1,721,008 research outputs found
Human exfoliated deciduous teeth and oral mucosa: promising applications in tissue regeneration
Full text linkIn the last three decades, the constantly increasing need for therapies,
efficiently preventing and/or treating human diseases, has raised the interest
in Regenerative Medicine (RM). RM is based on employing mesenchymal stem
cells (MSCs), that showed to have great proliferation, self-renewal and multilineage
differentiation potential, in vitro as well as in vivo. The opportunity
of an accessible, painless and low-cost reservoir of MSCs constitutes the first
important step of a successful regenerative therapy to include in the current
clinical practice. Oral cavity has recently demonstrated to contain different
MSCs niches: dental pulp from permanent and deciduous teeth, periodontal
ligament, dental follicle, apical papilla and mucosa. MSCs from dental pulp
of deciduous teeth, naturally lost in pediatric age, and the oral mucosa have
shown to be easily harvested and to have a promising regenerative potential.
Thus, the aim of the paper is to review the potentialities of human exfoliated
deciduous teeth stem cells (SHEDs) and oral mucosa stem cells (OMSCs) in RM,
with the purpose of their use as accessible source of MSCs for the future of
pediatric patient
Oral Squamous Cell Carcinoma Mimicking Medication-Related Osteonecrosis of the Jaws (MRONJ): A Case Series
Full text link(1) Background: Medication-related osteonecrosis of the jaw (MRONJ) is a potential adverse drug reaction of antiresorptive and/or antiangiogenic treatment. MRONJ is mostly diagnosed by anamnestic data, clinical examination and radiological findings, with signs and symptoms often unspecific. On the other hand, oral squamous cell carcinoma (OSCC) is characteristic for its pleomorphic appearance (e.g., ulcer, mucous dehiscence, non-healing post-extractive socket). We report three cases where OSCC mimicked MRONJ lesions. (2) Patients: Three patients undergoing amino-bisphosphonate treatment for osteoporosis presented with areas of intraorally exposed jawbone and unspecific radiological signs compatible with MRONJ. Due to the clinical suspicious of malignant lesion, incisional biopsy for histological examination was also performed. (3) Results: Histological examination of the tissue specimen revealed the presence of OSCC. All patients underwent cancer treatment. (4) Conclusions: Several signs and symptoms of OSCC may simulate, in patients with a history of anti-resorptive, MRONJ; for these reasons, it is important to perform histologic analysis when clinicians are facing a suspicious malignant lesion
Drug assumption and awareness about adverse drug reactions. The right to know. The case of the bone-modyfing agents: a systematic review
Full text linkIntroduction: Medication-related osteonecrosis of the Jaw (MRONJ) is an adverse drug reaction that affects the mandible and maxilla of patients exposed to BMA and AA therapies, causing the progressive destruction and death of bone. To date, oral health preventive measures remain the most effective strategy to reduce MRONJ incidence, and, in this sense, the major goal is to diagnose, treat, and eradicate any oral diseases that could compromise oral health. The present systematic review aims to investigate the awareness of MRONJ among patients assuming BMAs.
Methods: A systematic literature search was performed, selecting studies that concern the awareness of patients of the risk of MRONJ.
Results: Six studies were included in this review. In total, 483 patients were evaluated. Of the 483 included patients, 391 were not aware of the possibility of MRONJ onset (391/483, 81%) and 92 were aware of it (92/483, 19%).
Discussion: The problem of patient's lack of awareness with respect to MRONJ risk presents different layers of complexity (“what?”, “who?”, “where?”, “when?” and “why?”). Among its causal factors, there are an inadequate level of communication with patients and the lack of collaboration between healthcare professionals, which is related to an individualistic view of liability and deontological duties. MRONJ is a drug adverse reaction that can greatly affect the quality of life of patients if not promptly diagnosed and treated. Therefore, patients must be fully aware of the risks of adverse and the importance of preventive measures, which imply effective and exhaustive communication by each member of the multidisciplinary team. Effective teamwork and collaborative care should be promoted to positively impact patients' awareness
Emotional states in patients with cancer or with suspected oral potentially malignant disorders: a cross-sectional study in an oral medicine setting
Full text linkBackground: This cross-sectional study aims to investigate the emotional states (i.e., anxiety, depression, and stress) of 4 distinct groups of patients attending an Oral Medicine setting.
Material and Methods: four distinct subgroups of patients have been enrolled: 25 patients with OSCC (OSCC group); 25 patients with other solid tumor (ONCO group), 25 cancer patients with MRONJ (MRONJ group), 25 patients with oral potentially malignant disorder (OPMD group). Standardized assessment tools (i.e. Beck Depression Inventory (BDI) and Depression Anxiety Stress Scales-21 (DASS-21) questionnaires) were utilized to evaluate the patients’ emotional states.
Results: Among the 100 patients enrolled, 59% of whom were female, and most patients were aged between 70 and 80 years. The mean total BDI score was 16.57, and the mean total DASS-21 score was 15.32. The mean scores of the OSCC group showed moderate depression, all the other groups were classified as mild depression. The OPMD group showed a significantly higher level of anxiety.
Conclusions: Patients in the oral medicine setting may face various diseases and may develop emotional states that affect their treatment adherence. For effective management of these emotional states, the presence of a multidisciplinary team, including a psychologist, and the adoption of individualized approaches, seem to be necessary
Application of Ozone Therapy in the Conservative Surgical Treatment of Osteonecrosis of the Jaw: Preliminary Results
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Human Papilloma Virus (HPV) Detection in Oral Rinse vs. Oral Sponge: A Preliminary Accuracy Report in Oral Cancer Patients
Full text linkBackground/Objectives: Human Papillomavirus (HPV) is a significant etiological factor
in the development of oropharyngeal carcinogenesis. The detection of HPV in oral squamous cell
carcinoma (OSCC) could be also crucial for diagnosis, prognosis, and treatment planning. This
study compares the efficacy and accuracy of two non-invasive sampling methods, oral rinse, and
oral sponge, in detecting HPV DNA in patients with OSCC. Methods: Twenty-six patients with
histologically confirmed OSCCs were recruited (M/F = 15/11; mean age 68.6). From each patient,
two self-collected oral specimens, in the form of an oral rinse and a salivary sponge (i.e., LolliSponge),
were collected, and subsequently processed, utilizing INNO-LiPA HPV Genotyping Extra II for
HPV DNA detection; Results: Oral sponge detection showed high specificity (100%), sensitivity
(85.7%), and accuracy (96.2%) compared to the oral rinse sampling, also demonstrating an area AUC
for its diagnostic performance significantly greater than 0.5 (0.93 vs. 0.5, p < 0.0001). Conclusions:
This study supports that oral sponge sampling offers valuable non-invasive alternatives for HPV
detection in patients with OSCC, with the potentiality to facilitate saliva sampling in patients that may
exhibit functional deficit due to OSCC. Further research is recommended to validate these findings in
larger cohorts and to explore the integration of these methods into routine clinical practice for the
management of HPV-related OSCC
The Humanization of Health Care: In-Depth Knowledge Regarding the Ethics of Dental Care in Oncological Patients
No full textThis chapter provides an illuminating insight into the processes of the humanization of care in order to increase specialist knowledge regarding the nature of the doctor-patient relationship. It will deal with the notion of care and its various aspects, including the existential dimension of the process of caregiving by means of a narrative (storytelling) interview. After a brief analysis of the changes which have affected medical science in past centuries, the focus of the paper will be directed to the remarkable transformation which clinical practice has undergone, by virtue of which the concept of the taking care of the patient has gained increasing attention. Thus, care can be provided by means of the narrative interview, not only as medical history but also as action: it recognises the patient’s world, in turn opening up the processes of the humanization of care in the field of dental medicine. The scientific community has long questioned the traditional medical approach, which is centred on disease, and it now pays ever more attention to the involvement of the patient in the process of diagnosis and treatment. Every time a patient sits down in front of a specialist, they bring with them stories, their own and ours, describing their stomatognathic system. A technically accurate medical history with information untouched by the doctor makes space for the narrative interview and ‘caring presence’ of the operator, to reflect on what it means to ‘care for the patient’. From the point of view of optimising care, it is therefore useful to rethink the relationship between dentist and patient: effective clinical practice is not possible without listening empathically to the patient’s story, their perceptions, and their experiences. It is necessary to reformulate settings to improve and render them more effective and, where possible, to include appropriate active listening strategies and adopt specific communication techniques. In this paper the authors will describe their vision of the humanisation of care in the form of a narrative
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