Πέμπτη 24 Ιουνίου 2021

Well-Demarcated Nasopharyngeal Mass in an Adolescent Male

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A 19-year-old man presents with left nasal obstruction, mild s eptal deviation, and a pedunculated mass on the posterior wall of the nasopharynx. What is your diagnosis?
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Association of COVID-19 Vaccination and Facial Nerve Palsy

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This case-control study examines whether the Pfizer-BioNTech BNT 162b2 vaccine is associated with an increased risk of acute-onset peripheral facial nerve palsy.
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Bell Palsy and COVID-19

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The emergency use authorization of the first 2 messenger RNA COVID-19 vaccines in the US has given rise to a fascinating study of otolaryngological medical and social influence issues. As of May 1, 2020, the COVID-19 pandemic has resulted in more than 151 million cases and 3.2 million deaths worldwide. In the US, these statistics include 32.4 million cases (9757 per 100 000 population) and 576 000 deaths (173 per 100 000 population). The cold sterility of numbers is difficult to put into context. Likewise, when Pfizer-BioNTech and Mode rna revealed cases of Bell palsy in their vaccine trials, concerns grew regarding the potential of the vaccines to cause Bell palsy. Numbers thrown out to either demonstrate or refute safety are likewise difficult for the public to contextualize. Epidemiologically, linking the vaccine with an adverse event requires accurate estimation of event incidence in association with the vaccine, comparison with a nonvaccinated group, and understanding of the background incidence.
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Incidence of Bell Palsy in Patients With COVID-19

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This cohort study compares the incidence of Bell palsy among p atients with COVID-19 and those vaccinated against the disease.
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Oral cancer awareness in North-Western Spain: a population-based study

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24401. doi: 10.4317/medoral.24401. Online ahead of print.

ABSTRACT

BACKGROUND: An early diagnosis depends greatly on patient awareness. Thus, the aim of this study was to investigate general awareness of oral cancer and knowledge about its risk factors, signs and symptoms.

MATERIAL AND METHODS: Cross-sectional population-based survey of randomly selected respondents conducted from March 1, 2015 to 30 June 2016.

RESULTS: A total of 5,727 people entered the survey (response rate: 53%). When asked what cancers participants had heard about, 20.3% mentioned oral cancer. Regarding risk factors, tobacco was mentioned by 55.3% of the sample (n=3,169), followed by alcohol (12.5%; n=708), poor oral hygiene (10.8%; n=618), diet (6.5%; n=377), and genetics (4.5%; n=248).

CONCLUSIONS: General population has low awareness of oral cancer with poor knowledge of risk factors and main alarm si gns. In addition, individuals in the risk group scored lower values in the main variables analysed; even those highly educated showed insufficient awareness and knowledge of oral cancer. In these circumstances, there is clear need for educational interventions tailored to the target audience and aimed at increasing knowledge and awareness of oral cancer to promote primary prevention of oral cancer and minimising the time interval of patients with symptomatic oral cancer in their path to treatment.

PMID:34162825 | DOI:10.4317/medoral.24401

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Gray value measurement for the evaluation of local alveolar bone density around impacted maxillary canine teeth using cone beam computed tomography

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24677. doi: 10.4317/medoral.24677. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate whether any relationship between local alveolar bone density and maxillary canine impaction using gray values from cone beam computed tomography.

MATERIAL AND METHODS: The cone beam computed tomography images of 151 patients were retrospectively evaluated. Maxillary canine was defined as an impacted tooth when root formation was complete and the patient's age older than 13 or the other side of the maxillary canine has completely erupted. Similarly, complete eruption was defined as the tooth in its expected occlusion and position. Using the cone beam computed tomography software, the region of interest which was 5 mm2 in area, was placed in the trabecular bone on cross sectional cone beam computed tomography images and the gray value measurements were recorded. After measuring the gray values of all the teeth, the images were grouped according to the field of view size. Comparison of the gray values of impacted and non-impacted teeth was made between images with the same field of view size.

RESULTS: A total of 151 patients, 101 (66.9%) female and 50 (33.1%) male, were included in the study. The mean age of the patients was 24.94 ±13.9. In images with a 40X40 field of view, the gray values of the impacted canine teeth were higher than the gray values of the non-impacted ones and statistically significant difference was found between them (p=0.003). However no statistically significant difference was found between the gray values of impacted and non-impacted canine teeth in 60x60 and 100x50 field of view (p=0.197, p=0.170, respectively).

CONCLUSIONS: We suggest using the smallest field of view size when evaluating bone density using gray values from cone beam computed tomography images and we support the idea that the local increased bone density may influence on impaction.

PMID:34162816 | DOI:10.4317/medoral.24677

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Application of remote online learning in oral histopathology teaching in China

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24441. doi: 10.4317/medoral.24441. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study was to investigate the application of remote learning and virtual microscopy in oral histopathology teaching, a unique experience in China. The oral histopathology teaching in Nanjing Medical University has been extraordinary.

MATERIAL AND METHODS: 98 third-year dental students of Grade 2016 took oral histopathology theoretical course face-to-face in 2019 (Traditional group). The 94 participants of Grade 2017 took online oral histopathology course using digital methods(E-Learning platform and Virtual Simulation Experiment Teaching Center for Dentistry) in 2020. During the practical laboratory sessions, the students in both Traditional group and Online group observed the same glass slides for morphological learning. A questionnaire survey explored students' attitudes towards the remote onl ine learning.

RESULTS: The mean Theory test scores of the Online group (80.93±12.15) were significantly higher than those of the Traditional group (73.65±8.46) (P < 0.01). The mean total scores of the Online group (82.94±10.76) were significantly higher than those of the Traditional group (77.25±7.55) (P < 0.01). The percentage of high total test score (test score > 85) of the Online group (54%) was also significantly higher than that of the Traditional group (15%) (P< 0.01). Furthermore, both remote learning and virtual microscopy courses were well accepted by students according to the questionnaire.

CONCLUSIONS: This study found that remote learning and virtual technology have a positive impact on oral histopathology. The findings reveal that the application of remote online learning has enhanced oral histopathology teaching in China.

PMID:34162817 | DOI:10.4317/medoral.24441

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Oral complaints in patients with acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24647. doi: 10.4317/medoral.24647. Online ahead of print.

ABSTRACT

BACKGROUND: Acute myeloid leukemia belongs to proliferative diseases of the hematopoietic system. It is currently the leading indication for allogeneic hematopoietic stem cell transplantation. This study was designed to determine the most common subjective oral mucosa complaints in patients with acute myeloid leukemia after allogeneic hematopoietic cell transplantation, in relation to the type of conditioning used.

MATERIAL AND METHODS: Eighty patients diagnosed with acute myeloid leukemia were assigned to two groups depending on the intensity of the conditioning regimen before transplantation: myeloablative and reduced-intensity chemotherapy. The oral symptoms were evaluated based on an authorial questionnaire designed for this analysis. The following oral mucosa subjective complaints were included: pain, paraesthesia, b urning mouth sensation, taste disorders, excessive salivation, halitosis, and dryness of the oral mucosa.

RESULTS: The most commonly reported subjective oral complaint in the examined patients was xerostomia, which was found in 92% of patients during the second visit, followed by spontaneous pain in the mouth (55%), burning (36%), and dysgeusia (20%). It occurred significantly more frequently in patients who underwent myeloablative conditioning. Moreover, it was observed that the frequency of complaints increased considerably after the transplantation, reaching a peak intensity during the second week following the procedure.

CONCLUSIONS: Oral complaints significantly decrease the patients' quality of life during the transplantation and may lead to premature termination of the treatment. As the number of transplantations in patients with acute myeloid leukemia increases, further investigations of oral complaints and symptoms induced by the disease itself and by the therap eutic approaches are required.

PMID:34162819 | DOI:10.4317/medoral.24647

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Comparison of the effect of ginger and aloe vera mouthwashes on xerostomia in patients with type 2 diabetes: A clinical trial, triple-blind

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:23998. doi: 10.4317/medoral.23998. Online ahead of print.

ABSTRACT

BACKGROUND: Ginger and aloe vera are two medicinal herbs mostly used to produce mouthwash. This study aimed to compare the effects of ginger and aloe vera mouthwashes on the xerostomia in patients referred to Bandar Abbas diabetes clinic (Iran).

MATERIAL AND METHODS: In this triple-blind clinical trial, three groups (n=35 patients in each group) were studied. One group was given aloe vera mouthwash, the other group used ginger mouthwash, and the control group was only given normal saline. All the mouthwashes were used 20 ccs three times daily for 14 consecutive days. The symptoms and severity of xerostomia were measured before and after the intervention by the questionnaire proposed by Fox et al. as well as VAS scale, respectively. Statistical analysis, including the Shapiro-Wilk test used to measure the normality of vari ables, and Chi-square and McNemar used to compare the scores questionnaire proposed by Fox et al., were also applied. Scores of VAS were analyzed using a one-way ANOVA test. P<0.05 was considered as statistically significant in all these tests.

RESULTS: The mean age of the participants included in the normal saline group was 58.13±14.75 years old, 54.14±9.35 years old in the ginger group, and 53.37±11.57 years old in the aloe vera group. The difference between the scores of xerostomia before and after performing the intervention (The amount of reduction in xerostomia) in the ginger group was 6.12±2.004 cm, in the aloe vera group it was 4.08±2.09 cm, and in the normal saline group it was 2.45±2.09 cm. Finally, the ginger and aloe vera mouthwashes significantly reduced all symptoms and severity related to xerostomia, respectively(p<0.001).

CONCLUSIONS: The use of mouthwash is an effective measure to reduce xerostomia under chronic conditions. Aloe vera, ginger, and normal saline are known as effective mouthwashes on controlling this complication. According to the results of this study, ginger and aloe vera mouthwashes could significantly decrease xerostomia and promote oral health in patients with diabetes.

PMID:34162822 | DOI:10.4317/medoral.23998

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Juvenile ossifying fibroma of the maxillofacial region: analysis of clinico-pathological features and management

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24592. doi: 10.4317/medoral.24592. Online ahead of print.

ABSTRACT

BACKGROUND: The diagnosis and management of juvenile ossifying fibroma (JOF) remains a highly debated topic with paucity of studies with long-term follow-up, hence the aim of this study was to report on the clinico-pathological features and management of these neoplasms.

MATERIAL AND METHODS: A retrospective analysis was performed on all histopathologically confirmed JOF presenting at two tertiary hospitals in Cape Town, South Africa over a period of 39 years. Clinical, demographic, histopathological and radiological features were analyzed. Surgical methods were documented and a minimum post-operative follow-up of 12 months was a prerequisite.

RESULTS: Seventeen patients met the inclusion criteria and were included in this study. Overall, the ages of patients ranged from 3-31 years (mean= 13 years) with male to fema le ratio of 1.8:1. The ages of patients diagnosed with Trabecular JOF were significantly younger than patients with Psammomatoid JOF (P = 0.01). The majority of patients presented with marked swelling (88.2%). Interestingly, most neoplasms occurred in the mandible (76.5%) with all Psammomatoid JOF uncharacteristically occurring in the mandible. There was only one case of Trabecular JOF occurring in the sinonasal area. Most neoplasms appeared as unilocular (76.5%) and well-defined (82.4%) with mixed radio-density (70.6%) on radiographs and computed tomography. Curettage with peripheral ostectomy was shown to be the least invasive method with an acceptable recurrence rate (10%). Six lesions underwent resection without any recurrences however caused high morbidity to these young patients.

CONCLUSIONS: The high number of lesions occurring in the mandible for both variants of JOF demonstrates that site should not be a major determining factor in the diagnosis of JOF. Moreover, cure ttage with peripheral ostectomy should be used as the first line of management to minimize morbidity to the patient and that resection should be reserved for large and recurrent lesions.

PMID:34162821 | DOI:10.4317/medoral.24592

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Effect of bone loss on the fracture resistance of narrow dental implants after implantoplasty. An in vitro study

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Med Oral Patol Oral Cir Bucal. 2021 Jun 24:24624. doi: 10.4317/medoral.24624. Online ahead of print.

ABSTRACT

BACKGROUND: Implantoplasty (IP) involves polishing of the exposed surface of implants affected by peri-implantitis (PI). A study was made to determine whether the degree of bone loss influences the fracture resistance of implants with or without IP.

MATERIAL AND METHODS: An in vitro study was carried out on 32 narrow (3.5 mm) dental implants with a rough surface and external hexagonal connection. Implantoplasty was performed in half of the implants of the sample. Both the IP and control implants were divided into two subgroups according to the amount of bone loss (3 mm or 7.5 mm). Standardized radiographic assessment of implant width was performed using specific software. The main outcome variable was the maximum compression force (Fmax) of implants when subjected to static resistance to fracture tests. Implant fractures were subsequently analyzed by scanning electron microscopy. A descriptive and bivariate analysis of the data was performed.

RESULTS: Significant changes in implant width were observed after IP (p<0.05). No significant differences between IP and control implants were recorded in terms of the Fmax values in the two bone loss subgroups (3 mm: control 854.37N 195.08 vs. IP 752.12N 186.13; p=0.302, and 7.5 mm: control 548.82N 80.02 vs. IP 593.69N 111.07; p=0.370). Greater bone loss was associated to a decrease in Fmax, which proved significant for the control implants (p=0.001). Fractures were more frequently located in the platform (n=13).

CONCLUSIONS: Implants with more apical bone levels appear to be more susceptible to fracture. On the other hand, IP does not seem to significantly decrease the fracture resistance of narrow (3.5 mm) platform dental implants with external hexagonal connections. The fact that most fractures occur in the platform area indicates that the la tter is exposed to more mechanical stress.

PMID:34162823 | DOI:10.4317/medoral.24624

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