Real-Time PCR Detection of Candida Species in Biopsy Samples from Non-Smokers with Oral Dysplasia and Oral Squamous Cell Cancer: A Retrospective Archive Study.

The impact of Candida sp. in the development of oral cancer remains uncertain and requires sensitive analytical approaches for clarification. Given the invasive capabilities of these microorganisms in penetrating and invading host tissues through hyphal invasion, this study sought to detect the presence of five Candida sp. in oral biopsy tissue samples from non-smoker patients. Samples were obtained from patients at varying stages of oral carcinogenesis, including dysplasia, carcinoma in situ, OSCC, and histologically benign lesions, and analyzed using Real-Time PCR. Oral tissue samples from 80 patients (46 males and 34 females) were included. Significantly higher C. albicans presence was detected in the mild/moderate dysplasia group compared to the healthy (p = 0.001), carcinoma in situ (p = 0.031) and OSCC groups (p = 0.000). Similarly, C. tropicalis carriage was higher in tissues with mild/moderate dysplasia compared to healthy (p = 0.004) and carcinoma in situ (p = 0.019). Our results showed a significant increase in the presence of C. albicans and C. tropicalis within the mild/moderate dysplasia group compared to other cohorts. Coexistence of these two microorganisms was observed, suggesting a potential transition from a commensal state to an opportunistic pathogen, which could be particularly linked to the onset of oral neoplasia.

Is It Time to Consider Implementation of Telemedicine in Current Oral Health Care Services?

Telemedicine offers an excellent opportunity to provide continuing health care for those in need during local/global pandemics and disasters. It provides a safe and effective communication tool between health professionals and can be used as "forward triage" to manage medical/dental emergencies and to minimize the contact between the patients and clinicians during the coronavirus disease (COVID-19) pandemic. Patients with noncommunicable diseases, like cancer, diabetes, cardiovascular, or chronic respiratory diseases, may present with critical health problems due to less access to health care systems during global disasters; opportunities for screening oral mucosa might be significantly disrupted, leading to delayed diagnosis of malignant/potentially malignant lesions. Telemedicine and oral health care associated mobile applications should be implemented to provide equal access to care, to eliminate unnecessary visits to health centers, and to improve practical coordination between professionals and health facilities.

The contribution of artificial intelligence to reducing the diagnostic delay in oral cancer.

Oral cancer (OC) is the sixth most commonly reported malignant disease globally, with high rates of disease-related morbidity and mortality due to advanced loco-regional stage at diagnosis. Early detection and prompt treatment offer the best outcomes to patients, yet the majority of OC lesions are detected at late stages with 45% survival rate for 2 years. The primary cause of poor OC outcomes is unavailable or ineffective screening and surveillance at the local point-of-care level, leading to delays in specialist referral and subsequent treatment. Lack of adequate awareness of OC among the public and professionals, and barriers to accessing health care services in a timely manner also contribute to delayed diagnosis. As image analysis and diagnostic technologies are evolving, various artificial intelligence (AI) approaches, specific algorithms and predictive models are beginning to have a considerable impact in improving diagnostic accuracy for OC. AI based technologies combined with intraoral photographic images or optical imaging methods are under investigation for automated detection and classification of OC. These new methods and technologies have great potential to improve outcomes, especially in low-resource settings. Such approaches can be used to predict oral cancer risk as an adjunct to population screening by providing real-time risk assessment. The objective of this study is to (1) provide an overview of components of delayed OC diagnosis and (2) evaluate novel AI based approaches with respect to their utility and implications for improving oral cancer detection.

Dental radiographic procedures during COVID-19 outbreak and normalization period: recommendations on infection control.

Dental professionals have always been meticulous about infection control due to high risk of cross-contamination during dental procedures. Nevertheless, there is an urgent need to review and revise our current practice of infection control and develop more strict protocols that will prevent nosocomial spread of infection during COVID-19 outbreak and future pandemics. The risk of contamination is high during dental radiography if proper disinfection techniques are not applied. This document provides advice and guidance for infection control when practicing dental radiography during COVID-19 pandemic.

Potentially premalignant disorder/lesion versus potentially premalignant patient: Relevance in clinical care.

This communication presents a discussion of patient risk factors and outcomes for potentially malignant and malignant lesions in contrast to lesion assessment and lesion management. The shift in consideration may have implications for research and clinical intervention. This compact review discusses several local and systemic components that contribute to the development of malignant changes and discusses whether patients instead of lesions should be defined as having a potentially premalignant condition.

Oral health-related quality of life among institutionalized patients after dental rehabilitation.

AIM: The aim of the present study was to determine the changes in oral health-related quality of life before and 3 months after dental rehabilitation among geriatric patients residing in a state-owned nursing home, using the General Oral Health Assessment Index (GOHAI). METHODS: Data from 40 patients were collected through the administration of a structured questionnaire, as well as from medical records and intraoral examinations. Sociodemographic and behavioral variables, and denture use/length of use were recorded. The GOHAI questionnaire was completed before and 3 months after dental rehabilitation by the same examiner. Normality of the GOHAI scores was examined with the Kolmogorov-Smirnov test. Data were analyzed using descriptive statistics, t-tests, one-way ancova and ancova (P < 0.05). RESULTS: The study sample included 32 men (80%) and eight women (20%) with a mean age of 72.75 years. Mean GOHAI scores increased from 41.275 (low) to 53.100 (moderate) 3 months after dental rehabilitation (t = 1.42, P < 0.001, r = 0.86). Patients with poor oral hygiene (P = 0.000), those who had been using dentures (P = 0.000) and patients younger than 70 years-of-age (P = 0.03) provided higher GOHAI scores after dental rehabilitation. GOHAI scores before and after dental rehabilitation were not influenced by sociodemographic and behavioral variables (P > 0.05). The after treatment GOHAI scores, which were corrected according to gender and age, showed no significant differences regarding the education level, income, behavioral variables, use of dentures, oral hygiene status and presence of systemic diseases (F = 0.62, P = 0.69). CONCLUSIONS: Dental rehabilitation of institutionalized geriatric patients resulted in a significant improvement in GOHAI scores, indicating an improvement in oral health-related quality of life after receiving proper dental care.

Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs.

OBJECTIVES: There is no consensus on the relationship between fractal dimension and trabecular bone complexity. Our aims were to examine the changes in fractal dimension (FD) from peri-implant alveolar bone on digital panoramic radiographs 6 and 12 months after prosthodontic loading and to compare these with baseline values calculated just after loading. MATERIAL AND METHODS: Three panoramic radiographs taken from 76 implant patients taken (1) after prosthodontic loading (3 months ± 2 weeks after insertion = baseline), (2) 6 months ± 2 weeks after loading, and (3) 12 months ±2 weeks after loading were considered for the study. Panoramic images were obtained using storage phosphor plates of the Digora PCT system and saved into a computer. Three regions of interest from mesial, distal, and apical areas were selected for each implant on three consecutive panoramic images. Statistical analysis of the data was performed using two-way repeated measures ANOVA, independent t test and paired t test, and pairwise comparisons (P < 0.05). RESULTS: Mean FD values at baseline were 1.202, 1.224, and 1.199 for apical, mesial, and distal areas. The FD values were calculated as 1.121, 1.113, and 1.128 at the 6th month. The differences between values calculated at baseline and the 6th month were statistically significant for all aspects, indicating a significant decrease in FD 6 months after prosthodontic loading (P < 0.05). FD values calculated at the 12th month were 1.121, 1.110, and 1.121 for apical, mesial, and distal aspects, respectively, with no significant differences from corresponding values obtained at the 6th month (P > 0.05). CONCLUSIONS: FD values of trabecular bone around implants 6 months after prosthodontic loading are significantly lower than the baseline values. However, no significant decrease or increase was observed at 12 months, which revealed comparable results with peri-implant alveolar bone at 6 months. CLINICAL RELEVANCE: Trabecular bone around successful dental implants exhibits lower fractal dimension values 6 months after prosthodontic loading and displays stable bony microstructure at 12 months of follow-up.

Clinical application of a digital method to improve the accuracy of color perception in toluidine blue stained oral mucosal lesions.

OBJECTIVE: Color perception is an important variable in detecting and assessing oral conditions. The aim was to investigate clinicians' perception of toluidine blue (Tblue) staining compared to digital color analysis, which may impact mucosal lesion detection, affect the decision to biopsy, and biopsy site selection. METHOD AND MATERIALS: Four oral lesions were stained with Tblue. Digital color analyses of eight areas on each image were completed and were considered as "gold standard" (GS). Twenty specialists ranked these areas according to their perceived intensity of blue stain in two sessions. RESULTS: Consistency between GS and observers rankings was 0.8791. However, more than half of the observers inaccurately perceived the intermediate blue tones. Overall interobserver agreement was 0.8714; stability between two sessions decreased to 45% for intermediate tones. CONCLUSION: Assessing the equivocal blueness of an oral mucosal lesion in clinical settings may vary due to variation in visual perception. A digital method for objective color analysis in clinical practice may be used to eliminate this deficiency by implementing a mathematical formula.