Adenoid Cystic Carcinoma of the Minor Salivary Glands: A Systematic Review and Meta-Analysis of Clinical Characteristics and Management Strategies.

BACKGROUND: Intraoral adenoid cystic carcinoma (ACC) arising from minor salivary glands (MSG) is a rare malignancy associated with delayed diagnosis and unfavorable outcomes. This study aimed to comprehensively review ACC of MSGs, focusing on clinical characteristics, imaging modalities, treatment approaches, and long-term outcomes. METHODS: A systematic search was conducted in PubMed, Web of Science, and MEDLINE databases to identify relevant articles reporting cases of ACC of MSGs between January 1997 and March 2023. The study was registered in PROSPERO (ID: CRD42023449478). A total of 10 studies that met the inclusion criteria were selected for critical review. In total, 902 patients were diagnosed with ACC of MSGs with an age range of 44.3 to 63 years, and an average age of 56.6 years. The female to male ratio ranges from 1:1 to 2.4:1. Regarding the primary site of ACC, the palate was the most common location, accounting for 30.5% to 83.3%, followed by the buccal mucosa, floor of the mouth, and lip and the retromolar area. For histology, the solid mass pattern was the most prevalent, seen in 95.2% of patients, followed by the cribriform pattern. Regarding treatment modalities, surgery was the most common approach, applied in 76.3% of cases, with a combination of surgery and radiotherapy used in 29.0% of cases. A smaller fraction, 3.2%, received a combination of surgery, chemotherapy, and radiotherapy, and 8.3% underwent radiotherapy alone. Local recurrence rates varied between 1% and 28.5%, and distant metastasis occurred in 18.2% to 33.3% of cases, predominantly to lymph nodes (14.5%). An analysis of overall survival across various stages and patient numbers indicated a 5-year survival rate of 68.0%. The findings of this study provide valuable insights for physicians in making treatment decisions and emphasize the need for ongoing research and collaborative clinical efforts to improve the management and outcomes of this challenging disease. CONCLUSION: ACC of MSGs is a multifaceted condition typically manifesting as asymptomatic enlargement and ulceration. This disease is marked by distinct histopathological patterns and perineural invasion (PNI). Recognizing these distinctive aspects is key in shaping the treatment plan, which can range from surgical procedures to radiation therapy, chemotherapy, and evolving targeted treatments. Continuous research and collaborative clinical efforts remain critical for ongoing progress in the treatment and management of this challenging condition.

A Comparative Study of Condylar Bone Pathology in Patients with and without Temporomandibular Joint Disorders Using Orthopantomography.

This study aimed to compare condylar bony pathology in patients with and without temporomandibular joint disorder (TMD) using orthopantomography at Ajman University dental clinics between 2017 and 2021. Patient data from the Ajman University archives were collected after obtaining ethical approval. OPG (orthopantomogram) views were evaluated for potential TMJ pathology. Three independent observers underwent calibration and image analysis, with their agreement level calculated using Kappa statistics (score 0.781). Condylar changes were coded from 0 to 6. Statistical tests such as the Mann-Whitney Test, Kruskal-Wallis test, Spearman's correlation, and logistic regression analysis were used to analyze the data. The inter-examiner reliability for OPG was 0.903, and intra-examiner reliability was 0.908. The most common condylar bony changes observed in OPG views were flattening and osteophyte. Female participants had a higher prevalence of all bony changes. Temporomandibular Disorder (TMD) can manifest with symptomatic and detectable bony changes in OPG views. The prevalence of temporomandibular disorder appeared similar between genders, but differences were observed regarding the number of teeth lost, with unilateral tooth loss being more common. Interestingly, bruxism did not seem to significantly impact of temporomandibular disorder patients.

Arab dentists' refusal to treat HIV positive patients: a survey of recently graduated dentists from three Arab dental schools.

OBJECTIVE: To assess intended refusal of recent graduates from three Arab dental schools to treat HIV + patients and factors associated with this intention. MATERIALS AND METHODS: In 2015, convenience samples of recent dental graduates were included from Libya, Egypt and the United Arab Emirates. Participants responded to a questionnaire assessing personal background, knowledge of oral manifestations and fluids transmitting HIV, perceived adequacy of training and self-efficacy to manage blood exposures, attitude to risk of infection, moral beliefs and willingness to treat HIV + patients. Logistic regression assessed factors associated with intended refusal to treat HIV + patients. RESULTS: The overall response rate was 552/710 (77.8%), mean age = 23.7 years with 41.8% males. The mean (SD) scores for knowledge of oral manifestations and fluids transmitting HIV were 5.5 (1.3)/8 and 4.2 (1.7)/7. The mean (SD) scores for attitude to risk of infection and moral beliefs were 2.9 (1.0)/4 and 2 (0.9)/3, respectively. One-third of respondents indicated intention to refuse treating HIV + patients. Knowledge of body fluids transmitting HIV and moral beliefs were associated with lower odds of refusing to treat HIV + patients (OR = 0.86 and 0.38) whereas attitude indicating greater concern for risk of infection was associated with higher odds (OR = 1.54). CONCLUSIONS: One third of dentists from three Arab dental schools indicated they would refuse to treat HIV + patients. Adequate knowledge and moral beliefs reflecting professional ethics were associated with lower odds of refusal counterbalancing the association with attitude indicating increased concern for risk of infection with implications for dentist education and training.

Self-reported occupational health problems among Libyan dentists.

OBJECTIVES: To investigate the prevalence of the most common occupation-related health problems as well as factors associated with their incidence among dental practitioners. MATERIALS AND METHODS: A cross-sectional, questionnaire-based survey of Libyan dental practitioners. Participants provided information regarding their experience of occupationally related problems they encountered over the past 12 months which included inquiries about musculoskeletal pain, percutaneous injuries, allergy, eye and sight problems, and hearing problems. RESULTS: Musculoskeletal problems were the most frequently reported (48.2%), followed by percutaneous injuries (35%), eye problems (22%), allergy (11%) and hearing problems (7.6%). Musculoskeletal problems were significantly higher among dentists who work in private sector, full timer as well as those who prefer to work in a sitting position (p=0.021, 0.027 and 0.008, respectively). Practitioners with less than 5 years in service reported significantly higher percentage of percutaneous injuries (p=0.027) than their senior counterparts, whereas practitioners who spent more than 10 years in service were more likely to suffer from visual disturbances (p=0.033). CONCLUSION: The findings of this study indicate that musculoskeletal problems and percutaneous injuries are the most commonly reported occupational health problems among dentists, whereas allergic reactions and hearing problems are the least reported ones. CLINICAL SIGNIFICANCE: Dentists should use alternate working positions to minimise musculoskeletal problems and adopt more effective strategies to prevent percutaneous injuries particularly among novices.

Perceived competency towards preventive dentistry among dental graduates: the need for curriculum change.

BACKGROUND: A previous study has shown that dental practitioners in Benghazi believed that the less prevention-oriented education system is one of the barriers to applying preventive dentistry. OBJECTIVE: To assess attitudes and perceived competence of the dental graduates in Benghazi towards prevention and early management of dental caries. METHODS: A cross-sectional, questionnaire-based survey was conducted among internship students attending the Department of Community and Preventive Dentistry in Faculty of Dentistry, Benghazi, Libya. The participants were asked to provide demographic information, to respond to statements about their attitudes towards preventive dentistry, and to answer questions regarding their perceived competence in applying preventive dentistry procedures. RESULTS: Data from 108 Libyan dental graduates were analysed for this study, of which 64% of them were females and 42.1% of them passed their final year with grade: acceptable. The most acknowledged aspects of preventive dentistry were being useful and essential to the community (95.4 and 90.8%, respectively). The percentage of participants expressing a proficiency in providing oral hygiene instructions was the highest (95.4%). There were differences between study subgroups in their perceived competence of preventive dental practices by gender and academic performance (p≤0.05). CONCLUSION: This study highlighted that the currently implemented undergraduate education programme in Benghazi dental school does not provide dentists with the required attitude and skills to fulfil their role in providing preventive-oriented health services.

Clinico-pathological study of odontomas in 19 Libyan patients.

BACKGROUND: Odontomas are among the most common benign odontogenic tumors, which are mostly discovered in the first and second decades of life with no clear sex predilection. MATERIALS AND METHODS: The present retrospective study reviews the clinical, radiological, and the histopathological characteristics of odontomas in 19 Libyan patients seen during the last 18 years in our department. RESULTS: Most odontomas in our study were discovered when they obstruct a tooth from an eruption at its normal eruption time although a few cases were noticed on routine radiological examination of the region. Panoramic radiographs computed Tomography Scan of the area and the histopathological examination are helpful to elicit the diagnosis. Two cases in this series were found associating with dentigerous cyst and in another two cases the odontomas were seen erupting intraorally. CONCLUSION: Odontomas should be considered in the differential diagnosis of the mixed radioopaque radiolucent lesions, especially if they found obstructing the teeth from eruption.