miRNAs in liquid biopsy for oral squamous cell carcinoma diagnosis: Systematic review and meta-analysis.

Oral squamous cell carcinoma (OSCC) is often diagnosed at advanced stages and is associated with poor survival rates. Increasing evidence suggests that microRNAs (miRNAs) present in liquid biopsies could be potential biomarkers for non-invasive OSCC diagnosis. Here, we performed a comprehensive meta-analysis to evaluate the overall diagnostic accuracy of blood and salivary miRNAs in detecting OSCC. A literature search using PubMed EMBASE, Web of Science, LILACS, Scopus, and the Cochrane Library was undertaken up to February 2019. Study quality was assessed with the Quality Assessment for Studies of Diagnostic Accuracy-2, and sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and their corresponding 95% confidence intervals (CIs) were calculated using a bivariate random-effect meta-analysis model. Meta-regression and subgroup analyses were performed to assess the heterogeneity. Twenty-five study units from 16 articles with 2562 subjects were included in this meta-analysis. The pooled sensitivity and specificity of blood and salivary miRNAs in the diagnosis of OSCC were 0.78 (95% CI: 0.76-0.80) and 0.82 (95% CI: 0.79-0.84), respectively, and the pooled positive and negative likelihood ratios were 4.31 (95% CI: 3.38-5.51) and 0.25 (95% CI: 0.20-0.32), respectively. The overall area under the curve was 0.91 (95% CI: 0.88-0.93), with a diagnostic odds ratio of 21.46 (95% CI: 13.37-34.45). These findings provide evidence regarding the potential clinical application of blood and salivary miRNAs as a novel, non-invasive, and accurate diagnostic tool for OSCC.

Prevalence and caries-related risk factors in schoolchildren of 12- and 15-year-old: a cross-sectional study.

BACKGROUND: To assess the prevalence and severity of caries in 12- and 15-year-old schoolchildren, and to analyse the related risk factors. METHODS: We conducted a cross-sectional study on a random sample of 1843 schoolchildren aged 12 and 15 from Galicia (northwest of Spain). Self-administered questionnaire and dental clinical examination were performed to obtain information about oral health habits, dental caries and oral hygiene. A logistic regression model including dental-caries-related variables was generated for each age group. RESULTS: The respective findings for 12- and 15-years-old were as follows: decayed, missing, filled teeth index both for permanent and temporary dentition (DMFT/dmft) of 0.89 (95% CI, 0.87-0.91) and 1.38 (95% CI, 1.33-1.43), respectively; caries prevalence 39.6% (95% CI, 36.3-42.9) and 51.7% (95% CI, 48.0-55.4), respectively. In the 12-year-old group, individuals who occasionally, never or hardly ever brushed their teeth had higher values of caries (OR = 1.83, 95% CI 1.07-3.15, and OR = 9.14, 95% CI1.63-51.17, respectively). Also, the presence of plaque on more than 1/3 gingival was statistically associated with an increase of caries (OR = 2.03; 95% CI, 1.11-3.70), and living in a rural environment was a risk factor (OR = 1.3; 95% CI,1.02-1.80). In the 15-year-old group, higher caries risk was found when brushing was performed once a day (OR = 1.61; 95% CI,1.03-2.50), and among individuals who visited private clinics (OR = 1.77; 95% CI, 1.17-2.66), while electric toothbrush was associated with a lower caries risk (OR = 0.50; 95% CI, 0.29-0.86). CONCLUSIONS: This study revealed that risk factors of dental caries showed differences in schoolchildren of 12- and 15-year-old. Strongest evidence related to caries in 12-year-old group were found in frequency of toothbrushing and dental plaque. In 15-year old group, electric toothbrush, time since the last visit to the dentist and type of dental care (public/private) had a stronger association with dental caries. Caries prevalence and mean DMFT/dmft increased from 12- to 15-year-old, in spite of improvement in oral hygiene at the age of 15.

Cooperative learning in 'Special Needs in Dentistry' for undergraduate students using the Jigsaw approach.

INTRODUCTION: The goals of this study were to (i) describe the use of the Jigsaw approach for the resolution of clinical cases by undergraduate students in the subject 'Special Needs in Dentistry' and (ii) assess the impact of its implementation on academic performance and the students' perception. MATERIALS AND METHODS: The Jigsaw approach was applied to the fifth-year in the subject 'Special Needs in Dentistry', as part of the Dentistry degree curriculum of the University of Santiago de Compostela, during the academic years 2012/2013 and 2013/2014. A total of 109 dental students were enrolled in the study, and the final marks of the Jigsaw (n = 55) and the non-Jigsaw groups (n = 54) were compared. Students' perceptions on the Jigsaw technique were assessed using a 13-question questionnaire. RESULTS: Academic performance based on the final examination mark for the Jigsaw and non-Jigsaw groups was 6.45 ± 1.49 and 6.13 ± 1.50, respectively. There were not students in the Jigsaw group who failed to attend the mandatory examination (0% vs. 12.96% in the non-Jigsaw group, P = 0.006). The questionnaire's internal consistency was 0.90. The mean value for all the questionnaire items was 3.80, with the highest response score of 4.35 for the statement 'I have seen the complexity that the resolution of a clinical case can involve'. CONCLUSION: Based on the students' perceptions, the Jigsaw approach could contribute to a better understanding of the complexity of solving clinical cases in the subject 'Special Needs in Dentistry'. However, further investigations should be conducted to analyse the influence of this technique on students' academic performance in the field of clinical dentistry.

Morphometric study of the greater palatine canal: cone-beam computed tomography.

PURPOSE: To analyze greater palatine canal (GPC) dimensions using cone-beam computed tomography (CBCT) images, and to evaluate the position of the greater palatine foramen (GPF) with respect to various landmarks selected in relation to dental status. METHODS: This study included 150 CBCTs. Axial slices were used to determine the position and dimensions of the GPF. Sagittal slices were used to assess GPC length. Reference lines were established to evaluate the GPC diameter in sagittal and coronal slices. RESULTS: From the 77 GPF analyzed, 76 were located on level 2. Average posterior GPF distance was 6.59 ± 3.27 mm on right side and 7.35 ± 3.40 mm on left side. Several measurements to determine the position and dimensions of the GPF presented significant values (p ≤ 0.05). GPC length was 12.31 ± 1.96 mm on right side and 12.52 ± 2.15 mm on left side, statistically significant differences were detected between genders only on right canal (p ≤ 0.004). Sagittal and coronal reference lines presented significantly higher values for men except for the S3 (p < 0.062) and C1 (p < 0.067) in the left GPC. CONCLUSIONS: CBCT is a useful tool for evaluating GPC morphometrically in the three anatomical slices. The sagittal nasal plane and posterior nasal plane are two intraoral anatomical landmarks for the location of the GPF. Their scant variability allows accurate identification of GPFs in both dentate as well as edentulous patients.

Descriptive study of the bifid mandibular canals and retromolar foramina: cone beam CT vs panoramic radiography.

OBJECTIVES: To examine the presence and morphologic characteristics of bifid mandibular canals (BMCs) and retromolar foramens (RFs) using cone beam CT (CBCT) and to determine their visualization on panoramic radiographs (PANs). METHODS: A sample of 225 CBCT examinations was analysed for the presence of BMCs, as well as length, height, diameter and angle. The diameter of the RF was also determined. Subsequently, corresponding PANs were analysed to determine whether the BMCs and RFs were visible or not. RESULTS: The BMCs were observed on CBCT in 83 out of the 225 patients (36.8%). With respect to gender, statistically significant differences were found in the number of BMCs. There were also significant differences in anatomical characteristics of the types of BMCs. Only 37.8% of the BMCs and 32.5% of the RFs identified on CBCT were also visible on PANs. The diameter had a significant effect on the capability of PANs to visualize BMCs and RFs (B = 0.791, p = 0.035; B = 1.900, p = 0.017, respectively). CONCLUSIONS: PANs are unable to sufficiently identify BMCs and RFs. The diameter of these anatomical landmarks represents a relevant factor for visualization on PANs. Pre-operative images using only PANs may lead to underestimation of the presence of BMCs and to surgical complications and anaesthetic failures, which could have been avoided. For true determination of BMCs, a CBCT device should be considered better than a PAN.

Three-dimensional study of nasopalatine canal morphology: a descriptive retrospective analysis using cone-beam computed tomography.

PURPOSE: For dental implant treatment planning and placement, a precise anatomic description of the nasopalatine canal (NC) is necessary. This descriptive retrospective study evaluated dimensions of the NC and buccal bone plate (BBP) and the tridimensional association of the anatomic variants of NC, using cone-beam computed tomography (CBCT). METHODS: This study included 230 CBCTs. Sagittal slices were used for measurements of the NC and BBP and to evaluate shape and direction-course of the NC. Coronal slices were used to assess NC shape and axial slices to assess number of incisive foramina and foramina of Stenson. RESULTS: Mean NC length was 12.34 ± 2.79 mm, statistically significant differences were detected between genders (p < 0.001). Mean BBP length was 20.87 ± 3.68 mm, statistically significant differences were found for the dental status (p < 0.001) and mean BBP width was 6.83 ± 1.28 mm, significant differences were detected between genders (p < 0.001). Mean nasopalatine angle was 73.33° ± 8.11°, significant differences were found in sagittal and coronal classifications. The most prevalent canal was: cylindrical sagittal shape (48.2 %); slanted-straight direction-course (57.6 %); Ya-type coronal shape (42.4 %); and one foramen incisive with two Stenson's foramina (1-2) (50.9 %). Sagittal shape was associated with sagittal direction-course (p < 0.001). Coronal shape was associated with axial classification (p < 0.001). CONCLUSIONS: The NC anatomy is highly variable. Gender is related to the NC length and BBP width, while dental status is related to BBP length. There was an association between the different sagittal classifications of the NC and between the coronal shape and axial classification.

Sandwich osteotomy for vertical and transversal augmentation of the posterior mandible.

The aim of this study is to describe the treatment outcome after alveolar ridge augmentation in the atrophic posterior mandible by segmental sandwich osteotomy combined with an interpositional autograft prior to placement of endosseous implants. Thirteen consecutive patients (five males, mean age 48 years, and eight females, mean age 61 years) were included in this study. The postoperative course was uneventful in six patients. Sensory disturbances in the mental nerve were found in five patients, all of them with hypoaesthesia. None of these patients complained of permanent sensory disturbances. Vertical gain ranged from 2.0 to 7.8mm (mean value 4.61mm). Horizontal gain ranged from 2.0 to 6.3 (mean value 3.42mm). A total of 41 implants were placed in 22 surgical sites, 12 weeks after bone reconstruction. In conclusion, segmental mandibular sandwich osteotomy is recommended to meet the dimensional requirements of preimplant bone augmentation in atrophic posterior mandible.

Computer-assisted therapy in orbital and mid-facial reconstructions.

BACKGROUND: Management of orbital and mid-facial fractures requires a thorough ophthalmic evaluation and precise imaging. A principle goal of therapy is to anatomically reduce fracture segments and to restore a normal orbital volume as soon as possible. Diagnostic advances such as new surgical and imaging techniques have dramatically improved both the functional and aesthetic outcome of reconstructions. METHODS: Orbital reconstruction is performed using computer-assisted navigation. This technique makes preoperative simulation by mirroring the unaffected side onto the affected side. RESULTS: Results from computer-assisted navigation application to both primary and secondary orbital and mid-facial reconstruction are shown. CONCLUSION: Navigation technique it offers significant advantages in both primary and secondary reconstructions. Navigation facilitates reconstruction in unilateral defects through mirroring techniques, and in bilateral defects by importing virtual models from standard CT datasets improving the software tool to fulfil the need for maxillofacial surgery reconstruction.

Endoscopic assistance in the removal of a foreign body in the condylar process.

This case report describes the application of the endoscopic technique in the removal of a metallic foreign body in the condylar process in an 81-year-old man. The patient's history indicated 60 years of pain in the left preauricular region as well as complaints of localized headaches. Physical examination revealed multiple scars on the patient's left preauricular region. No limitation of mandibular movement and no joint clicking were detected. Maximal mouth opening was 45 mm. According to the patient, masticatory function was normal. Digital palpation of the temporomandibular joint did not produce pain. Radiographic diagnosis was performed, which showed a pointed metallic foreign body lodged in the left condylar process. The removal of the foreign body was performed under endoscopic visualization via an intraoral approach. A 30 degrees-angled 4-mm diameter endoscope (Karl Storz, Tuttlingen, Germany) with a xenon light source was used.

Arteriovenous malformation in the temporalis muscle.

An 18-year-old man presented with an arteriovenous malformation (AVM) in the temporalis muscle. It was shown by magnetic resonance imaging (MRI) and confirmed by intra-arterial angiography. The lesion was completely resected and the defect reconstructed with titanium mesh and cancellous bone.