Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

Background: Quality of life research with respect to patient reported outcomes (PROs) other than pain has not yet been conducted in the field of Diffuse Sclerosing Osteomyelitis. This cross-sectional study aims to investigate changes in quality of life regarding 34 subjective parameters in patients with diffuse sclerosing osteomyelitis after intravenous Ibandronic acid administration (6mg).

Material and methods: 15 patients (11 female, 4 male) with diffuse sclerosing osteomyelitis (DSO) treated with 6mg of Ibandronic acid completed the standardized questionnaires (EORTC QLQ-C30, EORTC QLQ-H&N35, OHIP-G 14) considering quality of life before and two weeks after infusion.

Results: All 15 patients reported a significantly improved quality of life after administration of Ibandronate. Patients reported improvements in oral health associated quality of life as well as reduction of pain and intake of analgesics. In addition patients reported a significant improvement in fatigue, sexuality, social interactions, emotional, cognitive and role functioning. Furthermore patients reported an improvement in mouth opening, weight loss and loss of appetite as well as a reduction of speech and swallowing problems. Moreover, insomnia occurred less frequently after bisphosphonate infusions.

Conclusions: The study evaluates patients subjectively benefit from a standardized Ibandronic acid regimen. A significantly improved quality of life after administration of Ibandronate was observed in all 15 patients.

Background: Today, idiopathic infertility is becoming more frequent, affecting more than 186 million people in the world. The presence of comorbidities makes patient management complex, requiring individualized infertility treatment. Periodontal diseases could contribute negatively to the management of infertility, increasing inflammation, oxidative stress and insulin resistance, and contributing negatively to the development and progression of comorbidities associated with these two entities. The aim of this systematic review is to explore whether there is an association between periodontal diseases and male and female infertility and deepen into the possible mechanisms underlying this association.

Material and methods: The studies analyzed in this research included a total of 4871 patients (732 men and 4139 women), were original studies with high quality, mostly with a control group. Authors who have investigated idiopathic infertility suggest that infertility is associated with diseases that present low-grade chronic inflammation, oxidative stress and insulin resistance (such as obesity, type 2 diabetes and polycystic ovary syndrome), which are in turn related to periodontal diseases.

Results: A higher prevalence of periodontal disease was found in patients with infertility compared with controls. Periodontal diseases could initially be mediated by a local and systemic proinflammatory environment, which favors a pro-oxidant state, leading to oxidative stress and, finally, irreversible destruction of the periodontal tissue. Insulin resistance, oxidative stress and inflammation are present in the pathologies associated with an increase in the prevalence and severity of periodontal diseases (such as obesity, type 2 diabetes and polycystic ovary syndrome). Therefore, IR, low-grade chronic inflammation and the oxidative stress could be the pathophysiological mechanisms linking idiopathic infertility and periodontal diseases.

Conclusions: Studies suggest an association between infertility and periodontitis. Future researches are necessary to find causality factors. Studying the patient in a global and multidisciplinary way could help in the management and treatment of idiopathic infertility.

Background: The purpose of this study was to examine the periodontal state and oral health-related quality of life (OHRQoL) of patients with end-stage renal disease (ESRD) and the effect of ESRD on OHRQoL by comparison with age- and sex-matched systemic healthy controls with similar periodontal status levels.

Material and methods: Fifty patients with ESRD and 150 healthy individuals without ESRD were recruited. Medical characteristics were recorded for the test group and periodontal examination was performed in both groups. A structured Korean version of the Oral Health Impact Profile (OHIP-14K) questionnaire for subjective evaluation of OHRQoL was administered. To evaluate the effect of ESRD on OHRQoL, 50 healthy controls who had been matched for age, sex, and periodontal status were selected and compared with ESRD patients by using propensity score-matched analysis.

Results: ESRD patients had significantly higher mean score of Community Periodontal Index and mean numbers of missing teeth compared with the controls (P < 0.05). Mean OHIP-14K total score and mean scores of all subdomains were significantly higher in the test group than in the controls (P < 0.05). Even after matching analysis, mean OHIP-14K total score and mean scores of subdomains were significantly higher in the test group than in the control group (P < 0.05), except in one subdomain (physical pain).

Conclusions: Within the limitations of this investigation, the present study showed worse periodontal state and lower level of OHRQoL in ESRD patients compared with those in healthy subjects. Through comparison with matched healthy controls, ESRD was found to have a negative effect on OHRQoL.

Background: This retrospective study investigates the clinicopathological features and outcomes of young and elderly patients diagnosed with lip squamous cell carcinoma (LSCC).

Material and methods: Data from LSCC patients from Dr. Luiz Antonio Hospital in Natal, Brazil (2000-2015) were analyzed, grouping individuals below 40 and above 60 years old. Demographics, lifestyle habits, clinicopathologic characteristics, and treatment outcomes were examined using descriptive statistics, Chi-square and Fisher's tests, and Kaplan-Meier survival analysis.

Results: A total of 47 patients was analyzed, being 20 younger and 27 older, finding significant age-related differences (p = < 0.0001). Although in both groups the tumor was more common in males, older patients had a higher rate of females (29.6%) (p=0.0358) and smoking (70.4%) (p = 0.0043) and underwent more modalities of treatments (p = 0.0027). There were no significant differences in the other analyzed clinicopathologic factors, and survival rates did not differ significantly, though younger patients showed slightly better survival metrics in univariate analysis.

Conclusions: LSCC exhibits some distinct clinicopathological features across different age groups, with significant differences in treatment modalities and progression rates. Age-specific approaches may be required to optimize treatment outcomes.

Background: Monitoring the outcome and evolution of periodontitis treatment requires analyzing changes in the periodontium. However, traditional methods for analyzing volumetric changes in periodontal soft tissues have limitations due to their invasiveness or inaccuracy. The aim of this study was to measure the volumetric changes in periodontal tissues following scaling and root planing treatment using digital methods, such as the superimposition of pre- and post-treatment STL files Material and Methods: The study started with an initial periodontal examination and intraoral scanning. Periodontal treatment was then performed, and at the one-month re-evaluation, the same records were repeated. Finally, the clinical data and STL files of pre- and post-treatment scans were compared.

Results: in terms of clinical data, there was a mean decrease in probing depth of 0.34 ± 0.54 mm and a significant decrease in bleeding rate. Digital measurements showed a mean loss in height of 0.196 ± 0.188 mm and width of 0.344 ± 0.338 mm.

Conclusions: Quantifying periodontal tissue changes after scaling and root planing was possible by superimposing STL files. Post-treatment gingival tissue shrinkage occurred in both height and width, which was not visible with conventional recordings.

Background: Oncological therapy can trigger various complications and side effects in certain tissues, such as the oral cavity, inducing a direct or indirect impact on basic functions and the patient's quality of life. The aim of the study is to determine the prevalence of chronic oral complications of oncological treatments in patients with head and neck cancer and assess their possible relationship with risk indicators associated with the patient, the tumor, and the treatment.

Material and methods: A retrospective, single-center, observational pilot cohort study was designed at the Dental Hospital of the University of Barcelona, involving patients with head and neck cancer who underwent surgery, non-surgical oncological therapy (radiotherapy/chemotherapy/immunotherapy), or combined therapy. Medical histories were analyzed, and data related to demographics, toxic, hygienic, and dietary habits, systemic and oral health status, characteristics of cancer and its treatment, and registered chronic oral complications were collected. The results were expressed in descriptive measures (means, standard deviations, counts, prevalence, and 95% confidence intervals), and for statistical associations, parametric and non-parametric tests were used.

Results: The overall prevalence of chronic oral complications was 92.57%. Dental disease (81.14%), periodontal disease (65.14%), and hyposalivation/xerostomia (62.86%) showed the highest prevalence. Advanced age, certain cancer locations, advanced cancer stages, and oncological therapy including radiotherapy were significantly associated with the presence and number of complications.

Conclusions: The elevated noticed prevalence necessitates rigorous monitoring and preventive care. The combination of risk factors can significantly contribute to oral complications. Understanding these factors services dentists establish protocols for preventing, diagnosing, and treating oncology patients.

Background: Accurate mandibular reconstruction following tumor ablation is important yet challenging. While computer-assisted surgery and surgical navigation have been applied widely in maxillofacial reconstruction, the accuracy and the efficacy remain debatable due to the native mobile nature. This study aimed to evaluate the surgical outcomes and accuracy of mandibular reconstruction aided by different types of adjunctive computer-assisted techniques with or without intraoperative navigation.

Material and methods: Patients with anterior and/or lateral mandibular defects who underwent microvascular mandibular reconstruction aided by adjunct computer-assisted techniques, with or without intraoperative navigation were assessed. The deviations in spatial alignment of the bony segments between the pre-operative and post-operative datasets were measured to evaluate the overall surgical outcomes and accuracy. Independent t-test was performed and p-value less than 0.05 was statistically significant.

Results: A total of 93 patients with L/LC or LCL defects who underwent microvascular mandibular reconstruction aided by adjunct computer-assisted techniques with or without surgical navigation were assessed. No significant difference was observed when comparing the mean differences between the preoperative and postoperative intercondylar and intergonial distance in both navigation-assisted and computer-aided design/computer-aided manufacturing (CAD/CAM) groups. There were also no significant differences noted among the different mandibular defects, osteosynthesis plates and types of free flap.

Conclusions: Accurate mandibular reconstruction following tumor resection can be achieved by incorporating intraoperative navigation and adjunctive methods such as computer-assisted techniques and our innovative device, mandibular fixation device.

Background: Orthognathic surgery is commonly performed to correct malocclusion and facial asymmetry, typically in young and healthy patients. However, it's crucial to recognize that facial deformities can also be features of various syndromes, complicating the surgical and anesthetic management.

Material and methods: This review examines the key factors influencing anaesthesia management in orthognathic surgery patients. The perioperative care process was analyzed, focusing on the surgical procedure, airway management, and anaesthesia techniques. Additional factors considered include bleeding control, postoperative nausea and vomiting (PONV), antibiotic prophylaxis, analgesia, and deep venous thrombosis (DVT) prevention.

Results: The review highlighted the critical role of comprehensive anaesthesia management in determining the outcomes of orthognathic surgery. Proper airway management, effective bleeding control, and the prevention of PONV and DVT were identified as significant factors in optimizing patient recovery. The use of protocols and a multidisciplinary approach were emphasized as essential in minimizing complications and improving postoperative outcomes.

Conclusions: Comprehensive and carefully planned anesthesia management is vital for the success of orthognathic surgery. Employing a multidisciplinary approach and adhering to established protocols can enhance patient outcomes and expedite recovery, especially in cases involving complex syndromic patients.

Background: Oral lichen planus (OLP) is a very prevalent disease whose main clinical feature is the appearance of white hyperkeratotic reticular lesions, which may or may not be accompanied by erosive and/or atrophic lesions, among others. One of the most relevant aspects of the process is its current consideration as an oral potentially malignant disorder (OPMD), although this is currently the subject of considerable controversy.

Material and methods: A review of the literature was carried out in order to critically analyze the controversies surrounding the consideration of OLP as an OPMD, where they originate from and the available evidence that has led to the conclusion that OLP patients are at risk of developing oral cancer.

Results: The controversies over the definitive acceptance of OLP as an OPMD were classified as controversies related to the lack of widely accepted diagnostic criteria for OLP; controversies related to histopathological aspects of OLP and the presence of epithelial dysplasia as a diagnostic exclusion criterion; and controversies related to clinical aspects of OLP (which in turn were subclassified into: controversies on how to interpret reticular lesions in OLP, on the nature of the white plaques that appear in OLP; on the changing character of reticular lesions in OLP; and on the criteria for accepting a case as a true malignant OLP). Furthermore, evidence to justify the acceptance of OLP as an OPMD was in depth reviewed, including the molecular evidence, evidence from research studies with the highest evidence design -systematic reviews and meta-analyses-, and evidence from case series reporting strong results.

Conclusions: This paper presents the reasons for the controversies as well as the evidence that allows us to accept that OLP behaves as an OPMD.

Background: Diabetes mellitus is a prevalent metabolic disorder that can result in the non-enflamatuar enlargement of the parotid gland. It is recognised as a condition that can impair microvascular perfusion.

Material and methods: The parotid glands of 38 individuals with diabetes and 38 healthy controls were examined bilaterally using ultrasound to assess parameters of volume, stiffness and microvascularity.

Results: A statistically significant increase in parotid gland volume and a statistically significant decrease in microvascularity were observed in diabetic patients. Furthermore, a statistically significant increase in parotid gland volume was noted in diabetic individuals who were using antidiabetic drugs in comparison to non-users. A significant negative correlation was identified between the duration of exposure to diabetes and microvascularity.

Conclusions: Ultrasonographic imaging can be used to assess the dimensions and microvascularity of the parotid gland.