Guided Tissue Regeneration in Peri-radicular Surgery

Guided tissue regeneration techniques have been available in dentistry for decades. Primarily used for periodontal surgery and implant placement, their usefulness in periapical surgery has been getting increased attention. From the currently available evidence, guided tissue regeneration can improve patient outcomes. As a result, this technique might become more common in the future. Therefore, this review outlines the main uses of guided tissue regeneration and provides a brief summary of evidence surrounding it, with particular focus on periapical surgery

Utilising blood-derived products for guided tissue regeneration in periradicular surgery: a systematic review and meta-analysis

Background Since 1982, guided tissue regeneration (GTR) has become increasingly popular. The recent progress in GTR research focuses on the application of blood-derived products. However, no comprehensive systematic review has been conducted to assess its effectiveness specifically in periradicular surgery. Therefore, the aim of this review was to analyse the outcomes of periradicular with GTR using blood-derived products compared to standard periradicular surgery. Methods This review was based on randomised controlled trials comparing periradicular surgery in conjunction with GTR with blood-derived products and the standard periapical surgery. The databases searched included Embase, MEDLINE, Cochrane CENTRAL, and Dentistry and Oral Sciences Source, with the most recent search conducted on December 16th, 2022. Additionally, reference lists of similar systematic reviews were examined, while international trials registries and repositories were consulted for unpublished studies. Two blinded independent reviewers carried out the screening and the included studies underwent critical appraisal. The findings are reported in accordance with the PRISMA guidelines. Results A total of 261 publications were initially reviewed based on their title and abstract, resulting in seventeen studies that underwent full-text screening. At this stage, 14 studies were excluded, leaving three randomised controlled trials to be included. These trials involved a total of 85 patients. A meta-analysis was conducted for the outcome of healing. The overall treatment effect was 0.78 (95% CI 0.18 to 3.34), indicating a preference towards the control group. Conclusion Based on a meta-analysis of three studies, there was no statistically significant distinction observed in terms of healing between the GTR involving blood-derived products and standard procedure groups. However, critical appraisal revealed indirectness and imprecision, resulting in a certainty rating of 'low'. Thus, additional robust evidence is necessary to support the utilisation of blood-derived products in GTR techniques to enhance periradicular surgery outcomes. Systematic review registration number PROSPERO CRD42020222663

Postoperative delirium in patients with head and neck oral cancer in the West of Scotland

Our aims were to determine the prevalence and association of postoperative delirium (POD) in head and neck (H&N) cancer patients undergoing free flap reconstruction at the oral and maxillofacial surgery (OMFS) unit, Queen Elizabeth University Hospital (QEUH) Glasgow, and to assess whether these determinants can be modified to optimise patient care and reduce the occurrence of POD. Delirium remains an important problem in the postoperative care of patients undergoing major H&N surgery, and early detection and management improve overall outcomes. The patient database containing details of the preoperative physical status (including alcohol misuse, chronic comorbidity, and physiological status) of 1006 patients who underwent major H&N surgery with free-flap repair at the QEUH from 2009-2019, was analysed. Factors associated with delirium were studied, identifying univariate associations as well as multivariate models to determine independent risk factors. The incidence of POD was 7.5% (75/1006; 53 male:22 female; mean (SD) age 65.41 (13.16) years). POD was strongly associated with pre-existing medical comorbidities, excess alcohol, smoking, a prolonged surgical operating time (more than 700 minutes), tracheostomy, blood transfusion, and bony free flaps. Those with POD were at an increased risk of postoperative wound and lung complications, and were more likely to require a hospital stay of more than 21 days. Presurgical assessment should identify risk factors to optimise the diagnosis and treatment of POD, and will enhance patient care by reducing further medical and surgical complications, and overall hospital stay

Microbial diversity in waters, sediments and microbial mats evaluated using fatty acid-based methods

The review summarises recent advances towards a greater comprehensive assessment of microbial diversity in aquatic environments using the fatty acid methyl esters and phospholipid fatty acids approaches. These methods are commonly used in microbial ecology because they do not require the culturing of micro-organisms, are quantitative and reproducible and provide valuable information regarding the structure of entire microbial communities. Because some fatty acids are associated with taxonomic and functional groups of micro-organisms, they allow particular groups of micro-organisms to be distinguished. The integration of fatty acid-based methods with stable isotopes, RNA and DNA analyses enhances our knowledge of the role of micro-organisms in global nutrient cycles, functional activity and phylogenetic lineages within microbial communities. Additionally, the analysis of fatty acid profiles enables the shifts in the microbial diversity in pristine and contaminated environments to be monitored. The main objective of this review is to present the use of lipid-based approaches for the characterisation of microbial communities in water columns, sediments and biomats

Risk factors associated with short-term complications in mandibular fractures: the MANTRA study—a Maxillofacial Trainee Research Collaborative (MTReC)

Abstract Introduction Complications following mandibular fractures occur in 9–23% of patients. Identifying those at risk is key to prevention. Previous studies highlighted smoking, age and time from injury to presentation as risk factors but rarely recorded other possible confounders. In this paper, we use a collaborative snapshot audit to document novel risk factors and confirm established risks for complications following the treatment of mandibular fractures. Methods The audit was carried out by 122 OMFS trainees across the UK and Ireland (49 centres) over 6 months, coordinated by the Maxillofacial Surgery Trainees Research Collaborative. Variables recorded included basic demography, medical and social history, injury mechanism and type, management and 30-day outcome. Results Nine hundred and forty-seven (947) patients with fractured mandibles were recorded. Surgical management was carried out in 76.3%. Complications at 30 days occurred 65 (9%) of those who were managed surgically. Risk factors for complications included male sex, increasing age, any medical history, increasing number of cigarettes smoked per week, increasing alcohol use per week, worse oral hygiene and increased time from injury to presentation. Discussion We have used a large prospective snapshot audit to confirm established risk factors and identify novel risk factors. We demonstrate that time from injury to presentation is confounded by other indicators of poor health behaviour. These results are important in designing trial protocols for management of mandibular fractures and in targeting health interventions to patients at highest risk of complications. </jats:sec

How does diabetes mellitus impact on the prognosis of dental implants?

DATA SOURCES: Web of Science, Embase, PubMed and Cochrane Library databases were searched for publications up to August 2021. STUDY SELECTION: The study noted clear inclusion and exclusion criteria. Search terms were provided; only observational studies were considered. DATA EXTRACTION AND SYNTHESIS: A total of 122 studies were identified through the search strategy. Following deduplication, two reviewers conducted the screening. RESULTS: A total of 21 observational studies were included, involving cohort, case-control, and cross-sectional study designs. A meta-analysis identified increased risk of peri-implantitis in patients with diabetes mellitus and in smokers when compared to non-diabetic subjects and non-smokers. No significant association was found between poor plaque control or periodontal history and peri-implantitis. CONCLUSIONS: Patients with diabetes mellitus appear to have a higher risk of peri-implantitis.accepted version (6 months), submitted versionThe article is available via Open Access. Click on the 'Additional link' above to access the full-text

Do e-cigarettes have a part to play in peri-implant diseases?

Systematic review. The following databases were searched for publications up to May 2022: Medline, EMBASE, Scopus, Web of Science, LILACS, Cochrane and Open Grey. Additionally, four journals were hand searched. Clear inclusion and exclusion criteria were provided. A focused question was outlined using PICO format. A full search protocol was supplied, and all study designs were considered. Two reviewers screened 97 articles after de-duplication. Fourteen full-text articles were assessed. Data were collected using a spreadsheet. Four cross-sectional studies were included in the systematic review, all reporting on male participants. Meta-analysis was performed highlighting worse outcomes in electronic cigarette (e- cigarette) user group regarding increased bone loss, probing depth, plaque index and bleeding on probing, as well as increased levels of inflammatory cytokines, when compared to never-smokers. From the limited number of studies available, e-cigarettes appear to have a negative impact on dental implant outcomes in male patients

Artificial intelligence - can it be used to outsmart oral cancer?

Data Sources Electronic search on PubMed, Cochrane, Scopus, Embase, Google Scholar, Saudi Digital Library and Web of Science, and hand searching carried out for studies published January 2000-March 2021. Language was restricted to English.Study selection Original research studies involving artificial intelligence technology for oral cancer diagnosis and prognosis prediction were considered. The studies had to provide quantitative data of their evaluation analysis. The exclusion criteria were reported. No limit was set on study design.Data extraction and synthesis The initial search yielded 628 articles. Following deduplication, 340 full-text articles were screened. QUADAS-2 tool was used to assess the quality of the included studies regarding diagnostic accuracy.Results A total of 16 studies were included with various study designs: 14 cross-sectional, one cohort and one retrospective study. Six studies reviewed the diagnosis aspect. All studies indicate an overall positive trend of artificial intelligence technology.Conclusions Artificial intelligence appears to have good accuracy in oral cancer diagnosis and its prediction

Artificial intelligence - can it be used to outsmart oral cancer?

Data Sources Electronic search on PubMed, Cochrane, Scopus, Embase, Google Scholar, Saudi Digital Library and Web of Science, and hand searching carried out for studies published January 2000-March 2021. Language was restricted to English.Study selection Original research studies involving artificial intelligence technology for oral cancer diagnosis and prognosis prediction were considered. The studies had to provide quantitative data of their evaluation analysis. The exclusion criteria were reported. No limit was set on study design.Data extraction and synthesis The initial search yielded 628 articles. Following deduplication, 340 full-text articles were screened. QUADAS-2 tool was used to assess the quality of the included studies regarding diagnostic accuracy.Results A total of 16 studies were included with various study designs: 14 cross-sectional, one cohort and one retrospective study. Six studies reviewed the diagnosis aspect. All studies indicate an overall positive trend of artificial intelligence technology.Conclusions Artificial intelligence appears to have good accuracy in oral cancer diagnosis and its prediction.The article is available via Open Access. Click on the 'Additional link' above to access the full-text.accepted version (6 months), submitted versio