A support vector machine-based algorithm to identify bisphosphonate-related osteonecrosis throughout the mandibular bone by using cone beam computerized tomography images.

OBJECTIVE: This study aimed to develop an algorithm to distinguish the patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ) from healthy controls using CBCT images by evaluating both trabecular and cortical bone changes through the whole body of the mandibular bone. METHODS: Patient data set was created from axial CBCT images of 7 BRONJ patients (28 slices) and 8 healthy controls (27 slices). The healthy bone of healthy controls, bone sclerosis of BRONJ patients, bone necrosis of BRONJ patients, and normal appearing bone of BRONJ patients (NBP) were labeled on CBCT images by three maxillofacial radiologists. Proposed algorithm had preparation and background cancellation, mandibular bone segmentation and centerline determination, spatial transformation of gray values, and classification steps. RESULTS: Significant differences between the statistical moments (mean, variance, skewness, kurtosis, standard error, median, mode and coefficient of variance) of healthy and diseased (bone sclerosis and necrosis) groups were observed (p = 0.000, p < 0.05). Also, variations were noted between healthy controls and NBP of BRONJ patients (p = 0.000, p < 0.05).The statistical moments were utilized to develop the algorithm which has resulted with accuracy of 0.999, sensitivity of 0.998, specificity of 0.998, precision of 1, recall of 0.998, AUC of 1, and F1 score of 0.999 in identification of BRONJ patients from healthy ones. CONCLUSION: The proposed algorithm differentiated the mandibular bones of the healthy and the BRONJ patients with high accuracy in the present test sample.

Adjunctive methods and devices for clinical detection of oral squamous cell carcinoma.

Oral squamous cell carcinoma (OSCC) is the most prevalent cancer of the head and neck with over 500,000 new cases every year worldwide. The stage of disease at diagnosis is associated with the 5-year survival rate. Unfortunately, approximately two-thirds of patients are diagnosed with advanced disease with local and regional or distant spread. Earlier detection of OSCC may be improved with the development of adjunctive techniques for clinical detection and diagnosis, which is expected to enhance the prognosis of the disease. This narrative review aims to provide an overview of adjuncts that are available for clinical use to assist in improving detection of potentially malignant epithelial lesions and early-stage OSCC.

Impact of Buccotherm® on xerostomia: a single blind study.

OBJECTIVE: The purpose of this single blind study was to investigate effects of Buccotherm® spray on subjective symptoms of xerostomia patients. METHODS: Twenty patients with dry mouth complaint were instructed to use placebo six times a day for 2 weeks. After a wash period, mineral water spray was provided. Patients were asked to reply questions regarding dry mouth using visual analog scale (VAS). Baseline and subsequent subjective findings on 1 hour after the application of the materials at the end of 1st, 7th, and 14th days were recorded. RESULTS: At the end of 14-day treatment, no statistically significant differences were observed between the efficacy of placebo and commercial mineral water dental spray (p > 0.05). The VAS scores revealed that difficulty in mastication (p = 0.006), difficulty in swallowing (p = 0.00), need to sip liquids while eating (p = 0.000), difficulty in speech (p = 0.003), and waking up at night to sip water (p = 0.005) were statistically lower for placebo than commercial mineral water spray. CONCLUSION: The commercial mineral water dental spray was not more efficient than placebo in the management of dry mouth-related symptoms. CLINICAL RELEVANCE: This study emphasizes the fundamental role of saliva in oral health and evaluates the clinical utility of a commercial dental spray.

Dental students' knowledge of characteristics and management of oral complications of cancer therapy.

OBJECTIVE: The aim of this study is to investigate the level of Turkish senior dental students' knowledge regarding the orodental complications and their treatment methods of cancer patients. STUDY DESIGN: A 15-item questionnaire which was obtained from National Institute of Dental and Craniofacial Research that contained information about the orodental complications of the cancer therapy and the dentists' role to provide their treatment protocols was used. Seventy-seven senior dental students answered the questionnaire and the replies were analyzed with stratified and logistic data analyses. RESULTS: Overall, correct replies ranged from 5.2 to 98.7 %. The students knew the basic knowledge of the complications of cancer therapy; however, they failed to answer to the questions (ranging between 1.3 and 94.8 %) about the required clinical practices. The respondents preferred not to answer the questions about the prophylactic measures dentist shall take during a precancer treatment oral evaluation (9.1 %), management of pain in cancer treatment (6.5 %), and necessary considerations before a dental procedure in a chemotherapy patient (3.9 %). The multiple logistic regression analysis revealed that gender had no statistically significant effect on the correct or false answers to the questions (p > 0.05). CONCLUSION: Our results disclosed that dental students' knowledge about oral complications of cancer therapy and the modalities to manage these complications vary. Reevaluation of current undergraduate curricula and continuing education for graduates might address the gaps identified and an educational program about oral and dental management of patients who are to receive/receiving/have received cancer therapy can be prepared and augmented into dental curriculum.

In vitro antimicrobial effects of commercially available mouth-wetting agents.

Products have been developed to provide palliation for persons with dry mouth. In addition to mouth-wetting agents, some products incorporate antimicrobial constituents with the goal of improving oral microbial defenses. The aim of this in vitro study was to investigate the potential antimicrobial and antifungal effects of two commercially available saliva substitutes on Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans by using the agar-well diffusion method. Antimicrobial activity as measured by the size of the inhibition zone growth for S. mutans and L. acidophilus was observed only with Biotene Dry Mouth Oral Rinse® and BioXtra® gel. The zone of inhibition of Biotene Dry Mouth Oral Rinse was larger than that of BioXtra gel (p= 0.00, p < 0.01). No anticandidal effect was seen with any of the test products. The pH of the preparations, the variations between the amount of active ingredients within the products, and the potential antimicrobial effects of inactive ingredients should be investigated to determine the factors that impacted microbial inhibition.

Effects of hydroxychloroquine on salivary flow rates and oral complaints of Sjögren patients: a prospective sample study.

OBJECTIVE: The objective of this study was to evaluate whether hydroxychloroquine (HCQ) therapy effects subjective and/or objective complaints and salivary flow rates of patients with primary Sjögren's syndrome (PSS). STUDY DESIGN: Thirty women recently diagnosed with PSS, scheduled for HCQ treatment (400 mg daily), participated and were clinically examined before initiation of 30 weeks of HCQ treatment. During baseline evaluation, both the objective and/or subjective oral findings were recorded. Unstimulated (uSFR) and stimulated salivary flow rates (sSFR) were determined. After initiation of HCQ treatment, study parameters were assessed at 6, 12, 18, 24, and 30 weeks. Each patient served as her own control; measurements of the baseline and control times were analyzed by ANOVA. RESULTS: uSFR values increased significantly with HCQ treatment, but sSFR values, objective and/or subjective complaints did not change considerably. CONCLUSION: A positive impact of 30 weeks of HCQ treatment only on uSFRs of SS patients was revealed.

The efficacy of Xialine in patients with Sjögren's syndrome: a single-blind, cross-over study.

Sjögren syndrome (SS) is a chronic inflammatory autoimmune disease of unknown cause whose main characteristic is severe dryness of the eyes and the mouth. The decreased functional capacity of the lacrimal and salivary glands which is the result of the inflammatory process and lymphocytic infiltration observed in SS is accountable for this complication. Twenty-nine patients with SS whose ages were ranging between 24-77, who were under treatment in Ege University Faculty of Medicine Department of Rheumatology, participated in the study, and their informed consents were obtained upon enrollment. Each patient recorded their subjective complaints on a separate questionnaire. The baseline and subsequent evaluation of the subjective findings on predetermined times (1 h after application of the material, at the end of the 1st, 7th, and 14th days) were also recorded on separate questionnaire sheets. Throughout the 14-day treatment period, no statistically significant differences were noted between the Xialine and placebo groups with regard to burning tongue, diminished taste, and waking up at night to sip water (p = 0.925, 0.527, and 0.066, respectively). However, patients' satisfaction with placebo decreased by 25.63% at the end of the test period, whereas it increased by 16.37% after Xialine administration. Overall, the patients preferred Xialine at the end of the study (p = 0.011). The main motive to administer saliva substitute is to improve lubrication and hydration of oral tissues. The results of this study indicated that Xialine is helpful in the management of xerostomia-related symptoms of SS patients. However, further investigations in larger scale group of patients are recommended to provide the effects of these agents on various complaints of xerostomia.

Primary oral cancer in a Turkish population sample: association with sociodemographic features, smoking, alcohol, diet and dentition.

The aim of this multicentre case-control study was to investigate the association of a variety of factors with oral cancer in a group of Turkish patients. Questionnaires were used to investigate the sociodemographic features, smoking and alcohol consumptions, dietary habits and dental status of 79 primary oral cancer patients and 61 controls. Data were statistically analysed with Mann-Whitney U-test, Pearson Chi-square and binary logistic regression analyses to determine the odds ratios. Low level of education, gender, dietary habits, having poor oral hygiene and denture sores were associated with primary oral cancer in this patient sample; but eating salads and raw vegetables, fish, and drinking red wine were related with healthy status. Determination of the factors associated with oral cancer and of the high-risk groups would be beneficial to provide efficient screening protocols and prevention programmes for oral cavity cancers.