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Aim: Accurately identifying primary lesions in oral medicine, particularly elementary white lesions, is a significant challenge, especially for trainee dentists. This study aimed to develop and evaluate a deep learning (DL) model for the detection and classification of elementary white mucosal lesions (EWMLs) using clinical images. Materials and Methods: A dataset was created by collecting photographs of various oral lesions, including oral leukoplakia, OLP plaque-like and reticular forms, OLL, oral candidiasis, and hyperkeratotic lesions from the Unit of Oral Medicine. The SentiSight.AI (Neurotechnology Co.®, Vilnius, Lithuania) AI platform was used for image labeling and model training. The dataset comprised 221 photos, divided into training (n = 179) and validation (n = 42) sets. Results: The model achieved an overall precision of 77.2%, sensitivity of 76.0%, F1 score of 74.4%, and mAP of 82.3%. Specific classes, such as condyloma and papilloma, demonstrated high performance, while others like leucoplakia showed room for improvement. Conclusions: The DL model showed promising results in detecting and classifying EWMLs, with significant potential for educational tools and clinical applications. Expanding the dataset and incorporating diverse image sources are essential for improving model accuracy and generalizability. [ABSTRACT FROM AUTHOR]

Adverse drug reactions (ADRs) represent a significant threat to patients' safety in dentistry, necessitating proactive measures for prevention and treatment. However, identifying ADRs of dental and oral interest can be challenging, and underreporting remains a persistent issue globally. This paper illustrates a smart system to help Italian healthcare personnel, including dentists, in identifying and reporting dental and oral ADRs. This educational program is within a larger multi-regional project financed by the Italian Agency of Drugs (AIFA). The proposed system comprises a free online questionnaire on ADRs of dental interest (including specific items about awareness and attitudes), and after the free consultation of an atlas of clinical images of dental and oral ADRs linked with a digital synopsis of drugs potentially related to ADRs. This section of the project was presented in April 2023 at the 30th National Congress of the Italian College of University Professors of Dental Disciplines, and the system appears to hold tremendous potential to improve the knowledge of healthcare professionals on oral and dental ADRs. [ABSTRACT FROM AUTHOR]

The use of digital health technologies, including telemedicine and teledentistry, has become a necessity in healthcare due to the SARS-CoV-19 pandemic. These technologies allow for the reduction of the workload of healthcare providers and the improvement of patient outcomes in cases of remote monitoring, diagnosis, and communication. While there are no doubtful benefits, there are some counterparts, such as concerns about clinical risks, data security, and privacy protection. This paper aims to review the regulations regarding the use of digital health apps and software in healthcare. This scoping review followed the PRISMA-ScR guidelines and the five-step framework of Arksey and O'Malley. Study selection was based on eligibility criteria that were defined using the population-exposure framework. The review of the articles selected (n = 24) found that the majority focused on data security policies in the healthcare industry, highlighting the need for comprehensive regulations and app control systems to protect patient data. The articles also emphasized the requirement for more appropriate research and policy initiatives to improve data security practices and better address privacy and safety challenges related to health-related apps. The review recognized that papers did not report consistent standards in professional obligation and informed consent in online medical consultations, with potential risks for data privacy, medical liabilities, and ethical issues. Digital health has already revolutionized medical service delivery through technology but faces some challenges, including the lack of standardized protocols for handling sensitive patient data and the absence of common legislative provisions, raising concerns about confidentiality and security. To address these issues and deficiencies, regulatory compliance is crucial to clarify and harmonize regulations and provide guidelines for doctors and the health system. In conclusion, regulating patient data, clarifying provisions, and addressing informed patients are critical and urgent steps in maximizing usage and successful implementation of telemedicine. [ABSTRACT FROM AUTHOR]

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction, mainly due to bone-modifying agents (BMA), and it is a potentially painful and debilitating condition. To date, the literature has reported a 90% rate of successful outcomes for MRONJ patients undergoing surgical treatment. Particularly for patients with advanced disease stages who are unsuitable for surgery, prolonged medical treatment is required, with a consequent risk of the overuse of antibiotics and antibiotic resistance. The aim of this study is to evaluate the efficiency and safety of ozone, via oral mucosal infiltrations, in seven cancer patients with MRONJ, who are not eligible for surgery. The protocol (OZOPROMAF) consists of intratissue injections of an oxygen ozone (O2O3) mixture, which is applied until formation of a sequestrum and clinical healing. Follow-up was scheduled to confirm the healing of MRONJ and radiological evaluations by CBCT were planned. In order to assess the level of pain, a questionnaire including the Numeric Rating Scale for Pain (NRS Pain) was administered on the first visit, one day after treatment, and one week after treatment. After an application of OZOPROMAF, all patients reported discomfort for some hours, probably due to soft tissue pressure around the infiltration site. Thereafter, the discomfort subsided within 6–8 h. Complete mucosal healing of MRONJ occurred within a number of cycles ranging from 7 to 16. Complete resolution with an improvement in bone condition was observed in all patients. The MRONJ lesions of all patients healed after 18–24 months. The authors of this study contend that these preliminary results suggest the efficiency and safety of the O2O3 mixture. However, further research is required to confirm the efficacy of the O2O3 mixtures in MRONJ treatment, at least for patients who are unsuitable for surgery. [ABSTRACT FROM AUTHOR]

Featured Application: The investigation of sleep quality can be an important parameter in order to identify potential paediatric subjects at risk of obstructive sleep apnoea syndrome (OSAS) more effectively. Obstructive sleep apnoea syndrome (OSAS) is the most severe condition on the spectrum of sleep-related breathing disorders (SRBDs). The Paediatric Sleep Questionnaire (PSQ) is one of the most used and validated screening tools, but it lacks the comprehensive assessment of some determinants of OSAS, specifically anamnestic assessment and sleep quality. This study aims to assess the accuracy of some specific items added to the original PSQ, particularly related to the patient's anamnestic history and to the quality of sleep, for the screening of OSAS in a paediatric population living in Sicily (Italy). Fifteen specific items, divided into "anamnestic" and "related to sleep quality" were added to the original PSQ. The whole questionnaire was administered via a digital form to the parents of children at 4 schools (age range: 3–13 years). For each item, sensitivity and specificity, positive and negative predictive values, and positive and negative likelihood ratios were calculated. The highest sensitivity (80.0, 95% CI: 28.4; 99.5), in combination with the highest specificity (61.1, 95% CI: 35.7; 82.7), was found for the Item 32 ("assumption of bizarre or abnormal positions during sleep"). This item was found statistically significant for predicting the occurrence of OSAS in children (p-value ≤0.003). The study demonstrates the accuracy of specific items related to sleep quality disturbance for the preliminary assessment of the disease. Although these results should be validated on a larger sample of subjects, they suggest that including the factors discriminating sleep quality could further increase the efficiency and accuracy of PSQ. [ABSTRACT FROM AUTHOR]