Comparative clinicopathological study of the main anatomic locations of oral squamous cell carcinoma.

OBJECTIVE: To analyze the clinicopathological and evolutionary profile of the main locations of oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: This is a retrospective study on 133 patients treated for OSCC. The group was composed of 48 women and 85 men, with a mean age 63.9 ± 12.73 years. Most cases involved the lingual border of tongue (63), followed by the gingiva (36) and the floor of mouth (34). A comparative analysis was performed using multinomial regression. RESULTS: There were significant differences regarding age, sex, tobacco and alcohol consumption, liver pathology, oral potentially malignant disorders, and bone and perineural invasion. In multivariate regression, tobacco consumption, and bone invasion remained significant. There were no significant differences in relation to prognosis. CONCLUSION: The location of OSCC is an important factor in the clinicopathological assessment of this neoplasm. The main locations of OSCC show differential etiopathogenic and clinicopathological aspects. Tobacco consumption has a great relevance in the floor of mouth; nonetheless, it is less important in the tongue border and the gum, which suggests other pathogenic factors. It is necessary to consider the anatomical location of OSCC in preventive protocols, with the aim of reducing its high mortality.

Epidemiological, clinical, and prognostic analysis of oral squamous cell carcinoma diagnosed and treated in a single hospital in Galicia (Spain): a retrospective study with 5-year follow-up / Análisis epidemiológico, clínico y pronóstico del carcinoma oral de células escamosas diagnosticado y tratado en un único hospital de Galicia (España): un estudio retrospectivo con un seguimiento de 5 años

Background: Oral cancer is a common neoplasm worldwide, mostly corresponding to squamous cell carcinoma(OSCC). Unfortunately, its overall prognosis remains poor, with no improvement in recent decades. In this study,we have analysed the epidemiological, clinical, and prognostic characteristics of OSCC on patients of a specificSpanish region (Galicia), in order to improve its prognosis and apply effective preventive and early diagnosismeasures.Material and Methods: We retrospectively analysed 243 cases of OSCC, diagnosed and treated in a single hospitalcentre in Galicia between 2010 and 2015 (minimum of 5 years of evolution). Overall and specific survival werecalculated (Kaplan-Meier) and associated variables were identified (log rank test and Cox regression).Results: The mean age of the patients was 67 years, with the majority being male (69.5%), smokers (45.9%) andalcohol consumers (58.6%), who lived in non-urban areas (79.4%). Cases diagnosed at advanced stages entailedthe 48.1% of the sample, and 38.7% of cases relapsed. The 5-year overall and disease-specific survival rates were39.9% and 46.1%, respectively. Patients who consumed tobacco and alcohol had a worse prognosis. OSCC casesreferred to hospital by specialist dentists had a better prognosis, as those who were previously diagnosed with anoral potentially malignant oral disorder (OPMD) or received dental care during OSCC treatmen. Conclusions: In view of these findings, we conclude that OSCC in Galicia (Spain) still has a very poor overall prog-nosis, which is mainly related to the advanced age of the patients and the late diagnosis. Our study highlights thebetter survival of OSCC in relation to the referring health professional, the presence of a previous OPMD and thedental care after diagnosis. This demonstrates the importance of dentistry as a health profession involved in the earlydiagnosis and multidisciplinary management of this malignant neoplasm.(AU)

Assessing Facilitator Fidelity to Principles of Public Deliberation: Tutorial.

Public deliberation, or deliberative democracy, is a method used to elicit informed perspectives and justifiable solutions to ethically fraught or contentious issues that affect multiple stakeholder groups with conflicting interests. Deliberative events bring together stakeholders (deliberants) who are provided with empirical evidence on the central issue or concern and then asked to discuss the evidence, consider the issue from a societal perspective, and collectively work toward a justifiable resolution. There is increasing interest in this method, which warrants clear guidance for evaluating the quality of its use in research. Most of the existing literature on measuring deliberation quality emphasizes the quality of deliberants' inputs (eg, engagement and evidence of compromise) during deliberative sessions. Fewer researchers have framed quality in terms of facilitator inputs, and these researchers tend to examine inputs that are consistent with generic group processes. The theory, process, and purpose of public deliberation, however, are distinct from those of focus groups or other group-based discussions and warrant a mechanism for measuring quality in terms of facilitator fidelity to the principles and processes of deliberative democracy. In our public deliberation on ethical conflicts in minor consent for biomedical HIV prevention research, we assessed facilitator fidelity to these principles and processes because we believe that such assessments serve as a component of a comprehensive evaluation of overall deliberation quality. We examined verbatim facilitator remarks in the deliberation transcripts and determined whether they aligned with the 6 principles of public deliberation: equal participation, respect for the opinions of others, adoption of a societal perspective, reasoned justification of ideas, expression of diverse opinions, and compromise or movement toward consensus. In this tutorial, we describe the development of a blueprint to guide researchers in assessing facilitator fidelity, share 3 templates that will assist them in the task, and describe the results of our assessment of facilitator fidelity in 1 of the 4 sites in which we conducted deliberations.

Bleeding during tooth extraction in patients with chronic kidney disease: A cross-sectional pilot study.

OBJECTIVE: This work measures the intra-operative bleeding in end-stage renal disease patients and assesses whether laboratory coagulation tests and nitrogenous compounds are related to a higher bleeding risk. METHODS: Laboratory tests were performed on the day of surgery and some patients with thrombocytopenia and values above the normal levels of international normalised ratio (INR), thrombin time (TT) and activated partial thromboplastin time (aPTT) were identified. RESULTS: Haemostatic time ranged from 2 to 35 min (mean of 8.51 min) after suture. Bleeding volume ranged from 0.02 to 67.06 mL (mean of 4.38 mL) and the bleeding volume per minute ranged from 0.05 to 2.10 mL/min (median of 0.6 mL/min). Only seven patients (16.27%) had abnormal bleeding (more than 0.6 mL/min). Spearman's coefficient showed weak correlations between bleeding volume (mL/min) and serum urea (r = 0.226), TT (r = 0.227), plasma urea (r = 0.148) and creatinine (r = 146), as well as very weak correlations with all other variables (r < 0.140) such as age, haemodialysis time, glycaemia, glycated haemoglobin, platelets, INR, aPTT and fibrinogen. CONCLUSION: It was not possible to associate any laboratory test or nitrogenous compounds present in the blood and saliva with an increased bleeding.

Identification of Proteomic Biomarkers in Proliferative Verrucous Leukoplakia through Liquid Chromatography With Tandem Mass Spectrometry.

Proliferative verrucous leukoplakia (PVL) is an oral potentially malignant disorder associated with high risk of malignant transformation. Currently, there is no treatment available, and restrictive follow-up of patients is crucial for a better prognosis. Oral leukoplakia (OL) shares some clinical and microscopic features with PVL but exhibits different clinical manifestations and a lower rate of malignant transformation. This study aimed to investigate the proteomic profile of PVL in tissue and saliva samples to identify potential diagnostic biomarkers with therapeutic implications. Tissue and saliva samples obtained from patients with PVL were compared with those from patients with oral OL and controls. Label-free liquid chromatography with tandem mass spectrometry was employed, followed by qualitative and quantitative analyses, to identify differentially expressed proteins. Potential biomarkers were identified and further validated using immunohistochemistry. Staining intensity scan analyses were performed on tissue samples from patients with PVL, patients with OL, and controls from Brazil, Spain, and Finland. The study revealed differences in the immune system, cell cycle, DNA regulation, apoptosis pathways, and the whole proteome of PVL samples. In addition, liquid chromatography with tandem mass spectrometry analyses showed that calreticulin (CALR), receptor of activated protein C kinase 1 (RACK1), and 14-3-3 Tau-protein (YWHAQ) were highly expressed in PVL samples. Immunohistochemistry validation confirmed increased CARL expression in PVL compared with OL. Conversely, RACK1 and YWHA were highly expressed in oral potentially malignant disorder compared to the control group. Furthermore, significant differences in CALR and RACK1 expression were observed in the OL group when comparing samples with and without oral epithelial dysplasia, unlike the PVL. This research provides insights into the molecular mechanisms underlying these conditions and highlights potential targets for future diagnostic and therapeutic approaches.

Gait Function after High-Intensity Focused Ultrasound Thalamotomy for Essential Tremor: Searching for Technique Optimization.

INTRODUCTION: Essential tremor (ET) is one of the most prevalent movement disorders in adults and may be highly disabling for some. Magnetic resonance image-guided high-intensity focused ultrasound (MRIgFUS) has been shown to control tremor efficaciously and with acceptable risk. To date, paresthesia and ataxia are the most common adverse effects (AE). Nevertheless, the impact of MRIgFUS thalamotomy on balance is not well established. METHODS: Thirty-two patients underwent MRIgFUS for ET and completed 6 months of follow-up. Tremor severity and functional disability were assessed using the Essential Tremor Rating Scale and the Quality of Life in Essential Tremor Questionnaire. The Berg Balance Scale (BBS) was applied to objectively measure balance status. RESULTS: All treatments were successful. The sonication target was 1-2 mm above the depth of the intercommissural line. Procedures lasted less the 2 h, with an average of 8 sonications per patient. Twenty-four patients were included in the tremor analysis. The hand tremor score was improved by 76% after 6 months of follow-up and 87% of patients self-reported marked improvement (≥75%). Disability scores showed marked improvement (78%), leading to a significant improvement in quality of life. At the final follow-up, 48% of the patients reported no side effects. When present, AE were generally transient and were considered mild in 96% of affected patients. Paresthesia and subjective feeling of unsteadiness were the most common persistent complaints (23% and 20%, respectively). Regarding objective ataxia, BBS scores remained stable throughout follow-up for most patients. Only 2 patients suffered a mild worsening of balance although no patients experienced moderate or severe ataxia. CONCLUSIONS: Subjective feeling of unsteadiness is one of the most frequent AE after MRIgFUS, although objective ataxia is infrequent and mild. Selecting the most appropriate lesion location and procedural parameters should increase treatment benefits while reducing side effects.

Role of thyroid hormones in burning mouth syndrome. Systematic review

Background: Burning mouth syndrome is an idiopathic condition characterized by burning pain in a normal-appearing oral mucosa lasting at least four to six months. In the case of secondary burning mouth syndrome is associated with local or systemic factors (such as thyroid disorders) that can cause these symptoms. The aim of this review was to study the relationship between thyroid disorders and burning mouth syndrome.Material and methods: The present study followed the PRISMA guidelines. An electronic search strategy was developed for PubMed/Medline, Scopus and Cochrane. The following combination of keywords and Boolean operators were used: Thyroid AND burning mouth; Thyroid AND burning mouth syndrome; Hypothyroidism AND burning mouth; Hypothyroidism AND burning mouth syndrome; Hyperthyroidism AND burning mouth; Hyperthyroidism AND burning mouth syndrome. The results were processed by existing free software in https://www.graphpad.com/. To evaluate the association of the categorical variables we used the Fisher test at a level of significance of p-value ≤ 0,05. As a primary summary measure the Odds Ratio (OR) has been used. To analyze the risk of bias the guidelines of the GRADE guide were used and the grade of evidence was analyzed by the guide of Joanna Briggs Institute: Levels of Evidence and Grades of Recommendations.Results: After applying the inclusion and exclusion criteria, 5 studies were selected for review. The Chi-square was 10.92 and the Odds Ratio was 3.31 with respect to TSH values with p <0.0001 (Fisher's test). The population of patients with TSH alterations is increased in 80.49% and decreased in 19.51%.Conclusions: It can be concluded that thyroid hormone abnormalities are a factor in secondary burning mouth syndrome; specially in patients with hypothyroidism. (AU)

Drug use, risk perceptions and attitudes towards drug use amongst medical and dentistry students.

AIMS: To analyse the use of psychoactive substances and the risk perceptions amongst odontology and medical students. To study their perceptions, attitudes and knowledge, and to evaluate their motivation when helping their patients to stop using these substances. METHODS: A cross-sectional study was conducted amongst 962 students in Spain, using validated questionnaires on an anonymous basis. RESULTS: Amongst these students, drug use varies and increases with age as assessed by the DAST and CAST tests, with more problematic use being observed as the academic cycle progresses (p < .001). Participants in the 2nd cycle presented higher consumption than those in the 1st cycle, in the univariate model (OR = 1.77, IC 95% 1.27-2.48, p = .001) and in the adjusted model (OR = 1.86, IC 95% 1.32-2.62, p < .001). Regarding CAST, non-problematic use in the 1st cycle versus the 3rd cycle presented an OR = 8.69 (IC 95% 4.50-16.78, p < .001) and for low risk use it presented an OR = 15.18 (IC 95% 1.83-14.68). Only 46.7% considered using marijuana on a regular basis as a high risk, whilst 60.5% stated that smoking a pack of cigarettes represents a high risk. Alcohol was the substance for which the risk perception was lowest. 66.2% are in the maintenance stage "I provide my regular drug-using patients help to give up," with women being more likely to be in this stage (p = .012). CONCLUSIONS: High risk of drug use increases after the 1st cycle in Dentistry and in Medicine. Training programmes should be implemented in both degrees, focusing on the 1st years in order to simultaneously prevent drug use amongst students.

Importance of the vaporization margin during CO2 laser treatment of oral leukoplakia: A survival study.

OBJECTIVES: The main purpose of this study was to assess the response of oral leukoplakia to CO2 laser vaporization treatment, as well as determining possible factors that may affect recurrence of lesions. MATERIALS AND METHODS: A retrospective study was conducted, in which the medical records of patients who had been clinically and histologically diagnosed with oral leukoplakia and treated with CO2 laser between 1996 and 2019 at the Oral Medicine Teaching Unit of the Faculty of Dentistry of the University of Santiago de Compostela were reviewed. RESULTS: Fifty-eight patients were included: 36 female and 22 male subjects, with a mean age of 63.7 years old (SD ±13.1). The average follow-up time was 57.5 months (SD ±57.9). A relapse rate of 52.6% was determined. Of all the studied variables, the margin was the only one for which a statistically significant association with recurrence of lesions was demonstrated (p < 0.05). CONCLUSION: The vaporization of lesions using CO2 laser with a safety margin of at least 3 mm from the clinical limits of OL is a key factor in preventing recurrence.

Effectiveness of the SMART Sex Ed program among 13-18 year old English and Spanish speaking adolescent men who have sex with men.

Adolescent men who have sex with men (AMSM) have a high HIV incidence and low utilization of testing and prevention services. However, very few HIV prevention programs exist that focus on the unique sexual health needs of AMSM. SMART is a stepped care package of eHealth interventions that comprehensively address the sexual and HIV prevention needs of AMSM. This study examines the impact of the first step of SMART, "SMART Sex Ed," on 13- to 18-year-old AMSM (n = 983) from baseline to three-month follow-up across 18 separate outcomes measuring HIV prevention attitudes, skills, and behaviors. We observed significant change from baseline to three-month post-intervention in nine HIV-related outcomes (e.g., receipt of HIV and STI test, HIV knowledge), as well as largely consistent effects across demographic subgroups (e.g., race, age, rural, low SES). Analyses observed no effects on condom use behaviors. SMART Sex Ed shows promise as an effective sexual health education program for diverse AMSM.

RESUMEN: Los adolescentes hombres que tienen sexo con otros hombres (AHSH) experimentan alta incidencia del VIH y baja utilización de servicios de prueba y prevención. Sin embargo, existen muy pocos programas de prevención del VIH enfocados en las necesidades particulares para la salud sexual de AHSH. SMART es un paquete de intervenciones de cuidado escalonado que usa plataformas electrónicas (eHealth) y que atiende de forma integrada las necesidades de salud sexual y prevención del VIH de AHSH. Este estudio examina el impacto de la primera etapa de SMART, llamada "SMART Sex Ed", entre AHSH (n = 983) entre las edades de 13 a 18 años e integra datos desde el reclutamiento con seguimiento cada 3 meses. Se recopilaron datos de 18 indicadores de actitudes, destrezas y prácticas de prevención del VIH (Ej. Historial de pruebas de VIH o ITS; conocimiento sobre VIH), así como los efectos en diferentes grupos demográficos (Ej. Raza, edad, área rural, y bajo nivel socioeconómico). Los análisis realizados demuestran que las características demográficas no tienen efecto en las prácticas de uso de condón. SMART Sex Ed es una intervención prometedora para educación sexual efectiva para AHSH.

Photobiomodulation in dental implant stability and post-surgical healing and inflammation. A randomised double-blind study.

BACKGROUND: The aim of this randomized clinical trial was to evaluate the effect of diode laser photobiomodulation (PBM) on post-surgical healing, inflammation and implant stability. METHODS: Forty dental implants were inserted into 13 patients. The implants were randomly divided into two groups. The test group (PBM+) underwent two sessions of PBM (combined diode laser of 630 and 808 nm), the first of which after surgery, and the second, 7 days after the surgical procedure. The control group (PBM-) received simulated laser treatment. The implant stability quotient (ISQ) was determined immediately after the surgical procedure, and 7 days, 4 and 8 weeks later. Post-surgical inflammation was assessed following the criteria described by Bloemen and Cols. Healing was calculated using the healing index (HI). RESULTS: No differences were found in terms of the mean values of implant stability between the test and control groups over time. Only two of the implants (18.2%) from the PBM- group were classified with the maximum healing index (HI = 5), whereas in the PBM+ group, nine implants (45%) were classified with the aforementioned index (P < 0.0001). Using the logistic regression, it was determined that the non-application of the laser in the PBM- group caused an OR of 4.333 times of presenting inflammation (IC95% 1.150-16.323; P = 0.030). CONCLUSIONS: The application of 808 nm infra-red laser for bone tissue, and 630 nm for mucosal tissue in two sessions is considered to be an effective way of reducing inflammation and improving early healing. More studies are needed to confirm these results.

Xerostomia, the perception of general and oral health and health risk behaviours in people over 65 years of age.

BACKGROUND: This study investigated the association between xerostomia and health risk behaviours, general and oral health and quality of life. METHODS: A cross-sectional study involving 800 adults over 65 years of age residing in Spain using a computer-assisted telephone questionnaire. The severity of xerostomia was assessed through the Xerostomia Inventory (XI). Both univariate and adjusted multinomial logistic regression were used to determine the risk (OR) of xerostomia. RESULTS: The sample comprised of 492 females (61.5%) and 308 males, with a mean age of 73.7 ± 5.8 years. Some, 30.7% had xerostomia: 25.6% mild, 4.8% moderate and 0.3% severe, the majority being female (34.8% vs 24%; p = 0.003). The mean XI was 24.6 ± 6.3 (95% CI 19.2-24.8) for those with poor health, whereas it was 17.4 ± 6.3 (95%CI 16.1-18.6) in those reporting very good health (p < 0.001). This difference was also observed in terms of oral health, with the XI mean recorded as 14.7 ± 10.7 for very poor oral health and 6.4 ± 5.4 for those with very good health (p = 0.002). Logistic regression showed that the highest OR for xerostomia was observed among adults with poor general health (2.81; 95%CI 1.8-4.3; p < 0.001) and for adjusted model the OR was still significant (2.18; 95%CI 1.4-3.4; p = 0.001). Those who needed help with household chores had 2.16 higher OR (95%CI 1.4-3.4; p = 0.001) and 1.69 (95%CI 1.1-2.7; p = 0.03) in the adjusted model. Females had a higher risk of suffering from xerostomia than males. CONCLUSION: The strong association between xerostomia and the general and oral health status of older adults justifies the need for early assessment and regular follow-up.

DNA Methylation by Bisulfite Next-Generation Sequencing for MLH1 and MGMT in Oral Squamous Cell Carcinomas and Potentially Malignant Disorders: An Integrative Analysis towards Field Cancerization.

Background and Objectives: MGMT methylation is a well-described biomarker in several solid tumors and MLH1 seems to occur in the initial stages of oral carcinogenesis. The aims of this study were to evaluate MHL1 and MGMT methylation levels in oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs), and to integrate this information with The Cancer Genome Atlas (TCGA) database. Materials and Methods: To determine the percentage of gene methylation in MLH1 and MGMT, pyrosequencing analysis was conducted. Samples were divided as follows: (1) patients diagnosed with OSCC (N = 16); (2) patients with OPDM who developed OSCC in the same location (N = 47); and (3) patients with OPDM who developed OSCC in a different location (N = 22). As a validation cohort in this study, data from The Cancer Genomic Atlas (TCGA) database, particularly regarding Head and Neck Squamous Cell Carcinoma, was used. Results: Overall MLH1 methylation levels of 8.6 ± 11.5% and 8.1 ± 9.2% for MGMT were obtained. With regard to MHL1, the OSCC presented the highest degree of methylation with 9.3 ± 7.3% (95%CI 5.1-13.6), and with regards to MGMT, the simultaneous malignancy group presented the highest degree of methylation with 10 ± 13.5% (95%CI 6-10), although no significant differences were found between the groups (p = 0.934 and p = 0.515, respectively). The estimated survival was higher for MGMT methylated cases (19.1 months, 95%CI 19.1-19.1) than for unmethylated cases (9.4 months, 95%CI 6-12.8), but not statistically significant. Conclusions: Our results did not show a correlation between MGMT and MLH1 methylation and any clinicopathological feature or survival in our institutional cohort. MLH1 methylation was present mainly in OSCC, whilst MGMT in OPMD represented a modest contribution to field cancerization, with an overall consistency with the TCGA database.

Lichenoid areas may arise in early stages of proliferative verrucous leukoplakia: A long-term study of 34 patients.

BACKGROUND: Proliferative verrucous leukoplakia is considered an uncommon oral potentially malignant disorder with a high malignant transformation rate. The objective of this paper was to define its cancer incidence and related risk factors. METHODS: A retrospective audit of 34 patients diagnosed with proliferative verrucous leukoplakia from a university-based unit, during the period from 1995 to 2019 was performed. The mean number of visits was 23 ± 18.6. The follow-up was divided into four-time intervals to evaluate the clinical presentation, number of lesions, dysplasia grade, and malignant transformation rate. RESULTS: The majority of patients were females 29 (85.3%), with verrucous component (77.8%), with a gingival presentation (31.8%), and with a preceding lichenoid area (44.1%). Eleven patients (32.4%) were affected by oral cancer during the follow-up, developing a total of 15 carcinomas. The mean age of malignant transformation was 67.2 ± 12.9 years, particularly 8 ± 8.5 from the onset of the lesions. Warty forms presented a higher mean estimate for malignant transformation (15.2 years, 95% confidence interval 4.4-26 years) than nodular forms (1.9 years, 95% confidence interval 1.9-1.9) (p = 0.019). Patients with an initial proliferative verrucous leukoplakia diagnosis suffered a higher risk of malignancy, particularly 15.55 times (95% confidence interval 1.69-143.17; p = 0.015) than those who did present a preceding area with lichenoid morphology. CONCLUSION: Proliferative verrucous leukoplakia presented a high malignant transformation rate and sometimes displayed preceding oral lichenoid areas in early stages. Further studies are needed to understand the impact of these lichenoid areas in proliferative verrucous leukoplakia progression.

Chronic Kidney Disease After Liver Transplantation.

Improved survival after liver transplantation has led to an aging cohort of recipients at risk of renal dysfunction. The etiology of renal dysfunction is typically multifactorial; calcineurin inhibitors nephrotoxicity, pretransplant renal dysfunction, and perioperative acute kidney injury are important risk factors. Metabolic complications such as hypertension, diabetes mellitus, and metabolic-associated fatty liver disease also contribute to the development of renal disease. Most LT recipients will eventually develop some degree of renal dysfunction. Criteria to select candidates for simultaneous liver and kidney transplantation have been established. Both delayed introduction of CNIs and renal-sparing immunosuppressive regimens may reduce progression of renal dysfunction.

Critical update, systematic review, and meta-analysis of oral erythroplakia as an oral potentially malignant disorder.

BACKGROUND: Oral erythroplakia has been classically considered as the potentially malignant disorder with the highest rate of malignant development into squamous cell carcinoma. This critical systematic review and meta-analysis aim to estimate the malignant development rate of oral erythroplakia and identify the associated risk factors. METHODS: We performed a bibliographic search in PubMed, Scopus, Web of Science, Embase, and LILACS, with keywords "erythroplakia," "erythroplasia," "malignant transformation," "malignant development," "malignization," "carcinogenesis," "oral cancer," "oral squamous cell carcinoma," "mouth neoplasm," and "prognosis." Meta-analysis was conducted using a random-effects model. RESULTS: Ten observational studies with 441 patients met the inclusion criteria, whose mean malignant development rate was 12.7% and with a mean follow-up period of patients of 6.66 years. In the initial biopsy, 42.8% of oral erythroplakia were already squamous cell carcinoma. The buccal mucosa was the most frequent location of oral erythroplakia, but the floor of the mouth was the most common site of malignant development. All patients who underwent malignant development showed epithelial dysplasia on the initial diagnostic biopsy. CONCLUSION: Overall malignant development rate of OE in the meta-analysis was 19.9%. We could not associate any specific clinicopathological feature with the malignant development. The presence of epithelial dysplasia in the initial biopsy remains the worst prognostic factor. Further observational studies on OE are needed, with well-established diagnostic criteria and good clinical follow-up, in order to identify the true risk of malignant development of oral erythroplakia and the related risk factors.

Influence of loading and drilling on marginal bone loss around implants with a Dynamic Bone Management design: A single-blind, randomised, 12-month clinical trial.

PURPOSE: To evaluate marginal bone loss 6 and 12 months after prosthetic loading of implants with Dynamic Bone Management (Straumann, Basel, Switzerland) through the implementation of different drilling protocols. MATERIALS AND METHODS: A balanced, randomised, single-blind clinical trial was conducted with four parallel experimental arms: immediate loading and under-drilling, immediate loading and complete drilling, early loading and under-drilling, and early loading and complete drilling. Forty-four implants with a Dynamic Bone Management design and with a diameter of 3.75 mm and a length of 10.00 mm were placed in healed mature bone (more than 6 months post-extraction). RESULTS: The mean primary stability achieved was 60.6 ± 12.2 implant stability quotient, with a range from 21 to 75, and no differences were observed when considering the drilling protocol used, bone type or location. Early loading resulted in a loss of 0.728 mm (standard error 0.212; 95% confidence interval 1.134 to -0.325; t value -3.440), whereas immediate loading did not result in any bone loss. When the interaction between the loading and drilling protocols was studied, performing the complete drilling protocol in conjunction with early implant loading was found to result in lower marginal bone loss, with a marginal bone gain effect of 0.814 mm (standard error 0.283; 95% confidence interval -0.274 to 1.353; t value 2.880). CONCLUSIONS: Use of the complete drilling protocol in conjunction with early implant loading resulted in the lowest marginal bone loss at 12 months.

Efficacy of photobiomodulation in reducing pain and improving the quality of life in patients with idiopathic burning mouth syndrome. A systematic review and meta-analysis.

Burning mouth syndrome is a chronic condition, which is characterised by a burning sensation or pain in the mucosa of the oral cavity. Treatment options include antidepressants, antipsychotics, anticonvulsants, analgesics, hormone replacement therapies and more recently photobiomodulation. This study aims to perform a systematic review with meta-analysis in order to determine the effect of photobiomodulation on pain relief and the oral health-related quality of life associated with this condition. A bibliographical search of the Pubmed, Embase, Web of Science and Scopus databases was conducted. Only randomised clinical trials were included. Pain and quality of life were calculated as mean difference and pooled at different treatment points (baseline = T0 and final time point = Tf) and laser modality. From a total of 103 records, 7 articles were retrieved for inclusion. PBM group had a greater decrease in pain than control group at Tf with a mean difference = - 2.536 (IC 95% - 3.662 to - 1.410; I2 = 85.33%, p < 0.001). An improvement in oral health-related quality of life was observed in both groups, although this was more significant in the photobiomodulation group mean difference = - 5.148 (IC 95% - 8.576 to - 1.719; I2 = 84.91%, p = 0.003). For the red laser, a greater improvement than infrared was observed, in pain, mean difference = - 2.498 (IC 95% - 3.942 to - 1.053; I2 = 79.93%, p < 0.001), and in quality of life, mean difference = - 8.144 (IC 95% - 12.082 to - 4.206; I2 = 64.22%, p = 0.027). Photobiomodulation, in particular, red laser protocols, resulted in improvement in pain and in quality of life of burning mouth syndrome patients.

Counselling toward reducing alcohol use, knowledge about its morbidity and personal consumption among students of medical and dental courses in north-western Spain

Background: Alcohol use disorder (AUD) is directly linked to high-risk consumption. Healthcare students have a crucial role to play in its prevention and management. The aim of this study is to analyse alcohol consumption, as well as to consider the knowledge and attitudes regarding morbidity, and the stage of change when providing assistance to quit AUD. Material and Methods: A cross-sectional study was conducted among Dentistry and Medical students using specific and validated questionnaires in an anonymous and voluntary way. Initially, 925 students were invited to participate, of them 500 were reached. Results: Among them 85.9% suffered from AUD of whom 75% were women (p<0.001), and it was considered that the female gender constituted an independent risk factor (OR=2.63, CI 95% 1.55-4.45, p<0.001). The majority of the participants did not achieve the pass mark, nonetheless, the results showed improved levels of knowledge among participants in the latter years of their studies (p<0.001). Dental students demonstrated greater shortcomings in terms of their knowledge of general pathology, whereas the medical students’ knowledge of oral pathologies proved worse (p<0.001). Most of students believed that identifying cases of AUD-affected patients falls within their competence, nonetheless, they believed that they do not have the necessary competencies. Among participants 58.2% were in a stage of change regarding AUD attitudes. Conclusions: The majority of respondents presented AUD. In general, the participants’ knowledge about alcohol was low. Reviewing the syllabuses and evaluating the implementation of gender-differentiated training programmes in both degrees would be considered necessary.(AU)

Malignant development of proliferative verrucous/multifocal leukoplakia: A critical systematic review, meta-analysis and proposal of diagnostic criteria.

BACKGROUND: Proliferative verrucous/multifocal leukoplakia (PVML) is an oral potentially malignant disorder (OPMD) that exhibits high rates of malignant development (MD). This study aimed to analyse the risk of MD of PVML, as well as to investigate the possible risk factors associated with its malignization. METHODS: A bibliographical search of the PubMed, Embase, Web of Science, and Scopus databases was conducted. PVML MD rates were calculated as a pooled proportion, and the risk factors were calculated as risk ratios, using fixed and random models based on the presence of heterogeneity. RESULTS: From a total of 417 records, 16 articles were retrieved for inclusion. The subgroup analysis revealed a higher MD rate in the studies that were conducted in America, and, likewise, said studies involved a longer follow-up time (>6 years). There was a non-significant lower risk of malignization among males. A negative correlation was observed between MD and the year in which the studies were published. CONCLUSIONS: The pooled MD of PVML was 65.8% (95% CI: 55.3-76.2, p < 0.001). Prospective studies of PVML must be designed using simple and universal clinical diagnostic criteria to be able to make an early diagnosis of this important OPMD and acknowledge the frequency of MD.