Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

Background: The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) are commonly used prognostic indicators for a variety of cancers. However, their utility in oral cancers is unknown. We systematically examined evidence on the ability of SII and SIRI to predict overall survival (OS) and disease-free survival (DFS) after oral cancers.

Material and methods: Embase, PubMed, Web of Science, and Scopus were searched for oral cancer studies reporting OS or DFS based on SII or SIRI. Articles published up to 25th May 2024 were included.

Results: 17 studies were eligible (14 on SII and 3 on SIRI). Pretreatment high SII scores were found to be significantly linked with poor OS (HR: 1.62 95% 1.26, 2.08 I2=88%) and DFS (HR: 1.62 95% 1.25, 2.27 I2=86%) after oral cancer. Similarly, high SIRI was associated with worse OS in oral cancer patients (HR: 1.60 95% 1.31, 1.94 I2=0%). All results were unchanged on sensitivity analysis. Subgroup analysis based on location, cancer type, sample size, treatment, cut-off, methods of determining cut-off, analysis method, and study quality showed mixed results.

Conclusions: Acknowledging the limitations of current evidence, it seems that both SII and SIRI can predict the prognosis of oral cancers. High SII and SIRI are both associated with worse OS while high SII also predicts worse DFS.

Background: To evaluate the evidence comparing bone morphogenetic proteins (BMPs) and autogenous bone grafts (ABGs) for regenerating bone defects from ameloblastoma.

Material and methods: An electronic search was performed in PubMed and Scopus from October to December 2023, supplemented by manual searches and review of relevant study reference lists. Cohen's kappa was calculated to assess the interrater reliability between two independent investigators. The methodological quality and risk of bias of the selected articles was assessed using the JBI checklist for case series and the NOS for observational studies.

Results: Nine studies met the inclusion criteria and were selected for the qualitative synthesis. Cohen's kappa (κ) value resulted in 98.21% agreement. A total of 229 participants were included. The BMPs were evaluated in five studies, and four evaluated the ABGs. The BMPs has been tested in 25.76% of the patients, while ABGs were studied in 74.24%. In order to evaluate the final result of regeneration, all the studies based their analysis on postoperative questionnaires, radiographical (CBCT and/or panoramic) and/or clinical examination. The results showed a higher regeneration success rate in the studies where the BMPs was used.

Conclusions: Considering the limitations of the studies and the review, it has been shown that BMPs may yield favorable outcomes in terms of bone regeneration, as compared with ABGs.

Background: This systematic review and meta-analysis qualitatively and quantitatively analyzes the current evidence on the implications of p53 upregulation in oral lichen planus (OLP) assessed by immunohistochemical techniques, in order to identify molecular mechanisms involved in the behavior of OLP as an oral potentially malignant disorder.

Material and methods: We searched MEDLINE/PubMed, Embase, Web of Science and Scopus for studies published before February-2024. We critically assessed the methodological quality of primary-level studies and performed meta-analyses.

Results: Twenty-four individual studies met the inclusion criteria, comprising 721 OLP samples, in which the expression of p53 was analyzed through immunohistochemistry. Most OLP displayed p53 protein upregulation (pooled proportion [PP]= 66.76%, 95%CI=54.84-77.76). Regarding the magnitude of association analysis, oral squamous cell carcinoma (OSCC) cases showed a significantly higher frequency according to p53 expression in comparison to OLP (OR=2.79, 95%CI=1.84-4.24; p<0.001); while, OLP exhibited a significantly higher frequency for p53 expression in comparison to healthy controls (OR=5.70, 95%CI=2.90-11.19; p<0.001).

Conclusions: In conclusion, the present study demonstrates the frequent p53 protein upregulation in patients with OLP, which is probably indicating an antitumor response in an epithelium whose cells are under cellular stress and at risk of cancer.

Background: Our objective was to carry out a systematic review of available data regarding pigmented contact cheilitis (PCC).

Material and methods: Electronic searches were performed using PubMed, Scopus, Embase, Web of Science and LILACS electronic databases. The risk of bias was assessed using the Joanna Briggs Institute tool.

Results: A total of 2070 articles were retrieved, with 7 of them reporting PCC cases. Female individuals (n=6/85.7%) were more affected, with a mean age of 32±15.4 years (range: 22-47 years). Ricinoleic acid and gum ester were the most frequently observed allergic compounds, each present in two cases. Three patients had lesions in both lips (42.8%), while three other patients (42.8%) had lesions only in the lower lip. All reported cases presented with multiple pigmented lesions (n=7/100.0%). Associated symptoms involved itching, scaling, swelling, erythema, vesicles and papules. The mean evolution time was 13.5±15.6 months (range: 2-36 months), and the average follow-up time was 12±0 months.

Conclusions: This is a condition that often scares the patient due to the unexpected appearance of hyperpigmentation. For this reason, the information transmitted in this review is expected to be relevant so that the health professional can include PCC in their list of differential diagnoses.

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, it affects 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.

Background: Rehabilitation for segmental mandibular defect is vital for mastication function and facial aesthetics. Interestingly spontaneous bone regeneration after segmental mandibulectomy sporadically occurs to avoid further bony rehabilitation. This study aimed to assess the potential of spontaneous bone regeneration in the treatment of mandibular defects.

Material and methods: An electronic search was conducted using the PubMed, EMBASE, Wiley Online Library, and Cochrane Library databases to identify eligible studies. Critical appraisal of the included articles was done using the Joanna Briggs Institute critical appraisal checklist.

Results: A total of 35 studies, including 60 patients, that investigated spontaneous bone regeneration after segmental mandibulectomy were included. Among these patients, 39 (65%) were male and 21 (35%) were female, with a mean age of 20.81 ± 16.38 years. Periosteum was completely and partially preserved during mandibulectomy in 25 and 13 patients, respectively. Continuous bone regeneration between mandibular stumps was observed in 53 (88.3%) patients during follow-up. Although the mandibular stump was not stabilized in 13 (21.67%) patients, continuous bony regeneration still occurred, with a mean recovery period of 30.29 months. This was significantly greater than the overall average recovery time of 19.87 months.

Conclusions: Spontaneous bone regeneration could occur in segmental mandibular defects, particularly in young patients with intact periosteum and rigid mandibular stump fixation.

Background: This study aimed to determine the association between sleep quality and oral lichen planus (OLP).

Material and methods: The protocol was registered in PROSPERO. The inclusion criteria used in the literature search consisted of studies that investigated sleep quality in patients with OLP, without language or publication time restrictions. The outcome measures included sleep quality, expressed by the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and General Health Questionnaire scores. A search was performed in PubMed, Embase, Web of Science, LILACS and Scopus. Another search in Google Scholar and manual search through the references as well were performed up to January 2024. Bias risk was determined using the JBI Critical Appraisal Checklist.

Results: Four observational case-control studies with a total of 1125 participants were identified. Mean age ranged between 40 and 65.2 years, and all participants were over 18 years old. In all studies, OLP patients had higher sleep disturbance scores than control groups (p<.05). Patients with erosive OLP type had higher mean scores for insomnia.

Conclusions: Even though the results disclose an association between OLP and sleep disturbances, the evidence for such association is limited, because of the small number of studies published and their heterogeneity.

Background: Dental extraction is the most common oral surgery, but it leads to the remodelling of the socket, such that an implant is required for repair. We performed meta-analysis to determine whether leucocyte- and platelet-rich fibrin (L-PRF) improves dental extraction.

Material and methods: Following a search of Scopus, Web of science, ProQuest and PubMed, six relevant studies were included (239 patients treated with L-PRF after dental extraction).

Results: The results provide higher percentage of bone formation after dental extraction in L-PRF implant patients with a mean difference of -13.16 (-15.89, -10.43) than control. Socket filling and horizontal width were also higher in the L-PRF implant group. A sub-group meta-analysis showed a significantly higher healing index 7 and 14 days after dental extraction in the L-PRF-treated group. The VAS score for pain stimuli was lower in the L-PRF group with a mean difference of 1.26 (1.00, 1.51) than control group; the difference in the heterogeneity of the studies was significant.

Conclusions: These results show that L-PRF prevents ridge formation by improving the percentage of bone formation and socket width (improved horizontal width and socket filling). In such patients, the healing index was higher and the VAS score for pain stimuli lower than in the control group.

Background: The overarching aim of this study is to furnish dental experts and researchers with a comprehensive understanding of the role of machine learning in dentistry. This entails a nuanced understanding of prevailing technologies, discerning emerging trends, and providing strategic guidance for future research endeavors and practical implementations.

Material and methods: We assessed the literature by looking for papers related to the issue after 2019 in the Pubmed, Web of Science, and Google Scholar databases. A narrative review of 29 papers satisfying the search criteria was undertaken, with an emphasis on the application of machine learning in dentistry.

Results: A review was conducted, including 29 publications. The advent of emerging technologies holds promise for enhancing the accuracy and efficiency of dental diagnosis, treatment, and prognosis. Nevertheless, the intricate nature of oral disease diagnosis and outcome prediction mandates acknowledgment of variables such as individual idiosyncrasies, lifestyle, genetics, image quality, and tooth morphology. These factors may impact the precision of machine learning models. Dental professionals should not rely solely on AI-based results but rather use them as references. Integrating these findings with clinical examinations, assessing the patient's overall health, and oral condition is crucial for informed decision-making.

Conclusions: This review explores the clinical applications of machine learning in dentistry, encompassing disciplines like cariology, endodontics, periodontology, oral medicine, oral and maxillofacial surgery, prosthodontics and orthodontics. It serves as a valuable resource for dental practitioners and scholars in understanding the computer algorithms employed in each study, facilitating the clinical translation of machine learning research outcomes.

Background: This study aimed to explore the clinical, histopathologic, and immunohistochemical characteristics of myofibromas (MFs) affecting the head and neck region.

Material and methods: Formalin-fixed paraffin-embedded tissue blocks of patients diagnosed with MFs in the head and neck were retrieved from the archives of three oral and maxillofacial pathology laboratories. Data including clinical, radiographic, microscopic and immunohistochemical findings, treatment employed, and follow-up status were retrieved from the patient's medical records or pathology reports.

Results: Sixteen cases were included in the study. Females were slightly more affected than males. The first and second decades of life were more prevalent. The most common locations were the alveolar ridge and cheek. Although rare, some of the patients were presented with intraosseous lesions. Microscopically, tumors consisted of plump, spindle-shaped myofibroblasts arranged in whorls or fascicles with varying degrees of differentiation. Immunohistochemically, diffuse positivity for vimentin and α-SMA was observed, while Ki-67 mostly showed low immunoreactivity (<5%). Treatment primarily involved complete excision.

Conclusions: MFs in the head and neck region are rare and predominantly affect female patients during the second decade of life. Despite their rarity, central MFs should be considered in the differential diagnosis of intraosseous lesions in infants.