Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

Background: The best technique to harvest gingival graft to treat gingival recessions (GR) remains a topic of ongoing debate. This systematic review aimed to evaluate the effect of de-epithelialized free gingival graft (DFGG) compared to subepithelial connective tissue graft (SCTG) in the treatment of GR Miller Class I and II or Cairo type I.

Material and methods: Five databases were searched up to June 2024 to include randomized clinical trials (RCTs) comparing the clinical effects of DFGG with SCTG in the treatment of GR. The random effects model of mean differences was used to determine GR, and gain in keratinized tissue width (KTW), gingival thickness (GT) and clinical attachment level (CAL). The risk ratio was used to complete root coverage (CRC) at 6 and 12 months.

Results: Five RCTs including 183 and 111 GR at 6 and 12 months were included in this systematic review. The meta-analysis showed no statistically significant difference in GR reduction, gain in KTW, GT, CRC or CAL between groups at 6 and 12 months.

Conclusions: At 12 months, the clinical results of DFGG were similar to those of SCTG in the treatment of GR.

Background: Stomatitis and Cheilitis Glandularis are inflammatory conditions of the minor salivary glands with uncertain aetiology, uncommon in clinical practice. Local factors and systemic comorbidities associated with hyposalivation could contribute to the onset of the disease. The aim of this study is to describe retrospectively a case series of Stomatitis and Cheilitis Glandularis from two Oral Medicine and Pathology Departments. Also, a review of the clinical and epidemiological variables and a discussion of the diagnostic criteria is presented.

Material and methods: There were included cases of Stomatitis and Cheilitis Glandularis from two Oral Diagnosis Centres from Argentina and Brazil, according to Reiter et al criteria. Demographic and clinicopathological features were described. A concise review of current literature was performed discussing diagnostic criteria and possible etiological factors.

Results: There were included six cases sequentially retrieved from the last ten years. The patients included were 4 men and 2 women with an average age of 65.33 years old. The majority of the included cases showed comorbidities or were treated with drugs associated with hyposalivation or a decrease in salivary flow. Clinically, firm nodules and pus discharge was observed in minor salivary glands. Actinic damage was a poorly associated factor in this series. Histopathology revealed sialoadenitis, oncocytic metaplasia with different degrees of periductal inflammation in all cases.

Conclusions: Stomatitis and Cheilitis Glandularis are challenging disorders of the oral cavity. Hyposalivation could be an early phenomenon in a multifactorial context. More studies are needed for a better understanding of these conditions.

Background: Chemotherapy-induced oral mucositis (OM) is a common complication of cancer treatment that significantly impacts patients' quality of life. Butyrate, a short-chain fatty acid, has been shown to inhibit inflammation and mitigate intestinal mucosal damage. How, its effect in treating OM remains unclear.

Material and methods: OM model in mice pretreated with 5-FU solution was established by injecting 20% acetic acid into oral mucosa. Sodium butyrate was given for treatment. H&E staining was used to observe histopathological changes, and qRT-PCR to assess inflammatory factor level changes in ulcer tissues after treatment. Also, qRT-PCR and immunofluorescence staining were used to evaluate the expression and distribution of tight junction protein in ulcer tissues.

Results: Sodium butyrate treatment improved the weight loss in mice caused by OM and promoted the repair of oral mucosa in a time-dependent manner. In addition, sodium butyrate significantly inhibited the mRNA levels of inflammatory factors such as tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and interleukin-18 (IL-18) in the ulcer tissue. Moreover, sodium butyrate promoted the mRNA and protein expressions of tight junction protein-1 (ZO-1) and Claudin-1 in the epithelial cells of the ulcer tissue.

Conclusions: Butyrate promotes OM healing by reducing inflammation and increasing the expression of tight junction proteins in ulcer tissues.

Background: The objectives of this study were to better understand the association between simple bone cysts (SBC) diagnosed within florid cemento-osseous dysplasia (FCOD) by systematically reviewing the literature with a meta-analysis. This review allows us to study the epidemiology, characteristics, treatments, and follow-up of the association between these two entities.

Material and methods: A systematic review was performed on PubMed, Scopus, Cochrane library, Embase and Google Scholar. Articles reporting primary studies, case reports and case series were included. We reviewed all articles between 1976 and November 2024. Recorded data were patient's characteristics, clinical and radiological features, diagnosis, treatment, and follow-up. The meta-analysis was performed for the prevalence of the localization of SBC associated FCOD and the number of SBC lesions within FCOD.

Results: A total of 615 studies were assessed for eligibility by reading titles and abstracts. Finally, 16 articles were included, with 51 patients presenting SBC associated with FCOD. Patients were mostly women (92%) with most of an African origin (81,25% ). The mean age was 41-year-old. The usual treatment for the cyst was surgical exploration with bleeding stimulation to improve healing. After surgical procedure, a majority of the followed-up cases healed completely (52%) or partially (32%). Eight cases reported a recurrence during the mean follow-up period of 6,6 years.

Conclusions: SBC and FCOD are two conditions which can be rarely associated. This may be under-diagnosed as SBC can be misdiagnosed as part of the FCOD lesions. This review highlights the similar clinical characteristics to FCOD which makes important to find out more clinical and radiographic diagnosis criteria to better diagnose and provide the adequate treatment to obtain bone healing.

Background: The odontogenic keratocyst (OKC) corresponds to the third most common odontogenic cyst of the maxillary bones, originating from the dental lamina or its remnants. Apoptosis dysregulation, due to an imbalance between anti-apoptotic and proapoptotic proteins, has been proposed as a promoter for the development and progression of OKC. This study aimed to conduct a systematic review to synthesize the current knowledge on effector proteins of the intrinsic and extrinsic pathways, and executor proteins of apoptosis in OKC and compare their expression to other odontogenic cysts and tumors.

Material and methods: Primary studies were searched in PubMed, Scopus, and Web of Science databases, following the recommendations of PRISMA. Inclusion criteria were articles in English reporting the expression of at least two apoptosis-related proteins in OKC, studies using human tissues, descriptive retrospective case series, or in vitro assays.

Results: Seven articles met the inclusion criteria and were considered for data extraction and analysis. Of the selected articles, six studied proteins related to the regulation of the intrinsic pathway of apoptosis, all reporting the immunohistochemical expression of Bcl-2 and BAX. Only one study reported the immunohistochemical expression of proteins related to the regulation of the extrinsic pathway, specifically Fas and FasL. Regarding apoptosis execution proteins, only one article characterized the immunohistochemical expression of caspases, specifically caspase-3.

Conclusions: OKC expresses proteins related to apoptosis regulation similar to other aggressive odontogenic lesions, such as ameloblastoma. This suggests that apoptosis dysregulation may be essential in its development and progression.

Background: Periodontitis triggers systemic inflammatory reactions that may be associated with different oncological diseases, such as prostate cancer (PC), although little information exists on the possibility of this association. To determine whether periodontitis is associated with PC and other non-metastatic urological cancers in patients over 50.

Material and methods: This cross-sectional study was conducted between August and September 2024 at the outpatient clinic of the Belén de Trujillo Hospital (HBT) and the Regional Institute of Neoplastic Diseases "Dr. Luis Pinillos Ganoza" - IREN Norte (IREN), in Trujillo, Peru. In total, 192 patients were evaluated: 64 with PC, 64 with non-prostatic urological cancer (NPUC), and 64 with non-oncological urological disease (NOUD). Reliability was determined through inter- and intra-evaluator calibration to diagnose periodontitis, gingivitis inflammation, and plaque control. The corresponding specialist physician diagnosed PC, NPUC, and NOUD. Statistical analysis was performed using the Chi-square and Kruskal-Wallis tests, including nonparametric multiple comparison tests, with a significance level of p<0.05.

Results: An association between periodontitis and PC was found in patients over 50. PC was also directly associated with moderate periodontitis (p=0.014) and generalized gingivitis inflammation (p=0.019). Concerning NPUC, an association was found with periodontal pockets of 3.5 - 5.5 mm (p=0.031) and last visit to the dentist more than one year ago (p=0.012).

Conclusions: There was an association between periodontitis and PC in patients over 50. Patients with moderate periodontitis and generalized GI were more likely to present PC compared with patients with NOUD. In addition, there was a greater probability of presenting PC versus NPUC in patients with periodontal pockets of 3.5-5.5 mm and in those whose last visit to the dentist was more than one year ago.

Background: The aim of this study was to evaluate the awareness and knowledge about oral cancer in a Portuguese population and to assess its possible relations with sociodemographic variables.

Material and methods: A cross-sectional questionnaire survey was conducted, with 2650 individuals that attended oncological screening initiatives in the southern region of Portugal. The questionnaire collected data on participants' socio-demographic information, life-style habits, and awareness of oral cancer.

Results: Over four-fifths of the participants (83.4%) mentioned that had already heard about oral cancer. Knowledge of oral cancer was significantly associated with age (p = 0.034), education level (p < 0.001), frequency of dentist visits (p < 0.001), and smoking (p = 0.015) and alcohol habits (p = 0.031). Regarding risk factors, smoking and alcohol usage were identified by 86% and 58.5% of the sample, respectively. Only 62.8%, 45.5%, and 37.9%, respectively, were able to correctly identify ulcers that don't heal, red and white lesions, and lumps/tissue that overgrows as early signs of oral cancer.

Conclusions: A general lack of awareness regarding oral cancer was found in this Portuguese population. Lower levels of knowledge were found in individuals of higher risk for oral cancer. Therefore, educational programs targeting the risk population are highly recommended for the primary prevention and early diagnosis of oral cancer in the Portuguese population.

Background: Osteoradionecrosis of the jaws (ORNJ) is a pernicious complication of radiation therapy that significantly affects the quality of life of patients with head and neck cancer. The present study aimed to investigate the risk factors for the clinical prognosis of ORNJ in the same scenario.

Material and methods: A cross-sectional study was designed and implemented in a tertiary teaching hospital from January 2005 to December 2020. A total of 106 patients were divided into normal wound healing group (n = 79) and delayed wound healing group (n = 27) according to two different prognosis. The risk factors associated with the prognosis in patients with ORNJ were comparatively analyzed via performing one-way and multifactorial logistic analyses.

Results: The majority of the study cohort (n = 59, 55.7%) was found to be characterized with Glanzmann and Gratz grade 2 and followed up for a median of 38.6 months. Diabetes mellitus (P = .045), Charlson comorbidity index (P = .042), American Society of Anesthesiologists score (P < .001), primary tumour site (P = .012), T stage (P = .008), ORNJ grade at initial diagnosis (P < .001), pan-immune-inflammatory value and systemic immune-inflammatory index at initial radiotherapy (P = .01 and P < .001 respectively) were detected as risk factors associated with poor prognosis in patients with ORNJ.

Conclusions: We conclude that there are abundant risk factors for poor prognosis in these patients, and it is important to be evaluated before irradiation so that suitable post-radiated treatments can be given.

Background: Oral cavity tumours represent a global oral health issue due to their prevalence and incidence, in this paper, we will explain the procedure for the removal of various tumours and the restoration of the patient's anatomy, function and aesthetics through a novel approach that rely on a temporal muscle flap for the reconstruction of soft tissues in the surgical area.

Material and methods: This study is based on an analysis of temporal flap technique data, collected at the public health hospital of Santiago de Compostela (CHUS), from 2015 to 2024.

Results: The results are shown in table 1, being the most relevant data the fact of having a series of 11 successful cases treated with temporal flap. The surgical technique involves tumor resection, preferably through an intraoral approach.

Conclusions: This novel technique must be taken into account when solving this type of oncological cases with associated maxillectomy due to it's better results in terms of reconstruction of tissues and anatomy, shorter execution time and possibility of offering immediate function to the patient, leading to less number of surgeries with their consequent lower morbidity and social-health and economic savings.