Oral Surgery Oral Medicine Oral Pathology Oral Radiology最新文献

Background: Oral potentially malignant disorders (OPMDs) are abnormalities with an elevated risk of transforming into oral squamous cell carcinoma (OSCC). Despite the visibility of early lesions, OSCC is frequently diagnosed at advanced stages due to low public awareness. YouTube offers potential for oral health education, but the reliability of OPMD-related content remains uncertain.

Methods: This study systematically assessed the content, reliability, and educational value of 100 English-language YouTube videos on OPMDs and oral cancer. Two independent evaluators analyzed videos using a 6-domain content rubric, JAMA benchmarks, DISCERN, and the Global Quality Scale (GQS). Inter-observer agreement was calculated.

Results: Of the 100 videos screened, 36 met inclusion criteria. The mean view count was 6,741.9 ± 14,315.5, with limited engagement (interaction index = 1.9 ± 2.3). The highest content scores were observed for Definition and Classification (4.47 ± 0.63) and Diagnostic Approaches (4.07 ± 1.05), while Patient Education ranked lowest (2.57 ± 1.09). Overall video quality was moderate (GQS = 2.94 ± 0.75; DISCERN = 47.29 ± 15.55; JAMA = 2.16 ± 0.67; VIQI = 14.13 ± 2.13). Strong correlations existed among quality indices (ρ = 0.70-0.75, P < .001), but engagement did not correlate with quality.

Conclusions: OPMD-related YouTube content frequently lacks comprehensive patient education, and credible sources are not always the most viewed. Developing accurate, accessible, and engaging educational videos remains essential.

Objective: Surgical site infections (SSI) are a common but clinically significant postoperative complication in oral squamous cell carcinoma (OSCC) surgery with center-specific microbiology. This study aimed to quantify SSI incidence, identify independent predictors as a pre-ERAS baseline, with an exploratory estimate of ERAS impact.

Study design: Retrospective cohort at a major Italian center, including 575 adults undergoing OSCC resection. SSI were defined per Centers for Disease Control and Prevention (CDC/NHSN) criteria with a 30-day surveillance window. Cultures/susceptibility testing were obtained when infection was suspected. Multivariable logistic regression with Lasso and Cox models estimated odds and hazard ratios; receiver operating characteristic analyses assessed discrimination.

Results: SSI occurred in 24.3% patients with a median onset 7 days. Independent predictors were age per 10 years, smoking, alcohol use, and radical neck dissection (RND) as supported by Cox estimates. Exploratorily, the ERAS period (late-2022 onward) was associated with lower SSI hazard. Microbiology was predominantly polymicrobial (71.4%), led by Staphylococcus aureus and Pseudomonas aeruginosa.

Conclusion: s: Age, smoking, alcohol use, and RND predict SSI. ERAS pathway was introduced in 2022. Future prospective studies are needed to improve outcomes, considering that microbiological findings and resistance rates reflect the local ecology of a tertiary Italian center and may differ in other settings.

Objective: This case series evaluates the impact of well-controlled human immunodeficiency virus (HIV) on the success of elective orthognathic osteotomies.

Methods: A retrospective review of HIV-positive patients undergoing elective orthognathic osteotomies was conducted. Inclusion criteria required patients to have an HIV diagnosis, undergo orthognathic surgery, and be treated with ART, leading to well-controlled HIV (viral load below 200 copies/mL). Those with incomplete records were excluded. Study variables were grouped into demographic (e.g., age, sex, dentofacial deformity), HIV-specific (e.g., viral load, CD4 count), and operative (e.g., procedure type). Perioperative management included continued antiretroviral therapy (ART), antibiotic prophylaxis, and strict infection control.

Results: Three patients (aged 34-59) with well-controlled HIV underwent Le Fort osteotomy and bilateral sagittal split osteotomy (BSSO). Two had developmental dentofacial deformities, one was post-traumatic. Two Le Forts were 2-piece, one was 3-piece; 2 patients had BSSO. All showed successful bone healing without increased infection or nonunion rates post-allogenic bone grafts.

Conclusion: Well-managed HIV-positive patients can achieve successful outcomes in elective orthognathic osteotomies, comparable to those in HIV-negative individuals. The small sample limits generalizability, warranting further research to assess long-term outcomes and refine perioperative guidelines.

Objective: This randomized, double-blind, split-mouth clinical trial evaluated the effects of oral vitamin C supplementation on early wound healing and postoperative complications following the surgical extraction of impacted mandibular third molars.

Study design: Fifty-six healthy individuals underwent bilateral extractions, with vitamin C and placebo randomly assigned to each side. Supplementation began 1 day before surgery and continued for 7 days. Clinical outcomes, including pain, analgesic consumption, wound healing, facial swelling, and trismus, were measured preoperatively and on postoperative days 2 and 7.

Results: Pain scores were significantly lower in the vitamin C group on day 2, while analgesic use and wound healing showed favorable trends, although these differences did not reach statistical significance. Facial swelling was significantly reduced on day 2 in the vitamin C group across all measurements. Trismus did not differ significantly between groups.

Conclusions: Oral vitamin C supplementation may reduce early postoperative pain and swelling and may support early wound healing following third molar surgery. As a safe, accessible, and low-cost intervention, vitamin C could serve as a useful adjunct in oral surgical practice to improve patient recovery and comfort. Further randomized controlled trials with longer follow-up and optimized dosing protocols are warranted.

Objective: This retrospective cross-sectional study aimed to evaluate whether patients diagnosed with Sjögren's Disease (SjD) after the COVID-19 pandemic exhibited different clinical features compared to those diagnosed before the pandemic.

Methods: A total of 24 medical records from the Oral Medicine Service of Araraquara dental school - UNESP were analyzed. Patients were diagnosed according to ACR/EULAR criteria. Fourteen patients diagnosed BETWEEN 2022 AND 2024, all with a history of COVID-19, were compared to ten patients diagnosed between 2002 and 2019. DATA on sociodemographic characteristics, systemic comorbidities, subjective symptoms, and histopathological findings were collected and statistically analyzed.

Results: An increase in the number of SjD diagnoses was observed after 2022. The post-COVID group showed a significantly higher frequency of anxiety, fatigue, memory and concentration problems, genital dryness, dysphagia, insomnia, reflux, and oral burning. No significant differences were found in objective histopathological findings between the groups.

Conclusion: These findings suggest that SARS-CoV-2 infection may be associated with an increased prevalence of subjective symptoms in patients with SjD. Further prospective studies with larger sample sizes and control groups are warranted to clarify these associations and their clinical relevance.

Objective: The Glasgow Microenvironment Score (GMS) combines the tumor stroma percentage (TSP) with the inflammatory component of the tumor microenvironment and has demonstrated prognostic significance in several malignancies. This study explored the prognostic significance of the GMS in oral squamous cell carcinoma (OSCC).

Study design: Sixty patients with OSCC were examined for Klintrup-Makinen grade (KM) and TSP, which were then merged to generate a GMS. Ki-67 immunohistochemistry was performed to assess cellular proliferation. Clinicopathological characteristics and lymph node metastases were assessed using univariate and multivariate analyses.

Results: The GMS score indicated that 27 (45%) cases were categorized as 0-KM strong, 10 (16.7%) as 1-KM weak/low TSP, and 23 (38.3%) as 2-KM weak/high TSP. A high GMS score (grade 2) was associated with the depth of invasion, increased Ki-67 index, low KM grade, and high TSP. It also showed a strong correlation with lymph node metastases and was identified as an independent prognostic indicator (OR: 22.0, CI: 2.97-163.21).

Conclusion: The GMS, a cumulative scoring system for the tumor microenvironment, can be easily evaluated on standard H and E sections without the need for additional staining. A high GMS score, marked by elevated TSP and reduced inflammatory infiltration, emerged as a robust independent predictor of lymph node metastasis.