Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

Background: Tooth loss leads to alveolar bone resorption due to deficiency of blood supply and socket shield technique was introduced to prevent this bone loss. Therefore, this study aimed to evaluate the effect of the modified socket shield technique (mSST) without immediate implant placement (test group) compared with unassisted socket healing (USH) (control group) on vertical and horizontal bone dimensional changes.

Material and methods: Patients requiring dental extraction at a non-molar site were recruited and randomly allocated to the test or control group. Cone-beam computed tomography (CBCT) scans obtained before and 4 months after surgery were superimposed to assess horizontal ridge width and vertical bone height changes. Group comparisons were performed using analysis of covariance (ANCOVA).

Results: Significant differences between the groups were found for buccal height (BH) reduction (p<0.001), buccal bone width (BW) reduction at 1mm, 3mm and 5mm (p<0.001), and overall bone resorption (p<0.001). The test group showed reduced dimensional changes, with mean differences of 1.527mm in BH, 0.982mm in BW1, 0.783mm in BW3, 0.545mm in BW5, and 26.2mm³ in volume resorption (p<0.001). No significant differences were observed in vertical or horizontal bone resorption on the lingual side. Regarding the influence of buccal bone thickness (BBT) on buccal socket dimensional changes, significant differences between groups were detected. A critical threshold of 1.5mm BBT was identified.

Conclusions: The modified socket shield technique without immediate implant placement appears to be a protective factor against post-extraction bone remodeling, particularly in sites with buccal bone thickness less than 1.5mm.

Background: This study aimed to investigate the impact of different patient information modalities on anxiety levels and physiological responses during the surgical extraction of impacted mandibular third molars.

Material and methods: A prospective randomized clinical trial was conducted involving 97 individuals undergoing surgical removal of impacted mandibular third molars. Participants were allocated into three groups: Control, verbal, and visual. Anxiety was measured using the Modified Dental Anxiety Scale (MDAS) and the State-Trait Anxiety Inventory (STAI). Heart rate, blood pressure, and oxygen saturation (SpO2) were recorded at five surgical stages. Pain was assessed using a Visual Analog Scale (VAS).

Results: VAS scores did not differ between groups. Significant intergroup differences were observed in diastolic blood pressure after local anesthesia and in SpO2 during tooth extraction and postoperatively (p<0.05). All groups showed reductions in MDAS, STAI-T, and STAI-S from the preoperative to the postoperative period. MDAS decreased significantly in the control and visual groups, while STAI-T decreased in all groups (p<0.05). STAI-S showed no significant change.

Trial registration: ClinicalTrials.gov Identifier: NCT07018115; Registration date: 10 June, 2025.

Conclusions: Although no significant differences were found between information methods in reducing anxiety, providing preoperative information may enhance patient comfort during third molar surgery. Further studies are needed to determine the most effective strategies for patient education.

Background: Patients treated with guided bone regeneration (GBR) may be treated using resorbable or non- resorbable membranes, which differ in their efficacy, failures and complication profiles. The objective is to evaluate the efficacy and failures and complications of resorbable membranes versus non-resorbable membranes in patients undergoing guided bone regeneration (GBR). A search was conducted until July 31, 2025. Randomized clinical trials (RCTs) comparing both types of membrane in ROG were the eligibility criteria.

Material and methods: Data collection and risk of bias assessment (RoB 2.0) were performed. Primary endpoints included bone regeneration efficacy and membrane-associated complications.

Results: Twenty-five RCTs with a total of 684 patients were included. Most studies reported a high success rate for both types of membranes. However, non-resorbable membranes had a higher incidence of complications, such as membrane exposure (up to 71%), disinheritance and infections.

Conclusions: Both types of membranes are effective for ROG, they should be chosen according to the defect and type of patient. Resorbable membranes have a lower complication rate and non-resorbable membranes offer greater dimensional stability and the need to perform a second surgery for its removal.

Background: Third-molar agenesis represents one of the most common developmental dental anomalies and has important clinical implications for orthodontic treatment planning and space management. Numerous epidemiological studies have evaluated third-molar agenesis worldwide; however, contemporary data based on standardized radiographic criteria in Turkish paediatric populations remain limited. This study aimed to evaluate the prevalence and early detection patterns of third-molar germ agenesis in Turkish children and adolescents.

Material and methods: Panoramic radiographs of 1,570 individuals aged 9-18 years (811 females, 759 males) were retrospectively evaluated. Agenesis was diagnosed when no radiolucency corresponding to the osseous crypt was observed and no extraction history was present. All images were assessed by two calibrated examiners demonstrating excellent inter-examiner agreement (κ=0.90). Prevalence and distribution patterns were analysed according to jaw, side, gender, and age group (9-12 vs. 13-18 years) using Chi-square and Mann-Whitney U tests (p<0.05). Multivariate logistic regression analysis was performed to identify independent predictors of third-molar agenesis, and adjusted odds ratios with 95% confidence intervals were calculated.

Results: Of 6,280 third-molar sites evaluated, 1,312 (20.9%) demonstrated agenesis. At the individual level, 33.1% of participants had at least one missing third-molar. Agenesis was more frequent in the maxilla (24.9%) than in the mandible (16.9%). The most common pattern was bilateral absence of two molars (11.7%). Agenesis prevalence was significantly higher in the 9-12-year group across all tooth regions (p<0.001).

Conclusions: Third-molar germ agenesis was common in Turkish children and adolescents. Age- and jaw-specific distribution patterns support early radiographic assessment during late mixed dentition and may provide clinically relevant information for orthodontic treatment planning while supporting ALARA(As Low As Reasonably Achievable)-based imaging strategies.

Background: Non-odontogenic bone tumors of the jawbones constitute a heterogeneous group of tumors that may arise in various regions of the maxillofacial complex and present as chondroid or bone-forming tumors (BFTs). Therefore, this 53-year retrospective study aimed to evaluate the clinical, radiographic, and histopathological characteristics of BFTs (osteoma-OT, osteoblastoma-OB and osteosarcoma-OS) diagnosed at a single oral pathology referral center in Brazil.

Material and methods: Gender, age, symptoms, clinical diagnosis, lesion duration, anatomical site, size of the lesion, and radiographic characteristics were collected from all cases previously diagnosed as BFTs, and all histological sections were reviewed.

Results: Among 19.596 cases diagnosed at the service during the study period, 74 (0.37%) were identified as OTs, OBs or OSs, with OTs being the most common (55.4%). There was a predominance of female patients (70.2%), and the mandible was the most affected gnathic bone (84.7%). Radiographically, OTs typically presented as well-delimited, radiopaque lesions (68.4%), whereas OBs (68.4%) and OSs (75.0%) frequently exhibited mixed radiolucent patterns. Histopathologically, OTs were predominantly classified as compact, and OBs were commonly typical. Osteosarcomas were frequently of osteoblastic subtype.

Conclusions: Awareness of clinical, radiographic and histopathological characteristics is essential for improving recognition of the distinct profiles of BFTs.

Background: Cleft lip and palate (CLP) are the most prevalent congenital anomalies, often resulting in impaired maxillofacial complex in all three planes of space and maxillary growth deficiency, leading to aesthetic and functional challenges. Traditional methods like calipers and rulers have limitations in precision, reproducibility, and volumetric capture for soft tissues (ST) and dental arches (DA) in CLP patients. Three-Dimensional Stereophotogrammetry (3DS) offers a non-invasive digital alternative for accurate 3D imaging. The aim of this systematic review of comparative studies was to evaluate 3DS versus standard measurements (SM) for ST and DA analysis in CLP.

Material and methods: This study identified comparative studies in humans. Six electronic databases were searched to find articles meeting the eligibility criteria up to December 2025, without language or date restrictions. Risk of bias for each included study was assessed using the 4-stage quality assessment tool for diagnostic accuracy studies (QUADAS-2). Data on outcomes of interest were extracted and tabulated. Due to methodological heterogeneity, a qualitative synthesis was performed, with quantitative evaluation where possible; no meta-analysis was conducted.

Results: From 788 records (413 PubMed, 150 ScienceDirect, 47 Scopus, 34 Web of Science, 8 Cochrane, 136 manual/gray literature), 85 underwent full-text review, yielding 7 studies (269 patients, mean age 12 years, primarily unilateral CLP). Despite methodological heterogeneity among studies, 3DS marked different landmarks in the cleft area (CA) and DA models. There was individual consensus on the accuracy and reproducibility of 3DS markings compared to other methods, and all studies showed low risk of bias in applicability and no meta-analysis due to variability.

Conclusions: All included studies demonstrated that, despite minor methodological differences, digital measurements using 3DS in patients with unilateral cleft lip and palate (UCLP) were more accurate and highly reliable than SM. Future standardized studies are needed for meta-analysis.

Background: Minor salivary gland carcinomas of the tongue are rare tumors with diverse clinical and histological features and poor prognosis. Evidence regarding their characteristics and survival is limited. This study aimed to describe their clinical presentation, histology, and survival.

Material and methods: We conducted a retrospective study of 29 patients with a histopathological diagnosis of minor salivary gland carcinoma of the tongue, treated at a referral cancer center between January 1990 and December 2024. Clinical, histological, therapeutic, and survival data were evaluated using the Kaplan-Meier method.

Results: The median age was 61 years (range, 21-99), with a female predominance (62.1%). The base of the tongue was the most common site (65.5%). Adenoid cystic carcinoma was the most frequent histology (48.3%), followed by adenocarcinoma (27.6%) and mucoepidermoid carcinoma (24.1%). Most patients were diagnosed at advanced stages (III-IV, 65.4%), with node involvement in 41.4% of cases. Surgery was the primary treatment modality (38%), and radiotherapy was administered in 48.3% of cases. Five-year disease-free survival was 70%, while overall survival was 35%, with a median of 87 months. Moderately differentiated tumors showed a trend toward better survival, without statistical significance.

Conclusions: Minor salivary gland carcinomas of the tongue are rare and frequently diagnosed at advanced stages. Prognosis is largely influenced by histology and tumor differentiation, highlighting the importance of long-term follow-up and multicenter studies to more reliably identify prognostic factors.

Background: To determine the causal efficacy of supportive periodontal care (SPC) frequency on inflammatory and anatomical periodontal outcomes using a propensity score-matched analysis.

Material and methods: This retrospective cohort study utilized electronic health records from a multi-center dental data repository. Adult patients with periodontitis and at least one year of follow-up were classified into two maintenance cohorts based on their average recall interval: Frequent Maintenance (≤4.5 months) and Infrequent Maintenance (≥5.5 months). Propensity score matching (1:1) was performed to balance baseline covariates, including age, gender, diabetes, smoking status, and baseline disease severity (PPD and CAL), resulting in a matched sample of 1,500 patients. The primary outcomes were the annualized rates of change in PPD and Bleeding on Probing (BOP). Secondary outcomes included changes in clinical attachment level (CAL), furcation involvement, and tooth mobility.

Results: Patients in the Frequent Maintenance group demonstrated significantly greater annual reductions in PPD (-0.19mm vs. -0.12mm; p<0.001) and BOP (-8.97% vs. -4.38%; p<0.001) compared to the Infrequent group. This represented a two-fold greater reduction in inflammatory burden for frequent attendees. However, no statistically significant differences were observed between groups regarding the improvement of acquired periodontal defects, including furcation involvement (p=0.15) and tooth mobility (p=0.57).

Conclusions: Frequent SPC provides a robust biological benefit by significantly reducing gingival inflammation and pocket depth but does not independently reverse acquired defects like furcation involvement or tooth mobility. These findings support a risk-based maintenance approach where visit frequency targets inflammation, while structural stability requires distinct therapeutic expectations or interventions.

Background: Rhinocerebral mucormycosis (RCM) is a severe, rapidly progressing opportunistic fungal infection with a high mortality rate, primarily affecting immunocompromised patients with diabetes mellitus or haematological malignancies. Its incidence has increased in recent years, particularly since the SARS-CoV-2 pandemic, coinciding with population ageing and the growing prevalence of immunocompromised patients. Data regarding survival rates and the most effective diagnostic and therapeutic strategies in Spain are limited. This study analyses the clinical characteristics, risk factors, and prognosis of RCM at a tertiary care centre in southern Spain.

Material and methods: A retrospective study was conducted on 36 patients treated for RCM between 2009 and 2023. Clinical-epidemiological variables, history of immunosuppression, extent of infection, diagnostic and therapeutic management, and survival outcomes were evaluated. Statistical analysis was performed using chi-square tests and regression models (p<0.05).

Results: Males predominated (66.7%), with a mean age of 58 years (range 17-83). The primary risk factors were haematological malignancies (61.1%), solid tumours (16.6%), and uncontrolled diabetes mellitus (22.2%). The most common clinical presentation was orbital involvement (86.1%), followed by sinusitis (47.2%), neurological symptoms (36.1%), and palatal necrosis (25%). Imaging studies revealed pansinusitis in 97.2% of cases and periorbital/nasomaxillary cellulitis in 66.7%. Treatment consisted of combined antifungal therapy (liposomal amphotericin B/azoles) and management of the underlying disease. Twenty-seven patients (75%) underwent surgical intervention, including endoscopic sinus surgery, maxillectomy, or orbital exenteration. Overall mortality was 66.7% (24 deaths), which was significantly associated with advanced age and the absence of surgical treatment.

Conclusions: RCM is a rare but highly lethal infection in our setting. Early diagnosis and prompt combined treatment, involving multidisciplinary management and standardised protocols, are essential to improve outcomes. The main prognostic factors identified were age, control of immunosuppression, and timely surgical intervention. Further multicentre studies are needed to optimise treatment strategies.

Background: Dental students experience high stress from academic and clinical demands, which may affect performance and well-being. Surgical procedures often increase patient anxiety, adding complexity for students. This study explored the relationship between perceived difficulty, emotional regulation, and empathy, and their impact on clinical outcomes and patient satisfaction.

Material and methods: A prospective cohort study included fourth-year dental students in the Clinical Oral Surgery and Implantology subject at the University of Barcelona Dental Hospital. Data collected comprised demographics, emotional regulation difficulties, and preoperative anxiety, using validated questionnaires. Procedure-related variables (perceived difficulty, operative time, complications) and patient data (anxiety, perceived empathy, satisfaction) were recorded.

Results: Thirty-six students performed 108 extractions on 72 patients, with a mean operative time of 38.2±19.9 minutes. Emotional regulation difficulties were not associated with surgical difficulty, empathy, operative time, or complications. Interestingly, patient state anxiety was significantly related to higher difficulty on emotional regulation by the undergraduate. No significant correlation was found between patient anxiety and number of visits. Perceived empathy positively correlated to patient satisfaction.

Conclusions: Empathy and emotional regulation are essential for enhancing patient experience and outcomes. Our findings suggest that students' emotional regulation difficulties are related to situational anxiety during clinical encounters. These results support integrating interpersonal skills into dental education to improve clinical practice and patient-centered care.