Oral diseases最新文献

Objective: To systematically evaluate rehabilitation interventions for oral cancer patients with trismus and clarify effects on trismus.

Materials and methods: A comprehensive search for randomized controlled trials and quasi-experimental studies published up to November 28, 2024, was conducted across PubMed, Embase, Cochrane Library, Web of Science, CINAHL, CBM, CNKI, VIP, and Wanfang using the PICOS strategy. The primary outcome was mouth opening distance. Two authors independently assessed risk of bias and methodological quality using the Cochrane Handbook (version 5.1.0) and ROBINS-I. The study protocol was registered with PROSPERO (CRD42024613003).

Results: The review included 15 articles, including eight randomized controlled trials and seven quasi-experimental studies. There were variations in the timing and type of rehabilitation. Most interventions started 2-3 weeks post-surgery. Three types of interventions, including exercise training, physical therapy, and speech training, improved trismus.

Conclusion: Rehabilitation interventions are often used in combination, but the effectiveness of individual interventions remains unclear. Physical therapy has been shown to alleviate pain, while remote reminders can enhance adherence. Only a basic consensus on rehabilitation interventions can be summarized due to design differences. Future research should focus on conducting rigorous trials to provide more conclusive evidence.

Aim: To evaluate whether periodontal parameters and tooth loss are associated with lung cancer incidence and mortality among older adults.

Materials and methods: Data are from the Health, Aging and Body Composition (Health ABC) study, which included 1136 older adults who received a periodontal examination and were followed for up to 16 years. Pocket depth and clinical attachment level were assessed for all present teeth. Adjusted Cox regression models were used to examine the relationship between periodontal parameters and number of natural teeth with lung cancer incidence and mortality.

Results: Lung cancer incidence was 4.4% (n = 50) and was identified as cause of death in 3.3% (n = 38). Those presenting at least 10% of sites with probing depth ≥ 6 mm demonstrated a higher risk of lung cancer and death due to lung cancer (hazard ratio [HR]: 3.12, 95% confidence interval [CI]: 1.45-6.72 and HR: 3.08, 95% CI: 1.27-7.46), respectively. Tooth loss was associated with a reduced hazard of lung cancer incidence (HR: 0.96; 95% CI: 0.93-0.99) and related mortality (HR: 0.96; 95% CI: 0.92-0.99).

Conclusion: The association between severe periodontal disease parameters and tooth loss with lung cancer among older adults underscores the importance of oral health maintenance for cancer prevention strategies.

Background: This study examined the impact of early childhood exposure to China's 1959-1961 famine on the likelihood of adult edentulism.

Methods: We used data from 8209 adults surveyed in 2011-2012 China Health and Retirement Longitudinal Study (CHARLS). Logistic regression was used to analyze the odds ratios (ORs) and confidence intervals (CIs) of early starvation and edentulism in adulthood.

Results: Compared with unexposed individuals, famine-exposed individuals had a significantly increased odds of edentulism. After adjustment for age, sex, location, severity, income, education, smoking, drinking, hypertension, dyslipidaemia, diabetes, and heart disease, the final ORs (95% CIs) were 2.097 (1.047, 4.355) for the foetal exposure group, 2.625 (1.245, 5.746) for the preschool group, and 3.907 (1.608, 9.726) for the school-age exposure group.

Conclusions: Exposure to China's 1959-1961 famine during early childhood is associated with significantly increased odds of edentulism in adulthood, particularly among those exposed during school age (OR = 3.907; 95% CI: 1.608-9.726).

Objectives: Stable condyle positioning is crucial for temporomandibular joint (TMJ) function, but its long-term stability in patients undergoing segmental mandibulectomy with free fibular flap (FFF) reconstruction is unclear. This study aimed to assess the long-term stability of TMJ parameters and the factors influencing it.

Methods: This retrospective study included patients who underwent mandibular reconstruction using FFF with condyle preservation. CBCT was used to assess TMJ measurements at four time points: pre-surgery (T0), 1 ± 1 month (T1), 6 ± 1 months (T2), and at least 20 ± 4 months post-surgery (T3). Parameters such as condylar inclination, position, dimensions, and joint spaces were measured.

Results: A total of 89 patients participated (51 with conventional freehand, 38 with 3D procedure). Condylar position changed over time: the operated side showed a slight downward shift, and the contralateral side showed inward and medial movement. Factors affecting condylar stability included surgical accuracy, mandible angle involvement, defect location (especially if crossing midline), and postoperative radiation therapy (p < 0.05).

Conclusion: TMJ parameters are highly sensitive to skeletal changes post-reconstruction with condylar preservation. Our findings suggest that condylar position lacks long-term stability after surgery. Further studies are needed to assess clinical outcomes and disc-condyle relationship after mandibular reconstruction.

Background: Histological grading of oral epithelial dysplasia (OED) is used for predicting malignant transformation risk. However, grading is associated with significant subjectivity and observer variability leading to inconsistency in prognosis prediction. Alternate histological feature-specific models ('six-point' and 'two-point') have been shown to have potentially better prognostic reliability than conventional grading. This study conducts a multicentre validation of these models.

Methods: 102 OED cases (dating 2012-2017) were acquired from 4 independent centres (13 (13%) Sheffield; 40 (39%) Belfast; 30 (29%) Birmingham; 19 (19%) Piracicaba, Brazil) were independently scored using the 'six-point' and 'two-point' models. Feature prevalence, observer agreement and malignant transformation risk were evaluated and compared to conventional grading systems.

Results: The 'six-point' system demonstrated superior predictive value (AUROC of 0.81) compared to the 'two-point' system (AUROC = 0.73, p = 0.004), WHO grading (AUROC = 0.71, p = 0.03) and binary grading (AUROC = 0.68, p = 0.009). Transformation rate for the 'six-point' model was 50% (95% CI 27%-78%) when all 6 features were present compared to 14% (95% CI 5%-32%) when 2-3 features were present.

Conclusions: This study supports the superior performance of the 'six-point' system for transformation prediction on a multicentric sample. Findings indicate that feature-specific models may be more reliable than existing histological grading systems for prognosis prediction.