Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

Background: The objective of this research was to evaluate the performance of specialists in oral medicine doing diagnosis of oral mucosa lesions through digital images comparing general dental practitioner in Chile.

Material and methods: 20 oral medicine specialists from the national registry of specialists in Chile and 20 general dental practitioners were invited to participate. Each participant reviewed 33 cases with digital images of oral mucosa lesions and was asked to submit diagnostic hypotheses. The proportions of correct diagnoses and diagnostic accuracy were determined. Analyses were performed using STATA 16.0.

Results: Specialists presented a higher total proportion of correct diagnoses than general dental practioners (86.5% vs 49.2%). Specialists also showed higher sensitivity (88.5% vs 59.3%) and greater specificity (85.8% vs 48.6 %) than general dental practioners in the diagnosis of oral cancer and oral potentially malignant disorders compared to benign oral lesions.

Conclusions: In Chile, oral medicine specialists are a reliable alternative to provide diagnostic guidance through e-consult, but its margin of error must be considered.

Background: The use of low-level laser is a therapeutic resource that has been widely used in medicine in general, which has properties capable of modulating inflammatory effects such as pain, edema, and trismus resulting from oral surgeries for the extraction of impacted third molars. This study aimed to evaluate the effect of laser therapy at two different wave frequencies (660nm and 808nm) in patients undergoing impacted 3rd third lower molar extraction. For this, 30 patients were selected and randomly distributed into three groups with 10 individuals each (Control Group, 660nm Group, and 808nm Group).

Material and methods: Each participant, according to their experimental group, received irradiation before the start of each surgery and immediately after the surgical procedure. The data regarding edema, pain intensity, and trismus collected before the surgeries, immediately after, and after seven days were spreadsheeted and analyzed to determine the mean and standard deviation. After the Shapiro-Wilk normality test, differences between the experimental groups were determined using Multiple Analyses of Variance, considering a significance level of 5% (p<0.05).

Results: The results showed no statistically significant difference between the experimental groups in the analyzed items. Despite this, both groups irradiated with 660nm and 808nm frequencies experienced a reduction in the perception of postoperative pain, thus suggesting the benefit of using low-power laser therapy as an adjunct in the surgical treatment of impacted lower third molars.

Conclusions: Despite the results showing no differences between the groups, using LLLT resulted in lower pain perception in the irradiated participants compared to those in the control group. This fact supports the use of LLLT as an adjuvant therapy in patients undergoing oral surgery procedures to remove impacted third molars.

Background: Chronic obstructive pulmonary disease (COPD) and periodontitis are common chronic diseases. The presence of either of the two diseases increases the risk of the other, whereas managing one reduces the risk of the other. This study aimed to summarize the current state of research and trends in this field using bibliometric analysis and visualization.

Material and methods: We used PubMed to search and download all periodontal disease- and COPD-related studies published until August 20, 2023. We further performed bibliometric analysis on the text R and Python software and visualized the results using Gephi and VOSviewer to construct latent Dirichlet allocation models that summarize idiosyncratic research themes.

Results: A total of 2, 109 publications were analyzed, with recent ones focusing on risk factors and pandemics. The country that produced the most publications was the United States with 427 publications. The most cited article was by Prof. Wang Zuomin. International Journal of Chronic Obstructive Pulmonary Disease ranked first in publications. Keywords were focused on Risk Factors and Pandemics. In addition, COVID- 19, SARS-CoV-2 and coronavirus infections have become a research hotspot since 2020. However, little attention has been paid to environmental contamination and biological mechanisms.

Conclusions: Research on periodontitis and COPD is expanding, and it currently focused on exploring risk factors and conducting clinical epidemiological studies. This exhaustive study provides a comprehensive summary of trends in this field and has important clinical implications for the screening and treatment of patients with COPD and periodontitis.

Background: This study aimed to identify and analyze the most influential Mouth Breathing (MB) articles in children and adolescents with the highest relative citation rates (RCRs), through bibliometric and altmetric analysis, from 2002 to 2021.

Material and methods: On March 27, 2023 a PubMed search was conducted to detect papers published about MB. From a total of 826 documents, the article data were downloaded from iCite database. The 100 articles with the highest RCRs were selected for analysis in terms of RCR, citations, altmetric attention score, year, journal, first author (name, institution, country), subfield and design of study. The key words were analyzed using Vosviewer.

Results: Among the 100 articles, there were no differences between the two periods analyzed for RCR and AAS values, yet 2002-11 was more cited than 2012-2021. There was no correlation between RCR and AAS; but there was with citations. Brazil was the most cited country (n=30). The articles were published in 48 journals pertaining to 8 categories, 44 corresponding to Dentistry. The most frequent study design was the cross-sectional (n=48). Although all subfields were well represented, the most frequent ones were "treatment", "sleep disorders" and "clinical characteristics/cephalometry". The most prominent keywords were "malocclusion" and "cephalometry".

Conclusions: Using RCR, a time- and field-normalized metric, one can identify influential articles in MB, a multidisciplinary research field of great importance for orthodontics. Because this bibliometric approach reduces the time from publication to the detection of an article´s importance for readers, it could be a valid alternative to using citation counts.

Background: Hypovitaminosis D raised a significant public health concern due to its potential association with various diseases, including Oral Squamous Cell Carcinoma (OSCC). The objective of this study was to compare serum 25(OH)D3 levels between individuals with and without OSCC, and by subgroups based on their smoking habits.

Material and methods: A case-control study was conducted utilizing progressive multicenter recruitment, involving 46 patients with Oral Squamous Cell Carcinoma (OSCC) and 65 controls. Serum levels of 25(OH)D3 were evaluated via electrochemiluminescence. Patients were categorized according to their vitamin D levels into sufficiency, mild deficiency, moderate deficiency, and severe deficiency. Comparative analyses of serum 25(OH)D3 levels were performed between OSCC patients and controls, as well as among subgroups based on their smoking habits. Group comparisons were made with the Mann-Whitney test, and subgroup analyses used the Kruskal-Wallis test. Significance was set at p < 0.05 Results: 91% of participants, including both OSCC patients and controls, exhibited some degree of 25(OH)D3 deficiency. Among them, 71.7% of OSCC patients and 50.7% of controls had serum levels characterized by moderate to severe deficiencies. Patients with OSCC showed lower levels of 25(OH)D3, with medians of 20.2 ng/ml (IQR 9.48), compared to controls, with medians of 24.8 ng/ml (IQR 9.13) (p=0.002). Furthermore, when comparing the medians among the four study groups (smoking and non-smoking controls and smoking and non-smoking patients with OSCC), a significant difference was observed between non-smoking control patients with 25.04 ng/ml (IQR = 9.71) and smoking OSCC patients with 19.65 ng/ml (IQR = 12.14) (p < 0.05).

Conclusions: Individuals with oral squamous cell carcinoma (OSCC) exhibited lower serum levels of vitamin D (25(OH)D3) compared to controls, suggesting a potential link between vitamin deficiency and the development of this type of cancer. Vitamin D supplementation could serve as a preventive and therapeutic strategy.

Background: To evaluate the efficacy of a novel topical dressing (composed of triamcinolone, ground Dianthus caryophyllus, eugenol, honey, and Iris germanica) for alveolar osteitis (dry socket) against Alvogyl® (composed of eugenol, butamben, and iodoform).

Material and methods: In a randomized parallel-armed clinical trial at Mashhad Dental School's Department of Oral and Maxillofacial Surgery, 36 patients with alveolar osteitis were randomly allocated into two groups according to the inclusion criteria (n=18), using sealed envelopes: one receiving a novel topical dressing and the other receiving Alvogyl®. Post-treatment pain was assessed using a visual analog scale immediately after the procedure and at 30 and 60 minutes, 24, 48, 72, and 96 hours, and one week later, as well as the frequency of dressing applications and analgesic usage. Data analysis was performed using SPSS version 26.

Results: Analyses were completed on all 36 participants without dropouts. No significant age or gender differences were found between the groups at baseline (p=0.370 and p=0.502, respectively). The novel dressing group experienced significantly lower pain scores at 30 and 60 minutes post-treatment (p<0.001), but higher scores at 24 (p=0.029), 48 (p=0.001), and 72 (p=0.017) hours, and similar pain scores immediately after the procedure and at 96 hours and 1 week (p>0.05), compared to the Alvogyl® group. The mean number of analgesics taken (p=0.097) and the mean frequency of dressing application (p=0.839) were not significantly different between the two groups.

Conclusions: The novel topical dressing demonstrated efficacy comparable to Alvogyl®, with the added benefits of cost-effectiveness and the absence of side effects, suggesting its potential as an alternative treatment for dry socket.

Background: Oral biopsy is a fundamental surgical procedure used to obtain a histopathological result that assists clinicians in establishing a definitive diagnosis of oral mucosal lesions. The aim of this study was to asses the knowledge and attitudes of dental students, general dentists, and oral surgery experts regarding the detection of oral lesions and the use of biopsy as a diagnostic tool.

Material and methods: a self-administered questionnaire consisting of 26 questions and 3 clinical cases on oral lesions was distributed to general dentists, oral surgery specialists and final-year dentistry students at the University of Barcelona. A descriptive analysis of all variables included was performed. The chi-square test was used to compare categorical variables, and a multivariate logistic regression model was performed.

Results: A total of 281 questionnaires were included in the study. In terms of diagnosing of oral lesions, 44.7% of students and 32.1% of general dentists were unable to make an accurate diagnosis, compared to 81.7% of specialists. Twelve students (15.8%) and twenty general dentists (14.9%) reported lacking the skills to perform a biopsy. Ninety general dentists (67.2%) reported feeling uncomfortable performing biopsies due to a lack of experience. Oral surgeons are 84.4 times more likely to identify lesions of the oral mucosa compared to students. General dentists experience 9.6 times more difficulty diagnosing oral lesions compared to students. General dentists are 0.43 times less likely to perform sample analysis compared to students.

Conclusions: Oral biopsy is a procedure primarily performed by specialists in oral surgery, with its use among general dentists being limited, likely due to a lack of training in the field. To encourage the use of biopsy among general dentists, clinical training should be a fundamental component of the education of oral healthcare providers.

Background: Normocalcemic Primary Hyperparathyroidism (NPHPT) is a complex syndrome that causes excess secretion of parathyroid hormone (PTH) from the parathyroid glands. PTH in bone activates the function of osteoclasts, to increase bone resorption and thus increase plasma calcium levels. Given that periodontitis generates osteolytic lesions and has a high prevalence in adults, both pathologies could share etiopathogenic mechanisms, although no studies have been found to date that have investigated this. Therefore, the aim of the study was to evaluate the bone density, periodontal status and biochemistry variables to determinate if there is a relationship between both pathologies.

Material and methods: A case-control study was carried out with 86 cases (NPHPT) and 87 controls. Bone density was evaluated through computed tomography, measured in Hounsfield units, in seven Regions of Interest. Periodontal status and biochemical variables, such as marker hormones of bone metabolism (25 OH vitamin D and PTH), were analyzed. A Student's t test, bivariate correlations were performed and the OR was calculated.

Results: NPHPT patients are more susceptible to changes in the pattern of bone remodeling due to elevated serum levels of PTH and a decrease in 25OH vitamin D under conditions of normocalcemia. The 58.9% of cases group had periodontitis Stage IV, 27% Stage III, 9.45% Stage II and 8.1% with Stage I. Control group showed a 32% periodontitis Stage IV, 39% Stage III, 8.82% have Stage II and 16.2% Stage I.

Conclusions: There was an association between NPHPT and periodontitis, with patients with NPHPT showing a 1.78 (OR) greater probability of suffering from periodontitis. Our biochemical results showed that the increase in PTH and the decrease in 25OH VIT-D were associated with loss of bone density and these patients presented advanced periodontitis.

Background: Oral cancer is a global public health problem. Late diagnosis leads to treatment delays, which consequently result in a worse prognosis and a decrease in the 5-year survival rate. The purpose of this study is to evaluate the oral pathology in a population observed within an oral cancer screening developed in Portugal.

Material and methods: Oral cancer opportunistic screening activities were conducted by the non-profit organization Liga Portuguesa Contra o Cancro ‑ Núcleo Regional do Sul (LPCC-NRS) and data collection occurred between March and December 2022. Participants completed an anonymous questionnaire to collect sociodemographic data and lifestyle habits, followed by a clinical examination of the oral cavity. All individuals classified with oral potentially malignant disorders (OPMD), or suspected lesions of malignant neoplasia were subsequently contacted between January and February 2023 and were questioned about undergoing a biopsy and its respective pathological examination result. Descriptive and analytical statistics were applied.

Results: A total of 2674 participants with a mean age of 57 years were screened. Fordyce granules (16.30%) were the most common non-pathological condition, and hairy tongue (11.04%) was the most frequently observed benign lesion. Leukoplakia (43.58%) was the most common oral potentially malignant disorder. Additionally, histological confirmation was obtained for the presence of 4 oral squamous cell carcinomas (OSCC), representing 0.15% of all population screened.

Conclusions: Although benign pathology is the most frequently found, oral potentially malignant disorders and suspected malignant lesions were identified in 6.3% of participants in these oral cancer screenings. In this regard, we conclude that the oral cancer screening actions developed by LPCC-NRS were effective in identifying positive cases of OPMDs and oral cancer, using an intraoral visual examination of the oral cavity.

Background: Periodontal disease (PD) is a chronic inflammatory disease of multifactorial origin that affects the supporting tissues of the tooth. According to WHO in 2022, severe periodontal disease will affect around 19% of the adult population worldwide. Its risk factors include the presence of periodontopathogenic bacteria in biofilm and the susceptibility of the host's immune system, among others. Preterm birth is defined as birth occurring before 37 weeks of gestational age. It also has a multifactorial origin and it's associated with risk factors such as intrauterine and extrauterine infections. There is a possibility that periodontal disease in pregnant women increases the risk of preterm birth through hematogenous pathways or the presence and intervention of inflammatory mediators.

Material and methods: Through a systematic review of existing scientific articles from 2014 to 2024, five randomized clinical trials were selected, including a total of 1984 pregnant patients diagnosed with periodontal disease. Half of these patients received non-surgical treatment, while the other half did not, aiming to evaluate a possible association between periodontal disease and/or its treatment and the occurrence of preterm birth. The risk of bias was assessed using the Cochrane "RoB 2" tool, and finally, a meta-analysis was conducted to compare the results obtained in the selected studies.

Results: Four articles showed a trend favoring non-surgical periodontal treatment as a preventive measure for preterm birth. These articles accounted for 92.2% of the total weight, while the remaining 7.85% corresponded to the single article that did not favor the treatment. However, none of the articles showed statistically significant results.

Conclusions: There is no demonstrated association between periodontal disease in pregnant women and the incidence of preterm birth. On the other hand, there is a slightly favorable trend towards non-surgical periodontal treatment during pregnancy as a measure to reduce the incidence of preterm birth, but it's not statistically significant. To obtain a definitive answer, more randomized clinical trials following similar study and design parameters are needed.