Virtual learning object about oral ulcerative lesions: controlled educational intervention study

The aim of this study was to develop a virtual learning object (VLO) to teach undergraduate dental students about the diagnostic and therapeutic approaches to oral ulcerative lesions. The VLO was developed with information on the diagnostic process, lesion classification, and clinical-surgical management of oral ulcerative lesions. The VLO content was initially validated by a group of specialists. Learning was evaluated in a sample of 58 undergraduate dental students, divided into control group (conventional theoretical class, n = 29) and intervention group (interaction with VLO, n = 29). All students answered a pre-test and post-test questionnaire. The VLO group also answered a specific questionnaire on the evaluation of the VLO. Both quantitative and qualitative descriptive analyses were performed. The validation showed that professors and students considered the VLO adequate. The use of the VLO was recommended by 100% of professors and 86.6% of students. In the intervention group, the results showed a significantly higher number of correct answers in the post-test (p < 0.01). In conclusion, the VLO proved to be a useful tool for teaching oral medicine, contributing significantly to the knowledge of ulcerated lesions in the mouth.

Prognostic factors from squamous cell carcinoma of the hard palate, gingiva and upper alveolar ridge

The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell carcinoma (OSCC) of the hard palate, upper gingiva, and alveolar ridge (HPUGAR). This retrospective cohort study collected data of patients treated in two head and neck surgery departments in southern Brazil between 1999 and 2021. Information on clinicodemographic data, habits, site, size, clinical aspect, clinical staging, cervical metastasis, treatment, and survival was collected. Associations between independent variables and outcomes were assessed using Pearson's chi-square test and binary regression. Kaplan-Meier test was employed to compare the survival between the neck approaches. Forty-one patients were included; most were male (61%), with a mean age of 68.8 (± 13.9) years. The consumption of tobacco (p = 0.003) and alcohol (p = 0.02) was significantly higher in male than in female patients. The main clinical features observed in the study sample were lesions larger than 2 cm (48.7%), no cervical (90.2%), or distant metastasis (90.2%). Surgery alone was the main treatment approach (48.8%). The watch-and-wait strategy was adopted in 34 cases (83.0%), while elective neck dissection was applied in five (12.2%). Only two patients with cN0 disease (4.9%) presented with cervical metastasis at follow-up. Eight patients (12.2%) died of the disease. Clinicodemographic variables, habits, surgical margins, and histological subtype were not significantly associated with cervical metastasis or survival. Cervical metastasis (p = 0.004) was associated with poor survival. No difference was detected in survival between different neck approaches (p = 0.28). Cervical metastasis and local recurrence are negative prognostic factors for HPUGAR OSCC.

Analysis of factors that influence quality of life of individuals undergoing treatment for mandibular fractures: A systematic review and meta-analysis

OBJECTIVE

To address the factors that affect the quality of life (QoL) of individuals undergoing treatment for mandibular fractures.

STUDY DESIGN

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the search strategy was constructed according to the Populations, Interventions, Comparison, Outcomes, and Study Design principle in the following databases: PubMed, Web of Science, Scopus, and EMBASE. Risk of bias assessment was performed with Risk Of Bias In Non-randomized Studies of Interventions and Cochrane Risk of Bias tool for randomized trials 2.

RESULTS

Nineteen studies were included: 15 observational and 4 clinical trials. Mean age ranged from 28 to 39 years, with a higher proportion of males. The condyle was the main fracture location and traffic accident was the fracture cause. Treatment approaches were mostly open reduction (89.4%) and maxillomandibular fixation (63%). QoL measurements varied considerably with the General Oral Health Assessment Index (31.5%) and Oral Health Impact Profile-14 (21%) as the main instruments. Meta-analysis showed that open reduction and maxillomandibular fixation did not present significant differences to QoL (P = .39), but significant differences were observed with time (P < .00001). Other factors affected QoL, such as mental health, pain, socializing, appearance, and eating difficulties.

CONCLUSIONS

Several factors, apart from the treatment approach, mentioned in this review seemed to affect the QoL of patients with mandibular trauma. Treatment choice should be based on well-stablished clinical criteria and on all other factors mentioned here.

Effects of osteoporosis on alveolar bone repair after tooth extraction: A systematic review of preclinical studies

OBJECTIVE

This systematic review aimed to address whether the alveolar socket repair after a tooth extraction is impacted by an osteoporotic phenotype and propose methodological observations.

DESIGN

A search strategy in MEDLINE/PubMed, EMBASE, Web of Science, and Scopus databases was performed. Quality assessment was carried out through the SYRCLE Risk of Bias tool.

RESULTS

Out of the 1147 potentially relevant records, 25 met the inclusion criteria. Most of the studies were performed in rats, and ovariectomy (OVX) was the most frequent osteoporosis induction method. Histomorphometry, micro-computed tomography (microCT), and immunohistochemistry were the main bone repair evaluation methods. Most of the included studies (88 %) presented negative impacts of osteoporosis on the alveolar socket repair. Only three studies (12 %) showed no statistical differences among groups. Overall, most of the quality assessment categories presented a high percentage of unclear risk of bias due to insufficient information in the studies.

CONCLUSIONS

The results indicated that an osteoporotic phenotype seems to impair alveolar socket repair after tooth extraction. However, there is still a lack of information and standardization. Therefore, further studies should consider the proposed methodological aspects regarding animal characteristics, OVX associated with a low calcium diet, waiting 8 weeks to osteoporosis induction, maxillary molars as the best option for tooth extraction, confirming and reporting OVX and osteoporosis success, and an appropriate method of repair analysis.

Impact of crack cocaine use on the occurrence of oral lesions and micronuclei

The aim of this study was to investigate the occurrence of oral lesions and micronuclei in crack cocaine users. A cross-sectional study was conducted involving 106 crack users and 106 non-users matched for age, sex, and tobacco use. Socio-demographic characteristics, the consumption of psychoactive substances, and the occurrence of fundamental lesions were investigated. Cellular changes in the oral mucosa (karyolysis, karyorrhexis, 'broken egg' events, and micronuclei) were determined by exfoliative cytology for 54 participants in each group. Crack users had a greater occurrence of fundamental lesions (P=0.001). Furthermore, they had higher mean occurrences of micronuclei (17.25 vs. 3.80), karyolysis (12.39 vs. 9.46), and karyorrhexis (30.39 vs. 10.11) (number per 1000 cells) than non-users (all P<0.05). No difference between the groups was found with regard to broken egg events (P>0.05). After controlling for confounding variables, fundamental lesions were 2.02-fold more frequent and micronuclei were 3.54-fold more frequent in crack users. Crack use was found to be associated with clinical and cellular changes in the oral mucosa. These findings can contribute to the planning of health care for individuals who are dependent on street drugs.