ABSTRACT
El objeto de este estudio fue investigar la influencia de la experiencia profesional en el tratamiento de maxilares atróficos y cómo afecta a las indicaciones, la incidencia de complicaciones y la tasa de éxito cuando se utilizan técnicas de elevación del seno maxilar.Se envió una encuesta a través de Google forms a odontólogos en activo que estaban familiarizados con este tipo de técnicas quirúrgicas. Se pidió a los profesionales que indicaran qué técnicas usa ban con más frecuencia en escenarios con hueso residual mayor o menor de 5 mm. También se preguntaron las compli caciones más frecuentes en el uso de las técnicas de elevación del seno maxilar y la tasa de éxito durante los primeros 12-24 meses. La encuesta alcanzó un total de 400 profesionales y la muestra se dividió en 3 grupos. El grupo A estaba compuesto por 158 profesionales con menos de 5 años de experiencia (39,5%), 87 sujetos de entre 6 y 10 años de trayectoria profesional componían el grupo B (21,75%) y el grupo C estaba compuesto por 155 sujetos con más de 10 años de experiencia (38,75%). Como conclusiones, se observó que la experiencia no es un factor decisivo en el éxito de la elevación de seno, ya que ambas técnicas gozan de gran predictibilidad. Si que existe una tendencia en los grupos más experimentados a simplificar la técnica, siendo la complicación más frecuente la perforación de la membrana de Schneider (AU)
The purpose of this study was to investigate the influence of professional experience in the management of atrophic maxilla and how it affects on indications, incidence of complications and survival rate when using maxillary sinus techniques. A survey was lunched via Google forms to active dentists that were familiar with this type of surgical techniques. The professionals were asked for indications of techniques in scenarios with residual bone greater or lesser than 5 mm. The complications more frequently encountered in the use of close and open maxillary sinus techniques and the survival rate during the first 12-24 months were also asked. The survey reached a total of 400 professionals and sample was divided in 3 groups. Group A was composed by 158 professionals with less than 5 years of experience (39.5%), 87 subjects with professional experience ranging between 6 to 10 years composed group B (21,75%) and group C was composed by 155 subjects with more than 10 years of experience (38,75%). According to the conclusions, it was observed that experience is not a decisive factor in the success of sinus lift since both techniques are highly predictable. There is a tendency in the more experienced groups to simplify the technique, the most frequent complication was the perforation of Schneiders membrane (AU)
Subject(s)
Humans , Male , Female , Young Adult , Adult , Sinus Floor Augmentation , Clinical Competence , Surveys and QuestionnairesABSTRACT
The sentinel node biopsy (SNB) is highly protocolized in other cancers, however, this is not the case for oral squamous cell carcinoma patients, hence our objective was to evaluate the different protocols published. A specific study protocol was designed and subsequently registered on PROSPERO (Ref. CRD42021279217). Twenty-three articles were included in the meta-analysis. The grouped sensitivity of the SNB was 82% (95% CI: 0.74-0.88), and the grouped specificity was 100% (95% CI: 0.99-1.00). The use of other radiotracers other than pre-operative lopamidol showed higher values of sensitivity of 82.80% (95% CI: 76.90%-87.50%; p < 0.001). The use of the blue dye stain showed higher sensitivity values of 85.60% (95% CI: 71.90%-93.20%), compared to sensitivity values of 77.50% when it was not used (95% CI: 69.10%-84.20%) (p < 0.001). Diagnostic rates are variable and they were significantly better when 99mTc was used in all its variations and accompanied by the blue dye staining.
Subject(s)
Lymph Nodes , Mouth Neoplasms , Sentinel Lymph Node Biopsy , Squamous Cell Carcinoma of Head and Neck , Clinical Protocols , Coloring Agents , Humans , Indocyanine Green , Lymph Nodes/pathology , Mouth Neoplasms/diagnosis , Mouth Neoplasms/pathology , Squamous Cell Carcinoma of Head and Neck/diagnosis , Squamous Cell Carcinoma of Head and Neck/pathologyABSTRACT
Background and objectives: The purpose of this study was to analyse the diagnostic and prognostic efficiency of the sentinel lymph node biopsy technique (SLNB). Materials and Methods: This is a prospective observational study performed by the Hospital Complex in Santiago de Compostela (CHUS) in Spain, between February 2013 and June 2020. The study included 60 patients, who had been diagnosed with OSCC in stage T1/T2N0M0. Results: 10 patients (16.7%) presented with SN+ (sentinel node positive). The majority (80%) only presented subcapsular affection, however one case also presented with extracapsular affection. Using the Kaplan-Meier curves, we determined that the average survival estimation for SN- patients was 74.0 months (CI95% 67.6-80.5) and it was 45.4 months (CI95% 10.9-24.0) for SN+ patients (p = 0.002). SN+ patients presented an OR = 11.000 (CI95% 2.393-50.589, p = 0.002) for cancer-related mortality. In terms of the diagnostic performance of the SN (sentinel node) test, a 55% sensitivity, a 100% specificity, 100% PPV and a 84% NPV were obtained. The analysis using ROC (receiver operating characteristic) curves revealed an AUC = 0.671 (CI95% 0.492-0.850, p = 0.046). Conclusions: SLNB seems to be an adequate technique for the detection of hidden metastases.
