Maia-Lima MP, Ferreira LM, de Oliveira FES
… +14 more, da Silva TA, Bergo BR, Kaminagakura E, de Andrade BAB, Bonan PRF, de Souza FTA, Oliveira MC, Villarroel-Dorrego M, Sanchez-Mendez A, Gilligan GM, Vega CPP, Jímenez AR, Martinez-Pedraza R, Martelli-Júnior H
OBJECTIVE: To evaluate the training, clinical experience, and attitudes related to oral biopsy among dental students from Latin America. MATERIALS AND METHODS: The study included 326 final-year dental students from unive...OBJECTIVE: To evaluate the training, clinical experience, and attitudes related to oral biopsy among dental students from Latin America. MATERIALS AND METHODS: The study included 326 final-year dental students from universities in Argentina, Brazil, Colombia, Mexico, and Venezuela. Participants completed a structured, anonymous 35-item online questionnaire addressing demographic data, exposure to oral biopsy procedures, self-perceived knowledge and skills, and attitudes towards biopsy practice. Data were analyzed using descriptive statistics, Fisher's exact test, and the Wilcoxon test, with a significance level of 5%. RESULTS: Most students reported having received formal theoretical training in oral biopsy (89.9%). Only 53.4% had performed at least one biopsy during their undergraduate studies, with excisional biopsies being the most common. Despite a high level of agreement regarding the relevance of oral biopsy to clinical practice (p < 0.001), students demonstrated low self-confidence in performing incisional and excisional biopsies (p < 0.001 for both), particularly in lesions suspected of malignancy (p < 0.001). Prior practical experience was significantly associated with higher levels of confidence and more favorable attitudes towards performing biopsies (p < 0.001). CONCLUSION: Oral biopsy training among Latin American dental students is heterogeneous and largely theoretical, with limited practical experience contributing to reduced diagnostic autonomy and clinical confidence.
INTRODUCTION: Oral mucosal melanoma (OMM) is a rare subtype of melanoma but exhibits highly invasive biological behavior. Programmed cell death protein 1 (PD-1) monotherapy showed lower response in OMM than other subtype...INTRODUCTION: Oral mucosal melanoma (OMM) is a rare subtype of melanoma but exhibits highly invasive biological behavior. Programmed cell death protein 1 (PD-1) monotherapy showed lower response in OMM than other subtypes of melanoma. MATERIALS AND METHODS: We retrospectively analyzed the efficacy and safety of pembrolizumab with anlotinib in patients with advanced OMM between August 2018 and September 2024. The primary endpoint was objective response rate (ORR); the secondary endpoints included disease control rate (DCR), duration of response (DOR), progression-free survival (PFS), overall survival (OS), and treatment-related adverse events (TRAEs). RESULTS: Forty-one patients were enrolled in our study. Seventeen patients (41.4%) achieved an objective response. The median PFS was 6.4 months (95% confidence interval [CI], 4.5-8.3 months), and the median OS was 10.0 months (95% CI, 8.3-11.7 months). Thirty-three patients (80.5%) experienced at least one TRAE. The most common TRAEs were hypertension (29.3%), hand-foot syndrome (19.5%), and anemia (19.5%). Grade 3 or higher TRAEs occurred in two patients (4.8%), and no grade 5 TRAEs were observed. CONCLUSIONS: Our study suggested that pembrolizumab with anlotinib in patients with advanced OMM showed potential efficacy and manageable adverse effects. Further studies are needed to confirm the efficacy of this combination strategy.
OBJECTIVES: Hyposalivation is a common condition, particularly among older adults, often resulting from polypharmacy or age-related salivary gland degeneration. While sialometry is the reference method for diagnosing hyp...OBJECTIVES: Hyposalivation is a common condition, particularly among older adults, often resulting from polypharmacy or age-related salivary gland degeneration. While sialometry is the reference method for diagnosing hyposalivation, it is challenging to use in dependent patients or those with cognitive impairments. This study aimed to test a new tool, FishburneTabs (FBTs), by comparing it with sialometry and evaluating its concordance with the Clinical Oral Dryness Score (CODS). MATERIALS AND METHODS: This study compared three different techniques for assessing hyposalivation in 59 patients (care home residents): CODS evaluation, saliva collection using FBTs, and stimulated salivary flow sialometry. RESULTS: Positive correlations were identified between FBTs and salivary flow measurements (r = 0.68, p < 0.05), and negative correlations between CODS and both FBTs (r = -0.51, p < 0.05) and salivary flow (r = -0.62, p < 0.05). The sensitivity and specificity of FBTs for identifying hyposalivation were 62.2% and 61.9%, respectively, with a positive predictive value of 74.2% and a negative predictive value of 48.1%. CONCLUSION: FBTs show promise as a supportive tool for assessing hyposalivation in settings where sialometry is not feasible, although they are not a direct substitute for sialometry as the reference method.
OBJECTIVE: Treatment methods of laryngeal cancer (LC) often include radiotherapy (RT), commonly combined with cytotoxic drugs. This approach is associated with early adverse effects, notably oral mucositis (OM). The C-re...OBJECTIVE: Treatment methods of laryngeal cancer (LC) often include radiotherapy (RT), commonly combined with cytotoxic drugs. This approach is associated with early adverse effects, notably oral mucositis (OM). The C-reactive protein to albumin ratio (CAR) is a promising novel biomarker used to assess the severity of inflammatory responses in various chronic conditions. The aim of this study was to evaluate the predictive value of pretreatment CAR for the occurrence and severity of OM of varying grades during RT in patients with LC. METHODS: The pretreatment CAR values were calculated in 68 patients treated with RT due to locally advanced or advanced LC. RESULTS: The increased incidence of severe grade OM in LC patients between weeks III and VII of RT was significantly associated with higher CAR values. A high CAR was significantly correlated with an increased risk of grade 3 OM at the end of the III (p = 0.026), IV (p = 0.018), V (p = 0.027), VI (p = 0.018), and VII (p = 0.004) week of RT. Multivariable analysis demonstrates a higher probability of developing severe OM in LC patients with an elevated median CAR following III (p = 0.025), IV (p = 0.025), V (p = 0.025), VI (p = 0.020), and VII (p = 0.035) cycle of irradiation. Furthermore, CAR values allowed reliable differentiation of patients who developed grade 3 OM between the III-VII weeks of treatment (p < 0.001). CONCLUSIONS: The pretreatment CAR value indicates clinical utility in predicting the likelihood of severe OM induced by RT-based therapy in patients with LC.
OBJECTIVE: This study examined associations between psychological factors, serum zinc/iron levels, and clinical features of factitious oral ulcers in children (3-16 years). METHODS: A cross-sectional analysis of 69 patie...OBJECTIVE: This study examined associations between psychological factors, serum zinc/iron levels, and clinical features of factitious oral ulcers in children (3-16 years). METHODS: A cross-sectional analysis of 69 patients (78.3% male) from two Chinese hospitals assessed ulcer characteristics, pain (VAS), micronutrient levels, and psychological scores (SCARED, DSRSC, CPRS, SDQ). Statistical analysis used nonparametric tests and correlation analysis (SPSS 26.0). RESULTS: Zinc deficiency (37.7%) correlated with longer disease duration (12.0 vs. 6.0 months, p = 0.035) and shorter ulcer-free intervals (60.0 vs. 95.2 days, p = 0.040). Zinc levels inversely linked to emotional symptoms (r = -0.416, p = 0.022) but positively to prosocial behavior (r = 0.526, p = 0.003). Pain intensity associated with anxiety (VAS: 4.0 vs. 3.0, p = 0.025) and psychosocial distress (r = 0.461, p = 0.010). Older children (8-16 years) had longer disease duration (12.0 vs. 3.6 months, p < 0.001) and higher zinc deficiency (47.5% vs. 24.1%, p = 0.048). Iron showed paradoxical associations with emotional symptoms (r = 0.452, p = 0.012) and prosocial behavior (r = -0.382, p = 0.037). CONCLUSION: Zinc deficiency and psychological factors critically influence the chronicity of FOU. Multidisciplinary care combining micronutrient supplementation and behavioral interventions is recommended.
BACKGROUND: The atrophic-erosive forms of oral lichen planus (OLP) remain a major concern as these lesions can cause a wide range of symptoms leading to reduced quality of life. Nowadays, newer possibilities are offered...BACKGROUND: The atrophic-erosive forms of oral lichen planus (OLP) remain a major concern as these lesions can cause a wide range of symptoms leading to reduced quality of life. Nowadays, newer possibilities are offered by micro-needles as an effective transmucosal drug delivery. The aim of this single-blinded randomized clinical trial was to determine the therapeutic efficacy of micro-needling (MN) as a novel technique for transmucosal delivery of triamcinolone acetonide (TA) and hyaluronic acid (HA) on symptomatic OLP lesions. METHODS: Twenty volunteers with bilateral symptomatic OLP lesions were randomly assigned to the study involving four different treatment groups (G): G, topical TA alone; G, MN as an adjunct to the topical TA; G, topical TA and HA; and G, MN as an adjunct to the topical TA and HA. Lesions were assessed at baseline, and on Days 7, 14, 28, and 56 using parameters including the percentage healing index (PHI), reticulation/erythema/ulceration (REU) score, and visual analogue scale (VAS). Statistical analysis was then performed using SPSS software. RESULTS: Twenty patients (40 lesions; 10 per group) were included. G showed a significantly higher PHI compared to both G (p 0.001) and G (p < 0.05) at all observation times. Regarding the REU score, G achieved significantly greater reductions compared to G at all observation times (p < 0.05), compared to G on Days 7, 28, and 56 (p < 0.05), and compared to G on Days 28 and 56 (p < 0.05). Regarding the VAS, both G and G showed a statistically significant reduction on Day 7 compared to G and G (p < 0.05). CONCLUSION: This study uncovered the advantages of MN in promoting healing, reducing severity, and alleviating pain in OLP patients. Therefore, MN has the potential to become an effective and well-tolerated treatment modality for symptomatic OLP. Moreover, the adjunctive use of MN with topical application of both TA and HA demonstrated the most significant therapeutic benefits, suggesting a synergistic effect. TRIAL REGISTRATION: irct.behdasht.gov.ir: IRCT20231213060357N1 (17 February 2024).
OBJECTIVES: This study aims to address the challenges in the diagnosis of oral cancer by proposing a novel computer-aided diagnostic framework that leverages advanced deep learning (DL) and optimization techniques to enh...OBJECTIVES: This study aims to address the challenges in the diagnosis of oral cancer by proposing a novel computer-aided diagnostic framework that leverages advanced deep learning (DL) and optimization techniques to enhance early detection and improve patient outcomes. MATERIALS AND METHODS: In the framework proposed, the histopathological images are subjected to a preprocessing technique, and then, the images are fed directly to the NASNet-Large model for the extraction of high-level discriminative texture features. The resultant vectors obtained from the features extracted act as input to the search space of Archimedes Optimization Algorithm that carries out dimensionality reduction and optimal hyperparameter tuning simultaneously. The optimized feature subset is fed to the final classifier, namely the Stacked Sparse Denoising Autoencoder that learns robust latent representations. RESULTS: The findings demonstrate that the proposed approach achieves superior performance, achieving an accuracy of 95.38%, a precision of 95.15%, a sensitivity of 91.78%, a specificity of 91.85%, and an F1-score of 93.72%. CONCLUSIONS: These findings underscore the potential of the SSDA-AOA framework as an effective tool for the early detection and precise classification of oral cancer, paving the way for improved patient outcomes through timely intervention. CLINICAL RELEVANCE: This innovative approach may significantly enhance patient outcomes by facilitating earlier diagnosis and treatment, addressing the urgent need for more reliable diagnostic tools in oncology.
OBJECTIVE: This trial aimed to assess the adjunctive therapeutic effect of low-intensity pulsed ultrasound (LIPUS) in promoting bone regeneration following jaw cyst enucleation with curettage. METHODS: This triple-blinde...OBJECTIVE: This trial aimed to assess the adjunctive therapeutic effect of low-intensity pulsed ultrasound (LIPUS) in promoting bone regeneration following jaw cyst enucleation with curettage. METHODS: This triple-blinded, randomized trial enrolled 29 patients (33 jaw cysts) undergoing enucleation. 17 patients (18 cysts) received daily LIPUS therapy for 10 days (Ultrasound group), while 12 patients (15 cysts) received sham LIPUS therapy (control group). Volumetric changes of the cystic cavities and bone density (relative Hounsfield units) were assessed at baseline, at 3, and 6 months following LIPUS therapy. RESULTS: At the 3rd month, a significant reduction in cyst volume was observed in the Ultrasound group, which showed a 63% reduction, compared to a 35% reduction in the control group (p = 0.031). By the 6th month, the Ultrasound group demonstrated a further decrease in volume compared to the control group (82% vs. 61%; p = 0.027). Moreover, LIPUS therapy consistently resulted in significantly greater bone density than the control group at both 3 and 6 months (p = 0.026 and p = 0.031, respectively). CONCLUSIONS: Adjunctive LIPUS therapy following jaw cyst enucleation improves bone regeneration postoperatively without adverse effects. LIPUS is a promising non-invasive method for promoting bone healing post-enucleation. TRIAL REGISTRATION: Thailand Clinical Trials Registry on June 16, 2025 (https://www.thaiclinicaltrials.org/show/TCTR20250616017).
OBJECTIVES: The aim of this study was to develop and validate a questionnaire for assessing the knowledge, attitude and practice (KAP) related to the daily management of oral lichen planus (OLP). MATERIALS AND METHODS: A...OBJECTIVES: The aim of this study was to develop and validate a questionnaire for assessing the knowledge, attitude and practice (KAP) related to the daily management of oral lichen planus (OLP). MATERIALS AND METHODS: A 25-item questionnaire with three dimensions was developed. Using convenience sampling, 136 OLP patients from a tertiary hospital in Guangdong Province (December 2023-April 2024) completed the survey. Among them, 30 patients were retested 2-4 weeks after the initial survey, during which no participants received any OLP-related health education interventions. Reliability was evaluated using Cronbach's α coefficient, split-half reliability, and test-retest reliability, while validity was assessed via the content validity index, exploratory factor analysis, and confirmatory factor analysis. RESULTS: The questionnaire showed strong reliability (Cronbach's α = 0.923; test-retest reliability = 0.909) and validity (content validity index = 0.93). Factor analysis identified three dimensions, explaining 60.84% of the total variance, with adequate model fit indices. CONCLUSIONS: This validated 25-item questionnaire (covering knowledge, attitude, and practice dimensions) serves as an initial, reliable measure of OLP-related knowledge, attitudes, and self-management practices with acceptable construct validity in a single-center sample.
OBJECTIVES: To evaluate evidence in relation to postoperative bleeding in humans aged ≥ 16 with preoperative platelet counts < 50,000/μL, compared to those above, undergoing dental interventions. METHODS: Quantitative sy...OBJECTIVES: To evaluate evidence in relation to postoperative bleeding in humans aged ≥ 16 with preoperative platelet counts < 50,000/μL, compared to those above, undergoing dental interventions. METHODS: Quantitative synthesis without meta-analysis was conducted through an electronic search conducted on Ovid MEDLINE and Embase from 1946 to April 2024 with no restriction on study design. Primary outcome was postoperative bleeding in patients with platelet count < 50,000/μL due to dental interventions. Two reviewers assessed independently, and a third resolved conflicts. This study was reported according to PRISMA 2020 and registered on PROSPERO (CRD42024527279). RESULTS: 1633 unique articles were identified. Six case reports, four case series, nine cohort studies and one trial fulfilled the inclusion. Overall, 983 included cases consisted of 968 oral surgery, 10 periodontology and 5 dental anaesthesia cases. Postoperative bleeding occurred in 65 cases following oral surgery procedures, of which 1 was life-threatening. Bleeding rates for cases with platelet levels < 50,000/μL were 12.9%, and 4.9% for ≥ 50,000/μL. Risk ratio was 2.95 (95% CI: 1.76-4.96; p < 0.0001). CONCLUSIONS: There is no evidence that platelet counts < 50,000/μL is a contraindication for dental interventions, although findings suggest higher postoperative bleeding rates, particularly in oral surgery. Patients should be assessed individually, with more controlled trials required.