CBCT vs panoramic radiography in assessment of impacted upper canine and root resorption of the adjacent teeth: A systematic review and meta-analysis.

Background: The IC may cause reabsorption of adjacent teeth; therefore detailed assessment of its position would enhance decision-making in the clinical workflow. The objective was to compare cone-beam computed tomography (CBCT) and panoramic radiography (PR) in assessing the position of the impacted upper canine (IC) and root resorption of adjacent teeth. Material and Methods: Pubmed, EMBASE, Science Direct, Web of Science, and SCOPUS databases were searched for studies published before August 2023. Studies that evaluated IC by using both imaging methods were included. For statistical analysis, the Comprehensive Meta-Analysis software (Biostat; Englewood, NJ) was used, p≤0.05. Results: A total of 17 articles were included, with 877 patients (average age of 17.6 years) and 1,115 ICs. The most frequent mesio-distal location of the IC was in sectors 3 and 4. The meta-analysis was performed with eleven studies. CBCT was more accurate in determining the labio-palatal position compared with PR (p<0.001) (CI 95%; 60% in labial position, 0.254-0.542, OR:0.398; 56% in palatal position, 0.350-0.533, OR:0.441; 78% in mid-alveolus position, 0.188-0.234, OR:0.221). For IC angulation to the midline, CBCT showing a smaller and more accurate angle than PR (p<0.001) (CI 95%, 18.008-33.686). IC angulation to the occlusal plane and lateral incisor, there was smaller angle in PR compared to CBCT (p<0.001) (CI 95%, 51.292-65.934; CI 95%, 30.011-55.954). With PR, fewer cases of root resorption of teeth adjacent to the IC were visualized compared with CBCT (86% less) (p<0.001) (CI 95%, 0.089-0.186; OR value: 0.138; n=1049). Conclusions: CBCT showed statistically significant differences compared to PR in the assessment of IC position and root resorption of adjacent teeth. CBCT provided clinically relevant information that may contribute to diagnosing and planning IC treatment when PR was not sufficient. Key words:Canine teeth, tooth, impacted, panoramic radiography, Cone-beam computed tomography, systematic review, meta-analysis.

Symptoms of oropharyngeal dysphagia, efficiency, and safety of swallowing in patients after treatment for head and neck cancer.

PURPOSE: The aim of this study is to investigate the relation between symptoms and signs of oropharyngeal dysphagia after treatment for head and neck cancer. METHODS: An observational analytical study with retrospective and prospective components was carried out including 25 adult and elderly patients with head and neck cancer who had completed the treatment at least 3 months before data collection. Data from the Eating Assessment Tool (EAT-10) protocol were analyzed, as well as from the videofluoroscopic swallowing exams. Based on videofluoroscopy, the degree of oropharyngeal dysphagia was classified, as well as the safety and efficiency grade using the DIGEST (Dynamic Imaging Grade of Swallowing Toxicity) scale. Pearson's correlation test was applied, adopting a significance level of 5%. RESULTS: There was a significant correlation between question 4 of the EAT-10 (swallowing solids takes extra effort) and the efficiency profile (p = 0.004), as well as between question 4 and the DIGEST score (p = 0.002). No significant relation was found between the DIGEST score and EAT-10 total score (p = 0.180) and not even between EAT-10 total score and efficiency (p = 0.129) or safety grade (p = 0.878). CONCLUSION: In conclusion, no relation was found between most of the dysphagia signs and symptoms investigated, demonstrating that the individual's perception of the swallowing function may not be consistent with the findings of the instrumental evaluation after long-term treatment for head and neck cancer.

Segmental resection vs. partial resection on treating solid multicystic ameloblastomas of the jaws - recurrence rates: A systematic review and meta-analysis.

Background: The aim of the present study was to compare the recurrence rates of solid multicystic ameloblastomas after segmental resection or marginal resection. Material and Methods: PubMed, ScienceDirect, Web of Science, Scopus, Embase were searched for studies published up to July 2022. The gray literature was also searched. Meta-analysis was performed using OpenMeta Software, p< 0.05 considered significant. Results: Among the search, 8 studies met all eligibility criteria. The group that underwent marginal resection was 1.1 times more likely to present recurrence of the lesion compared to the group that underwent segmental resection. There was no statistically significant difference between the two groups (segmental resection and marginal resection) in all eight studies regarding reducing ND (95% Confidence interval, 0.339 - 3.705; heterogeneity: Q value= 3.105; I2= 0%). Conclusions: The results showed that there was no statistically significant difference between segmental and marginal resection for the treatment of solid multicystic ameloblastomas; however, prospective studies with more rigorous methodological procedures are needed to better compare the surgical techniques. Key words:Ameloblastoma, solid multicystic ameloblastoma, treatment, recurrence.

Clinical-pathologic profile of head and neck rhabdomyosarcoma in children: a systematic review.

This systematic review aimed to analyze the clinicopathological profile and relevant prognostic factors of head and neck rhabdomyosarcoma in pediatric patients. The search was carried out in the electronic search portals PubMed, Lilacs, Embase, Scopus, and Web of Science. The search yielded studies that were then analyzed regarding study topic, data extraction, and risk of bias using the STROBE (Strengthening the Reporting of Observational Studies) guidelines. Finally, three studies were included for qualitative analysis. Most of the cases involved embryonic and alveolar rhabdomyosarcoma. Expression of MYOD1 was highly correlated with diagnosis of spindle cell/sclerosing rhabdomyosarcoma, which appears to have a poor prognosis in children. Furthermore, tumor size <5 cm and absence of metastasis accompanied by complete resection and administration of adjuvant therapies such as chemotherapy and radiotherapy favored a better prognosis.

Clinicopathological Analysis of Actinic Cheilitis: A Systematic Review with Meta-analyses.

BACKGROUND: This systematic review aimed to conduct a complete investigation of the demographic aspects, clinicopathological features, degrees of epithelial dysplasia, and malignant transformation rate of actinic cheilitis. METHODS: The study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in the International Prospective Register of Systematic Reviews (CRD42020201254). A search without year and language restrictions was performed using PubMed/MEDLINE, Embase, Virtual Health Library, Scopus, Web of Science, and gray literature. Studies that provided information on patients with actinic cheilitis were included, excluding those with general information on other diseases or other types of cheilitis. Risk of bias was explored using the Joanna Briggs Institute tool. Narrative and quantitative data syntheses were performed using meta-analyses and subgroup analyses. Association tests were also performed. RESULTS: Thirteen studies (728 patients) were included. The most prevalent clinical signs were dryness (99%), blurred demarcation between the lip vermilion and skin (82%), scaling (69%), and atrophy (69%). Regarding epithelial dysplasia, a prevalence of mild dysplasia (34.2%), followed by moderate (27.5%), and severe (14.9%). The malignant transformation rate was 14%. Crusts, ulcerations, and erythematous areas were associated with lip carcinoma (p < 0.001), and scaling was associated with actinic cheilitis (p < 0.001). CONCLUSIONS: This study revealed several features of actinic cheilitis, providing an overview of the disease. It is suggested that new studies help develop policy guides for the standardization of clinical criteria, enabling more rigorous and homogeneous analysis of actinic cheilitis.

Double mandible coronoid process: a very unusual feature.

PURPOSE: The double coronoid process (DCP) is a very unusual feature in patient. The literature, which briefly describes just only one case. Being this a very unusual feature, the aim of the paper is to describe the finding, discuss the anatomic, radiological, and clinical characteristics of a DCP. METHODS: A 61-year-old-woman with no significant medical history, extraoral and intraoral examination was unremarkable. Following panoramic radiography (PR) for assessment of periodontal support and pre-implant planning suspicious radiopaque area in the mandibular notch on the left side was observed. Cone-Beam Computed Tomography (CBCT) and Magnetic resonance imaging (MRI) were subsequently performed. RESULTS: No signs and symptoms of syndromes or medical records with a relevant contribution to the DCP existence and the patient denied any type of facial trauma. CBCT image showed the structure found on the PR was indeed a DCP and it was not superimposed on the mandibular notch area, MRI was performed to investigate soft tissue components and temporomandibular joint (TMJ) or other alterations. CONCLUSION: DPC is extremely rare with the only case reported in the literature within the same comparison parameters. In this case images revealed the muscles, articular surfaces and articular disc were well preserved, and no other alterations were found.

Prevalence of retromolar foramen in nineteenth century Spanish population.

Among the non-metrical variants of the mandible that have been proven to be a key issue for dental practitioners, the retromolar foramen constitutes one of the most controversial details regarding its prevalence and associated variables. Thus, this study evaluated the prevalence of the retromolar foramen and the variables associated with its presence in a large Spanish collection of human dry mandibles from the nineteenth century. Six hundred Spanish human dry mandibles (1200 sides) belonging to an osteology collection were examined. The presence of teeth, the presence or absence of retromolar foramen, as well as its side, diameter, number, and location were evaluated. Descriptive analysis and analysis of the associations between the variables were performed. The retromolar foramen was observed in 184 mandibles (31%) and was predominantly present unilaterally (60.8%). Most mandibles (54.9%) had a single foramen. The most common location was the retromolar trigone region (84%). On analysis of the association of variables, it was observed a strong association (p < 0.001) between the presence or absence of the foramen and the presence of teeth. Moreover, a significant association was also found between sex vs. presence of teeth (p = 0.033), sex vs. presentation side of the foramen (p = 0.028), sex vs. number of foramina found (p = 0.004), and diameter vs. number of foramina found (p < 0.001). This study reveals that the retromolar foramen showed a high prevalence of 31% in nineteenth century Spaniards and was located primarily in the retromolar trigone, suggesting that dentists should be aware of and consider the relevant findings of this study.

Occurrence of field cancerization in clinically normal oral mucosa: A systematic review and meta-analysis.

OBJECTIVE: The purpose was to describe whether there are field cancerization (FC) indicators in clinically normal mucosa opposite to primary oral squamous cell carcinoma (OSCC). METHODS: A search of the Cochrane Library, PubMed, Embase, Web of Science, Scopus, and Livivo databases was performed on June 12, 2022, which retrieved 152 records without duplicates. Studies that analyzed FC in biopsies in clinically normal tissue opposite to primary OSCC were included. The search was conducted under the PRISMA guideline and the protocol was registered in PROSPERO (CRD42017077125). RESULTS: Eight articles with 302 patients were included, 192 men and 110 women, mean age 57.1 years. Most patients had deleterious habits. All studies performed histopathological confirmation of OSCC and biopsies were obtained the clinically normal mirror mucosa. The meta-analysis carried out with eight studies. The studies showed 57.3 % of cases with histopathological changes of clinically normal mucosa opposite to primary OSCC (Confidence interval 95 %, 0.443-0.703; heterogeneity: Q value 18.715; I2 73.284 %; n = 205). p53 and Ki-67 immunohistochemical analysis may be predictive for detecting changes. There was p53 immunoexpression in 41.3 % of cases (p = 0.872) (n = 55), ki-67 immunoexpression (< 20 %) in 68 % (p = 0.001) (n = 97) and ki-67 immunoexpression (> 20 %) in 28.4 % of cases (p = 0.000) (n = 110). CONCLUSIONS: The findings suggest that FC can occur, and there are histopathological changes in clinically normal tissue opposite to primary OSCC. Nevertheless, the review showed that more longitudinal studies on FC are needed to draw a conclusive indication of the occurrence of FC in oral tissues opposite to OSCC.

Impact of the absence of dental support on cancer patients during COVID-19 pandemic: a cross-sectional study.

PURPOSE: This study identifies the impact of the absence of dental support for patients with cancer whose clinical dental care was interrupted by the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Individuals with oncologic diseases were selected from a telephone list of a Clinical Research Center (CRC) that specialized in the care of patients with cancer at the Bauru School of Dentistry, University of São Paulo (FOB/USP). The convenience sample comprised 280 patients (aged > 18 years) with a history of cancer that underwent dental treatment at the FOB/USP CRC in 2019 and did not receive care in 2020 owing to the pandemic. The participants completed a questionnaire sent via email or a text messaging application. Individuals receiving treatment or who were already treated for cancer were divided into two groups for data tabulation. Statistical analyses were performed using Fisher's and chi-square tests. RESULTS: Of the 280 patients, 104 answered the questionnaire, and 75 (72.1%) were women. Among the women, 45 (60.0%) were receiving antineoplastic treatment, and 30 (40.0%) had already been treated. Among the men, 15 (51.7%) were receiving antineoplastic treatment, and 14 (48.3%) had already been treated. Regarding oral problems that arose during the pandemic, dental pain when eating hot or cold food or drinks (57.0%), muscle pain (53.8%), and difficulties when chewing (51.0%) were the most common reported among patients. Furthermore, most individuals reported not having received any type of remote dental follow-up, before being contacted by our team, which could contribute to reducing these oral problems. CONCLUSION: It is impossible to say whether the absence of dental support in cancer patients during the coronavirus disease 2019 (COVID-19) pandemic had a negative impact on oral issue rates.

Radiotherapy changes the salivary proteome in head and neck cancer patients: evaluation before, during, and after treatment.

OBJECTIVES: Salivary glands are affected during radiotherapy in the head and neck region, leading to a reduction in salivary flow and changes its composition. Besides negatively affecting the oral soft tissues, this can also lead to dental impairment. Thus, we evaluated the effect of radiotherapy in the proteomic profile of the saliva in patients with head and neck cancer (HNC). MATERIALS AND METHODS: HNC patients had their saliva collected before (BRT), during (2-5 weeks; DRT), and after (3-4 months; ART) radiotherapy. Saliva was also collected from healthy volunteers (control; C). Samples were processed for proteomic analysis. RESULTS: In total, 1055 proteins were identified, among which 46 were common to all groups, while 86, 86, 286, and 395 were exclusively found in C, BRT, DRT, and ART, respectively. Remarkably, alpha-enolase was increased 35-fold DRT compared with BRT, while proline-rich proteins were decreased. ART there was a 16-fold increase in scaffold attachment factor-B1 and a 3-fold decrease in alpha-enolase and several cystatins. When compared with C, salivary proteins of BRT patients showed increases cystatin-C, lysozyme C, histatin-1, and proline-rich proteins CONCLUSION/CLINICAL REVELANCE: Both HNC and radiotherapy remarkably change the salivary protein composition. Altogether, our results, for the first time, suggest investigating alpha-enolase levels in saliva DRT in future studies as a possible biomarker and strategy to predict the efficiency of the treatment. Moreover, our data provide important insights for designing dental products that are more effective for these patients and contribute to a better understanding of the progressive changes in salivary proteins induced by radiotherapy. Graphical abstract.

Poor Oral Health Increases the Physical Pain, Psychological Discomfort and Social Incapacity of Individuals with Oncohaematological Diseases

ABSTRACT: The objective of this study was to evaluate the relationship between oral health status and its impact on quality of life, and to suggest dental management strategies in patients undergoing antineoplastic therapy for onco-hematological diseases. A retrospective study including 33 individuals (age 9-79 yr) was conducted. It was observed that the dimensions related to physical pain, psychological discomfort, and social incapacity had statistically significant values. The most frequently performed dental treatments were periodontal treatment (45.45 %), dental restoration (36.36 %), tooth extractio n (33.33 %), and endodontic treatment (24.24 %). Thus, poor oral health directly affects the quality of life. Dental management should consider the aspects of the disease and antineoplastic treatment while aiming for safe and effective dental care.

RESUMEN: El objetivo de este estudio fue evaluar la relación entre el estado de salud oral y su impacto en la calidad de vida, y sugerir estrategias de manejo odontológico en pacientes sometidos a terapia anti-neoplásica por enfermedades onco-hematológicas. Se realizó un estudio retrospectivo que incluyó a 33 personas (de 9 a 79 años de edad). Se observó que las dimensiones relacionadas con dolor físico, malestar psicológico e incapacidad social tuvieron valores estadísticamente significativos. Los tratamientos dentales realizados con mayor frecuencia fueron el tratamiento periodontal (45,45 %), la restauración dental (36,36 %), la extracción dentaria (33,33 %) y el tratamiento endodóntico (24,24 %). Así, la mala salud oral afecta directamente la calidad de vida. El tratamiento dental debe tener en cuenta los aspectos de la enfermedad y el tratamiento antineoplásico mientras se busca una atención dental segura y eficaz.

Diagnostic accuracy of CBCT compared to panoramic radiography in predicting IAN exposure: a systematic review and meta-analysis.

OBJECTIVES: The aim of this study is to verify whether the diagnostic accuracy of cone beam computed tomography (CBCT) is superior to panoramic radiography (PR) in predicting inferior alveolar nerve (IAN) exposure during the lower third molar extraction. MATERIALS AND METHODS: Eight electronic databases were searched up to September 2020. Studies that evaluated the accuracy (sensitivity, specificity, positive-predictive value, and negative predictive value) of both imaging methods were included. The gold standard was the visualization of the IAN exposure during the extraction of lower third molars. The gray literature was also used to include any other paper that might meet the eligibility criteria. The meta-analysis was performed with OpenMeta-Analyst and ReviewManager v.5.3 software. The methodology of the studies was evaluated using QUADAS-2. RESULTS: Among the search, three studies met all the eligibility criteria and were included in the qualitative and quantitative synthesis. The meta-analysis was conducted with all included studies. Accuracy values for CBCT were 95.1% for sensitivity (p=0.666) and 64.4% for specificity (p<0.001). For PR sensitivity and specificity, we observed 73.9% (p=0.101) and 24.8% (p<0.001), respectively. CONCLUSIONS: Both exams were reliable for detecting positive cases of exposure of the IAN. However, CBCT had a better performance compared to PT in predicting IAN exposure during surgery. CLINICAL RELEVANCE: To better understand the CBCT accuracy in predicting the IAN exposure during surgery, since this event can increase the likelihood of IAN injury and, consequently, cause neurosensory disturbances.

Cone-beam computed tomography artifacts in the presence of dental implants and associated factors: an integrative review.

PURPOSE: This study was conducted to review the literature regarding the types of cone-beam computed tomography (CBCT) artifacts around dental implants and the factors that influence their formation. MATERIALS AND METHODS: A search strategy was carried out in the PubMed, Embase, and Scopus databases to identify published between 2010 and 2020, and 9 studies were selected. The implants included 306 titanium, titanium-zirconium, and zirconia implants, as well as 5 titanium cylinders. RESULTS: The artifacts around the implants were the beam-hardening artifact, the streaking artifact, and band-like radiolucent areas. Some factors that influenced the formation of artifacts were the implant material, bone type, evaluated regions, distance, type of CBCT, field of view (FOV) size, milliamperage, peak kilovoltage (kVp), and voxel size. The beam-hardening artifact was the most widely reported, and it was minimized in protocols with a smaller FOV, larger voxels, and higher kVp. CONCLUSION: The risk and benefit of these protocols in individuals with dental implants must be considered, and clinical examinations and complementary radiographs play an essential role in implantology.

Prevalence of retromolar canal and its association with mandibular molars: study in CBCT.

OBJECTIVE: Investigate the presence and characteristics of the retromolar canal and association with mandibular molars using cone-beam computed tomography (CBCT). STUDY DESIGN: CBCT images of 200 consecutive patients were analyzed using the Anatomage Invivo 5® software. Retromolar canal present evaluated the type of trajectory, buccal or lingual location, uni or bilateral, origin and final diameters. Pearson's Chi square test was used to verify the association between the retromolar canal and the presence of the third molar (p ≤ 0.05). RESULTS: The prevalence of the retromolar canal was 24.5%. The oblique trajectory was the most common (33.3% on the right side and 50% on the left side). Buccal location was the most frequent (right side 50% and left side 70%). The unilateral canal was the most frequent (77.6%). As for the caliber, the diameters vary from 1.12 to 2.37 mm. Regarding the association between the retromolar canal and the third molar, there was no statistically significant difference (right side p = 0.60 and left side p = 0.90). CONCLUSION: The retromolar canal is not a rare anatomical variation showing a prevalence of 24.5%. Surgical procedures should consider the presence of the retromolar canal to avoid excessive bleeding, considering its significant caliber.

Is there difference in the comparative and quantitative salivary proteome between stimulated and unstimulated saliva in head and neck cancer patients treated by radiotherapy?

Stimulation of saliva production is an alternative to improve the quality of life of patients treated by radiotherapy. However, there is no information about changes in the salivary proteome of stimulated and unstimulated saliva in these patients. OBJECTIVES: Thus, we evaluated the difference in the proteomic profile of stimulated and unstimulated saliva in patients with head and neck cancer (HNC) treated by radiotherapy. METHODS: Stimulated and unstimulated saliva were collected from 9 patients with HNC before (BRT), during (DRT; 2-5 weeks) and after (ART; 3-4 months) treatment. Healthy patients paired by age and gender also had their saliva collected (C; control group). The stimulated and unstimulated salivary flow were evaluated (p < 0.05). Salivary proteins were extracted and processed for shotgun proteomic analysis. RESULTS: Significant differences were observed between stimulated and unstimulated salivary flows for C and BRT (p greater than 0.001), but not for DRT and ART. Proteins involved with apoptosis, antibacterial and acid-resistance were decreased in stimulated saliva in comparison to unstimulated saliva DRT and ART. Isoforms of keratins were not identified in control and BRT. CONCLUSION: there is a marked difference in the protein profile of stimulated and unstimulated salivary flows in HNC patients treated by radiotherapy. In addition, saliva stimulation in patients with HNC decreases important proteins involved with dental protection. The unstimulated salivary flow seems to be the best alternative to search for biomarkers. Our results contribute in an unprecedented way to understand the changes in the salivary proteome of different flows in HNC patients undergoing radiotherapy treatment.

Bilateral jaws involvement of Burkitt's lymphoma in a pediatric patient.

A case of Burkitt's lymphoma with bilateral jaws involvement in a 5-year-old boy is reported discussing the dentist's role in the diagnosis and management of this disease. The initial clinical diagnosis established of maxillary swelling causing trismus was a dentoalveolar abscess. The incisional biopsy was performed and histopathological analysis, including immunohistochemistry, confirmed the Burkitt's lymphoma. The patient underwent treatment and remains free of the disease for 36 months of follow-up. The occurrence of intraoral bilateral jaws involvement of Burkitt's lymphoma in child is unusual and its accurate diagnosis avoids complications in the patient's treatment. Key words:Burkitt's lymphoma, Non-Hodgkin's lymphoma, Oral cavity, Maxilla, Child.

Radiotherapy changes acquired enamel pellicle proteome in head and neck cancer patients.

OBJECTIVES: To evaluate in vivo the proteomic profile of the acquired enamel pellicle (AEP) in patients with head and neck cancer (HNC) before, during and after radiotherapy. METHODS: Nine patients, after prophylaxis, had their AEPs collected before (BRT), during (DRT; 2-5 weeks) and after (ART; 3-4 months) radiotherapy. AEP was also collected from nine healthy patients (Control). The proteins were extracted in biological triplicate and processed by label-free proteomics. RESULTS: Statherin was increased more than 9-fold and several hemoglobin subunits were increased more than 5-fold DRT compared to BRT, while lactotransferrin, proline-rich proteins, cystatins, neutrophil defensins 1 and 3 and histatin-1 were decreased. ART, there was an increase in lactotransferrin and several isoforms of histones, while statherin and alpha-amylase proteins were decreased. MOAP-1 was exclusively found ART in comparison to BRT. When compared to Control, AEP of patients BRT showed an increase in proteins related to the perception of bitter taste, mucin-7 and alpha-amylases, while cystatin-S was decreased. CONCLUSIONS: HNC and radiotherapy remarkably altered the proteome of the AEP. Antibacterial and acid-resistant proteins were decreased during radiotherapy. CLINICAL SIGNIFICANCE: Our results provide important information for designing more effective dental products for these patients, in addition to contributing to a better understanding of the differential protective roles of the AEP proteins during radiotherapy. Moreover, some proteins identified in the AEP after radiotherapy may serve as prognostic markers for survival of HNC patients.

Cleft lip and palate cause large variations in size and location of the posterior superior alveolar canal.

OBJECTIVE: The aim of this study was to evaluate the posterior superior alveolar canal (PSAC) in patients with cleft lip and palate (CLP) as compared to patients with no cleft lip and palate (NC) using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This was a retrospective multicenter study based on two steps: (1) evaluating intra- and inter-calibration and (2) detecting the presence or absence of PSAC and its location, diameter, and anastomosis with anterior superior alveolar canal. RESULTS: A total of 300 patients were selected for the study, out of which 150 were categorized as CLP (75 men, 75 women; mean age: 29.8 years) and 150 were categorized as NC (75 men, 75 women; mean age: 40.3 years). PSAC in patients with CLP and NC was visible in 100% of the cases, in men and women, bilaterally. PSAC location in CLP was middle and upper third of the maxillary sinus as compared to NC (lower third) (chi-squared < 0.001). PSAC mean diameter in CLP was 1.12 mm. It was larger compared to 0.6 mm in NC (t-test < 0.0001). CONCLUSION: PSAC location in patients with CLP was predominantly in the middle and upper third of the maxillary sinus, compared with NC. PSAC mean diameter in CLP was 1.12 mm. It was larger compared to that of 0.6 mm in NC. CLINICAL RELEVANCE: These anatomical variations in CLP are important and should be acknowledged by surgeons for the following reasons: (1) to perform pre-surgical planning, (2) to avoid bleeding, and (3) to avoid neurosensory alterations.

A case-control study of oral diseases and quality of life in individuals with rheumatoid arthritis and systemic lupus erythematosus.

OBJECTIVE: To evaluate the impact of oral alterations on the quality of life (QoL) of individuals with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). METHODS: A case-control study in 32 individuals with RA, 28 with SLE, and 29 in the control group (CG). The questionnaire SF-36 (Medical Outcomes Study Short-Form 36) was used to evaluate the health-related quality of life (HRQoL), and OHIP-14 (Oral Health Impact Profile-14) was used to evaluate the oral health-related quality of life (OHRQoL). The severity of xerostomia was evaluated by the Xerostomia Inventory (XI). In the clinical examination, decayed (D-T), missing(M-T), and filled teeth (F-T) (DMF-T), periodontal status, plaque index (PI), gingival index (GI), unstimulated whole salivary flow rate (UWSFR), and stimulated whole salivary flow rate (SWSFR) were also assessed. Data were analyzed by Student's t tests, chi-square test, Kruskal-Wallis test, ANOVA, Pearson's correlation, and Spearman's correlation. RESULTS: Individuals with RA had a higher caries index (D-T/p = 0.004) and more frequent periodontal disease (PI/p = 0.017). In the SLE group, there was a significant lower salivary flow (SFR/p = 0.016, SFMS/p = 0.004) and severe xerostomia (p = 0.002). The impact of ORHQoL in individuals with RA occurred due to oral candidiasis, halitosis, and xerostomia, compromising the HRQoL. Overall, OHRQoL and HRQoL were more compromised in individuals with SLE, with xerostomia being the main oral problem. CONCLUSION: Individuals with RA and SLE present oral diseases with negative impact on their QoL. CLINICAL RELEVANCE: This study shows the main oral manifestations in rheumatic autoimmune diseases, with mainly xerostomia compromising the quality of life.