Analysis of the citation impact of Brazilian researchers in oral pathology and oral medicine over two decades.

BACKGROUND: Brazilian Oral Pathology (OP) and Oral Medicine (OM) have gained significant international recognition. However, no study has yet evaluated the impact of citations in scientific publications. Therefore, this study aimed to analyze the impact of citations from Brazilian researchers in OP and OM over the last two decades. MATERIAL AND METHODS: This was a cross-sectional study involving 50 researchers linked to postgraduate programs in OP/OM. Data collected from each professional's Lattes curriculum included gender, academic affiliation, the corporate category of the institution, and location. The number of papers published and citations received between 2004 to 2013 and 2014 to 2023 was also collected from the Web of Science database. RESULTS: Most researchers were male (56%) and from public institutions (90%), mainly in the Southeast region (60%). Over two decades, they collectively published 8,033 scientific articles, with significant growth (p<0.001) from to 2004-2013 to 2014-2023. While the average citations per researcher did not differ significantly between 2004-2013 and 2014-2023 (p=0.538), there was a notable 67.67% increase in citations in the last decade. CONCLUSIONS: Brazilian researchers in the areas of OP and OM have demonstrated a significant academic impact over the past two decades, with a marked increase in publications and citations over the last ten years. This highlights the contribution of Brazilians to the global scientific community in these areas.

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.

The Spectrum of Histological Findings in Oral Biopsies

Aim: To undertake a retrospective analysis of the use of a diagnostic pathology service, to determine the source of oral biopsies submitted for histological analysis, and to examine the range and frequencies of histologically diagnosed oral lesions in an Irish population. Methods: A retrospective analysis was carried out on all oral biopsies submitted for histological analysis to an oral and maxillofacial diagnostic pathology service from June to December 2015. Results: In total 724 oral biopsies were submitted. The majority of diagnoses were benign (80.3%) and the remaining diagnoses were made up of malignancies (6.7%) and potentially malignant disorders (PMDs), histologically characterised by epithelial dysplasia (13%). Less than 1% of biopsies were submitted from general dentists in primary care. Conclusion: This study showed that oral biopsies are not submitted from the primary care setting, but rather from hospital-based specialist units or referral-based specialist practitioners. There was a broad range of histological diagnoses, the majority of which were benign.

A retrospective study of 51,781 adult oral and maxillofacial biopsies.

BACKGROUND: Few studies have compared patient and anatomic characteristics across the broad scope of oral and maxillofacial disease seen in dental clinics. The authors conducted a study to make these comparisons by surveying a large sample of histologically diagnosed oral and maxillofacial lesions in a US adult population. METHODS: A total of 51,781 specimens biopsied from 51,781 adult patients were received by an oral pathology service over 13 years (2001-2015) and analyzed. A description of patients' sex and age at diagnosis, as well as the anatomic site of biopsy was given for diagnoses of 10 oral disease types, including malignant neoplasm, benign neoplasm, infectious, reactive, potentially malignant, developmental, healthy tissue, immune dysfunction, physical trauma, and other. RESULTS: The authors reported reactive lesions were the most prevalent disease type found in the sample (74.9%). Malignant diagnoses comprised 1.97% of all biopsies. The 3 most prevalent diagnoses in this study included benign keratosis, chronic apical periodontitis, and radicular cyst. Different anatomic sites, patient age groups, and sexes show different distributions of disease. CONCLUSIONS: Certain disease types and diagnoses were found to have a higher prevalence by sex, among particular age groups, and in certain anatomic sites. PRACTICAL IMPLICATIONS: This information provides clinicians with a detailed and broad scope of the variety of oral and maxillofacial lesions processed at an oral pathology service and may assist practitioners in forming clinical impressions and differential diagnoses.

Análise das patologias bucais e maxilofaciais de uma população brasileira durante um período de 15 anos / Analysis of oral and maxillofacial pathologies of a brazilian population over a period of 15 years

O propósito desta pesquisa foi analisar o banco de dados de diagnósticos histopatológicos de lesões bucais biopsiadas na Clínica Odontológica Universitária da Universidade Estadual de Londrina (UEL) e que estão armazenados no Laboratório de Anatomia Patológica do Hospital Universitário - UEL, no período de 01 de janeiro de 1998 a 31 de dezembro de 2012, correspondendo a 15 anos de pesquisa. A coleta de dados envolveu ano do exame, idade e gênero do paciente, localização anatômica da lesão e diagnóstico histopatológico. Obteve-se 3.991 casos, os quais foram separados em 11 categorias diagnósticas: patologia da mucosa bucal, patologia das glândulas salivares exceto neoplasias, miscelânea, neoplasias benignas incluindo tumores de glândulas salivares, cistos odontogênicos e não odontogênicos, patologia gengival e periodontal, neoplasias malignas, tumores odontogênicos, doenças infecciosas e parasitárias, patologia dental, patologia óssea. A maioria das lesões é de carácter benigno, sendo a hiperplasia fibrosa inflamatória o diagnóstico histopatológico mais prevalente com 38,76% do total, seguida da mucocele (9,8%). As décadas de vida mais acometidas são a 5ª e 6ª e o sítio anatômico mais comumente afetado é o rebordo alveolar. O carcinoma espinocelular representa 81,7% das neoplasias malignas, com uma razão masculino : feminino (M:F) de 6:1, idade média de ocorrência de 55,7 anos e se apresenta mais frequente que a leucoplasia. Tal fato pode sugerir que a falha no reconhecimento, na identificação, na abordagem ou no acompanhamento das leucoplasias pode estar ocorrendo, permitindo que consequências mais sérias, como a transformação maligna destas, ocorra e que o número de carcinomas, desta forma, exceda o número de casos de leucoplasias. A necessidade do diagnóstico precoce do câncer bucal deve novamente ser salientada...

A 10-year study of specimens submitted to oral pathology laboratory analysis: lesion occurrence and demographic features

The purpose of the present paper was to describe the range of lesions histologically diagnosed in an oral pathology laboratory in southern Brazil. A retrospective study of 8,168 specimen analyses recorded between 1995 and 2004 was conducted. The records were retrieved from the Oral Pathology Laboratory, School of Dentistry, Federal University of Rio Grande do Sul, RS, Brazil. A total of 6,831 valid cases (83.63%) were examined. Of these, inflammatory lesions were the most common occurrences (n = 4,320; 63.24%). Benign and malignant tumors accounted for 7.66% (n = 523) and 1.9% (n = 130) of the occurrences, respectively. Significant associations were observed between nonneoplastic proliferative disorders and benign mesenchymal tumors in females, and between squamous cell carcinoma and leukoplakia in males. Most diagnoses were benign in nature and had an inflammatory etiology. The association of some demographic characteristics with the occurrence of lesions suggests that these characteristics should be considered in performing differential diagnoses.

A 10-year study of specimens submitted to oral pathology laboratory analysis: lesion occurrence and demographic features.

The purpose of the present paper was to describe the range of lesions histologically diagnosed in an oral pathology laboratory in southern Brazil. A retrospective study of 8,168 specimen analyses recorded between 1995 and 2004 was conducted. The records were retrieved from the Oral Pathology Laboratory, School of Dentistry, Federal University of Rio Grande do Sul, RS, Brazil. A total of 6,831 valid cases (83.63%) were examined. Of these, inflammatory lesions were the most common occurrences (n = 4,320; 63.24%). Benign and malignant tumors accounted for 7.66% (n = 523) and 1.9% (n = 130) of the occurrences, respectively. Significant associations were observed between nonneoplastic proliferative disorders and benign mesenchymal tumors in females, and between squamous cell carcinoma and leukoplakia in males. Most diagnoses were benign in nature and had an inflammatory etiology. The association of some demographic characteristics with the occurrence of lesions suggests that these characteristics should be considered in performing differential diagnoses.

Analysis of demographic data obtained from pathology records.

INTRODUCTION: Pathologists commonly analyse patient data obtained from pathology records. Such information is useful in that it might provide an indication of changing patterns of disease, or of the aetio-pathogenesis of a disease process, but such data is seldom standardised. AIM: To determine to what extent the lack of standardisation may influence the resultant data and the conclusions drawn. MATERIALS AND METHODS: Pathology reports of all cysts diagnosed from 1994 to 2004 were retrieved. The diagnosis and site of the cyst, and the age, gender and race of patient were analysed. Comparative data from 1958 to 1992 was obtained from the text "Cysts of the oral regions". The data from the different periods was statistically compared. Only the four most common cysts were included: radicular, dentigerous, odontogenic keratocyst and nasopalatine duct cysts. RESULTS: There was no difference in frequency and site of cysts or in age of patients. Statistically significant differences were found in the gender and race comparisons. CONCLUSION: Do the differences reflect a changing pattern of disease or are they due to changes in the demographics of the patient pool from which the surgical specimens were obtained? We favour the latter. Awareness of the fact that data from either survey is not reliable due to lack of standardisation is pertinent to avoid drawing fundamental conclusions from such data.

Patterns of second-opinion diagnosis in oral and maxillofacial pathology.

OBJECTIVES: Several studies have documented the beneficial effect of second opinions in diagnostic pathology. Among disease sites, the head and neck can be a particularly problematic area for pathologists, prompting frequent second opinions. However, the effect of second opinion requests made by physician pathologists (PPs) to oral and maxillofacial pathologists (OMPs) has not been well studied and might identify disease and subsites that pose diagnostic challenges. The objectives of this study were to study the referral patterns of PPs to a referral center for oral and maxillofacial pathology and to assess changes in diagnosis following second opinion. STUDY DESIGN: We retrospectively reviewed 142 consecutive pathology consultation requests over a 2-year period. The submitted report and matched second opinion report were reviewed to extract predetermined demographic, clinical, and pathologic data. Each diagnosis was reviewed to determine if there was agreement, minor disagreement, or major disagreement between the original and the second opinion. RESULTS: The most common diagnostic categories sent for second opinion were dysplasia/carcinoma, odontogenic cysts, and odontogenic tumors. In the 135 cases where agreement could be assessed, there were a total of 46 cases (34.1%) with differences in diagnostic opinion. Minor disagreements occurred in 24 cases (17.8%) and major disagreements in 22 cases (16.3%). Importantly, major disagreements identified here would have resulted in significant differences in patient evaluation and management. CONCLUSIONS: This study supports the positive impact of second-opinion surgical pathology for lesions in the maxillofacial complex and supports the role of OMPs in subspecialty diagnostic pathology.

A retrospective analysis of referral patterns for oral radiologic consultation over 3 years in Ontario, Canada.

OBJECTIVES: To determine the types of practitioners who most commonly refer and the film type and diagnostic entities that are most frequently submitted for oral radiologic consultation in Ontario, Canada. STUDY DESIGN: A total of 430 referral letters and responses from 2 Ontario oral radiologists from 2003 to 2005 were analyzed. Data collected included the specialty of the referring practitioner, the film type(s) submitted, the radiographic density of the entity of interest, and the interpretation by the radiologist. RESULTS: General practitioners (58.9%) and oral surgeons (21.5%) were the most frequently referring practitioner types, representing 1.2% and 17.1% respectively of each group practicing in Ontario. Also, 18.2% of oral pathologists referred. Panoramic radiographs (79.5%) were included in referrals more often than intraoral radiographs (46.0%). Of the entities, 37.0% were radiopacities, 27.4% were radiolucencies, and 13.5% had mixed radiopaque-radiolucent density. The radiologists interpreted normal features (55.6%) most often. CONCLUSION: Panoramic radiographs with normal findings were submitted to oral radiologists for consultation most frequently in Ontario.

Scope of practice, referral patterns and lesion occurrence of an oral medicine service in Australia.

AIM: The purpose of this study was to examine the scope of practice, lesion occurrence and utilisation of referral-based hospital and private practice oral medicine and oral pathology (OMP) services in Australia. MATERIALS AND METHODS: Clinical records of patients referred to a hospital (n=500) and private (nbequals;1104) OMP clinic were audited. For each patient, the following parameters were recorded: age, gender, source of referral, reason for referral, site of lesion/condition if applicable, medical and drug history, diagnostic services utilised, clinical and histopathological diagnoses rendered, medications prescribed and further treatment required. RESULTS: A majority of the referrals were generated by general dental practitioners. The most commonly seen problems were epithelial hyperplasia/hyperkeratosis, oral candidosis, oral lichen planus, xerostomia, recurrent aphthous ulcers and burning mouth syndrome. OMP specialists requested diagnostic imaging for 13% of hospital and 9.42% of private patients, diagnostic biopsies were required for 18.4% of hospital and 19.3% of private patients, blood tests were ordered for 14.4% of hospital and 12.13% of private patients, while medications were prescribed for approximately 36% of hospital and 51% of private patients. CONCLUSIONS: This study is the first to detail the scope of practice, lesion occurrence and utilisation of services offered by OMP specialists in Australia. The demand for OMP services is strong.

Review of oral pathology service, Medlab Dental, University of Otago, 2002-2005.

The School of Dentistry of the University of Otago operates a diagnostic oral pathology service, Medlab Dental, as a joint venture with the private pathology service Medlab South. This report reviews the use of the service in 2005 and provides information on current activities that highlights the importance of oral pathology diagnostic services in patient management.

A survey of oral and maxillofacial pathology specimens submitted by general dental practitioners over a 30-year period.

OBJECTIVES: To determine the range and frequency of diagnoses in specimens submitted for histopathological examination by general dental practitioners (GDPs). METHODS: A retrospective analysis was carried out of all cases submitted by GDPs for the period 1974-2003, using a Foxpro Windows database. The data were collated into 10 diagnostic categories each comprising number of diagnoses, percentage of each diagnosis within a diagnostic category and each diagnosis as a percentage of total cases. RESULTS: GDPs submitted 6,666 cases out of a total of 53,474 for this period. While the total number of specimens increased four-fold over the 30-year period, specimens from GDPs increased from 7% to 17%. The range of diagnoses increased from 18 to 45. Of the 617 GDPs who submitted material, 279 (45%) submitted less than two specimens each in 30 years. Nine malignant neoplasms were diagnosed. Other significant pathology included 320 benign neoplasms as well as diagnoses ranging from mucosal lesions such as lichen planus to odontogenic cysts. CONCLUSIONS: It is clear that GDPs have provided an increased number of biopsy specimens over the last three decades. This reflects an increasing demand by GDPs for a diagnostic oral histopathology service and their use of this service should be encouraged.

Estudo epidemiológico de urgências odontológicas / Epidemiologic study of urgencies in dentistry

O objetivo deste estudo retrospectivo foi determinar a razão da procura de atendimento de urgência na Faculdade de Odontologia da Universidade de Pernambuco, no segundo semestre de 2000, e relacionar o diagnóstico dos casos com o tratamento proposto, gênero e idade dos pacientes. Foram utilizados 227 prontuários de pacientes de ambos os gêneros, com idade variando de 11 a 81 anos. De posse dos dados, foram realizados as estatísticas descritivas e inferencial. A amostra consistiu de 70,5% de pacientes do gênero feminino e 29,5% do masculino. A idade média foi de 29 anos (DP = 11,75 anos). Dos casos atendidos, 33% tiveram como diagnóstico pulpite irreversível sintomática, seguida de 17,2% de pulpite reversível. A abertura coronária doi indicada nos casos de pulpite irreversível sintomática, abcesso dentoalveolar agudo e periodontite apical aguda, correspondendo a 55,1% dos tratamentos realizados. Conclui-se que o alto percentual de urgências endodônticas reflete o perfil de saúde bucal da população atendida, exibindo um alto padrão cariogênico que necessita ser revertido

Referral patterns, lesion prevalence, and patient care parameters in a clinical oral pathology practice.

OBJECTIVE: The purpose of this study was to determine the following parameters in a referral-based private practice oral and maxillofacial pathology clinic: (1) sources of clinical referrals; (2) types of problems referred; and (3) clinical effectiveness of treatment. STUDY DESIGN: Clinical charts were reviewed for a cohort of 362 patients seen over a 2 1/2-year period (1993-1995). From these charts, we determined the source of referral and the final diagnosis for each patient. In addition, 50 patients were randomly selected and surveyed by telephone; each was asked a series of questions to determine the following: (1) the number of health care practitioners previously seen with regard to the patient's condition; (2) the length of time that the condition had been present before the patient came to the oral and maxillofacial pathology clinic; (3) the costs associated with medications and office visits that had been incurred before the patient came to the oral and maxillofacial pathology clinic; (4) the costs associated with medications and office visits that were incurred at the oral and maxillofacial pathology clinic; and (5) the patient's level of satisfaction with the oral and maxillofacial pathology clinic. RESULTS: Fifty-five percent of the referrals came from dentists, and 45% came from physicians. The 3 problems most commonly seen were candidiasis (12%), burning mouth syndrome (10%), and lichen planus (8%). For the 50 patients who were interviewed, the mean number of health care practitioners seen previously was 2.2 (range, 1-9). The mean time from initial symptoms to evaluation by an oral pathologist was 15 months. The mean approximate cost of medications and office visits before evaluation by an oral pathologist was $350 (range, $30-$4,000; median, $100); this compared with a cost of $94 (range, $50-$300; median, $70) for the patient visit and medications associated with the oral pathology appointment. The difference was statistically significant (P < or = .001). CONCLUSIONS: This preliminary study suggests that the clinical evaluation of oral lesions by an oral pathologist appears to be cost-effective and should be an integral part of a comprehensive health management system. These results should be corroborated by similar multicenter studies.

The use by general dental practitioners of an oral pathology diagnostic service over a 20-year period: the Birmingham Dental Hospital experience.

OBJECTIVE: To investigate the use of an oral pathology service by general dental practitioners over a 20-year period. DESIGN: Retrospective analysis of the number of cases received for histological examination in 1975, 1984 and 1994. SETTING: Birmingham Dental Hospital. SUBJECTS AND METHODS: 1101, 2395 and 3366 specimens were accessed respectively for the three years studied. Number and proportion of specimens received, number and proportion that were hard or soft tissue specimens and the information on the request form were recorded. A comparison was made between the provisional clinical and histological diagnoses. RESULTS: Although the number of specimens accessed increased approximately 3-fold, the number of specimens accessed from general dental practitioners increased 5-fold. The variety of histological categories increased by over 50%, most being soft tissue specimens. The number of correct provisional diagnoses increased steadily but the percentage with inappropriate provisional diagnoses remained the same. Information on request forms steadily improved. CONCLUSIONS: The increased number of specimens received from general dental practitioners over the 20-year period reflects an increased demand for an oral pathology diagnostic service. The referral pattern most likely indicates an increased awareness by general dental practitioners of the need to biopsy lesions arising within the oral cavity.