Oral diseases最新文献

Introduction: Oral mucosal melanoma (OMM) is a rare subtype of melanoma but exhibits highly invasive biological behavior. Programmed cell death protein 1 (PD-1) monotherapy showed lower response in OMM than other subtypes of melanoma.

Materials and methods: We retrospectively analyzed the efficacy and safety of pembrolizumab with anlotinib in patients with advanced OMM between August 2018 and September 2024. The primary endpoint was objective response rate (ORR); the secondary endpoints included disease control rate (DCR), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (TRAEs).

Results: Forty-one patients were enrolled in our study. Seventeen patients (41.4%) achieved an objective response. The median PFS was 6.4 months (95% confidence interval [CI], 4.5-8.3 months), and the median OS was 10.0 months (95% CI, 8.3-11.7 months). Thirty-three patients (80.5%) experienced at least one TRAE. The most common TRAEs were hypertension (29.3%), hand-foot syndrome (19.5%), and anemia (19.5%). Grade 3 or higher TRAEs occurred in two patients (4.8%), and no grade 5 TRAEs were observed.

Conclusions: Our study suggested that pembrolizumab with anlotinib in patients with advanced OMM showed potential efficacy and manageable adverse effects. Further studies are needed to confirm the efficacy of this combination strategy.

Objectives: Hyposalivation is a common condition, particularly among older adults, often resulting from polypharmacy or age-related salivary gland degeneration. While sialometry is the reference method for diagnosing hyposalivation, it is challenging to use in dependent patients or those with cognitive impairments. This study aimed to test a new tool, FishburneTabs (FBTs), by comparing it with sialometry and evaluating its concordance with the Clinical Oral Dryness Score (CODS).

Materials and methods: This study compared three different techniques for assessing hyposalivation in 59 patients (care home residents): CODS evaluation, saliva collection using FBTs, and stimulated salivary flow sialometry.

Results: Positive correlations were identified between FBTs and salivary flow measurements (r = 0.68, p < 0.05), and negative correlations between CODS and both FBTs (r = -0.51, p < 0.05) and salivary flow (r = -0.62, p < 0.05). The sensitivity and specificity of FBTs for identifying hyposalivation were 62.2% and 61.9%, respectively, with a positive predictive value of 74.2% and a negative predictive value of 48.1%.

Conclusion: FBTs show promise as a supportive tool for assessing hyposalivation in settings where sialometry is not feasible, although they are not a direct substitute for sialometry as the reference method.

Objective: This study examined associations between psychological factors, serum zinc/iron levels, and clinical features of factitious oral ulcers in children (3-16 years).

Methods: A cross-sectional analysis of 69 patients (78.3% male) from two Chinese hospitals assessed ulcer characteristics, pain (VAS), micronutrient levels, and psychological scores (SCARED, DSRSC, CPRS, SDQ). Statistical analysis used nonparametric tests and correlation analysis (SPSS 26.0).

Results: Zinc deficiency (37.7%) correlated with longer disease duration (12.0 vs. 6.0 months, p = 0.035) and shorter ulcer-free intervals (60.0 vs. 95.2 days, p = 0.040). Zinc levels inversely linked to emotional symptoms (r = -0.416, p = 0.022) but positively to prosocial behavior (r = 0.526, p = 0.003). Pain intensity associated with anxiety (VAS: 4.0 vs. 3.0, p = 0.025) and psychosocial distress (r = 0.461, p = 0.010). Older children (8-16 years) had longer disease duration (12.0 vs. 3.6 months, p < 0.001) and higher zinc deficiency (47.5% vs. 24.1%, p = 0.048). Iron showed paradoxical associations with emotional symptoms (r = 0.452, p = 0.012) and prosocial behavior (r = -0.382, p = 0.037).

Conclusion: Zinc deficiency and psychological factors critically influence the chronicity of FOU. Multidisciplinary care combining micronutrient supplementation and behavioral interventions is recommended.

Objective: Treatment methods of laryngeal cancer (LC) often include radiotherapy (RT), commonly combined with cytotoxic drugs. This approach is associated with early adverse effects, notably oral mucositis (OM). The C-reactive protein to albumin ratio (CAR) is a promising novel biomarker used to assess the severity of inflammatory responses in various chronic conditions. The aim of this study was to evaluate the predictive value of pretreatment CAR for the occurrence and severity of OM of varying grades during RT in patients with LC.

Methods: The pretreatment CAR values were calculated in 68 patients treated with RT due to locally advanced or advanced LC.

Results: The increased incidence of severe grade OM in LC patients between weeks III and VII of RT was significantly associated with higher CAR values. A high CAR was significantly correlated with an increased risk of grade 3 OM at the end of the III^rd (p = 0.026), IV^th (p = 0.018), V^th (p = 0.027), VI^th (p = 0.018), and VII^th (p = 0.004) week of RT. Multivariable analysis demonstrates a higher probability of developing severe OM in LC patients with an elevated median CAR following III^rd (p = 0.025), IV^th (p = 0.025), V^th (p = 0.025), VI^th (p = 0.020), and VII^th (p = 0.035) cycle of irradiation. Furthermore, CAR values allowed reliable differentiation of patients who developed grade 3 OM between the III^rd-VII^th weeks of treatment (p < 0.001).

Conclusions: The pretreatment CAR value indicates clinical utility in predicting the likelihood of severe OM induced by RT-based therapy in patients with LC.

Background: The atrophic-erosive forms of oral lichen planus (OLP) remain a major concern as these lesions can cause a wide range of symptoms leading to reduced quality of life. Nowadays, newer possibilities are offered by micro-needles as an effective transmucosal drug delivery. The aim of this single-blinded randomized clinical trial was to determine the therapeutic efficacy of micro-needling (MN) as a novel technique for transmucosal delivery of triamcinolone acetonide (TA) and hyaluronic acid (HA) on symptomatic OLP lesions.

Methods: Twenty volunteers with bilateral symptomatic OLP lesions were randomly assigned to the study involving four different treatment groups (G): G₁, topical TA alone; G₂, MN as an adjunct to the topical TA; G₃, topical TA and HA; and G₄, MN as an adjunct to the topical TA and HA. Lesions were assessed at baseline, and on Days 7, 14, 28, and 56 using parameters including the percentage healing index (PHI), reticulation/erythema/ulceration (REU) score, and visual analogue scale (VAS). Statistical analysis was then performed using SPSS software.

Results: Twenty patients (40 lesions; 10 per group) were included. G₄ showed a significantly higher PHI compared to both G₁ (p  0.001) and G₃ (p < 0.05) at all observation times. Regarding the REU score, G₄ achieved significantly greater reductions compared to G₁ at all observation times (p < 0.05), compared to G₂ on Days 7, 28, and 56 (p < 0.05), and compared to G₃ on Days 28 and 56 (p < 0.05). Regarding the VAS, both G₂ and G₄ showed a statistically significant reduction on Day 7 compared to G₁ and G₃ (p < 0.05).

Conclusion: This study uncovered the advantages of MN in promoting healing, reducing severity, and alleviating pain in OLP patients. Therefore, MN has the potential to become an effective and well-tolerated treatment modality for symptomatic OLP. Moreover, the adjunctive use of MN with topical application of both TA and HA demonstrated the most significant therapeutic benefits, suggesting a synergistic effect.

Trial registration: irct.behdasht.gov.ir: IRCT20231213060357N1 (17 February 2024).

Objectives: This study aims to address the challenges in the diagnosis of oral cancer by proposing a novel computer-aided diagnostic framework that leverages advanced deep learning (DL) and optimization techniques to enhance early detection and improve patient outcomes.

Materials and methods: In the framework proposed, the histopathological images are subjected to a preprocessing technique, and then, the images are fed directly to the NASNet-Large model for the extraction of high-level discriminative texture features. The resultant vectors obtained from the features extracted act as input to the search space of Archimedes Optimization Algorithm that carries out dimensionality reduction and optimal hyperparameter tuning simultaneously. The optimized feature subset is fed to the final classifier, namely the Stacked Sparse Denoising Autoencoder that learns robust latent representations.

Results: The findings demonstrate that the proposed approach achieves superior performance, achieving an accuracy of 95.38%, a precision of 95.15%, a sensitivity of 91.78%, a specificity of 91.85%, and an F1-score of 93.72%.

Conclusions: These findings underscore the potential of the SSDA-AOA framework as an effective tool for the early detection and precise classification of oral cancer, paving the way for improved patient outcomes through timely intervention.

Clinical relevance: This innovative approach may significantly enhance patient outcomes by facilitating earlier diagnosis and treatment, addressing the urgent need for more reliable diagnostic tools in oncology.