Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

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.

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.