French Dentists' knowledge, attitudes and practices toward oral cancer detection: A national survey.

BACKGROUND: France is ranked 6th in Europe in terms of oral cancer incidence. Dental surgeons are on the front line in examining the oral mucosa, but little is known about the knowledge, attitudes and practices of French dental surgeons with respect to lesions suspected of malignancy. METHODS: An online survey including 18 self-administered questions was widely shared on social media using major networks of French dentists. Items included socio-demographic characteristics of the respondents, their self-assessed knowledge, screening practices and training on oral cancer detection and care. RESULTS: A total of 676 dental surgeons participated in this survey. The vast majority, 92.8 %, were general dental surgeons, 83.9 % had a private practice and 49.1 % had less than 5 years of dental experience. Almost 55 % declared that they did not conduct systematic examinations of the oral mucosa and 45 % reported that they did conduct such examinations. In-hospital practice, lower patient age, dental surgeon experience, and specialty were all positively associated with systematic examination of the oral mucosa. Conversely, absence of a patient complaint, absence of an obvious lesion, lack of time, and lack of training/skills were all negatively associated. DISCUSSION: This is the first survey to analyze the practices of French dental surgeons in oral cancer screening. Only half of the respondents, the best trained, performed systematic oral mucosa examinations which objectively help to early detect mucosal cancer lesions. To improve oral cancer early detection, we recommend mandatory screening training programs for all dental students and dental surgeons.

Use of Patient-Specific Titanium Plates to Prevent Iatrogenic Mandibular Fracture During the Surgical Removal of Dentigerous Cysts: A Two-Case Series.

Dentigerous cysts, if left untreated, can grow significantly and weaken the mandible, posing risks of pathological or iatrogenic fracture. Treatment options may include decompression, marsupialization, and enucleation, which are available, with the choice being multifactorial and tailored to each case. This article describes the management of two complex dentigerous cysts at risk of fracture, one about an 84-year-old woman and the second about a 41-year-old man. The cysts and associated teeth were surgically removed, and simultaneously custom-made titanium osteosynthesis plates were placed to prevent per- and postoperative fracture risks. This approach appears to be indicated in cases where marsupialization or decompression is impossible and when there is a high risk of iatrogenic fracture.

Critères influençant le choix du premier poste après l'internat de chirurgie orale en France.

INTRODUCTION: The Specialized Diploma in Oral Surgery (Diplôme d’études spécialisées en chirurgie orale) was established in 2011. It gives its holders a unique combination of medical and surgical expertise. As a specialty, oral surgery can be pursued via both medical and dental pathways. However, the criteria guiding students’ choice of first job after residency remain largely unknown. PURPOSE OF THE RESEARCH: The primary objective was to evaluate the factors influencing students’ choice of first job after completing their oral surgery residency. RESULTS: The main geographical factors influencing job choice were the presence of family or friends, a short commute, and the location of the spouse’s place of work. Key practice conditions included access to advanced technical facilities and an operating theater offering general anesthesia. Clinical activities ranged from pre-implant grafts to general oral surgery. The likelihood of pursuing a hospital-based position in the same facility was correlated with the well-being experienced during the residency (p < 0.05) and with the oral surgeons’ medical background (p = 0.001). Significant associations exist between region of origin, internship location, and practice region (p < 0.001; p <0.001). CONCLUSIONS: The main factors influencing the choice of first position after oral surgery residency depend on family-related and technical criteria.

A Giant Posterior Maxillary Intra-Sinusal Complex Odontoma: A Clinical Case.

Odontomas are the most common odontogenic neoplasms. They are generally small and asymptomatic. This article presents an unusual case of a giant maxillary complex odontoma, which obscured a part of the maxillary antrum and impacted a tooth. This was discovered during an episode of maxillofacial cellulitis. In this case, surgical excision of the lesion was performed under general anesthesia, and the closure was performed with a fat pad pedicled flap. A brief review of the literature was performed to analyze the characteristics of this clinical entity and their implication in the treatment.

Chondroblastic Osteosarcoma of the Mandible in a Patient on Risedronate: A Rare Case of Neoadjuvant Chemotherapy Failure.

Osteosarcoma of the jaw only represents 0.5-1% of tumors of the facial mass. Due to its rarity, clinical diagnosis is thus difficult. The guidelines for this pathology remain unclear, and the need for neoadjuvant chemotherapy is still debated. This case report aims to describe a rare case of chondroblastic osteosarcoma in a 50-year-old woman on risedronate treated by neoadjuvant chemotherapy. The tumor extended from the mandibular left first premolar to the mandibular right canine. An excisional biopsy was performed, leading to a diagnosis of chondroblastic osteosarcoma. Neoadjuvant chemotherapy was ineffective, as it did not result in the shrinkage of the tumor. A pelvi-mandibulectomy with fibula free flap reconstruction of the mandible was subsequently successfully performed followed by radiotherapy.