Comparison of virtual clinical scenario and role play in learning oral pathology among dental students.

In oral pathology, virtual clinical scenario illustrating dentist-patient interactions can be utilized by both students and health professionals to deliver/gain knowledge and make clinical diagnosis of oral lesions. Role play is also an educational technique which is designed to engage and motivate students in classrooms. This study aimed to compare usefulness of virtual clinical scenario and role play in learning oral pathology among second-year dental students. The students were randomly divided to one of the two groups: virtual clinical scenario group (n = 50) and role play group (n = 50). Virtual clinical scenario group was provided with virtual clinical cases of oral lesions through Google Forms whereas role play group was exposed to virtual clinical cases of oral lesions through role playing activity. Both groups underwent assessments before and after the intervention. Students' perceptions on usefulness of both techniques in terms of diagnosis, visual parameters and impact on learning were evaluated by feedback questionnaire. Data were analyzed using Statistical Package for the Social Sciences version 27.0. Wilcoxon signed-rank test was used to compare pre-test and post-test scores. Additionally, the scores and students' responses from both groups were compared using the Mann-Whitney U test. A P-value of < 0.05 was set as statistically significant. Students in both groups showed significantly higher post-test scores compared to their pre-test scores (P < 0.001). However, the role play group outperformed the virtual clinical scenario group, with a significantly higher post-test score (P = 0.04). Furthermore, feedback concerning role play was significantly higher than that for the virtual clinical scenario across multiple aspects (P < 0.05). Our findings suggest that role play emerges as the preferred method, significantly enhancing dental students' learning experiences in oral pathology.

Manejo quirúrgico del paciente con patología pseudoquística sinusal: a propósito de un caso / Surgical management of the patient with sinusal pseudocyst pathology: a case report

Introducción: la patología sinusal puede comprometer el éxito del tratamiento de implantes. Existe una elevada incidencia de patología sinusal. El tratamiento de esta patología puede implicar a otros profesionales, lo que supone un mayor coste sanitarios y demora en la realización de los tratamientos de implantes. El objetivo del presente artículo es presentar un caso clínico representativo de la patología pseudoquística del seno maxilar y una alternativa de su manejo quirúrgico simultáneo a la regeneración ósea requerida para su posterior rehabilitación mediante implantes, así como actualizar la evidencia científica disponible. Caso clínico: se presenta una paciente de 46 años con una lesión pseudoquística sinusal que es remitida para rehabilitar mediante implantes en 1.4 y 1.7, por movilidad y dolor en relación a prótesis fija dentosoportada en maxilar derecho. Se realiza el tratamiento quirúrgico de exodoncias, elevación de seno maxilar y eliminación de la lesión pseudoquística de manera simultánea. Discusión: existe controversia sobre el momento idóneo para realizar el tratamiento sinusal. Algunos estudios muestran éxito de la cirugía endoscópica simultáneamente a la eliminación de la fuente odontogénica. Otros han demostrado que realizar primero la cirugía sinusal tiene el mismo porcentaje de curación que realizar primero el tratamiento odontológico. Conclusión: el diagnóstico de la patología y la planificación quirúrgica deben tener en cuenta el tipo de patología, la extensión y las necesidades de tratamiento del paciente. El manejo quirúrgico de la patología sinusal de manera simultánea a la regeneración ósea es una alternativa segura y beneficiosa para el paciente. (AU)

Introduction: Sinus pathology can compromise the success of implant treatment. There is a high incidence of sinus pathology. The treatment of this pathology may involve other professionals, which means higher healthcare costs and delays in carrying out implant treatments. Besides updating available scientific evidence, the objective of this article is to present a representative clinical case of pseudocystic pathology of the maxillary sinus and an alternative to its simultaneous surgical management in the bone regeneration required for subsequent rehabilitation using implants. Clinical case: A 46-year-old patient with a pseudocystic sinus lesion, referred for rehabilitation using implants in 1.4 and 1.7, due to mobility and pain in relation to a tooth-supported fixed prosthesis in the right maxilla. The surgical treatment, consisting of extractions, maxillary sinus elevation and removal of the pseudocystic lesion, was performed simultaneously. Discussion: There is controversy about the ideal time to perform sinus treatment. Some studies show success of endoscopic surgery simultaneously with removal of the odontogenic source. Others have shown that performing sinus surgery first has the same cure rate as performing dental treatment first. Conclusion: Pathology diagnosis and surgical planning must take into account the type and extent of the pathology and the treatment needs of the patient. Surgical management of sinus pathology simultaneously with bone regeneration is a safe and beneficial alternative for the patient. (AU)

Evaluación de los cambios faciales y dentoalveolares en pacientes tratados con Twin block Modificado: resultados preliminares / Evaluation of facial and dentoalveolar changes in patients treated with modified twin block: preliminary results

Introducción: el déficit de crecimiento mandibular es un aspecto muy importante en los pacientes en crecimiento, ya que genera diferentes tipos de patología a nivel facial, bucal y funcional. Objetivo: el propósito de este trabajo es dar a conocer resultados de la investigación realizada sobre los cambios faciales, alveolares y dentales que se producen en tratamientos sobre pacientes en crecimiento con Twin Block Modificado (TBM), combinado con aparatología fija multibrackets para el acabado dentario final. Material y método: la población estudiada son 24 pacientes, 16 de sexo femenino (66,6%), y 8 de sexo masculino (33,33%), con edades comprendidas entre los 12 y 15 años, que presentaron un valor del ángulo ANB de clase II (ángulo formado por el punto A - punto Na - punto B). Se utilizaron las telerradiografías laterales de cráneo iniciales y finales del mencionado grupo, habiéndose creado un método específico de 26 medidas para realizar la investigación. Resultados: en los resultados obtenidos de la muestra se ha observado un claro aumento de los valores del crecimiento mandibular, tanto verticales como horizontales, como los valores que evalúan la posición sagital horizontal de los dientes inferiores del grupo estudiado. Conclusiones: los resultados muestran una relevante diferencia a favor de tratar con TBM a los pacientes que se encuentren en crecimiento con la mandíbula en una posición posterior respecto al maxilar. (AU)

Introduction: Mandibular growth deficiency is a very important condition in patients who are still growing, as it can lead to different types of pathology at the facial, mouth and functional level. Objective: The purpose of this work is to publicize the results of the research that the doctoral candidate is carrying out on the facial, alveolar and dental changes that occurin treatments on growing patients with Modified Twin Block (from this moment abbreviated as TBM). Material and method: The population studied is 24 patients, 16 female (66.6%), and 8 male (33.33%), aged between 12 and 15 years, who presented a value of the class II ANB angle (angle formed by point A - point Na - point B). The initial and final lateral skull radiographs of the aforementioned group were used, having created a specific method of 27 measurements to carry out the research. Results: In the results obtained from the sample, a clear increase in the values of mandibular growth, both vertical and horizontal, has been observed, as well as the values that evaluate the horizontal sagittal position of the lower teeth of the group studied. Conclusions: The results show a relevant difference in favor of treating with TBM patients who are growing with the mandible in a posterior position with respect to the maxilla. (AU)

Oral pathology and oral medicine in Latin American countries: current stage.

BACKGROUND: Oral Pathology (OP) and Oral Medicine (OM) are specialties in dentistry whose main objective is the diagnosis and treatment of oral and maxillofacial diseases, and aspects related to the academic training of professionals and fields of practice are distinct and heterogeneous around the world. This study aimed to evaluate professional training and areas of activity in OP and OM in Latin American countries. MATERIAL AND METHODS: A questionnaire was sent to 11 countries, with a professional in each country responsible for answering it. The questionnaire had 21 questions related to the process of professional training, areas of practice, the existence of scientific events in each country, and also collected demographic and population information. RESULTS: OP and OM are practiced in all the countries studied, but the specialty is not recognized in all of them. Brazil was the first to recognize both as a specialty. Postgraduate programs designed to train specialists are available in various countries. Two countries offer residency programs, 6 countries provide specialization courses, 6 offer master's programs, and 3 have doctoral programs. Brazil boasts the highest number of undergraduate courses (n=412), while Uruguay has the lowest (n=2). Professional societies representing the specialty exist in ten countries. Brazil has the highest number of OP and OM specialists (n=422 and 1,072), while Paraguay has the smallest number (n=1 and 3). CONCLUSIONS: Although both specialties are widely practiced around the globe, professional training, the number of dentists trained and the fields of professional practice are very different between the countries studied.

The Impact of a Pandemic on a Military Oral and Maxillofacial Pathology Biopsy Service.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) and the resulting societal reaction presented new challenges to the medical community by limiting patient access to care in 2020 and 2021. The Navy Postgraduate Dental School (NPDS) oral and maxillofacial pathology biopsy service is dependent on in-office physician or dentist appointments and patient biopsies. The purpose of this study was to understand the regulatory and societal impacts of COVID-19 restrictions on biopsy service submissions by assessing NPDS biopsy submission quantities and disease distribution. MATERIALS AND METHODS: All NPDS oral and maxillofacial pathology biopsy submissions from calendar years 2015 to 2016 and 2019 to 2021 were evaluated, and patient demographics and biopsy diagnoses were recorded in a biopsy registry. Data collected included age, sex, biopsy site, and diagnosis. Data from 2015, 2016, and 2019 were defined as pre-COVID and 2020 and 2021 as COVID. Biopsy reports for each year were organized in quarters. Diagnoses were categorized as malignant, pre-malignant, or benign. Categorical and continuous data were evaluated and presented as counts with percentages and means or medians with standard deviations, respectively. Significant differences in proportions or means were assessed using chi-square analysis or Student t-test, respectively. Cases were aggregated by quarter and year and assessed for temporal trends using linear regression analysis. RESULTS: The study evaluated 9,351 biopsy submission reports. The annual pre-COVID count mean (± standard deviation) and yearly counts for 2020 and 2021 were 2,063 ± 33.3, 1,421, and 1,742, respectively. The mean (± standard deviation) percentage of diagnoses classified as malignant from pre-COVID, 2020, and 2021 were 2.46 ± 0.005%, 3.59%, and 3.04%, respectively. Case counts and representation as a percentage of all biopsy diagnoses for Human Papillomavirus (HPV)-associated squamous cell carcinoma increased significantly during COVID compared to pre-COVID years (P < .05). CONCLUSIONS: Overall, preventative COVID-19 health measures and protocols resulted in a reduction in biopsy submission frequency, particularly during the second quarter (April to June) of 2020. However, case counts for malignant biopsies remained consistent between pre-COVID and COVID time intervals, suggesting that the identification and analysis of cases requiring follow-on care were unaffected by COVID-19 protocols.

Performance of AI chatbots on controversial topics in oral medicine, pathology, and radiology.

OBJECTIVES: In this study, we assessed 6 different artificial intelligence (AI) chatbots (Bing, GPT-3.5, GPT-4, Google Bard, Claude, Sage) responses to controversial and difficult questions in oral pathology, oral medicine, and oral radiology. STUDY DESIGN: The chatbots' answers were evaluated by board-certified specialists using a modified version of the global quality score on a 5-point Likert scale. The quality and validity of chatbot citations were evaluated. RESULTS: Claude had the highest mean score of 4.341 ± 0.582 for oral pathology and medicine. Bing had the lowest scores of 3.447 ± 0.566. In oral radiology, GPT-4 had the highest mean score of 3.621 ± 1.009 and Bing the lowest score of 2.379 ± 0.978. GPT-4 achieved the highest mean score of 4.066 ± 0.825 for performance across all disciplines. 82 out of 349 (23.50%) of generated citations from chatbots were fake. CONCLUSIONS: The most superior chatbot in providing high-quality information for controversial topics in various dental disciplines was GPT-4. Although the majority of chatbots performed well, it is suggested that developers of AI medical chatbots incorporate scientific citation authenticators to validate the outputted citations given the relatively high number of fabricated citations.

Oral lichen planus in children: A systematic review / Liquen plano oral en niños: una revisión sistemática

Background: Oral Lichen Planus is a common chronic inflammatory disease of the oral mucosa. The prevalencein adults ranges between 0.5% and 2%, while in children is reported to be about 0,03%. Clinical features of OralLichen Planus could be variable in both adults and children, ranging from painless white hyperkeratotic lesions topainful erythematous atrophic ones.Actually, there are no systematic reviews in the literature on OLP in children, whereby this paper aims to sum-marize all the pathophysiological aspects and identify all cases described in the literature of Oral Lichen Planusin children, reporting their clinical characteristics.Material and Methods: A systematic review of the literature was performed in online databases including PubMed,Scopus, Web of Science, Science Direct, EMBASE. In addition, in order to identify reports not otherwise identifi-able, an analysis of the gray literature was performed on google scholar and in Open Gray.Results: By literature analysis, it emerged that most cases were reported from India. The mean age at time of diag-nosis of the disease was 11 years, ranging from 3 to 17 years. The most frequent pattern was the reticular patternfollowed by plaque-like, erosive, atrophic, sclerosus, and bullous. The buccal mucosa was the most involved oralsite, followed by the tongue, lips and gingiva.Conclusions: Although Oral Lichen Planus in children is rare, it may cause oral discomfort and need to be dif-ferentiated from other oral white lesions and/or chronic ulcers.(AU)

Has the 8th American joint committee on cancer TNM staging improved prognostic performance in oral cancer? A systematic review / ¿Ha mejorado la estadificación TNM del octavo comité conjunto estadounidense sobre cáncer? ¿Rendimiento pronóstico en el cáncer oral? Una revisión sistemática

Background: The 8th edition of the American Joint Committee on Cancer (AJCC) classification has introduced two new parameters: depth of invasion (DOI) and extranodal extension (ENE). The aim of this systematic review was to determine whether this 8th edition referred to oral squamous cell carcinoma (OSCC) offers performance superior to that of the 7th edition in relation to overall survival (OS) and disease-specific survival (DSS). Material and Methods: The review was carried out following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The PubMed (MEDLINE), Scopus and Cochrane Library databases were searched covering the period up until April 7th, 2022.Results: Thirteen retrospective cohort studies were finally included. The introduction of DOI and ENE in the 8th edition of the AJCC classification resulted in improved prognostic performance of the classification. Conclusions: Patients with OSCC can be better classified in relation to OS and DSS, while maintaining the simplicity and ease of use of the classification. This allows more appropriate treatment protocols to be applied and affords a better estimation of the prognosis of each patient.(AU)

Early complications and quality of life in patients with immediately loaded implant-supported maxillary partial rehabilitations: A prospective cohort study / Complicaciones tempranas y calidad de vida en pacientes con rehabilitaciones parciales maxilares implantosoportadas con carga inmediata: un estudio de cohorte prospectivo

Background: Immediate loading of dental implants is considered an excellent option to reestablish function and aesthetics in a short period of time, thereby reducing the psychological impact of edentulism. The aim of this study was to describe the incidence of complications in immediately loaded implant-supported single or partial maxillary provisional rehabilitations; to assess changes in patient quality of life (QoL); to evaluate patient overall satisfaction; and to determine whether the occurrence of complications affects these outcomes. Material and Methods: Patients requiring partial rehabilitation with implants in the maxilla were included in a prospective cohort study. In all cases, implant-based restoration with an immediate loading protocol was indicated. A provisional restoration was placed within 72 hours after implant placement. Patient QoL was measured at the first appointment and just before placing the final restoration, using two validated questionnaires. All mechanical and biological complications occurring up until placement of the final restoration were documented. A descriptive and bivariate analysis of the data was performed. Results: Thirty-five patients with 40 prostheses supported by 60 implants were analyzed. Three implant failures were observed, yielding a 95% survival rate. Five provisional prosthesis fractures and two prosthetic screw loosenings were recorded in four patients. A significant reduction in OHIP-14 score was observed. Likewise, significant differences were found in the results of the QoLFAST-10, with a mean difference in score of 7.3 between the initial and final evaluation. Conclusions: Patients receiving immediately loaded implant-supported single or partial maxillary provisional rehabilitations seem to have a low risk of developing early mechanical (13.3%) or biological complications (5%)...(AU)

Coronectomy of impacted mandibular third molars: a clinical and radiological retrospective case series study with 2-9 years of follow-up / Coronectomía de terceros molares mandibulares impactados: un estudio de serie de casos retrospectivo clínico y radiológico con 2-9 años de seguimiento

Background: Impacted mandibular third molars occasionally are in intimate relation to the inferior alveolar nerve (IAN). Coronectomy has been proposed as a good alternative to prevent injury of the IAN. The present study evaluates the clinical and radiological outcomes of impacted mandibular third molars presenting radiographic signs associated with a high risk of IAN injury, and which were treated with the coronectomy technique. Material and Methods: A retrospective case series evaluated the outcomes of coronectomies of impacted mandibular third molars. The inclusion criteria were: available preoperative, immediate postoperative and two-year panoramic radiographs, preoperative cone-beam computed tomography (CBCT), and a complete case history. The clinical evaluation comprised intraoperative complications (mobilized fragments of root and damage to adjacent structures), short-term complications (sensory alterations and postoperative infection), and long-term complications (infection or oral exposure). The IAN position with respect to the roots, root shape, eruption status, third molar position, radicular-complex migration and bone above roots were radiographically evaluated as well. Results: Approximately a total of 2000 mandibular third molars were removed from 2011 to 2022. Of these, 39 molars in 34 patients were partially extracted using the coronectomy technique. The mean age was 36 years (range 22-77), and the mean follow-up was 28 months (range 24-84). There were two short-term postoperative infections. One of them was resolved through reintervention to remove the roots after antibiotic treatment, while the other required hospital admission and removal of the roots. One case of short-term transient lingual paresthesia was also recorded. Two long-term oral exposures were detected, and the root fragments had to be extracted. There were no permanent sensory alterations...(AU)

The evaluation of nasolacrimal duct injury in Le Fort I osteotomy patients / Evaluación de la lesión del conducto nasolagrimal en pacientes con osteotomía Le Fort I

Background: Although Le Fort I surgeries are safe and successful procedures; nasolacrimal duct injuries may be observed due to these surgeries. The study aimed to investigate the prevalence of nasolacrimal duct injury in Le Fort I osteotomy patients. Material and Methods: The authors conducted a retrospective cohort study consisting of patients who underwent Le Fort I osteotomies between 2017 and 2021 in the Erciyes University Faculty of Dentistry. The primary predictor variables were the distance of the nasolacrimal canal to the outer cortex of the maxilla and the nasal floor, as well as the superior-inferior level of the superiorly positioned screw inserted in the maxilla aperture region relative to the nasolacrimal canal. The outcome variable was the presence of a nasolacrimal duct injury. Mann Whitney U test was used for quantitative variables between the two groups. A Pearson chi-squared analysis was used to compare categorical data. A p-value <0.05 was considered statistically significant.Results: A total of 290 nasolacrimal canals were evaluated in 145 patients, 87 females, and 58 males. The mean age was 23.47± 6.67. There was a statistically significant relationship between screw level and nasolacrimal canal perforation (p<0,001). The distance between the most anterior border of the nasolacrimal canal and the outer cortical of the maxilla was significantly less in the perforation group (p<0,001). The fixation screw was significantly closer to the nasolacrimal canal in the perforation group (p<0,001). Conclusions: In Le Fort I surgery, nasolacrimal duct injury may occur during screw fixation to the aperture region. Superiorly positioned fixation screws in the aperture region may damage the nasolacrimal canal. In patients where the nasolacrimal canal is close to the outer cortex, care should be taken when applying the fixation screws to the aperture region to avoid damaging the canal.(AU)

Evaluation of lymph node findings in patients with and without odontogenic infection: A clinical and ultrasonographic study / Evaluación de hallazgos ganglionares en pacientes con y sin infección odontogénica: un estudio clínico y ecográfico

Background: The present study aimed to evaluate the ultrasonographic findings of submandibular and submental lymph nodes in patients with and without odontogenic infection. Material and Methods: Systemically healthy patients aged 18-30 years old with or without odontogenic infections were included in this study. Clinical examinations were performed on all patients; those with any odontogenic infection were placed in the study group, and those without were placed in the control group. Ultrasonographic examinations of bilateral submental and submandibular lymph nodes were performed for both groups. The data were statistically analyzed using Pearson’s Chi-square test and Student’s t-test.Results: A total of 150 patients voluntarily participated (female: n=86 (57%), male: n=64 (43%)), 75 in the study group and 75 in the control group. During the ultrasonographic examination, patients in the study group had more than one lymph node the same patient was mostly detected, in the study group (right submandibular: n=42, 56%, and left submandibular: n=43, 57.3%). The long-axis diameter of the submandibular lymph nodes was 9.30±5.30 mm and 5.50±5.20 mm in the study and control groups, respectively. Conclusions: Ultrasonography revealed that the presence, number, and long-axis diameter of the submandibular lymph nodes in the patients with and without odontogenic infection were statistically different.(AU)

Identification of ferroptosis-related diagnostic markers in primary Sjögren's syndrome based on machine learning / Identificación de marcadores diagnósticos relacionados con la ferroptosis en el síndrome de Sjögren primario basado en aprendizaje automático

Background: Primary Sjogren's syndrome (pSS) is a common autoimmune disorder that affects up to 0.3-3% of the global population. Ferroptosis has recently been identified to play a significant role in autoimmune diseases. However, the molecular mechanisms of ferroptosis in the initiation and progression of pSS remains unclear. Material and Methods: To investigate the molecular mechanisms underlying the occurrence and progression of pSS, we utilized a comprehensive approach by integrating data obtained from the Gene Expression Omnibus (GEO) database with data from the FerrDb database to identify the ferroptosis-related differentially expressed genes (DEGs). Furthermore, we implemented an innovative transcriptomic analysis method utilizing a computer-aided algorithm to establish a network between hub genes associated with ferroptosis and the immune microenvironment in pSS patients. Results: Our results revealed significant differences in the gene expression profiles of pSS samples compared to normal tissues, with 1,830 significantly up-regulated genes and 1,310 significantly down-regulated genes. In addition, our results showed a significant increase in the proportions of B cells and CD4+ T cells in pSS samples compared to normal tissues. AND then, our analysis revealed that a combination of six ferroptosis-related genes, including TBK1, SLC1A4, PIK3CA, ENO3, EGR1, and ATG5, could serve as optimal markers for the diagnosis of pSS. The combined analysis of these six genes accurately diagnosed the occurrence of pSS. Conclusions: This study offers valuable insights into the pathogenesis of pSS and highlights the importance of targeting ferroptosis-related DEGs, which suggests a novel treatment strategy for pSS.(AU)

Effect of transcutaneous electrical nerve stimulation on pain, edema, and trismus after surgical removal of impacted third molars: a split-mouth randomized clinical trial / Efecto de la estimulación nerviosa eléctrica transcutánea sobre el dolor, el edema y el trismo después de la extirpación quirúrgica de terceros molares impactados: un ensayo clínico aleatorizado de boca dividida

Background: The transcutaneous electrical nerve stimulation (TENS) stimulus inhibits the activity of nociceptive neurons of the central nervous system. Pain relief is achieved by increasing the pulse amplitude of TENS to induce a non-painful paranesthesia beneath the electrodes. This study aimed to assess the effect of TENS on acute pain, edema, and trismus after surgical removal of impacted third molars.Material and Methods: This randomized, double blind, split-mouth clinical trial was conducted on 37 patients with bilaterally impacted mandibular third molars. The angle and body of mandible at the site of surgery in one randomly selected quadrant underwent TENS immediately after surgery (50 Hz, 100-μs short pulse, 15 minutes for 6 days). The TENS stimulator device was used in off mode for the placebo quadrant. The pain score (primary outcome) was measured for 7 days postoperatively, and edema and trismus (secondary outcomes) were assessed at 2, 4 and 7 days, postoperatively. The results were analyzed by repeated measures ANOVA using R software (alpha=0.05). Results: The overall mean pain score was significantly lower in the TENS than the placebo group (P<0.05). The number of taken analgesics in the first 3 days was significantly lower in the TENS group (P<0.001). Postoperative edema in the TENS group was lower than the placebo group but only the difference was not statistically significant (P>.05). The inter-incisal distance, as an index to assess trismus, was not significantly different between the two group at day 2, but it was significantly higher in the TENS group after the second day (P<0.001)...(AU)

Therapeutic response of oral chronic graft-versus-host disease to topical corticosteroids according to the 2014 National Institutes of Health (USA) consensus criteria / Respuesta terapéutica de la enfermedad de injerto contra huésped crónica oral a los corticosteroides tópicos según los criterios de consenso de los Institutos Nacionales de Salud (EE. UU.) de 2014

Background: Chronic graft-versus-host-disease (cGVHD) is a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation. The oral cavity is one of the most frequently affected anatomic sites and is affected in 70% of all patients who develop cGVHD. The objective of this study was to determine the therapeutic response to topical corticosteroids and clinical outcome of patients with oral cGVHD using the 2014 NIH consensus criteria. Material and Methods: The oral manifestations of cGVHD were collected at the first and the follow-up (FU) visits after the therapeutic treatment of oral GVHD. The FU intervals were: FU0, first visit; FU1, 0-1 month; FU2, 1-3 months; FU3, 3-6 months; FU4, 6-9 months; and FU5, 9-12 months. The oral cGVHD activity was assessed using the NIH modification of the Schubert Oral Mucosa Rating Scale (OMRS) and Thongprasom sign score. The functional impact was assessed by the organ-specific severity score. Results: Fourteen patients (93.3%) at FU0 were being treated with at least one form of systemic immunosuppressive therapy, i.e., prednisolone, cyclosporin, and tacrolimus. The OMRS was reduced between FU0 and FU3 (p < 0.001), FU0 and FU4 (p < 0.001), and FU0 and FU5 (p = 0.004). The organ-specific severity scores were also reduced between FU0 and FU4 (p = 0.016), and FU0 and FU5 (p = 0.001). There was no significant difference in the highest Thongprasom sign score between all follow-up intervals (FU0-FU5) (p = 0.201). One patient (6.7%) at FU4 and three patients (20.0%) at FU5 did not receive topical corticosteroid therapy for oral cGVHD....(AU)

Oral maxillofacial surgeons and Orthodontists’ perceptions about anterior inferior crowding and indications of mandibular third molar extraction / Percepciones de los cirujanos maxilofaciales y ortodoncistas sobre el apiñamiento anteroinferior y las indicaciones de la extracción del tercer molar mandibular

Background: There are still many doubts about anterior inferior crowding and indications of mandibular third molar extraction, although it is very studied subject in the literature. The aim of this study was to evaluate the perceptions of oral maxillofacial surgeons (OMFSs) and orthodontists about anterior inferior crowding and indications of mandibular third molar extraction. Material and Methods: A web-based survey was developed and sent to professionals in order to collect their opinion about the fact that third lower molars cause crowding and questions about the indication of third molars for orthodontic treatment. Descriptive analysis was performed and Chi-square or G tests were applied with a 95% confidence interval. Results: The study included a total of 218 participants, of whom 115 were OMFSs and 103 were orthodontists. The results showed that 56.5% of OMFSs and 35.0% of orthodontists believe that the lower third molars cause anterior inferior crowding (p<0.001). A total of 91.3% of OMFSs and 70.9% of orthodontists indicate the extraction of lower third molars to aid orthodontic treatment (p<0.001). Conclusions: It can be concluded that in being an oral maxillofacial surgeon, a higher odds ratio is observed to consider that lower third molars cause dental crowding compared to those who are orthodontist. The indication of exodontia of lower third molars for orthodontic treatment was more frequent among OMFSs when compared to orthodontists.(AU)

Preservation of the inferior alveolar vasculonervous bundle in mandibular resective therapies: systematic review and report of two cases

Background: Segmental surgical resection is a frequently indicated procedure to treat aggressive mandibular tumors. One of the most important complications derived from this technique is permanent paresthesia of the inferior alveolar nerve (IAN), which significantly affects the quality of life of patients who experience it. This could be avoided through maneuvers that preserve the IAN. The objective of this paper is to review the main techniques for IAN preservation and to present 2 cases with the technique used by the author. Material and Methods: A systematic review was performed according to the PRISMA guidelines, apropos of two clinical cases reported in this study. The MEDLINE/PubMed and Scopus databases were searched. Several variables were considered and are presented in detail in the form of tables and figures. In addition, 2 case reports with NAI preservation techniques are presented. Results: 13 articles were finally obtained for analysis. 127 patients were evaluated, reporting mandibular resections associated with various pathologies. Various surgical techniques were used, all with the same goal of maintaining the IAN. In most of the patients, the maintenance of sensitivity was achieved, which was verified with different methods. Conclusions: Preservation of the IAN in maxillofacial surgical procedures where surgical resection of the mandibular bone has been performed is an alternative that has demonstrated successful results in terms of reducing postoperative sequelae and is currently positioned as a necessary and feasible procedure. (AU)

Oral squamous cell carcinoma arising from areas of Graft-versus-host disease: A systematic review / Carcinoma oral de células escamosas que surge de áreas de enfermedad de injerto contra huésped: una revisión sistemática

Background: Graft-versus-host disease (GVHD) is an immune system reaction that occurs in patients with ahistory of hematopoietic stem cell transplantation (HSCT), in which the grafted donor's cells attack those of thehost. The objective of this systematic review was to present a study on oral squamous cell carcinoma (OSSC) thatdeveloped from GVHD areas in patients undergoing HSCT.Material and Methods: An electronic search was conducted in the databases PUBMED, WEB OF SCIENCE,SCOPUS, MEDLINE and SCIENCE DIRECT, according to PRISMA guidelines. Results: Of the 1582 results, 23 articles were included, resulting in 81 cases. The most common underlying diseasefor performing the transplant was Myeloid Leukemia (55.6%). The mean age was 39 years, with a predilection formales (64.2%). The tongue was the site of GVHD that most frequently underwent transformation to SCC (59.3%).The average time between transplantation and the development of GVHD was of approximately of 8 months, whilethe average period of development between transplantation and the development of OSCC was of approximately of111 months. The most common treatment to GVHD was cyclosporine associated with corticosteroids.Conclusions: OSCCs arising from areas of GVHD present a different evolution from conventional oral carcinomas,since they affect younger patients, smoking and alcohol are not important etiological factors and finally because theypresent good prognosis, but further studies with larger number cases followed are needed to confirm our findings.(AU)