The objective of this study was to characterize the current oral medicine (OM) workforce by examining the distribution of OM diplomates (OMDs) across the Unites States and to determine the need for expanding access to care.
Study Design
The OMD access was calculated based on the OMDs per 10,000 state population from the 2020 US Census data as well as their distance from state capitals and most populated cities. OMD penetrance in hospitals and cancer centers was assessed at National Cancer Care Network (NCCN) cancer centers, and Best Hospitals as reported in the 2022 US News and World Report (USNWR).
Results
OMDs are present in 64% of the states with an uneven geographic distribution. Primary workplaces included dental schools (47%), hospitals (30%), and private practices (19%). Of the OMDs in private practice, 57% limited their practice to OM. OMDs were noted at 28% of NCCN cancer centers, 30% of USNWR Best Hospitals for Cancer, and 20% of USNWR Best Hospitals.
Conclusions
There is low density and uneven distribution of OMDs with approximately one-third of the population without access to an OMD in their state, thus limiting access to care. This suggests both vast opportunities for growth and expansion of OM, as well as challenges in developing and training the necessary workforce.
{"title":"The oral medicine workforce and impact on access to care in the United States","authors":"Petros Yoon DDS , Brittany Klein DDS , Lama Alabdulaaly BDS, DMSc , Abdulrahman Nakshabandi BDS , Mandlin Almousa DMD , Laurel Henderson DDS , Malak Al-Hadlaq BDS, DMSc , Amal Bajonaid BDS, DMSc , Piamkamon Vacharotayangul DDS, PhD , Nathaniel Treister DMD, DMSc , Stephen Sonis DMD, DMSc","doi":"10.1016/j.oooo.2024.08.010","DOIUrl":"10.1016/j.oooo.2024.08.010","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this study was to characterize the current oral medicine (OM) workforce by examining the distribution of OM diplomates (OMDs) across the Unites States and to determine the need for expanding access to care.</div></div><div><h3>Study Design</h3><div>The OMD access was calculated based on the OMDs per 10,000 state population from the 2020 US Census data as well as their distance from state capitals and most populated cities. OMD penetrance in hospitals and cancer centers was assessed at National Cancer Care Network (NCCN) cancer centers, and Best Hospitals as reported in the 2022 US News and World Report (USNWR).</div></div><div><h3>Results</h3><div>OMDs are present in 64% of the states with an uneven geographic distribution. Primary workplaces included dental schools (47%), hospitals (30%), and private practices (19%). Of the OMDs in private practice, 57% limited their practice to OM. OMDs were noted at 28% of NCCN cancer centers, 30% of USNWR Best Hospitals for Cancer, and 20% of USNWR Best Hospitals.</div></div><div><h3>Conclusions</h3><div>There is low density and uneven distribution of OMDs with approximately one-third of the population without access to an OMD in their state, thus limiting access to care. This suggests both vast opportunities for growth and expansion of OM, as well as challenges in developing and training the necessary workforce.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 6","pages":"Pages 745-752"},"PeriodicalIF":2.0,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-19DOI: 10.1016/S2212-4403(24)00383-3
{"title":"Information for Readers","authors":"","doi":"10.1016/S2212-4403(24)00383-3","DOIUrl":"10.1016/S2212-4403(24)00383-3","url":null,"abstract":"","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 3","pages":"Page A8"},"PeriodicalIF":2.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142012045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-17DOI: 10.1016/j.oooo.2024.08.011
Eduardo Morato de Oliveira, Cinthia Veronica Bardález Lopéz de Cáceres, Carla Isabelly Fernandes-Rodrigues, Paulo Victor Mendes Penafort, Juan Manuel Arteaga Legarrea, Nathalia Rodrigues Gomes, Hélder Antônio Rebelo Pontes, Pablo Agustin Vargas, José Narciso Rosa Assunção Júnior, Ciro Dantas Soares, Felipe Paiva Fonseca
Objective: The objective of this study was to describe a series of peripheral T-cell lymphoma, not otherwise specified (PTCL NOS) affecting the oral cavity and to review the available literature.
Study design: Cases diagnosed as PTCL-NOS affecting the oral cavity were retrospectively retrieved from pathology files. Original hematoxylin and eosin-stained slides and immunohistochemical reactions were reviewed for microscopic confirmation. The presence of Epstein-Barr virus (EBV) was investigated by in situ hybridization. Clinical and follow-up data were retrieved from patients' pathology and medical files.
Results: A total of 5 cases were obtained with a mean age of 51.8 years old, 3 male patients and 2 female patients. Three cases affected the palate and 2 cases affected the gingiva, whereas 1 case affected the maxillary bone. Tumors presented as destructive, infiltrative, and painful lesions causing swelling, ulceration, and tissue necrosis. All cases exhibited CD3 expression. GATA3 was expressed in 3 cases. Four patients were deceased of the disease during follow-up.
Conclusions: PTCL NOS affecting the oral cavity is rare and usually present as a very aggressive disease, associated with a poor prognosis and dismal outcome. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).
{"title":"Oral manifestations of peripheral T cell lymphoma, not otherwise specified: case series and review of the current literature.","authors":"Eduardo Morato de Oliveira, Cinthia Veronica Bardález Lopéz de Cáceres, Carla Isabelly Fernandes-Rodrigues, Paulo Victor Mendes Penafort, Juan Manuel Arteaga Legarrea, Nathalia Rodrigues Gomes, Hélder Antônio Rebelo Pontes, Pablo Agustin Vargas, José Narciso Rosa Assunção Júnior, Ciro Dantas Soares, Felipe Paiva Fonseca","doi":"10.1016/j.oooo.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.08.011","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to describe a series of peripheral T-cell lymphoma, not otherwise specified (PTCL NOS) affecting the oral cavity and to review the available literature.</p><p><strong>Study design: </strong>Cases diagnosed as PTCL-NOS affecting the oral cavity were retrospectively retrieved from pathology files. Original hematoxylin and eosin-stained slides and immunohistochemical reactions were reviewed for microscopic confirmation. The presence of Epstein-Barr virus (EBV) was investigated by in situ hybridization. Clinical and follow-up data were retrieved from patients' pathology and medical files.</p><p><strong>Results: </strong>A total of 5 cases were obtained with a mean age of 51.8 years old, 3 male patients and 2 female patients. Three cases affected the palate and 2 cases affected the gingiva, whereas 1 case affected the maxillary bone. Tumors presented as destructive, infiltrative, and painful lesions causing swelling, ulceration, and tissue necrosis. All cases exhibited CD3 expression. GATA3 was expressed in 3 cases. Four patients were deceased of the disease during follow-up.</p><p><strong>Conclusions: </strong>PTCL NOS affecting the oral cavity is rare and usually present as a very aggressive disease, associated with a poor prognosis and dismal outcome. (Oral Surg Oral Med Oral Pathol Oral Radiol YEAR;VOL:page range).</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-16DOI: 10.1016/j.oooo.2024.08.009
Renata C. Campelo DDS, MSc , Bruno B. Benatti DDS, PhD , Joana A.B. de Sousa DDS, MSc , Gilvan C. Nascimento MD, PhD , Rossana S.S. Azulay MD, PhD , Manuel dos S. Faria MD, PhD , Marcelo Magalhães PhD , Vandilson P. Rodrigues DDS, PhD
Objective
To investigate the stimulated salivary flow (SSF) and unstimulated salivary flow (USF) in adults with acromegaly and to identify possible clinical factors associated with salivary flow.
Study design
A case-control study was conducted with a group composed of adults diagnosed with acromegaly (n = 29, mean age = 50.2 years) and a control group (n = 29, mean age = 54.3 years). Variables for socio-demographic characterization, lifestyle habits, and diabetes diagnosis, body mass index (BMI), cervical circumference (CC) and abdominal circumference (AC) were collected. USF and SSF variables were analyzed as outcomes. Unpaired t-test, Pearson's correlation, and multivariate regression models were used for statistical analysis.
Results
Both groups were 44.8% male and 55.2% female. Diabetes was present in 55.2% of the acromegaly group and in 51.7% of the controls (P = .792). The acromegaly group had a higher USF than the control group (0.50 mL/min versus 0.22 mL/min). SSF showed a direct correlation with CC (r = 0.470, P = .010). Acromegaly was associated with higher USF (standardized coefficient = 0.780, P = .039), and age was inversely related to USF (standardized coefficient = −0.333, P = .013).
Conclusions
The findings suggest that adults with acromegaly have an increased USF and that being older is associated with a decrease in USF.
{"title":"Clinical factors associated with salivary flow rate in adults with acromegaly","authors":"Renata C. Campelo DDS, MSc , Bruno B. Benatti DDS, PhD , Joana A.B. de Sousa DDS, MSc , Gilvan C. Nascimento MD, PhD , Rossana S.S. Azulay MD, PhD , Manuel dos S. Faria MD, PhD , Marcelo Magalhães PhD , Vandilson P. Rodrigues DDS, PhD","doi":"10.1016/j.oooo.2024.08.009","DOIUrl":"10.1016/j.oooo.2024.08.009","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the stimulated salivary flow (SSF) and unstimulated salivary flow (USF) in adults with acromegaly and to identify possible clinical factors associated with salivary flow.</div></div><div><h3>Study design</h3><div>A case-control study was conducted with a group composed of adults diagnosed with acromegaly (n = 29, mean age = 50.2 years) and a control group (n = 29, mean age = 54.3 years). Variables for socio-demographic characterization, lifestyle habits, and diabetes diagnosis, body mass index (BMI), cervical circumference (CC) and abdominal circumference (AC) were collected. USF and SSF variables were analyzed as outcomes. Unpaired t-test, Pearson's correlation, and multivariate regression models were used for statistical analysis.</div></div><div><h3>Results</h3><div>Both groups were 44.8% male and 55.2% female. Diabetes was present in 55.2% of the acromegaly group and in 51.7% of the controls (<em>P</em> = .792). The acromegaly group had a higher USF than the control group (0.50 mL/min versus 0.22 mL/min). SSF showed a direct correlation with CC (r = 0.470, <em>P</em> = .010). Acromegaly was associated with higher USF (standardized coefficient = 0.780, <em>P</em> = .039), and age was inversely related to USF (standardized coefficient = −0.333, <em>P</em> = .013).</div></div><div><h3>Conclusions</h3><div>The findings suggest that adults with acromegaly have an increased USF and that being older is associated with a decrease in USF.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 6","pages":"Pages 735-744"},"PeriodicalIF":2.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The oral cavity is a common site for mucosal conditions which may be confined to the mouth, or may manifest as mucocutaneous involvement at other sites, including the anogenital region. This retrospective analysis aimed to assess the appropriateness of oral medicine referrals to a specialized vulval clinic and review the prevalence of oral disease associated with vulval involvement of the same condition.
Study Design
One hundred thirty-six patients referred from oral medicine to the vulval service at Guy's Hospital were analyzed. Retrospective data collated included: reason(s) for referral, onset of oral and genital symptoms, oral diagnosis, vulval diagnosis, correlation between the oral and vulval diagnosis, and discharge at first appointment.
Results
Forty-nine percent (n = 67) of the patients had oral and vulval manifestations of the same disease. The majority of these patients (n = 63) were diagnosed with vulval lichen planus, of whom 61 had concomitant oral lichen planus involvement (97%). Other associated oral and vulval diseases included aphthous ulceration, Behçet's disease, dryness secondary to Sjögren's disease, Crohn's disease, and mucous membrane pemphigoid. The remaining 51% (n = 69) of the patients presented with independent vulval conditions unrelated to their oral disease.
Conclusion
Clinicians should recognize the association between genital symptoms and oral disease and refer to specialist allied services, as appropriate.
{"title":"Oral and vulval disease: prevalence, associations, and management recommendations for the oral medicine clinician","authors":"Sangeetha Yogarajah BDS , Fiona Tasker MBBS, IntBSc, MRCP, PGDip , Barbara Carey MB, BCh, BAO, BDS, FDS (OM), RCSI , Fiona Lewis MD, FRCP","doi":"10.1016/j.oooo.2024.08.007","DOIUrl":"10.1016/j.oooo.2024.08.007","url":null,"abstract":"<div><h3>Objective</h3><div>The oral cavity is a common site for mucosal conditions which may be confined to the mouth, or may manifest as mucocutaneous involvement at other sites, including the anogenital region. This retrospective analysis aimed to assess the appropriateness of oral medicine referrals to a specialized vulval clinic and review the prevalence of oral disease associated with vulval involvement of the same condition.</div></div><div><h3>Study Design</h3><div>One hundred thirty-six patients referred from oral medicine to the vulval service at Guy's Hospital were analyzed. Retrospective data collated included: reason(s) for referral, onset of oral and genital symptoms, oral diagnosis, vulval diagnosis, correlation between the oral and vulval diagnosis, and discharge at first appointment.</div></div><div><h3>Results</h3><div>Forty-nine percent (n = 67) of the patients had oral and vulval manifestations of the same disease. The majority of these patients (n = 63) were diagnosed with vulval lichen planus, of whom 61 had concomitant oral lichen planus involvement (97%). Other associated oral and vulval diseases included aphthous ulceration, Behçet's disease, dryness secondary to Sjögren's disease, Crohn's disease, and mucous membrane pemphigoid. The remaining 51% (n = 69) of the patients presented with independent vulval conditions unrelated to their oral disease.</div></div><div><h3>Conclusion</h3><div>Clinicians should recognize the association between genital symptoms and oral disease and refer to specialist allied services, as appropriate.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 6","pages":"Pages 728-734"},"PeriodicalIF":2.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-16DOI: 10.1016/j.oooo.2024.08.006
Thomas J.W. Klein Nulent MD, DMD , Robert J.J. van Es MD, DMD, PhD , Gerben E. Breimer MD, PhD , Matthijs H. Valstar MD, DMD , Laura A. Smit MD, PhD , Caroline M. Speksnijder MSc, PhD , Remco de Bree MD, PhD , Stefan M. Willems MD, PhD
Objectives
Diagnosing adenoid cystic carcinoma (AdCC) is challenging due to histopathological variability and similarities with other tumors. In AdCC pathogenesis, the cellular myeloblastosis gene (c-MYB) often exhibits a MYB::NFIB fusion from a reciprocal translocation. This study aimed to assess the predictive accuracy of MYB immunohistochemistry for detecting this translocation compared to fluorescence in situ hybridization (FISH).
Study design
This study included 110 AdCC patients (1999-2017) from two Dutch head and neck centers using tissue microarrays and full slides. Median MYB expression levels by immunohistochemistry were compared based on translocation status by FISH, and differences within clinicopathological parameters were examined. An immunohistochemical cut-off was established to estimate the translocation.
Results
MYB immunohistochemistry was available in 90/110 patients, with a median expression of 27%. FISH was interpretable in 79/108 tumors, identifying MYB::NFIB fusion in 44 (56%). Among 62 patients with both MYB expression and translocation data, the fusion was present in 38 (61%). These tumors had higher MYB expression (30%) than nontranslocated tumors (6%); P = .02. A 60% MYB expression cut-off yielded 100% specificity for detecting the translocation but had no prognostic value.
Conclusions
Although MYB protein expression alone lacks diagnostic precision, protein expression >60% predicted the MYB::NFIB fusion in all tumors.
{"title":"MYB immunohistochemistry as a predictor of MYB::NFIB fusion in the diagnosis of adenoid cystic carcinoma of the head and neck","authors":"Thomas J.W. Klein Nulent MD, DMD , Robert J.J. van Es MD, DMD, PhD , Gerben E. Breimer MD, PhD , Matthijs H. Valstar MD, DMD , Laura A. Smit MD, PhD , Caroline M. Speksnijder MSc, PhD , Remco de Bree MD, PhD , Stefan M. Willems MD, PhD","doi":"10.1016/j.oooo.2024.08.006","DOIUrl":"10.1016/j.oooo.2024.08.006","url":null,"abstract":"<div><h3>Objectives</h3><div>Diagnosing adenoid cystic carcinoma (AdCC) is challenging due to histopathological variability and similarities with other tumors. In AdCC pathogenesis, the cellular myeloblastosis gene (c-MYB) often exhibits a <em>MYB::NFIB</em> fusion from a reciprocal translocation. This study aimed to assess the predictive accuracy of MYB immunohistochemistry for detecting this translocation compared to fluorescence in situ hybridization (FISH).</div></div><div><h3>Study design</h3><div>This study included 110 AdCC patients (1999-2017) from two Dutch head and neck centers using tissue microarrays and full slides. Median MYB expression levels by immunohistochemistry were compared based on translocation status by FISH, and differences within clinicopathological parameters were examined. An immunohistochemical cut-off was established to estimate the translocation.</div></div><div><h3>Results</h3><div>MYB immunohistochemistry was available in 90/110 patients, with a median expression of 27%. FISH was interpretable in 79/108 tumors, identifying <em>MYB</em>::<em>NFIB</em> fusion in 44 (56%). Among 62 patients with both MYB expression and translocation data, the fusion was present in 38 (61%). These tumors had higher MYB expression (30%) than nontranslocated tumors (6%); <em>P</em> = .02. A 60% MYB expression cut-off yielded 100% specificity for detecting the translocation but had no prognostic value.</div></div><div><h3>Conclusions</h3><div>Although MYB protein expression alone lacks diagnostic precision, protein expression >60% predicted the <em>MYB::NFIB</em> fusion in all tumors.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 6","pages":"Pages 772-780"},"PeriodicalIF":2.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113856","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}
Pub Date : 2024-08-10DOI: 10.1016/j.oooo.2024.07.014
Dong Hyun Kim MD, MS , Seo Yoon Jang MD , Bhumsuk Keam MD, PhD
Objective
We analyzed the predictive value of dynamic changes in neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) treated with immune checkpoint inhibitors (ICIs).
Study Design
A total of 104 patients with R/M HNSCC treated with ICIs during August 2018 to June 2023 were included. Dynamic changes were defined as the difference between NLR and PLR on day 1 of cycles 1 and 2.
Results
Patients with increased NLR or PLR had an independently increased risk of disease progression at the first response evaluation (odds ratio [OR] 5.26, P = .005; OR 2.29, P = .042), disease progression (hazard ratio [HR] 2.29, P = .003; HR 1.68, P = .027), and death (HR 1.86, P = .027; HR 1.68, P = .037). Furthermore, patients with a decrease in NLR showed longer progression-free survival, with HRs of 0.36 (P < .001) for those with low pre-ICI NLR and 0.52 (P = .041) for those with high pre-ICI NLR, compared to those with increased NLR.
Conclusions
Increased NLR or PLR was associated with adverse outcomes after ICI treatment in patients with R/M HNSCC.
{"title":"Predictive value of early dynamic changes of NLR and PLR for the efficacy of immune checkpoint inhibitor in head and neck squamous cell carcinoma","authors":"Dong Hyun Kim MD, MS , Seo Yoon Jang MD , Bhumsuk Keam MD, PhD","doi":"10.1016/j.oooo.2024.07.014","DOIUrl":"10.1016/j.oooo.2024.07.014","url":null,"abstract":"<div><h3>Objective</h3><div>We analyzed the predictive value of dynamic changes in neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in recurrent and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) treated with immune checkpoint inhibitors (ICIs).</div></div><div><h3>Study Design</h3><div>A total of 104 patients with R/M HNSCC treated with ICIs during August 2018 to June 2023 were included. Dynamic changes were defined as the difference between NLR and PLR on day 1 of cycles 1 and 2.</div></div><div><h3>Results</h3><div>Patients with increased NLR or PLR had an independently increased risk of disease progression at the first response evaluation (odds ratio [OR] 5.26, <em>P</em> = .005; OR 2.29, <em>P</em> = .042), disease progression (hazard ratio [HR] 2.29, <em>P</em> = .003; HR 1.68, <em>P</em> = .027), and death (HR 1.86, <em>P</em> = .027; HR 1.68, <em>P</em> = .037). Furthermore, patients with a decrease in NLR showed longer progression-free survival, with HRs of 0.36 (<em>P</em> < .001) for those with low pre-ICI NLR and 0.52 (<em>P</em> = .041) for those with high pre-ICI NLR, compared to those with increased NLR.</div></div><div><h3>Conclusions</h3><div>Increased NLR or PLR was associated with adverse outcomes after ICI treatment in patients with R/M HNSCC.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 6","pages":"Pages 763-771"},"PeriodicalIF":2.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.1016/j.oooo.2024.08.004
Matheus Akira Sakurada DDS, MSc , Luiz Eduardo Gregoris Rabelo DDS, MSc, PhD , Ivonete Barreto Haagsma DDS , Luis Carlos do Carmo Filho DDS, MSc, PhD , Carlos Estrela DDS, MSc, PhD , Isabela Reginaldo DDS , Thais Marques Simek Vega Gonçalves DDS, MSc, PhD
Objective
To assess the effect of a blooming artifact reduction (BAR) filter on cone beam computed tomography (CBCT) images in the dimensional analysis of dental implants.
Study Design
Six types of implants (n = 5 for each type) composed of titanium (3 types), titanium-zirconia alloy, zirconium oxide, and titanium-aluminum-vanadium alloy, and made with 2 manufacturing processes (milled and printed) were individually installed in a bovine rib block according to the manufacturer's protocol. CBCT images were acquired with i-CAT and Carestream scanners, randomized, and analyzed without and with the e-Vol DX BAR filter (60 images for each scanner). Implant length, diameter, and thread-to-thread distance were measured by two radiologists, with a stereomicroscopic image of each implant as the reference standard for calculation of distortion in measurements. Repeated measures ANOVA with Bonferroni corrections and intraclass correlation coefficients (ICC) were applied (α = 0.05).
Results
The BAR filter significantly reduced distortion in various parameters for specific implants, aligning closely with stereomicroscopic measurements. Titanium and printed implants showed reduced dimensional distortion regardless of BAR filter use. Carestream measurements presented smaller dimensional differences than i-CAT for most implants and parameters, especially without BAR (P < .05). Interexaminer reliability was good to excellent, with ICC ranging from 0.80 to 0.95.
Conclusions
The BAR filter can enhance implant dimensional analysis, although variations based on implant material and manufacturing process were observed.
{"title":"The effect of a blooming artifact reduction filter on the dimensional analysis of implants","authors":"Matheus Akira Sakurada DDS, MSc , Luiz Eduardo Gregoris Rabelo DDS, MSc, PhD , Ivonete Barreto Haagsma DDS , Luis Carlos do Carmo Filho DDS, MSc, PhD , Carlos Estrela DDS, MSc, PhD , Isabela Reginaldo DDS , Thais Marques Simek Vega Gonçalves DDS, MSc, PhD","doi":"10.1016/j.oooo.2024.08.004","DOIUrl":"10.1016/j.oooo.2024.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effect of a blooming artifact reduction (BAR) filter on cone beam computed tomography (CBCT) images in the dimensional analysis of dental implants.</div></div><div><h3>Study Design</h3><div>Six types of implants (<em>n</em> = 5 for each type) composed of titanium (3 types), titanium-zirconia alloy, zirconium oxide, and titanium-aluminum-vanadium alloy, and made with 2 manufacturing processes (milled and printed) were individually installed in a bovine rib block according to the manufacturer's protocol. CBCT images were acquired with i-CAT and Carestream scanners, randomized, and analyzed without and with the e-Vol DX BAR filter (60 images for each scanner). Implant length, diameter, and thread-to-thread distance were measured by two radiologists, with a stereomicroscopic image of each implant as the reference standard for calculation of distortion in measurements. Repeated measures ANOVA with Bonferroni corrections and intraclass correlation coefficients (ICC) were applied (α = 0.05).</div></div><div><h3>Results</h3><div>The BAR filter significantly reduced distortion in various parameters for specific implants, aligning closely with stereomicroscopic measurements. Titanium and printed implants showed reduced dimensional distortion regardless of BAR filter use. Carestream measurements presented smaller dimensional differences than i-CAT for most implants and parameters, especially without BAR (<em>P</em> < .05). Interexaminer reliability was good to excellent, with ICC ranging from 0.80 to 0.95.</div></div><div><h3>Conclusions</h3><div>The BAR filter can enhance implant dimensional analysis, although variations based on implant material and manufacturing process were observed.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 6","pages":"Pages 813-822"},"PeriodicalIF":2.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142185671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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