Non-invasive visual tools for diagnosis of oral cancer and dysplasia: a systematic review

Background: Gold standard for the diagnosis of oral dysplasia (OD) oral squamous cell carcinoma (OSCC) and malignant lesions is the histological examination. Several adjunctive diagnostic techniques have been proposed in order to increase the sensitivity (SE) and specificity (SP) of conventional oral examination and to improve the diagnostic first level accuracy. The aim of this study is to perform a systematic review on non-invasive tools for diagnosis of OD and early OSCC. Material and Methods: Medline, Scopus, Web of Knowledge databases were searched, using as entry terms “oral dysplasia AND diagnosis” / ”oral cancer AND diagnosis”. Data extracted from each study included number of lesions evaluated, histopathological diagnosis, SE, SP, positive and negative predictive values (PPV and NPV), diagnostic accuracy (DA) and the main conclusions. Results: After title and abstract scanning of 11.080 records, we selected 35 articles for full text evaluation. Most evaluated tools were autofluorescence (AF), chemiluminescence (CL), toluidine blu (TL) and chemiluminescence associated with toluidine blue (CLTB). Conclusions: There is a great inhomogeneity of the reported values and there is no significant evidence of superiority of one tool over the other. Further clinical trials with a higher level of evidence are necessary in order to assess the real usefulness visual diagnostic tools

Code formula for the fundamental period of RC precast buildings

Recent seismic events in Europe, as L’Aquila earthquake (2009) and Emilia earthquake (2012), seriously hit the precast concrete structures. Among the others, one of the most widespread damage is the collapse of the cladding panels system. The high vulnerability of precast panels connections motivate the need of an extended study on the behavior of precast panels and on their interaction with the structure. The first step of this study must be the investigation of the dynamic behavior (in particular, the vibration periods) of one-story precast structures with and without cladding panels. In this paper a parametric study is performed in order to evaluate the first period of one-story precast buildings, without and with the cladding system. In particular, the aim of the work is to compare the results of the model with cladding panels to the dynamic properties of the bare model, in order to evaluate the cladding system influence on the stiffness and on the first period of this structural typology. Moreover, the results are compared with the code relationships that predict the first period of structures in linear static analysis

Seismic behavior of beam-to-column dowel connections: numerical analysis vs experimental test

The high vulnerability of precast structures during seismic events is mainly related to the poor performance of the connection systems, among which the beam-to-column connections. The dowel typology is largely used in Europe and a detailed study is required in order to understand its seismic response. The behavior of dowel beam-to-column connections is influenced by a lot of parameters and it can be analyzed through numerical analyses. In this work a FEM model of a typical dowel connection is provided; it is validated by experimental evidences and it is used for several parametric analyses in order to investigate the influence of different parameters on the connection behavior in terms of strength and failure mechanism

Surgical Approach and Laser Applications in BRONJ Osteoporotic and Cancer Patients

Bisphosphonates-related Osteonecrosis of the Jaw (BRONJ) has been reported with increasing frequency in literature over last years, but its therapy is still a dilemma. One hundred ninety patients affected by BRONJ were observed between January 2004 and November 2011 and 166 treated sites were subdivided in five groups on the basis of the therapeutical approach (medical or surgical, traditional or laser-assisted approach, with or without Low Level Laser Therapy (LLLT)). Clinical success has been defined for each treatment performed as clinical improvement or complete mucosal healing. Combination of antibiotic therapy, conservative surgery performed with Er:YAG laser and LLLT applications showed best results for cancer and noncancer patients. Nonsurgical approach performed on 69 sites induced an improvement in 35 sites (50.7%) and the complete healing in 19 sites (27.5%), while surgical approach on 97 sites induced an improvement in 84 sites (86.6%) and the complete healing in 78 sites (80.41%). Improvement and healing were recorded in 31 (81.5%) and 27 (71.5%) out of the 38 BRONJ sites treated in noncancer patients and in 88 (68.75%) and in 69 (53.9%) out of the 128 in cancer patients

SIPMO 2019

The biennial Congress of the Italian Society of Oral Pathology and Medicine (SIPMO) is an International meeting dedicated to the growing diagnostic challenges in the oral pathology and medicine field. The III International and XV National edition will be a chance to discuss clinical conditions which are unusual, rare, or difficult to define. Many consolidated national and international research groups will be involved in the debate and discussion through special guest lecturers, academic dissertations, single clinical case presentations, posters, and degree thesis discussions. The SIPMO Congress took place from the 17th to the 19th of October 2019 in Bari (Italy), and the enclosed copy of Proceedings is a non-exhaustive collection of abstracts from the SIPMO 2019 contributions

A 5-year retrospective longitudinal study on the incidence and the risk factors of osteonecrosis of the jaws in patients treated with zoledronic acid for bone metastases from solid tumors

Background: The aim of this study was to evaluate the incidence and the risk factors of osteonecrosis of the jaw (ONJ) in a group of patients treated with zoledronic acid (ZA) for bone metastases from solid tumors and enrolled in a preventive dental program. Material and Methods: This 5-year retrospective longitudinal study included all consecutive oncological patients who underwent at least one infusion with ZA between 2004 and 2011 for bone metastases due to solid neoplasms. Results: Of the 156 patients enrolled in the study, 17 developed ONJ (10.89%). At the multivariate analysis, severe periodontal disease (P=0.025), tooth extraction (P<0.0001) and starting the preventive dental program after the beginning of ZA therapy (P=0.02) were the only factors which showed a significant association with the occurrence of ONJ. Conclusions: This study demonstrated the importance of beginning dental prevention before zoledronic acid exposure in reducing ONJ occurrence, especially in the long term. The results of this research show that control of periodontal disease and an increase in the time between tooth extraction and the first ZA administration are recommended in order to reduce the risk of ONJ developmen

Odontogenic myxofibroma: a concise review of the literature with emphasis on the surgical approach

Purpose : The aim of this work is to report a review of the literature concerning epidemiology, clinical and radiographic features as well as treatment of odontogenic myxofibroma (MF). Methods : The PubMed database was searched using the following keywords: “odontogenic myxofibroma”, “odontogenic fibromyxoma”, “myxofibroma of the jaw” and “fibromyxoma of the jaw”. Results : Fifteen articles reporting the experience with 24 patients were identified. Male/female ratio was 1:1.4 and the average age was 29.5 years. The most frequent location was the mandible. In 66.7% of the cases the radiographic appearance was a multilocular radiolucency. Swelling was observed in 13 patients (92.86%), varying degrees of pain in 5 (35.71%) and paresthesia in only one patient (7.14%). Six out of 24 patients (26.09%) were treated with radical surgery and 17 (73.91%) with a conservative approach. In two out of 21 cases (9.52%) a recurrence was reported. Conclusions : MF is an extremely rare tumor and no agreement exists on the causes of its development. According to the present review, the choice of treatment should depend on variables such as localization, presence of a primary or of a recurrent lesion, age, general medical conditions and aesthetic needs of the patien

Case series of 589 tooth extractions in patients under bisphosphonates therapy. Proposal of a clinical protocol supported by Nd: YAG low-level laser therapy

Objective: Trauma during dental surgery is a predisposing factor for bisphosphonates (BP)-related osteonecrosis of the jaws (BRONJ). However, about 40% of cases of BRONJ are not related to dental invasive procedures, be ing probably associated to endodontic or periodontal infections. Extraction of non-treatable teeth is considered a reliable choice, to improve symptoms and to reduce the risk of BRONJ. Here we report our experience of tooth extractions in patients under oral or intravenous BP therapy. Study Design: Two-hundred and seventeen patients (38 males, 179 females; mean age 68.72 ± 11.26 years, range 30 to 83 years) under BP therapy received 589 tooth extractions at the Unit of Oral Medicine, Pathology and Laser-assisted Surgery of the University of Parma, Italy, between June 2006 and December 2010. Ninety five patients were under BP therapy for oncological disease (multiple myeloma (MM): 23; bone metastases (BM): 72) and 122 patients for non oncological diseases: 119 osteoporosis (OP), 2 rheumatoid arthritis (RA) and 1 Paget's disease (PD). The mean duration of BP was of 35 months. Antibiotic treatment was administered three days before and 2 weeks after tooth extractions. Patients were additionally treated with low level laser therapy (LLLT) through Nd:YAG laser (1064 nm - power 1.25 W; frequency 15 Hz; fibre diameter: 320 µm), 5 application of 1 minute each. Patients were evaluated 3 days and once a week for 2 months after the extractions and every time they received LLLT. Mean follow-up was 15 months (ranging from 4 to 31 months). Results: In a total of 589 extractions (285 mandibular, 304 maxillary) performed, a minimal bone exposure was observed in 5 cases, treated with Er:YAG laser vaporization and than healed. Conclusions: Our experience supports the hypothesis that the association of antibiotic treatment and LLLT can be effective in preventing ONJ after tooth extractions in patients under BPT

Low energy KTP laser in oral soft tissues surgery : a 52 patients clinical study

Objectives: Since 1962 laser appliances have been used for soft tissues surgery of oral cavity with significant advantages compared to the traditional instruments: excellent bleeding control, possibility to avoid the use of suture, good patient compliance thanks to a decrease of intra- and post-operative discomfort and biostimulating effect. Unfortunately, the wavelengths so far used have been seen to cause, in association with an excellent ablation capacity, heat damage of the tissues that can decrease healing process and cause a greater discomfort to patients. The aim of this study was to evaluate the laser-assisted KTP laser surgery at low power in terms of characteristics of intervention and patients compliance. Study design: In this study, we describe the application of a new and recently introduced in dentistry wavelength, the KTP laser (532 nm), used with low power (1 Watt - CW), evaluating the time of interventions and, by a Numerical Rating Scale, the intra and postoperative pain. Results: KTP laser used at low power permits to obtain good pain control during operations that were carried out with only a topic anaesthetic (EMLA, Astratech), as shown in VAS tests. Good healing with limited or absent burning areas in treated portion of tissue. Conclusions: These preliminary study allows us to affirm that KTP laser with low parameters permits to perform oral surgery with good pain control and good wound healing. A greater number of clinical cases are however necessary to confirm the result obtained. © Medicina Oral

All-Polymer Photonic Microcavities Doped with Perylene Bisimide J-Aggregates

Thanks to exciting chemical and optical features, perylene bisimide (PBI) J-aggregates are ideal candidates to be employed for high-performance plastic photonic devices. However, they generally tend to form - stacked H-aggregates that are unsuitable for implementation in polymer resonant cavities. In this work, we demonstrate the efficient compatibilization of a tailored perylene bisimide forming robust J-aggregated supramolecular polymers into amorphous polypropylene. The new nanocomposite was then implemented into an all-polymer planar microcavity which provides strong and directional spectral redistribution of the J-aggregate photoluminescence, owing to a strong modification of the photonic states. A systematic analysis of the photoemitting processes, including photoluminescence decay and quantum yields, shows that the optical confinement in the polymeric microcavity does not introduce any additional nonradiative de-excitation pathways to those already found in the J-aggregate nanocomposite film and pave the way to PBI-based high-performance plastic photonic devices