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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2019. Vol. 24, no. 4
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- Immediate dental implants placed into infected sites present a higher risk of failure than immediate dental implants placed into non-infected sites : systematic review and meta-analysis(2019) de Oliveira-Neto, Olavo-Barbosa; Lemos, Cleidiel-Aparecido-Araújo; Barbosa, Fabiano-Timbó; de Sousa-Rodrigues, Célio-Fernando; Camello de Lima, Fernando-JoséAlveolar infection is known as a risk factor for implant failure. Current meta-analysis on the theme could not prove statistically that immediate dental implants placed into infected sites have a higher risk of failure than immediate dental implants placed into non-infected sites. The purpose of this meta-analysis was to determine the effectiveness of immediate dental implants placed into infected versus non-infected sites. Seven databases were sought by two reviewers. Randomized or non-randomized clinical trials that compared the placement of dental implants into infected versus non-infected sites were eligible for the study. Exclusion criteria were: papers in which the survival rate was not the primary outcome; papers without a control group; studies with less than one year of follow-up; studies whose patients did not receive antibiotic therapy; studies with medically compromised patients; duplicated papers. Risk of bias assessment was performed with the Cochrane Collaboration tool. Of the 3.253 initial hits, 8 studies were included in both qualitative and quantitative synthesis (kappa=0.90; very good agreement). Forest plot for implant failure showed that immediate implants placed into infected sites presented a statistically significant risk of failure that is almost 3 times higher than when placed into non-infected sites (risk ratio= 2.99; 95% confidence interval: 1.04, 8.56; p= 0.04; 935 implants; i2= 0%). Peri-implant outcomes showed no statistical difference. Immediate dental implants placed into infected sites presented a statistically significant higher risk of failure than immediate dental implants placed into non-infected sites. Peri-implant outcomes were not statistically affected in this intervention.
- Efficacy of botulinum toxin in the treatment of bruxism : systematic review(2019) Fernández-Núñez, Tania; Amghar-Maach, Sara; Gay-Escoda, CosmeCurrently it has been shown that botulinum toxin is effective for a wide variety of medical conditions, and can be applied for therapeutic purposes as cosmetic. In recent years, there has been a growing trend in the use of this drug substance to control the muscular overactivity of bruxism. The objective of this study was the use of botulinum toxin type A (BTX-A) than traditional methods, by conducting a systematic review of randomized clinical trials (RCTs) published in the health sciences literature. An electronic search was made in the databases of the PubMed, Cochrane Library and Scopus data between March and October 2017, ECA, which will analyze the effect of botulinum toxin in the treatment of bruxism. We included studies of bruxist patients older than 18 years where BTX-A tests were performed on the masseter and / or temporal muscles and the control systems were injections of placebo (saline) or the use of traditional methods for the treatment of bruxism. such as occlusal splints, other medications or cognitive-behavioral therapy. Of the 68 studies identified, 4 RCTs that fit our inclusion criteria were selected. These studies show that BTX-A injections can reduce the frequency of bruxism episodes, decrease pain levels and maximum occlusal force generated by this pathology, offer superior efficacy in the treatment of bruxism compared to control groups who were treated with placebo or with traditional methods for the treatment of bruxism. Infiltrations with BTX-A are a safe and effective treatment for patients with bruxism, so its use is justified in daily clinical practice, especially in patients diagnosed with severe bruxism.
- E-Cadherin gene expression in oral cancer : clinical and prospective data(2019) López-Verdín, Sandra; Martínez-Fierro, Margarita de la Luz; Garza Veloz, Idalia; Zamora Pérez, Ana Lourdes; Grajeda-Cruz, Jonathan; González González, Rogelio; Molina Frechero, Nelly; Arocena, Miguel; Bologna Molina, RonellLow protein expression of E-cadherin in oral squamous cell carcinoma (OSCC) has been associated with clinical and histopathological traits such as metastases, recurrence, low survival and poor tumor differentiation, and it is considered a high-risk marker of malignancy. However, it is still unknown whether low expression of E-cadherin is also present at the mRNA level in OSCC cases. Objective: The aim of this study was to compare E-cadherin mRNA expression in OSCC patients and controls and to correlate the expression with clinical and prospective characteristics. Forty patients and 40 controls were enrolled. E-cadherin mRNA expression was evaluated by quantitative real-time polymerase chain reaction using TaqMan probes. E-cadherin mRNA expression was significantly decreased in OSCC patients compared to that of controls (p<0.001). Whereas no significant association between clinical parameters and E-cadherin expression levels was observed, we noted lower E-cadherin expression levels in patients with positive lymph node metastasis. E-cadherin mRNA expression was markedly diminished in OSCC, in agreement with previous results that examined E-cadherin expression at the protein level. E-cadherin is downregulated in the early clinical stages of OSCC, and its mRNA levels do not change significantly in the advanced stages, suggesting that there is limited usefulness of this parameter for predicting disease progression.
- Radiographic estimation of the growth rate of initially underdiagnosed ameloblastomas(2019) Mariz, Bruno A.L.A.; Andrade, Bruno Augusto Benevenuto de; Agostini, Michelle; Almeida, Oslei Paes de; Romañach, Mário José; Jorge, Jacks; Vargas, Pablo Agustín; Lopes, Márcio Ajudarte; Santos Silva, Alan Roger; Rocha, André CaroliTo evaluate the specific growth rate (SGR) of ameloblastoma. Cases of ameloblastoma initially underdiagnosed (e.g. cases overlooked or diagnosed as reactive lesions) which had adequate radiographic documentation to evaluate their progression were retrospectively selected. Two panoramic radiographs were analyzed to determine the specific growth rate (SGR) of each tumor, defined as the logarithm of the ratio of final tumor area (when the diagnosis of ameloblastoma was made) to the initial tumor area (when the lesion was underdiagnosed), divided by the time interval between the radiographic images. The tumor area was measured using the software ImageJ. Twelve patients with mandibular ameloblastomas were selected, including 5 males and 7 females, with a mean age of 24.9 years (range: 14-61 years). In four cases, the lesion was associated with the crown of an impacted third molar. In three cases, it was initially diagnosed as a periapical lesion. Three cases were extrafollicular and were not noticed in the initial radiographs. Two cases were initially diagnosed as ameloblastoma, but the surgery was delayed for personal reasons. The mean interval of time between the two radiographic images was 4.3 years (range: 0.4-9 years). Based on our analysis, ameloblastoma grows in average 40.4% per year (range: 14.9-88.7%). Ameloblastoma is a progressively growing tumor, but its growth rate seems to be smaller than initially reported in the literature. Better understanding the radiographic progression of ameloblastoma might improve its early diagnosis, management, and prognosis.
- Oral mucosal peeling related to dentifrices and mouthwashes : a systematic review(2019) Pérez López, Daniel; Varela Centelles, Pablo Ignacio; García Pola, María José; Castelo Baz, Pablo; García Caballero, Lucía; Seoane Romero, Juan M.The aim of this systematic review was to summarise the clinical information available about oral mucosal peeling (OMP) and to explore its aetiopathogenic association with dentifrices and mouthwashes. PICOS outline: Population: subjects diagnosed clinically and/or pathologically. Intervention: exposition to oral hygiene products. Comparisons: patients using products at different concentrations. Outcomes: clinicopathological outcomes (primary) and oral epithelial desquamation (secondary) after use. Study design: any. Exclusion criteria: reports on secondary or unpublished data, in vitro studies. Data were independently extracted by two reviewers. Fifteen reports were selected from 410 identified. Descriptive studies mainly showed low bias risk, experimental studies mostly an ?unclear risk?. Dentifrices or mouthwashes were linked to OMP, with an unknown origin in 5 subjects. Sodium lauryl-sulphate (SLS) was behind this disorder in 21 subjects, tartar-control dentifrices in 2, and flavouring agents in 1 case. Desquamation extension was linked to SLS concentration. Most cases were painless, leaving normal mucosa after desquamation. Tartar-control dentifrices caused ulcerations more frequently. OMP management should consider differential diagnosis with oral desquamative lesions, particularly desquamative gingivitis, with a guided clinical interview together with pathological confirmation while discouraging the use of the product responsible for OMP.
- Salivary myeloperoxidase and malondialdehyde are increased in patients exhibiting an asymptomatic mandibular impacted third molar(2019) Camacho Alonso, Fabio; Tudela-Mulero, María del Rosario; Peñarrocha Oltra, David; Peñarrocha Diago, Miguel; Balaguer Martí, José Carlos; Sánchez Siles, Mariano AlbertoTo determine whether saliva is a good means of evaluating concentrations of oxidative stress biomarkers, analyzing the correlation between concentrations in saliva and in follicular tissue, and to compare biomarker concentrations in patients with one asymptomatic mandibular impacted third molar (MITM) (before extraction) with a healthy control, and to determine how biomarkers are modified by extraction. 80 patients with one asymptomatic MITM and 80 healthy controls were included. Saliva samples were collected from all subjects (before extraction in the study group) to evaluate Myeloperoxidase (MPO) and Malondialdehyde (MDA) concentrations. Follicular tissues were obtained during surgery to measure biomarkers. One month after extraction, saliva samples were collected to assess changes of oxidative stress. Salivary MPO and MDA showed positive correlation with concentrations in follicular tissue (MPO: correlation coefficient=0.72, p=0.025; MDA: =0.92, p=0.001). Patients with asymptomatic MITMs showed higher salivary concentrations of oxidative stress biomarkers than healthy control subjects, with statistical significance for both MPO (p<0.001) and MDA (p<0.001). One month after extraction, salivary biomarkers decreased significantly in the study group (p<0.001). Salivary MPO and MDA are higher among patients with one asymptomatic MITM, but these levels decrease significantly one month after surgical extraction. The large decrease in oxidative stress biomarkers could justify third molar extraction despite the absence of symptoms.
- Bisphosphonate-related osteonecrosis. Application of adipose-derived stem cells in an experimental murine model(2019) Alonso Rodríguez, Estefanía; González Martín-Moro, Javier; Cebrián Carretero, José Luis; Castillo Pardo de Vera, José Luis del; Pozo Kreilinger, Jose Juan; Ruiz Bravo, Elena; García Arranz, Mariano Andrés; Hernandez Godoy, Juan; Burgueño García, MiguelBisphosphonate-related osteonecrosis of the jaw is a pathological condition without effective established treatment and preventive strategies. The aim of this study was to analyse the effect of adipose-derived stem cells (ASC) in an experimental murine model of osteonecrosis. 38 Wistar rats were injected intraperitoneally with zoledronic acid. After treatment, upper jaw molars were extracted. The animals were randomly assigned to one of two groups. In the control group, saline solution was applied over the alveolar sockets after the tooth extractions. In the treatment group, ASCs were applied instead of saline solution. The control and treatment groups were subdivided based on the time of euthanasia. A clinical and histological analysis was performed. The presence of osteonecrosis in alveolar bone was observed in a similar distribution in both groups. In the ASC-treated group, new bone formation was greater than in controls. In this study, application of ASCs showed greater new bone formation in an osteonecrosis-like murine model. Previous inhibited post-extraction bone remodelling could be reactivated, and these findings appeared to be secondary to implantation of ASCs.
- Development and viability of biofilms grown on experimental abutments mimicking dental implants : an in vivo model(2019) Cortes-Acha, Berta; Figueiredo, Rui; Blanc, Vanessa; Soler-Ollé, Agnès; León, Rubén; Valmaseda Castellón, E.To determine whether an experimental abutment mimicking the macro- and microstructure of a dental implant is a suitable method for recovering biofilm, and to describe the features of biofilms formed around such abutments on healthy implants. Experimental abutments were used in 15 patients without peri-implant diseases. After 14 days? absence of dental hygiene in this area, the abutments were retrieved and analyzed through confocal laser scanning microscopy and scanning electron microscopy. The biofilm formation on the surface of the first 5 abutments was determined by a fluorescence-staining method using SYTO9 nucleic acid stain. In order to study the biofilm?s coverage and vitality, 10 additional abutments were assessed using live and dead bacterial viability. Descriptive and bivariate analyses of the data were performed. A global plaque coverage of the abutments was observed in all cases. The submucosal area of the abutment was mostly covered with biofilm (over 21%). Moreover, significant differences between supra- and subgingival locations were detected. This in vivo experimental model allows detailed observation of the extensive plaque growth found on exposed experimental abutments mimicking dental implants when hygiene measures are absent. The biofilm coverage is significantly higher in the supragingival zone than in the subgingival portion.
- Recurrence rate of oral squamous cell papilloma after excision with surgical scalpel or laser therapy : a retrospective cohort study(2019) Toledano-Serrabona, Jorge; López Ramírez, Marta; Sánchez-Torres, Alba; España Tost, Antonio Jesús; Gay-Escoda, CosmeThe aim was to describe the recurrence rates of Oral Squamous Cell Papilloma (OSCP) following surgical treatment with surgical scalpel and two different lasers (CO2 or Er,Cr;YSGG) and to determine the clinical and histopathologic features of these lesions. A retrospective cohort study covering a period of 12 years (1997-2009) that included patients diagnosed of OSCP treated with surgical excision was performed. Data was processed using SPSS 22.0 (SPPS Inc. Chicago, USA) and a descriptive and bivariate analysis were conducted. A total of 37 histopathologically confirmed OSCP in 36 patients, 19 women (52.7%) and 17 men (47.2%) with an average age of 33.4 years (14-86 years) were included. Twenty-two cases were treated by excision with surgical scalpel excision, 11 with CO2 laser and 3 with Er,Cr:YSGG laser. The mean age was 35.4 years (14-86 years) and the distribution by gender was 19 women (52.7%) and 17 men (47.2%). The most common locations were the palate in 14 cases (37.8%), followed by the tongue in 11 cases (29.7%) and gingiva with 5 cases (13.5%). The average size of the lesions was 4.25 mm in diameter, with a mean evolution time of 5.9 months. The recurrence rate was slightly higher with the CO2 laser (14.3 %) in comparison with the conventional scalpel (10%). No recurrences for Er,Cr:YSGG were found. No differences for recurrence rates for OSCP between groups were found. The recurrence rate is low, happening usually before 15 months of follow-up. OSCPs are lesions usually appearing in patients between 30 and 50 years of both genders and located predominantly on the palate, tongue and gingiva.
- Patient-centered web-based information on oral lichen planus : quality and readability(2019) Lorenzo Pouso, Alejandro Ismael; Pérez-Sayáns, Mario; Kujan, Omar; Castelo Baz, Pablo; Chamorro Petronacci, Cintia Micaela; García García, Abel; Blanco Carrión, AndrésTo assess the readability and quality of web-based information available for patients about oral lichen planus (OLP). Three major search engines (Google, Bing and Yahoo!) were used to identify websites of particular interest to the study using the search term ?oral lichen planus?. The first 100 sites of each search engine were considered for the study. The quality of the contents was evaluated using the DISCERN instrument. The Flesch-Kinkaid Reading Grade Level (FKRGL) and the Flesh Reading Ease Score (FRES) were used to assess readability. The presence of the Health on the Net (HON) seal was also evaluated. Following the application of the study?s exclusion criteria, only 28 websites were compiled for further analysis. The median of the DISCERN instrument was 3 [2-3] which means serious or potentially important shortcoming in the quality of the information. Readability indexes pointed to a high reading difficulty (FRES: 48.14±11.22; FKRGL:11.13±2.90). The information provided by the Internet to the general public regarding OLP has major deficits in terms of quality, and at the same time is difficult for a comprehensive reading. Further studies are warranted to test well-produced patient-centered information on OLP.
- Association between marfan syndrome and oral health status : a systematic review and meta-analysis(2019) Galletti, Cosimo; Camps Font, Octavi; Teixido Tura, Gisela; Llobet-Poal, Inmaculada; Gay-Escoda, CosmeBackground: The purpose was to identify and assess the existing scientific evidence from epidemiologic, non-experimental, observational studies of associations between Marfan?s syndrome and oral diseases. Material and Methods: Electronic literature searches in MEDLINE (OVID), The Cochrane Library, Scopus and the Web of Science were conducted to identify all relevant articles. Eligibility was based on inclusion criteria, and quality assessments were conducted. The outcome variables were probing depth, gingival margin, clinical attachment level, bleeding on probing, gingival status, periodontal status, tooth mobility, furcation involvement and decayed, missing and filled teeth index. After extracting data, meta-analyses were carried out. Results: Out of 527 potentially eligible papers, 3 cross-sectional studies were included. No statistically significant differences were found in the number of sites with bleeding on probing (OR: 1.26; 95% CI: 0.47 to 3.42; P = 0.65; I2: 0%), probing depth (MD: -0.14 mm; 95% CI: -0.24 to 0.53; P = 0.46; I2: 93%), periodontal status (WMD: 0.68 points; 95% CI: -0.48 to 1.83; P = 0.25; I2: 98%) nor number of decayed, missing and filled teeth index score (MD: 1.08 points.; 95% CI: -1.27 to 3.42; P = 0.37; I2: 0%). Conclusions: Patients diagnosed with Marfan?s syndrome do not seem to have worsened oral health status. Due to the high number of patients with Marfan?s syndrome that have prosthetic heart valves, an adequate dental monitoring as well as a strict maintenance therapy program should be implemented.
- Risk factors associated with the family care of people with serious mental illness(2019) Carbonell Marqués, Ángela; Navarro Pérez, José Javier; Mestre Escrivá, María VicentaThe aim of the present study is to analyse the variables associated with the family care of people diagnosed with serious mental illness. A cross-sectional study was carried out involving caregivers of people with serious mental illness (SMI) who were known to the mental health services in Valencia (España) and associations for those with SMI. The sample comprised 417 caregivers who completed a sociodemographic questionnaire and the Zarit Burden Interview. Bivariate analyses (t-test, analysis of variance and Pearson correlation) were performed, as was a multiple linear regression model. Values of p< .05 were considered significant. The study was carried out in accordance with the recommendations of the ethics committees of the participating institutions. The statistical analyses showed significant associations between the sociodemographic and clinical variables of the caregivers and patients and the burden felt by caregivers of people with SMI. The importance of both formal and informal social support stands out as a protective factor against the consequences of the illness?s impact on the main caregiver. The role of spaces of mutual support is crucial. The results suggest that family psychoeducational programmes should be created, applied and evaluated in all mental healthcare services so as to reinforce training in mental health matters and provide support and assessment to caregivers in order to ease their burden.
- Effect on osseointegration of two implant macro-designs : a histomorphometric analysis of bicortically installed implants in different topographic sites of rabbit?s tibiae(2019) Soto-Peñaloza, David; Caneva, Marco; Viña Almunia, José; Martín de Llano, José Javier; García Mira, Berta; Peñarrocha Oltra, David; Botticelli, Daniele; Peñarrocha Diago, MiguelTo evaluate the effect of two different implant macro-designs on the sequential osseointegration at bicortically installed implants in the rabbit tibia. A further aim is to compare the osseointegration at different topographic zones. 27 New Zealand rabbits were implemented. Two implants, one for each macro-design (Ticare Inhex® or Ticare Quattro®, Mozo-Grau, Valladolid, Spain), were randomly implanted in the diaphysis or metaphysis of each tibia. The flaps were sutured to allow a submerged healing. The animals were sacrificed after 2, 4 or 8 weeks. Ground sections were prepared and analyzed. No statistically significant differences were found between the two groups for newly formed bone in contact with the implant surface, being about 16%, 19% and 33% in both groups, after 2, 4, and 8 weeks of healing. Bone apposition was slightly higher in the diaphysis, reaching values of 36.4% in the diaphysis, and 29.3% in the metaphysis at 8 weeks of healing. It was observed that the implant position showed a statistical significance regarding BIC values at 4 and 8 weeks (p<0.05). Multivariate analysis fails to detect statistical significant differences for the interaction between implant designs and topographic site. Ticare Quattro® design had a slight better BIC values at diaphysis sites across healing stages, but without reaching a statistical significance. The both implant macro-designs provided similar degrees of osseointegration. Bone morphometry and density may affect bone apposition onto the implant surface. The apposition rates were slightly better in diaphysis compared to metaphysis.
- Nanosecond pulsed electric field inhibits malignant melanoma growth by inducing the change of systemic immunity(2019) Zhang, Xingxing; Zhang, Yunxia; Chen, Jian; Wu, Yuyan; Zhang, Jue; Wang, JingNanosecond pulsed electric fields (nsPEFs) showed an inhibitory effect on proliferation of malignant melanoma. In this study, the growth of melanoma were inhibited by changing the systemic immunity. C57BL/6 mice with B16 malignant were exposed to 200 pulses of 100 ns duration, 30kV/cm. The mice were executed four days later. T lymphocyte has been extracted from spleen. Cell viability was evaluated by CCK-8 assay. CD3+CD4+ T cells, CD3+CD8+ T cells, regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSC) were analyzed by flow cytometry. TNF-?, IL-2, IL-10, TGF-?, IFN? ? levels in supernatants were assessed by ELISA. C57 malignant melanoma model were established successfully. After the treatment of nsPEFs(30 kV/cm 100 ns 200p), the numbers of T lymphocytes were increased.CD3+ CD4+ T cells changed from 48% to 51.2%;CD3+CD8+T lymphocytes increased from 39.6% to 40.4%.Treg cells reduced from 4.3% to 2.4%,MDSC decreased by 39.0% to 19.7% . In addition, the level of TNF-?, IL-2 were increased (P< 0.05) and the level of IL-10 were decreased (P<0.05) and the level of TGF-? and IFN-? remained stable (P>0.05). Tumor growth can be effectively inhibited by nsPEFs in vivo, which activate targets of immune respones, accumulation of inflammatory cells and immune cytokines.
- Bone regeneration in diabetic patients. A systematic review(2019) Sábado-Bundó, Helena; Sánchez-Garcés, María Angeles; Gay-Escoda, CosmeOral bone regeneration techniques (OBRT) attempt to provide the appropriate bone volume and density to correctly accomplish dental implant treatments. The objective was to determine whether differences exist in the clinical outcomes of these techniques between diabetic and non-diabetic patients, considering the level of scientific evidence. A systematic review following PRISMA statements was conducted in the PubMed, Scopus and Cochrane databases with the search terms: ?Diabetes Mellitus?, ?guided bone regeneration?, ?bone regeneration?, ?alveolar ridge augmentation?, ?ridge augmentation?, bone graft*, ?sinus floor augmentation?, ?sinus floor elevation?, ?sinus lift?, implant*. Articles were limited to those published less than 10 years ago and in English. Inclusion criteria were: human studies of all bone regeneration techniques, including at least 10 patients and the using OBRT in diabetic and non-diabetic patients. Non-human studies were excluded. They were stratified according to their level of scientific evidence related to SORT criteria (Strength of Recommendation Taxonomy). The initial search provided 131 articles, after reading the abstracts a total of 33 relevant articles were selected to read the full text and analyzed to decide eligibility. Finally, seven of them accomplished the inclusion criteria: two controlled clinical trials, one cohort study and four case series. A low grade of evidence regarding the use of OBRT in diabetic patients was found. The recommendation for this intervention in diabetic patients is considered type C due to the high heterogeneity of the type of diabetic patients included and the variability of the techniques applied.
- Age and gender variations in the cone-beam computed tomographic location of mandibular canal : implications for mandibular sagittal split osteotomy(2019) Al-Shayyab, Mohammad H.; Qabba?ah, Khalid; Alsoleihat, Firas; Baqain, Zaid H.Mandibular sagittal split osteotomy (MSSO) may incur unfavorable split and sensorineural injuries. Knowledge of the anatomic location of the mandibular canal (MC) and bone thickness in the region of interest for MSSO, and the possible variations by age and gender can assist in avoiding such complications. Purpose: To study the location of the MC and bone thickness in the region of MSSO by cone-beam computed tomography (CBCT) radiographs and to evaluate the possible variations by age and gender in a Jordanian population. This retrospective radio-anatomical study examined all CBCT radiographs for patients treated over three years at the University of Jordan Hospital, Amman, Jordan. Distances from the MC to the cortical external surfaces and MC diameter (MCD) were measured by a reliable observer at three predetermined regions for MSSO: region (A) [mandibular foramen area], region (B) [mandibular angle area] and region (C) [directly mesial to the second molar]. Gender and age differences in all measurements were then compared using non-parametric Mann-Whitney U test. The final study radiographs comprised a total of 202 CBCT belonged to a cohort of 202 subjects; 91 males (45.1%) and 111 (54.9%) females, with mean age (± SD) of 42.94 ± 18.54 years (range 18?90 years). Whereas only the bone thickness superior, buccal and inferior to MC in regions (B) and (C), and MCD in the three regions exhibited significant (p< 0.05) gender differences, all measured distances exhibited statistically significant (p< 0.05) differences between young and adult patients. The location of MC and bone thickness in the region of MSSO were significantly variable according to age, but exhibited sexual diamorphism only in regions (B) and (C). This fundamental knowledge should be considered during MSSO planning.
- Quality assessment of systematic reviews regarding dental implant placement on diabetic patients : an overview of systematic reviews(2019) de Oliveira-Neto, Olavo-Barbosa; Santos, Isabelle-Oliveira; Barbosa, Fabiano-Timbó; de Sousa-Rodrigues, Célio-Fernando; de Lima, Fernando-José C.Since implant placement on diabetic patients still is a controversial topic and systematic reviews are at the top of scientific evidence hierarchy, a thorough assessment of the methodological quality of these reviews must be performed to inform clinicians if their conclusions and recommendations can be followed on clinical practice. An overview of systematic reviews was performed with the purpose to assess the methodological quality of systematic reviews regarding dental implant placement on diabetic patients. In addition, we presented a synthesis of clinical outcomes about the focused theme. An online search was performed on MEDLINE via PubMed, EMBASE, DARE-Cochrane, Scopus, Web of Science, LILACS, and SIGLE via Open Grey. Searches were conducted from database inception to May 2018. Systematic review articles with or without meta-analysis about the placement of dental implants on diabetic patients were included. Exclusion criteria were: articles whose primary outcome was not the survival/success rate of dental implants on diabetic patients; studies that do not relate the survival/success rate of dental implants with diabetes; duplicated papers. Methodological quality assessment was performed with AMSTAR. A descriptive synthesis of clinical outcomes was performed. We identified 1.661 initial hits and eight articles were selected for overview (kappa=0.83; strong agreement). Six studies presented moderate methodological quality and two showed high methodological quality. Implant survival rate ranged from 31.8% to 100% and data from four meta-analysis showed that diabetes does not affect implant survival rate. On the other hand, data from two meta-analysis for marginal bone loss showed that diabetes statistically affects this outcome. Two of the eight included studies presented high methodological quality and their meta-analysis showed that implant placement on diabetic patients does not affect implant survival rate and statistically affects marginal bone loss. However, clinicians must be aware that marginal bone loss values were not clinically relevant and may not be safe to follow the conclusions and recommendations of these studies.
- Recurrence of odontogenic keratocysts and possible prognostic factors : review of 455 patients(2019) Fidele, Nyimi-Bushabu; Yueyu, Zheng; Zhao, Yifang; Tianfu, Wu; Liu, Jinyuan; Sun, Yanfang; Liu, BingTo describe epidemiological features of 565 Chinese patients with odontogenic keratocysts (OKC), to investigate possible prognostic factors related to recurrence, and to analyse features of recurrent OKC (rOKC). A retrospective chart review of 565 cases of OKC treated between 2003 and 2015 was undertaken. The probability of recurrence related to prognostic factors including large size, cortical perforation combined with involved teeth in the lumen of the cyst, inflammation, sites of the involved lesion, sex, and daughter cyst variables were analysed. The subsequent relapse of each OKC was compared. Patients ranged in age from 7 to 81 years (mean age, 28.4 years) and, of those affected, 66.9% were male and 33.1% were female. Mandibular OKC occurred in 63.01% and 36.99% occurred in the maxilla, 80.53% of patients had non-rOKC, 10.44% rOKC, and 9.03% had multiple OKC lesions. Enucleation with preservation of the involved teeth in the cystic lesion combined with cortical perforation was statistically associated with high recurrence rate, as were daughter cysts, and multilocular lesions. The number of recurrences and the average time (in years) to relapse decreased from the first relapse of OKC to the third relapse, and the difference was significant (P<.05). Preservation of the involved teeth combined with cortical perforation appeared to be a potential prognostic factor associated with high recurrence. The follow-up evaluation period for rOKC with ? 2 previous treatments should be shorter than for first-time rOKC. The decreasing average duration (years postoperatively) to relapse was related to the number of rOKCs, timing of relapse, and rOKC type.
