The value of a specialized second-opinion pathological diagnosis for oral and maxillofacial lesions.

OBJECTIVES: An error in the diagnosis of an oral or maxillofacial lesion could potentially be detrimental to a patient's prognosis and management. Major discrepancies between the initial and subsequent diagnoses of head and neck pathologies range from 7 to 53%. This study determined the rate of discrepancies found in the diagnoses of oral and maxillofacial lesions after a second opinion in Saudi Arabia. METHODS: A retrospective single-center study was conducted by oral and maxillofacial pathology consultants to review all cases referred for a second opinion to the oral and maxillofacial pathology laboratory between January 2015 and December 2020. If the second-opinion diagnosis matched the original diagnosis, this was described as "agreement." If the second-opinion diagnosis did not match the original diagnosis but would not change the management or prognosis of a patient, this was classified as a "minor disagreement." If the second-opinion diagnosis resulted in the changing of a patient's management or prognosis, this was categorized as a "major disagreement." Chi-square test and Fisher's exact test were used to compare data between original and second-opinion diagnoses. A p-value of less than 0.05 was considered significant. RESULTS: Of 138 cases, 59 (43%) had an initial diagnosis and a second-opinion diagnosis that were in major disagreement. The most common tumor for which there was a major disagreement was squamous cell carcinoma. No single factor influenced the occurrence of major disagreements. CONCLUSIONS: Our evaluation reiterates the importance of obtaining a second opinion from a specialist in oral and maxillofacial pathology to improve the diagnostic accuracy for lesions. A formal system for this step, in addition to the obtaining of adequate clinical and radiographic information about a patient, is mandatory for the review of difficult cases.

Assessing the Knowledge of HPV-Associated Oropharyngeal Squamous Cell Carcinoma, HPV Vaccination, and Practice Scope among Saudi Dental Students in the Western Region.

(1) Background: Human papillomavirus (HPV) infection is significantly associated with oropharyngeal squamous cell carcinoma (HPV-OPSCC), which is one of the fastest-growing cancer incidences globally. Dental practitioners play a crucial role in the primary and secondary prevention of HPV-OPSCC. There is little known about dental students' awareness regarding HPV-OPSCC and HPV vaccination, as well as their intention to promote 'primordial prevention' among their patients. HPV vaccine, and the extent of their professional responsibilities. (2) Methods: This cross-sectional study was conducted in the western region of Saudi Arabia and involved undergraduate dental students (n = 688) from six public and private dental schools. Participants were requested to complete a sequential-section anonymous online survey, with 257 successfully completing all sections of the questionnaire. The association between participant characteristics and HPV-OPSCC, HPV vaccination awareness ratings, and perceived engagement in prevention were analyzed using ANOVA and chi-squared testing. A binary logistic regression analysis was conducted to examine the variables linked to these outcomes. (3) Results: Generally, the overall level of awareness of HPV-OPSCC and HPV vaccination was acceptable, with an average score of 53.44 ± 29.3 out of 100. However, a significant knowledge gap was observed, with 53% of respondents being unaware of the common sites for HPV-OPSCC and 63.8% being uninformed of the appropriate age for HPV vaccination. Females and those with a prior history of sexually transmitted diseases (STDs) had considerably higher levels of HPV vaccination knowledge (p < 0.05). The participants showed a favorable attitude towards their responsibility of informing patients about HPV-OPSCC and advocating HPV immunization. (4) Conclusions: This study underscores the need to enhance dental students' understanding of HPV-OPSCC and HPV immunization, enabling them to effectively engage in primary and secondary preventative efforts against HPV-OPSCC.

Oral Nodular Fasciitis: A Case Report in an Uncommon Location and Review of the Literature.

Nodular fasciitis (NF) is a benign, self-limiting condition that is often misdiagnosed due to its resemblance to other lesions. Although NF is common, its occurrence in the oral cavity is rare and particularly challenging for both clinicians and pathologists. To date, no case has been reported in the retromolar area of the oral cavity. A 49-year-old male patient presented with a painless, rapidly growing, firm nodule in the right retromolar area. Histopathological examination revealed spindle cell proliferation with characteristics of NF and immunohistochemical analysis confirmed the diagnosis. The lesion was treated by conservative surgical excision, without recurrence at a one-year follow-up. In the current case, 54 cases of oral nodular fasciitis (ONF) have been documented. The majority of ONF-affected individuals are in their 40s, with a 1:1 male-to-female ratio. The buccal mucosa was the most commonly involved site followed by the tongue and labial mucosa. Histopathologically, the most prominent features were the proliferation of uniform spindle-shaped cells within a myxomatous and/or fibrotic background. A positive smooth muscle actin (SMA) stain was a consistent finding. Complete local excision remains the preferred treatment method, and no recurrences have been reported. This report underscores the importance of considering NF in the differential diagnosis of oral spindle cell lesions and emphasizes the need for a comprehensive evaluation to guide appropriate management.

Digital technologies in dentistry in Saudi Arabia: Perceptions, practices and challenges.

Background: The aim of this study was to assess practicing dentists' characteristics and professional aspects that influence users to adopt Digital Technologies in Dentistry (DTD) in Saudi Arabia (SA). Moreover, we aimed to identify dentists' perceived barriers and challenges and to anticipate future potential developments towards implementing DTDs in their practices in SA. Methods: This analytical cross-sectional study based on a validated questionnaire was conducted using a snowball sampling technique to include a conveniently selected sample of dentists from all dental specialties currently working in SA. Results: The response rate was 64% completed and returned. A statistically significantly large share of Gen X (10.1%) used digital technologies (DTs) in dental practice compared with non-digital users. 40% received sufficient postgraduate education on DT, 92% agreed that DT should be included in the undergraduate dental curriculum. However, 79% actually gained skills or knowledge on DT through workshops and formal courses. 'Lack of practitioners' awareness', 'lack of education and pioneers' and 'lack of clinical evidence' were highlighted as the foremost barriers. Lower-frequency DT users believed that treating patients with DT makes treatment more predictable. Together, clinical trials and hands-on training courses can help overcome the barriers to the adoption of new dental technologies. Conclusions: Exploring technology adoption and usage amongst practicing dentists allows healthcare stakeholders and policymakers to set a clear direction towards the digitalisation of the healthcare system and within healthcare organisations. The study also highlighted the foremost barriers, challenges and actions towards the adoption of DTDs.

Forecasting Head and Neck Cancer Trends in GCC Countries: Implications for Public Health Policy and Strategy.

Purpose: The data available on the incidence and mortality rates of head and neck cancer types (HNCs) in the Gulf Cooperation Council countries (GCC) have relied on global trends and covered only certain cancer sites, types or certain age groups. This study aimed to assess the incidence and mortality rates of head and neck cancer (HNCs) within the Gulf Cooperation Council (GCC) countries, providing insights into their geographic variability in 2020. Methods: Prediction of the magnitude of the disease to 2040 was explored based on demographic projections. Estimates of incidence and mortality and the population projections were extracted from the Global Cancer Observatory (GLOBOCAN) database and the United Nations Department of Economic and Social Affairs respectively for the time frame 2020 to 2040. Additionally, we analyzed the distribution of cases and deaths by age and sex for both time periods. Results: The analysis indicates varying patterns in HNC rates across GCC countries in 2020, with Oman and Saudi Arabia carrying the highest burden. Projections for 2040 reveal a substantial increase in new HNC cases and related deaths, particularly in Qatar, UAE, and Bahrain. Furthermore, incidence rates are predicted to rise significantly for individuals aged 50 and older, while remaining relatively stable for those under 50. With regards to sex, males generally exhibit higher rates, except in Qatar. Conclusion: HNC burden is anticipated to rise significantly in the GCC, with variations per age, sex and geographical location. By 2040, a 2-3-fold increase in HNCs in the GCC is anticipated, emphasizing the need for focused public health strategies to address this rising health challenge.

Oral Manifestations of COVID-19: A Cross-Sectional Study of Their Prevalence and Association with Disease Severity.

BACKGROUND: COVID-19, caused by SARS-CoV-2, has impacted the world in an unprecedented way since December 2019. SARS-CoV-2 was found in the saliva of patients, and entry points for the virus may have been through the numerous angiotensin-converting enzyme 2 receptors in the oral cavity. Oral manifestations of COVID-19 could contribute to the burden of oral disease. OBJECTIVE: To determine the prevalence of oral manifestations of COVID-19 in patients and their association with disease severity. METHODS: Interviews were conducted with adult participants diagnosed with COVID-19 between October 2021 and March 2022 to document their demographic and health status data, symptoms, and the presence of oral manifestations of COVID-19. Chi-square and the Fisher's exact test were used to compare data on the presence or absence of oral manifestations of COVID-19. RESULTS: Of 195 participants interviewed, 33% were 18 to 24 years old, 33% were 25 to 34 years old, and 75% were female. A total of 57 (29%) had oral manifestations; the most common were taste disorders (60%), xerostomia (42%), and oral ulcers (11%). There was no relationship between the severity of COVID-19 and the presence of the oral manifestations. CONCLUSION: Oral manifestations of COVID-19 were common among female patients and linked to certain general COVID-19 symptoms regarding frequency and extent.

Trend Analysis of Head and Neck Neoplasms between 2012-2018 in Patients Residing in Al-Madinah, Saudi Arabia: A Retrospective Study.

OBJECTIVES: This study sought to present a view of head and neck neoplasms (HNN) prevalence with specific focus on sociodemographic determinants in Al-Madinah Province, Saudi Arabia. MATERIALS AND METHODS: This was a hospital-based retrospective study based on retrieval of histopathological data for a period of 6 years between 2012 and 2018. Data was collected from the archives of the Oral and Maxillofacial Pathology Laboratory at King Fahad Hospital (the only referral center for biopsy services) in Al-Madinah City. STATISTICAL ANALYSIS: An independent t-test and/or nonparametric (Mann-Whitney U test, chi-squared test) tests were used to determine the differences between groups. Statistical significance was set at the p-value < 0.05. RESULTS: Out of 96 patients, a total of 58 patients had valid biopsy data with preoperative diagnosis. Over three quarters of the cases (n = 44) were benign with only 24% were malignant. Males were more likely to be diagnosed with a benign tumor than females (54.5 vs. 45.6%, respectively), and malignancy was also more common in males (64.3 vs. 24.1). A significant difference was found in relation to mean age of older patients who were more likely to be diagnosed with malignant tumors (p = 0.001). CONCLUSIONS: The findings suggest that most of biopsied HNN cases are benign neoplasms. Age is a significant risk factor for head and neck malignancy in this region. Delays in diagnosis of HNN need to be explored.