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Varela-Centelles P, Seoane-Romero J, García-Pola MJ, Leira-Feijoo Y, Seoane-Romero JM. Therapeutic approaches for actinic cheilitis: therapeutic efficacy and malignant transformation after treatment. Int J Oral Maxillofac Surg 2020; 49:1343-1350. [PMID: 32171621 DOI: 10.1016/j.ijom.2020.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 01/10/2020] [Accepted: 02/24/2020] [Indexed: 10/24/2022]
Abstract
Actinic cheilitis (AC) is a sun-induced premalignant lesion. AC is a clinical term housing a wide pathological spectrum ranging from hyperkeratosis to invasive squamous cell carcinoma. The aim of this systematic review was to examine the therapeutic efficacy of different approaches in clinical, histological, and cosmetic terms, and the malignization rate after treatment. A systematic search was undertaken in October 2016 and updated in April 2019 at MEDLINE (from 1966), Embase (from 1980), and Proceedings Web of Science (Conference Proceedings Citation Index-Science (CPCI-S) from 1990) databases. The search strategy was (("actinic" or "solar") AND ("cheilitis")) using both medical subject headings (MeSH) and freetext. A total of 392 potentially eligible reports were identified. After the selection procedure, 20 articles were included. It was concluded that surgical treatment is the first line of treatment for AC and has proved useful for the clinical and pathological control of the disorder. However, there was no evidence of effective treatment in preventing malignant transformations. Non-surgical procedures showed less consistent results, although drug therapy may improve the results obtained by other therapeutic approaches.
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Affiliation(s)
- P Varela-Centelles
- CS Praza do Ferrol, EOXI Lugo, Cervo, e Monforte, Galician Health Service, Lugo, Spain.
| | - J Seoane-Romero
- School of Medicine & Dentistry, University "Santiago de Compostela", Coruña, Spain
| | - M J García-Pola
- Department of Surgery and Medical-Surgical Specialities, University of Oviedo, Oviedo, Spain
| | - Y Leira-Feijoo
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - J M Seoane-Romero
- Department of Surgery and Medical-Surgical Specialities, University of Oviedo, Oviedo, Spain
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Varela-Centelles P, Estany-Gestal A, Bugarín-González R, Seoane-Romero JM. Oral cancer awareness in Spain: A pilot study. Oral Dis 2018; 24:124-127. [DOI: 10.1111/odi.12756] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 08/04/2017] [Accepted: 08/07/2017] [Indexed: 12/12/2022]
Affiliation(s)
- P Varela-Centelles
- CS Praza do Ferrol; EOXI Lugo, Cervo, e Monforte de Lemos; Galician Health Service; Lugo Spain
- School of Medicine and Dentistry; University of Santiago de Compostela; Santiago de Compostela Spain
| | - A Estany-Gestal
- Epidemiology and Clinical Research Unit; Foundation for Research, Development and Innovation Ramón Domínguez; University Hospital of Santiago de Compostela; Santiago de Compostela Spain
| | - R Bugarín-González
- Scientific Advice Unit; Avalia-t. Galician Agency for Health Knowledge Management (ACIS); Santiago de Compostela Spain
| | - JM Seoane-Romero
- School of Medicine and Dentistry; University of Oviedo; Oviedo Spain
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Varela-Centelles P, Seoane J, Lopez-Cedrun JL, Fernandez-Sanroman J, García-Martin JM, Takkouche B, Alvarez-Novoa P, Seoane-Romero JM. The length of patient and primary care time interval in the pathways to treatment in symptomatic oral cancer. A quantitative systematic review. Clin Otolaryngol 2017. [PMID: 28627802 DOI: 10.1111/coa.12919] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To examine the relative length of the patient and primary care intervals in symptomatic oral cancer. DESIGN Quantitative systematic review. SEARCH STRATEGY Oral cancer OR oral squamous cell carcinoma OR oropharyngeal cancer AND time interval OR diagnostic delay. SETTING Primary and secondary care. PARTICIPANTS Oral and oropharyngeal cancer patients. MAIN OUTCOME MEASURES We computed five measures (patient, primary care, diagnosis, total diagnosis and total treatment intervals). Most studies did not provide any dispersion measure. We then used the sample size of each study to compute a weighted average of the mean intervals. When the median was provided, we assumed normality of the distribution of the means and used the median as a proxy of the mean. RESULTS A total of 1089 articles were identified, and 22 met the inclusion criteria, reporting on 2710 patients from Europe, USA, India, Australia, Japan, Argentina and Iran. The weighted average of patient interval was 80.3 days. Primary care interval was five times shorter: 15.8 days. The diagnostic interval was appreciably shorter (47.9 days) when compared with the patient interval during symptomatic period. CONCLUSIONS Patient interval represents the major component of waiting times since the detection of the first signs/symptoms to the definitive diagnosis of oral cancer. Thus, strategies focused on high-risk patients should be prioritised. Interventions aimed at optimising the health systems should be implemented by monitoring and facilitating diagnostic and treatment pathways of patients with oral cancer.
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Affiliation(s)
- P Varela-Centelles
- Primary Care, EOXI Lugo, Cervo, e Monforte, Galician Health Service, Lugo, Spain.,Stomatology Department, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain
| | - J Seoane
- Stomatology Department, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain
| | - J L Lopez-Cedrun
- Service of Oral and Maxillofacial Surgery, A Coruña University Hospital, Galician Health Service, A Coruña, Spain
| | - J Fernandez-Sanroman
- Service of Oral and Maxillofacial Surgery, POVISA Hospital, Vigo (Pontevedra), Spain
| | - J M García-Martin
- Department of Medical-Surgical Specialities, University of Oviedo, Oviedo, Spain
| | - B Takkouche
- Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain
| | - P Alvarez-Novoa
- Stomatology Department, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain
| | - J M Seoane-Romero
- Stomatology Department, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain
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Varela-Centelles P, Seoane J, Loira-Gago M, González-Mosquera A, Seoane-Romero JM. Diameter of alveolar antral artery in the lateral sinus wall: study of related factors. Br J Oral Maxillofac Surg 2016; 55:413-415. [PMID: 27986307 DOI: 10.1016/j.bjoms.2016.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 12/01/2016] [Indexed: 11/29/2022]
Abstract
To identify the variables that influence the diameter of the artery in the lateral sinus wall, we studied 240 sinuses, focusing on sex, pattern of tooth loss, type of residual crest, thickness of the lateral wall, height and width of the ridge, and width of the sinus.
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Affiliation(s)
- P Varela-Centelles
- C.S. Praza do Ferrol, EOXI Lugo, Cervo, e Monforte de Lemos, Galician Health Service, Pza Ferrol 11, 27001 Lugo, Spain; Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, C/Entrerríos s/n, 15782 Santiago de Compostela, A Coruña, Spain
| | - J Seoane
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, C/Entrerríos s/n, 15782 Santiago de Compostela, A Coruña, Spain.
| | - M Loira-Gago
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, C/Entrerríos s/n, 15782 Santiago de Compostela, A Coruña, Spain
| | - A González-Mosquera
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, C/Entrerríos s/n, 15782 Santiago de Compostela, A Coruña, Spain
| | - J M Seoane-Romero
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, C/Entrerríos s/n, 15782 Santiago de Compostela, A Coruña, Spain
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Varela-Centelles P, López-Cedrún JL, Fernández-Sanromán J, Seoane-Romero JM, Santos de Melo N, Álvarez-Nóvoa P, Gómez I, Seoane J. Key points and time intervals for early diagnosis in symptomatic oral cancer: a systematic review. Int J Oral Maxillofac Surg 2016; 46:1-10. [PMID: 27751768 DOI: 10.1016/j.ijom.2016.09.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 09/11/2016] [Accepted: 09/27/2016] [Indexed: 11/29/2022]
Abstract
The aim of this study was to identify key points and time intervals in the patient pathway to the diagnosis of oral cancer, from the detection of a bodily change to the start of treatment. A systematic search of three databases was performed by two researchers independently. Articles reporting original data on patients with symptomatic primary oral or oropharyngeal squamous cell carcinoma that was pathologically confirmed were included. These articles had to include an outcome variable of 'diagnostic delay', 'time interval', or 'waiting time to diagnosis', or report time intervals from first symptom to treatment. Furthermore, the outcome variable had to have a clearly defined start point and end point, with the time measurement presented as a continuous or categorical variable. A total of 1175 reports were identified; 28 articles on oral cancer studies and 13 on oral and oropharyngeal cancer studies were finally included. These papers showed poor quality in terms of questionnaire validation, acknowledgement of biases influencing time-point measurements, and strategies for verification of patient self-reported data. They also showed great heterogeneity. The review findings allowed the definition of key points and time intervals within the Aarhus framework that may better suit the features of the diagnostic process of this neoplasm, particularly when assessing the impact of waiting time to diagnosis.
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Affiliation(s)
- P Varela-Centelles
- Galician Health Service, EOXI Lugo, Cervo e Monforte, Lugo, Spain; Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain
| | - J L López-Cedrún
- Service of Oral and Maxillofacial Surgery, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - J Fernández-Sanromán
- Service of Oral and Maxillofacial Surgery, Povisa Hospital, Vigo (Pontevedra), Spain
| | - J M Seoane-Romero
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain
| | - N Santos de Melo
- Departamento de Odontologia, Faculdade de Ciências da Saúde, Universidade de Brasília, Campus Universitário, Asa Norte, Brasília DF, Brazil
| | - P Álvarez-Nóvoa
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain
| | - I Gómez
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain
| | - J Seoane
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela (A Coruña), Spain.
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López Silva MC, Diz-Iglesias P, Seoane-Romero JM, Quintas V, Méndez-Brea F, Varela-Centelles P. [Update in family medicine: Periodontal disease]. Semergen 2016; 43:141-148. [PMID: 27068254 DOI: 10.1016/j.semerg.2016.02.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 02/05/2016] [Indexed: 01/18/2023]
Abstract
About 85-94% of the Spanish adults older than 35 experience gum problems, and about 15-30% suffer from periodontitis, being severe in up to 5-11% of them. Unlike other inflammatory conditions, periodontal disease rarely causes discomfort, or limits life or causes functional limitations until its advanced stages, when clinical signs and symptoms arise (gingival recession, pathological teeth migration, or mobility). Lack of knowledge about the disease, together with the idea that tooth loss is linked to ageing, frequently results in a late diagnosis, requiring extensive treatments with a worse prognosis. At Primary Care level, there is series of drugs have been related to periodontal disease (anticonvulsants, immunosuppressive drugs, and calcium channel blockers) as secondary effects, which vary as regards their frequency and severity depending of the amount of accumulated plaque. Stress and depression have also been reported to alter the immune response and to increase the inflammatory response as well as periodontal susceptibility. Certain systemic conditions, such as diabetes mellitus, cardiovascular disorders, respiratory diseases, as well as low-weight pre-term birth, have also been linked to periodontitis.
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Affiliation(s)
- M C López Silva
- Atención Primaria, CS Praza do Ferrol, EOXI Lugo, Cervo, e Monforte de Lemos, Servizo Galego de Saúde, Lugo, España
| | - P Diz-Iglesias
- Departamento de Estomatología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - J M Seoane-Romero
- Departamento de Estomatología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - V Quintas
- Departamento de Estomatología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - F Méndez-Brea
- Pregrado de Odontología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - P Varela-Centelles
- Atención Primaria, CS Praza do Ferrol, EOXI Lugo, Cervo, e Monforte de Lemos, Servizo Galego de Saúde, Lugo, España; Departamento de Estomatología, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España.
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Varela-Centelles P, Loira-Gago M, Seoane-Romero JM, Takkouche B, Monteiro L, Seoane J. Detection of the posterior superior alveolar artery in the lateral sinus wall using computed tomography/cone beam computed tomography: a prevalence meta-analysis study and systematic review. Int J Oral Maxillofac Surg 2015. [PMID: 26215383 DOI: 10.1016/j.ijom.2015.07.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A systematic search of MEDLINE, Embase, and Proceedings Web of Science was undertaken to assess the prevalence of the posterior superior alveolar artery (PSAA) in the lateral sinus wall in sinus lift patients, as identified using computed tomography (CT)/cone beam computed tomography (CBCT). For inclusion, the article had to report PSAA detection in the bony wall using CT and/or CBCT in patients with subsinus edentulism. Studies on post-mortem findings, mixed samples (living and cadaveric), those presenting pooled results only, or studies performed for a sinus pathology were excluded. Heterogeneity was checked using an adapted version of the DerSimonian and Laird Q test, and quantified by calculating the proportion of the total variance due to between-study variance (Ri statistic). Eight hundred and eleven single papers were reviewed and filtered according to the inclusion/exclusion criteria. Ten studies were selected (1647 patients and 2740 maxillary sinuses (study unit)). The pooled prevalence of PSAA was 62.02 (95% confidence interval (CI) 46.33-77.71). CBCT studies detected PSAA more frequently (78.12, 95% CI 61.25-94.98) than CT studies (51.19, 95% CI 42.33-60.05). Conventional CT revealed thicker arteries than CBCT. It is concluded that PSAA detection is more frequent when CBCT explorations are used. Additional comparative studies controlling for potential confounding factors are needed to ascertain the actual diagnostic value of radiographic explorations for assessing the PSAA prior to sinus floor elevation procedures.
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Affiliation(s)
- P Varela-Centelles
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain; EOXI Lugo, Cervo e Monforte de Lemos, Galician Health Service, Lugo, Spain
| | - M Loira-Gago
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - J M Seoane-Romero
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - B Takkouche
- Department of Preventive Medicine, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - L Monteiro
- Medicine and Oral Surgery Department, Dental Sciences Group - Health Sciences Research Centre, Instituto Superior de Ciências da Saúde Norte, CESPU, Paredes, Portugal
| | - J Seoane
- Stomatology Department, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.
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