Proliferative Verrucous Leukoplakia of the Gingiva: An Early Lesion Refractory to Surgical Excision

This report describes a case of proliferative verrucous leukoplakia (PVL) of the gingiva with no discernible aetiology, which presented in a 36-year-old female. The initial nonscrapable gingival lesion was treated with CO2 laser ablation, and the histopathological evaluation was carried out. The presence of koilocytic cells in the superficial epithelium led to immunohistochemical investigations with p16 antibody, which showed strong nuclear positivity and slight cytoplasmic positivity in >50% of the cells with >25% confluency. However, it was not possible to confirm the presence of HPV infection with further investigations due to logistic reasons. The lesion recurred twice within a short time despite the surgical resection following the first recurrence. Thus, this paper presents a case of proliferative verrucous leukoplakia, which demonstrated a significant resistance to routine treatment protocols recommended in the management of such lesions

Quality of life of patients treated with robotic surgery in the oral and maxillofacial region: a scoping review of empirical evidence

Abstract Background There is a blooming trend in the application of robotic surgery in oral and maxillofacial care, and different studies had evaluated the quality of life (QoL) outcomes among patients who underwent robotic surgery in the oral and maxillofacial region. However, empirical evidence on the QoL outcomes from these procedures is yet to be mapped. Thus, this study was conducted to evaluate the available scientific evidence and gaps concerning the QoL outcomes of patients treated with robotic surgery in the oral and maxillofacial region. Methods This study adopted a scoping review design, and it was conducted and reported based on the Arksey and O’Malley, PRISMA-ScR, and AMSTAR-2 guidelines. SCOPUS, PubMed, CINAHL Complete, and APA PsycINFO were searched to retrieve relevant literature. Using Rayyan software, the retrieved literature were deduplicated, and screened based on the review’s eligibility criteria. Only the eligible articles were included in the review. From the included articles, relevant data were charted, collated, and summarized. Results A total of 123 literature were retrieved from the literature search. After deduplication and screening, only 18 heterogeneous original articles were included in the review. A total of 771 transoral robotic surgeries (TORSs) were reported in these articles, and the TORSs were conducted on patients with oropharyngeal carcinomas (OPC), recurrent tonsillitis, and obstructive sleep apnoea (OSA). In total, 20 different QoL instruments were used in these articles to assess patients’ QoL outcomes, and the most used instrument was the MD Anderson Dysphagia Inventory Questionnaire (MDADI). Physical functions related to swallowing, speech and salivary functions were the most assessed QoL aspects. TORS was reported to result in improved QOL in patients with OPC, OSA, and recurrent tonsillitis, most significantly within the first postoperative year. Notably, the site of the lesion, involvement of neck dissections and the characteristics of the adjuvant therapy seemed to affect the QOL outcome in patients with OPC. Conclusion Compared to the conventional treatment modalities, TORS has demonstrated better QoL, mostly in the domains related to oral functions such as swallowing and speech, among patients treated with such. This improvement was most evident within the initial post-operative year

Perceptions of Dental Undergraduates Towards Online Education During COVID-19: Assessment From India, Nepal and Sri Lanka

Purpose: The social distancing mandates instituted during COVID-19 pandemic mark the sudden transition in the mode of dental education’s delivery to the virtual instruction. It is vital to assess students’ perceptions towards virtual learning environments, particularly among those gaining education in resource-strained countries. This cross-sectional study aims to assess the perceptions of dental undergraduates towards online education, environment and transferable skills and patient care during COVID-19 in India, Nepal, and Sri Lanka. Materials and Methods: Dental preclinical and clinical undergraduate students from India, Nepal and Sri Lanka were recruited from November 2020 to March 2021 through a 47-item web-based survey consisting of psychometrically valid subscales of Dundee Ready Educational Environment Measure (DREEM) and Transferable Skills Questionnaire. The mean scores of students’ perceptions of learning, environment, and patient care skills were compared among preclinical and clinical students of the participating countries. Results: Of total 930 participants, 44.4% were from India, 26.1% from Sri Lanka and 29.5% responses from Nepal. Sri Lanka reported the highest mean scores across all domains of perception indicative of positive attitude. Clinical students from all participating countries had statistically significantly higher positive perception of transferable skills in patient care as opposed to their preclinical counterparts. On the contrary, perception towards learning was higher among preclinical students as opposed to clinical students. These differences were statistically significant for Nepal and Sri Lanka. Conclusion: The findings of this study underscore the need to develop and implement effective online dental educational interventions to foster academic growth and essential practical skills without compromising academic rigor and continuity in the dental education curriculum

The use of Qigong and Tai Chi in the management of temporomandibular joint dysfunction: A systematic review

Abstract Background and Aims Qigong and Tai Chi (QTC) are mind‐body exercises involving a sequence of graceful movements, which promote self‐healing, meditation, and self‐cultivation. There is growing evidence that Qigong and/or Tai Chi therapy may improve the physical and psychological health among adults with multiple health conditions including joint movement. This systematic review aims to synthesize the available evidence on the type and effectiveness of QTC therapies used in the management of temporomandibular joint (TMJ) dysfunction. Methods This systematic review followed the AMSTAR‐2 guideline, and it was reported based on guidelines in the PRISMA checklist. The review involved a systematic search of nine electronic databases. After deduplication and screening of the literature retrieved from the search, only one article was included based on the review's inclusion criteria. Data was extracted from this article and synthesized. Results The only included article was on a non‐randomized control trial which investigated the role of Tai Chi Qigong (a form of Qigong) therapy in improving joint mobility and alleviating trismus among 52 survivors of nasopharyngeal carcinoma who had TMJ disorders. The study reported, at different time intervals (at pretest; at mid‐intervention; at posttest; and at follow‐up posttest), that no significant difference (p > 0.05) was observed concerning mouth opening capacity between the intervention group and the control group. However, over time, less severe deterioration in mouth‐opening was noted among the participants in the intervention group (p = 0.181) as compared to the control group (p < 0.001). Conclusion The role of QTC therapies in improving joint mobility and alleviating trismus is not yet fully understood, but it seems promising. The available evidence is inadequate to categorically conclude on the efficacy of these therapies. Further studies will be required to fully assess the effectiveness of QTC therapies in the management of TMJ dysfunction