Oral Surgery Oral Medicine Oral Pathology Oral Radiology最新文献

Objective: to identify the treatment planning systems (TPS) used in radiotherapy for head and neck cancer patients and evaluate their impact in reducing toxicities to teeth, salivary glands, and nontarget tissues.

Methods: A comprehensive search was conducted in 6 databases and gray literature sources. Eligible studies involved patients with head and neck cancer undergoing radiotherapy and evaluated dosimetric strategies or planning software to protect critical structures. TPS impact was categorized as low, moderate, or high based on dose reduction and clinical benefit reported in each study.

Results: A total of 26 studies were included, covering 8 different TPS. Of these, 23 studies assessed dose reduction to the salivary glands or nontarget tissues and 3 studies focused on dental structures. Overall, 51% of TPS assessments (n = 19) reported a high impact on dose reduction, 35% showed a moderate impact, and 14% demonstrated a low impact in minimizing radiation exposure to critical structures. Eclipse was the most frequently assessed TPS, showing predominantly high or moderate impact across all structure types. These findings indicate a predominance of evidence supporting Eclipse's dosimetric performance, whereas variability among other systems (Pinnacle, Monaco, KonRad, XiO, and CORVUS) suggests differences in optimization algorithms and clinical implementation.

Conclusion: TPS show heterogeneous results regarding the sparing of nontarget tissues. Eclipse demonstrated the most consistent positive outcomes, but dental structures remain underexplored concerning TPS approaches.

Objectives: To evaluate the effects of electronic smoking devices (e-cigarettes) on the genotoxicity of oral mucosal cells compared with conventional cigarette smokers and nonsmokers, and to critically assess the methodological frameworks generating this evidence.

Study design: Searches were conducted up to July 2025 in PubMed, EMBASE, Scopus, Web of Science, CINAHL, Cochrane Library, LILACS, and grey literature. Eligible studies were observational designs assessing genotoxic damage in oral mucosal cells of adult e-cigarette users through the buccal micronucleus cytome assay (BMNcyt). Data extraction and risk of bias assessment (JBI checklists) were performed independently by two reviewers. Meta-analyses used random-effects models.

Results: Nine cross-sectional studies (n = 711) were included. Meta-analysis showed that e-cigarette users had significantly lower micronucleus (MN) frequency than smokers (mean difference: 2.75; 95% CI: 0.02-5.47; P = .048), but no significant difference compared with nonsmokers. Subgroup analysis indicated higher MN frequencies in e-cigarette users versus nonsmokers when ≥1,000 cells were analyzed per sample. Risk of bias ranged from low to high, and the certainty of the pooled evidence was rated as "very low."

Conclusions: E-cigarettes induce less genotoxicity than conventional smoking but may increase DNA damage compared with nonsmokers under standardized BMNcyt protocols. Stronger prospective studies with methodological rigor are needed.

Objectives: Dental defects were evaluated in high-risk neuroblastoma survivors (HRNBLs) who underwent myeloablative conditioning with 1 of 2 high-dose chemotherapy (HDC) regimens prior to autologous peripheral blood stem cell transplantation (PBSCT), without exposure to total body irradiation. The regimens compared were busulfan/melphalan (BuMel) and carboplatin/etoposide/melphalan (CEM).

Study design: Clinical records from 2019-2022 of HRNBL survivors at the Children's Hospital at Westmead were reviewed. Dental defects were assessed using orthopantomograms and quantified using Holtta's defect index (HDI).

Results: Thirteen BuMLP and thirteen CEM patients were included. Mean age at HDC was 3.0 ± 1.1 years and mean age at assessment was 11.3 ± 3.2 years. The study population presented with a mean HDI of 45.6 (±18.8). BuMLP presented with a mean HDI of 51.9 (±18.8) compared to CEM with a mean HDI of 39.4 (±17.3), although this was not statistically significant. All subjects demonstrated altered root development (P = .04), while 65.4% (n = 17) presented with microdontia and 69.2% (n = 18) exhibited dental agenesis.

Conclusion: HRNBLs show a high prevalence of dental defects after HDC. Impacts of BuMLP versus CEM require further investigation.

Aim: This study evaluated whether fractal analysis of periapical radiographs can detect periradicular disease.

Materials and methods: Sixty periapical radiographs of mandibular molars were divided into four groups based on the Periapical Index (PAI) (n = 15 per group; scores 1-4). Fractal analysis of periapical and furcation regions was performed using the box-counting method in ImageJ. Multiple region of interest (ROI) sizes were tested (20 × 20, 25 × 25, 30 × 30, 40 × 40, 50 × 50, 60 × 60, 70 × 70, 20 × 50, and 20 × 40 pixels) to determine the best correlation with PAI scores. Statistical analyses included one-way analysis of variance with Tukey's post hoc test, Student t-test, and ROC analysis (p < 0.05). External validation was conducted using 33 additional radiographs.

Results: Fractal dimension (FD) values from periapical ROIs (20 × 20, 25 × 25, and 30 × 30) and bifurcation ROIs (20 × 20 and 25 × 25) significantly differed between healthy (PAI 1-2) and diseased (PAI 3-4) teeth (P < .05). ROC analysis supported the diagnostic value of these ROIs, with the highest AUC for the bifurcation 20 × 20 ROI. In the internal dataset, periapical and bifurcation 20 × 20 ROIs achieved the highest accuracies (0.82 and 0.80, respectively), and the bifurcation 20 × 20 ROI showed the greatest sensitivity (0.93). External validation confirmed the robustness of the bifurcation 20 × 20 ROI (accuracy 0.76, sensitivity 0.65, and specificity 0.88).

Conclusion: Fractal analysis can identify periradicular disease on periapical radiographs. Diagnostic accuracy depends on the analyzed region and ROI size, with the 20 × 20-pixel bifurcation ROI yielding the best performance.