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Antiresorptive therapy in combination with radiation results in enhanced risk for necrosis and associated complications 抗骨质吸收疗法与放射治疗相结合会增加坏死和相关并发症的风险
Pub Date : 2024-08-09 DOI: 10.1016/j.oooo.2024.07.008
Katharina Theresa Obermeier DMD MD, Wenko Smolka, Benjamin Palla, Moritz Kraus, David Steybe, Jens Tobias Hartung, Florian Nepomuk Fegg, Tim Hildebrandt, Ina Dewenter, Nicholas Callahan, Philipp Poxleitner, Sven Otto
Patients exposed to a combination of antiresorptive medication and radiotherapy of the head and neck area developing necrosis of the jaw in the course of treatment are extremely rare. Therefore, the aim of this study was to identify the outcome and complications in this highly vulnerable patient cohort. Seventeen patients who received both antiresorptive treatment and radiotherapy (medication-related osteonecrosis of the jaw/osteoradionecrosis = the [MRONJ/ORN] group) in the head and neck area were enrolled in this study. Included patients were treated in our department between 2005 and 2022. Four hundred twenty-four patients with MRONJ (the MRONJ group) and 138 patients with ORN of the jaw were enrolled as two control groups (the ORN group). Demographic data, lesion localization, date of primary diagnosis, clinical symptoms, type of therapy (surgical or non-surgical), details on antiresorptive treatment, outcome, and complications were recorded. Pathological fractures, continuity resection, and recurrence appear more often in patients who receive a combination of antiresorptive treatment and radiotherapy in the head and neck area compared with patients undergoing only one of these treatments. There was a statistically significant difference ( < .001) between the MRONJ/ORN group and the MRONJ group and the MRONJ/ORN group and the ORN group considering recurrence, fracture, and continuity resection. Patients with ORN combined with MRONJ have a 4-times higher risk for developing recurrence compared with patients with MRONJ and a 1.5-times higher risk for recurrence compared with patients with ORN. Jaw fracture and continuity resection appear more often in patients with MRONJ/ORN. Patients under antiresorptive therapy in combination with radiation therapy in the head and neck area have a higher risk for developing complications in case of osteonecrosis of the jaw. Therefore, a strict follow-up care schedule is highly recommended.
头颈部接受抗骨质吸收药物和放射治疗的患者在治疗过程中发生颌骨坏死的情况极为罕见。因此,本研究旨在确定这一极易受伤害的患者群体的治疗结果和并发症。本研究选取了头颈部同时接受抗骨质吸收治疗和放射治疗的17名患者(药物相关性颌骨坏死/骨坏死=[MRONJ/ORN]组)。所纳入的患者均在 2005 年至 2022 年期间在我科接受过治疗。424 名 MRONJ 患者(MRONJ 组)和 138 名颌骨 ORN 患者作为两个对照组(ORN 组)。研究人员记录了患者的人口统计学数据、病变定位、初诊日期、临床症状、治疗类型(手术或非手术)、抗骨吸收治疗的详细情况、疗效和并发症。与只接受其中一种治疗的患者相比,头颈部接受抗骨质吸收治疗和放疗联合治疗的患者更容易出现病理性骨折、连续性切除和复发。考虑到复发、骨折和连续性切除,MRONJ/ORN组与MRONJ组、MRONJ/ORN组与ORN组之间的差异有统计学意义(< .001)。ORN 合并 MRONJ 患者的复发风险是 MRONJ 患者的 4 倍,是 ORN 患者的 1.5 倍。MRONJ/ORN患者更容易发生颌骨骨折和连续性切除。头颈部接受抗骨质吸收治疗和放射治疗的患者发生颌骨骨坏死并发症的风险较高。因此,强烈建议严格执行随访护理计划。
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引用次数: 0
The effect of a blooming artifact reduction filter on the dimensional analysis of implants 减少模糊伪影过滤器对植入物尺寸分析的影响
Pub Date : 2024-08-09 DOI: 10.1016/j.oooo.2024.08.004
Matheus Akira Sakurada DDS MSc, Luiz Eduardo Gregoris Rabelo DDS MSc PhD, Ivonete Barreto Haagsma DDS, Luis Carlos do Carmo Filho DDS MSc PhD, Carlos Estrela DDS MSc PhD, Isabela Reginaldo DDS, Thais Marques Simek Vega Gonçalves DDS MSc PhD
To assess the effect of a blooming artifact reduction (BAR) filter on cone beam computed tomography images (CBCT) in the dimensional analysis of dental implants. Six types of implants ( = 5 for each type) composed of titanium (3 types), titanium-zirconia alloy, zirconium oxide, and titanium-aluminum-vanadium alloy, and made with 2 manufacturing processes (milled and printed) were individually installed in a bovine rib block according to the manufacturer's protocol. CBCT images were acquired with i-CAT and Carestream 9600 scanners, randomized, and analyzed without and with the e-Vol DX BAR filter (60 images for each scanner). Implant length, diameter, and thread-to-thread distance were measured by two radiologists, with a stereomicroscopic image of each implant as the reference standard for calculation of distortion in measurements. Repeated measures ANOVA with Bonferroni corrections and intraclass correlation coefficients (ICC) were applied (α = 0.05). The BAR filter significantly reduced distortion in various parameters for specific implants, aligning closely with stereomicroscopic measurements. Titanium and printed implants showed reduced dimensional distortion regardless of BAR filter use. Carestream measurements presented smaller dimensional differences than i-CAT for most implants and parameters, especially without BAR ( < .05). Interexaminer reliability was good to excellent, with ICC ranging from 0.80 to 0.95. The BAR filter can enhance implant dimensional analysis, although variations based on implant material and manufacturing process were observed.
目的:评估锥形束计算机断层扫描图像(CBCT)在牙科植入物的尺寸分析中使用花斑伪影减少(BAR)滤波器的效果。按照生产商的规程,将六种类型的种植体(每种类型 5 个)分别安装在牛肋骨块上,这些种植体由钛(3 种)、钛-氧化锆合金、氧化锆和钛-铝-钒合金组成,采用两种生产工艺(铣削和印刷)制造。使用 i-CAT 和 Carestream 9600 扫描仪采集 CBCT 图像,对图像进行随机化处理,并在不使用和使用 e-Vol DX BAR 过滤器的情况下对图像进行分析(每台扫描仪各采集 60 幅图像)。由两名放射科医生测量种植体的长度、直径和螺纹间距,并以每个种植体的立体显微镜图像作为计算测量失真的参考标准。采用重复测量方差分析,并进行 Bonferroni 校正和类内相关系数 (ICC) 计算(α = 0.05)。BAR 过滤器明显减少了特定种植体各种参数的失真,与体视显微镜测量结果非常吻合。无论是否使用 BAR 过滤器,钛和印刷种植体的尺寸变形都有所减少。对于大多数种植体和参数,Carestream 测量的尺寸差异比 i-CAT 测量的尺寸差异要小,尤其是在不使用 BAR 的情况下 ( < .05)。检查者之间的可靠性从良好到极佳,ICC 在 0.80 到 0.95 之间。BAR 过滤器可以提高种植体的尺寸分析能力,但根据种植体材料和生产工艺的不同也会出现差异。
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引用次数: 0
Severe odontogenic infections in patients with mental disorders—the challenge of ineffective initial treatment 精神障碍患者的严重牙源性感染--初期治疗无效的挑战
Pub Date : 2024-08-08 DOI: 10.1016/j.oooo.2024.08.002
Satu Manninen BDS, Johanna Snäll MD DDS PhD, Tero Puolakkainen DDS PhD, Aleksi Haapanen DDS PhD
This study clarified possible delays and deficiencies in severe odontogenic infection (OI) treatment in patients with mental disorders. Data of hospitalized patients with severe OI were evaluated retrospectively. The outcome variable was preceding health care visits prior to hospitalization. The primary predictor was patient's mental disorder. Explanatory variables were age, sex, smoking, heavy alcohol use, immunocompromised disease or medication, and time span from beginning of symptoms to hospitalization. Also, factors leading to intensive care unit (ICU) care were evaluated. Preceding visits prior to hospitalization were found in 61 (35.5%) out of 172 patients with OI. In total, 27 patients (15.7%) had a current mental disorder, more commonly in women (26.0%) than in men (8.1%) ( = .001). Patients with mental disorders had preceding health care visits related to the current infection notably more often than patients without recent psychiatric history (51.9% vs. 32.4%), = .053. Patient-related treatment delay remained nonsignificant. Heavy alcohol use ( = .010) and smoking ( = .025) predicted ICU treatment, but no association with patient's mental disorder was found. A patient's mental disorder can complicate diagnosis of OI. Effective and timely treatment requires the professional's ability to simultaneously identify the patient's mental health challenges and progressing OI.
本研究阐明了精神障碍患者在严重牙源性感染(OI)治疗中可能存在的延误和不足。研究人员对严重牙源性感染住院患者的数据进行了回顾性评估。结果变量是住院前的医疗就诊。主要预测因素是患者的精神障碍。解释变量包括年龄、性别、吸烟、酗酒、免疫力低下的疾病或药物以及从症状开始到住院的时间跨度。此外,还对导致重症监护室(ICU)护理的因素进行了评估。在 172 名 OI 患者中,有 61 人(35.5%)在住院前曾就诊。共有 27 名患者(15.7%)目前患有精神障碍,其中女性患者(26.0%)多于男性患者(8.1%)(= 0.001)。与近期无精神病史的患者(51.9% 对 32.4%)相比,有精神障碍的患者之前就诊与当前感染相关的次数明显增多(= .053)。与患者相关的治疗延迟仍然不显著。大量饮酒(=0.010)和吸烟(=0.025)会影响重症监护室的治疗,但与患者的精神障碍没有关联。患者的精神障碍会使开放性损伤的诊断复杂化。有效而及时的治疗要求专业人员能够同时识别患者的心理健康挑战和正在发展的 OI。
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引用次数: 0
Automated detection and classification of mandibular fractures on multislice spiral computed tomography using modified convolutional neural networks 利用修正的卷积神经网络在多层螺旋计算机断层扫描上对下颌骨骨折进行自动检测和分类
Pub Date : 2024-08-05 DOI: 10.1016/j.oooo.2024.07.010
Jingjing Mao MDS RES, Yuhu Du BCS, Jiawen Xue BDS RES, Jingjing Hu MDS RES, Qian Mai MDS ATP, Tao Zhou PhD, Zhongwei Zhou DDS PhD
To evaluate the performance of convolutional neural networks (CNNs) for the automated detection and classification of mandibular fractures on multislice spiral computed tomography (MSCT). MSCT data from 361 patients with mandibular fractures were retrospectively collected. Two experienced maxillofacial surgeons annotated the images as ground truth. Fractures were detected utilizing the following models: YOLOv3, YOLOv4, Faster R-CNN, CenterNet, and YOLOv5-TRS. Fracture sites were classified by the following models: AlexNet, GoogLeNet, ResNet50, original DenseNet-121, and modified DenseNet-121. The performance was evaluated for accuracy, sensitivity, specificity, and area under the curve (AUC). AUC values were compared using the -test and values <.05 were considered to be statistically significant. Of all of the detection models, YOLOv5-TRS obtained the greatest mean accuracy (96.68%). Among all of the fracture subregions, body fractures were the most reliably detected (with accuracies of 88.59%-99.01%). For classification models, the AUCs for body fractures were higher than those of condyle and angle fractures, and they were all above 0.75, with the highest AUC at 0.903. Modified DenseNet-121 had the best overall classification performance with a mean AUC of 0.814. The modified CNN-based models demonstrated high reliability for the diagnosis of mandibular fractures on MSCT.
评估卷积神经网络(CNN)在多层螺旋计算机断层扫描(MSCT)上对下颌骨骨折进行自动检测和分类的性能。回顾性收集了 361 名下颌骨骨折患者的 MSCT 数据。两名经验丰富的颌面外科医生对图像进行了注释,作为基本真相。利用以下模型检测骨折:YOLOv3、YOLOv4、Faster R-CNN、CenterNet 和 YOLOv5-TRS。用以下模型对断裂点进行分类:AlexNet、GoogLeNet、ResNet50、原始 DenseNet-121 和修改后的 DenseNet-121。根据准确性、灵敏度、特异性和曲线下面积(AUC)对其性能进行了评估。AUC 值使用-检验进行比较,<.05 的值被认为具有统计学意义。在所有检测模型中,YOLOv5-TRS 的平均准确率最高(96.68%)。在所有骨折亚区域中,体部骨折的检测最为可靠(准确率为 88.59%-99.01%)。在分类模型中,体部骨折的 AUC 值高于髁部骨折和角部骨折,均在 0.75 以上,其中最高的 AUC 值为 0.903。改进型 DenseNet-121 的整体分类性能最佳,平均 AUC 为 0.814。基于改进型 CNN 的模型在 MSCT 下颌骨骨折诊断中表现出很高的可靠性。
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引用次数: 0
Illicit cocaine and opioid drug-related maxillofacial trauma: a 10-year review of a state-wide database of all hospitals admissions 与非法可卡因和阿片类药物有关的颌面部创伤:对全州所有医院入院数据库的十年回顾
Pub Date : 2024-08-05 DOI: 10.1016/j.oooo.2024.07.013
Vincent Tran BDS, Michael Qiu BDS MBBS FRACDS (OMS), Santosh Kumar Tadakamadla PhD BDS MDS PGD-HP FHEA MRACDS (DPH), Kai Lee PhD BDSc MBBS MMedSc FRACDS (OMS)
The aim of this study was to investigate the characteristics of illicit cocaine and opioid drug-related facial trauma and determine whether the presence of cocaine or opioid drug use in facial trauma patients influenced the cause of injury, morbidity, or management. A retrospective observational cohort study was performed using records from a state-wide database of all patients who presented to a Victorian hospital with a facial fracture between 2004 and 2014. Data collected included demographics, concomitant opioid and cocaine use, mechanism of injury, facial injuries, and management. Statistical analysis was done using chi-square test, Student's tests, binary logistic regression analysis, and multivariable linear regression analysis. Results were considered statistically significant if < .05. A total of 54,613 patient presentations for facial trauma were analyzed with 363 patients in the cocaine and opioid-related group, and 54,250 patients in the nondrug-related group. Patients with illicit drug use were more likely to have facial fractures caused by interpersonal violence when compared with nondrug users (47.9% vs 23.5%, OR = 2.23, < .001). Opioid and cocaine users had 0.3 more total fractures per presentation, which included more midface and skull fractures, and more facial lacerations ( < .001). There was no statistically significant difference in the need for surgical management between the two groups. Opioid and cocaine affected patients also on average had a longer hospital stay of 3.4 days and required 0.9 more allied health inputs during their admission when compared with nondrug users ( < .05). This effect was similarly reflected when controlling for confounding variables ( < .001). Concomitant cocaine or opioid use in facial trauma patients leads to more violence-related injuries with higher morbidity and healthcare costs.
本研究旨在调查非法可卡因和阿片类药物相关面部创伤的特征,并确定面部创伤患者使用可卡因或阿片类药物是否会影响受伤原因、发病率或治疗。我们利用全州数据库中的记录开展了一项回顾性观察队列研究,该数据库收录了 2004 年至 2014 年间因面部骨折前往维多利亚州一家医院就诊的所有患者。收集的数据包括人口统计学特征、同时使用阿片类药物和可卡因的情况、受伤机制、面部损伤和处理方法。统计分析采用卡方检验、学生检验、二元逻辑回归分析和多变量线性回归分析。如果结果小于 0.05,则认为具有统计学意义。共分析了 54,613 名面部创伤患者,其中可卡因和阿片类药物相关组有 363 名患者,非药物相关组有 54,250 名患者。与非吸毒者相比,使用非法药物的患者更有可能因人际暴力而导致面部骨折(47.9% vs 23.5%,OR = 2.23,< .001)。阿片类药物和可卡因使用者每次发病时的骨折总数比其他人多0.3例,其中包括更多的中面部和颅骨骨折,以及更多的面部撕裂伤(< .001)。两组患者在手术治疗需求方面没有明显的统计学差异。与非吸毒者相比,受阿片类药物和可卡因影响的患者平均住院时间延长了3.4天,入院期间需要的专职医疗投入增加了0.9 ( < .05)。在控制了混杂变量后,这一影响也得到了类似的反映(< .001)。面部外伤患者同时使用可卡因或阿片类药物会导致更多与暴力相关的伤害,并带来更高的发病率和医疗费用。
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引用次数: 0
Expression and clinical significance of U2AF homology motif kinase 1 in oral squamous cell carcinoma U2AF 同源结构激酶 1 在口腔鳞状细胞癌中的表达及其临床意义
Pub Date : 2024-07-22 DOI: 10.1016/j.oooo.2024.07.005
Xuan Zhang, Yuanyong Feng, Fei Gao, Tongtong Li, Yan Guo, Shengyou Ge, Ning Wang
U2AF homology motif kinase 1 (UHMK1) is a newly discovered molecule that may have multiple functions. Recent studies have revealed that UHMK1 had aberrant expression in many tumors and was associated with tumor progression. However, UHMK1 was rarely reported in oral squamous cell carcinoma (OSCC). In this study, Western blot, quantitative real-time polymerase chain reaction (PCR), and immunohistochemistry were used to detect the expression of UHMK1 in OSCC and peritumoral non-neoplastic tissues. Then, its relationship with clinicopathologic parameters was analyzed. The Kaplan–Meier method and Cox regression model were used to analyze the effects of UHMK1 expression on the prognosis and survival of OSCC patients. Our results showed that UHMK1 had higher expression in OSCC tissues compared with in peritumoral non-neoplastic tissues, and its high expression was associated with high TNM stage and lymph node metastasis. High UHMK1 expression was related to short overall and disease-free survival times. Moreover, UHMK1 expression was identified as an independent prognostic factor that influences overall and disease-free survival of OSCC patients. High expression of UHMK1 is associated with the poor prognosis of patients, and it can be used as a potential prognostic molecule for OSCC.
U2AF同源基序激酶1(UHMK1)是一种新发现的分子,可能具有多种功能。最近的研究发现,UHMK1 在许多肿瘤中都有异常表达,并与肿瘤进展有关。然而,UHMK1在口腔鳞状细胞癌(OSCC)中却鲜有报道。本研究采用Western印迹、定量实时聚合酶链反应(PCR)和免疫组织化学方法检测UHMK1在OSCC和瘤周非肿瘤组织中的表达。然后分析了其与临床病理参数的关系。采用Kaplan-Meier法和Cox回归模型分析了UHMK1表达对OSCC患者预后和生存的影响。结果表明,与瘤周非肿瘤组织相比,UHMK1在OSCC组织中的表达量更高,且其高表达与TNM分期和淋巴结转移相关。UHMK1 的高表达与总生存期和无病生存期的缩短有关。此外,UHMK1的表达被认为是影响OSCC患者总生存期和无病生存期的独立预后因素。UHMK1的高表达与患者的不良预后有关,可作为OSCC的潜在预后分子。
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引用次数: 0
First Report – Parotid Tissue Choristomas Within and Adjacent to TMJ Ligaments 首次报告--颞下颌关节韧带内和颞下颌关节韧带附近的腮腺组织瘤
Pub Date : 2024-07-22 DOI: 10.1016/j.oooo.2024.07.006
Scotty Bolding DDS, S. Bryan Whitaker DDS, R. Constance Wiener DMD PhD, Jerry Bouquot DDS MSD
To report the first examples of ectopic salivary glands of TMJ ligaments & capsules. Nine subjects with chronic TMJ disorders were found incidentally to have ectopic salivary glands (choristomas) within or near damaged TMJ ligaments and capsules. Clinicopathologic characteristics of 12 TMJs are summarized. The 9 subjects were ages 22-64 years (average = 43.0); 6 were female. Microscopic examination revealed major, almost complete ligament replacement by dense, avascular fibrous scar tissue in all but 1 sample. Chronic inflammatory cells were present in the stroma of 3 samples. A total of 33 lobular, independent salivary structures of variable sizes where embedded in or near ligaments and/or capsules. Half were multiple in the same joint; 13 were bilaterally located in the joints of a single subject, with 8 small glandular lobules in one TMJ. All glands consisted of histologically normal serous acini except 1 which showed a focal lobule of mucus acini and another comprised only of mucus acini. Serial sections showed no connection to parotid glands. Some choristomas showed the aging phenomena of fatty infiltrates (n = 7) and oncocytosis (n = 7). Additionally, 3 of the 12 TMJ samples contained preauricular lymph nodes, with 3 nodes in 1 joint and bilateral involvement in 1 subject. Of the 5 identified nodes, all but one was hyperplastic, with nonspecific inflammatory histiocytosis. We report, for the first time, independent salivary gland choristomas (n = 33) within the soft tissues of the TMJ (n = 12), with one joint containing 8 such choristomas. All consisted of normal serous tissue except one, a mucus gland. Additionally, a fourth of TMJ surgical samples contained hyperplastic preauricular lymph nodes.
报告颞下颌关节韧带和关节囊异位唾液腺的首例病例。偶然发现九名患有慢性颞下颌关节疾病的受试者在受损的颞下颌关节韧带和囊内或附近有异位唾液腺(绒毛膜瘤)。现总结 12 例颞下颌关节病的临床病理特征。9 名受试者的年龄在 22-64 岁之间(平均 = 43.0),其中 6 人为女性。显微镜检查发现,除 1 个样本外,所有样本的韧带几乎全部被致密的无血管纤维瘢痕组织取代。3 个样本的基质中存在慢性炎症细胞。韧带和/或韧带囊内嵌或附近共有 33 个大小不等的分叶状独立唾液结构。其中一半位于同一关节中;13 个位于单个受试者的双侧关节中,其中一个颞下颌关节中有 8 个小腺叶。所有腺体均由组织学上正常的浆液性尖头组成,只有一个腺体显示出局灶性的粘液性尖头小叶,另一个腺体仅由粘液性尖头组成。连续切片显示与腮腺没有联系。一些绒毛膜瘤出现了脂肪浸润(7 例)和肿瘤细胞增多(7 例)的老化现象。此外,12 个颞下颌关节样本中有 3 个包含耳前淋巴结,其中 1 个关节有 3 个淋巴结,1 个受检者为双侧受累。在已确定的 5 个淋巴结中,除一个外,其余均为增生性淋巴结,并伴有非特异性炎性组织细胞增生症。我们首次报告了颞下颌关节软组织内的独立唾液腺绒毛膜瘤(33 个)(12 个),其中一个关节包含 8 个此类绒毛膜瘤。除一个粘液腺外,其余均为正常浆液组织。此外,四分之一的颞下颌关节手术样本中含有增生的耳前淋巴结。
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引用次数: 0
Local anesthesia nerve block for managing burning mouth syndrome: a scoping review 局部麻醉神经阻滞治疗烧灼口腔综合征:范围综述
Pub Date : 2024-07-22 DOI: 10.1016/j.oooo.2024.07.007
Camila Barcellos Calderipe DDS, Laura Borges Kirschnick DDS MSc, Thaís Cristina Esteves Pereira DDS, Erison Santana dos Santos DDS MSc, Ana Carolina Uchoa Vasconcelos DDS MSc PhD, Marcio Ajudarte Lopes DDS MSc PhD, Nathaniel Simon Treister DMD DMSc, Alan Roger Santos-Silva DDS MSc PhD FAAOM
To assess the clinical scenarios in which nerve blocks are employed in the context of burning mouth syndrome (BMS). This scoping review followed the PRISMA-ScR. A protocol was generated on Open Science Framework. Electronic searches were performed in the following databases: PubMed, Scopus, EMBASE, Web of Science, LILACS, and Cochrane, in addition to the grey literature and citations from Grémeau-Richard et al. (2010). Nerve blocks were used for treatment purposes in all cases. The mandibular nerve and the stellate ganglion were both blocked in 50% studies, while the maxillary nerve and lingual nerve were blocked in 25% study each. The anesthetics used were lidocaine (50%) and bupivacaine (50%). Relief was generally reported after immediate block, and at a mean follow-up of 4.5 weeks, there was considerable improvement compared to the initial conditions when the mandibular and/or maxillary nerve were targeted. The use of nerve blocks has been employed in the treatment of patients with refractory BMS. Clinical studies with standardized methodology are necessary to validate and understand the potential role of mandibular and maxillary nerve block in this setting.
评估烧灼口腔综合征(BMS)中使用神经阻滞的临床情况。本范围界定综述遵循 PRISMA-ScR。在 "开放科学框架"(Open Science Framework)上生成了一份协议。在以下数据库中进行了电子检索:PubMed、Scopus、EMBASE、Web of Science、LILACS 和 Cochrane,以及灰色文献和 Grémeau-Richard 等人(2010 年)的引文。所有病例均采用神经阻滞治疗。50%的研究对下颌神经和星状神经节均进行了阻滞,而上颌神经和舌神经阻滞的研究各占25%。使用的麻醉剂为利多卡因(50%)和布比卡因(50%)。据报道,立即阻滞后症状普遍得到缓解,在平均 4.5 周的随访中,与针对下颌神经和/或上颌神经的初始条件相比,症状有了显著改善。神经阻滞已被用于治疗难治性 BMS 患者。为了验证和了解下颌和上颌神经阻滞在这种情况下的潜在作用,有必要采用标准化方法进行临床研究。
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引用次数: 0
A systematic review and meta-analysis on the use of regenerative graft materials for socket preservation in randomized clinical trials 关于在随机临床试验中使用再生植骨材料进行牙槽窝保存的系统回顾和荟萃分析
Pub Date : 2024-07-18 DOI: 10.1016/j.oooo.2024.07.003
Seyed Abdolhojeh Alavi DDS, Mahsa Imanian DDS, Salem Alkaabi DDS MSc MOMS RCS Ed, Ghamdan Alsabri DDS MSc, Tim Forouzanfar MD PhD, Marco Helder PhD
To evaluate if regenerative materials with/without scaffold deployed in dental socket preservation led to reduced radiographic height and width bone resorption. English-written human studies from January 2010 to December 2023 were selected from PubMed, EMBASE, MEDLINE, Cochrane CENTRAL, Google Scholar and manually searched journals. Six meta-analyses were conducted, addressing treatments with all blood-derived growth factor preparations as well as L-platelet-rich fibrin (L-PRF) separately, and recombinant human BMP-2 (rhBMP-2). An unpaired t-test on L-PRF and rhBMP-2 determined the clinically best preservation treatment. Cochrane risk of bias in all studies was analyzed. Twenty-nine articles (1068 participants) were included. Meta-analyses on blood-derived preparations demonstrated nonsignificant alveolar width, but significant ( = .001) height preservation. L-PRF vs. natural healing demonstrated nonsignificant changes in both dimensions. RhBMP-2 caused highly significant reduced horizontal ( = .01) and vertical ( < .0008) bone resorptions. When comparing mean resorption rates, significant benefits of rhBMP-2 over L-PRF were observed for width but not height preservation ( < .0001 and = .057, respectively). Six studies recorded low, 8 moderate, and 15 high net risks. Regenerative materials appear beneficial for radiographic bone width and height preservation after tooth extraction. Although rhBMP-2 performed better in alveolar width preservation, L-PRF can be an autologous and cost-effective alternative.
评估在牙槽窝保存中使用带/不带支架的再生材料是否会减少放射线高度和宽度骨吸收。研究人员从 PubMed、EMBASE、MEDLINE、Cochrane CENTRAL、Google Scholar 和人工搜索的期刊中筛选出 2010 年 1 月至 2023 年 12 月期间的英文人类研究。共进行了六项荟萃分析,分别探讨了所有血源性生长因子制剂、L-富血小板纤维蛋白(L-PRF)和重组人BMP-2(rhBMP-2)的治疗方法。通过对 L-PRF 和 rhBMP-2 进行非配对 t 检验,确定了临床上最佳的保存治疗方法。对所有研究的科克伦偏倚风险进行了分析。共纳入 29 篇文章(1068 名参与者)。关于血源性制剂的 Meta 分析表明,牙槽宽度的保存效果不显著,但高度的保存效果显著(= 0.001)。L-PRF 与自然愈合相比,两个维度的变化都不显著。RhBMP-2 可显著减少水平(= 0.01)和垂直(< 0.0008)骨吸收。在比较平均骨吸收率时,观察到 rhBMP-2 比 L-PRF 在保持宽度方面有显著优势,但在保持高度方面则没有(分别为 < 0.0001 和 = 0.057)。6项研究记录了低净风险,8项为中度,15项为高度。再生材料似乎有利于拔牙后放射骨宽度和高度的保存。虽然 rhBMP-2 在保留牙槽宽度方面表现更好,但 L-PRF 可以作为一种自体的、具有成本效益的替代材料。
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引用次数: 0
The Effect of Imaging Programs and Segmentation Methods on the Accuracy of Volume Measurements of Teeth 成像程序和分割方法对牙齿体积测量准确性的影响
Pub Date : 2024-07-01 DOI: 10.1016/j.oooo.2024.07.001
Merve Aydoğdu, M. Adisen, Gülsah Ertas
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引用次数: 0
期刊
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
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