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Med Oral Patol Oral Cir Bucal
2020 Nov 28;23162. doi: 10.4317/medoral.23162. Online ahead of print.
Quantitative interactions between Candida albicans and the mutans streptococci in patients with Down Syndrome
A-G Linossier 1, B Martinez, C-Y Valenzuela
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PMID: 33247579 DOI: 10.4317/medoral.23162
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Med Oral Patol Oral Cir Bucal
2020 Nov 28;24009. doi: 10.4317/medoral.24009. Online ahead of print.
Trend of hospitalized cases of oral cancer in Brazil and its relationship with oral health coverage in public health system between 2009 and 2017
M-L-B Raymundo 1, A-R Freire, D-E Gomes-Freire, R-O Silva, E-C Araújo, R-T Ishigame, S-A Sousa, E-H Lucena, Y-W Cavalcanti
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PMID: 33247574 DOI: 10.4317/medoral.24009
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Abstract
Background: This study aimed to analyze the trend in the number of hospitalized cases of oral cancer in Brazil, according to the coverage of oral health services in public health system, and also investigate the influence of healthcare and clinical characteristics on the severity of oral cancer cases.
Material and methods: This retrospective study considered the period between 2009 and 2017. Data from the Hospital Registry of Cancer from the National Cancer Institute were used, considering the primary locations C00 to C06. Detailed information including sex, age, alcohol and tobacco use, year of first consultation, and the clinical stage of the cases were also collected. The frequency of hospitalized cases was correlated with the coverage of Primary Care Oral Health Teams (ESB) and the number of Dental Specialty Centers (CEO). It was also estimated the chance of advanced oral cancer cases, according to healthcare and clinical characteristics. Data were analyzed using Tweedie's multiple regression and multiple binary logistic regression (α<0.05).
Results: There was an increasing trend in the number of hospitalized cases of oral cancer in Brazil between 2009 and 2017 (B=0.043, p<0.001, PR=1.044). The increase in ESB coverage was associated with small increase in the number of hospitalized cases of oral cancer (B=0.001, p=0.003, PR=1.001). The increase in the number of CEO was associated with decrease in the number of hospitalized cases of oral cancer (B=-0.085, p<0.001, PR =0.918). The increase of ESB (OR=0.998) and CEO (OR=0.974) contributed for reducing the number of stage IV cases, whilst the history of alcohol and tobacco use (OR=1.574) was associated with an increase in the number of stage IV cases.
Conclusions: Although an increasing trend was detected, the expansion of the public health system reduced the number of hospitalized cases and the frequency of advanced oral cancer cases in Brazil.
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Med Oral Patol Oral Cir Bucal
2020 Nov 28;24185. doi: 10.4317/medoral.24185. Online ahead of print.
The incidence of severe oral mucositis and its occurrence sites in pediatric oncologic patients
J-R Guimarães 1, L-G Carvalho, L-C Damascena, M-E Sampaio, I-L Ribeiro, S-A Sousa, A-M Valença
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PMID: 33247566 DOI: 10.4317/medoral.24185
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Abstract
Background: Childhood cancer is one of the main causes of child mortality and its treatment has debilitating effects on the oral cavity. Several oral mucositis (SOM) is one of the most common and may cause undesirable symptoms such as pain and risk of systemic infection.
Material and methods: This was a longitudinal, retrospective, and observational study determining the incidence of severe oral mucositis (SOM) and its occurrence sites in pediatric oncologic patients, in João Pessoa, Brazil, between 2013 and 2018. Data from 56 patients aged 1 to 18 years were collected from their medical records and through an oral mucosa examination, from the 1st to 5th week of chemotherapy treatment (CT) using the modified Oral Assessment Guide, by previously calibrated examiners (Kappa index > 0.7). The data were analyzed by the Chi-square test, and Odds Ratios were calculated.
Results: Most patients were females (54.5%), aged 8.8 years (± 4.8), with hematologic tumors (73.2%), predominantly Acute Lymphoid Leukemia (50.0%). An increase in the occurrence of SOM was observed throughout the CT (P = 0.05), ranging from 12.5% in the 1st to 35.7% in the 5th CT week. In the 1st CT week, there was a predominance of alterations in the lips (5.5%) and saliva (5.5%), while in the 5th, the jugal / palate mucosa (21.4%) remained the most affected site by SOM. Differences in the severity of SOM in the jugal / palate mucosa (P = 0.01) and labial mucosa (P = 0.04) were observed over time. In the 5th CT week, the likelihood of developing SOM was 13.3-fold higher (95% CI: 1.5 - 105.6) in patients with hematologic tumors.
Conclusions: The incidence of SOM was higher in the 5th CT week, most commonly affecting the jugal / palate mucosa, and patients with hematologic tumors were more prone to develop SOM.
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Med Oral Patol Oral Cir Bucal
2020 Nov 28;24175. doi: 10.4317/medoral.24175. Online ahead of print.
Malignant transformation of oral leukoplakia: a multicentric retrospective study in Brazilian population
J-M Cerqueira 1, F-S Pontes, A-R Santos-Silva, O-P Almeida, R-F Costa, F-P Fonseca, R-S Gomez, N-C Neto, L-A Miyahara, C-I Rodrigues-Fernandes, E-D Neto, A-L Araújo
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PMID: 33247570 DOI: 10.4317/medoral.24175
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Abstract
Background: Among the oral potentially malignant disorders, leukoplakia stands out as the most prevalent. The purpose of this study was to analyse the clinical-pathological features of oral leukoplakia in groups of patients from three major pathology centers in two different regions of Brazil, in order to determine which factors would be associated to the clinical risk of malignant transformation.
Material and methods: A total of 148 patients was analyzed, and data regarding gender, age, site, classification of the clinical subtype, harmful habits such as use of tobacco and alcohol, time of evolution and presence of dysplasia were collected. The association between risk factors and malignant transformation was investigated using the chi-square test and Fischer's exact test for correlation of variables. A significance level of 5% (p≤0.05) was used.
Results: The mean age of the patients was 60 years, and 56% were female. Most of the lesions (34,5%) were located in the lateral and ventral regions of the tongue. Of the 148 patients, ninety had clinical follow-up. Malignant transformation occurred in 13 patients (8.8%), with an average of 44 months of follow up.
Conclusions: Non-smoker, nonhomogeneous clinical presentation, location at the tongue, and the presence of high degree of dysplasia were statistically relevant factors associated with a higher risk of transformation transformation.
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Med Oral Patol Oral Cir Bucal
2020 Nov 28;24248. doi: 10.4317/medoral.24248. Online ahead of print.
Salivary gland cancer in Southern Brazil: a prognostic study of 107 cases
V-G Zanella 1, V-P Wagner, T-R Schmidt, S Thieme, C Correa, F-P Fonseca, P Rigon, M-B Barra, R-G Kroef, P-A Vargas, M-D Martins
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PMID: 33247564 DOI: 10.4317/medoral.24248
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Abstract
Background: Salivary gland cancers (SGC) represent an uncommon group of heterogeneous tumors. We performed a retrospective survey of SGC diagnosed in a reference center for treatment of malignant tumors from the south of Brazil aiming to determine the prognostic value of demographic, clinic and pathologic features.
Material and methods: Cases diagnosed as SGC between 2006 and 2016 were retrospectively collected. Medical records were examined to extract demographic, clinic, pathologic and follow-up information.
Results: One-hundred and seven cases of SGC were identified. The most common SGC were mucoepidermoid carcinoma (MEC) (n = 39) followed by adenoid cystic carcinoma (AdCC) (n = 29). Among AdCCs, 55.2% of cases were classified as cribriform, 27.6% as tubular and 17.2% as solid. The tubular subtype had the highest percentage of cases with perineural invasion (p=0.01). Among MEC, 61.5% of cases were classified as low grade, 15.4% as intermediate grade and 19.9% as high grade. Low grade MEC had the lowest percentage of cases with perineural invasion (p=0.04). The 5-year survival for loco-regional control, disease-free survival (DFS) and disease-specific survival were 75%, 70% and 84%, respectively. The following features were associated with poor DFS: advanced age (p=0.03), rural residency (p=0.01), being a smoker or former smoker (p=0.01), pain (p=0.03), nodal metastasis (p<0.001), need for chemotherapy (p=0.02), neck dissection (p=0.04), perineural invasion (p=0.01), and being diagnosed with AdCC compared to MEC (p=0.02).
Conclusions: The clinco-demographic and pathologic features identified as prognostic factors reveal the profile of patients at increased risk of recurrence and who would benefit from closer follow-up.
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6
Med Oral Patol Oral Cir Bucal
2020 Nov 28;24155. doi: 10.4317/medoral.24155. Online ahead of print.
Are mucous retention cysts and pseudocysts in the maxillary sinus a risk factor for dental implants? A systematic review
E Anitua 1, M-H Alkhraisat, A Torre, A Eguia
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PMID: 33247569 DOI: 10.4317/medoral.24155
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Abstract
Background: Mucous retention cysts and pseudocysts of the maxillary sinus are benign lesions present in up to 13% of adult patients. Different surgical approaches for sinus lift and dental implant placement in the presence of these lesions have been proposed.
Material and methods: A systematic review was performed following the PRISMA statement recommendations to answer the PICO question: Does the aspiration or removal of mucous retention cysts/pseudocysts before or during sinus lifting and dental implant placing, affect the survival of the implants? The study was pre-registered in PROSPERO (CRD42020185528). Included articles quality was assessed using the "NIH quality assessment tool" and "The Newcastle-Ottawa scale".
Results: Previous literature in this field is scarce and with a low level of evidence. There are no randomized prospective studies. Only 19 studies were identified, being composed of 2 cohort studies and 17 case series/reports. These studies involved 182 patients with a previous history of mucous retention cyst or pseudocyst in 195 maxillary sinuses where 233 implants were placed. The mean age of the patients was 45.5 (range: 12-80 years); 122 (67%) were male patients and 60 (33%) were female patients. The mean follow-up of the patients was 17.6 (range: 4-90 months). Only two fail was reported. No differences were identified in relation to the surgical approach or in relation to the removal/aspiration of the sinus lesion (prior to or simultaneous to sinus grafting) or not.
Conclusions: The level of evidence was grade 4 according to the CEBM and further studies are needed to confirm this observations, but with the available data, dental implants placement after sinus lift procedure in patients with mucous retention cysts and pseudocysts seems to be safe and present high survival regardless on the removal of the lesion or not.
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7
Med Oral Patol Oral Cir Bucal
2020 Nov 28;23912. doi: 10.4317/medoral.23912. Online ahead of print.
Evaluation of the salivary function of patients in treatment with radiotherapy for head and neck cancer submitted to photobiomodulation
L-N Ribeiro 1, M-H Lima, A-T Carvalho, R-F Albuquerque, J-C Leão, I-H Silva
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PMID: 33247577 DOI: 10.4317/medoral.23912
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Abstract
Background: Head and neck radiotherapy is typically associated with toxicities that can have profound effects on the patient's quality of life. Xerostomia, which may or may not be related to hypofunction of the salivary gland, leading to negative consequences, mainly in quality of life, leaving patients more susceptible to the development of oral mucositis, dental caries, oral infection and difficulties in speech is one of the most common side effects of such treatment. The aim of the present study was to evaluate salivary function of patients in treatment with radiotherapy for head and neck cancer submitted to photobiomodulation.
Material and methods: A cross-sectional study with a quantitative approach was carried out in the Dentistry Department of the Hospital de Câncer de Pernambuco between February and September 2019.
Results: The study sample comprised 23 patients of both genders, treated with radiotherapy for cancer in the head and neck region. The patients were submitted to photobiomodulation with infrared laser, as intraoral applications in order to prevent mucositis and extraoral applications to stimulate salivary glands. The applications were undertaken three times a week on alternate days throughout the radiotherapy period. The following parameters were used: Intraoral 15mW, 12J / cm2, 10s / point, 2.4 J / point, and extraoral 30mW, 7.5J / cm2, 10s / point, 0.3J / point, both with a wavelength of 830nm and area of 0.028cm². Subjective and objective symptoms were evaluated by measuring the unstimulated salivary flow (USF) using the spitting technique before, during and after radiotherapy treatment. For statistical analysis, a significance level of 5% was adopted. Most patients were male (70%) with 60 years of age on average. At the beginning of treatment, 22 patients had USF > 0.2 ml / min (grade 1), at the end of which 15 patients remained unchanged and only 3 patients progressed to grade 3. As for the subjective classification, most (52%) remained in grade 1 (absence of disability) throughout the treatment.
Conclusion: Based upon the results of this study it was possible to conclude that the use of photobiomodulation did not significantly interfere with the xerostomia complaint of patients in treatment with radiotherapy, however, it does seem to prevent patients from reaching higher degrees of xerostomia taking into account salivary flow measures.
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8
Med Oral Patol Oral Cir Bucal
2020 Nov 28;23996. doi: 10.4317/medoral.23996. Online ahead of print.
Qualitative mucin disorders in patients with primary Sjögren's syndrome: a literature review
M Fusconi 1, F Candelori, L Weiss, A Riccio, R Priori, R Businaro, L Mastromanno, I Musy, M de Vincentiis, A Greco
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PMID: 33247578 DOI: 10.4317/medoral.23996
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Abstract
Background: It is a common opinion that Primary Sjögren Syndrome (pSS) damages the exocrine glands and determines the reduction of secreted saliva, some studies show that there are qualitative anomalies of the mucins produced in saliva, including MUC7, MUC5B, MUC1. The purpose of this study is to trace all the information useful to establish whether there is a qualitative or quantitative defect of the mucins in the pSS.
Material and methods: We reviewed the literature by looking for publications relevant to the topic in electronic databases. Sixteen articles met the search criteria. The studies were divided into two categories, those that studied the rheological characteristics of the saliva and those that studied the structural and / or metabolism modifications of the muciparous cells in the salivary glands.
Results: in Patients with pSS, xerostomia and the reduction of salivary spinnbarkeit are only partially related to the reduction of the unstimulated salivary flow. In pSS, pathological alterations of mucins' chemical-physical properties prevail as a cause of the clinical characteristics. Moreover, in pSS there are structural and metabolism changes in salivary glands' muciparous cells.
Conclusions: There is much evidence that supports the presence of qualitative alterations in the saliva's rheological properties in Patients with pSS, and these are the main cause, more than the reduction of the unstimulated salivary flow, of the disease clinical characteristics - dry mouth and complications in the oral cavity. Therefore we propose to add to the classification criteria of pSS also a qualitative test of salivary glycoproteins.
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9
Med Oral Patol Oral Cir Bucal
2020 Nov 28;24308. doi: 10.4317/medoral.24308. Online ahead of print.
Association between periodontal disease and prostate cancer: a systematic review and meta-analysis
Y Wei 1, Y Zhong, Y Wang, R Huang
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PMID: 33247563 DOI: 10.4317/medoral.24308
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Abstract
Background: Periodontal 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.
Material and methods: 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.
Results: 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.
Conclusions: 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.
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10
Med Oral Patol Oral Cir Bucal
2020 Nov 28;24056. doi: 10.4317/medoral.24056. Online ahead of print.
Incidence and profile of benign epithelial tumors of salivary glands from a single center in Northeast of Brazil
B-W Santana 1, L-P Silva, M-S Serpa, M-D Borges, S-R Moura, M-M Silveira, A-P Sobral
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PMID: 33247571 DOI: 10.4317/medoral.24056
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Abstract
Background: Benign tumors of the salivary glands are a group of lesions with varied histopathological and clinical spectrum. The aim was to determine the incidence and clinicopathological characteristics of benign salivary gland neoplasms diagnosed between 2007 and 2016 in a single center located in northeastern Brazil.
Material and methods: Records regarding sex, age, anatomical location, histopathological subtype and treatment were retrieved, and data were analyzed using the Stata/IC software (version 12.0).
Results: There were above 7,100 cases of neoplasms in the head and neck region, of which 403 corresponded to salivary gland neoplasms. Of these, 238 (59%) were benign, being pleomorphic adenoma (PA) the most frequent neoplasm (n=178; 74.8%), followed by Warthin's tumor (WT) (n=23; 9.7%). Overall, most cases occurred in females (n=136; 57.1%) and age ranged from 11 to 83 years. The parotid gland (n=188; 79%) was the most common anatomical site, and all patients were treated by surgical excision. Of the cases diagnosed as PA, malignant transformation to carcinoma ex-pleomorphic adenoma (CAEXPA) occurred in 7 (3.9%) cases.
Conclusions: The present study confirmed the clinical and demographic profile of benign salivary gland neoplasms, which contributes to the continuous knowledge of current data about these lesions.
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11
Med Oral Patol Oral Cir Bucal
2020 Nov 28;23854. doi: 10.4317/medoral.23854. Online ahead of print.
Comparison of the whole slide imaging and conventional light microscopy in the grading of oral epithelial dysplasia: a multi-institutional study
P-B Diniz 1, M Sena-Filho, K-M Graner, B-A Mariz, L-A Reis, O-P Almeida, J Jorge
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PMID: 33247580 DOI: 10.4317/medoral.23854
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Abstract
Background: Whole Slide Imaging (WSI) is an alternative method to light microscopy (LM). However, few studies have compared the diagnostic agreement between WSI and LM, especially to grade oral epithelial dysplasia (OED). The purpose of this study was to evaluate the variability in grading OED by the World Health Organization grading system, using WSI and conventional LM, and to investigate whether the access to clinical information, and psychologic or physical states of the pathologists could interfere with the diagnosis.
Material and methods: eleven experienced pathologists from seven Brazilian universities independently evaluated twenty-five OED cases. The analyses were performed in duplicate for each method, with an interval of at least 30 days, and the time consumed in each analysis was measured. Physical and psychologic states were evaluated by blood pressure levels, heart rate and two questionnaires: State-Trait Anxiety Inventory and Perceived Stress Scale. Clinical information was provided after the second evaluation using WSI and the pathologist could change their diagnostic decision or not.
Results: LM showed a higher inter-examiner agreement (k=0.53) than WSI (k=0.45) and a smaller time consumed by the pathologists (mean of 65.53 seconds compared to 91.02 seconds in WSI). In the first analysis using conventional microscopy, there was a positive correlation between kappa values and anxiety (r=0.47, p=0.02), and stress (r=0.64, p<0.01), and an inverse correlation with heart rate (r=-0.48, p=0.02). In the digital analysis, there was also a positive correlation between kappa values and anxiety (r=0.75, p<0.001). After clinical information was given, there was a slight change in 11.3% of the cases, and a great discrepancy in 1.1% of the cases, mainly increasing the OED grade.
Conclusions: both microscopy systems had similar results, although LM had slightly higher kappa values, and WSI was more time consuming.
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12
Med Oral Patol Oral Cir Bucal
2020 Nov 28;24303. doi: 10.4317/medoral.24303. Online ahead of print.
PMS2: a potential prognostic protein marker in oral squamous cell carcinoma
J-M Decker 1, O-V Filho, M-O Freitas, I-J Silva-Fernandes, T-S Dantas, C-S Campêlo, M-D Cunha, P-G Silva, F-B Sousa
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PMID: 33247565 DOI: 10.4317/medoral.24303
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Abstract
Background: An 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.
Material and methods: 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).
Results: 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.
Conclusions: The findings of this study indicate that PMS2 can be a potential prognostic protein marker in OSCC patients 60 years of age and younger.
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Med Oral Patol Oral Cir Bucal
2020 Nov 28;24146. doi: 10.4317/medoral.24146. Online ahead of print.
Stability and marginal bone loss in implants placed using piezoelectric osteotomy versus conventional drilling: systematic review and meta-analysis
I Godoy-Reina 1, G Moreu-Burgos, M González-Jaranay
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PMID: 33247573 DOI: 10.4317/medoral.24146
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Abstract
Background: The main objective of this systematic review was to compare primary and secondary implant stability between placement with piezoelectric osteotomy and conventional drilling, comparing marginal bone losses as a secondary objective.
Material and methods: An electronic search was conducted using PubMed (MEDLINE), Scopus, and Cochrane Library (Wiley) databases, besides a manual search.
Results: A total of 153 articles were retrieved, 39 from Pubmed, 44 from Scopus, and 70 from the Cochrane Library. After removing duplicates, 112 articles (1 from the manual search) were screened, and 9 were finally selected for qualitative and statistical analyses.
Conclusions: Piezoelectric surgery is a predictable alternative to conventional drilling for dental implant placement. Medium/long-term survival rates and marginal bone losses are similar between piezoelectric osteotomy and conventional drilling, and there is no difference in ISQ values for primary stability. However, implants placed with ultrasound showed a lower decrease in implant stability quotient (ISQ) during the osseointegration period and a higher ISQ value for secondary stability. This study contributes further information on peri-implant bone tissue at 3 and 6 months after implant placement with piezoelectric osteotomy or conventional drilling and provides an updated meta-analysis of comparative studies.
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14
Med Oral Patol Oral Cir Bucal
2020 Nov 28;24238. doi: 10.4317/medoral.24238. Online ahead of print.
Accuracy of computer-aided image analysis in the diagnosis of odontogenic cysts: A systematic review
M-A Bittencourt 1, P-H Sá Mafra, R-S Julia, B-A Travençolo, P-U Silva, C Blumenberg, V-K Silva, L-R Paranhos
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PMID: 33247568 DOI: 10.4317/medoral.24238
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Abstract
Background: This study aimed to search for scientific evidence concerning the accuracy of computer-assisted analysis for diagnosing odontogenic cysts.
Material and methods: A systematic review was conducted according to the PRISMA statements and considering eleven databases, including the grey literature. Protocol was registered in PROSPERO (CRD [Blinding]). The PECO strategy was used to define the eligibility criteria and only studies involving diagnostic accuracy were included. Their risk of bias was investigated using the Joanna Briggs Institute Critical Appraisal tool.
Results: Out of 437 identified citations, five papers, published between 2006 and 2019, fulfilled the criteria and were included in this systematic review. A total of 5,264 images from 508 lesions, classified as radicular cyst, odontogenic keratocyst, lateral periodontal cyst, glandular odontogenic cyst, or dentigerous cyst, were analyzed. All selected articles scored low risk of bias. In three studies, the best performances were achieved when the two subtypes of odontogenic keratocysts (solitary or syndromic) were pooled together, the case-wise analysis showing a success rate of 100% for odontogenic keratocysts and radicular cysts, in one of them. In two studies, the dentigerous cyst was associated with the majority of misclassifications, and its omission from the dataset improved significantly the classification rates.
Conclusions: The overall evaluation showed all studies presented high accuracy rates of computer-aided systems in classifying odontogenic cysts in digital images of histological tissue sections. However, due to the heterogeneity of the studies, a meta-analysis evaluating the outcomes of interest was not performed and a pragmatic recommendation about their use is not possible.
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15
Med Oral Patol Oral Cir Bucal
2020 Nov 28;24051. doi: 10.4317/medoral.24051. Online ahead of print.
Binaural beats or 432 Hz music? which method is more effective for reducing preoperative dental anxiety?
D Menziletoglu 1, A-Y Guler, T Cayır, B-K Isik
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PMID: 33247575 DOI: 10.4317/medoral.24051
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Abstract
Background: The aim of this prospective clinical study was to investigate the effectiveness of binaural beats and music at a frequency of 432 Hz and compare which method is more effective for reducing preoperative dental anxiety in impacted third molar surgery.
Material and methods: Ninety patients were randomly selected to the binaural beats group, music group and control group. Visual analog scale used to evaluate dental anxiety before the local anesthesia in the first measurement. Local anesthesia was applied to the all patients. Patients in the music group listened to 432 Hz tuned music using earphones for 10 minutes. Patients in the binaural beats group listened to binaural beats using earphones (for the right ear, 220 Hz and for the left ear 210 Hz) for 10 minutes. No special treatment was applied to the patients in control group. In the second measurement, dental anxiety was measured again in all three groups. For analysis of differences between three groups was used One way Anova and Kruskal Wallis test.
Results: Twenty seven male and 53 female patients included the study. In the first measurement, the same level of anxiety was recorded in all three groups. (p=0.811) There was a significant decrease in anxiety in both the binaural beats and music group in the second measurement. (p<0.001).
Conclusions: Binaural beats and 432 Hz tuned music are a valid non pharmacological adjuvant to reduce dental anxiety in impacted third molar surgery. They have a positive effect to reduce the dental anxiety.
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16
Med Oral Patol Oral Cir Bucal
2020 Nov 28;24088. doi: 10.4317/medoral.24088. Online ahead of print.
Is Dexamethasone superior to Ketorolac in reducing pain, swelling and trismus following mandibular third molar removal? A split mouth triple-blind randomized clinical trial
A-V Martins-de-Barros 1, A-M Barros, A-K Siqueira, E-E Lucena, P-H Sette de Souza, F-A Araújo
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PMID: 33247572 DOI: 10.4317/medoral.24088
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Abstract
Background: The preemptive use of anti-inflammatory drugs, such as corticosteroids and NSAIDs, has the potential to reduce pain, swelling and trismus following oral surgery. The aim of this study was to compare the efficacy of dexamethasone and ketorolac tromethamine in reducing pain, swelling and trismus after mandibular third molar removal.
Material and methods: The researches implemented a triple-blind, randomized clinical trial. The study was conducted with ASA I individuals aging between 18 and 35 years, which were randomized and submitted to two interventions, one with 8mg dexamethasone and the other with 20mg ketorolac tromethamine given 1h before the procedure. The primary predictor variable was the use of dexamethasone or ketorolac. The primary outcome variable was the postoperative pain level, measured with a Visual Analogue Scale. The secondary outcome variables were the amount of rescue analgesic consumed, swelling and trismus. Repeated-measures ANOVA and t-test for paired samples were used to compare the means. Significance was set at p < 0.05.
Results: Fifty individuals were randomized and allocated to intervention, and the sample was composed of 40 subjects who completed the study (27 female and 13 male). Dexamethasone, when compared to ketorolac tromethamine, showed a significantly higher reduction in pain level at 8h, 16h, 24h, 32h, 40h and 72h, in swelling and trismus at 24h, 48h, 72h and 7 days and in total number of rescue analgesics taken up to 72h postoperative (p < 0.05).
Conclusions: The clinical performance of dexamethasone in controlling pain, swelling and trismus after mandibular third molar removal was superior to ketorolac tromethamine's.
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17
Med Oral Patol Oral Cir Bucal
2020 Nov 28;24196. doi: 10.4317/medoral.24196. Online ahead of print.
A new morphologic classification of the alveolar ridge after distraction osteogenesis in human patients. A 17 years retrospective case series study
J-M Somoza-Martín 1, A Vázquez-Casal, M Suárez-Cunqueiro, A García-García, P Gándara-Vila, M Pérez-Sayáns
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PMID: 33247567 DOI: 10.4317/medoral.24196
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Abstract
Background: To perform a morphologic classification based on the results of bone augmentation after a distraction osteogenesis.
Material and methods: Thirty-four (34) patients (24 women and 10 men; mean age, 47.1 years (SD=9.5); age range, 23 to 62 years) underwent a total of 42 alveolar ridge distractions before the placement of a total of 89 dental implants. Ridge bone morphology was evaluated as the main ordinal variable. Chi-squared, Kruskal-Wallis and ANOVA one-way test were used.
Results: Category I (30.95%): consisted of wide alveolar rim and no bone defects Category II (28.57%): wide alveolar rim, lateral bone surface concavity. Category III (23.81%): narrow alveolar rim, lateral bone surface concavity. Category IV (2.38 %): distraction transport segment forming a bridge, without bone formed beneath and requiring guided bone regeneration. Category V (9.52%): return of the transport segment to its initial position due to the reverse rotation of the distractor screw. Category VI (4.76 %): distraction transport segment completely lost. Subcategory D (28.57%), consisted of lingual deviation of the distraction axis, occurring in any of the categories I to IV. More men (76.9 %) presented with category I (p<0.001). The use of the chisel resulted mainly in categories I and II (69.4 %) (p<0.001). GBR was only required in 23.1 % of the cases in Category I (p=0.011). The bone height achieved decreases as the category increases, due to the accompanying osteogenic limit ations (p<0.001). The implants placed in category I were longer 11.5 ± 0.9 mm (CI95% 10.9-11.9 mm) compared to those placed in category III with a length of 10.4 ± 1.5 mm (CI95% 9.5-11.4 mm) (p=0.035).
Conclusions: The alveolar ridge after distraction osteogenesis could be divided into six morphologic categories which provide a useful basis for decision-making regarding implant placement.
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Med Oral Patol Oral Cir Bucal
2020 Nov 28;24054. doi: 10.4317/medoral.24054. Online ahead of print.
Accidental dental displacement into the maxillary sinus during extraction maneuvers: a case series
J Toledano-Serrabona 1, J Cascos-Romero, C Gay-Escoda
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PMID: 33247576 DOI: 10.4317/medoral.24054
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Abstract
Background: The aims of this study were to describe the clinical findings of patients that suffered teeth displacement into the maxillary sinus, and to report the surgical technique used to solve this complication.
Material and methods: A retrospective observational study was conducted involving patients that suffered a displacement of teeth into the maxillary sinus. Demographic and clinical data were recorded from the affected patients and a descriptive statistical analysis was made of the study variables.
Results: A total of nine patients were enrolled, six males (66.7%) and three females (33.3%), with a mean age of 36.0 years (range 22-54). In five patients (55.5%) the displaced teeth remained asymptomatic; however, dental fragments were retrieved from the maxillary sinus using Caldwell-Luc technique or endoscopic approach.
Conclusions: Dental displacement into the maxillary sinus during the extraction manoeuvres is an uncommon finding. Even in asymptomatic cases, these displaced teeth should be extracted in order to avoid the development of sinus pathology.
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