study is to investigate the presence of condylar and ramal asymmetry in patients with a cyst larger than 10 mm in the maxilla or mandible. Material and Methods Condylar and ramal asymmetry index measurements of 47 patients (mean age: 28.85 ± 15.348) in the study group and 40 patients in the control group (mean age: 33.73 ± 13.095) were performed using panoramic radiographs. The study group consists of patients with cysts larger than 10 mm in diameter in the maxilla or mandible. The control group consisted of patients with no radiolucent lesions and no history of trauma. The possible statistical difference between the groups was evaluated by the Mann-Whitney U test. Results No statistically significant difference was observed in asymmetry indices according to gender and the jaw (maxilla or mandible) in which the cyst was located. However, it was determined that CAI and RAI values were statistically significantly different between the study and control groups (p = 0.047 and p = 0.016, respectively). Conclusions The presence of intraosseous cysts larger than 10 mm in the jaws was found to be associated with condylar and ramal asymmetry. Key words:Condylar asymmetry, ramal asymmetry, odontogenic cysts
背景:本研究的目的是探讨上颌或下颌骨囊肿大于10mm的患者是否存在髁突和下颌不对称。材料与方法对研究组47例患者(平均年龄28.85±15.348岁)和对照组40例患者(平均年龄33.73±13.095岁)进行髁突和髁突不对称指数的测量。研究组由上颌骨或下颌骨囊肿直径大于10mm的患者组成。对照组为无放射性病变、无外伤史的患者。通过Mann-Whitney U检验评估两组之间可能的统计学差异。结果不同性别、不同颌骨(上颌骨和下颌骨)的不对称指数差异无统计学意义。但经测定,实验组与对照组CAI、RAI值差异有统计学意义(p = 0.047、p = 0.016)。结论颌骨骨内囊肿大于10mm,与髁突和颧突不对称有关。关键词:髁突不对称,牙髓不对称,牙源性囊肿
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引用次数: 0
Intraoral onlay block bone grafts versus cortical tenting technique on alveolar ridge augmentations: a systematic review 牙槽嵴增强的口腔内嵌块骨移植物与皮质帐篷技术:系统回顾
Pub Date : 2022-02-20 DOI: 10.4317/medoral.25169
Amparo Aloy-Prósper, E. Carramolino-Cuéllar, D. Peñarrocha-Oltra, David Soto-Peñaloza, M. Peñarrocha-Diago
Background To review systematically the bone gain and superficial resorption rate of the onlay block bone grafts versus the cortical tenting technique, as well as secondarily study the postoperative complications, implant survival and success rates, and peri-implant marginal bone loss. Material and Methods Following the recommended methods for systematic reviews and meta-analyses (PRISMA), an electronic search was performed in the PubMed (MEDLINE), EMBASE and the Cochrane Library of the Cochrane Collaboration (CENTRAL) databases to identify all relevant articles published up to March 2021 on onlay block bone grafts and cortical tenting technique. Results Eighteen papers complied with the inclusion criteria. In onlay grafts, the vertical bone gain mean was 4.24 mm, and resorption 20.91%; and 4.29 mm in the horizontal augmentation with a resorption of 10.28%. The complication rate was 14.8%. The implant survival and success rates were 100% and 92%; and the mean peri-implant bone loss ranged from 0.6 to 1.26 mm. In cortical tenting technique, the vertical bone gain mean was 6.17 mm and the resorption of 9.99%; and 5.55 mm in the horizontal augmentation with a 6.12% of resorption. The complication rate was 24.6%. The implant survival and success rates were 96.63% and 100%; and the mean peri-implant bone loss ranged from 0.27 to 0.77mm. Conclusions Despite the limitations, both techniques offer a predicTable way to reconstruct atrophic alveolar ridges, though the cortical tenting technique seems to achieve a greater bone gain and a lower surface resorption. Current evidence is still limited due to the inadequate follow-up, lack of information referred to methodological quality and sample attrition. Key words:Onlay graft, cortical graft, intraoral bone, augmentation procedure.
研究背景:系统回顾与皮质支架技术相比,嵌体块骨移植的骨增重和表面吸收率,并对其术后并发症、种植体存活率和成功率以及种植体周围边缘骨丢失进行二次研究。材料和方法按照推荐的系统评价和荟萃分析方法(PRISMA),在PubMed (MEDLINE)、EMBASE和Cochrane Collaboration (CENTRAL)数据库的Cochrane Library中进行电子检索,以确定截至2021年3月发表的所有有关嵌体块骨移植物和皮质帐篷技术的相关文章。结果18篇论文符合纳入标准。种植体垂直骨长高平均为4.24 mm,骨吸收率为20.91%;水平增加4.29 mm,吸收率为10.28%。并发症发生率为14.8%。种植体成活率和成功率分别为100%和92%;种植体周围骨损失平均为0.6 ~ 1.26 mm。皮质支棚法垂直骨增重平均为6.17 mm,骨吸收率为9.99%;水平增大5.55 mm,吸收率为6.12%。并发症发生率为24.6%。种植体成活率和成功率分别为96.63%和100%;种植体周围骨损失平均为0.27 ~ 0.77mm。结论:尽管存在局限性,这两种技术都提供了一种可预测的方法来重建萎缩的牙槽嵴,尽管皮质帐篷技术似乎可以获得更大的骨增重和更低的表面吸收。目前的证据仍然有限,由于不充分的随访,缺乏信息提到的方法质量和样本损耗。关键词:移植体;骨皮质;口腔内骨;
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引用次数: 6
Hypovitaminosis D, oral potentially malignant disorders, and oral squamous cell carcinoma: a systematic review 维生素D缺乏症,口腔潜在恶性疾病和口腔鳞状细胞癌:系统综述
Pub Date : 2022-02-20 DOI: 10.4317/medoral.25049
A. Maturana-Ramírez, J. Aitken-Saavedra, Arantxa Ladrón de Guevara-Benítez, I. Espinoza-Santander
Background Oral squamous cell carcinoma (OSCC) and potentially malignant oral disorders (OPMDs) could be associated with low levels of vitamin D. This systematic review aimed to determine the relationship between serum levels of vitamin D with OPMDs and OSCC. Material and Methods This review was conducted according to Cochrane guidelines (PROSPERO CRD42020207382) on literature retrieved from the PubMed, Cochrane, and Web of Science databases. The antecedents extracted were study design, methodology, sample (country, number of patients, age, and sex), oral manifestations (type of lesion, location, prevalence, and follow-up), serum vitamin D levels or use of vitamin D supplements, results, and conclusions. Results Twelve articles were selected. Some of the most relevant findings were alterations in vitamin D could favor the progress of OPMDs to OSCC. Higher levels of vitamin D can increase levels of anti-inflammatory mediators, CD4+ T lymphocytes and CD8+ T lymphocytes and CD3+ T lymphocytes in intratumoral tissue. The normalization of vitamin D levels in patients with OSCC can increased cytotoxic activity of natural killer cells, favoring antitumor immune response. Vitamin D supplemented can lower adverse effects associated with chemotherapy like mucositis and pain. Tobacco can increase risk of developing OSCC altering vitamin D levels. Conclusions Hypovitaminosis D could increase risk of developing OSCC from OPMDs, thus altering the immune response and it is associated with a lower survival rate in patients with OSCC, a greater recurrence of tumors in patients who underwent surgical treatment, and an increase in adverse reactions to chemotherapy. The use of vitamin D supplements can be a complement to primary therapy to prevent the recurrence of lesions and reduce adverse events associated with treatment. Key words:Oral squamous cell carcinoma (OSCC), Oral potentially malignant disorders (OPMDs), Vitamin D, Oral cancer.
口腔鳞状细胞癌(OSCC)和潜在恶性口腔疾病(OPMDs)可能与低水平维生素D有关。本系统综述旨在确定血清维生素D水平与OPMDs和OSCC之间的关系。材料和方法根据Cochrane指南(PROSPERO CRD42020207382)对PubMed、Cochrane和Web of Science数据库检索的文献进行综述。提取的前因包括研究设计、方法、样本(国家、患者数量、年龄和性别)、口腔表现(病变类型、位置、患病率和随访)、血清维生素D水平或维生素D补充剂的使用、结果和结论。结果共选择12篇文章。一些最相关的发现是维生素D的改变可能有利于opmd向OSCC的进展。较高水平的维生素D可增加肿瘤内组织中抗炎介质、CD4+ T淋巴细胞、CD8+ T淋巴细胞和CD3+ T淋巴细胞的水平。在OSCC患者中,维生素D水平的正常化可以增加自然杀伤细胞的细胞毒活性,有利于抗肿瘤免疫反应。补充维生素D可以降低与化疗相关的副作用,如粘膜炎和疼痛。烟草会增加患OSCC的风险,改变维生素D水平。结论维生素D缺乏可增加opmd患者发生OSCC的风险,从而改变免疫反应,与OSCC患者生存率降低、手术治疗患者肿瘤复发率增加、化疗不良反应增加有关。使用维生素D补充剂可以作为初级治疗的补充,以防止病变复发并减少与治疗相关的不良事件。关键词:口腔鳞状细胞癌,口腔潜在恶性疾病,维生素D,口腔癌
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引用次数: 4
Effects of a local single dose administration of growth hormone on the osseointegration of titanium implants 局部单剂量生长激素对钛种植体骨整合的影响
Pub Date : 2022-02-20 DOI: 10.4317/medoral.25164
J. Grossi, Marcelo Parra, E. B. Benalcázar-Jalkh, A. Giovanini, J. Zielak, Aline Monise Sebstiani, C. Gonzaga, P. Coelho, L. Witek, T. Deliberador
Background The aim of the present study was to evaluate the effect of different concentrations of growth hormone (GH) on endosteal implant’s surface at the early stages of osseointegration. Material and Methods Sixty tapered acid-etched titanium implants were divided into four groups: i) Collagen, used as a control group; and three experimental groups, where after collagen coating, GH was administered directly to the surface in varying concentrations: ii) 0.265 mg, iii) 0.53 mg, and iv) 1 mg. Implants were placed in an interpolated fashion in the anterior flange of C3, C4 or C5 of 15 sheep with minimum distance of 6 mm between implants. After 3-, 6- and 12-weeks of healing samples were harvested, histologically processed, qualitatively and quantitatively assessed for bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). Results Statistical analysis as a function of time in vivo and coating resulted in no significant differences for BIC and BAFO at any evaluation time point. Histological evaluation demonstrated similar osseointegration features for all groups with woven bone formation at 3 weeks and progressive replacement of woven for lamellar bone in close contact with the implant surface and within the implant’s threads. Conclusions A single local application of growth hormone to the surface of titanium implants did not yield improved implant osseointegration independent of healing time. Key words:Growth hormone, osseointegration, low density bones, metallic implants, sheep, bone-to-implant contact.
本研究的目的是评估不同浓度生长激素(GH)对骨融合早期种植体表面的影响。材料与方法将60个锥形酸蚀钛植入物分为4组:ⅰ)胶原蛋白组,作为对照组;和三个实验组,胶原包被后,GH直接以不同浓度给药于表面:ii) 0.265 mg, iii) 0.53 mg, iv) 1 mg。种植体以内插的方式放置在15只羊的C3, C4或C5的前法兰中,种植体之间的距离最小为6mm。愈合3周、6周和12周后采集标本,进行组织学处理,定性和定量评估骨与种植体接触(BIC)和骨面积分数占用(BAFO)。结果BIC和BAFO在任何评估时间点随体内时间和包衣时间的变化均无显著性差异。组织学评估显示,所有组在3周时编织骨形成,并在与种植体表面和种植体螺纹紧密接触的板层骨中逐步更换编织骨,均具有相似的骨整合特征。结论单纯在钛种植体表面局部应用生长激素不能改善种植体的骨整合,与愈合时间无关。关键词:生长激素,骨整合,低密度骨,金属种植体,羊,骨与种植体接触。
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引用次数: 1
期刊
Medicina Oral, Patología Oral y Cirugía Bucal
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