Time-to-Treatment in Oral Cancer: Causes and Implications for Survival.

The purpose of this review was to identify and describe the causes that influence the time-intervals in the pathway of diagnosis and treatment of oral cancer and to assess its impact on prognosis and survival. The review was structured according to the recommendations of the Aarhus statement, considering original data from individual studies and systematic reviews that reported outcomes related to the patient, diagnostic and pre-treatment intervals. The patient interval is the major contributor to the total time-interval. Unawareness of signs and/or symptoms, denial and lack of knowledge about oral cancer are the major contributors to the process of seeking medical attention. The diagnostic interval is influenced by tumor factors, delays in referral due to higher number of consultations and previous treatment with different medicines or dental procedures and by professional factors such as experience and lack of knowledge related to the disease and diagnostic procedures. Patients with advanced stage disease, primary treatment with radiotherapy, treatment at an academic facility and transitions in care are associated with prolonged pre-treatment intervals. An emerging body of evidence supports the impact of prolonged pre-treatment and treatment intervals with poorer survival from oral cancer.

Oral Lichen Planus and Dental Implants: Protocol and Systematic Review.

A systematic review was conducted to answer the following PICO question: "Can patients diagnosed with oral lichen planus (OLP) be rehabilitated with dental implants as successfully as patients without OLP?". A systematic review of the literature was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements to gather available and current evidence of oral lichen planus and its relationship with dental implants. The synthesis of results was performed using a Binary Random-Effects Model meta-analysis. Summary measures were odds ratios (ORs), frequencies, and percentages comparing the survival rate of dental implants placed in patients with OLP vs. those in patients without OLP. The electronic search yielded 25 articles, after removing the duplicated ones, 24 articles were selected. Out of the 24 articles, only 15 fulfilled the inclusion criteria. According to the results of the meta-analysis, with a total sample of 48 patients with OLP and 49 patients without OLP, an odds ratio of 2.48 (95% CI 0.34-18.1) was established, with an I2 value of 0%. According to the Strength of Recommendation Taxonomy (SORT) criteria, level A can be established to conclude that patients with OLP can be rehabilitated with dental implants.

A Double Case: Socket Shield and Pontic Shield Techniques on Aesthetic Zone.

When a tooth is extracted, a bone remodeling of the alveolar process occurs irretrievably. Various techniques have emerged over time to maintain the thickness of the bone crest in fixed prosthetics on teeth and implants. The socket shield and pontic shield techniques are aimed at minimizing buccal bone remodeling, especially in the aesthetic area. We present a case of an aesthetic sector rehabilitated with partial fixed denture using the socket shield and pontic shield techniques.

Guided Bone Regeneration of an Atrophic Maxilla Using Heterologous Cortical Lamina.

Alloplastic dental implants are currently the best way to replace lost teeth. In order to achieve good function and prognosis of dental implants, having bone and soft tissue to support them is necessary. When the amount of bone left is not enough to ensure the outcome of the implant, techniques such as shorts implants, zygomatic implants, or guided bone regeneration have been used. Even though autologous bone is mostly the "gold standard," other biomaterials such as xenografts have led to the reduction of the morbidity of treatments and to the improvement of the regeneration technique outcomes. We present a clinical case of severe atrophy of the maxilla in which we used different types of biomaterials: heterologous cortical lamina, xenograft and autologous bone, and microscrews.

Functional outcomes after glossectomies: Pilot study on use of a thrombin-fibrinogen biosponge (TachoSil).

OBJECTIVE: The aim of this study was to investigate whether the use of a thrombin-fibrinogen biosponge (TachoSil) has any advantage in tongue healing. STUDY DESIGN: A retrospective study with 30 patients treated with partial glossectomy (below half a tongue) was designed. We compared the results from a group using the biosponge (n =15 patients) and a control group (n = 15). Variables taken into consideration were bolus clearance, frenulum flexibility, and oral transit time. With these parameters, we formulated a "tongue remaining functional" (TRF) scale to assess tongue functionality after the surgery. We also evaluated long-term quality of life by using the Functional Intraoral Glasgow Scale (FIGS). RESULTS: In this study, TRF score, bolus clearance, oral transit time, and frenulum flexibility were significantly improved in the biosponge group. However, there were no differences between the 2 groups in the FIGS scores. CONCLUSIONS: The use of the biosponge in this pilot study showed positive long-term effects in lingual healing and functionality after partial glossectomies.

Autogenous teeth used for bone grafting: A systematic review

Background: Recently, bone graft materials using permanent teeth have come to light, and clinical and histological outcomes of this material have been confirmed by some studies. The aim of this systematic review was to evaluate the reliability of the autogenous tooth bone graft material applied to alveolar ridge augmentation procedures. Material and Methods: A systematic review of literature was conducted analyzing articles published between 2007 and 2017. The following four outcome variables were defined: a) implant stability b) post-operative complication c) evaluation of implant survival and failure rates, and d) histological analysis. A total of 108 articles were identified; 6 were selected for review. Based on the PICO (problem, intervention, comparison, outcome) model, the chief question of this study was: Can patients with alveolar ridge deficiency be successfully treated with the autogenous teeth used as bone graft? Results: The mean primary stability of the placed implants was 67.3 ISQ and the mean secondary stability was 75.5 ISQ. The dehiscence of the wound was the most frequent complication with a rate of 29.1%. Of the 182 analyzed implants, the survival rate was 97.7% and the failure rate was 2.3%. In the histological analysis, most of studies reported bone formation (AU)

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Intraosseous Leiomyoma of the Jaw in an Adolescent.

Leiomyoma is a benign tumor of the smooth muscle that rarely occurs in the mouth as an intraosseous lesion. The purposes of this paper are to: (1) present a case of an intraosseous solid leiomyoma of the mandible in a 13-year-old child, who presented with a well-defined unilocular radiolucency in the right mandible incidentally discovered during a routine dental radiographic examination; and (2) conduct a review of the literature to describe clinicopathological features and management of intraosseous jaw leiomyoma (IJL). A total of 17 articles describing 18 cases of IJL satisfied the selection criteria; including the present patient, to date a total of 19 cases of IJL have been reported. IJL occurs mainly in young patients (36.8 percent), more often in boys (1:5:1 male-to-female ratio), and reaches a larger size in children than in adults. The treatment of choice for IJL is surgical excision, which should be as minimally invasive as possible, especially in children.

Inflammatory papillary hyperplasia: A systematic review

INTRODUCTION: Inflammatory papillary hyperplasia (IPH) is a benign lesion of the palatal mucosa. It is usually found in denture-wearers but also has been reported in patients without a history of use of a maxillary prosthesis use. OBJECTIVES: The aim of this study is to review the literature to assess the prevalence of denture stomatitis and inflammatory papillary hyperplasia and the etiological factors associated. MATERIAL AND METHODS: A search was carried out in PubMed (January 2005 to October 2015) with the key words «inflammatory papillary hyperplasia», «denture stomatitis», «granular stomatitis» and «Newton's type III» The inclusion criteria were studies including at least a sample of 50 apparently healthy patients, articles published from 2005 to 2015 written in English. The exclusion criteria were reviews and non-human studies. RESULTS: Out of the 190 studies obtained initially from the search 16 articles were selected to be included in our systematic review. The prevalence of denture stomatitis was 29.56% and 4.44% for IPH. We found 5 cases of denture stomatitis among non-denture-wearer individuals. All IPH cases were associated with the use of prosthesis. Smoking and continued use of ill-fitting dentures turned out to be the most frequent risk factors for developing IPH. CONCLUSIONS: IPH is a rare oral lesion and its pathogenesis still remains unclear. Its presentation among nondenture-wearers is extremely unusual

Coronectomy versus surgical removal of the lower third molars with a high risk of injury to the inferior alveolar nerve. A bibliographical review.

BACKGROUND: Coronectomy is the surgical removal of the crown of the tooth deliberately leaving part of its roots. This is done with the hope of eliminating the pathology caused, and since the roots are still intact, the integrity of the inferior alveolar nerve is preserved. OBJECTIVE: The aim is to carry out a systematic review in order to be able to provide results and conclusions with the greatest scientific evidence possible. MATERIAL AND METHODS: A literature review is carried out through the following search engines: Pubmed MEDLINE, Scielo, Cochrane library and EMI. The level of evidence criteria from the Agency for Healthcare Research and Quality was applied, and the clinical trials' level of quality was analyzed by means of the JADAD criteria. RESULTS: The following articles were obtained which represents a total of 17: 1 systematic review, 2 randomized clinical trials and 2 non-randomized clinical trials, 3 cohort studies, 2 retrospective studies, 3 case studies and 4 literature reviews. CONCLUSIONS: Coronectomy is an adequate preventative technique in protecting the inferior alveolar nerve, which is an alternative to the conventional extraction of third molars, which unlike the former technique, presents a high risk of injury to the inferior alveolar nerve. However, there is a need for new clinical studies, with a greater number of samples and with a longer follow-up period in order to detect potential adverse effects of the retained roots.

The importance of a good evaluation in order to prevent oral nerve injuries: a review.

OBJECTIVE: Oral nerve injuries are a less frequent complication but they involve a decrease in the patient life quality. The purpose of the current review is to know the described risk factors to prevent injuries and to know the therapies against an established injury. MATERIALS AND METHODS: A Pubmed search of the English and Spanish language literature from 2000-2012 using the keywords 'oral surgery' or 'trigeminal nerve injuries' or 'lingual nerve injuries' or 'mandibular nerve injuries' was performed. Review articles were included and important articles from the references were added. RESULTS: A total of 662 were obtained from the search, from which 25 were selected accomplishing the inclusion criteria. Moreover, seven important articles were selected from the references of the ones mentioned, obtaining a total of 32 articles for the review. CONCLUSIONS: There is a relationship between the position of the extracted tooth and the incidence of the inferior alveolar nerve and lingual nerve injuries; as well as the age of the patient, the intra-operatory exposition of the nerve, the technique access for the lower third molar extraction and the surgeon's inexperience. The radiological examination is useful to evaluate the nerve damage and to decide on the surgical technique.

Tumor pardo mandibular: primera manifestación clínica de hiperparatiroidismo primario / Brown tumor of the madible: first clinical presentation of prymary hyperparathyroidism

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