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1.
Artigo em Inglês | MEDLINE | ID: mdl-38703195

RESUMO

BACKGROUND: The widespread diffusion of Artificial Intelligence (AI) platforms is revolutionizing how health-related information is disseminated, thereby highlighting the need for tools to evaluate the quality of such information. This study aimed to propose and validate the Quality Assessment of Medical Artificial Intelligence (QAMAI), a tool specifically designed to assess the quality of health information provided by AI platforms. METHODS: The QAMAI tool has been developed by a panel of experts following guidelines for the development of new questionnaires. A total of 30 responses from ChatGPT4, addressing patient queries, theoretical questions, and clinical head and neck surgery scenarios were assessed by 27 reviewers from 25 academic centers worldwide. Construct validity, internal consistency, inter-rater and test-retest reliability were assessed to validate the tool. RESULTS: The validation was conducted on the basis of 792 assessments for the 30 responses given by ChatGPT4. The results of the exploratory factor analysis revealed a unidimensional structure of the QAMAI with a single factor comprising all the items that explained 51.1% of the variance with factor loadings ranging from 0.449 to 0.856. Overall internal consistency was high (Cronbach's alpha = 0.837). The Interclass Correlation Coefficient was 0.983 (95% CI 0.973-0.991; F (29,542) = 68.3; p < 0.001), indicating excellent reliability. Test-retest reliability analysis revealed a moderate-to-strong correlation with a Pearson's coefficient of 0.876 (95% CI 0.859-0.891; p < 0.001). CONCLUSIONS: The QAMAI tool demonstrated significant reliability and validity in assessing the quality of health information provided by AI platforms. Such a tool might become particularly important/useful for physicians as patients increasingly seek medical information on AI platforms.

2.
BMC Oral Health ; 24(1): 122, 2024 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-38263027

RESUMO

BACKGROUND: Since AI algorithms can analyze patient data, medical records, and imaging results to suggest treatment plans and predict outcomes, they have the potential to support pathologists and clinicians in the diagnosis and treatment of oral and maxillofacial pathologies, just like every other area of life in which it is being used. The goal of the current study was to examine all of the trends being investigated in the area of oral and maxillofacial pathology where AI has been possibly involved in helping practitioners. METHODS: We started by defining the important terms in our investigation's subject matter. Following that, relevant databases like PubMed, Scopus, and Web of Science were searched using keywords and synonyms for each concept, such as "machine learning," "diagnosis," "treatment planning," "image analysis," "predictive modelling," and "patient monitoring." For more papers and sources, Google Scholar was also used. RESULTS: The majority of the 9 studies that were chosen were on how AI can be utilized to diagnose malignant tumors of the oral cavity. AI was especially helpful in creating prediction models that aided pathologists and clinicians in foreseeing the development of oral and maxillofacial pathology in specific patients. Additionally, predictive models accurately identified patients who have a high risk of developing oral cancer as well as the likelihood of the disease returning after treatment. CONCLUSIONS: In the field of oral and maxillofacial pathology, AI has the potential to enhance diagnostic precision, personalize care, and ultimately improve patient outcomes. The development and application of AI in healthcare, however, necessitates careful consideration of ethical, legal, and regulatory challenges. Additionally, because AI is still a relatively new technology, caution must be taken when applying it to this industry.


Assuntos
Algoritmos , Inteligência Artificial , Humanos , Processamento de Imagem Assistida por Computador , Prontuários Médicos , Boca/patologia , Face/patologia
3.
BMC Oral Health ; 24(1): 78, 2024 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-38218874

RESUMO

BACKGROUND: Temporomandibular disorders (TMD) are manifested by soreness in the jaw joint area and jaw muscles, clicks or creaks when opening or closing the mouth. All these symptoms can be disabling and occur during chewing and when the patient yawns or speaks. Several classes of drugs are used to treat symptoms. This review aims to assess which drug suits the different signs. METHODS: Pubmed, Web of Science and Lilacs were systematically searched until 01/02/2023. Clinical trials were selected that dealt with drugs used in temporomandibular dysfunction RESULTS: Out of 830 papers, eight studies were included. The Meta-Analysis with Continuous Outcomes with Pre-Calculated Effect Sizes resulted in the rejection that there is intergroup variability (p.0.74). CONCLUSIONS: Treatment of orofacial pain is still a significant challenge for dentistry. We can conclude that there is no drug of first choice in the treatment of temporomandibular pain. However, the clinician must distinguish the type of pain and the aetioloic cause of the pain so that the patient can be treated and managed pharmacologically.


Assuntos
Dor Facial , Transtornos da Articulação Temporomandibular , Humanos , Dor Facial/tratamento farmacológico , Dor Facial/diagnóstico , Mastigação , Articulação Temporomandibular , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/tratamento farmacológico
4.
J Clin Pediatr Dent ; 48(1): 26-31, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38239153

RESUMO

Caries experience of children and complex clinical circumstances are an actual challenge for any healthcare professional. To investigate the early childhood caries (ECC) in autistic and non autistic children (≤4 years of age) evaluating the amount of dental damage and the treatments carried out in both groups. Data regarding the oral health status of 40 patients (≤4 years of age) were assembled. The sample group was constituted of 20 autistic children (12 males with a mean age of 2.5 years and 8 females with a mean age of 3.2 years) whereas 20 patients without the autistic spectrum represented the control group (11 males with a mean age of 3 and 9 females with a mean age of 3.3 years). There were no significant differences between the two groups as regards both the extent of dental damage and the treatments carried out. About the frequency, in the autistic group, the most frequent caries were the white spots and enamel proximal lesions (2.2%), followed by only white spots (1.2%) and brown-black cavities and root stumps (0.6%). In the control group, the brown-black cavities and root stumps represented the most frequent findings (2.2%), followed by white spots and enamel proximal lesions (1.4%) and white spots (0.4%). Regarding the treatments, the most repeated management of dental damage among autistic patients was composite restorations (2.2%) while in nonautistic patients were tooth extractions (2%).


Assuntos
Transtorno Autístico , Cárie Dentária , Criança , Masculino , Feminino , Humanos , Pré-Escolar , Transtorno Autístico/complicações , Transtorno Autístico/epidemiologia , Cárie Dentária/complicações , Cárie Dentária/epidemiologia , Cárie Dentária/terapia
5.
Acta Neurochir Suppl ; 135: 61-67, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38153450

RESUMO

Surgery of fractures involving the skull base and the facial skeleton often presents challenges that should be addressed to prevent secondary brain injuries (i.e., cerebro-spinal fluid leak), preserve visual functioning, and guarantee a good esthetic result. Complex craniofacial reconstruction can be aided by navigation and pre-operative planning. In recent years, computerized planning of surgical reconstruction drastically increased the safety and efficacy of surgery, but the impact of intraoperative high quality image devices such as an intraoperative computed tomography (CT) scan has not been investigated yet. This case-control study reports the institutional preliminary experience of using intraoperative CT scans in the surgical management of complex cranio-facial fractures. The results in terms of accuracy of bony reconstruction and neurological or surgical complications have been analyzed in 12 consecutive patients treated with (6 cases) or without (6 cases) i-CT. Comparative analysis demonstrated a greater accuracy of reconstruction in patients treated with the assistance of i-CT. Intraoperative CT is a useful tool with a promising role in a multidisciplinary surgical approach to complex cranio-facial surgery.


Assuntos
Base do Crânio , Cirurgia Assistida por Computador , Humanos , Estudos de Casos e Controles , Base do Crânio/diagnóstico por imagem , Base do Crânio/cirurgia , Tomografia Computadorizada por Raios X , Computadores
6.
J Pers Med ; 13(10)2023 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-37888036

RESUMO

The correlation between depressive and cognitive symptoms and OSAS (obstructive sleep apnea syndrome) is between 5 and 63%. We reported the case of two patients with severe OSAS and its associated depressive symptoms that were intolerant to continuous positive airway pressure (C-PAP) and underwent maxillomandibular advancement (MMA) surgery. The severity of cognitive and depressive symptoms was assessed using validated questionnaires (Beck Depression Inventory, Beck Anxiety Inventory, Epworth Sleepiness Scale, and quality of life), medical observation, and patient-reported symptoms. We performed pre- and post-treatment polysomnography. Six months after treatment, the value of the apnea-hypopnea index (AHI) had returned to the normal range and, together with it, the depressive component was considerably reduced and the patients' overall quality of life (BDI, BAI, ESS, and qol) improved. Conclusion: We described significant improvement in all the analyzed parameters, such as physical and mental functioning, and depression and anxiety rates.

7.
Saudi Dent J ; 35(6): 684-691, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37817790

RESUMO

Digitalized workflow eliminates the need for the tray, impression materials, its decontamination, packaging and shipping, pouring with plaster, cast fabrication, mounting in an articulator, reducing storage spaces, and the risks of any loss or fracture of the plaster model is overcome by archiving on the computer. This clinical investigation aimed to evaluate the effectiveness of the fully digitalized rehabilitation [implant-supported prosthesis] method in partially edentulous patients and with TMD, using advanced software. Twelve patients requiring implant-supported prosthesis in the mandibular molar area with Temporomandibular disorders [TMD] were selected. The fully digitalized rehabilitation method with advanced software was used for rehabilitation. For each subject, Optical impressions, CBCT scan, and Digital recording of jaw movement data. Guided implant surgery and digitalized prosthetic rehabilitation; were performed. The effectiveness of the digitalized workflow was assessed by evaluating the changes in the joint symptoms before and after the end of the treatment, changes in the electromyographic tracings, the precision of the prosthetic artefact, assessed through the amount of chair adjustment operating time and the number of retouching/ modifications to be carried out before the completion of the work. The results showed that the mean operative time required in 12 patients was 9.42 min, significantly less than the time recorded in previous studies when the medium mean was 16.00 min. The mean number of touch-ups [adjustments] was less than 3, most of which were on the interproximal surfaces. There were no significant changes recorded in the electromyography tracings. There were also no changes in joint symptoms. It was found that this way of working was entirely reliable and significantly reduced operating times and the number of appointments. Digital flow is beneficial ei dysfunctional patients, not about improvements in temporomandibular symptoms but in times of operability and prosthetic retouching.

8.
Artigo em Inglês | MEDLINE | ID: mdl-37595113

RESUMO

OBJECTIVE: To investigate the accuracy of Chat-Based Generative Pre-trained Transformer (ChatGPT) in answering questions and solving clinical scenarios of head and neck surgery. STUDY DESIGN: Observational and valuative study. SETTING: Eighteen surgeons from 14 Italian head and neck surgery units. METHODS: A total of 144 clinical questions encompassing different subspecialities of head and neck surgery and 15 comprehensive clinical scenarios were developed. Questions and scenarios were inputted into ChatGPT4, and the resulting answers were evaluated by the researchers using accuracy (range 1-6), completeness (range 1-3), and references' quality Likert scales. RESULTS: The overall median score of open-ended questions was 6 (interquartile range[IQR]: 5-6) for accuracy and 3 (IQR: 2-3) for completeness. Overall, the reviewers rated the answer as entirely or nearly entirely correct in 87.2% of cases and as comprehensive and covering all aspects of the question in 73% of cases. The artificial intelligence (AI) model achieved a correct response in 84.7% of the closed-ended questions (11 wrong answers). As for the clinical scenarios, ChatGPT provided a fully or nearly fully correct diagnosis in 81.7% of cases. The proposed diagnostic or therapeutic procedure was judged to be complete in 56.7% of cases. The overall quality of the bibliographic references was poor, and sources were nonexistent in 46.4% of the cases. CONCLUSION: The results generally demonstrate a good level of accuracy in the AI's answers. The AI's ability to resolve complex clinical scenarios is promising, but it still falls short of being considered a reliable support for the decision-making process of specialists in head-neck surgery.

9.
J Pers Med ; 13(7)2023 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-37511696

RESUMO

OBJECTIVE: The objective of this study is to investigate whether age is a significant risk factor for spinal nerve injury following selective neck dissection (SND) in patients with head and neck cancer. METHODS: A retrospective cohort study was conducted on patients who had undergone SND for head and neck cancer at a tertiary hospital between 2020 and 2022. The primary outcome was the incidence of spinal nerve injury after SND. The secondary outcomes included the types and severity of spinal nerve injury and the impact of age on these outcomes. RESULTS: A total of 78 patients were included in the study and subdivided into two groups. Two shoulder-specific questionnaires (the Shoulder Pain and Disability Index (SPADI) and the Shoulder Disability Questionnaire (SDQ)) were administered to assess shoulder morbidity postoperatively. Twelve patients showed shoulder impairment following surgery. We divided the sample into two age-based groups; the older group showed a higher rate of SAN injury and the younger group showed a lower rate of improvement over time. CONCLUSION: This study suggests that age is a significant risk factor for spinal nerve injury following SND in patients with head and neck cancer. Older patients are more likely to experience spinal nerve injury after SND than younger patients. The findings of this study may help in the development of strategies to prevent spinal nerve injury in older patients undergoing SND for head and neck cancer.

10.
J Cancer Res Clin Oncol ; 149(12): 10465-10471, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37278829

RESUMO

PURPOSE: Oral Squamous Cell Carcinoma (OSCC) is characterized by a high aggressiveness and a tendency to metastasize. The management of the neck in cT1-2N0 patients c follows three strategies: watchful waiting, elective neck dissection (END) or sentinel lymph node biopsy (SLNB). The aim was to assess the viability of intraoperative frozen sections of the nodes of cT1-2N0 to spot occult metastases as an alternative to SLNB, performing a modified radical neck dissection (MRND) in intraoperatively positive patients. METHODS: The patients were treated at the Maxillo-Facial Surgery Unit of Policlinico San Marco of Catania between 2020 and 2022. END was performed in all patients, including frozen section examination of at least one clinically suspicious node per level. In case of positivity after frozen section examination, neck dissection was extended to levels IV and V. RESULTS: All frozen sections were compared with a definitive test after paraffin inclusion. During surgery, 70 END were performed, and 210 nodes were analyzed with frozen sections. Among the 70 END, 52 were negative after frozen Sects. (156 negative nodes), and surgery was ended. Five of the 52 negative ENDs resulted in pN + after paraffin inclusion (9.6%), which underwent postoperative adjuvant treatment. The sensibility of our END + frozen section method was 75%, while the specificity of our test was 94%. The negative predictive value was 90,4%. CONCLUSIONS: Elective neck dissection + intraoperative frozen section could be an alternative to SLNB to spot occult nodal metastases in cT1-2N0 OSCC due to the opportunity to perform a one-step diagnostic/therapeutic procedure.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Humanos , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Bucais/cirurgia , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Esvaziamento Cervical/métodos , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Secções Congeladas , Parafina , Neoplasias de Cabeça e Pescoço/patologia , Linfonodos/cirurgia , Linfonodos/patologia , Estadiamento de Neoplasias
11.
J Pers Med ; 13(6)2023 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-37373868

RESUMO

The objective of this study was to investigate the effectiveness of buccinator myomucosal island flaps for tongue reconstruction following malignant tumor resections. A retrospective study was performed on 52 patients who underwent tongue reconstructions with buccinator myomucosal island flaps between 2012 and 2020. We reviewed the flap type and size, harvesting time, recipient- and donor-site complications, postoperative oncologic outcomes, functional recovery and QoL assessment. All of the flaps were transposed successfully without any total flap loss. Neither in the primary site nor in the neck were cancer relapses observed. An evaluation of the sensitivity revealed that 96.1% of patients experienced a recovery of touch, two-point and pain sensations. There were significant differences between the flap and the native mucosa in terms of the tactile (p < 0.001), pain (p < 0.001) and two-point (p < 0.001) thresholds. The average swallowing score recorded was 6.1 out of 7, with only minor complaints. The quality of life assessments demonstrated high scores across physical (24.5 out of 28), social (25.8 out of 28), emotional (20.3 out of 24) and functional (25 out of 28) aspects. The present study showed how buccinator myomucosal island flaps represent an effective and functional tongue reconstructive option, requiring a short operative time with a low rate of donor site morbidity, and with evidence of long-term oncologic safety and high quality of life.

12.
J Pers Med ; 13(6)2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-37373925

RESUMO

BACKGROUND: Orthognathic surgery is a multidisciplinary surgery in which the aesthetic results have become increasingly important, and consequently, also the predictability of the surgical outcomes. In this paper, we analyzed the volumetric distribution of the lower two-thirds of the face, in patients operated by orthognathic surgery and selected for their attractiveness. Our goal was to analyze the aesthetic volumetric distribution for gender and to propose our operating philosophy, that a normative distribution of facial volumes could be used like a new 3D aesthetic guide in orthognathic planning. METHODS: A group of 46 orthognathic patients (26 females, 20 males) with the best postoperative aesthetic score was selected by a jury of plastic surgeons, orthodontists, and journalists. The mean soft tissue volumes of the malar, maxillary, mandibular, and chin regions were analyzed. RESULTS: Overall, we measured a mean female facial volume distribution of 38.7%, 29%, 27.6%, and 4.7%, respectively, in the malar, maxillary, mandibular, and chin regions, while in males, it was 37%, 26%, 30%, and 6%, respectively. CONCLUSIONS: In this paper, the expansion of facial volumes in orthognathic surgery is proposed as a key point for facial harmonization. Beauty could be scientifically interpreted as a balanced distribution of facial volumes, and the virtual study of this distribution can become an important part of the preoperative analysis, such as a "volumetric" 3D cephalometry, where the surgeon could use average values of aesthetic volumetric distribution as preoperative surgical references.

13.
J Clin Med ; 12(7)2023 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-37048735

RESUMO

BACKGROUND: Temporomandibular disorders (TMDs) are a series of disorders that affect the muscles and joint. Symptoms include joint pain, muscle pain, and limitation of mouth opening. One of several multifactorial diseases, temporomandibular dysfunction has mostly been linked to five etiological factors: occlusion, trauma, severe pain stimuli, parafunctional activities, and psychological elements, including stress, anxiety, and depression. The position of the human body as it is displayed in space is referred to as posture. Several nerve pathways regulate posture, and through ligaments, TMD and posture affect each other. The purpose of this study is to evaluate the possible correlation between posture and TMD through a meta-analysis of the literature; Methods: A literature search was performed on PubMed, Lilacs, and Web of science, and articles published from 2000 to 31 December 2022 were considered, according to the keywords entered. The term "temporomandibular disorders" has been combined with "posture", using the Boolean connector AND; Results: At the end of the research, 896 studies were identified from the search conducted on the 3 engines. Only three were chosen to draw up the present systematic study summarizing the article's main findings. The meta-analysis showed through forest plot analysis a correlation between posture and TMD Conclusions: This literature meta-analysis showed a correlation between posture and TMD. Nerve pathways probably regulate both body posture and mandibular posture. Further clinical studies will be needed to confirm this hypothesis and to indicate the main conclusions or interpretations.

14.
Neurosurg Rev ; 46(1): 6, 2022 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-36471011

RESUMO

Post-traumatic orbital meningoencephaloceles related to orbital roof fractures are a challenging clinical entity because of their rarity and difficult differential diagnosis. We report a case of post-traumatic intra-orbital meningoencephalocele in a 69-year-old man, secondary to a likely trapdoor mechanism, treated with a modified one-piece orbitozygomatic craniotomy. We also performed an extensive literature review of traumatic Intra-Orbital Encephalocele related to Orbital Roof Fracture focused on adult patients on electronic databases including Scopus, MEDLINE/PubMed, and Google Scholar. Patient well recovered after surgery with immediate exophthalmos resolution and discharged without visual or neurological deficits. The literature review included 22 papers with a total of 28 patients: 22 males (78.6%) and 6 females (21.4%), with a median age of 34.7 years. Twenty-six patients (92.9%) reported ocular injuries, with associated intracranial complications in 16 cases (61.5%). Twenty-seven patients (96.4%) were surgically treated, 18 of those underwent unilateral or bilateral frontal approach. Most orbital roof fractures can be managed nanoperatively if asymptomatic. Indeed, when the intra-orbital volume decreases, for example due to an encephalocele, the intra-orbital pressure could increase and determine an orbital compartment syndrome. In our case, we performed a one-piece modified orbitozygomatic approach, which has several advantages in comparison to the frequent unilateral or bilateral frontal craniotomy like the better exposure of the brain and orbit and a minimum brain retraction.


Assuntos
Exoftalmia , Meningocele , Fraturas Orbitárias , Masculino , Adulto , Feminino , Humanos , Idoso , Encefalocele/cirurgia , Encefalocele/diagnóstico , Meningocele/cirurgia , Fraturas Orbitárias/complicações , Fraturas Orbitárias/cirurgia , Órbita/cirurgia
15.
J Craniofac Surg ; 33(7): 2188-2194, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36100974

RESUMO

INTRODUCTION: Secondary alveolar cleft repair using autologous bone graft is currently the gold standard in treating residual alveolar clefts. Despite its effectiveness, this technique is still burdened by several withdrawals, mostly related to donor site morbidity. To decrease disadvantages for patients, numerous attempts in the literature regarding bone substitutes have been described. The aim of this study is to compare the viability of bovine-based replacement bone material with respect of autologous bone graft in alveolar cleft reconstruction, through 3-dimensional alveolar cleft segmentation and bone density evaluation from preoperative and postoperative cone-beam computed tomography. PATIENTS AND METHODS: A retrospective cohort study of 10 patients who underwent surgical procedure for alveolar cleft grafting at Sant'Orsola Malpighi University Hospital of Bologna from December 2012 to December 2016 was undertaken. Five patients received autologous bone graft and 5 a bovine bone substitute graft. Preoperative and immediate postoperative orthopanoramic x-rays were recorded. Cone-beam computed tomography scans have recorded both pre and postoperatively. Volumetric evaluation on 3-dimensional cone-beam computed tomography images was performed. RESULTS: Alveolar clefts repaired using substitute bovine bone/biological membrane scaffold had a mean fill of 69.00% of total cleft volume, while this figure was of 67.07% with autologous bone grafting. The immediate postoperative course and subsequent discharge were uneventful for both groups, with a difference in timing. The cost of substitute bovine bone was offset by cost savings associated with a reduction in operative and postoperative and hospitalization time. CONCLUSIONS: Bone substitutes showed to be a promising solution in alveolar cleft grafting.


Assuntos
Enxerto de Osso Alveolar , Substitutos Ósseos , Fenda Labial , Fissura Palatina , Enxerto de Osso Alveolar/métodos , Animais , Densidade Óssea , Substitutos Ósseos/uso terapêutico , Transplante Ósseo/métodos , Bovinos , Fenda Labial/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Estudos Retrospectivos
16.
Noncoding RNA ; 8(4)2022 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-36005828

RESUMO

Oral cancer is one of the most common malignancies worldwide, accounting for 2% of all cases annually and 1.8% of all cancer deaths. To date, tissue biopsy and histopathological analyses are the gold standard methods for the diagnosis of oral cancers. However, oral cancer is generally diagnosed at advanced stages with a consequent poor 5-year survival (~50%) due to limited screening programs and inefficient physical examination strategies. To address these limitations, liquid biopsy is recently emerging as a novel minimally invasive tool for the early identification of tumors as well as for the evaluation of tumor heterogeneity and prognosis of patients. Several studies have demonstrated that liquid biopsy in oral cancer could be useful for the detection of circulating biomarkers including circulating tumor DNA (ctDNA), microRNAs (miRNAs), proteins, and exosomes, thus improving diagnostic strategies and paving the way to personalized medicine. However, the application of liquid biopsy in oral cancer is still limited and further studies are needed to better clarify its clinical impact. The present manuscript aims to provide an updated overview of the potential use of liquid biopsy as an additional tool for the management of oral lesions by describing the available methodologies and the most promising biomarkers.

17.
J Craniofac Surg ; 32(8): 2603-2610, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34191768

RESUMO

ABSTRACT: Aesthetics and function of maxillofacial district are closely related and could interfere with patient psychological conditions. The aim of this paper is to describe and to analyze the procedures necessary for a proper surgical visualized treatment objective (VTO) realization through the use of the tracing on lateral head film, applying the divine proportion (or golden ratio) in certain steps. The method described is easy to realize, cheap and help both orthodontist and maxillo-facial surgeon to communicate each other and to the patients.For the following article, digital research and handheld research on surgical VTO planning for patients with skeletal or dentoalveolar severe deformities managed by surgeons and orthodontics were used. The research included articles in English published on dental and maxillofacial surgery journals.The surgical VTO consists of a "previsualization" of the objectives in order to make the desired changes for the individual patient. The result can thus be visualized and pre-evaluated rather than just imagined by the mind's eye. To simplify the procedure, the surgical VTO has been divided into 11 steps. The accurate model of the surgical result is fundamental in the treatment of dentofacial deformities. These predictions are intended to guide the treatment towards the desired result, to give the patient a reasonable preview of the outcome, and to ensure communication between the orthodontist and the surgeon.This technique proves to be effective in planning surgical treatment and it allows the clinician to view changes before, during, and after orthognathic surgery. The skeletal, dental, and aesthetic complete cephalometric evaluation is the key point to the long-term success of the results.


Assuntos
Estética Dentária , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Face/anatomia & histologia , Humanos , Planejamento de Assistência ao Paciente
18.
Biomed Res Int ; 2021: 3582342, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33834063

RESUMO

In the field of biology and medicine, one hears often about stem cells and their potential. The dental implant new surfaces, subjected to specific treatments, perform better and allow for quicker healing times and better clinical performance. The purpose of this study is to evaluate from a biological point of view the interaction and cytotoxicity between stem cells derived from dental pulp (DPSCs) and titanium surfaces. Through the creation of complex cells/implant, this study is aimed at analyzing the cytotoxicity of dental implant surfaces (Myth (Maipek Manufacturer Industrial Care, Naples, Italy)) and the adhesion capacity of cells on them and at considering the essential factors for implant healing such as osteoinduction and vasculogenesis. These parameters are pointed out through histology (3D cell culture), immunofluorescence, proliferation assays, scanning electron microscopy, and PCR investigations. The results of the dental implant surface and its interaction with the DPSCs are encouraging, obtaining results increasing the mineralization of the tissues. The knowledge of this type of interaction, highlighting its chemical and biological features, is certainly also an excellent starting point for the development of even more performing surfaces for having better healing in the oral surgical procedures related to dental implant positioning.


Assuntos
Implantes Dentários , Polpa Dentária/citologia , Células-Tronco/citologia , Matriz Óssea/efeitos dos fármacos , Matriz Óssea/metabolismo , Adesão Celular/efeitos dos fármacos , Morte Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Meios de Cultivo Condicionados/farmacologia , Humanos , Neovascularização Fisiológica/efeitos dos fármacos , Osseointegração/efeitos dos fármacos , Osteocalcina/metabolismo , Células-Tronco/efeitos dos fármacos , Células-Tronco/ultraestrutura , Propriedades de Superfície , Fator A de Crescimento do Endotélio Vascular/metabolismo
19.
J Craniofac Surg ; 32(5): 1894-1897, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33538449

RESUMO

ABSTRACT: Osteolipoma is a benign neoplasm originating from the mesenchymal fat tissue cells and characterized by the presence of bone formation. In the head and neck district osteolipoma has been described as parapharyngeal, nasopharinx, submandibular gland, eyelid, floor of the mouth, and skull base lesion. Only 1 case of osteolipoma was reported as a neoplasm of the parotid region. Considering the rarity of the osteolipoma, our purpose was to describe the first case of totally intraparotid gland localization of osteolipoma and summarize and review the actual literature concerning the presence of this tumor in the region of major salivary glands. A 56-years-old male patient was treated for intraparotid osteolipoma. Surgical removal of tumor was done with a standard preauricular/cervical incision and blunt dissection. The facial nerve was identified and preserved completely. In the reviewed series, all cases were reported in adult patients with a relative long history of slow progression. According to our paper and the review of the literature, we can assess that Osteolipoma is an extremely rare lesion affecting the major salivary glands, which should be considered along with common salivary gland tumors in the differential diagnosis.


Assuntos
Lipoma , Tecido Adiposo , Adulto , Diagnóstico Diferencial , Nervo Facial , Humanos , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Masculino , Pessoa de Meia-Idade , Região Parotídea
20.
Head Neck ; 43(5): 1563-1573, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33511711

RESUMO

BACKGROUND: The aim of this Italian multicenter study was to evaluate the diagnostic performance of a minimally invasive method for the detection of oral squamous cell carcinoma (OSCC) based on 13-gene DNA methylation analysis in oral brushing samples. METHODS: Oral brushing specimens were collected in 11 oral medicine centers across Italy. Twenty brushing specimens were collected by each center, 10 from patients with OSCC, and 10 from healthy volunteers. DNA methylation analysis was performed in blindness, and each sample was determined as positive or negative based on a predefined cutoff value. RESULTS: DNA amplification failed in 4 of 220 (1.8%) samples. Of the specimens derived from patients with OSCC, 93.6% (103/110) were detected as positive, and 84.9% (90/106) of the samples from healthy volunteers were negative. CONCLUSION: These data confirmed the diagnostic performance of our novel procedure in a large cohort of brushing specimens collected from 11 different centers and analyzed in blindness.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/genética , Metilação de DNA , Humanos , Itália , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/genética
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