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.

Knowledge, Practices, and Nasal Carriage Rate of MRSA Amongst Dental Professionals.

OBJECTIVE: Resistance of Staphylococcus aureus (S. aureus) against common antibiotics has been increasing given the rampant use of antibiotics. Methicillin-resistant S. aureus (MRSA) is particularly important because it has been reported to present in hospital-acquired as well as community-acquired infections. Our aim was to study the types and subtypes of MRSA isolated from nasal swabs taken from volunteering dental school students and to assess and analyse the knowledge of dental health care workers (DHCWs) on MRSA and prevention of its infection. METHODS: A total of 100 participants, which included staff, students, and dental auxiliaries, from the School of Dental Sciences, Krishna Institute of Medical Sciences, Deemed to Be University, Karad, India, were included in the study which was conducted from June 2020 to 1 June 2021. All the participants completed a survey and underwent collection of nasal swabs. The samples were cultured and underwent microbiological and molecular analysis for MRSA. The questionnaire was sent out electronically via SurveyMonkey. RESULTS: Sixty-three percent of the participants were female. The majority were undergraduate students (66%) and younger than 25 years (77%). The prevalence of MRSA in the sample was the MRSA type SCCmec type V (54.8%). The survey reports a lack of knowledge amongst dental students on MRSA and prevention of its infection. The majority (69%) of participants had not heard of MRSA infection and had inadequate knowledge of MRSA infection. Only 29% of the participants think that a healthy person may have MRSA without feeling ill. Eighty-five percent of the participants reported that they have written polices and guidelines to control MRSA. Eighty-five percent of the participants indicated that they are less confident in their knowledge on MRSA infection control protocols, and 94% mentioned that the dental clinics have written guidelines for hand hygiene. CONCLUSIONS: DHCWs have limited knowledge of MRSA infection, emphasising the need for appropriate clinical training. Academic institutions should promote effective infection control training to protect students, faculty, and other employees.

Prevalence and Socio-Demographic Correlates of Dental Anxiety among a Group of Adult Patients Attending Dental Outpatient Clinics: A Study from UAE.

OBJECTIVES: The aims of this paper were twofold: first, to evaluate dental anxiety levels among patients undergoing oral surgery procedures; second, to assess how dental anxiety and fear are connected to age, gender, educational background, past traumatic experiences, and the frequency of dental appointments. METHODS: A cross-sectional Likert-scale questionnaire survey was conducted to collect quantitative data from 206 patients at the Oral Surgery Clinics at Dubai Dental Clinics, Dubai, United Arab Emirates. The reliability and validity of the questionnaire were tested using Cronbach's alpha. The normality of the MDAS score was tested using the Kolmogorov-Smirnov test. The chi square and Kruskal-Wallis tests were used to determine the association between categorical variables. Descriptive statistics were used to describe continuous and categorical variables. The statistical significance was set at p-value ≤ 0.05. RESULTS: The evaluation of the degree of dental anxiety among patients who visited the Dubai Dental clinics revealed that there was a considerably high level of moderate or high anxiety (72.3%). Tooth extraction and dental surgery procedures (95%), followed by local anesthetic injection in the gingiva (85%) and teeth drilling (70%), were the primary causes of anxiety, whereas scaling and polishing resulted in the lowest degree of anxiety (35%). There was no substantial difference in dental anxiety between male and female patients or among patients with different marital statuses. A total of 70% of patients preferred the tell-show-do method, whereas 65% chose communication strategies to reduce dental anxiety. CONCLUSIONS: The evaluation of the degree of dental anxiety among patients who visited Dubai Dental clinics revealed that there was a considerably high level of anxiety. Tooth extraction and dental surgery procedures, followed by local anesthetic injection and teeth drilling, were the primary causes of anxiety, whereas scaling and polishing resulted in the lowest degree of anxiety. Despite the use of a modified anxiety scale and a large and representative sample of oral surgery patients, more research is necessary to investigate the impact of various factors on dental anxiety.

Health and Well-Being through COVID-19 Vaccination: Physical, Oral, and Psychological Effects.

The Coronavirus Disease 2019 (COVID-19) pandemic and its evolving variants have spurred a worldwide effort to control its transmission and reduce its impact [...].

Necrotizing Ulcerative Gingivitis, a Rare Manifestation as a Sequel of Drug-Induced Gingival Overgrowth: A Case Report.

PURPOSE: The purpose of this case report is to present a rare case of amlodipine-induced gingival overgrowth with a secondary formation of necrotizing ulcerative gingivitis involving the upper and lower arches of a 68-year-old female patient with a chief complaint of "swollen gums and pain on mastication which has been recurring for the past 5 years." MATERIALS AND METHODS: The treatment plan of this case was divided according to quadrants of the mouth. Each week, one quadrant was surgically excised, and the remaining quadrants were observed for any changes. The gingival overgrowths were excised using a 15 blade, and debris/plaque was removed with Gracey curettes. RESULTS: Although full-mouth exodontia was performed, the patient unfortunately suffered with recurrences in GO. These results are suggestive of idiopathic causes of GO. CONCLUSION: Careful examination, physician referrals, and biopsy to rule out any specific anomalies and to assist in proper diagnosis are followed by sequential management of the case results in productive outcomes.

Patterns of Maxillofacial Injuries in the Middle East and North Africa: A Systematic Review.

OBJECTIVE: The objective of this review was to investigate the epidemiological characteristics of maxillofacial fractures (MFFs), to establish the prevalence of MFFs, and to recognise the major causative factors in both males and females in the Middle East and North Africa (MENA) region. STUDY DESIGN: The protocol of this systematic reviews was established according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P); the following databases were searched: PubMed/Medline, Scopus, Google Scholar and Web of Science. We used STROBE checklist to assess the risk of bias in all identified studies, 37 studies fulfilled the eligibility criteria, and hence were selected for analysis. RESULTS: A total of 27,994 patients (22,965 males and 5,129 females) ranging from 0 to 97 years who experienced maxillofacial injuries during the study period were entered into this review. Road traffic accidents (RTAs) were the most common cause of MFF followed by falls. The mandible was the most common site of injury. In the MENA region, males outnumbered females in terms of maxillofacial injuries with a ratio of 4.5:1. CONCLUSION: Maxillofacial fractures are highly prevalent in the MENA region, and they are mainly caused by RTAs, especially among young males. Therefore, the concerned authorities need to employ and implement stricter traffic rules in order to minimise the risk of maxillofacial injuries and their subsequent increased morbidity and mortality rates.

Oral health status and dental needs of autistic children and young adults.

AIM: Children with autism might need more dental care than non-autistic, healthy children. The aims of this study were: (a) to describe the caries experience and treatment needs of autistic children aged 6-16 years in the United Arab Emirates; and (b) to provide baseline data at national and regional levels to enable comparisons and future planning of dental services for children with autism. METHODS: All children attending a day centre in Sharjah, United Arab Emirates, for autism were selected for the study. Sixty-one autistic children aged 6-16 years (45 males and 16 females) were included in the study. Each patient received a complete oral and periodontal examination using codes and criteria as described by the World Health Organization. RESULTS: The overall mean for Decayed, Missing, and Filled Teeth/decayed, missing, and filled teeth was 2.4. Female autistic children had significantly higher mean Decayed, Missing, and Filled Teeth/decayed, missing, and filled teeth scores (4.4) than males (1.63). The percentage of decayed, missing, and filled teeth increased with increasing age. The restorative index and met need index for the autistic children aged 11-15 years were 0.02 and 0.10, respectively. CONCLUSION: Effective oral health promotion strategies need to be implemented to improve the oral health status of autistic children.

Oral epithelial dysplasia in non-users of tobacco and alcohol: an analysis of clinicopathologic characteristics and treatment outcome.

Oral epithelial dysplasia (OED) is a histopathological diagnosis that is associated with an increased risk of oral cancer. The purpose of this study was to compare the clinical features and long-term outcome of OED between users and non-users of tobacco and alcohol. The hospital records of 456 patients diagnosed as having OED were reviewed. Two groups of patients were selected based upon tobacco and alcohol usage: 37 patients who had neither smoked tobacco nor drank alcohol and 419 patients who both smoked tobacco and drank alcohol. OED in non-users of tobacco and alcohol was uncommon, accounting for only 8.1% of all OED. There was a male to female ratio of 1:1 in the group. The tongue and buccal mucosa were the most commonly affected sites. An erythro-leukoplakic-type lesion with mild dysplasia was the common presenting feature. Mixed type lesions with severe dysplastic changes, particularly of the gingiva, may progress to malignancy. These findings support the notion that OED may also develop in persons who have never used tobacco or alcohol. Lesions more commonly occurred in women, especially in the tongue and buccal mucosa, and were mostly of the erythroplakic type. The presence of OED in patients who do not smoke tobacco or drink alcohol suggests that risk factors other than alcohol and tobacco may exist.

The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: a review of 230 cases.

OBJECTIVE: Maxillofacial injuries constitute a substantial proportion of cases of trauma. This descriptive analytical study assesses the cause, type, incidence, demographic, and treatment data of maxillofacial fractures managed at Al Qassimi Hospital in Sharjah, United Arab Emirates, during a 4-year period and compares them with the existing body of literature on the subject. STUDY DESIGN: The medical records and radiographs of 230 patients treated for maxillofacial fractures at the Al Qassimi General Hospital over a 4-year period (from 1999 to 2002) were reviewed. A number of parameters, including the patient's age, gender, race, occupation, and mechanism of injury, type of facial injuries, treatment modality, and postoperative complications were recorded and assessed. RESULTS: Men 20 to 29 years of age sustained the most maxillofacial fractures. The ratio of males to females was 11:1. Most fractures were caused by motor vehicle crashes (75%), followed by falls (12%) and violent assaults (8%). There were 150 (51%) mandibular, 102 (34%) maxillary, and 22 (7.4%) zygomatic fractures. Regarding distribution of mandibular fractures, the majority (25%, 38/150) occurred in the condyle, 23% (35/150) in the angle, and 20% (30/150) in the body. The distribution of maxillary fractures were 49.0% (50/102) dentoalveolar, 29.4% (30/102) Le Fort I, and 10.7% (11/102) were Le Fort II fractures. More than half of all cases were treated by closed reduction (67%). Complications occurred in 5.6% of patients. CONCLUSION: The findings of this study, compared with similar studies reported in the literature, support the view that the causes and incidence of maxillofacial injuries vary from one country to another and, as such, can provide a guide to the design of programs geared toward prevention and treatment.