Malignant Transformation Rate in Patients Presenting Oral Epithelial Dysplasia: Systematic Review and Meta-Analysis

Objective. To perform a systematic review and meta-analysis on studies that assess malignant transformation rates (MTR) of oral epithelial dysplasia. Materials and Methods. This review was planned and conducted in accordance with the meta-analysis of observational studies in epidemiology (MOOSE) guidelines. PubMed, EMBASE, Google Scholar, and Cochrane databases were screened to identify observational studies. Quality assessments were completed by two reviewers independently using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Pooled-malignant transformation rate (MTR) in person years, subgroup, sensitivity, and publication bias analysis were calculated using STATA 13.0 and Comprehensive Meta-Analysis software. Results. Sixteen observational cohort studies were identified with a total of 3708 participants from Asia, North America, and Europe. Analysis showed a MTR of 10.5% (pooled-MTR: 10.5, 95% CI: 3.7 to 17.3; fixed effect model, I2=0.0%; Q-value = 2.389; p>0.05) among patients with histologically confirmed oral epithelia dysplasia undergoing long-term follow-up. Higher MTR in person year were seen among the sever dysplastic cases (pooled-MTR: 14.4%, 95% CI: 5.3% to 23.5%), studies published in Europe (pooled-MTR: 12.6%, 95% CI: 8.0% to 24.3%), and retrospective studies (pooled-MTR: 11.0%, 95% CI: 2.2% to 19.9%). Conclusion. These studies show that oral epithelial dysplasia has a significant high rate of transformation to cancer

Oral Contraceptive Use and Alveolar Osteitis Following Third Molar Extraction: A Systematic Review and Meta-Analysis

PURPOSE: Alveolar osteitis (AO) is a common postoperative complication of third molar extractions that is thought to be associated with the intake of oral contraceptives (OCPs). This meta-analysis sought to evaluate the risk of AO associated with OCP use and sex independently and whether this risk was affected by the use of postoperative analgesics or antibiotics. METHODS: PubMed/Medline, EMBASE, and Cochrane databases were searched for articles pertaining to OCP use and the incidence of AO using MESH terms. The measured outcome was the development of AO following a third molar extraction. Additional variables such as sex, analgesic, and antibiotic use were documented and included in the analysis. The data were analyzed in R using the Mantel-Haenszel method. RESULTS: Fifteen studies with a total of 1366 female participants who were OCP users and 2919 nonuser female participants were included in this meta-analysis. OCP users were approximately twice (pooled-RR: 1.98, 95% CI: 1.42–2.76) as likely to develop AO following a third molar extraction when compared to nonuser females. The increased incidence of AO in the OCP group was statistically significant (p < 0.01). The pooled-RR of AO in females not taking OCPs was not significantly different from males (p=0.45). CONCLUSIONS: OCP use significantly elevated the risk of AO in females. Females who did not take OCPs had a similar risk of developing AO compared to males, suggesting that OCP use is a potential effect modifier. Neither postoperative antibiotics use nor the type of postoperative analgesic significantly affected AO incidence in those taking OCPs

Parent Attitudes Regarding Orthodontists’ Role as Potential Administrators of Human Papilloma Virus (HPV) Vaccines

OBJECTIVE: To assess parent attitudes regarding orthodontists' role as potential administrators of human papilloma virus (HPV) vaccines. MATERIALS AND METHODS: 275 parents of adolescents, aged 11–17, who attended the orthodontic clinic at an American university for orthodontic adjustment visits and met inclusion criteria were given information about HPV and HPV vaccines. A paper questionnaire was administered to assess comfort level with orthodontists as HPV vaccinators. Demographic and other potential explanatory characteristics were collected. Descriptive, bivariate, and multivariate ordinal logistic regression analyses were performed with SPSS statistical software v25. RESULTS: The majority of participants were between 31 and 40 years old, with 79.6% identifying as female. 54.3% of the subjects' children identified as female. Although 71.3% of participants identified as Hispanic, 55.3% of the total participants chose to respond to the questionnaire in Spanish. 66.7% of the participants reported education level as high school degree or less. Overall, 52.4% of parents responded that they would be comfortable with orthodontists administering HPV vaccines to their children. Bivariate analysis suggested a significant association (p < 0.05) of parents taking the survey in Spanish and parents' educational attainment with HPV vaccine administration comfort level. Multivariate ordinal logistic regression indicates that parents taking survey in Spanish (adjusted OR: 2.42, 95% CI: 1.24–4.72; p < .01) and parents of male children (adjusted OR: 1.66, 95% CI: 1.01–2.73; p < 047) were comfortable with orthodontists administering the HPV vaccine. CONCLUSIONS: The language of the survey influenced parents' comfort level with orthodontists as HPV vaccinators, with Spanish having a positive correlation to comfort level. Parents of male children were more comfortable with orthodontists as HPV vaccinator