A Snapshot of Knowledge about Oral Cancer in Italy: A 505 Person Survey

Objectives: Patients' knowledge about oral squamous cell carcinoma (OSCC) plays an important role in primary prevention, early diagnosis, and prognosis and survival rate. The aim of this study was to assess OSCC awareness attitudes among general population in order to provide information for educational interventions. Methods: A survey delivered as a web-based questionnaire was submitted to 505 subjects (aged from 18 to 76 years) in Italy, and the answers collected were statistically analyzed. Information was collected about existence, incidence, features of lesions, risk factors of oral cancer, and self-inspection habits, together with details about professional reference figures and preventive behaviors. Results: Chi-square tests of independence with adjusted standardized residuals highlighted correlations between population features (age, gender, educational attainment, provenance, medical relationship, or previous diagnoses of oral cancer in family) and knowledge about oral cancer. Conclusions: Knowledge about OSCC among the Italian population is limited, and it might be advisable to implement nudging and sensitive customized campaigns in order to promote awareness and therefore improve the prognosis of this disease

Response to a Comment on “Malignant transformation evidences of Oral Lichen Planus: When the time is of the essence”

Dear Editor, We want to thank Desai et al. [1] for the comment and discussion on our article “Malignant transformation evidences of Oral Lichen Planus: When the time is of the essence” [2]. Firstly, we are pleased to inform you that our extended work about Oral Lichen Planus (OLP) and malignant transformation was recently published, which allows us to better understand unclear issues [3]. However, regarding the letter by Desai RS et al., some clarifications deserve to be provided. We are in agreement with Guan et al. [4] who highlighted that OLP malignant transformation occurred also in not smokers patients. Our findings, indeed, showed a significant malignant transformation rate associated with localization of OLP lesions (especially on tongue margins, OR = 3.55 and P = 0.04) and with features of them (particularly erosive and ulcerative lesions, OR = 2.48 and P = 0.1). Regarding habits, smoking was found to be significantly associated with cancer transformation with an Odds Ratio (OR) of 3.29 (IC 0.58–18.37) and P = 0.18; on the other side, it was difficult to estimate the role of alcoholic consumption, due to uncertain answers of patients interviewed. Nevertheless, in our opinion, the important focus to evaluate is the observation period of patients when OLP is diagnosed and lesions. Our work showed the great importance of extending follow-up to early diagnose malignant transformation; indeed some of them occurred later than 4 years of observation, meaning that the cancer transformation rate of OLP lesions is a significant risk during the life as Guan et al. suggested in their research. Considering our results, we can conclude that clinical features of OLP lesions must be carefully evaluated for the correct timing of the follow-up, which must be as long as possible for them. We sincerely thank Desai RS et al. for the discussion about our work

Microleakage of Direct Restorations. Comparisonbetween Bulk-Fill and Traditional Composite Resins:Systematic Review and Meta-Analysis

Since the bulk-fill composites were produced, there was a progressive diffusion of their use for direct conservative treatment in posterior teeth. Their chemical structure increases the depth of cure and decreases the polymerization contraction; in this man- ner, bulk-fill composites can be placed in 4 mm single layers and the treatment times are considerably reduced. However, aesthetic and mechanical properties and impact on microleakage of bulk-fill resins are still unclear. This systematic review and meta-analysis aimed to assess the risk of microleakage of direct posterior restorations made of bulk-fill versus conventional composite resins. Researches were performed on PubMed and Scopus databases. Eligible in vivo studies, published since 2006, were reviewed. Outcomes of marginal discoloration, marginal adaptation, and recurrent caries were considered to conduct the systematic review and meta-analysis. Secondary data were examined to implement additional analysis and assess the risk of bias. Eight randomized clinical trials were analyzed, involving 778 direct restorations. The summary of RCTs led to significant but inconsistent results; the marginal discolor- ation and recurrent caries were found to be improved respectively by 5.1 and 1.4%, whereas the marginal adaptation was reduced of 6.5%. Secondary analyses revealed that follow-up periods, the adhesive system used and the class of carious lesions eval- uated are confounding factors, and they result in a risk of bias across studies. Bulk-fill composites are innovative materials for conservative dentistry and they can be used to reduce treatment steps and duration of operative times. There are insufficient data to explore the relationship between bulk-fill composites and microleakage and further investigations are needed

Aesthetic Dentistry, How You Say and How You See: A 500-People Survey on Digital Preview and Color Perception

Purpose: Digital technologies have improved ways to perform aesthetic dentistry in the last few years. The aims of this survey were to investigate the most preferred way to preview the result of an aesthetic dental rehabilitation among a population of dental professionals and laypeople and to compare aesthetic standards of the general population and dentists in terms of the color of teeth for aesthetic dental rehabilitations. Patients and Methods: A questionnaire was sent to the subjects (dentists and laypeople) during a 1-year period and, together with their demographic data, different ways to preview the result of an aesthetic rehabilitation were submitted, such as digital smile design, dental wax-up and oral explanation. Furthermore, an additional section of the questionnaire inves-tigated the most suitable color for an aesthetic rehabilitation based on the colors of the VITA Scale. Results were statistically analyzed (with Chi-square of independence and Mann\u2013 Whitney U-test) highlighting differences of answers based on age groups, educational attainment, gender, and belonging or not to the dental field. Results: Findings showed that digital smile design (digital preview) is a high-appreciated method for previewing and communicating with patients both by dental professionals and laypeople. Furthermore, lighter colors were found to be more valued by laypeople and significant differences were highlighted between the two populations assessed. Conclusion: It seems to be viable to use digital preview for dentists and laypeople to improve previewing and communicating ways. It might be advisable to better motivate patients in recognizing aesthetical features and to raise their awareness in preferring more mimetic aesthetic results. Great opportunities are opened up by digital smile design in teaching, learning, and routine practic

Oral squamous cell carcinoma as a complication of chronic graft-versus-host disease: a case report

Objectives. Chronic Graft-Versus-Host Disease (cGVHD) is an immunoregulatory disorder which occurs after allogeneic hematopoietic-cell transplantation (HCT) and often shares features of autoimmunity and immunodeficiency. GVHD related oral manifestations include severe oral pain, xerostemia, ulcerative lesions, and mucositis. Furthermore,a major late suggested complication of HSCT is the dramatically increased risk of secondary malignancies including oral cancer and oral cGVHD-releted inflammation may be considered a potential risk factor. Case report. A 51-year-old male patient referred in 1994 to our surgery for cGVHD oral lesions secondary to HCT for acute myelogenous leukemia developed in 1992. In 2010, an incisional biopsy in left retrocommissural region for an erosive lesion was performed and microscopic analysis revealed an intense lymphoplasmacytic inflammatory infiltrate. In 2011, clinical intraoral examination revealed white verrucous plaque lesion associated with ulcerations on the gingiva of the V sextant and on the lower labial mucosa; two incisional biopsies of oral mucosa and an incisional skin biopsy were performed. Microscopic analysis revealed a well differentiated SCC, a moderately differentiated SCC and a skin high grade dysplasia. Patient was surgically treated and is currently in follow up. Conclusions. Several authors suggest that cGVHD-related inflammation could be an important risk factor for carcinogenesis, also for oral cavity. Then it is recommended close follow-up to all patients treated with HCT, particularly when they develop graft-versus-host disease, and any suspicious oral lesions should be biopsied to rule out dysplasia or malignancy

Oral health status of 916 children in Tibetan settlement (Bylakuppe, India): A cross‐sectional descriptive study

Background: Dietary and oral hygiene habits among integrated migrant cultural minorities can vary and could impact susceptibility to caries. Aim: This study aimed to assess and compare the oral health status of Tibetan schoolchildren living in the Tibetan settlement of Bylakuppe, India, stratified by type of residence. Design: A descriptive cross-sectional study was conducted among Tibetan schoolchildren attending nine schools in the Bylakuppe region. Results: The study population consisted of 916 children aged 5-17: 702 (76.6%) living in secular houses (LSH) and 214 (23.4%) living in monasteries (LM). The prevalence of dental caries was 70.9%, and the mean value of decayed, missing, filled teeth for mixed and primary dentition (DMFT*; dmft) of LSH children (1.56 +/- 2.34/1.74 +/- 2.66) was higher than of LM ones (1.14 +/- 2.34/0.83 +/- 2.80; p < .001). DMFT for LM children (1.46 +/- 2.04) was slightly higher than for LSH children (1.38 +/- 1.96; p > .05). Among the sample, 99.1% had a good simplified Oral Hygiene Index (OHI) and LM children showed higher rates of good values (99.5% vs. 98.2% in LSH children). Most children needed preventive/routine dental treatment, whereas 16.6% needed urgent dental treatment. In 4.5% of children, oral mucosal lesions were present. Conclusion: This study confirms the high need for dental treatment in the children of the Tibetan settlement investigated

Paresthesia of the lip caused by a large osteoma of the mandible treated with a conservative approach: a case report.”

This study focused on a case of paresthesia of the right lip caused by an extensive osteoma of the mandible

Trigeminal trophic syndrome

Trigeminal trophic syndrome (TTS) is a rare facial/cranial affection that arises in ulcerations, itch and paresthesia. Etiology is debated, however trigeminal nerve damage seems to be frequent in pathogenetic patterns. The disease may affect any region innervated by the trigeminal nerve, especially the maxillary branch. A case of TTS, trigged by allergic reaction to osteosynthetic materials and involving infraorbital nerve, was presented. The feature that makes this case one-off in the literature is the association with osteolytic lesion surrounding infraorbital nerve. Diagnosis and treatment were difficult and multidisciplinary approach was required. Treatments administered were satisfying and signs and symptoms remitted, however patient quitted follow-up. TTS is a rare disease, diagnosis is difficult to be performed and it is often a diagnosis of exclusion. Treatment is challenging and it requires a multidisciplinary approach and a great compliance of patients

Conservative non-surgical management in medication related osteonecrosis of the jaw: A retrospective study

Objectives: To date, the best treatment for Medication Related Osteonecrosis of the jaw (MRONJ) is controversial. Recent studies suggest different therapies, considering the stage of MRONJ; however, sometimes patients, although with remarkable extension of disease, cannot undergo surgery. The purpose of present preliminary study was to evaluate the efficacy of conservative non-surgical treatment of MRONJ lesions in a cohort of patients ineligible for surgery or refusing any surgical treatment for stage II and III of MRONJ. Materials and methods: Patients with MRONJ (staging II or III) ineligible for surgical treatment were selected for a retrospective study. A conservative non-surgical therapy (antibiotics and antiseptic) was administered for 1 year. Five scheduled checks were performed to assess changes in signs and symptoms during the observational period. Results: Our observation was carried out on 12 patients. Improvement of signs and symptoms of disease were observed in population. Conclusion: This study suggests that non-surgical treatment may be a valid therapeutic option in patients ineligible for surgery. The sample size is small, further studies should be carried out to satisfy the aim of a conservative non-surgical treatment protocol establishmen