Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

Background: Oral cancer (OC) and oral potentially malignant disorders (OPMD) pose significant challenges to public health in Brazil. This study aimed to estimate the prevalence of oral cancer (OC) and oral potentially malignant disorders (OPMD) among patients who would be treated by Brazilian dentists during their careers.

Material and methods: Data on the number of dentists in Brazil were extracted from the 2022 census data, while incidence rates for OC cases were sourced from the Brazilian National Cancer Institute (INCA). Population estimates for Brazil and data on dental check-up rates were obtained from relevant national sources.

Results: Our analysis indicates that a general dentist in Brazil can expect to encounter on average two to three OC patients and on average 675 patients with OPMDs over a 35-year career. Regional disparities were observed, with certain regions showing higher than the average number of encounters due to low density of dentists in some rural districts.

Conclusions: Brazilian dentists are likely to confront a substantial number of OC and OPMD cases during their professional tenure, emphasizing the need for public health policies aimed at enhancing dental surgeons' education in oral cancer prevention and early detection.

Background: Oral lichen planus (OLP) is an inmuno-mediated mucocutaneous chronical inflammatory disease. Multiple predisposing factors are considered, such as autoimmune response, microorganisms, medications, dental materials, psychological stress, genetic predisposition or nutritional deficiencies. The deficiency of vitamin D has been related to various autoimmune diseases like OLP.

Material and methods: The electronic search was conducted in the MEDLINE (Pubmed), Scopus, Cochrane Library and Web of Science databases. To assess any potential risk of bias, the authors critically appraised each study by the Newcastle-Ottawa Scale for cohort and case-control studies. Pooled analyses were performed using a random-effects model. Heterogeneity of the studies was assessed by the I2 statistics. Forest Plots were performed to graphically represent the difference between vitamin D concentrations in the OLP compared to healthy group, with a 95% confidence interval.

Results: After applying our inclusion and exclusion criteria, 7 articles were included in our review. The median concentration vitamin D in ng/ml found in serum for patients with OLP was of 26,6311,75ng/ml and for healthy patients was of 31,438,7ng/ml. Regarding the quantitative analysis, 7 studies were included. The difference in the concentration of vitamin D in healthy patients and patients with OLP statistically significant (Weighted Mean Difference (WMD): -6.20, 95% CI: -11.24 to -1.15, p=0.02 and I2 heterogeneity: 94%, p<0.00001).

Conclusions: The patients with OLP have statistically lower vitamin D levels than healthy patients.

Background: Patients at high risk for obstructive sleep apnea (OSA) are characterized by intermittent transient hypoxias and upper respiratory tract collapse, with reactive oxygen production and oxidative imbalance which causes an inflammatory cascade. This can generate negative effects on the periodontium, causing severe tooth attachment loss. This study aimed to determine the association between periodontitis and the risk of OSA in adults who attend outpatient otolaryngology consultations.

Material and methods: A cross-sectional observational study was carried out with 118 patients seen in the otolaryngology service of the Hospital Victor Lazarte Echegaray-ESSALUD in Trujillo (Peru), between September and October 2023. The presence and severity of periodontitis were determined using the Page and Eke criteria, and the presence and severity of OSA risk were determined using the STOP-BANG questionnaire. The results were analyzed using Chi-square, Spearman correlation and logistic regression tests, considering a significance level of p<0.05.

Results: An association was found between periodontitis and risk of OSA (p=0.000), obtaining a positive relationship with rs=0.527. In addition, there was an association between periodontitis and DM2 (p=0.028) and bronchial asthma (0.017). No association was found between periodontitis and sex (0.503) or age (0.741).

Conclusions: There is an association between periodontitis and the risk of OSA in Peruvian adult patients who attended outpatient otolaryngology consultations. This association was also found according to age, sex, smoking, DM2 and asthma. In addition, an association was found between periodontitis and DM2 and asthma, but not with sex and age.

Background: The incidence of oral cancer has exhibited a rise within the young population. Considering that oral potentially malignant disorders (OPMDs) can precede the development of oral cancer, it is imperative to conduct studies in this particular younger population. This study aimed to evaluate the frequency and conduct a comparative analysis of the clinical-demographic characteristics of OPMDs in two distinct age groups.

Material and methods: A retrospective analysis was conducted with patients diagnosed with leukoplakia, erythroplakia, and leukoerythroplakia between 1965 and 2020. The individuals were categorized into two groups: those aged up to 40 years (Group Younger) and those aged 41 years and above (Group Older).

Results: A total of 640 lesions were subjected to analysis. Among these, patients aged up to 40 years constituted 10.63% of the sample, however, this proportion decreased significantly to 6.9% between 2010 and 2020. A predominant male representation was observed in both groups, with white lesions being the most common in both as well. However, the frequency of red or mixed lesions was significantly higher (p=0.034) in the older group, along with a higher prevalence of dysplastic lesions (26.9% versus 11.8%, p=0.01). Moreover, the older group exhibited a relatively higher percentage of smokers/ex-smokers (78.6%), compared to the younger group (61.5%, p=0.085) and alcohol consumers/ex-consumers (54.9% versus 22.7%, p=0.028). Elderly individuals exhibited an unfavorable progression (p=0.028). However, a logistic regression analysis identified as significant variables associated with malignant transformation, the presence of epithelial dysplasia, and red lesions diagnosed as erythroplakia.

Conclusions: A declining frequency of OPMDs in young adults was observed over the years, whereas in older adults, these disorders exhibited an unfavorable progression.

Background: The aim of this systematic review and meta-analysis was to analyze the scientific evidence about the association between osteoporosis in postmenopausal women and the prevalence of apical periodontitis, assessed radiographically.

Material and methods: PRISMA Guidelines have been followed. The research question was: In adult women, does the presence or absence of osteoporosis affect the prevalence of AP, radiographically diagnosed? A systematic search was performed in PubMed/MEDLINE, Web of Science, Scopus and EMBASE. The meta-analyses were calculated with the Open Meta Analyst software. Risk of bias was assessed using the Newcastle Ottawa Scale. The certainty of evidence was assessed by GRADE.

Results: Four studies were selected. Meta-analysis showed an overall OR = 2.2 (95% CI = 0.94 - 4.97; p = 0.07), indicating that osteoporotic women had approximately twice the probability of having periapical lesions, compared to control women, although the difference was only marginally significant. The overall risk of bias of the included studies was moderate, and the certainty of evidence was low.

Conclusions: Apical periodontitis, assessed as periapical lesion, is more frequently diagnosed in osteoporotic women, who are twice as likely to have periapical radiolucent lesions.

Background: This article aspires to show that pterygoid implants are a magnificent and viable alternative to other posterior implants of the maxilla, especially in cases of atrophy.

Material and methods: This study is based on a retrospective analysis of pterygoid implant data from 2003 to 2023, recollecting the following variables: year of placement, location, shape of the implant, diameter of the implant, length of the implant, torque of the implant, whether or not it was post-extraction, whether or not there was immediate loading, whether or not smoking was present (smoking habit), the brand of the implant and the success/survival or failure/non survival of the implant.

Results: The total of 178 pterygoid implants placed in the 113 patients eligible for the study was analysed by subgroups, with percentage of global success of 98.3% (3 failures).

Conclusions: Pterygoid implants offer biomechanical and success/survival characteristics similar or superior to the so-called conventional implants and avoid a series of surgical and prosthodontic procedures more difficult than the ones required by other implants in many occasions.

Background: To assess the feasibility of maximizing negative margins with minimal resection of healthy tissue, as confirmed by intraoperative assessment. This approach aims to be safe, effective, and to be considered a standard procedure.

Material and methods: A prospective pilot study. Peritumoral ink marking aided in identifying margins. Transtumoral incisions were made along the central line until healthy tissue was visible. If positive or close margins were identified, an extension was performed only in the involved area. The tumor bed and outer part of the tumor were inked to determine margins for intraoperative assessment of the specimen.

Results: Twelve patients with oral squamous cell carcinoma participated in the study, comprising 3 men and 9 women, with a mean age of 58 years. Four patients were diagnosed with clinical stage I (T1N0), while eight were classified as stage II (T2 N0). All patients underwent ipsilateral neck dissection (levels I-III). Intraoperative outcomes included negative, positive, or close margins. The number of tissue blocks varied based on the size of the tongue tumor and the segments that required expansion to ensure a tumor-free margin (>1 mm), which was necessary in 8 patients. All final pathological reports indicated negative margins of >1 mm.

Conclusions: Piecemeal resection emerges as a feasible and oncologically sound procedure for achieving margins >1mm, which are deemed safe. Precisely identifying positive areas within the tumor proves significantly safer than en bloc resections. The prognoses observed in this series depended more on regional disease factors than on specific characteristics of the primary tumor.

Background: Glass ionomers may be a good alternative to composite resin restorations in special needs patients with challenging behaviours. The present study was carried out to evaluate the restorative efficacy of glass ionomer in the occlusal cavities of permanent molars among patients with special needs after one year of follow-up.

Material and methods: A randomized split-mouth study was made of a cohort of patients with special needs. First and second permanent molars with occlusal caries were treated with glass ionomer, silver amalgam and composite resin. Assessments were made at 3, 6 and 12 months, using a scale based on the original code of Ryge and the USPHS criteria.

Results: A total of 34 patients and 102 restorations comprised the study sample. The survival rate of both the glass ionomer and silver amalgam was 100%, versus 97.1% in the case of composite resin. The glass ionomer afforded good marginal adaptation and stable color, with no fractures or secondary caries.

Conclusions: The glass ionomer remained successfully for one year in the occlusal cavities of the permanent molars, with the same survival rate as silver amalgam, and better survival than composite resin, in the patients with special needs.