Methods and risk of bias in molecular marker prognosis studies in oral squamous cell carcinoma.

BACKGROUND: We investigated methods and risk of bias, focusing on research design, aim, prognostic factors, outcome, and statistical analysis in molecular marker prognosis studies of oral squamous cell carcinoma. MATERIAL AND METHODS: We used a database search strategy to indentify relevant articles published in English in 2016. We developed a data extraction form to assess and extract information on methods of molecular marker prognosis studies in oral squamous cell carcinoma, based on methodological recommendations for prognosis studies. We used the Quality in Prognosis Studies tool to assess the risk of bias in six domains. RESULTS: Thirty-six papers were retrieved for full text review: 35 were replication prognosis factor studies and one was a model development based only on molecular markers to stratify patient's risk. Retrospective cohort was the design used in most studies (91%). Despite recommendations against dichotomizing continuous prognostic variables, this was observed in the majority of cases. A substantial number of studies (60%) conducted survival analysis, COX regression, and Kaplan-Meier. Prognostic variables included in the multivariate model were often preselected based on the results of univariable analysis. Risk of bias was assessed high for confounding, statistical analysis and reporting domains in 46% and 49% of studies, respectively. CONCLUSIONS: The prognosis studies analyzed here can be considered phase II explanatory studies. The next step is to construct and validate models, which can be applied for use in the clinical practice, to guide patient management or build explanatory models that can help better understand the causative role in the disease process of these markers.

Dental caries experience among Albanian pre-school children: a national survey.

OBJECTIVE: To determine the dental caries experience and treatment needs among 5-year-olds in Albania. RESEARCH DESIGN: This cross sectional study was conducted in 2015 by using a cluster sampling technique. The dmft was used to assess dental caries experience and caries prevalence as percentages of children with dmf⟩0. Caries treatment needs were assessed with dt/dmft x 100, missing teeth with mt/dmft x 100 and ft /dmft x 100 as the Care Index. PARTICIPANTS: 2,039 five-year-olds, from 17 districts of Albania were selected . Children's residency was divided into 3 main regions (South, West, Central and North). METHOD: WHO 2013 diagnostic criteria were used and dental caries was recorded at cavity level d3. RESULTS:: The mean age was 5.4 (SD 0.5) years. The caries prevalence (dmf⟩0) was 84.1%. The prevalence of children without cavitated lesions (d=0) was 20.1%. The mean dmft index was 4.41 (SD 3.83). The caries treatment needs were 84% (SD 26%). CONCLUSIONS: The Albanian 5-year-olds assessed in this survey had a high dental caries experience and untreated cavities in the primary dentition. The national health authorities should introduce preventive programs and improved dental care access for this age group.

Prevalence and aetiology of Molar-Incisor Hypomineralisation among children aged 8-10 years in Tirana, Albania.

AIM: Molar incisor hypomineralisation (MIH) describes the clinical appearance of enamel hypomineralisation of systemic origin affecting one or more permanent first molars (PFMs) that are frequently associated with affected incisors. The aim of this study was to investigate the prevalence and aetiology of MIH in children living in Tirana, Albania. DESIGN: The study was conducted at the Department of Paediatric and Preventive Dentistry, Faculty of Dental Medicine, and Tirana Dental Public Health Service. A total of 1,575 school children aged 8-10 years were examined by 7 calibrated examiners (dentists) (kappa: 0.86). The Weerheijm criteria were used for the diagnosis of demarcated opacities, post-eruption breakdown, atypical restorations, and extracted PFMs due to MIH. RESULTS: Prevalence of MIH was found to be 14% (n=227). In the 227 children with MIH, tooth 36 was the most affected PFM, and tooth 46 the least affected. Tooth 21 was the most affected incisor and tooth 32 the least affected incisor by MIH. MIH(+) children had significanly more childhood diseases in the first 3 years of life (p=0.006). Among the children who used antibiotics, MIH(+) cases were 1.41 (1.06-1.87) times higher than in children who did not usedantibiotics, MIH(-) cases. CONCLUSION: MIH was found to be common among 8-10 year-old Tirana children.

Caries experience and treatment needs among Albanian 12-year-olds.

OBJECTIVE: To determine the dental caries experience and treatment needs among 12-year-olds in Albania. RESEARCH DESIGN: This 2011 cross sectional survey used cluster sampling with DMFT and SiC indexes used to assess dental caries experience; DT/DMFT to assess untreated caries; FT/DMFT the care index and MT/DMFT as missing index. PARTICIPANTS: 1928 12-year-olds selected from state schools across 16 local districts with a mix of urban and rural areas and contrasting socio-economic groups. METHOD: WHO protocols were used. RESULTS: The caries prevalence (DMFT > 0) was 87% (95%CI 85.6,88.4) and 29.6% were without cavitated carious lesions (DT = 0). The mean caries experience (DMFT) was 3.73 (sd 2.71) for boys, 3.71 (sd 2.61, p = 0.88) for girls and 3.72 (sd 2.66) overall. The caries treatment needs DT/DMFT was 56% (sd 0.36), the mean FT/DMFT (Care Index) was 31% (sd 0.34) and the mean SiC index was 6.72 (sd 1.92). CONCLUSIONS: Dental caries experience and untreated dental caries were high compared with 12-year-olds in most European Union Member States. This suggests an urgent need for a national preventive program and improved access to oral care for this age group.

Fluoride varnish application: a new prophylactic method in Albania. Effect on enamel carious lesions in permanent dentition.

AIM: The aim of this study is to assess the effects of fluoride varnishes on enamel caries lesions on permanent dentition. MATERIALS AND METHODS: 92 children from primary school (Vasil Shanto, Tirana, Albania) aged 11-12 years were divided into varnish (experimental) and control group. The experiment group received the first fluoride varnish application (Fluoridin, Voco) at baseline, the second application after 3 months and the third application at 6 months from baseline, while the children in the control group received no professional fluoride application. Examinations were performed at baseline and after 7 months. RESULTS: We observed a slight increase in caries prevalence in the control group compared with the varnish group at the 7 month interval (P <0.1 for DMFT and P <0.5 for DMFS and DS). When enamel lesions were included the mean of DeMFT, DeMFS, DeS the caries prevalence was significantly lower in the varnish group after 7 months (P <0.001 for DeMFT, DeMFS). CONCLUSION: Fluoride varnish is an effective mean for arresting early enamel lesions. It is a safe, convenient and well accepted method by patients.

Staff recruitment, development and global mobility.

This paper considers issues that relate to staff recruitment, staff development and global mobility of dental academics. Published literature, which has a North American bias, is reviewed. Recommendations, which may be applicable world-wide, are made to address evident and pertinent areas of concern in terms of the availability of quality dental teaching staff in dental teaching institutions so as to sustain the global dental academic enterprise at appropriately high levels of achievement.