Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

Background: Selective serotonin reuptake inhibitors are currently the preferred drugs for treating depression, a condition that has become more prevalent in recent years. Fluoxetine is one of the most widely used, but, like other antidepressants, it can cause several systemic and oral adverse effects. This systematic review aimed to analyze the frequency of oral adverse effects of fluoxetine in comparison to other antidepressants.

Material and methods: For this purpose, a search was conducted in the Medline, Scopus, Cochrane, and Web of Science databases, which included randomized clinical trials and observational studies.

Results: A total of 333 articles were collected. After eliminating duplicates, articles that did not meet the inclusion criteria were discarded, and 31 studies were ultimately selected.

Conclusions: Dry mouth was the most prevalent oral adverse effect associated with fluoxetine, with a frequency rate ranging from 2.71% to 52.17%. However, it was less frequent compared to other antidepressants. It is unclear whether this sensation is accompanied by decreased salivary flow, as the studies did not perform objective determinations. Regarding dysgeusia, its frequency could not be analyzed since only two articles collected data on it. The selected articles also mention other adverse effects, such as nausea or vomiting. However, none of them evaluated the potential oral manifestations resulting from these effects.

Background: This study aimed to evaluate changes in buccal cortical bone and lesion volume in teeth with persistent periapical disease one year after periapical surgery using cone-beam computed tomography (CBCT).

Material and methods: A prospective study was conducted involving patients with persistent periapical disease undergoing periapical surgery, with one year of follow-up. Data collected included patient age, gender, teeth involved, and the number of roots/lesions. CBCT measurements were taken preoperatively and one year post-surgery, including the distance from the cementoenamel junction to the buccal bone crest (CEJ-BBC), marginal bone loss, buccal cortical height, presence of fenestration, apical depth, cortical bone width at 1, 3, and 5 mm from the buccal bone crest, and lesion volume in mm³. Success was assessed using the "Modified Penn 3D criteria."

Results: The study included 92 patients with 111 roots exhibiting persistent chronic periapical lesions. Statistically significant changes were observed in all buccal cortical bone parameters one year after surgery. The CEJ-BBC distance increased, indicating a marginal bone loss of 0.23 mm. Notably, the height from the buccal cortical bone crest to the lesion, apical depth, buccal bone thickness, the number of fenestrations, and lesion volume decreased (91.1%). Buccal cortical bone thickness was a predictor of volume reduction, showing a significant relationship at T1 between greater thickness and smaller volume variation. Patient age and gender did not significantly influence these changes. Fenestrations and larger lesion volumes correlated with reduced healing probabilities. The overall success rate was 88%, with tooth position and root involvement impacting healing outcomes.

Conclusions: One year post-surgery, buccal cortical bone showed no clinically relevant changes, while lesion volume decreased by 91.1%, more significantly in anterior teeth. Greater buccal cortical bone width was associated with smaller volume reduction. A larger lesion volume and presence of fenestrations adversely affected healing rates.

Background: Treatment methods for mandibular condylar fractures in children can be broadly divided into closed treatment and open treatment (open reduction and internal fixation). The aim of the study is to evaluate the feasibility of removing the fracture fragments when treating intracapsular condylar fractures in children.

Material and methods: A retrospective study was performed in patients aged ≤12 years with intracapsular condylar fractures treated with removal of the fracture fragments from June 2010 through June 2018. The preoperative and postoperative data of physical complaints, facial asymmetry, maximal interincisal distance, occlusal relationship and radiographic examinations were extracted from the patients' records. The collected preoperative and postoperative data were analysed.

Results: Thirteen intracapsular condylar fractures in nine cases were subjected to fracture fragments removal. In these patients, clinical and radiographic results at different follow-up periods displayed normal occlusion and satisfactory bone healing. New condyles were found to be regenerated, in the cases with follow-up period longer than 3 months.

Conclusions: Removal of fracture fragments proves to be effective in delivering satisfactory clinical results and permitting ongoing condyle remodelling and regeneration.

Background: The presence of mandibular third molars has been associated with the risk of mandibular fractures, highlighting the need for comprehensive studies considering the interaction with other mandibular structures. This study investigates how mandibular third molars and neighboring tissues can influence the structural fragility of the mandible using finite element analysis.

Material and methods: A finite element analysis study following the guidelines proposed by RIFEM 1.0 was performed using three previously created mandible models: Model A, without right and left third molars; Model B, without one third molar; Model C, with bilateral presence of third molars. A 2452N force was applied to the right mandibular body in a virtual environment, allowing for a structural analysis of each mandible.

Results: Models without third molars and with only one third molar showed similar energy dissipation patterns, contrasting with the model with both third molars. The presence of third molars influenced the magnitude and distribution of stress, highlighting fragility points in specific areas such as the lingual surface, the condyles bilaterally (models without and with one contralateral third molar to trauma), and the distal cervical region of the second molar (third molar absent), as well as significantly showed the path of energy towards the contralateral side of the trauma with a concentration of energy at the contact points of virtually all teeth present immediately after impact.

Conclusions: The presence of mandibular third molars influenced the distribution and magnitude of stress within the mandible during a simulated high-impact trauma. Models with third molars exhibit distinct stress patterns, with fragility points appearing in critical areas such as the lingual surface, condyles, and second molar regions. These findings suggest that the presence of third molars increases the structural fragility of the mandible, potentially elevating the risk of mandibular fractures, especially in the context of traumatic impacts.

Background: Celiac disease (CD) is a systemic disorder characterized by an enteropathy of highly variable clinical expression, in which the relationship with oral pathology has not yet been fully elucidated. We aimed to update the current knowledge on oral manifestations in CD, to identify evidence gaps and to point out future research lines.

Material and methods: PRISMA-ScR guidelines were followed. MEDLINE/PubMed, Embase, Web of Science and Scopus were searched for primary-level observational studies to analyze the prevalence of oral pathology in CD patients, without language or publication date restrictions.

Results: We included 107 studies, encompassing a total of 26148 celiac patients and 36063 controls. Our results point to several oral pathologies with higher prevalence in CD patients than in healthy controls, most notably recurrent aphthous stomatitis (RAS)(n=69 studies/12606 celiac patients), developmental enamel defects (n=61 studies/5037 patients), dental caries (n=33 studies/2730 patients), delayed eruption (n=12 studies/1062 patients), atrophic glossitis (n=10 studies/1062 patients), angular cheilitis (n=7 studies/10606 patients), gingivo-periodontal diseases (n=7 studies/1122 patients), and Sjögren's syndrome (n=5 studies/953 patients).

Conclusions: CD is frequently associated with oral pathologies, including RAS, dental caries, gingivitis, decreased salivary flow, dental enamel defects and some relevant autoimmune processes, such as oral lichen planus and probably Sjögren's syndrome.

Background: Recent studies have suggested that some opportunistic periodontal pathobionts have oncogenic properties. However, few bibliometric studies investigate the relationship between periodontitis and gastrointestinal cancer. This bibliometric study aimed to analyze these epidemiological studies conducted between 2014 and 2023 to guide future research.

Material and methods: In March 2024, the Scopus database was explored. The articles selected were subjected to a bibliometric analysis of study designs, trends in annual scientific production, and networks of collaboration among countries. Furthermore, the most outstanding countries, academic institutions, authors and journals with the most significant number of publications and the top most cited articles were analyzed. For this purpose, Microsoft Excel, SPSS and VOSviewer 1.6.20 were used.

Results: A total of 123 documents were included for analysis. China contributed the most significant number of publications (33 articles) and the United States had the most significant number of citations (2709). Weimin Ye (h-index:81) and Dominique Michaud (h-index:73) were the most prolific authors (5 articles); Dominique Michaud also had the most citations (470). International Journal of Cancer was the journal with the highest number of articles published (6), in addition to being the publication that had the most citations of these articles (409). Tufts University in the United States had the highest number of citations.

Conclusions: Between 2014 and 2023, 123 articles on the relationship between periodontitis and gastrointestinal cancer were published. The largest scientific production was found in China, and the most cited articles were those from the United States. Likewise, the research design most commonly used was the cross-sectional type.

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: Oral manifestations are frequent in patients with hematological malignancies undergoing chemotherapy and may be directly or indirectly related to drug toxicity. Few studies have assessed the chemotherapy and oral manifestations that patients might develop. Therefore, this study aimed to evaluate the incidence of oral manifestations in patients with hematologic neoplasms during hospitalization and chemotherapy.

Material and methods: A Prospective Cohort Study, in which adult patients diagnosed with hematological malignancies undergoing chemotherapy were followed up daily to observe the possible development of oral manifestations. Sociodemographic and oncological data as well as oral manifestations when presented were collected. All the patients underwent photobiomodulation to prevent mucositis. STATA/SE 12.0, and Excel 365 software were used to assess the collected data. Fisher's exact test was used to assess categorical variables.

Results: 95 patients were included in this study. Sixty four (67,4%) of the patients were male, 31 female (32,6%) and the mean age was 44 years of age (SD 15,1) ranging from 19 to 79. Non-Hodgkin's lymphoma is the most common neoplasm. Cytarabine was the most commonly administered drug used in 72 patients (75,8%). Fungal infections were the most frequent oral manifestations. There was no correlation between the histological diagnosis and the risk of developing oral mucositis.

Conclusions: Oral manifestations are frequent in patients with hematological malignancies who are undergoing chemotherapy. Since there is a tendency for increasing cases of hematologic neoplasms annually, it is of paramount importance to know the treatments offered to these patients and the related side effects in order to prevent them and consequently decrease morbimortality.

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: Extraction of impacted third molars is a standard procedure in dentistry. However, the postoperative inflammation and pain are undesired and uncomfortable. Methylprednisolone has emerged as a possible solution to improve outcomes. This systematic review aimed to evaluate methylprednisolone in the postoperative period of impacted third molars in relation to its efficacy in postoperative pain and edema, dosage regimens, administration forms, and adverse effects.

Material and methods: Following the PRISMA guidelines, the focus question was: "In patients who underwent impacted third molar extraction, what was the effect of methylprednisolone used postoperatively compared to non-use or the use of other medications within the same pharmacotherapeutic group to reduce inflammation and pain?" PubMed/MEDLINE and Scopus were consulted, and an additional manual was performed. The search included articles published in the last 10 years, with the language restriction to English. The articles were analyzed using the PRISMA principles, with pre-defined eligibility criteria. The data were extracted based on the general necessary information. The risk of bias for the RCTs included was performed using a revised Cochrane risk-of-bias tool for randomized trials, and a meta-analysis was performed.

Results: Nine articles were included, and five were quantitatively analyzed. Evaluating the test and control groups (methylprednisolone versus controls), there was no significant heterogeneity for pain at 24 hours (p=0.15, I²=47%) and 7 days (p=0.15, I²=47%), with non-significant effects (p=0.85). In the inter-incisal reduction, there was homogeneity at 48 hours (p=0.96, I²=0%) and 7 days (p=0.37, I²=0%), with a greater reduction in the methylprednisolone group (p<0.01 and p<0.05, respectively).

Conclusions: Methylprednisolone is efficient in safely treating patients after third molar extraction, reducing pain, edema, and trismus. It achieved better results for the inter-incisal level than dexamethasone; otherwise, dexamethasone is preferable in minimizing postoperative trismus, presenting superior potential in this specific clinical context.