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Background: to examine the process of epithelial reparation in a surgical wound caused by diode laser., Material and Methods: An experimental study with 27 Sprage-Dawley rats was undertaken. The animals were randomly allocated to two experimental groups, whose individuals underwent glossectomy by means of a diode laser at different wattages, and a control group treated using a number 15 scalpel blade. The animals were slaughtered at the 2nd, 7th, and 14th day after glossectomy. The specimens were independently studied by two pathologists (blinded for the specimens' group)., Results: at the 7th day, re-epithelisation was slightly faster for the control group (conventional scalpel) (p=0.011). At the 14th day, complete re-epithelization was observed for all groups. The experimental groups displayed a pseudoepitheliomatous hyperplasia., Conclusions: it is concluded that, considering the limitations of this kind of experimental studies, early re-epithelisation occurs slightly faster when a conventional scalpel is used for incision, although re-epithelisation is completed in two weeks no matter the instrument used. In addition, pseudoepitheliomatous hyperplasia is a potential event after oral mucosa surgery with diode laser. Knowledge about this phenomenon (not previously described) may prevent diagnostic mistakes and inadequate treatment approaches, particularly when dealing with potentially malignant oral lesions.

Objectives: To identify websites with adequate information on oral cancer screening for healthcare professionals (HCPs) and to assess both their quality and contents., Study Design: Websites were identified using Google and HON medical professional search engines using the terms "screening for oral cancer". The first 100 sites retrieved by each engine were analysed using the DISCERN questionnaire (reliability), the V instrument (contents on oral cancer) and further by the Flesch-Kinkaid Reading Grade Level and the Flesch Reading Ease (readability)., Results: The overall rating showed minimal shortcomings in the quality of the information in the websites. The coverage and correctness of information on "visual examination" was rated as fair/good, whereas updating of contents resulted very variable (eg: 81% for visual examination and 18.2% for molecular biomarkers). These results permitted to rank the websites housing relevant information for oral cancer. Top ranking websites were affiliated to the Oral Cancer Foundation (USA), WHO Collaborating Centre for oral cancer (UK) whose webpage is entitled "Oral Cancer Education and Research", and the Clinical Guidelines maintained by the British Columbia Cancer Agency (Canada) and the British Dental Association (UK) respectively., Conclusions: There are web-based, HCP-addressed, resources on screening for oral cancer housing heterogeneous information both in quality and contents. The use of specific evaluation tools permits the selection of reliable websites on this topic with a potential to improve the existing educational gaps among HCPs.

Objectives: To review the existing techniques for minor salivary gland biopsy (MSGB) in the lip and to suggest a new approach to ease the procedure and reduce post-operative complications., Study Design: A comprehensive literature review and a descriptive study of a new surgical technique., Results: Diverse incisions have been suggested for MSGB with different designs (ellipse, circular, linear), different directions (parallel, oblique, vertical) and a wide range of lengths (from 1 mm up to 3 cm), but no comparative studies supporting the advantages of a particular type of incision over the others could be retrieved. A variety of features of the existing techniques for MSGB are linked to undesired events and surgical complications which could be minimized by modifying certain aspects of these procedures. The technique described, together with the use of the S forceps, represents a significant improvement over the already described chalazion forceps because it allows for a better access and positioning of the lower lip, improves the ergonomic conditions of the assistant, and facilitates the identification of lip areas with more superficial gland lobules., Conclusion: The suggested approach for lip MSGB includes a specifically designed instrument whose performance during lip biopsy may contribute to minimize post-operative complications.

Objectives: To describe a new bench model for oral precancer/cancer biopsy training and to assess its effectiveness in terms of trainees' perception., Study Design: Cross-sectional, descriptive, performed on 424 general dental practitioners (GDP) who undertook biopsies on a pig tongue. The participants were assessed by direct observation for 2.5 hours using specific check-lists and by means of a self-applied questionnaire., Results: The workshop was perceived as "very interesting" even by those with previous surgical experience (Xi - Xj = 0.07; 95%CI= -0.20-0.09). Most GDPs considered themselves able to undertake oral biopsies on real patients after the workshop. Those who had previously received theoretical continuous education courses on oral biopsy scored higher values within the group (Xi - Xj = 0.20; 95%CI= 0.04-0.37)., Conclusions: There is a need for including clinical abilities workshops when instructing on oral biopsy techniques. More studies are needed to validate the procedure and to address cognitive and communication skills.

Objectives: To report on the use of lateral transport osteogenesis in cancer patients after maxillo/mandibular resections and on the implant survival rate in the generated bone, Material and Methods: Four patients treated using lateral transport osteogenesis entered this descriptive study and were retrospectively studied (mean age 55; range 41-62)., Results: Reconstruction of segmentary defects after surgical and radiological cancer treatment on maxilla and mandible was achieved. No relevant intra- or post-operative complications occurred. No differences on implant survival were observed between patients who had received radiotherapy and those who had not., Conclusions: This approach can be considered a recommendable reconstructive option after oral cancer treatment - including radiotherapy- particularly for high-surgical-risk, collaborative patients.

Objectives: to describe a bench model (workshop of abilities) for sinus floor elevation (SFE) training that simulates the surgical environment and to assess its effectiveness in terms of trainees' perception., Study Design: thirty-six randomly selected postgraduate students entered this cross-sectional pilot study and asked to fill in an anonymous, self-applied, 12-item questionnaire about a SFE workshop that included a study guide containing the workshop' s details, supervised practice on a simulated surgical environment, and assessment by means of specific check-lists., Results: Thirtiy-six fresh sheep heads were prepared to allow access to the buccal vestible. Using the facial tuber, third premolar and a 3D-CT study as landmarks for trepanation, the sinus membrane was lifted, the space filled with ceramic material and closed with a resorbable membrane. The participants agreed on their ability to perform SFE in a simulated situation (median score= 4.5; range 2-5) and felt capable to teach the technique to other clinicians or to undertake the procedure for a patient under supervision of an expert surgeon (median= 4; range 1-5 ). There were no differences on their perceived ability to undertake the technique on a model or on a real patient under supervision of an expert surgeon (p=0.36)., Conclusions: Clinical abilities workshops for SFE teaching are an essential educational tool but supervised clinical practice should always precede autonomous SFE on real patients. Simulation procedures (workshop of abilities) are perceived by the partakers as useful for the surgical practice. However, more studies are needed to validate the procedure and to address cognitive and communication skills, that are clearly integral parts of surgical performance.

Aims: To identify factors related to advanced-stage diagnosis of oral cancer to disclose high-risk groups and facilitate early detection strategies., Study Design: An ambispective cohort study on 88 consecutive patients treated from January 1998 to December 2003., Inclusion Criteria: pathological diagnosis of OSCC (primary tumour) at any oral site and suffering from a tumour at any TNM stage. Variables considered: age, gender, smoking history, alcohol usage, tumour site, macroscopic pattern of the lesion, co-existing precancerous lesion, degree of differentiation, diagnostic delay and TNM stage., Results: A total of 88 patients (mean age 60±11.3; 65.9% males) entered the study. Most patients (54.5%) suffered no delayed diagnosis and 45.5% of the carcinomas were diagnosed at early stages (I-II). The most frequent clinical lesions were ulcers (70.5%). Most cases were well- and moderately-differentiated (91%). Univariate analyses revealed strong associations between advanced stages and moderate-poor differentiation (OR=4.2; 95%CI=1.6-10.9) or tumour site (floor of the mouth (OR=3.6; 95%CI=1.2-11.1); gingivae (OR=8.8; 95%CI=2.0-38.2); and retromolar trigone (OR=8.8; 95%CI=1.5-49.1)). Regression analysis recognised the site of the tumour and the degree of differentiation as significantly associated to high risk of late-stage diagnosis., Conclusions: Screening programmes designed to detect asymptomatic oral cancers should be prioritized. Educational interventions on the population and on the professionals should include a sound knowledge of the disease presentation, specifically on sites like floor of the mouth, gingivae and retromolar trigone. More studies are needed in order to analyse the part of tumour biology on the extension of the disease at the time of diagnosis.

Unlabelled: Early diagnosis and referral of oral cancer is essential. Successful implementation of clinical guidelines must include current practitioners and students., Objective: To evaluate the diagnostic accuracy of students at oral cancer screening and to assess the effectiveness of clinical referral guidelines., Study Design: Fifth year dental students were randomly allocated to either control (n=19) or experimental groups (n = 18). Both received the customary training in oral diagnosis. The experimental group underwent a 2 hour workshop where the guidelines for the referral of suspicious lesions were discussed. Three months later, a set of 51 clinical cases including benign, malignant, and precancerous conditions/lesions were used to assess the screening ability of each subject., Results: All 37 students entered the study. Sensitivity (control group) ranged from 16.7% to 66.7%; the experimental group scored from 16.7% to 83.3%. Fifty percent of the experimental students reached sensitivity values ≥ 62.5% (p = 0.01). Diagnostic specificity (control group) spanned from 80% to 93.3% (median = 50%); amongst experimental group it ranged from 82.2% to 97.8% (median = 92.8%); (p = 0.003). Concordance -control group- was X = 82.5 (SD = 3.2), and X = 88.2 (SD = 4.3) for the experimental, (p > 0.001). Cohen's kappa test was poor (K < 0.40) for the controls and moderate for the experimental group. The experimental group referred more oral cancers urgently (p = 0.002) and left less unreferred cancers (0.04). This group also referred more precancerous lesions/conditions urgently (p = 0.02)., Conclusions: The implementation of a clinical referral guideline at undergraduate level has proved valuable, under experimental conditions, to significantly increase diagnostic abilities of the examiners and thus to improve screening for oral cancer.

Objective: To assess the knowledge and preventive attitudes that Spanish dentists have towards oral cancer, before and after an educational intervention., Methods: A quasi-experimental study based on a nationwide intervention. All Spanish dentists were offered an on-site course on oral cancer. An individual questionnaire was administered before and after attending the course. The main outcome measures were systematic examination of the oral cavity, promotion of healthy habits and knowledge of clinical aspects., Results: 440 GDPs entered the study. Age: 40.7+/-10.7, range 21-74. Professional experience: 13.9+/-8.9 years, range 0-45. Of those who participated in the study, 53.1% had never attended a course on oral cancer, 72.4% stated that they perform a systematic examination of the oral mucosa, 88.2% provided systematic counselling on tobacco cessation, and 54.7% reported that they did the same for alcohol. In addition, 32.3% advised patients to eat fruits and vegetables high in antioxidants. Professional experience was significantly associated with oral mucosa systematic examination (t= 2.9; p=0.003), advice on alcohol consumption (t=5.0; p=0.000), and on fruit and vegetable intake (t=5.1; p<0.001). None of these practices were specifically associated with knowledge on oral cancer. All areas of knowledge examined showed statistically significant improvement after the educational intervention., Conclusions: The intervention appears to have improved the GDP s knowledge, confirming the importance of this national campaign.

Aim: To ascertain the impact of routine application of the informed consent form at the primary dental care units of the Galician Health Service., Study Design: Non random selection of consecutive patients seeking tooth extraction between 9 January and 7 March 2007 at the dental care units of Burela, Praza do Ferrol and Viveiro (Lugo). The study included sociodemographic, clinical, utilization, behavioural and IC-related variables., Main Results: A total of 462 patients, mainly males (n=249; 53.9%) entered the study. The mean age of the participants was 57.87+/-17.54 years. 93.7% of the patients gave their consent for tooth extraction, whereas 47.3% did not want to be informed. The average time employed for obtaining the informed consent was 3.40+/-1.87 minutes, with a median of 4 and the same mode. The referred stress values did not differ before and after reading the informed consent form 3.28+/-2.52 vs 3.41+/-2.45 (p=0.661)., Conclusion: Routine application of the informed consent form before tooth extraction under local anaesthesia did not impair clinical practice nor is it a barrier to dental care. The use of this form does not require changes beyond the allocation of the time necessary for its completion.

Aims: to determine the prevalence of dental fear amongst primary dental care units (PDCU) patients and to characterize them according to socio-demographic features., Study Design: non-probabilistic sampling on new and consecutive patients demanding exodontia at the Burela, Praza do Ferrol and Viveiro (Lugo) PDCUs from 9 january to 7 march and from 18 june to 21 september 2007. The variables considered were "demographic" (age, gender, address and educational level), "treatment-related" (reason for extraction, root extraction), "attitudes" (accompanied yes/no, spontaneous fear comments yes/no) and "stress" determined using a visual analogue scale (VAS)., Results: A total of 804 patients entered the study. The mean VAS value was 3.54+/-2.63 (range 0 to 10; median 2.95; mode 0). A 96.8% referred some degree of stress, and a 10.1% of the sample scored high values (>7.5 in the scale). These values resulted to be influenced by sex (p=0.000), address (p=0.025) and by the presence of an accompanying person in the room (p=0.008). Logistic regression analysis identifies female gender (OR=3.26; 95%CI: 1.93 , 5.49), urban (OR=2.02 95%CI: 1.04 , 3.91) or rural (OR=2.16; 95%CI: 1.15 , 4.08) address and the absence of an accompanying person in the room (OR=1.68; 95%CI: 1.05 , 2.70) as predictors for a high level of stress., Conclusion: A 10.1% of the patients experience a high level of stress before tooth extraction. This phenomenon is more common among unaccompanied women from rural or urban areas.