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One of the most promising approaches to correct periodontal bone defects and achieve periodontal regeneration is platelet-rich fibrin (PRF). This systematic review and meta-analysis aimed to evaluate the regeneration of periodontal bone defects using PRF compared to other regenerative treatments. The data search and retrieval process followed the PRISMA guidelines. An electronic search of MEDLINE, Cochrane, and PubMed databases was performed, selecting exclusively randomized clinical trials where the following were measured: probing depth reduction (PD), clinical attachment level gain (CAL), and radiographic bone fill (RBF). Out of 284 selected articles, 32 were chosen based on inclusion criteria. The use of platelet-rich fibrin (PRF) + open flap debridement (OFD), PRF + metformin, PRF + platelet-rich plasma (PRP), and PRF + OFD/bone graft (BG) significantly reduced PD and improved CAL and RBF. However, the combination of PRF + BG, PRF + metformin, and PRF + STATINS reduced CAL. The intervention of PRF combined with different treatments such as metformin, OFD, PRP, BG, and STATINS has a significant impact on improving PD and CAL. The use of PRF significantly improved the regeneration of periodontal bone defects compared to other treatments. [ABSTRACT FROM AUTHOR]

Background: Oral mucositis (OM) is considered one of the most common side effects of patients undergoing cancer therapy. OM prevention plays a crucial role in the effectiveness of cancer treatment and the patient's quality of life. Different preventive treatments have been proposed in clinical trials, however with inconclusive results. Materials and Methods: A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: in cancer patients, do specific topical agents compared to standard treatments or placebo reduce the onset and severity of oral mucositis? The risk of bias was assessed, and a network meta‐analysis was conducted. Results: Of 2913 results, 30 randomized clinical trials were considered suitable for inclusion. A total of 2564 patients were analyzed, of which 1284 belonged to the test group and 1280 belonged to the control group. Natural products were the most used, followed mainly by antimicrobial agents, coating agents, and basic oral care measures. Topical sucralfate resulted in the most powerful intervention for the OM prevention (OR = 0.04, 95%C.I. = 0.01–0.25, p‐value = 0.001). Conclusion: Due to its cytoprotective action, low cost, ease of administration, and safety, sucralfate could become a potential ally to prevent the onset of OM during cancer therapy. [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether hydroxychloroquine (HCQ) or chloroquine (CQ) are effective for the treatment of oral lichen planus (OLP). Materials and Methods: A literature search was conducted in four databases. Clinical studies investigating the effect of HCQ/CQ in patients with OLP were included. Results: Eleven studies were included. Four were RCTs and seven quasi‐experimental studies. The studies included 390 patients diagnosed with OLP, of which 326 and 7 received HCQ and CQ, respectively. 46 patients received topical dexamethasone, 5 placebo and 6 griseofulvin as controls. Five studies assessed pain, and all of them obtained pain reduction with the use of HCQ. Six studies reported objective clinical improvement of OLP with the use of HCQ. Five studies that used a subjective scale obtained that 24%–100% of the patients achieved a complete/almost complete improvement of OLP lesions and its symptomatology. The most frequent side effects were vision problems, gastric discomfort, rash, nauseas, headaches, skin pigmentation, and elevated kidney function. 17 patients had to withdraw from the studies. Conclusions: Current evidence is scarce to confirm HCQ as a therapeutic option for OLP. More RCTs are needed to compare its efficacy with topical corticosteroids and to evaluate whether HCQ reduces relapses of OLP. [ABSTRACT FROM AUTHOR]

Simple Summary: Head and Neck Cancer is often diagnosed at an advanced stage, resulting in poor long-term prognosis. Additionally, this cancer is resistant to chemotherapy. This systematic review article aims to examine the literature on published methods to overcome resistance to chemotherapy for head and neck cancer. According to the "cancer stem cell" (CSCs) theory, tumors are a diverse and expanding group of malignant cells that originate from a small number of CSCs. Despite treatment, these cells can still become active and proliferate, which can result in distant metastasis and local recurrences. A new paradigm in cancer treatment involves targeting both CSCs and the cancer cells in a tumor. This review aims to examine the literature on methods published to overcome chemoresistance due to the presence of CSCs in head and neck cancers. The review was registered with PROSPERO (ID# CRD42024512809). After Pub Med, Scopus, and WoS database searches, 31 relevant articles on oral squamous cell carcinoma (OSCC) were selected. Compounds that increased chemosensitivity by targeting CSCs in head and neck squamous cell carcinoma (HNSCC) were divided into (1) natural products, (2) adjuvant molecules to traditional chemotherapy, and (3) CSCs targeting patient-specific fresh biopsies for functional precision medicine. [ABSTRACT FROM AUTHOR]

The cross-talk between the innate and adaptive immune response represents the first defense weapon against the threat of pathogens. Substantial evidence has shown a relationship between immune phenotype lymphocytes and COVID-19 disease severity and/or implication in susceptibility to SARS-CoV-2 infection. Recently, belonging to ABO blood groups has been investigated as a correlation factor to COVID-19 disease. This pilot study investigated lymphocyte typing in a cohort of blood donors to understand the underlying mechanism in SARS-CoV-2 infection linked to the blood group. The study cohort consisted of 20–64-year-old subjects, without comorbidities, from both sexes, who were COVID-19 vaccinated with previous or no infection history. Whole blood samples, collected at A.O.R.N. Sant'Anna and San Sebastiano Hospital (Campania Region), were processed by multiparametric cytofluorimetric assay, to characterize CD4+ helper and CD8+ cytotoxic T cell CD3+ subpopulations. The CD45RA, CCR7, CD27, CD28, CD57 and PD-1 markers were investigated to delineate the peripheral T-cell maturation stages. Differences were detected in ABO blood types in CD3+, CD4+ gated on CD3+, CD8+ and CD8+ gated on CD3+ percentage. These results contribute to identifying a memory cell "identikit" profile in COVID-19 disease, thus leading to a useful tool in precision medicine. [ABSTRACT FROM AUTHOR]

Among different therapeutic strategies proposed in the case of bone volume deficit, guided bone regeneration (GBR) is a consolidated surgical procedure. The objective of this study is to retrospectively evaluate the behavior of two bone grafts with different consistencies in the GBR procedure by measuring the volumetric tissue changes 1 year after surgery. For this retrospective analysis, 25 cases of GBR with simultaneous implant insertion were selected. A total of 13 were grafted with a porcine cortico-cancellous bone mix (CCBM group), and 12 were grafted with a pre-hydrated granulated cortico-cancellous bone mix of porcine origin blended with 20% TSV gel (Collagenated-CCBM). A collagen membrane was fixed to cover the bone defect. A total of 42 implants were placed with computer-guided surgery. Preoperative and 12-month postoperative digital impressions were used to evaluate dimensional changes. Student's t-test used for independent samples showed no statistically significant differences between the integrated distance (p = 0.995) and mean distance (p = 0.734). The mean integrated distance in the CCBM group was 41.80 (SD. 101.18) compared to a mean of 42.04 (SD. 66.71) in the Collagenated-CCBM group. Given the limitations of this study, in patients with peri-implant bone dehiscence, simple heterologous and collagenated heterologous cortico-cancellous bone grafts are suitable for filling the bone defect to promote bone regeneration, although further studies are needed. [ABSTRACT FROM AUTHOR]

Featured Application: Advances in Sleep Monitoring Technology. Background: SnoreLab (Version 5.3, Reviva Softworks Ltd., London, UK) is featured as the number one mobile application (app) for measuring snoring intensity and duration. The aim of this study was to conduct a comparative analysis between the results derived from SnoreLab and polysomnography (PSG). Methods: Male and female patients between 18 and 75 years of age, seeking medical counseling for suspected obstructive sleep apnea syndrome (OSAS), were considered eligible to participate in this study. Exclusion criteria were psychological or neurological disorders, drug or alcohol abuse, and inability to follow instructions. All patients underwent one overnight in-hospital PSG with simultaneous snoring recording using the SnoreLab app. Results: Nineteen patients (15 men, 4 women) aged 50.9 ± 10.5 years were included. The overall cohort exhibited a Snore Score of 24.8 ± 22.2 alongside an AHI of 15.1 ± 17.0, indicating moderate OSAS. Interestingly, elevated Snore Scores were observed in both the simple snoring (30.7 ± 19.2) and severe OSAS group (35.2 ± 21.4) (Kruskal–Wallis p-value = 0.176). The analysis of the Spearman's test did not reveal a statistically significant correlation between PSG parameters and the Snore Score. Conclusions: While SnoreLab records snoring, it is not designed for screening sleep apnea. Although SnoreLab may not replace PSG for use in diagnosis, it could serve as a complementary tool for monitoring snoring and to improve the interaction between patients and clinicians when integrated into a suitable clinical assessment. [ABSTRACT FROM AUTHOR]

Purpose: Human papillomavirus (HPV) is a prevalent sexually transmitted infection responsible for many anogenital and oropharyngeal cancers. Dental care providers have the potential to influence vaccine uptake, yet little is known about how patients perceive their role in HPV education and prevention. Methods: Parents of adolescents aged 9 to 17 years (n = 375) were recruited from Valdeorras District Hospital (Galicia, Spain) to investigate parents' attitudes concerning the involvement of dental care providers in discussions related to HPV. A survey was distributed to the participants, and 343 (91.5%) were included in the analysis. Results: In general, nearly half of the parents reported feeling comfortable regarding discussing HPV with their dentist. Participants described more comfort with dentists than with dental hygienists. Parents' comfort levels were influenced by various social determinants of health, including education level, marital status, geographic origin, and child vaccination status (p > 0.05). Conclusion: Parents reported varying comfort levels when discussing HPV and its vaccine with dental professionals, displaying a preference for dentists. Dental settings have the potential to promote vaccination, but the existence of ongoing barriers needs to be addressed. [ABSTRACT FROM AUTHOR]

Simple Summary: MLH1 methylation status was accessed by a Pyrosequencing (PSQ) assay, and the results point to the efficacy of PSQ for evaluating MLH1 methylation. While unmethylation appears to be associated with a higher relapse rate, the survival rate does not seem to be influenced by methylation. Quantitative percentages suggest that elevated MLH1 methylation is linked to relapse and mortality, though a study with a larger sample size would be essential for statistically significant results. Background: In cancer care, the MLH1 gene is crucial for DNA mismatch repair (MMR), serving as a vital tumor suppressor. Evaluating MLH1 protein expression status, followed by analysis of MLH1 promoter methylation, has become a key diagnostic and prognostic approach. Our study investigates the complex link between MLH1 methylation and prognosis in endometrial adenocarcinoma (EA) patients. Methodology: MLH1 methylation status was accessed by a Pyrosequencing (PSQ) assay. Qualitative positivity for methylation was established if it exceeded the 11% cut-off; as well, a quantitative methylation analysis was conducted to establish correlations with clinicopathological data, relapse-free survival, and disease-free survival. Results: Our study revealed that 33.3% of patients without MLH1 methylation experienced relapses, surpassing the 23.3% in patients with methylation. Furthermore, 16.7% of patients without methylation succumbed to death, with a slightly higher rate of 17.6% in methylated patients. Qualitative comparisons highlighted that the mean methylation rate in patients experiencing relapse was 35.8%, whereas in those without relapse, it was 42.2%. This pattern persisted in disease-specific survival (DSS), where deceased patients exhibited a higher mean methylation level of 49.1% compared to living patients with 38.8%. Conclusions: Our findings emphasize the efficacy of PSQ for evaluating MLH1 methylation. While unmethylation appears to be associated with a higher relapse rate, the survival rate does not seem to be influenced by methylation. Quantitative percentages suggest that elevated MLH1 methylation is linked to relapse and mortality, though a study with a larger sample size would be essential for statistically significant results. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to evaluate the expression of intracellular and vesicular LGALS3BP in oral squamous cell carcinoma (OSCC) patients and available cell lines to explore its potential as a target for antibody‐drug conjugate (ADC) therapy. Methods: Free and vesicular LGALS3BP expression levels were evaluated in cancer tissues from a cohort of OSCC patients as well as in a panel of OSCC cell lines through immunohistochemistry, qRT‐PCR, Western Blot analysis, and ELISA. Results: LGALS3BP resulted in being highly expressed in the cytoplasm of tumour cells in OSCC patient tissues. A strong correlation was found between high LGALS3BP expression levels and aggressive histological features of OSCC. Biochemistry analysis performed on OSCC cell lines showed that LGALS3BP is expressed in all the tested cell lines and highly enriched in cancer‐derived extracellular vesicles. Moreover, LGALS3BP high‐expressing HOC621 and CAL27 OSCC cell lines showed high sensitivity to the ADC‐payload DM4, with an IC50 around 0.3 nM. Conclusions: The present study highlights that LGALS3BP is highly expressed in OSCC suggesting a role as a potential diagnostic biomarker and therapeutic target for ADC‐based therapy. [ABSTRACT FROM AUTHOR]

Objectives: Head and neck squamous cell carcinoma (HNSCC) poses a diagnostic and therapeutic challenge worldwide and is associated with a poor survival rate. Due to the variability in the efficacy of treatments for HNSCC, new predictive biomarkers of therapy outcomes are needed. Recently, we developed an algorithm that employs the mutational profile of TP53 as an independent prognostic factor in HNSCC. In this study, we investigated its role as a predictive biomarker of treatment outcomes in HNSCC patients. We also tested the usefulness of two classification systems for TP53 mutational landscapes. Materials and Methods: Clinical and genomic data were retrieved from The Cancer Genome Atlas database. We built a multivariate stepwise backward binary regression model to assess the role of TP53 mutations in predicting therapeutic outcomes. Results: Cases harbouring high‐risk‐of‐death mutations reported an odds ratio of 3.301 for stable or progressive disease compared to wild‐type cases, while no significant difference in treatment outcomes was found between cases with low‐risk‐of‐death mutations and wild‐type TP53. Our analysis found that older patients with a history of alcohol consumption had a higher risk of stable/progressive disease. Conclusions: This study improves current evidence on the role of TP53 mutations in treatment response in HNSCC patients. [ABSTRACT FROM AUTHOR]

The O-6-methylguanine-DNA methyltransferase (MGMT) gene is a critical guardian of genomic integrity. MGMT methylation in diffuse gliomas serves as an important determinant of patients' prognostic outcomes, more specifically in glioblastomas (GBMs). In GBMs, the absence of MGMT methylation, known as MGMT promoter unmethylation, often translates into a more challenging clinical scenario, tending to present resistance to chemotherapy and a worse prognosis. A pyrosequencing (PSQ) technique was used to analyze MGMT methylation status at different cut-offs (5%, 9%, and 11%) in a sample of 78 patients diagnosed with IDH-wildtype grade 4 GBM. A retrospective analysis was provided to collect clinicopathological and prognostic data. A statistical analysis was used to establish an association between methylation status and treatment response (TR) and disease-specific survival (DSS). The patients with methylated MGMT status experienced progressive disease rates of 84.6%, 80%, and 78.4% at the respective cut-offs of 5%, 9%, and 11%. The number was considerably higher when considering unmethylated patients, as all patients (100%), regardless of the cut-off, presented progressive disease. Regarding disease-specific survival (DSS), the Hazard Ratio (HR) was HR = 0.74 (0.45–1.24; p = 0.251); HR = 0.82 (0.51–1.33; p = 0.425); and HR = 0.79 (0.49–1.29; p = 0.350), respectively. Our study concludes that there is an association between MGMT unmethylation and worse TR and DSS. The 9% cut-off demonstrated a greater potential for patient survival as a function of time, which may shed light on the future need for standardization of MGMT methylation positivity parameters in PSQ. [ABSTRACT FROM AUTHOR]

Pediatric thyroid cancer represents 2.3 % of thyroid cancers, and its long-term outcome data are sparse. There have not been studies in the UAE delineating its epidemiology, clinical and histological characteristics, and follow-up outcomes. We aimed to evaluate the clinical–pathological behavior, recurrence and survival rates in pediatrics with all types of thyroid cancer in the UAE. Multicentre retrospective chart review analysis of pediatric patients with thyroid carcinoma from January 2010 to December 2020 in Abu Dhabi, UAE. Thirty-four patients were included, 85 % being females. Papillary thyroid carcinoma (PTC) was the commonest type of thyroid cancer (88 %) vs. follicular thyroid carcinoma (FTC) (11.8 %). Almost half of our patients had a multifocal disease, 26 % had lymphovascular invasion (LVI), and 21 % had extrathyroidal extension (ETE). There were no mortalities during follow-up. 85 % of patients exhibited complete remission, while 15 % of patients showed evidence of progressive residual or recurrent disease. One patient had metastasis to lymph nodes and lungs. There were similar trends of incidence, sex prevalence, and histopathological patterns as the ones observed internationally. Potential risk factors in our population include a family history of thyroid cancer and obesity. The lower rate of ETE, LVI, metastasis, and recurrence indicates a possibly less aggressive disease. [ABSTRACT FROM AUTHOR]

Background: Minor salivary glands can be found in the ventral and anterior part of the tongue; these glands can rarely develop mucoceles that, due to their rarity and their unusual clinical appearance, may present an interesting differential diagnosis. Mucoceles appear as an exophytic, sometimes pedunculated, lesion, which is a feature that is due to the absence of a capsule; thus, the glands are right beneath the mucosa and over the muscle tissue. The aim of this article is to retrospectively present and discuss the anatomy, pathology, clinical features and therapy of several cases of Blandin-Nunh mucoceles collected from two different institutions. Methods: A retrospective case review was carried out in two university institutions, retrieving all cases of tongue mucoceles from 1999 to today. Two oral pathologists reviewed all the slides, confirming the diagnosis. Demographic data of the patient, anatomic location and clinical appearance were retrieved from clinical charts, together with the type of surgical procedure and possible relapses. Results: A total of 240 cases of tongue mucoceles were gathered from the archives: the mean age was 22 years (DS = 14,7; Range 2–83), 126 were females (52,5%, mean age 22,7 years, DS = 16,5; Range 2–83), and 114 were males (47,5%, mean age 20,9 years, DS = 12,4; Range 3–73); in all cases, a history of trauma was reported. The ventral surface was the most frequent location (224 cases – 93,3%), and in the great majority (235 cases – 97,9%), pathology revealed mucous spillage with a wall formed by fibrous connective and granulation tissue with no epithelium lining the cavity. Superficial mucocele and sclerosing sialoadenitis were the more frequent pathological variants (21 cases – 8,8%). All lesions were treated with excision and enucleation of the servicing gland. The healing was uneventful in all cases, but there were four recurrences and two cases of sensory paraesthesia of the border of the tongue, all in males, except one case of paraesthesia in a female. Conclusions: Tongue mucoceles must be differentiated from many benign and malignant lesions. For this reason, surgical removal of the lesion and of the associated gland with a pathological exam is mandatory. In fact, the anatomical location of the glands and the possible pathological variants must be considered to reach a correct diagnosis and diminish possible relapses. Trial registration: CE-Muc_Ton_3/2023. [ABSTRACT FROM AUTHOR]

The objective of this systematic review was to evaluate which salivary biomarkers are altered in patients with burning mouth syndrome (BMS) compared to a control group (CG). A comprehensive literature search was conducted in four databases. Case–control studies evaluating salivary biomarkers in BMS patients were included. Risk of bias was assessed using the Newcastle‐Ottawa tool. RevMan was used for meta‐analysis. Seventeen studies were selected. The included studies collected 54 different biomarkers. Of these biomarkers, only three (cortisol, α‐amylase, and dehydroepiandrosterone) were analyzed in three or more studies. Dehydroepiandrosterone obtained contradictory results among the studies. However, cortisol and α‐amylase levels were found to be higher in BMS patients. Cortisol was the only biomarker which could be included for meta‐analysis. Cortisol levels were significantly higher in the BMS group compared to the CG (Mean Difference = 0.39; 95% CI [0.14–0.65]; p = 0.003). In conclusion, different studies investigated salivary biomarkers in patients with BMS compared to a CG, with controversial results. Meta‐analysis, confirmed by trial‐sequential analysis, showed how cortisol levels were significantly higher in BMS. Cortisol emerges as an interesting salivary biomarker in BMS, but future properly designed studies are needed to evaluate its role in diagnosis and/or response to treatment. [ABSTRACT FROM AUTHOR]

Objectives : To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized clinical trials (RCT). There is controversy whether the placement of PCs in ARP is effective in the formation of new bone. Materials and methods: A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: In patients undergoing tooth extraction followed by ARP, do PCs alone in the post-extraction socket in comparison with spontaneous healing improve new vital bone formation percentage in histomorphometric analysis after more than 10 weeks? The risk of bias was assessed and a meta-analysis was conducted. Results: Of 3809 results, 8 studies were considered suitable for inclusion. A total of 255 teeth were extracted in 250 patients. Regarding the PCs used, ARP was performed with platelet- and leukocyte-rich fibrin (L-PRF) in 120 sockets, and with pure platelet-rich plasma (P-PRP) in 31 sockets and 104 sockets were controlled. PCs improved new bone formation in ARP with respect to the spontaneous healing group (SMD = 1.77, 95%C.I. = 1.47–2.06, p-value < 000.1). There were no differences between the different PCs (L-PRF and P-PRP). Conclusion: The results of this meta-analysis support the efficacy of the use of PCs in new bone formation in ARP. With respect to the different types of PCs studied, no differences were observed. Clinical relevance: When planning implant surgery after tooth extraction, treatment with PCs should be considered for ARP. Any PC increases new bone formation compared to spontaneous healing. [ABSTRACT FROM AUTHOR]

Simple Summary: The cells of the immune system can exert a dual effect on cancer development and growth. On the one hand, the immune system can be activated by tumor antigens and can elicit an antitumor response. On the other, the inflammatory milieu in the tumor microenvironment can trigger immune effector mechanisms that promote tumor growth. In the oral cavity, the balance between protumor and antitumor immunity can influence the progression from premalignancy to carcinoma. In this article, we review the cells and mechanisms that are thought to be the most important immune determinants of oral cancer development and progression. A still unresolved issue surrounding tumor formation concerns the role that the immune system plays in preventing the formation and progression of neoplasia, including oral squamous cell carcinoma (OSCC). Antitumor immunity has historically been seen as a critical barrier for cancer cells to develop, grow and spread, and this can be modulated using immunotherapies to achieve antitumor clinical responses. However, it has recently become clear that tumor-associated immunity, particularly the inflammatory microenvironment, has the paradoxical effect of enhancing tumorigenesis and progression. In this review, we discuss the multifaceted function of infiltrating immune cells in suppressing or promoting premalignancy and cancer. In particular, we report on the evidence supporting a role for T lymphocytes, dendritic cells, macrophages, and neutrophils in the development and progression of oral potentially malignant disorders (OPMD) and OSCC. We also draw attention to the clinical relevance of immune cell phenotypes and associated molecules for use as biomarkers and to the translatability of current research findings to improve classification systems and precision medicine in patients with OSCC. [ABSTRACT FROM AUTHOR]

Objective: Growing evidence is highlighting the inefficacy of clindamycin as an effective substitute to amoxicillin in patients self‐reporting a penicillin allergy. The hypothesis is that implant failure is higher in these patients, when compared to patients receiving penicillin. To test this hypothesis, a systematic review and meta‐analysis was undertaken and a protocol for delabeling penicillin allergic patients was presented. Materials and Methods: A systematic review was undertaken by searching across three different databases, namely PubMed, Scopus and Web of Science. Results: Out of 572 results, four studies were eligible to be included. Fixed‐effects meta‐analysis showed a higher number of failed implants in patients who were administered clindamycin, because of a self‐reported allergy to penicillin. Results showed that these patients are over three times more likely (OR = 3.30, 95% C.I. 2.58–4.22, p‐value <.00001) to undergo implant failure with an average cumulative proportion of 11.0% (95% C.I. 3.5–22.0%) versus 3.8% (95% C.I. 1.2–7.7%) of patients not requiring clindamycin and administered amoxicillin. A protocol for penicillin allergy delabeling is proposed. Conclusions: Current evidence is still limited and based on retrospective observational studies, it is difficult to state if penicillin allergy, clindamycin administration or a combination of both is responsible for the current trends and reported findings. [ABSTRACT FROM AUTHOR]

Background: Oral tongue squamous cell carcinoma (OTSCC) represents the most common malignancy of the oral cavity. Tumor budding (TB) is a reliable prognostic factor in OTSCC; however, a standardized scoring system is not still validated. Aims: The study aims to evaluate the prognostic role of TB in 211 OTSCC patients treated between 1997 and 2018. Materials & Methods: TB was evaluated on hematoxylin and eosin‐stained sections in the hotspot area of the infiltrative front (×200‐magnification). It was scored using a two‐tier system, a three‐tier system, and according to BD‐model and revised‐Grading system. Univariate and multivariate Cox regression analyses of disease‐specific survival (DSS) and disease‐free survival (DFS) were performed. A p < 0.05 was considered as statistically significant. Results: The two‐tier and three‐tier systems resulted an independent prognostic factor of DSS. High‐risk patients had a 2.21 and 3.08 times increased probability of poor DSS compared with low‐risk group. It is significantly increased even for intermediate‐risk group. No significant differences emerged classifying patients according to BD‐model and revised‐Grading system. Discussion: These data confirm the prognostic value of TB in predicting DSS in OTSCC. Classifying patients into two groups using the 5‐bud cutoff significantly discriminates their outcomes. Conclusion: Since the established role of DOI and the poor prognostic value of grading, TB could be considered an independent prognostic marker. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic, starting in 2020, has presented a major challenge in terms of early diagnosis and the subsequent containment and management of severe cases. The spread of viruses such as monkeypox in non-endemic countries is now creating new difficulties for healthcare professionals. Proper case definition and clinical examination are crucial for the early identification of suspected cases. For this reason, we performed a review of the literature in order to report the first signs, which are useful for healthcare providers for early case identification. Since 2022 to date, 86,930 laboratory-confirmed cases and 1051 probable cases have been reported worldwide, and of these, 116 were fatal cases and, for the first time, most of the cases were registered in countries that have not historically reported monkeypox and that lack direct or immediate epidemiological links to areas of West or Central Africa where the disease is endemic. Patients with Monkeypox experience prodromal symptoms, such as fever, fatigue, headache, muscle aches, and a rash after an incubation period of 5–21 days. The disease is usually self-limiting within 2–4 weeks but can lead to complications, such as pneumonia, encephalitis, kidney injury, and myocarditis in children, pregnant individuals, and those with weakened immune systems. The case–fatality ratio is between 1 and 10%. Today, prevention campaigns and the control of human monkeypox are the best weapons to prevent infection and stop transmission. Prevention strategies, such as avoiding contact with sick or dead animals, and the proper preparation of all foods containing animal meat or parts, should be adopted. Furthermore, close contact with infected people or contaminated materials should be avoided to prevent human-to-human transmission. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present review and meta‐analysis was to evaluate the influence of soft tissue thickness on initial bone remodeling after implant installation. Materials and Methods: A literature search was conducted by two independent reviewers on electronic databases up to May 2022. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) performed on human subjects were included. The risk of bias was evaluated using Cochrane Collaboration's tool. Meta‐analysis and Trial Sequential Analysis (TSA) were performed on the selected articles. The primary outcome was marginal bone loss. Results: After screening, 6 studies were included in the final analysis, with a total of 354 implants, and a follow‐up from 10 to 14 months. 194 implants were placed in a ≥ 2 mm soft tissue thickness, while 160 had <2 mm soft tissue thickness before implant placement. The included studies had a high level of heterogeneity (I2 > 50%). The meta‐analysis indicated a statistically significant difference between the two groups (0.54; p =.027) and the TSA analysis confirmed the results, despite the limited number of dental implants. Additional analysis showed that age and follow‐up parameters were not statistically significant factors influencing the bone loss (p =.22 and p =.16, respectively). Conclusions: Based on the available RCTS and CCTs, initial soft tissue thickness seems to influence marginal bone loss after a short follow‐up period. Based on TSA analysis, further studies are needed to assess the influence of the soft tissue thickness on marginal bone loss. PROSPERO registration number: CRD42021235324. [ABSTRACT FROM AUTHOR]

Background: Several solutions are available for the rehabilitation of edentulous jaws. Each treatment option is characterised by specific advantages and drawbacks. Objective: The aim of this research was to perform a cost‐effectiveness (CE) analysis of the main rehabilitative solutions of totally edentulous mandibles. Methods: Decision tree models were built using TreeAge Pro Healthcare 2021 software to compare the following strategies: Conventional Denture (CD), Overdenture retained by two implants (OD‐2), Overdenture retained by a bar on two implants (ODbar), Overdenture retained by 4 mini‐implants (ODmini) and Fixed denture supported by 4 implants (FD). Costs were estimated using data from public rate tables. Effectiveness measures were obtained from a meta‐analysis of literature data, normalising the different scales in 0–1 range. A value of 30 000€ per 1 normalised utility points was set as threshold of willingness to pay (WTP). Probabilistic sensitivity analysis (PSA) with 1000 Monte Carlo Simulations was performed to characterise uncertainty. Results: Total costs ranged between 1804,40€ for CD and 10 008,80€ for FD rehabilitations, with an effectiveness of 0,69 and 0,95 normalised points (0–1 scale) for the two solutions. The ODbar resulted to be the most CE strategy at the established WTP value, with the highest Net Monetary Benefit (22 001,20€), followed by the OD‐2 rehabilitation (21 866,80€). PSA analysis confirmed the dominance of OD‐2 and ODbar strategies, confirming a net separation from the other alternatives. Conclusion: OD stabilised by 2 implants could represent a good rehabilitative solution for patients with edentulous mandible, being a good trade‐off in terms of costs and effectiveness. Nevertheless, a standardised measure of oral health‐related quality of life is needed to obtain more reliable results. [ABSTRACT FROM AUTHOR]

Background: Survival rate for oral tongue squamous cell carcinoma (OTSCC) is still poor and, despite Tumor–Node–Metastasis staging system has been recently updated, patients included under the same stage still show difference in prognosis. Perineural invasion (PNI) emerged to be an indicator of tumor aggressive behavior and unfortunate events. In this study, we investigate the clinic and prognostic value of PNI in a cohort of OTSCC patients. Methods: About 200 patients with OTSCC were retrospectively evaluated the presence of PNI. PNI was furtherly descripted as uni‐/multifocal and as intra‐/peritumoral. Disease‐Specific and Relapse‐Free Survival (DSS; RFS) were estimated; moreover, we included PNI in the current AJCC 8th Staging System, improving the prognostication model. Results: Perineural invasion was found in 40.5% of patients. Intratumoral PNI predicted patients at high risk of being diagnosed with lymph–node metastasis. Tumors with positive PNI reported a worse DSS (Hazard Ratio=1.878, p‐value = 0.008). Moreover, patients exhibiting both multifocal intra‐ and peritumoral PNI reported poorest DSS (Hazard Ratio = 2.409, p‐value = 0.010). Patients were reclassified in a new staging system in case of multifocal PNI, providing better stratification capacity. Conclusions: Perineural invasion might serve as an additional prognostic factor in OTSCC, and by integrating PNI in the staging system, further improvements in prognostication might be reached. [ABSTRACT FROM AUTHOR]

Simple Summary: An oral cavity tumor, known as an oral squamous cell carcinoma (OSCC), has a five-year survival rate of just about 50%. Novel, easily, available biomarkers for prognosis evaluation are still required. Despite advancements in diagnosis and therapy, this rate has not grown in recent decades. Our study indicated that a lower expression of a protein named E-cadherin is related with a poor prognosis for OSCC patients. This evidence came from the meta-analysis of 25 studies, including 2553 patients, in which E-cadherin protein expression was assessed in their tumor sample by immunohistochemistry. This study highlights the promising role of E-cadherin assessment during routine histopathology diagnoses to support prognostic decision-making, and to pave the way for future studies to counteract its role in cancer progression. Oral squamous cell carcinoma (OSCC) is characterized by poor survival, mostly due to local invasion, loco-regional recurrence, and metastasis. Given that the weakening of cell-to-cell adhesion is a feature associated with the migration and invasion of cancer cells, different studies have explored the prognostic utility of cell adhesion molecules such as E-cadherin (E-cad). This study aims to summarize current evidence in a meta-analysis, focusing on the prognostic role of E-cad in OSCC. To find studies meeting inclusion criteria, Scopus, Web of Science, EMBASE, Medline, and OpenGrey databases were systematically assessed and screened. The selection process led to 25 studies, which were considered eligible for inclusion in the meta-analysis, representing a sample of 2553 patients. E-cad overexpression was strongly associated with longer overall survival (OS) with Hazard Ratio (HR)  = 0.41 95% confidence interval (95% CI) (0.32–0.54); p < 0.001 and disease-free survival with HR 0.47 95% CI (0.37–0.61); p < 0.001. In terms of OS, patients with tongue cancer experienced better survivability when expressing E-cad with HR 0.28 95% CI (0.19–0.43); p < 0.001. Globally, our findings indicate the prognostic role of the immunohistochemical assessment of E-cad in OSCC and its expression might acquire a different role based on the oral cavity subsites. [ABSTRACT FROM AUTHOR]

Air–powder abrasive treatment has shown interesting results for dental implant treatments; however, which powder is most effective is still an open question. This in vitro pilot study aims to compare the ability of six different powders (sodium bicarbonate powder—65 µm and 40 µm; glycine powder; erythritol powder—with and without cetylpyridinium chloride and calcium carbonate) to remove biofilm from contaminated titanium discs and to evaluate the physical effects of such treatments on surface topography. Seventy-four titanium discs with two different surface roughness were treated after S. sanguinis contamination. Cleaning ability and surface changes were assessed by scanning electron and confocal laser scanning microscopy as well as profilometry. All treated surfaces showed minimal bacterial residues compared to untreated ones, regardless of the treatment provided (remaining biofilm range 11.4% to 28.4% on machined discs—range 10.7% to 18.3% on moderately rough surface discs). No relevant changes on the microscopic ultrastructure of the disc surfaces were noted. The different treatments reduced biofilm up to 89.3 and 88.6% on moderately rough and machined discs, respectively, and they all showed statistically significant superiority over calcium carbonate powder. None of the tested treatments rendered the disc surfaces biofilm-free. Therefore, combined mechanical and chemical decontamination methods are still recommended to achieve maximum biofilm removal for peri-implantitis treatment. [ABSTRACT FROM AUTHOR]

This study aimed at investigating differences in heat generation and bone architecture following four different implant site preparation techniques: compressive osteotomes, conventional drills, osseodensification (OD mode with osseodensification drills), and piezoelectric systems. Porcine rib bones were used as a model for implant surgery. Thermocouples were employed to measure temperature changes, and micro-CT to assess the bone architecture. The primary stability and insertion torque values of the implants placed in the differently prepared sites were assessed. The temperature changes were higher with Piezo. The average primary stability using the ISQ scale was the greatest for drills (76.17 ± 0.90) and the lowest for osteotomes (71.50 ± 11.09). Insertion torque was significantly higher with the osseodensification method (71.67 ± 7.99 Ncm) in comparison to drills, osteotomes, and piezo. Osteotomes showed the highest bone to implant contact percentage (39.83 ± 3.14%) and average trabecular number (2.02 ± 0.21 per mm), while drills exhibited the lowest (30.73 ± 1.65%; 1.37 ± 0.34 per mm). Total implant site bone volume was the highest with osseodensification (37.26 ± 4.13mm3) and the lowest for osteotomes (33.84 ± 3.84mm3). Statistical analysis showed a high primary stability and decrease in temperature during implant site preparation with osseodensification technique. The results support the use of osseodensification technique for implant site preparation. [ABSTRACT FROM AUTHOR]

Head and neck cancer (HNC) is an ascending and agressive disease. The search for new molecular markers is emerging to solve difficulties in diagnosis, risk management, prognosis and effectiveness of treatments. Proteins related to apoptotic machinery have been identified as potential biomarkers. Caspase 3 is the main effector caspase and has a key role in apoptosis. The objective of this systematic review and meta-analysis is to review studies that analyze changes in Caspase 3 and Cleaved Caspase 3 expression both in oral premalignant disorders (OPMD) as well as in head and neck cancer (HNC). This study also proposes to review the prognostic values associated with HNC according to the expression of Caspase 3. Medline (via PubMed), EMBASE, Scopus, Cochrane, Web of Science and Grey Literature Database were screened from inception to june of 2022 and 18 studies were selected and 8 were included in the prognostic meta-analysis. Results related to the comparison of Caspase 3 expression demonstrated similar expression of Caspase 3 in HNC, with an average of 51.9% (9.5–98.1) showing high/moderate expression compared to 45.7% (14.6–84.7) in OPMD. Of interest, Cleaved Caspase 3 resulted incresed in HNC when compared with OPMD, being 73.3% (38.6–88.3) versus 22.9% (7.1–38.7). Pooled Fixed effect of HR values (95% CI) for OS related to Caspase 3 IHC expression in HNC patients was 1.48 (95% CI 0.95–2.28); also, the rate of heterogeneity was low, as revealed by I2 = 31%. For DFS was 1.07 (95% CI 0.79–1.45) with I2 = 0% and DSS showed a HR of 0.88 (95% CI 0.69–1.12) with I2 = 37%. Caspase 3 and Cleaved Caspase 3 expression could be linked with malignancy progression, but the expression of Caspase 3 did not influence the prognosis of patients with HNC. [ABSTRACT FROM AUTHOR]

Chronic hyperplastic candidiasis (CHC) is a prototypical oral lesion caused by chronic Candida infection. A major controversy surrounding CHC is whether this oral lesion owns malignant transformation (MT) potential. The aim of the present study was to evaluate current evidence on the MT of CHC and to determine the variables which have the greatest influence on cancer development. Bibliographical searches included PubMed, Embase, Web of Science, Scopus and LILACS. The cohort studies and case series used to investigate the MT of CHC were deemed suitable for inclusion. The quality of the enrolled studies was measured by the Joanna Briggs Institute scale. Moreover, we undertook subgroup analyses, assessed small study effects, and conducted sensitivity analyses. From 338 studies, nine were finally included for qualitative/quantitative analysis. The overall MT rate for CHC across all studies was 12.1% (95% confidential interval, 4.1–19.8%). Subgroup analysis showed that the MT rate increased when pooled analysis was restricted to poor quality studies. It remains complex to affirm whether CHC is an individual and oral, potentially malignant disorder according to the retrieved evidence. Prospective cohort studies to define the natural history of CHC and a consensus statement to clarify a proper set of diagnostic criteria are strongly needed. PROSPERO ID: CRD42022319572. [ABSTRACT FROM AUTHOR]

Background: Bone grafting in post-extractive site improves tissue regeneration. Soft tissue sealing of the grafted post-extractive alveolus is supposed to limit microbiological contamination from the oral cavity and to stabilize the coagulum. Several techniques are presented in the literature to reach this goal using different heterologous matrices or autogenous grafts. In addition, recently, a technique based on the use of granulation tissue in the post-extractive alveolus has been proposed. Aim: To compare the effect of different graft sealing approaches in post-extractive sites by qualitatively evaluating their healing process. Materials and Methods: This retrospective investigation included 30 patients requiring post-extractive site regeneration in the aesthetic area. Post-extractive sites were regenerated using a bovine bone matrix and patients were divided into three groups (10 patients in each group) according to the material used to seal the alveolar socket. In the UD group, the granulation tissue was used to seal the defect; in the PC group, epithelial-connective soft tissue graft was used, and in the COLL group, a collagen-based membrane was employed. Images of the post-extractive sites at different follow-up periods (2 and 12 weeks) were taken and the healing process was blindly evaluated by two independent practitioners. The Healing Index (HI) by Landry, Turnbull and Howley was used to assess the quality of the healing process. The combination of presence/absence of five clinical criteria defines an HI ranging from 1 (very poor) to 5 (excellent). Patients' clinical-pathological variables were recorded. One-way ANOVA was used to explore the dependence of HI on the different socket preservation protocols. Results: Based on clinical-pathological characteristics of the included patients, there were no statistically significant differences among the different sealing techniques. At the 2-week follow-up appointment, HI did not differ among the socket preservation protocols evaluated. Moreover, smoking status and reason for extraction did not influence the HI among the three groups (two-way ANOVA p-value = 0.686, p-value = 0.248 respectively). At the 2-week follow-up appointment, HI was significantly different among the socket preservation protocols investigated. Specifically, the group undergoing collagen-based socket preservation procedure reported the highest HI, compared to the other two techniques (COLL mean 4.60 ± 0.5; PC mean 3.5 ± 1.2; UD mean 3.4 ± 0.5, one-way ANOVA p-value 0.006). Conclusions: The use of collagen porcine membranes may represent a suitable option to improve the patient healing process in grafted post-extractive sites together with reducing the surgical intervention time compared to alternative sealing techniques. [ABSTRACT FROM AUTHOR]

Over the past decade, we witnessed a promising application of cold atmospheric plasma (CAP) in cancer therapy. The aim of this systematic review was to provide an exhaustive state of the art of CAP employed for the treatment of head and neck cancer (HNC), a tumor whose late diagnosis, local recurrence, distant metastases, and treatment failure are the main causes of patients' death. Specifically, the characteristics and settings of the CAP devices and the in vitro and in vivo treatment protocols were summarized to meet the urgent need for standardization. Its molecular mechanisms of action, as well as the successes and pitfalls of current CAP applications in HNC, were discussed. Finally, the interesting emerging preclinical hypotheses that warrant further clinical investigation have risen. A total of 24 studies were included. Most studies used a plasma jet device (54.2%). Argon resulted as the mostly employed working gas (33.32%). Direct and indirect plasma application was reported in 87.5% and 20.8% of studies, respectively. In vitro investigations were 79.17%, most of them concerned with direct treatment (78.94%). Only eight (33.32%) in vivo studies were found; three were conducted in mice, and five on human beings. CAP showed pro-apoptotic effects more efficiently in tumor cells than in normal cells by altering redox balance in a way that oxidative distress leads to cell death. In preclinical studies, it exhibited efficacy and tolerability. Results from this systematic review pointed out the current limitations of translational application of CAP in the urge of standardization of the current protocols while highlighting promising effects as supporting treatment in HNC. [ABSTRACT FROM AUTHOR]

Background: Antibiotic prophylaxis during implant placement may improve implant short term survival. Nevertheless, use of antibiotics carries risks of adverse effects and antibiotic resistance. The aim of the present study is to compare the use of antibiotics in dental implant procedures in terms of costs and effectiveness.Methods: A decision-tree model was developed using TreeAge Pro Healthcare software. Two strategies were compared: Antibiotics and No antibiotics in implant placement procedures. The costs were calculated considering direct costs for implant placement, antibiotic costs, and costs for implant replacement in case of failure. Effectiveness was defined in terms of General Oral Health Assessment Index. Outcomes were evaluated as Incremental Cost Effectiveness Ratio (ICER). One-way sensitivity analysis and Probabilistic Sensitivity Analysis were performed for the most influential variables to test parameter uncertainty. Patient and healthcare perspectives were considered.Results: Antibiotic prophylaxis resulted to be cost-effective compared to no use of antibiotics (ICER = 14,692,64 and ICER = 3841,18, respectively for patient's and healthcare perspective). The cost of antibiotics, cost of implant replacement in case of failure and probability of adverse effects significantly influenced the results.Conclusions: From an individual patient perspective, antibiotic strategy can be considered cost-effective, even when the cost of antibiotic therapy increases. We can conclude that the administration of antibiotics in association with implant placement is recommended in clinical practice, as it increases the success rate and makes the treatment more effective. However, attention should be placed when healthcare perspective is considered, particularly in terms of antibiotic resistance that may impact public health and associated costs. [ABSTRACT FROM AUTHOR]

Simple Summary: The results of tumor budding are an independent prognostic factor of locoregional recurrences in many solid cancers, including colorectal, nasopharyngeal, esophageal, and lung cancer. Regarding oral squamous cell carcinoma, tumor budding predicts poor survival outcomes regardless of the tumor subsite and the pathological stage. Several detection methods for tumor budding have been proposed in the literature in order to reach an agreement on a standardized scoring system. However, the lack of a standardized assessment method prevents its evaluation in a multidisciplinary setting. In this context, this study aims to critically review the literature data regarding the prognostic role of tumor budding in oral squamous cell carcinoma. The validation of a tumor budding detection method based on tumor stage and site could be relevant to improving risk stratification and planning the clinical management of patients. Moreover, tumor budding could be included in daily pathological practice to better predict the patient's outcomes. Tumor Budding (TB) represents a single cancer cell or a small cluster of less than five cancer cells on the infiltrative tumor front. Accumulating evidence suggests TB is an independent prognostic factor in oral squamous cell carcinoma (OSCC). However, its exact role is not yet elucidated, and a standardized scoring system is still necessary. The study aims to extensively review the literature data regarding the prognostic role of TB in OSCC. The results of TB are an independent prognostic factor of poor survival outcomes in OSCC. To date, the manual detection of hematoxylin and eosin-staining or pancytokeratin-immunostaining sections are the most commonly used methods. Between the several cut-offs, the two-tier system with five buds/field cut-offs provides better risk stratification. The prognostic role of the BD model in predicting survival outcomes was extensively validated; however, the inclusion of DOI, which is already a staging parameter, encouraged other authors to propose other models, integrating TB count with other adverse risk factors, such as the tumor–stroma ratio and tumor-infiltrated lymphocytes. The prognostic relevance of TB in OSCC highlights its evaluation in daily pathological practice. Therefore, the TB detection method and the TB scoring system should be validated based on tumor stage and site. [ABSTRACT FROM AUTHOR]

Background: Tobacco consumption remains a public health issue and is one of the major causes of death in India. This study presents a validated conceptual model to assess the interaction between education, perceived application of tobacco control measures, type of tobacco and their effects on the intention to quit tobacco. Additionally, the direct and mediating roles of tobacco use -frequency, -duration, and -dependency on the intention to quit is also investigated.Methods: An analytical cross-sectional study was carried out, and data from tobacco users of six randomly selected states in India was collected via face-to-face interviews. Structural equation modeling (SEM) was performed using R v 3.6.3 to test the model fit and to explore the association between tobacco control measures and the intention to quit tobacco.Results: From 1962 tobacco users, 43.7% wanted to quit tobacco immediately. Tambakoo (57.7%) was the most common type of tobacco used and 68.9% said that minors could buy tobacco. Findings from SEM showed that that one standard deviation (SD) increase in the perceived application of tobacco control measures is directly associated with a 0.181 SD increase in the intention to quit tobacco (B = 0.181, P < 0.001), and this effect was partially mediated by frequency of tobacco consumption (B = 0.06, P < 0.05). Also, a better education level was associated with a higher intention to quit tobacco (B = 0.14, P < 0.001).Conclusions: To conclude, the application of tobacco control measures and a better education level may positively affect the intention to quit tobacco. The frequency of tobacco use and the number of influencers play an essential role in deciding to quit. In future, longitudinal studies are recommended to further substantiate the evidence. [ABSTRACT FROM AUTHOR]

Background: Studies have examined the benefit of having keratinized peri‐implant mucosa width with mixed results. Purpose: This study examines whether the lack of a prespecified (2 mm) amount of keratinized mucosa width (KMW) is a risk factor for peri‐implant diseases. Methods: A systematic electronic and manual search of randomized or nonrandomized controlled or noncontrolled clinical trials was conducted. Qualitative review, quantitative meta‐analysis, and trial sequence analysis (TSA) of implants inserted at sites with <2 mm or ≥2 mm of KMW were analyzed to compare all the predetermined outcome variables. The level of evidence concerning the role of KMW in peri‐implant health was evaluated via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system guide. Results: Nine studies were included in the qualitative analysis and four in the meta‐analysis and TSA. No significant inter‐group difference (p > 0.05) and a low power of evidence were found for probing depth, soft‐tissue recession, and marginal bone loss. A significant difference favoring ≥2 mm KMW had a lower mean plaque index (MD = 0.37, 95% CI: [0.16, 0.58], p = 0.002) (3 studies, 430 implants, low‐quality evidence). GRADE system showed very low and low quality of evidence for all other outcome measures. Conclusion: Based on the available studies, the impact of amount of KMW (either <2 mm or ≥ 2 mm) as a risk factor for developing peri‐implant disease remains low. Future control studies with proper sample size and longer follow‐up are needed to further validate current findings. [ABSTRACT FROM AUTHOR]

Background: TATE has been proposed as a prognostic factor in oral cancer staging; however, the controversial literature data limit its application in the routine diagnosis. The aim of this study was to evaluate the prognostic value of TATE in patients with oral tongue cancer. The second aim was to identify any difference in the methods of eosinophil quantification or in the cutoff values reported in literature. Methods: Clinic‐pathological data of 204 patients treated at "Ospedali Riuniti" Hospital, Ancona, Italy, were collected. Evaluation of TATE was performed on hematoxylin‐and‐eosin‐stained slides and correlation with survival outcomes was evaluated. The number of eosinophils per square millimeter was evaluated by using two methods, namely density (TATE‐1) and classical (TATE‐2) methods. For each of the 2 methods tested, patients were stratified into two or three groups, according to the most used cutoff values reported in literature. Results: Regardless of the method of eosinophil quantification or the cutoff values used, patients with high TATE had a significantly better disease‐specific survival. The density method (TATE‐1) showed a better predictive performance, in particular when applying a single cutoff of 67 eosinophils/mm2, two cutoffs of 10 and 100 eosinophils/mm2, or two cutoffs of 50 and 120 eosinophils/mm2. Conclusion: The evaluation of TATE is simple, cost‐effective, and easy to implement in daily practice with the aim of improving risk stratification of patients affected by oral tongue cancer. Results of prognostic performance analysis suggest using density (TATE‐1) method as the standard approach to evaluate TATE in future studies, enhancing replicability. [ABSTRACT FROM AUTHOR]

Background: This systematic review and meta-analysis aimed to investigate the role of alendronate combined with step 2 of periodontal therapy in reducing probing pocket depth, improving clinical attachment level, and reducing bone defect depth in intra-bony and inter-radicular defects. Methods: RCTs with more than 6 months follow-up were included in this study. Risk of bias assessment was performed using the Cochrane collaboration tool. In addition, meta-analysis and trial sequential analysis were used to aggregate the available evidence. Results: Seven studies met the inclusion criteria and were included in the systematic review. Topical application of alendronate during second step of periodontal therapy significantly improved PD and CAL. Conclusion: Local application of alendronate may confer a beneficial effect when applied during step II of periodontal therapy even if long term studies are needed to confirm these results. Clinical relevance: Considering the emerging role of host-inflammatory response in treatment of periodontitis and the antiresorptive and osteostimulative properties of bisphosphonates, several studies are focusing on the role of alendronate as an addition to non-surgical periodontal therapy. [ABSTRACT FROM AUTHOR]

Inflammation seems to play a critical role in the development and progression of different cancers. Neutrophil-to-lymphocyte ratio (NLR) is an easily measurable marker of systemic inflammation. The purpose of this systematic review and meta-analysis was to evaluate the prognostic role of the pre-treatment NLR, in terms of overall survival (OS) and disease-free survival (DFS), in patients with primary head and neck squamous cell carcinoma (HNSCC) treated by surgery alone or followed by chemo/radiotherapy. This systematic review was performed according to the guidelines reported in the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Meta-analysis of OS and DFS was performed using the inverse of variance test. Fixed-effect models were used on the basis of the presence of heterogeneity. Risk of bias assessment and trial sequential analysis (TSA) were also performed; the quality of the evidence was evaluated via the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. The analysis revealed that a higher value of pre-treatment NLR correlates with a statistically significant decrease of OS (HR, 1.56; 95% CI: [1.35, 1.80]; p < 0.00001) and a lower DFS (HR, 1.64; 95% CI: [1.30, 2.07]; p < 0.0001) in HNSCC patients. [ABSTRACT FROM AUTHOR]

Background: Rough and/or plasma‐activated abutments seem to be able to increase soft tissue adhesion and stability; however, limited evidence is available about bacterial contamination differences. Purpose: The aim was to investigate the oral microbiota on four dental abutments with different surfaces by quantitative real‐time polymerase chain reaction (qRT‐PCR) and culturomic approach. Methods: Forty patients needing a single implant rehabilitation were involved in the study. Forty healing abutments, especially designed for the study, were divided into four groups according to the surface topography (1. machined [MAC], 2. machined plasma of argon treated [plasmaMAC], 3. ultrathin threaded microsurface [UTM], 4. UTM plasma of argon treated [Plasma UTM]). Random assignment was performed according to predefined randomization tables. All patients underwent surgical intervention for implant and contextual healing abutment positioning. After 2 months of healing, a sterile cotton swab was used for microbiological sampling for culturomics, while sterile paper points inserted into the sulcus were used for qRT‐PCR. Results: At the end of the study, 36 patients completed all procedures and a total of 36 abutments (9 per group) were analyzed. qRT‐PCR retrieved data for 23 bacterial species whereas culturomics revealed the presence of 74 different bacteria, most of them not routinely included into oral cavity microbiological kits of analysis or never found before in the oral microenvironment. No statistically significant differences emerged analyzing the four different surfaces (p = 0.053). On the contrary, higher total and specific bacterial counts were detected in the plasma‐treated surfaces compared to the untreated ones (p = 0.021). Conclusions: Abutments with different topographies and surface treatments resulted contaminated by similar oral bacterial flora. Abutments with moderately rough surface were not associated with a greater bacterial adhesion compared to machined ones. Conversely, more bacteria were found around plasma‐treated abutments. Furthermore, data reported suggested to include new species not previously sought in the routine analyses of the oral bacterial microflora. [ABSTRACT FROM AUTHOR]

Since December 2019, the global burden of the COVID-19 pandemic has increased rapidly and has impacted nearly every country in the world, affecting those who are elderly or with underlying comorbidities or immunocompromised states. Aim of this systematic review is to summarize lung histopathological characteristics of COVID-19, not only for diagnostic purpose but also to evaluate changes that can reflect pathophysiological pathways that can inform clinicians of useful treatment strategies. We identified following histopathological changes among our patients:: hyaline membranes; endothelial cells/ interstitial cells involvement; alveolar cells, type I pneumocytes/ type II pneumocytes involvement; interstitial and/ or alveolar edema; evidence of hemorrhage, of inflammatory cells, evidence of microthrombi; evidence of fibrin deposition and of viral infection in the tissue samples. The scenario with proliferative cell desquamation is typical of Acute Respiratory Distress Syndrome (ARDS) that can be classified as diffuse alveolar damage (DAD) and not DAD-ARDS. The proposed pathological mechanism concerns the role of both innate and adaptive components of the immune system. COVID-19 lethal cases present themselves as a heterogeneous disease, characterized by the different simultaneous presence of different histological findings, which reflect histological phases with corresponding different pathological pathways (epithelial, vascular and fibrotic changes), in the same patient. [ABSTRACT FROM AUTHOR]

Although biopsy was performed on every patient, for patients 5, 6, 7, 11, and 12, we only had the pathology report available with no specifics of the histology, so we could not provide a detailed report. However, in our case series, patients 2, 3, 7, 8, and 9, who presented lesions exclusively on the dorsum of the tongue did not have a history of frequent intake of sweets such as lollipops. Regarding patient number 11, who presented with keratotic papular and erythematous lesions on the buccal mucosae and ventrum of the tongue bilaterally, her general medical and dermatological history was negative. [Extracted from the article]

Background: In patients with squamous cell carcinoma of the oral tongue (OTSCC), current tumor node metastasis staging system fails to identify at‐risk patients associated with early relapse and poor prognosis despite complete surgical resection. Given the importance of tumor‐infiltrating lymphocytes (TILs) in the development of cancers, here we investigated the prognostic significance of the immune phenotype in OTSCC. Methods: Hematoxylin‐eosin stained sections of OTSCCs from 211 patients were evaluated. Cancers were classified as (a) immune‐inflamed when TILs were found next to tumor cell nests; (b) immune‐excluded when TILs were found in the stroma, outside the tumor; and (c) immune‐desert for tumors lacking lymphocyte infiltrate. The prognostic significance of these immune phenotypes classes was investigated. Data were further validated on an independent cohort from The Cancer Genome Atlas database. Results: Immune‐desert phenotype was the least represented group of OTSCCs in our cohort (11.8%) and served as an independent prognostic factor. Patients with immune‐desert tumors exhibited worse disease‐specific survival (HR = 2.673; [CI: 95% 1.497‐4.773]; P =.001), overall survival (HR = 2.591; [CI: 95% 1.468‐4.572]; P =.001), and disease‐free survival (HR = 2.313; [CI: 95% 1.118‐4.786]; P =.024) at multivariate analysis. Conclusions: We identified a specific subgroup of OTSCCs with poor prognosis. Tumor‐infiltrating lymphocytes density and localization could serve as an integrative parameter to the current staging system and inform the selection of most appropriate treatments. In particular, the tumor immune phenotype could improve the stratification of patients with more aggressive disease. [ABSTRACT FROM AUTHOR]

Background: Mutations of the tumour-suppressor gene TP53 are the most frequent somatic genomic alterations in head and neck squamous cell carcinoma (HNSCC). However, it is not yet clear whether specific TP53 mutations bear distinct clinical and pathophysiological significance in different HNSCC subgroups.Methods: A systematic bioinformatics appraisal of TP53 mutations was performed on 415 HNSCC cases available on The Cancer Genome Atlas (TCGA). The following features were analysed and correlated with known clinicopathological variables: mutational profile of TP53, location (within secondary structure and predicted domains of p53 protein) and well-known hotspot mutations. Interactome-genome-transcriptome network analysis highlighted different gene networks. An algorithm was generated to develop a new prognostic classification system based on patients' overall survival.Results: TP53 mutations in HNSCCs exhibited distinct differences in different anatomical sites. The mutational profile of TP53 was an independent prognostic factor in HNSCC. High risk of death mutations, identified by our novel classification algorithm, was an independent prognostic factor in TCGA HNSCC database. Finally, network analysis suggested that distinct p53 molecular pathways exist in a site- and mutation-specific manner.Conclusions: The mutational profile of TP53 may serve as an independent prognostic factor in HNSCC patients, and is associated with distinctive site-specific biological networks. [ABSTRACT FROM AUTHOR]

Purpose: Epidemiological data of odontogenic tumours (OT) are conflicting, with significant differences among the countries. This study aims to evaluate incidence and prevalence of OTs in the Marche population in a period of 25 years, according to 4th Edition of WHO Classification. Methods: In this study, only patients of Marche region treated for OTs were considered. Data were retrieved from Institute of Pathology, Marche Polytechnic University, Italy. Because this is the only tertiary referral centre for Head and Neck pathology within Marche region, the patient sample could be considered well representative of this area. From each case, age, sex, site, diagnosis and relapses were recorded. Results: Overall, 100 patients were treated for OTs from 1994 to 2018 in Marche region. The annual incidence rate ranged from 0.13 to 0.39 per 100,000, while life prevalence was 6.50 per 100,000. Mean age of onset for primary OTs was 49.7 ± 20.1 years. Twenty-seven patients developed recurrences, showing a mean age of 54 ± 19.7 years and a mean recurrence time of 51.2 ± 34 months. Conclusion: This is the first epidemiological study on OTs in Italian population according to 4th Edition of WHO Classification. Although limited in their retrospective nature, these findings could accurately estimate epidemiology of OTs in Italy. [ABSTRACT FROM AUTHOR]

Root canal cleaning plays an important role in endodontics. In most cases, root canal cleaning is performed using irrigants, such as sodium hypochlorite or EDTA (ethylenediaminetetraacetic acid). The efficacy of these irrigants may be compromised by different phenomena, such as vapor lock. Different methods can be used to overcome this problem; in this paper, we compare the efficacy of two such methods: manual dynamic agitation (MDA) and passive ultrasonic irrigation (PUI). We shaped 50 endo training blocks, which were divided into two groups of 25 samples each, into MDA or PUI groups. In both groups, the vapor lock was produced by delivering a watery solution using a disposable syringe with a tip-opened needle. Using the MDA technique, vapor lock was removed in 15/25 cases. The PUI technique produced the same results in 17/25 cases, where vapor lock was only reduced, not removed. The MDA method produced an average reduction in vapor lock of 80%, whereas the PUI method yielded a 55% reduction. The differences among groups were assessed through a Mann–Whitney U test, and the results had a p-value of 0.0013, which was considered to be statistically significant. The MDA method was able to effectively remove vapor lock. PUI, however, was only able to reduce but not remove vapor lock. [ABSTRACT FROM AUTHOR]

Background: Nitric Oxide (NO) has a role in immunitary defense, regulation of mucosal blood flow and mucus production, regulation of smooth muscle contraction, cerebral blood flow, glucose regulation, and mitochondrial function. NO can be synthetized endogenously through the L-arginine-NO pathway or it can be absorbed by the human intestine through the dietary intake. Most of the ingested NO is in the form of nitrate ( NO 3 − ). NO 3 − is a substrate of oral and intestinal microbiota and, at the end of the catabolic pathway, NO is released. Using antibacterial mouthwashes leads to an alteration of salivary NO 3 − metabolism, however, with unclear consequences on the circulating NO levels. The aim of this study is to perform a systematic review in order to elucidate if the alterations of oral microbiota lead to modifications in plasma NO content. Methods: Electronic databases were screened, using the following terms: ["oral bacteria" and (nitrate OR nitrite OR nitric)]. Clinical studies reporting NO 3 − and NO 2 − measurements in blood and their correlation to oral microbiota variations were included. We focused on the correlation between the changes in oral microbiota and plasma concentrations of nitrites (primary outcome). Subsequently, we investigated if modifications in oral microbiota could lead to changes in blood pressure and salivary NO 2 − concentration (secondary outcome). Results: Six studies, for a total of 82 participants were included in this review. In four studies, the use of mouthwash correlated to a reduction of plasma nitrite concentration (p < 0.05); Two studies did not find any difference in plasma nitrate or nitrite concentration. In five studies, a correlation between blood pressure (BP) changes and antibacterial mouthwashing emerged. Anyway, only three studies suggested a significant increase of systolic BP following mouthwashing compared with controls. Conclusions: Although, the role of oral bacteria has been unequivocally demonstrated in the regulation of salivary NO 3 − metabolism, their influence on plasma concentration of NO species remains ambiguous. Further studies with larger sample size are required in order to demonstrate if an alteration in oral microbiota composition may influence the blood content of NO 3 − / NO 2 − /NO and all the linked biological processes. [ABSTRACT FROM AUTHOR]

An altered oral microbiota has been linked with the development of several oral diseases, such as dental caries, periodontal disease, and oral stomatitis. Moreover, poor oral health has been linked to head and neck cancer, particularly oral cancer. In recent years a growing number of studies indicate that oral microbiota could be involved in the development of primary tumours outside of head and neck region. The aim of this article is to review the recent studies based on high-throughput technology to present evidences of a relationship between oral microbiota and "non-head and neck tumours." Oral dysbiosis seem to be more pronounced in patients with tumours of gastrointestinal tract, in particular oesophageal, gastric, pancreatic, and colorectal cancers, paving the way for developing specific oral microbiota test to allow early cancer detection. Regarding other tumour types, the results are promising but highly preliminary and still debated. Currently, there are several factors that limit the generalization of the results, such as the small sample size, the lack of adequate clinical information about patients, the different sequencing techniques used, and biological sample heterogeneity. Although only at the beginning, the analysis of oral microbiota could be the next step in the evolution of cancer therapy and will help clinicians to develop individualised approaches to cancer prevention and treatment. [ABSTRACT FROM AUTHOR]

Objective: Necrotizing sialometaplasia (NS) is an uncommon benign process which affects minor and, more rarely, major salivary glands. While self‐limiting, the condition might be clinically and histologically mistaken for malignancy. Furthermore, NS may accompany neoplasms. The aim of this paper was to report a series of Italian patients affected by NS associated with an unusual high presence of neoplasms of minor and major salivary glands. Study Design: Clinical and histological features of twelve patients with NS were retrospectively evaluated. Results: Eight patients presented NS of the minor salivary glands of the palate, and two of them had associated neoplasms (pleomorphic adenoma and adenoid cystic carcinoma) at the same site. Four patients had NS of the parotid gland associated with a history of fine‐needle aspiration biopsy performed to diagnose parotid neoplasms. These were epithelial–myoepithelial carcinoma, adenoid cystic carcinoma, Warthin's tumor, and oncocytoma, respectively. Conclusion: Tumors of minor and major salivary glands might be associated with NS more frequently than previously reported. While NS of the parotid is generally the result of invasive diagnostic procedure and is detected after the excision of the tumor, NS of the minor salivary glands may obscure an underlying neoplasm, resulting in delays in referral or treatment. [ABSTRACT FROM AUTHOR]

Background: ADAR1 is an enzymatic protein, which catalyzes a RNA editing reaction by converting Adenosine to Inosine, and its expression has been found to be dysregulated in many cancer types. The aim of this study was to analyze the expression of ADAR1 in oral squamous cells carcinoma.Methods: In order to analyze the ADAR1 mRNA expression, data from The Cancer Genome Atlas (TCGA) database were downloaded and analyzed. In addition, immunohistochemistry analysis was performed on an institutional database including 46 samples of oral squamous cell carcinoma in a tissue microarray (TMA).Results: No statistically significant correlation linked the mRNA ADAR1 expression to any clinic-pathological variables in the TCGA database. Immunohistochemistry analysis of ADAR1 showed different expressions between normal mucosa and tumor tissue. Focusing on the subcellular localization, the nuclear expression of ADAR1 correlated with higher grading of differentiation (ρ = 0.442; P-value = 0.002); the general expression of ADAR1 either in cytoplasm or in nuclei, correlated with the Gender of patients (Cytoplasm expression: ρ = -0.295; P-value = 0.049; while for nuclear expression: ρ = +0.374; P = 0.011); cytosol expression resulted to be an independent protective prognostic factor (HR = 0.047; C.I. 95% 0.007-0.321; P-value = 0.002).Conclusion: Higher expression of ADAR1 into the cytoplasm resulted to be an independent prognostic factor. In order to understand ADAR1 role in cancer, further studies should be performed, in bigger cohort and under a bio-molecular point of view. [ABSTRACT FROM AUTHOR]

Genodermatoses represent a group of uncommon, hereditary, single-gene skin disorders, characterized by multisystem involvement, heterogeneous clinical manifestations and different degrees of morbidity and mortality. Some genodermatoses may have oral mucosa and nail involvement, since the oral cavity and cutaneous organ system, including nails, share a close embryologic origin. Nail disorders can manifest with nail hypoplasia or nail hypertrophy. Clinical pictures of affected oral mucosa can be extremely heterogeneous, ranging from asymptomatic papules to painful blisters, leukokeratosis, oral papillomas and fibromas to oral potentially malignant disorders and cancerous lesions. Oral mucosa and nails pathological features may occur synchronously or not and are usually associated with other systemic and skin manifestations. In some cases, oral mucosa and nails diseases may be distinct and constitute the principal sign of the genetic disorder, in other cases they represent only a part of the puzzle for the confirmation of the diagnosis. Continued awareness of the correlation between oral mucosa and nails findings can help physicians to diagnose genodermatosis in a timely manner, allowing more effective clinical management and prevention and/or early detection of complications. This article provides an overview of all specific genodermatoses affecting both oral mucosa and nails. Moreover, the correlation between teeth and nails is summarized in tabular form. [ABSTRACT FROM AUTHOR]