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Head & Neck Nov 2016The purposes of this article were to review the literature regarding subjective outcomes, objective functional outcomes, and objective sensation return after sensate... (Review)
Review
The purposes of this article were to review the literature regarding subjective outcomes, objective functional outcomes, and objective sensation return after sensate and/or insensate free flap reconstruction of the oral cavity and oropharynx. Sensate radial forearm and anterolateral thigh free flaps tend to have better static 2-point discrimination and pressure threshold sensitivity than insensate flaps. There is insufficient evidence to draw conclusions on whether sensate flaps improve functional speech and swallowing outcomes measured by videofluoroscopic swallowing studies and percentage of word intelligibility by a listener blinded to the study. These data highlight the complexity and number of variables affecting functional outcomes in patients who have undergone reconstructive surgery after oral and oropharyngeal cancer ablative operations. A prospective randomized multicenter study that properly and rigidly stratifies patients by defect, flap and recipient nerve choice, adjuvant therapies, and uses widely agreed upon pretreatment and posttreatment evaluation tools could help to answer this important question. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.
Topics: Forearm; Humans; Mouth; Mouth Neoplasms; Oropharyngeal Neoplasms; Oropharynx; Quality of Life; Plastic Surgery Procedures; Surgical Flaps; Thigh; Tongue; Treatment Outcome
PubMed: 27131049
DOI: 10.1002/hed.24494 -
Archives of Oral Biology Nov 2022The purpose was to describe whether there are field cancerization (FC) indicators in clinically normal mucosa opposite to primary oral squamous cell carcinoma (OSCC). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The purpose was to describe whether there are field cancerization (FC) indicators in clinically normal mucosa opposite to primary oral squamous cell carcinoma (OSCC).
METHODS
A search of the Cochrane Library, PubMed, Embase, Web of Science, Scopus, and Livivo databases was performed on June 12, 2022, which retrieved 152 records without duplicates. Studies that analyzed FC in biopsies in clinically normal tissue opposite to primary OSCC were included. The search was conducted under the PRISMA guideline and the protocol was registered in PROSPERO (CRD42017077125).
RESULTS
Eight articles with 302 patients were included, 192 men and 110 women, mean age 57.1 years. Most patients had deleterious habits. All studies performed histopathological confirmation of OSCC and biopsies were obtained the clinically normal mirror mucosa. The meta-analysis carried out with eight studies. The studies showed 57.3 % of cases with histopathological changes of clinically normal mucosa opposite to primary OSCC (Confidence interval 95 %, 0.443-0.703; heterogeneity: Q value 18.715; I 73.284 %; n = 205). p53 and Ki-67 immunohistochemical analysis may be predictive for detecting changes. There was p53 immunoexpression in 41.3 % of cases (p = 0.872) (n = 55), ki-67 immunoexpression (< 20 %) in 68 % (p = 0.001) (n = 97) and ki-67 immunoexpression (> 20 %) in 28.4 % of cases (p = 0.000) (n = 110).
CONCLUSIONS
The findings suggest that FC can occur, and there are histopathological changes in clinically normal tissue opposite to primary OSCC. Nevertheless, the review showed that more longitudinal studies on FC are needed to draw a conclusive indication of the occurrence of FC in oral tissues opposite to OSCC.
Topics: Carcinoma, Squamous Cell; Female; Humans; Ki-67 Antigen; Male; Middle Aged; Mouth Mucosa; Mouth Neoplasms; Tumor Suppressor Protein p53
PubMed: 36126567
DOI: 10.1016/j.archoralbio.2022.105544 -
Journal of Dentistry Jun 2021A better understanding of the microstructure and mechanical properties of enamel and dentine may enable practitioners to apply the current adhesive dentistry protocols... (Review)
Review
OBJECTIVES
A better understanding of the microstructure and mechanical properties of enamel and dentine may enable practitioners to apply the current adhesive dentistry protocols to clinical cases involving dentine disorders (dentinogenesis imperfecta or dentine dysplasia).
DATA/SOURCES
Publications (up to June 2020) investigating the microstructure of dentine disorders were browsed in a systematic search using the PubMed/Medline, Embase and Cochrane Library electronic databases. Two authors independently selected the studies, extracted the data in accordance with the PRISMA statement, and assessed the risk of bias with the Critical Appraisal Checklist. A Mann-Whitney U test was computed to compare tissues damage related to the two dentine disorders of interest.
STUDY SELECTION
From an initial total of 642 studies, only 37 (n = 164 teeth) were included in the present analysis, among which 18 investigating enamel (n = 70 teeth), 15 the dentine-enamel junction (n = 62 teeth), and 35 dentine (n = 156 teeth). Dentine is damaged in cases of dentinogenesis imperfecta and osteogenesis imperfecta (p = 2.55E-21 and p = 3.99E-21, respectively). These studies highlight a reduction in mineral density, hardness, modulus of elasticity and abnormal microstructure in dentine disorders. The majority of studies report an altered dentine-enamel junction in dentinogenesis imperfecta and in osteogenesis imperfecta (p = 6.26E-09 and p = 0.001, respectively). Interestingly, enamel is also affected in cases of dentinogenesis imperfecta (p = 0.0013), unlike to osteogenesis imperfecta (p = 0.056).
CONCLUSIONS
Taking into account all these observations, only a few clinical principles may be favoured in the case of adhesive cementation: (i) to preserve the residual enamel to enhance bonding, (ii) to sandblast the tooth surfaces to increase roughness, (iii) to choose a universal adhesive and reinforce enamel and dentine by means of infiltrant resins. As these recommendations are mostly based on in vitro studies, future in vivo studies should be conducted to confirm these hypotheses.
Topics: Dental Cements; Dental Enamel; Dentin; Hardness; Tooth
PubMed: 33798638
DOI: 10.1016/j.jdent.2021.103654 -
Journal of Dental Research Feb 2021This living systematic review aims to summarize evidence on the prevalence of oral signs and symptoms in patients with COVID-19. The review was reported per the PRISMA...
This living systematic review aims to summarize evidence on the prevalence of oral signs and symptoms in patients with COVID-19. The review was reported per the PRISMA checklist, and the literature search was conducted in 6 databases and in gray literature. Studies published in any language mentioning oral symptoms and signs in patients with COVID-19 were included. The risk of bias was assessed by the Joanna Briggs Institute appraisal tools. The certainty of evidence was evaluated through GRADE assessment. After a 2-step selection, 40 studies were included: 33 cross-sectional and 7 case reports. Overall, 10,228 patients (4,288 males, 5,770 females, and 170 unknown) from 19 countries were assessed. Gustatory impairment was the most common oral manifestation, with a prevalence of 45% (95% CI, 34% to 55%; = 99%). The pooled eligible data for different taste disorders were 38% for dysgeusia and 35% for hypogeusia, while ageusia had a prevalence of 24%. Taste disorders were associated with COVID-19 (odds ratio [OR], 12.68; 95% CI, 6.41 to 25.10; = 63%; < 0.00001), mild/moderate severity (OR, 2.09; 95% CI, 1.25 to 3.49; = 66%; = 0.005), and female patients (OR, 1.64; 95% CI, 1.23 to 2.17; = 70%; = 0.0007). Oral mucosal lesions presented multiple clinical aspects, including white and erythematous plaques, irregular ulcers, small blisters, petechiae, and desquamative gingivitis. Tongue, palate, lips, gingiva, and buccal mucosa were affected. In mild cases, oral mucosal lesions developed before or at the same time as the initial respiratory symptoms; however, in those who required medication and hospitalization, the lesions developed approximately 7 to 24 d after onset symptoms. Therefore, taste disorders may be common symptoms in patients with COVID-19 and should be considered in the scope of the disease's onset and progression. Oral mucosal lesions are more likely to present as coinfections and secondary manifestations with multiple clinical aspects (PROSPERO CRD42020184468).
Topics: COVID-19; Cross-Sectional Studies; Female; Humans; Male; Mouth Diseases; Mouth Mucosa; Prevalence; Taste Disorders
PubMed: 32914677
DOI: 10.1177/0022034520957289 -
Journal of Oral and Maxillofacial... Mar 2016A systematic review was conducted to examine the evidence for the effectiveness and safety of corticotomy-facilitated orthodontics. (Review)
Review
PURPOSE
A systematic review was conducted to examine the evidence for the effectiveness and safety of corticotomy-facilitated orthodontics.
MATERIALS AND METHODS
Electronic databases (Ovid Medline, EMBASE, Cochrane, SCOPUS, and Web of Science) were searched for articles that examined the rate of corticotomy-facilitated orthodontic tooth movement and its effects on the periodontium, root resorption, and tooth vitality. Unpublished literature was searched electronically through ClinicalTrials.gov (http://www.clinicaltrials.gov) and the ISRCTN registry (http://www.controlled-trials.com). Relevant orthodontic journals and reference lists also were checked for eligible studies. Randomized clinical trials (RCTs) and controlled clinical trials (CCTs) were considered. Two article reviewers independently assessed the search results, screened the relevant articles, performed data extraction, and evaluated the methodologic quality of the studies.
RESULTS
Fourteen eligible articles (6 RCTs and 8 CCTs) were included in the review. There was a statistically meaningful increase in the rate of tooth movement compared with controls for all corticotomy techniques assessed. Some studies reported that acceleration in tooth movement was only temporary (lasting a few months). Corticotomy procedures did not seem to produce unwanted adverse effects on the periodontium, root resorption, and tooth vitality. The quality of the body of evidence was regarded as low owing to the presence of multiple methodologic issues, high risks of bias, and heterogeneity in the included articles.
CONCLUSION
Corticotomy procedures can produce statistically and clinically meaningful temporary increases in the rate of orthodontic tooth movement with minimal side-effects. Additional high-quality randomized clinical trials are needed to allow more definitive conclusions.
Topics: Dental Pulp; Humans; Osteotomy; Periodontium; Root Resorption; Tooth Movement Techniques
PubMed: 26608454
DOI: 10.1016/j.joms.2015.10.011 -
Clinical Oral Investigations Jan 2024This study aimed to review and synthesize studies using artificial intelligence (AI) for classifying, detecting, or segmenting oral mucosal lesions on photographs. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study aimed to review and synthesize studies using artificial intelligence (AI) for classifying, detecting, or segmenting oral mucosal lesions on photographs.
MATERIALS AND METHOD
Inclusion criteria were (1) studies employing AI to (2) classify, detect, or segment oral mucosa lesions, (3) on oral photographs of human subjects. Included studies were assessed for risk of bias using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). A PubMed, Scopus, Embase, Web of Science, IEEE, arXiv, medRxiv, and grey literature (Google Scholar) search was conducted until June 2023, without language limitation.
RESULTS
After initial searching, 36 eligible studies (from 8734 identified records) were included. Based on QUADAS-2, only 7% of studies were at low risk of bias for all domains. Studies employed different AI models and reported a wide range of outcomes and metrics. The accuracy of AI for detecting oral mucosal lesions ranged from 74 to 100%, while that for clinicians un-aided by AI ranged from 61 to 98%. Pooled diagnostic odds ratio for studies which evaluated AI for diagnosing or discriminating potentially malignant lesions was 155 (95% confidence interval 23-1019), while that for cancerous lesions was 114 (59-221).
CONCLUSIONS
AI may assist in oral mucosa lesion screening while the expected accuracy gains or further health benefits remain unclear so far.
CLINICAL RELEVANCE
Artificial intelligence assists oral mucosa lesion screening and may foster more targeted testing and referral in the hands of non-specialist providers, for example. So far, it remains unclear if accuracy gains compared with specialized can be realized.
Topics: Humans; Artificial Intelligence; Mouth Mucosa; Referral and Consultation
PubMed: 38217733
DOI: 10.1007/s00784-023-05475-4 -
Appetite Jun 2018Food delivers energy, nutrients and a pleasurable experience. Slow eating and prolonged oro-sensory exposure to food during consumption can enhance the processes that... (Meta-Analysis)
Meta-Analysis
Food delivers energy, nutrients and a pleasurable experience. Slow eating and prolonged oro-sensory exposure to food during consumption can enhance the processes that promote satiation. This systematic review and meta-analysis investigated the effects of oral processing on subjective measures of appetite (hunger, desire to eat) and objectively measured food intake. The aim was to investigate the influence of oral processing characteristics, specifically "chewing" and "lubrication", on "appetite" and "food intake". A literature search of six databases (Cochrane library, PubMed, Medline, Food Science and Technology Abstracts, Web of Science, Scopus), yielded 12161 articles which were reduced to a set of 40 articles using pre-specified inclusion and exclusion criteria. A further two articles were excluded from the meta-analysis due to missing relevant data. From the remaining 38 papers, detailing 40 unique studies with 70 subgroups, raw data were extracted for meta-analysis (food intake n = 65, hunger n = 22 and desire to eat ratings n = 15) and analyzed using random effects modelling. Oral processing parameters, such as number of chews, eating rate and texture manipulation, appeared to influence food intake markedly but appetite ratings to a lesser extent. Meta-analysis confirmed a significant effect of the direct and indirect aspects of oral processing that were related to chewing on both self-reported hunger (-0.20 effect size, 95% confidence interval CI: -0.30, -0.11), and food intake (-0.28 effect size, 95% CI: -0.36, -0.19). Although lubrication is an important aspect of oral processing, few studies on its effects on appetite have been conducted. Future experiments using standardized approaches should provide a clearer understanding of the role of oral processing, including both chewing and lubrication, in promoting satiety.
Topics: Adult; Appetite; Eating; Energy Intake; Female; Humans; Hunger; Lubrication; Male; Mastication; Mouth; Young Adult
PubMed: 29408331
DOI: 10.1016/j.appet.2018.01.018 -
Medicina Oral, Patologia Oral Y Cirugia... Jul 2016Earlier detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) is essential for dental professionals to improve patient... (Review)
Review
BACKGROUND
Earlier detection of oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) is essential for dental professionals to improve patient survival rates. The aim of this systematic review is to to evaluate the effectiveness of devices that utilise the principles of chemiluminescence and tissue autofluorescence as adjuncts in the detection of OSCC and OPMD.
MATERIAL AND METHODS
The electronic retrieval systems and databases searched for relevant articles were PubMed [MEDLINE] and Science direct. The search was for limited articles published in English or with an English abstract and articles published during the period from January 2005 to April 2014. Clinical trials utilized ViziLite, Microlux TM/DL and Visual Enhanced Light scope (VELscope) for early detection of OPMD and OSCC.
RESULTS
Twenty primary studies published satisfied our criteria for selection - 10 utilised chemiluminescence and 10 tissue autofluorescence. Senstivity of Vizilite for detecting OSCC nad OPMD ranged from 77.1 % to 100% and specificity was low that ranged from 0% to 27.8%.Most have shown that chemiluminescence increases the brightness and margins of oral mucosal white lesions and thus assist in identification of mucosal lesions not considered under Conventional visual examination. However, it preferentially detects leukoplakia and may fail to spot red patches. Clinical trials demonstrated that sensitivity of VELscope in detecting malignancy and OPMD ranged from 22 % to 100 % and specificity ranged from 16 % to 100%. Most studies concluded that VELscope can help the experienced clinician to find oral precursor malignant lesions. But it couldnot differentiate between dysplasia and benign inflammatory conditions.
CONCLUSIONS
Both devices are simple, non-invasive test of the oral mucosa but are suited for clinicians with sufficient experience and training. More clinical trials in future should be conducted to establish optical imaging as an efficacious adjunct tool in early diagnosis of OSCC and OPMD.
Topics: Carcinoma, Squamous Cell; Early Detection of Cancer; Humans; Light; Luminescent Measurements; Mouth Diseases; Mouth Mucosa; Mouth Neoplasms; Precancerous Conditions
PubMed: 26946209
DOI: 10.4317/medoral.21104 -
The Laryngoscope Jul 2016Dysphagia is still a treatment-related morbidity, despite advances in treatment modalities for oral and oropharyngeal squamous cell carcinoma. This systematic review... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES/HYPOTHESIS
Dysphagia is still a treatment-related morbidity, despite advances in treatment modalities for oral and oropharyngeal squamous cell carcinoma. This systematic review aimed to analyze the effects of swallowing outcomes of patients with oral or oropharyngeal squamous cell carcinoma treated with primary surgery with primary free flap reconstruction, with or without adjuvant therapy, for patients undergoing treatment with curative intent.
STUDY DESIGN
A comprehensive search strategy was undertaken across MEDLINE, CINAHL, Embase, and Scopus. Gray literature was sought through Cochrane Central Register of Controlled Trials, MedNar, and ProQuest.
METHODS
Studies included patients with oral cavity or oropharyngeal squamous cell carcinoma treated with primary surgery with primary free flap reconstruction. Swallowing function was the primary outcome, evaluated at 6 months or later following surgery. Methodological quality and data extraction was conducted as per the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument and standardized data extraction tool.
RESULTS
Fifteen articles comprising eight cohort studies and seven case series were included. Postoperative radiotherapy and oropharyngeal resections were demonstrated to be associated with increased dysphagia.
CONCLUSION
Advanced tumor-node-metastasis stage and use of adjuvant radiotherapy has been shown to have negative impacts on swallowing function. The majority of patients were able to have gastrostomy tubes removed at 6 months following curative therapy. Larger flap mass for the reconstruction of oral and oropharyngeal defects appeared to improve swallowing outcomes. A protocol for the identification of patients at high and low risk of developing dysphagia is proposed.
LEVEL OF EVIDENCE
N/A. Laryngoscope, 126:1572-1580, 2016.
Topics: Carcinoma, Squamous Cell; Combined Modality Therapy; Deglutition Disorders; Free Tissue Flaps; Humans; Mouth; Mouth Neoplasms; Oropharyngeal Neoplasms; Oropharynx; Pharyngectomy; Postoperative Complications; Plastic Surgery Procedures
PubMed: 26865034
DOI: 10.1002/lary.25894 -
Oral Surgery, Oral Medicine, Oral... Mar 2023The aim of this study was to determine the prevalence of acute oral mucosal toxicities in non-irradiated patients treated with systemic antineoplastics agents. The... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The aim of this study was to determine the prevalence of acute oral mucosal toxicities in non-irradiated patients treated with systemic antineoplastics agents. The secondary objective was to find out differences in its prevalence among the different types of systemic antineoplastics.
STUDY DESIGN
A systematic review and meta-analysis was performed. Articles from 2010 to July 2022 were retrieved and included if patients were adults undergoing oral assessment after administration of commercially available systemic antineoplastics. Data was extracted and pooled proportions were estimated using random-effect model method (Der Simonian and Lair).
RESULTS
Eighty-two articles were included in the study. The overall prevalence of acute oral mucosal damage across studies was 38.2% (95% CI: 33.1%-43.3%). The prevalence was 42.9% (95% CI: 32.8%-53%) in patients treated with chemotherapy alone, 38% (95% CI: 29.1%-47%) in patients treated with a combination of chemotherapy and targeted therapies, and 32.1% (95% CI: 26.8%-37.5%) in targeted therapies alone-treated patients. No statistically significant differences were found in the prevalence of oral mucosal toxicities between the different types of systemic antineoplastic treatments.
CONCLUSIONS
Oral mucosal toxicity is a major side effect in non-irradiated cancer patients undergoing systemic antineoplastics.
Topics: Adult; Humans; Prevalence; Antineoplastic Agents; Mouth Mucosa
PubMed: 36585342
DOI: 10.1016/j.oooo.2022.11.016