Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

Background: Normocalcemic Primary Hyperparathyroidism (NPHPT) is a complex syndrome that causes excess secretion of parathyroid hormone (PTH) from the parathyroid glands. PTH in bone activates the function of osteoclasts, to increase bone resorption and thus increase plasma calcium levels. Given that periodontitis generates osteolytic lesions and has a high prevalence in adults, both pathologies could share etiopathogenic mechanisms, although no studies have been found to date that have investigated this. Therefore, the aim of the study was to evaluate the bone density, periodontal status and biochemistry variables to determinate if there is a relationship between both pathologies.

Material and methods: A case-control study was carried out with 86 cases (NPHPT) and 87 controls. Bone density was evaluated through computed tomography, measured in Hounsfield units, in seven Regions of Interest. Periodontal status and biochemical variables, such as marker hormones of bone metabolism (25 OH vitamin D and PTH), were analyzed. A Student's t test, bivariate correlations were performed and the OR was calculated.

Results: NPHPT patients are more susceptible to changes in the pattern of bone remodeling due to elevated serum levels of PTH and a decrease in 25OH vitamin D under conditions of normocalcemia. The 58.9% of cases group had periodontitis Stage IV, 27% Stage III, 9.45% Stage II and 8.1% with Stage I. Control group showed a 32% periodontitis Stage IV, 39% Stage III, 8.82% have Stage II and 16.2% Stage I.

Conclusions: There was an association between NPHPT and periodontitis, with patients with NPHPT showing a 1.78 (OR) greater probability of suffering from periodontitis. Our biochemical results showed that the increase in PTH and the decrease in 25OH VIT-D were associated with loss of bone density and these patients presented advanced periodontitis.

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.

Background: Oral cancer is a global public health problem. Late diagnosis leads to treatment delays, which consequently result in a worse prognosis and a decrease in the 5-year survival rate. The purpose of this study is to evaluate the oral pathology in a population observed within an oral cancer screening developed in Portugal.

Material and methods: Oral cancer opportunistic screening activities were conducted by the non-profit organization Liga Portuguesa Contra o Cancro ‑ Núcleo Regional do Sul (LPCC-NRS) and data collection occurred between March and December 2022. Participants completed an anonymous questionnaire to collect sociodemographic data and lifestyle habits, followed by a clinical examination of the oral cavity. All individuals classified with oral potentially malignant disorders (OPMD), or suspected lesions of malignant neoplasia were subsequently contacted between January and February 2023 and were questioned about undergoing a biopsy and its respective pathological examination result. Descriptive and analytical statistics were applied.

Results: A total of 2674 participants with a mean age of 57 years were screened. Fordyce granules (16.30%) were the most common non-pathological condition, and hairy tongue (11.04%) was the most frequently observed benign lesion. Leukoplakia (43.58%) was the most common oral potentially malignant disorder. Additionally, histological confirmation was obtained for the presence of 4 oral squamous cell carcinomas (OSCC), representing 0.15% of all population screened.

Conclusions: Although benign pathology is the most frequently found, oral potentially malignant disorders and suspected malignant lesions were identified in 6.3% of participants in these oral cancer screenings. In this regard, we conclude that the oral cancer screening actions developed by LPCC-NRS were effective in identifying positive cases of OPMDs and oral cancer, using an intraoral visual examination of the oral cavity.

Background: The placement of Temporary Anchorage Devices (TADs) in the mandibular buccal shelf area is a common option for distalizing the lower arch. Therefore, the study of bone thickness and depth in this area is mandatory before planning TAD insertion. The aim of this study was to quantify the width and depth of the mandibular buccal shelf structure and examine its associations with sex, age, skeletal class and vertical pattern.

Material and methods: A cross-sectional study was carried out on cone beam computed tomographies obtained from 91 patients. The bone thickness was evaluated in the mandibular buccal shelf area 5 and 8 mm apical to the cement-enamel junction (CEJ), and the bone depth was measured 4 mm buccal to the CEJ at the level of the distal root of the mandibular first molar and the mesial root of the mandibular second molar using the InVivoDental 6.0 software.

Results: The depth and thickness of the bone increased in distal areas, and the thickness was greater at 8 mm. No differences were found between sex or skeletal class. Bone thickness decreased with age, and it was significantly lower in hyperdivergent patients.

Conclusions: The thickness of the bone was higher in distal and deeper areas, and the depth was greater in distal areas. The hyperdivergent facial pattern and age were negatively associated with bone thickness.

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, severe periodontal disease will affect 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: 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.