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Treatment protocol for medication-related osteonecrosis of the jaws: stages I and II-based on a pharmacological and surgical scheme. 药物相关性颌骨骨坏死的治疗方案:基于药物和手术方案的I期和ii期。
IF 1.9 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-28 DOI: 10.1016/j.oooo.2025.11.009
Nicolás Leonardi, Gerardo Gilligan, Eduardo David Piemonte, Rene Luis Panico

Introduction: Medication-related osteonecrosis of the jaws (MRONJ) is a complex oral condition for which no global consensus on management currently exists, underscoring the need to establish internationally accepted therapeutic protocols. The use of platelet-rich fibrin (PRF) and the adjunctive administration of pentoxifylline and tocopherol (PenTo) have shown promising preliminary results in the clinical management of MRONJ; however, robust data remain limited. The aim of this study is to analyze the outcomes of surgically treated patients with stage I and II MRONJ, incorporating PenTo as an adjuvant to platelet concentrate therapy. Furthermore, the study seeks to evaluate both clinical and radiographic outcome variables throughout the follow-up period.

Methods: A controlled pharmacological clinical trial was conducted, using a standard drug regimen as the comparator. Total 20 patients diagnosed with stage I or II MRONJ were allocated into 2 groups: one group received surgical treatment combined with PRF, while the other underwent the same protocol supplemented with an adjuvant therapeutic regimen based on PenTo. Participants were recruited from the Oral Medicine Department, School of Dentistry, Universidad Católica de Córdoba.

Results: Statistically significant differences were observed in the mean duration of antiresorptive therapy, which was notably longer in patients with osteoporosis (P = .01). Zoledronic acid was the most frequently associated drug (P = .0019). The addition of PenTo to the treatment protocol was associated with improved clinical and radiographic outcomes, with statistically significant differences (P = .0138 and P = .0046, respectively). Furthermore, the diagnostic stage (I or II) showed a significant correlation with clinical improvement following treatment (P = .0294). The healing index at 15, 90, and 180 days was higher in the group receiving PenTo, with statistically significant differences at each time point (P = .0441; P = .0001; P = .0018, respectively). In oncological patients, the healing index was also higher at all follow-up stages, with clear statistical significance (P = .0294; P = .0004; P = .0042).

Conclusions: This study contributes with patient-based evidence to support the interdisciplinary management of MRONJ. The combination of surgical treatment, PRF, and PenTo may serve to optimize and enhance clinical strategies for this condition.

药物相关性颌骨骨坏死(MRONJ)是一种复杂的口腔疾病,目前尚无全球共识的治疗方法,强调需要建立国际公认的治疗方案。富血小板纤维蛋白(PRF)和己酮茶碱和生育酚(PenTo)的辅助治疗在MRONJ的临床治疗中显示出有希望的初步结果;然而,可靠的数据仍然有限。本研究的目的是分析手术治疗的I期和II期MRONJ患者的结果,将PenTo作为血小板浓缩治疗的辅助药物。此外,该研究旨在评估整个随访期间的临床和影像学结果变量。方法:以标准用药方案为对照,进行对照药理临床试验。将20例诊断为I期或II期MRONJ的患者分为两组:一组采用手术联合PRF治疗,另一组采用相同的治疗方案,并辅以基于PenTo的辅助治疗方案。参与者从Católica de Córdoba大学牙科学院口腔医学系招募。结果:抗吸收治疗的平均持续时间差异有统计学意义,骨质疏松患者的平均持续时间明显更长(P = 0.01)。唑来膦酸是最常见的相关药物(P = 0.0019)。在治疗方案中加入PenTo与改善临床和影像学结果相关,差异有统计学意义(P = 0.0138和P = 0.0046)。此外,诊断阶段(I或II)与治疗后的临床改善有显著相关性(P = 0.0294)。PenTo组15、90、180天的愈合指数均高于对照组,各时间点差异均有统计学意义(P = 0.0441; P = 0.0001; P = 0.0018)。肿瘤患者各随访期愈合指数均较高,差异有统计学意义(P = 0.0294; P = 0.0004; P = 0.0042)。结论:本研究为支持MRONJ的跨学科治疗提供了基于患者的证据。手术治疗、PRF和PenTo的结合可能有助于优化和加强对这种情况的临床策略。
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引用次数: 0
Temporomandibular disorder and emergency department utilization: demographic, clinical, and economic perspectives from a national database. 颞下颌紊乱和急诊科的利用:来自国家数据库的人口统计学、临床和经济学观点。
IF 1.9 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-27 DOI: 10.1016/j.oooo.2025.11.011
Vaibhav Gandhi, Ezgi Cansu Firinciogullari, Maysaa Oubaidin, Min Kyeong Lee, Farheen Malek, Veerasathpurush Allareddy, Sumit Yadav

Objective: To evaluate the epidemiological characteristics, comorbidity patterns, and economic burden of temporomandibular disorder (TMD)-related hospital emergency department (ED) visits in the United States using a nationally representative database.

Study design: A retrospective cross-sectional analysis of 2021-2022 National Emergency Department Samples data identified TMD-related ED visits using ICD-10 codes. Descriptive statistics summarized demographics, hospital characteristics, payer status, and comorbidities. Multivariable linear regression model determined associations between patient- and system-level factors and ED charges.

Results: A total of 52,412 TMD-related ED visits were identified. Most patients were female (67.5%) with a mean age of 39.5 years. Black (19.1%) and Hispanic (18.7%) patients were overrepresented. The mean ED charge per visit was $2,827. Common comorbidities included hypertension (12.9%) and depression (2.5%). Regression analysis showed that older age, higher income, and Western U.S. location were associated with higher ED charges. Medicaid and self-pay status predicted lower charges, while hypertension increased ED charges.

Conclusions: More than 52,000 TMD-related ED visits resulting in $147 million in ED charges highlight a major public health issue disproportionately affecting women, minorities, and low-income groups. Many visits may be preventable with improved outpatient care. Integrated, cost-effective, multidisciplinary strategies are needed to reduce emergency use and long-term complications.

目的:利用一个具有全国代表性的数据库,评估美国颞下颌疾病(TMD)相关医院急诊科(ED)就诊的流行病学特征、合并症模式和经济负担。研究设计:对2021-2022年国家急诊科样本数据进行回顾性横断面分析,使用ICD-10代码确定与tmd相关的急诊科就诊。描述性统计总结了人口统计、医院特征、付款人状况和合并症。多变量线性回归模型确定了患者和系统水平因素与ED收费之间的关系。结果:共确定了52,412例与tmd相关的急诊科就诊。患者以女性居多(67.5%),平均年龄39.5岁。黑人(19.1%)和西班牙裔(18.7%)患者的比例过高。每次就诊的平均诊断费为2,827美元。常见的合并症包括高血压(12.9%)和抑郁症(2.5%)。回归分析显示,年龄较大、收入较高和美国西部地区与较高的ED费用相关。医疗补助和自我支付状况预示着较低的收费,而高血压会增加急诊科的收费。结论:超过52,000例与tmd相关的ED就诊导致了1.47亿美元的ED费用,这突出了一个主要的公共卫生问题,对妇女、少数民族和低收入群体的影响尤为严重。许多就诊可以通过改善门诊护理来预防。需要综合的、具有成本效益的多学科战略来减少紧急使用和长期并发症。
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引用次数: 0
Reply to Letter to the Editor “A surgeon with a fork, in a world of soup” 回复给编辑的信。
IF 1.9 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-27 DOI: 10.1016/j.oooo.2025.10.019
Pooja Gangwani DDS, MPH, FACD
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引用次数: 0
Autoimmune disorders as predictive factors for oral lichen planus and malignancy risk: real-world data analysis. 自身免疫性疾病作为口腔扁平苔藓和恶性肿瘤风险的预测因素:真实世界数据分析。
IF 1.9 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-26 DOI: 10.1016/j.oooo.2025.11.012
Adepitan A Owosho, Stella O Oyewole

Objective: Oral lichen planus (OLP) is a T-cell-mediated mucosal disorder with malignant potential and ∼1% prevalence. Its associations with autoimmune diseases and oral squamous cell carcinoma (OSCC), especially among smokers, remain unclear. This study quantified OLP prevalence across 17 autoimmune disorders and evaluated OSCC risk in these cohorts.

Methods: Data from TriNetX research network were analyzed in a retrospective cohort of adults ≥18 years. Patients with one of 17 autoimmune diseases were identified via ICD-10 codes and compared to nonautoimmune controls. OLP prevalence and risk were estimated using 1:1 age- and sex-matched propensity score matching. OSCC risk in autoimmune and OLP patients was assessed via ICD-O/ICD-10 codes, and tobacco impact was evaluated.

Results: In 4,480,330 patients with autoimmune disorders, OLP prevalence was 2.04%, ranging from 1.19% in multiple sclerosis to 4.57% in Sjögren's. OLP risk was significantly elevated in 13 conditions (OR = 1.06-2.44; P < .05), nonsignificant for scleroderma, myasthenia gravis, and Hashimoto, and inversely associated with multiple sclerosis (OR = 0.78; P < .0001). OSCC risk was 1.39%, with ORs of 15.93 overall and 23.6 in smokers with autoimmune disorders and OLP (P < .0001).

Conclusions: Autoimmune interactions in OLP are complex, with robust associations in Sjögren's, vasculitis, Addison's, and intriguing multiple sclerosis protection. The markedly elevated risk of OSCC in patients with autoimmune disease and OLP highlights the need for integrated screening protocols and patient education.

目的:口腔扁平苔藓(OLP)是一种具有恶性潜能的t细胞介导的粘膜疾病,患病率约1%。它与自身免疫性疾病和口腔鳞状细胞癌(OSCC)的关系,特别是在吸烟者中,尚不清楚。本研究量化了17种自身免疫性疾病的OLP患病率,并评估了这些队列中OSCC的风险。方法:来自TriNetX研究网络的数据在≥18岁的成年人中进行回顾性队列分析。通过ICD-10编码确定患有17种自身免疫性疾病之一的患者,并与非自身免疫性对照进行比较。使用1:1的年龄和性别匹配的倾向评分来估计OLP的患病率和风险。通过ICD-O/ICD-10代码评估自身免疫和OLP患者的OSCC风险,并评估烟草的影响。结果:在4480330例自身免疫性疾病患者中,OLP患病率为2.04%,从多发性硬化症的1.19%到Sjögren's的4.57%不等。OLP风险在13种情况下显著升高(OR = 1.06-2.44; P < 0.05),硬皮病、重症肌无力和桥本综合症的OLP风险不显著,与多发性硬化症呈负相关(OR = 0.78; P < 0.0001)。OSCC风险为1.39%,总体的or为15.93,合并自身免疫性疾病和OLP的吸烟者的or为23.6 (P < 0.0001)。结论:OLP中的自身免疫相互作用是复杂的,与Sjögren,血管炎,Addison's和有趣的多发性硬化症保护密切相关。自身免疫性疾病和OLP患者发生OSCC的风险显著升高,这凸显了综合筛查方案和患者教育的必要性。
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引用次数: 0
Oral squamous cell carcinoma risk and magnitude of association in inherited cancer predisposition syndromes: evidence from a large real-world cohort. 口腔鳞状细胞癌的风险和与遗传性癌症易感性综合征的关联程度:来自一个大型现实世界队列的证据
IF 1.9 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-26 DOI: 10.1016/j.oooo.2025.11.010
Stella O Oyewole, Adetokunbo B Olawuyi, Osariemen Okhuaihesuyi, Adepitan A Owosho

Objective: Inherited cancer predisposition syndromes (ICPS) are rare genetic disorders associated with an elevated cancer risk. This study evaluates oral squamous cell carcinoma (OSCC) prevalence across selected ICPS, including Fanconi anemia (FA), Plummer-Vinson syndrome, Cowden syndrome, Li-Fraumeni syndrome, dyskeratosis congenita, and xeroderma pigmentosum, quantifies risk magnitude, examines age at diagnosis, and assesses tobacco's modifying effect on OSCC risk in these populations.

Study design: We conducted a retrospective cohort study using the TriNetX Research Network, including patients with or without ICPS identified by ICD‑10 codes over a 20‑year period. OSCC cases were matched 1:1 by age and sex to controls. The analyses assessed prevalence, odds ratios, age at diagnosis, and the impact of tobacco use. Statistical significance was set at P < .05.

Results: The prevalence of OSCC among ICPS patients ranged from 0.11% to 4.66%, with the highest in patients with FA. Among ICPS, only FA showed a markedly increased OSCC risk (OR = 40.63, P < .01), while Plummer-Vinson syndrome and dyskeratosis congenita were inversely associated. Patients with ICPS developed OSCC at younger ages (P < .0001). Smoking increased OSCC risk within ICPS (OR = 1.47), whereas nonsmokers with ICPS had a reduced risk (OR = 0.78).

Conclusions: FA is strongly associated with OSCC; OSCC also occurs in Li-Fraumeni syndrome and Cowden syndrome. Patients with ICPS present with OSCC at a younger age, supporting targeted screening for high‑risk ICPS populations.

目的:遗传性癌症易感性综合征(ICPS)是一种罕见的与癌症风险升高相关的遗传性疾病。本研究评估了口腔鳞状细胞癌(OSCC)在选定的ICPS中的患病率,包括范可尼贫血(FA)、Plummer-Vinson综合征、考登综合征、Li-Fraumeni综合征、先天性角化不良症和着色性干皮病,量化了风险程度,检查了诊断时的年龄,并评估了烟草对这些人群中OSCC风险的调节作用。研究设计:我们使用TriNetX研究网络进行了一项回顾性队列研究,包括20年期间由ICD - 10代码确定的患有或不患有ICPS的患者。OSCC病例按年龄和性别与对照组1:1匹配。分析评估了患病率、优势比、诊断年龄和烟草使用的影响。差异有统计学意义,P < 0.05。结果:ICPS患者中OSCC患病率为0.11% ~ 4.66%,以FA患者最高。在ICPS中,只有FA显著增加了OSCC的风险(OR = 40.63, P < 0.01),而Plummer-Vinson综合征与先天性角化不良呈负相关。ICPS患者发生OSCC的年龄更小(P < 0.0001)。吸烟增加了ICPS患者的OSCC风险(OR = 1.47),而不吸烟的ICPS患者的风险降低(OR = 0.78)。结论:FA与OSCC密切相关;OSCC也见于Li-Fraumeni综合征和Cowden综合征。ICPS患者在较年轻时出现OSCC,支持对高危ICPS人群进行有针对性的筛查。
{"title":"Oral squamous cell carcinoma risk and magnitude of association in inherited cancer predisposition syndromes: evidence from a large real-world cohort.","authors":"Stella O Oyewole, Adetokunbo B Olawuyi, Osariemen Okhuaihesuyi, Adepitan A Owosho","doi":"10.1016/j.oooo.2025.11.010","DOIUrl":"10.1016/j.oooo.2025.11.010","url":null,"abstract":"<p><strong>Objective: </strong>Inherited cancer predisposition syndromes (ICPS) are rare genetic disorders associated with an elevated cancer risk. This study evaluates oral squamous cell carcinoma (OSCC) prevalence across selected ICPS, including Fanconi anemia (FA), Plummer-Vinson syndrome, Cowden syndrome, Li-Fraumeni syndrome, dyskeratosis congenita, and xeroderma pigmentosum, quantifies risk magnitude, examines age at diagnosis, and assesses tobacco's modifying effect on OSCC risk in these populations.</p><p><strong>Study design: </strong>We conducted a retrospective cohort study using the TriNetX Research Network, including patients with or without ICPS identified by ICD‑10 codes over a 20‑year period. OSCC cases were matched 1:1 by age and sex to controls. The analyses assessed prevalence, odds ratios, age at diagnosis, and the impact of tobacco use. Statistical significance was set at P < .05.</p><p><strong>Results: </strong>The prevalence of OSCC among ICPS patients ranged from 0.11% to 4.66%, with the highest in patients with FA. Among ICPS, only FA showed a markedly increased OSCC risk (OR = 40.63, P < .01), while Plummer-Vinson syndrome and dyskeratosis congenita were inversely associated. Patients with ICPS developed OSCC at younger ages (P < .0001). Smoking increased OSCC risk within ICPS (OR = 1.47), whereas nonsmokers with ICPS had a reduced risk (OR = 0.78).</p><p><strong>Conclusions: </strong>FA is strongly associated with OSCC; OSCC also occurs in Li-Fraumeni syndrome and Cowden syndrome. Patients with ICPS present with OSCC at a younger age, supporting targeted screening for high‑risk ICPS populations.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890466","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}
引用次数: 0
Self-reported race and ethnicity in relation to oral potentially malignant disorders and oral cancer. 自我报告的种族和民族与口腔潜在恶性疾病和口腔癌的关系。
IF 1.9 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-19 DOI: 10.1016/j.oooo.2025.11.006
Adriana Mendonca da Silva, Polyanna Oliveira, Mariana Bezamat Chappel, Alexandre Rezende Vieira

Objective: To investigate the association between self-reported race and ethnicity with oral potentially malignant disorders and oral cancer, considering environmental and genetic influences.

Study design: This was a case-control study including clinical information and DNA samples from 792 subjects from the University of Pittsburgh dental clinics. The cases were 264 subjects diagnosed with oral potential malignant disorders or oral squamous cell carcinoma. Controls were matched by sex and age in a 1:2 ratio. χ2 tests detected differences between groups regarding ethnicity, race, and covariates. A Post-hoc test with Bonferroni and Holm corrections accounted for multiple comparisons between groups. A standard χ2 residual test was used to investigate which ethnicity category contributed most to the association. Multiple logistic regression models were used to obtain the unadjusted and adjusted odds ratios (ORs) and to detect the association between single-nucleotide variants and outcomes, stratified by ethnicity and race.

Results: The risk of having the outcomes was 78% greater in those patients who self-reported as African American (OR, 1.78; P = .002; 95% confidence interval, 1.225-2.592). Minor allele G (rs9879992-GSK3B) increased the risk for the outcomes in patients who self-reported as African American (OR, 1.85; P = .002; 95% confidence interval, 1.236-2.772).

Conclusions: Self-reported race and ethnicity were associated with oral potential malignant disorder/oral cancer. Future studies using ancestry informative markers can confirm these findings.

目的:在考虑环境和遗传影响的情况下,探讨自我报告的种族和民族与口腔潜在恶性疾病和口腔癌的关系。研究设计:这是一项病例对照研究,包括来自匹兹堡大学牙科诊所的792名受试者的临床信息和DNA样本。264例被诊断为口腔潜在恶性疾病或口腔鳞状细胞癌的患者。对照组按性别和年龄按1:2的比例配对。χ2检验检测各组在民族、种族和协变量方面的差异。采用Bonferroni和Holm校正的事后检验解释了组间的多重比较。采用标准χ2残差检验来调查哪个种族类别对相关性贡献最大。采用多元逻辑回归模型获得未调整和调整后的优势比(or),并检测单核苷酸变异与结果之间的关联,并按种族和种族分层。结果:自我报告为非裔美国人的患者出现上述结果的风险高出78% (OR, 1.78; P = 0.002; 95%可信区间,1.225-2.592)。小等位基因G (rs9879992-GSK3B)增加了自我报告为非洲裔美国人的预后风险(OR, 1.85; P = 0.002; 95%可信区间,1.236-2.772)。结论:自我报告的种族和民族与口腔潜在恶性疾病/口腔癌相关。未来使用祖先信息标记的研究可以证实这些发现。
{"title":"Self-reported race and ethnicity in relation to oral potentially malignant disorders and oral cancer.","authors":"Adriana Mendonca da Silva, Polyanna Oliveira, Mariana Bezamat Chappel, Alexandre Rezende Vieira","doi":"10.1016/j.oooo.2025.11.006","DOIUrl":"https://doi.org/10.1016/j.oooo.2025.11.006","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between self-reported race and ethnicity with oral potentially malignant disorders and oral cancer, considering environmental and genetic influences.</p><p><strong>Study design: </strong>This was a case-control study including clinical information and DNA samples from 792 subjects from the University of Pittsburgh dental clinics. The cases were 264 subjects diagnosed with oral potential malignant disorders or oral squamous cell carcinoma. Controls were matched by sex and age in a 1:2 ratio. χ<sup>2</sup> tests detected differences between groups regarding ethnicity, race, and covariates. A Post-hoc test with Bonferroni and Holm corrections accounted for multiple comparisons between groups. A standard χ<sup>2</sup> residual test was used to investigate which ethnicity category contributed most to the association. Multiple logistic regression models were used to obtain the unadjusted and adjusted odds ratios (ORs) and to detect the association between single-nucleotide variants and outcomes, stratified by ethnicity and race.</p><p><strong>Results: </strong>The risk of having the outcomes was 78% greater in those patients who self-reported as African American (OR, 1.78; P = .002; 95% confidence interval, 1.225-2.592). Minor allele G (rs9879992-GSK3B) increased the risk for the outcomes in patients who self-reported as African American (OR, 1.85; P = .002; 95% confidence interval, 1.236-2.772).</p><p><strong>Conclusions: </strong>Self-reported race and ethnicity were associated with oral potential malignant disorder/oral cancer. Future studies using ancestry informative markers can confirm these findings.</p>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821810","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}
引用次数: 0
Prognostic significance of MMP-14 in oral squamous cell carcinoma: insights from a Colombian cohort. MMP-14在口腔鳞状细胞癌中的预后意义:来自哥伦比亚队列的见解。
IF 1.9 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-19 DOI: 10.1016/j.oooo.2025.11.007
Yeimy Valentina Castañeda Rojas, Sergio D Cruz-Romero, Ana Margarita Baldión, José Antonio Hakim Tawil, Paula A Rodriguez-Urrego, Paula Alejandra Baldión

Introduction: Matrix metalloproteinase 14 (MMP-14) is crucial in extracellular matrix remodeling and tumor progression. This study evaluated MMP-14 expression in oral squamous cell carcinoma (OSCC) and its correlations with clinical, histopathological, and sociodemographic factors.

Methods: Manual tissue microarrays were constructed from 39 OSCC and 22 healthy mucosa samples from a Colombian cohort (2015-2022). MMP-14 detection was performed via immunohistochemistry using a combined histological score. Nonparametric tests and ROC analysis assessed their prognostic value.

Results: MMP-14 was significantly overexpressed in OSCC relative to healthy mucosa (P < .05), with cytoplasmic and membranous localization. Elevated levels were observed in patients aged ≥50 (P = .05), in cases with perineural invasion (P = .01), and in tongue tumors (P = .03). ROC analysis yielded an area under the curve of 0.90, indicating diagnostic potential.

Conclusions: The findings confirm MMP-14 overexpression in OSCC and its association with perineural invasion, underscoring its role in tumor progression. No significant correlations were found with lymph node metastasis, clinical stage, or histological grade. Limitations include MMP-14's ubiquitous expression, reducing biomarker specificity. Further research incorporating additional molecular markers is warranted to refine prognostic accuracy.

基质金属蛋白酶14 (MMP-14)在细胞外基质重塑和肿瘤进展中起着至关重要的作用。本研究评估了口腔鳞状细胞癌(OSCC)中MMP-14的表达及其与临床、组织病理学和社会人口学因素的相关性。方法:对来自哥伦比亚队列(2015-2022)的39份OSCC和22份健康粘膜样本构建人工组织微阵列。MMP-14检测通过免疫组织化学使用联合组织学评分。非参数检验和ROC分析评估其预后价值。结果:与健康粘膜相比,MMP-14在OSCC中显著过表达(P < 0.05),并有胞质和膜质定位。≥50岁患者(P = 0.05)、神经周围侵犯患者(P = 0.01)和舌肿瘤患者(P = 0.03)血清中血清素水平均升高。ROC分析显示曲线下面积为0.90,显示诊断潜力。结论:研究结果证实了MMP-14在OSCC中的过表达及其与神经周围侵袭的关联,强调了其在肿瘤进展中的作用。未发现与淋巴结转移、临床分期或组织学分级有显著相关性。限制包括MMP-14的普遍表达,降低了生物标志物的特异性。进一步的研究纳入额外的分子标记是必要的,以提高预后的准确性。
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引用次数: 0
Intra-articular therapies for synovial joint dysfunction: a comprehensive integrative review. 关节内治疗滑膜关节功能障碍:一项综合综述。
IF 1.9 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-15 DOI: 10.1016/j.oooo.2025.10.026
Leonardo Brigido Metello Neves, Bernardo Correia Lima, Rafael Coutinho de Mello, Bruno Luiz Baldessarini, Rafael Vidal Peres

Objective: To summarize contemporary evidence for intra-articular therapies in synovial joint dysfunction-emphasizing temporomandibular joint (TMJ) osteoarthritis-across regenerative (platelet-rich plasma [PRP]/ injectable platelet-rich fibrin [i-PRF], mesenchymal stem cells), lubricating (hyaluronic acid [HA]), anti-inflammatory (corticosteroids), and selected adjunctive/combination approaches.

Study design: An integrative narrative review (2020-2025) was performed of randomized trials, systematic reviews/meta-analyses, and high-quality mechanistic/preclinical studies (PubMed/Scopus/Web of Science/SciELO; English/Portuguese/Spanish). Quality considerations followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidance, Mixed Methods Appraisal Tool, and Cochrane/risk of bias paradigms; TMJ-specific data were prioritized with biologically justified extrapolation from other synovial joints.

Results: Mesenchymal stem cells yield visual analog scale reductions ≈30%-50% and Western Ontario and McMaster Universities Arthritis Index gains ≈20%-40% with reassuring 2-year safety and synergy when paired with HA/PRP. PRP improves symptoms ≈3-6 months but is preparation-sensitive; i-PRF's fibrin matrix sustains bioactive release (7-14 days), shifts synovial cytokines (interleukin [IL]-1β ↓58%, IL-6 ↓63%, IL-17 ↓51%, IL-10 ↑3-5×), and is associated with magnetic resonance imaging chondral preservation and larger clinical effects in TMJ/temporomandibular disorders. HA (especially high-molecular weight or cross-linked, bacterial-derived) consistently reduces pain 25%-45% with outstanding safety. Corticosteroids offer 50%-70% short-term relief but carry dose-dependent chondrotoxicity. Adjuncts (botulinum toxin type A, dextrose, ozone) and combinations (i-PRF+HA/ozone) are promising.

Conclusions: Intra-articular therapy has advanced from palliation to mechanism-driven modulation. i-PRF and mesenchymal stem cells show the strongest disease-modifying signals; HA remains a safe backbone and carrier. Standardized preparation/ reporting and TMJ-focused randomized trials are priority needs. (Oral Surg Oral Med Oral Pathol Oral Radiol 2026;XXX:xxx-xxx).

目的:总结当前滑膜关节功能障碍突出的颞下颌关节(TMJ)骨关节炎的关节内治疗证据,包括再生(富血小板血浆[PRP]/可注射富血小板纤维蛋白[i-PRF]、间充质干细胞)、润滑(透明质酸[HA])、抗炎(皮质类固醇)和选择的辅助/联合方法。研究设计:对随机试验、系统评价/荟萃分析和高质量的机制/临床前研究(PubMed/Scopus/Web of Science/SciELO;英语/葡萄牙语/西班牙语)进行综合叙述性回顾(2020-2025)。质量考虑遵循系统评价和荟萃分析指南、混合方法评估工具和Cochrane/偏倚风险范式的首选报告项目;tmj特异性数据优先考虑其他滑膜关节的生物学合理推断。结果:当与HA/PRP配对时,间充质干细胞使视觉模拟规模减少约30%-50%,西安大略省和麦克马斯特大学关节炎指数增加约20%-40%,具有可靠的2年安全性和协同作用。PRP改善症状≈3-6个月,但对制剂敏感;i-PRF纤维蛋白基质维持生物活性释放(7-14天),转移滑膜细胞因子(白介素[IL]-1β↓58%,IL-6↓63%,IL-17↓51%,IL-10↑3- 5x),并与磁共振成像软骨保存和TMJ/颞下颌疾病的较大临床效果相关。透明质酸(特别是高分子量或交联的细菌衍生的)持续减少25%-45%的疼痛,具有出色的安全性。皮质类固醇可提供50%-70%的短期缓解,但具有剂量依赖性的软骨毒性。辅助剂(A型肉毒杆菌毒素,葡萄糖,臭氧)和组合(i-PRF+HA/臭氧)是有希望的。结论:关节内治疗已经从缓解发展到机制驱动的调节。i-PRF和间充质干细胞表现出最强的疾病修饰信号;HA仍然是一个安全的骨干和载体。标准化的准备/报告和以颞下颌关节为重点的随机试验是优先需要。(口腔外科口腔医学口腔病理口腔放射醇2026;XXX: XXX - XXX)。
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引用次数: 0
Artificial intelligence: why we need it and what it means for the future of oral medicine 人工智能:我们为什么需要它,它对口腔医学的未来意味着什么。
IF 1.9 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-15 DOI: 10.1016/j.oooo.2025.10.022
Jaisri R. Thoppay BDS, MBA, MS, DABOM, MHSA, EdD(c) , Andres Pinto DMD, MPH, MSCE, MBA
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引用次数: 0
A surgeon with a fork, in a world of soup 在汤的世界里,一个拿着叉子的外科医生:给编辑的信。
IF 1.9 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-11-15 DOI: 10.1016/j.oooo.2025.07.020
Ömer Uranbey DDS, PhD
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引用次数: 0
期刊
Oral Surgery Oral Medicine Oral Pathology Oral Radiology
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