Teledentistry: A Future Solution in the Diagnosis of Oral Lesions: Diagnostic Meta-Analysis and Systematic Review.

Introduction: Teledentistry (TD) can offer a wide range of possibilities in the field of oral medicine. Oral potentially malignant disorders (OPMDs) are hard to detect, and even harder to diagnose correctly. With the help of TD, OPMDs can be detected and diagnosed by a remote specialist. Our aim was to investigate whether TD could provide a reliable diagnostic method compared with clinical oral examination (COE) in the diagnosis of OPMDs. Methods: A systematic search was conducted in three databases (Medline, EMBASE, CENTRAL) until November 2021. We included studies that compared telediagnosis and COE, both made by experts. Pooled specificity and sensitivity were calculated and visualized on a two-dimensional plot. Risk of bias was assessed using the QUADAS-2 tool, and the level of evidence is shown with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) tool. Results: Of the 7,608 studies, 13 were included in the qualitative and 9 in the quantitative synthesis. Using TD tools in the detection of oral lesions (OLs) showed high specificity (0.92 confidence interval [95% CI] = 0.59-0.99) and sensitivity (0.93 95% CI = 0.17-1.00). In the differential diagnosis of lesions, we found high sensitivity and specificity (0.942 95% CI = 0.826-0.982 and 0.982 95% CI = 0.913-0.997), respectively. We summarized the available data on time-effectiveness, screening person, referral decision, and technical settings. Conclusion: Detecting OLs with TD tools might lead to earlier diagnosis, treatment, and stricter follow-up of OPMD. TD may offer a great substitution for COE in the diagnosis of OLs, and thus, fewer referrals could be made to special care, resulting in a greater number of treated OPMDs.

Patients with inflammatory bowel disease have a higher chance of developing periodontitis: A systematic review and meta-analysis.

Background and objective: Periodontitis affects up to one billion people worldwide, and has been proven to be associated with several systemic inflammatory conditions. This study investigates the specific relationship between two multifactorial diseases: Inflammatory bowel disease (IBD) and periodontitis. To thoroughly explore this issue, we investigated separately whether IBD patients have a higher chance of developing periodontitis, and equally, whether patients with periodontitis have a higher chance of developing IBD. Methods: The systematic search was performed in three databases: MEDLINE, Cochrane Trials, and Embase, up to 26 October 2021. The protocol was registered in PROSPERO. All eligible studies investigating the association between IBD and periodontitis from either direction were included. The Newcastle-Ottawa Scale was used to assess the risk of bias. As a primary outcome, we investigated the prevalence of IBD and periodontitis, and calculated the odds ratio (OR). Our secondary outcomes involved comparing the clinical periodontal outcomes of IBD patients to those of IBD-free patients. Results: The systematic search resulted in 1,715 records, 14 of which were eligible for qualitative synthesis and 8 for quantitative synthesis. On the basis of the results of the primary outcome, IBD diagnosis was associated with significantly higher odds of periodontitis: OR = 2.65 (CI: 2.09-3.36, I 2 = 0 (CI: 0-0.75)). For subgroup analysis, we investigated separately the odds in Crohn's disease (CD) patients: OR = 2.22 (CI: 1.49-3.31, I 2 = 0.05 (CI: 0-0.76)) and in ulcerative colitis (UC) patients: OR = 3.52 (CI: 2.56 to 4.83, I 2 = 0 (CI: 0-0.75)); the odds were significantly higher in all cases. Two studies investigated whether patients with periodontitis were more susceptible to IBD, and both found that periodontitis was significantly associated with the risk of subsequent UC, but not with subsequent CD. However, more studies are needed to prove an association. Conclusion: Our analysis confirmed that IBD patients have a higher chance of developing periodontitis, and are a higher risk population in dentistry. Both dentists and gastroenterologists should be aware of this relationship and should emphasize the importance of prevention even more than in the healthy population. Systematic review registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021286161].