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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2021. Vol. 26, no. 4
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- Oral mucositis. Is it present in the immunotherapy of the immune checkpoint pd1/pd-l1 against oral cancer? A systematic review(2021) Peña Cardelles, Juan Francisco; Salgado Peralvo, Ángel Orión; Garrido Martínez, Pablo; Cebrián Carretero, José Luis; Pozo Kreilinger, Jose Juan; Moro Rodríguez, José ErnestoOral mucositis (OM) is a painful lesion that takes place in the mucosa of the oral cavity, usually its etiology is associated with drug therapies in cancer patients. It is presented as well-defined ulcers whose painful symptomatology sometimes implies the suspension of oncological treatment or parenteral feeding, being therefore an important adverse effect, marking the evolution of these types of therapies against cancer. The present work aim is to know the prevalence of oral mucositis in oral cancer immunotherapy compared to its prevalence in standard therapy. A protocol was developed for a systematic review following PRISMA® guidelines and a focused question (PICO) was constructed. A comprehensive literature search was conducted on electronic databases including PubMed, the SCOPUS database, the Cochrane library and the Web of Science (WOS). Six clinical trials were included that met the different inclusion criteria. In these articles, a discrepancy between the prevalence of OM in patients treated with chemotherapy and patients treated with immunotherapy related to the immune checkpoint PD-1/PD-L1 (Nivolumab and Pembrolizumab) was observed. The prevalence of oral mucositis is lower in new immunotherapy with monoclonal antibodies against oral cancer than drugs used so far (chemotherapy drugs [methotrexate, cisplatin] as well as cetuximab). However, more studies should be carried out to confirm these data.
- Oral cancer awareness in North-Western Spain:a population-based study(2021) Varela Centelles, Pablo Ignacio; Seoane, Juan; Ulloa-Morales, Yaima; Estany Gestal, Ana; Blanco-Hortas, Andrés; García Pola, María José; Seoane Romero, Juan M.An early diagnosis depends greatly on patient awareness. Thus, the aim of this study was to investigate general awareness of oral cancer and knowledge about its risk factors, signs and symptoms. Cross-sectional population-based survey of randomly selected respondents conducted from March 1, 2015 to 30 June 2016. A total of 5,727 people entered the survey (response rate: 53%). When asked what cancers participants had heard about, 20.3% mentioned oral cancer. Regarding risk factors, tobacco was mentioned by 55.3% of the sample (n=3,169), followed by alcohol (12.5%; n=708), poor oral hygiene (10.8%; n=618), diet (6.5%; n=377), and genetics (4.5%; n=248). General population has low awareness of oral cancer with poor knowledge of risk factors and main alarm signs. In addition, individuals in the risk group scored lower values in the main variables analysed; even those highly educated showed insufficient awareness and knowledge of oral cancer. In these circumstances, there is clear need for educational interventions tailored to the target audience and aimed at increasing knowledge and awareness of oral cancer to promote primary prevention of oral cancer and minimising the time interval of patients with symptomatic oral cancer in their path to treatment.
- Whole exome sequencing and system biology analysis support the "two-hit" mechanism in the onset of Ameloblastoma(2021) Shi, Yueqi; Li, Mengyu; Yu, Yejia; Zhou, Yuqiong; Wang, ShaoyiAmeloblastoma is the most frequent odontogenic tumor. Various evidence has highlighted the role of somatic mutations, including recurrent mutation BRAF V600E, in the tumorigenesis of Ameloblastoma, but the intact genetic pathology remains unknown. We sequenced the whole exome of both tumor tissue and healthy bone tissue from four mandibular ameloblastoma patients. The identified somatic mutations were integrated into Weighted Gene Co-expression Network Analysis on publicly available expression data of odontoblast, ameloblast, and Ameloblastoma. We identified a total of 70 rare and severe somatic mutations. We found BRAF V600E on all four patients, supporting previous discovery. HSAP4 was also hit by two missense mutations on two different patients. By applying Weighted Gene Co-expression Network Analysis on expression data of odontoblast, ameloblast, and Ameloblastoma, we found a proliferation-associated gene module that was significantly disrupted in tumor tissues. Each patient carried at least two rare, severe somatic mutations affecting genes within this module, including HSPA4, GNAS, CLTC, NES, and KMT2D. All these mutations had a ratio of variant-support reads lower than BRAF V600E, indicating that they occurred later than BRAF V600E. We suggest that a severe somatic mutation on the gene network of cell proliferation other than BRAF V600E, namely second hit, may contribute to the tumorigenesis of Ameloblastoma.
- Application of remote online learning in oral histopathology teaching in China(2021) Zhong, Yi; Sun, Wen; Zhou, Lili; Tang, Miaoning; Zhang, Wei; Xu, Jiani; Jiang, Yue; Liu, Laikui; Xu, YanThe aim of this study was to investigate the application of remote learning and virtual microscopy in oral histopathology teaching, a unique experience in China. The oral histopathology teaching in Nanjing Medical University has been extraordinary. 98 third-year dental students of Grade 2016 took oral histopathology theoretical course face-to-face in 2019 (Traditional group). The 94 participants of Grade 2017 took online oral histopathology course using digital methods(E-Learning platform and Virtual Simulation Experiment Teaching Center for Dentistry) in 2020. During the practical laboratory sessions, the students in both Traditional group and Online group observed the same glass slides for morphological learning. A questionnaire survey explored students' attitudes towards the remote online learning. Results: The mean Theory test scores of the Online group (80.93±12.15) were significantly higher than those of the Traditional group (73.65±8.46) (P < 0.01). The mean total scores of the Online group (82.94±10.76) were significantly higher than those of the Traditional group (77.25±7.55) (P < 0.01). The percentage of high total test score (test score > 85) of the Online group (54%) was also significantly higher than that of the Traditional group (15%) (P< 0.01). Furthermore, both remote learning and virtual microscopy courses were well accepted by students according to the questionnaire. This study found that remote learning and virtual technology have a positive impact on oral histopathology. The findings reveal that the application of remote online learning has enhanced oral histopathology teaching in China.
- Evaluation of saliva as a complementary technique to the diagnosis of COVID-19:a systematic review(2021) Sagredo-Olivares, Katherine; Morales-Gómez, Constanza; Aitken Saavedra, JuanInfectious disease coronavirus 2019 (COVID-19) is caused by the SARS-CoV-2 virus, and it mainly affects the upper respiratory tract. The gold standard for its diagnosis is real-time reverse transcription polymerase chain reaction (RT-qPCR) performed on a nasopharyngeal swab. In contrast, testing saliva has significant advantages as a diagnostic method. We searched for articles evaluating saliva as a diagnostic method for COVID-19 on the PUBMED/MEDLINE, WEB OF SCIENCE, COCHRANE, and SCIELO platforms. We initially found 233 articles and 20 were selected for inclusion following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol: 18 cross-sectional studies and 2 case reports, including 8 from America, 8 from Asia, and 4 from Europe. The studies evaluated the presence of viral RNA, IgG, IgM, and IgA in samples of unstimulated saliva from adults with confirmed or suspected COVID-19. The vast majority of the studies performed RT-qPCR on the saliva samples and compared the results with the gold standard (a nasopharyngeal swab of the same patient). Saliva samples analyzed by RT-qPCR, reverse transcription isothermal amplification (RT-LAMP), spectroscopy, and enzyme-linked immunosorbent assay (ELISA) offer high sensitivity to detect SARS-CoV-2 in the early stages of the disease and among asymptomatic patients as compared to nasopharyngeal swab RT-qPCR. In addition, the self-collection of saliva offers the possibility of receiving telemedicine instructions to carry out the test, reducing the risk of contagion. The diagnosis of COVID-19 through saliva is sensitive, non-invasive, and is of low risk for the healthcare professionals. However, further studies are recommended to validate its clinical use.
- Dysplasia in oral lichen planus:relevance, controversies and challenges. A position paper(2021) González Moles, M.A.; Warnakulasuriya, Saman; González-Ruiz, Isabel; Ayen Rodríguez, Ángela; González-Ruiz, Lucía; Ruiz Avila, Isabel; Ramos-García, PabloPatients with oral lichen planus (OLP) have an increased risk of oral cancer. For this reason, OLP is classified as an oral potentially malignant disorder. However, the precise personal (or individual) risk is unknown. Recent meta-analytical studies have reported that dysplastic OLP may transform to cancer in around 6% of cases, while the rate of transformation is lower (<1.5%) in non-dysplastic cases. The presence of epithelial dysplasia has emerged as the most powerful indicator for assessing cancer risk in oral potentially malignant disorders in routine practice. However, the general acceptance of epithelial dysplasia as an accompanying histologic feature in OLP is subject to great controversy. Many pathologists consider the presence of dysplasia as a criterion to exclude OLP when routinely reporting on this disease. This practice, widespread among oral pathology professionals, has resulted in the underestimation of the potential for malignancy of OLP. A review of the literature was carried out in order to critically analyze the relevance, controversies and challenges encountered across the diagnosis of epithelial dysplasia in OLP. 12 studies have been published examining dysplastic changes in OLP, reporting Figures ranging from 0.54% to 25% of cases with dysplasia in the first diagnostic biopsy. The diagnosis of dysplasia in the OLP poses an additional difficulty due to the fact that the affected oral epithelium per se develops changes related to autoimmune aggression. Among the most frequent histological features of OLP that develops dysplasia are basal cell hyperplasia with basaloid appearance, loss of basal cells polarity, cellular and nuclear pleomorphism and irregular stratification. Epithelial dysplasia should not be considered an exclusion criterion for OLP; its evaluation requires experienced pathologists in this field.
- Nonendodontic periapical lesions:a retrospective descriptive study in a Brazilian population(2021) Guimarães, Giuliana Gismonti; Perez, Danyel Elias da Cruz; Netto, Juliana-de Noronha-Santos; da Costa, Ana Camily Oliveira; Leonel, Augusto-César-Leal-da Silva; Castro, Jurema Freire Lisboa de; Pires, Fábio-RamôaSeveral nonendodontic diseases can occur in the periapical region, resembling endodontic inflammatory conditions. Therefore, the aim of the present study was to determine the frequency of nonendodontic periapical lesions diagnosed in a Brazilian population. The files of two Oral Pathology laboratories were reviewed and all cases including at least one clinical diagnosis of endodontic periapical lesions were selected for the study. After initial selection, demographic and clinical data, clinical diagnosis and final diagnosis were reviewed and tabulated. Final diagnosis included endodontic periapical lesions, and benign and malignant nonendodontic periapical lesions. Data were descriptively and comparatively analyzed among the three groups, with a significance level of 5% (p<0.05). Nonendodontic periapical lesions were identified in 208 (19%) out of the 1.125 registries included in the final sample. Benign nonendodontic periapical lesions (200 cases, 18%) were mostly odontogenic keratocysts, ameloblastomas, nasopalatine cysts, dentigerous cysts, glandular odontogenic cysts, and benign fibroosseous lesions. Malignant nonendodontic periapical lesions (8 cases, 1%) included carcinomas, adenocarcinomas, and melanoma. In general, nonendodontic periapical lesions were more common in males and in the posterior mandible (p>0.05). The frequency of nonendodontic periapical lesions was high and, although the general distribution was similar to the results from other populations, some features were probably associated with the profile of the studied populations and to the methods applied in the present study. Knowledge on differential diagnosis of endodontic and nonendodontic periapical lesions is essential to avoid unnecessary treatments and diagnostic delay in routine dental practice.
- Retrograde filling material in periapical surgery:a systematic review(2021) Paños-Crespo, Anais; Sánchez-Torres, Alba; Gay-Escoda, CosmePeriapical surgery focuses on the treatment of teeth with persistent periapical lesions when orthograde root canal treatment fails. Although MTA® is the gold standard material for retrograde filling, Biodentine® - a tricalcium silicate-based cement - has been proposed in order to resolve several of its limitations. A systematic review has been carried out to compare the physicochemical properties of Biodentine® versus MTA® as root-end filling material in periapical surgery. An electronic search was conducted by two independent examiners during March 2020 in the Cochrane, PubMed-MEDLINE and Scopus databases. In addition, a manual search was made in specialized journals. Comparative human or in vitro studies that evaluated bond strength, the presence of marginal gap and sealing ability were included. No restriction on publication date was applied. Animal studies, clinical cases, cases series and expert opinions were excluded. After analyzing 147 initially selected studies, 13 publications were included. Regarding bond strength, the studies seemed to evidence better performance of Biodentine® in both acidic and blood contaminated environments. In relation to the presence of marginal gap and sealing ability, the studies yielded contradictory results. According to some authors, the sealing ability of Biodentine® is greater than that of MTA® during the first 24 hours, though both materials prove equal after one week. Other authors recorded no significant differences. Considering the limitations and heterogeneity of the studies included, there is not sufficient evidence to confirm the clinical superiority of Biodentine® as a root-end filling material in periapical surgery.
- Buccal fat pad excision for cheek refinement:a systematic review(2021) Traboulsi-Garet, Bassel; Camps Font, Octavi; Traboulsi-Garet, Marwan; Gay-Escoda, CosmeBuccal Fat Pad (BFP) excision has become an aesthetic surgical procedure. Although this procedure is quite common, it is important to bear in mind that the scientific evidence supporting the efficacy of this treatment is scarce and of low quality. The purpose of this systematic review was to analyse all relevant data to assess the efficacy and safety of BFP excision for improving midface aesthetics. A thorough search of MEDLINE (PubMed), Scopus and Cochrane Library databases was conducted. The PICO approach was used where healthy patients seeking cheek slimming and facial silhouette refining undergo BFP excision and were compared before and after surgery in terms of BFP volume reduction, adverse effects and patient satisfaction. Of the 1,413 references identified, 4 were included in the qualitative synthesis. Only one study reported BFP volume reduction, which was 3.10 mL (95%CI: 2.38 to 3.80; P < 0.001), and the mean volume of the excised tissue was 2.74 ± 0.69 mL (range, 1.8-4.9 mL). 84.6% of the patients stated that their facial contour was much better and the remaining 15.4% noticed that the appearance of their cheeks following BFP excision was better. Seven complications were reported in the 134 cheek refinement procedures. BFP removal has an initially favorable outcome for facial aesthetics and a low postoperative complication rate, however, there are many procedures being performed with poor quality methodology and there is also a lack of published data on its long-term follow-up results.
- An observational retrospective study of odontogenic cyst´s and tumours over an 18-year period in a Portuguese population according to the new WHO Head and Neck Tumour classification(2021) Monteiro, Luís Silva; Santiago, Catarina; Amaral, José Barbas do; Al-Mossallami, Azza; Albuquerque, Rui; Simao, Joao Carlos LopesOdontogenic cysts and tumours of the jaws represent one of the most prevalent groups of oral-maxillofacial lesions. We aimed to evaluate the clinical and pathological characteristics of a cohort of odontogenic cysts (OC) and odontogenic tumours (OT) of the jaws in a Portuguese population. This observational retrospective study analysed patients diagnosed with either an OC or OT of the jaws at a central hospital of Oporto, Portugal, between 1988 and 2006. Data collected from patients? files included demographic, clinical, radiological and histopathological information. Recurrence was evaluated using univariate and multivariate analysis. The sample consisted of 397 patients, 231 males (58.2%) and 166 females (41.8%), with a mean-age of 36.7±17 years. Twenty-seven patients (6.8%) presented with more than one lesion providing a total of 433 lesions. There were 396 (91.5%) OC, mostly represented by radicular cysts (n=257;59.4%), dentigerous cysts (n=79;18.2%), or odontogenic keratocysts (n=50;11.5%). There were 37 (8.5%) OT, mostly represented by ameloblastomas (n=16;3.7%), and odontomas (n=9;2.1%). The most common initial clinical manifestation was swelling (n=224;51.7%). Recurrence was observed in 30 cases (6.9%), mostly in ameloblastomas (n=6;37.5%) and odontogenic keratocysts (n=12;24%). In the multivariate analysis the diagnosis classification of the lesion was the only independent and significant variable related with the recurrence (P=0.04). Radicular cysts were the most commonly occurring type of OC and ameloblastomas the most commonly occurring OT. Amelobastomas and odontogenic keratocysts were the lesions with the highest rates of recurrence. This large sample provides useful information about the frequency profile and characteristics of OC and OT over a period of 18 years, allowing valuable comparison with data from other countries.
- Comparison of the effect of ginger and aloe vera mouthwashes on xerostomia in patients with type 2 diabetes:a clinical trial, triple-blind(2021) Badooei, Forouzande; Imani, Elham; Hosseini-Teshnizi, Saeid; Banar, Mania; Memarzade, Mohammad-RezaGinger and aloe vera are two medicinal herbs mostly used to produce mouthwash. This study aimed to compare the effects of ginger and aloe vera mouthwashes on the xerostomia in patients referred to Bandar Abbas diabetes clinic (Iran). In this triple-blind clinical trial, three groups (n=35 patients in each group) were studied. One group was given aloe vera mouthwash, the other group used ginger mouthwash, and the control group was only given normal saline. All the mouthwashes were used 20 ccs three times daily for 14 consecutive days. The symptoms and severity of xerostomia were measured before and after the intervention by the questionnaire proposed by Fox et al. as well as VAS scale, respectively. Statistical analysis, including the Shapiro-Wilk test used to measure the normality of variables, and Chi-square and McNemar used to compare the scores questionnaire proposed by Fox et al., were also applied. Scores of VAS were analyzed using a one-way ANOVA test. P<0.05 was considered as statistically significant in all these tests. The mean age of the participants included in the normal saline group was 58.13±14.75 years old, 54.14±9.35 years old in the ginger group, and 53.37±11.57 years old in the aloe vera group. The difference between the scores of xerostomia before and after performing the intervention (The amount of reduction in xerostomia) in the ginger group was 6.12±2.004 cm, in the aloe vera group it was 4.08±2.09 cm, and in the normal saline group it was 2.45±2.09 cm. Finally, the ginger and aloe vera mouthwashes significantly reduced all symptoms and severity related to xerostomia, respectively(p<0.001). The use of mouthwash is an effective measure to reduce xerostomia under chronic conditions. Aloe vera, ginger, and normal saline are known as effective mouthwashes on controlling this complication. According to the results of this study, ginger and aloe vera mouthwashes could significantly decrease xerostomia and promote oral health in patients with diabetes.
- Association between periodontal disease and prostate cancer:a systematic review and meta-analysis(2021) Wei, Yali; Zhong, Yongjin; Wang, Yan; Huang, RuijiePeriodontal disease is a chronic infectious disease caused by bacterial infection which may lead to various systematic diseases. Recently, increasing studies have explored the correlation of periodontal disease with the risk of prostate cancer. However, the findings were inconsistent. Hence, this study aims to investigate the association between periodontal disease and the risk of prostate cancer by a meta-analysis. PubMed, EMBASE, and Cochrane were searched for publications up to July 17, 2020. Cohort and case-control studies evaluating the risk of prostate cancer in patients with periodontal disease were included. A fixed or random-effect model was used to calculate the summary relative risk (RR) along with 95% confidence interval (CI). All analyses were conducted using Stata 12.0 software. Seven studies were included in the final analysis. The pooled estimates showed that periodontal disease was significantly associated with the risk of prostate cancer (RR = 1.17; 95% CI = 1.07-1.27; P = 0.001). Findings of sensitivity analyses proved that the overall results were robust. Periodontal disease may be considered as a potential risk factor for prostate cancer. Although it?s a possibility, males should be more aware of their oral health and implement effective measures to prevent and treat periodontal disease.
- A multicenter observational study on Medication-Related Osteonecrosis of the Jaw (MRONJ) in advanced cancer and myeloma patients of a cancer network in North-Western Italy(2021) Fusco, Vittorio; Cabras, Marco; Erovigni, Francesco; Dell?Acqua, Alessandro; Arduino, Paolo-Giacomo; Pentenero, Monica; Appendino, Paolo; Basano, Lorenzo; Ferrera, Francesco Della; Fasciolo, Antonella; Caka, Majlinda; Migliario, Mario; Franchi, Stefano; Gambino, AlessioIncidence of Medication-Related Osteonecrosis of the Jaw (MRONJ) related to cancer and myeloma treatments is undetermined, with scarce data varying from 2 to 7.8/million/year in limited investigated populations. A 9-years [2009-2018] regional-wide survey was conducted, deploying the North-Western Italy Cancer Network (?Rete Oncologica Piemonte e Valle d?Aosta?), to assess number and main characteristics of MRONJ cases among myeloma/cancer patients, within a population of 4.5 million inhabitants. MRONJ cases were collected retrospectively from January 2009 to June 2015; from July 2015 to December 2018, data were collected prospectively. Number of new MRONJ cases per year, underlying disorder, drug(s) administered, treatment duration, site and onset timing of MRONJ were detailed. 459 MRONJ cases were identified. Primary diseases were breast cancer (46%), prostate cancer (21%), myeloma (19%), and other types of carcinoma (14%). Patients received antiresorptive treatment either alone (399; 88.47%) or in combination with biological agents (52; 11.53%); 8 patients (1.7%) received only antiangiogenic drugs. Zoledronic acid [388] and denosumab [59] were the most frequently administered drugs. Mandible was involved in 296 (64,5%) cases. Number of new MRONJ cases was stable from 2009 to 2015, with a mean of 51.3 cases per year (raw incidence: 11.6/million/year), declining in the 2016-2018 years to 33.3 cases per year (raw incidence: 7.5/million/year). With such discrepancy of cases overtime being partially explicable, number of new MRONJ cases per year are consistent with those observed in a previous study [2003-2008] in the same region, being instead higher than those reported in other populations.
- PMS2:a potential prognostic protein marker in oral squamous cell carcinoma(2021) Decker, Jordana Medeiros Lira; Filho, Osias Vieira de Oliveira; Freitas, Milena Oliveira; Silva-Fernandes, Isabelle Joyce de Lima; Sousa-Dantas, Thinali; Campêlo, Clarissa Sales de Paula; Socorro-Saldanha-Cunha, Maria do Perpétuo; Silva, Paulo-Goberlânio-de Barros; Sousa, Fabrício BituAn increase in oral squamous cell carcinoma (OSCC) cases was observed despite the reduction in exposure to classic risk factors. Although the exact cause of this trend remains unknown, epigenetic factors could be contributing to an increased occurrence of these tumors. This study aims to assess the influence of PMS2 protein immunoexpression on the prognosis of patients with OSCC. This study comprised 76 cases of OSCC treated between 2011 and 2016. Immunohistochemical staining for PMS2 was performed. For evaluation, 10 fields per histological section were photographed at a 400x magnification and positively-stained cells were counted with Image J. Mann-Whitney and Kruskal-Wallis tests were used to compare the immunolabeling pattern with the clinical-pathological and prognostic characteristics. Survival analysis was performed with Chi-square, Long-Rank Mantel-Cox and Cox regression tests (p<0.05). An overexpression of PMS2 was observed in N0/1 tumors and in oral cancers found in unusual locations. In patients ?60 years of age, high levels of PMS2 ( >60%; p=0.041) were associated with low survival (p=0.029). In multivariate analysis, surgery combined with chemotherapy (p=0.030) and high PMS2 immunoexpression (p=0.042) significantly increased the risk of death for ?60 years old patients. The findings of this study indicate that PMS2 can be a potential prognostic protein marker in OSCC patients 60 years of age and younger.
- Periodontitis as a risk factor for head and neck cancer(2021) Gasparoni, Letícia Miquelitto; Abreu Alves, Fabio; Holzhausen, Marinella; Pannuti, Claudio; Serpa, Marianna-SampaioPeriodontitis may be associated with the development of head and neck cancer (HNC). A literature review was conducted to understand the possible association between them. Articles published in the PubMed database from January 1999 and May 2020 were retrieved. Limitations of the studies and biological mechanisms were discussed. A total of 4,232 articles were found. Of these, 13 were analyzed according to inclusion criteria. Most papers found some association between periodontitis and HNC, although differences in periodontal evaluation, sample size, study design and tumor sites were observed. Porphyromonas gingivalis appears to increase the chance of both diseases, and it may be one of their main potential risk factors. Genetic predisposition is increased by exposure to environmental factors which can directly induce epigenetic changes that contribute to these diseases. Understanding the mechanisms related to periodontitis and HNC has increased, however, well-designed clinical studies are needed for better conclusions. Furthermore, the advent of multiple "omic" technologies will help comprehend their possible association.
- A systematic review and meta-analysis on the effectiveness of xenograft to prevent periodontal defects after mandibular third molar extraction(2021) Toledano-Serrabona, Jorge; Ruiz Romero, Víctor; Camps Font, Octavi; Gay-Escoda, Cosme; Sánchez-Garcés, María ÁngelesTo evaluate the use of guided bone regeneration with xenograft to prevent periodontal defect in the distal aspect of the second molar after the surgical removal of the mandibular third molar. Three electronic databases (Pubmed, Cochrane Library and Scopus) were searched in April 2020. Randomized clinical trials in non-smokers and healthy patients, with at least six months follow-up, comparing periodontal probing depth, clinical attachment level, alveolar bone level and adverse events were selected by two independent investigators. The risk of bias assessment of the selected studies was evaluated by means of the Cochrane Collaboration?s Tool. Finally, a meta-analysis of the outcomes of interest was performed. Despite 795 articles were found in the initial search, only three randomized controlled clinical trials were included. Pooled results favoured the use of the xenograft plus collagen membrane over the spontaneous healing in terms of periodontal probing depth gain (MD=2.36; 95% CI 0.69 to 4.03; P=0.005) and clinical attachment level gain (MD=2.52; 95% CI 0.96 to 4.09; P=0.002). No other statistically significant differences were found. Within the limitations of the present review, the xenograft plus collagen membrane exhibited better periodontal results than spontaneous healing without increasing postoperative complications. However, future well-designed studies with larger samples are required to confirm our results.
- DNA integrity in diagnosis of premalignant lesions(2021) Azab, Noha Adel; Zahran, Fat'heya M.; Amin, Ayman Abdel Wahab; Rady, Normeen HanyCarcinogenesis is a dynamic process which traditional biopsying can not keep up with. Saliva as fluid in the vicinity of the tumor can offer better insights to this process. This study aimed to identify the accuracy of salivary DNA integrity index in differentiating between oral premalignant lesions and oral cancer. This phase II diagnostic test accuracy study included 93 patients divided into three groups: 30 oral cancer patients, 33 patients with oral premalignant lesions divided into 21 oral lichen planus patients and 12 patients with leukoplakia and 30 normal individuals who acted as controls. Oral rinse was collected from all participants and they all underwent conventional visual and tactile examination, and patients with oral lesions had the diagnosis confirmed by histopathological examination of tissue biopsy. DNA integrity index was determined as the ratio between ALU247 and ALU115 measured by qPCR. There was no statistically significant difference regarding ALU115, ALU247 and DNA integrity index between the three study groups. The index was significantly higher in the oral cancer group than the oral lichen planus patients, while no significant difference was found between the oral cancer and the leukoplakia cases. The DNA integrity index sensitivity, specificity, positive and negative predictive values were 73%, 45%, 55% and 65% respectively. Salivary DNA integrity index showed poor diagnostic abilities in differentiating between the oral cancer and premalignant lesions.
- Oral health-related quality of life of patients after solid organ transplantation is not affected by oral conditions:results of a multicentre cross-sectional study(2021) Schmalz, Gerhard; Garbade, Jens; Sommerwerck, Urte; Kollmar, Otto; Ziebold, DirkThis multicentre cross-sectional study aimed in examination of oral health-related quality of life (OHRQoL) of patients after solid organ transplantation (SOT). Patients after SOT (liver, lung and heart) at one out of three German centers (Goettingen, Essen, Leipzig) were included. For comparison, a healthy control (HC) was recruited. OHRQoL was assessed by German short form of oral health impact profile (OHIP G14). Oral examination comprised: decayed-, missing- and filled-teeth index (DMF-T), remaining teeth and periodontitis severity. In total, 196 patients after SOT and 130 HC with comparable age, gender and smoking habits were included (p>0.05). DMF-T and number of remaining teeth was worse in SOT group (p<0.01). OHIP G14 sum score was significantly higher in SOT (3.49 ± 5.73 vs. 1.33 ± 2.63, p<0.01). In contrast to HC, in SOT no associations between OHIP G14 and oral health parameters were found (p>0.05). Number of remaining teeth was not an independent predictor of OHIP G14 sum score in SOT (? -0.082, CI95 -0.156 - 0.045, p=0.28). OHRQoL of SOT recipients is not affected by their oral condition, leading to the assumption that the individual perception of patients physical oral health is not in line with the clinical situation.
