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Purpose: The aim of this study was to review the current knowledge regarding dental barotrauma. Methods: A search using the PubMed Bibliographic Index and Index-Medicus was performed to identify articles in English that were published between 1930 and 2007. The reference lists of the resulting articles were searched to find publications relating to dental barotrauma. Results: Only a few scientific publications reported this phenomenon. Moreover, a significant part of the relevant literature was from more than 60 years ago. There was no published study on the current incidence rate of this phenomenon. Conclusion: Besides other oral manifestations of barometric pressure changes, such as barodontalgia (barometric pressure-related oral pain), a clinician should be familiar with this entity and take preventive measures as well as periodically examine his or her patients who fly planes or scuba dive. The clinician should also search for occult pathologies such as leaking restorations or secondary caries lesions. In addition, the clinician should be aware of the possible influence of pressure changes on the retention of prosthetic devices and plan treatment accordingly. Int J Prosthodont 2009;22:354-357. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to evaluate the literature for the prevalence of and interventions for oral viral infections and, based on scientific evidence, point to effective treatment protocols. Quality of life (QOL) and economic impact were assessed if available in the articles reviewed.Methods: Our search of the English literature focused on oral viral infections in cancer patients within the timeframe of 1989-2007. Review methods were standardized. Cohort studies were used to determine the weighted prevalence of oral viral infection in cancer patients. The quality of selected articles were assessed and scored with respect to sources of bias, representativeness, scale validity, and sample size. Interventional studies were utilized to determine management guidelines. Literature search included measures of QOL and economic variables.Results: Prevalence of oral herpes simplex virus (HSV) infection in neutropenic patients was higher than in patients treated with radiotherapy for head and neck cancer (49.8% vs. 0%, respectively). In patients treated with radiochemotherapy for head and neck cancer, the prevalence of oral HSV infection increases up to 43.2% (CI, 0-100%). Prevalence of HSV infection was higher when oral ulcers existed. Information about other oral viral infections is sparse. There was a significant benefit of using acyclovir to prevent HSV oral infection (at 800 mg/day). Various dosing protocols of valacyclovir achieved prevention of HSV reactivation (500 or 1,000 mg/day). The prevalence of HSV reactivation was similar for acyclovir and valacyclovir. No information about impact on QOL and economic burden was available.Conclusions: Acyclovir and valacyclovir are equally effective in preventing oral HSV infection. Neutropenic patients, who were primarily treated for hematological malignancies in the studies reviewed, are at a greater risk for viral infection. [ABSTRACT FROM AUTHOR]

Objective: The goal of the study was to analyze dental attendance and self-assessment of dental status among Israeli military personnel, according to gender, education, and smoking status.Methods: Data were analyzed from a computerized questionnaire on dental attendance and dental status, completed by military personnel who attended one medical clinic for the required periodic medical examination between 1998 and 2006.Results: For 60% of the respondents, the last dental visit was within the previous 12 months. The last dental visit was for scheduled treatment for 49.8%, a dental examination for 21.5%, and emergency dental treatment for 12.2%. College graduates rated their dental self-care higher than non-college graduates, and nonsmokers rated their self-care higher than smokers. Of the participants, 50.9% considered their own dental status good or excellent and 7.2% considered their oral health status poor. No significant differences were found according to gender.Conclusions: The findings indicated high dental attendance but low self-perception of dental status in Israeli military personnel in comparison with the Israeli general population and low attendance in comparison with U.S. Army personnel. A compulsory periodic dental examination among Israeli military personnel, similar to the required periodic medical examination, is recommended. [ABSTRACT FROM AUTHOR]

Hidden occlusal caries was defined 20 years ago as a dentinal caries lesion near the occlusal surface of the tooth, visible on a radiograph, where in visual examination the occlusal enamel is seen intact or minimally perforated. Hidden caries present the dentist with challenges in prevention, diagnosis, treatment planning, patient education and research. This article describes these challenges and offers solutions. In trying to prevent the formation of hidden caries lesions, the dentist should consider using fissure sealants, which have already proved to be an efficient way of preventing fissure caries. Diagnosing hidden caries is a challenge for the dentist, who is used to detecting fissure caries solely by visual examination and probing, because, by definition, hidden caries should be diagnosed by radiographs. However, in order to diagnose occlusal carious lesions accurately, the practitioner must look for them on radiographs. In cases of inconclusive radiographic examinations and a stained fissure, an operative diagnosis approach should be employed. In treating hidden caries, the dentist should consider, according to clinical and radiographic examinations, an observation-only approach or a preventive resin restoration. The dentist should become familiar with this type of carious lesion and learn how to prevent, diagnose and treat it. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the influence of geographic location of graduation (Israel, Eastern Europe, Latin America) on decision making regarding management of dental caries, periapical lesions, and antibiotic prescribing routines. A questionnaire was given to ninety-eight general practitioners regarding demographic and work habits. Photographs of lesions were shown on a screen. Participants reported recommended treatment and whether they would routinely prescribe antibiotics following regular endodontic treatment, retreatment, and impacted third molar surgical extraction in healthy patients. There was a percent (n=92) response rate, of which eighty-five responses were used in the data analysis. Surgical treatment of asymptomatic enamel caries lesions was not recommended by most of the subjects, and surgery was recommended for DEJ caries lesions in low or moderate caries risk patients, both without significant differences between geographic regions of dental school graduation. Israelis had a lower frequency of retreatment in asymptomatic teeth that demonstrated periapical radiolucency with post restoration (without crown) compared to Latin Americans and East Europeans. Most of the participants would not retreat asymptomatic teeth that demonstrated periapical radiolucency with post and crown. After third molar surgery, 46 percent of participants routinely prescribed antibiotics. Significantly more Latin American graduates prescribed antibiotics following endodontic treatment, retreatment, and third molar extractions (p<0.05). Overmedication (antibiotics) and overtreatment (caries) among young practitioners reflect failure of undergraduate education in proper use of antibiotics and management of the carious lesions according to the patient's clinical presentation and caries risk assessment rather than routinely undertaking surgical caries treatment. [ABSTRACT FROM AUTHOR]

The incidence, etiology, and consequences of orofacial injuries during service were evaluated among active duty elite commando fighters in the Israel Defense Forces. Male fighters (N = 280) were interviewed. Orofacial injuries were reported by 76 (27.1%) participants, with tooth injuries as the most common: 40 (52.6%) suffered from dental fracture and 6 (7.9%) from subluxation/luxation. Overall incidence was 85.5 cases per 1,000 fighter-years. Most injuries occurred in an isolated training or operational field. Overall, 162 participants (57.9%) received a boil-and-bite mouth guard during recruitment, but only 49 (30.2%) used it regularly during training and sport activities. The prevalence of injuries among fighters who reported regular mouth guard use was smaller than among fighters who reported of no regular use (20.4% vs. 28.6%, respectively; p < 0.001). Commando fighters are highly predisposed to dental trauma, resulting in the interference of their continuous daily activity. Military health care professionals and commanders should promote mouth protection devices for high-risk populations. [ABSTRACT FROM AUTHOR]

A letter to the editor in response to the article about the recommendation of a single at- or post-extraction dose of 200mg metronidazole for prevention of infected socket in the previously published issue is presented .

Abstract We are in the era of "evidence based medicine" in which our knowledge is stratified from top to bottom in a hierarchy of evidence. Many in the medical and dental communities highly value randomized clinical trials as the gold standard of care and undervalue clinical reports. The aim of this editorial is to emphasize the benefits of case reports in dental and oral medicine, and encourage those of us who write and read them.

A letter to the editor is presented in response to the article "Mesenchymal stem cells and bisphosphonate-related osteonecrosis of the jaw: the future?"

Advances in the treatment of cancer have significantly improved mortality rates; however, this has come at a cost, with many treatments still limited by their toxic side effects. Mucositis in both the mouth and gastrointestinal tract is common following many anti-cancer agents, manifesting as ulcerative lesions and associated symptoms throughout the alimentary tract. The pathogenesis of mucositis was first defined in 2004 by Sonis, and almost 20 years on, the model continues to be updated reflecting ongoing research initiatives and more sophisticated analytical techniques. The most recent update, published by the Multinational Association for Supportive Care in Cancer and the International Society for Oral Oncology (MASCC/ISOO), highlights the numerous co-occurring events that underpin mucositis development. Most notably, a role for the ecosystem of microorganisms that reside throughout the alimentary tract (the oral and gut microbiota) was explored, building on initial concepts proposed by Sonis. However, many questions remain regarding the true causal contribution of the microbiota and associated metabolome. This review aims to provide an overview of this rapidly evolving area, synthesizing current evidence on the microbiota's contribution to mucositis development and progression, highlighting (i) components of the 5-phase model where the microbiome may be involved, (ii) methodological challenges that have hindered advances in this area, and (iii) opportunities for intervention., (© 2024. The Author(s).)

Purpose: A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians, which concentrates on practical information needed for the management of oral complications of cancer patients. This CPS is focused on the current understanding of controversies that may arise while providing basic oral care in hemato-oncology patients and hematopoietic cell transplantation recipients (HCT). The CPS will summarize and elucidate controversies that have appeared in the literature and professional discussions., Methods: This CPS was developed based on a critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets to generate a short manual about the best standard of care., Results: Controversies about the use of chlorhexidine (CHX) oral rinse, mechanical dental plaque removal procedures, the need for toothbrush replacement during phases of low blood cell counts, and the use of lidocaine mouthwash for oral pain were identified and discussed. Consensus about the best standard of care was outlined., Conclusion: The following ratifications are applicable for oral care in hemato-oncology patients and patients undergoing HCT: (1) CHX may reduce the risk of oral infections, although it was not found to reduce the risk of oral mucositis. (2) Toothbrushing and proficient interproximal cleaning should not be discouraged during HCT. (3) Toothbrushes do not need to be replaced daily and are preferred over cleansing swabs. (4) Lidocaine rinse, swish and spit, may be considered to palliate oral mucosal pain if applied in a certain manner., (© 2024. The Author(s).)

Purpose: A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians that concentrates practical information needed for the management of oral complications of cancer patients. This CPS is focused on the risk of secondary oral cancer following hematopoietic cell transplantation (HCT)., Methods: This CPS was developed based on critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets to generate a short manual about the best standard of care., Results: Studies described a 7-16-fold higher risk of secondary oral cancer (mainly squamous cell carcinoma) in allogeneic HCT (alloHCT) recipients, particularly in those who developed chronic graft versus host disease (cGVHD). Risk increases over time and is influenced by several risk factors. In autologous HCT, oral cancer risk seemed only slightly elevated., Conclusion: Clinicians should be aware of the higher oral cancer risk in alloHCT survivors, and emphasize the importance of lifelong oral cancer surveillance (at least every 6-12 months) and avoiding cancer promoting lifestyle factors in an empathic way, particularly of those with (a history of) cGVHD. Post-HCT for Fanconi anemia or dyskeratosis congenita, education and rigorous follow-up is even more crucial. In case of suspected oral lesions in the presence of oral mucosal cGVHD, a GVHD intervention may facilitate diagnosis. Suspected lesions should be biopsied. More research is needed on the role of HPV in oral cancer post-HCT., (© 2024. The Author(s).)

Purpose: A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians, which concentrates practical information needed for the management of oral complications of cancer patients. This CPS is focused on the management of oral manifestations of chronic graft-versus-host-disease (cGVHD)., Methods: This CPS was developed based on critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets and table to generate a short manual about the best standard of care., Results: The treatment goals in oral cGVHD are to relieve pain and xerostomia, improve oral function, prevent secondary infection, prevent deterioration of the dentition, and detect malignant transformation as early as possible. The prevention and treatment measures for oral mucosal lesions, hypofunction of the salivary glands, and sclerodermatous changes in the oral and perioral tissues are detailed, as well as the possible complications and side effects of these interventions., Conclusions: Patients post allogeneic hematopoietic cell transplantations, with cGVHD manifest in the oral and perioral tissues, should be regularly monitored and treated as needed by an oral care practitioner. This CPS provides the clinician with practical tools for examining, preventing, and treating the various sequalae that may affect the oral cavity in these patients., (© 2024. The Author(s).)

Oral mucositis (OM) is a common and debilitating toxicity of cancer treatments - chemotherapy, radiotherapy, hematopoietic cell transplant, or combinations. OM is associated with severe oral pain and has negative impacts on patient function and quality of life. Additionally, OM has accompanying systemic complications that may have critical implications. These local and systemic consequences can alter cancer treatment, and add an economic burden. This review covers the clinical presentation and course of OM, differential diagnosis, clinical and economic impacts, pathogenesis, risk factors, assessment measures, biomarkers and prediction of OM, management, research advances in the development of new drugs and treatments, and big data., (© 2024 Wiley Periodicals LLC.)

Background: Barometric pressure changes during flight or diving may cause facial barotrauma. Neuropathy of the fifth (CN5) or the seventh (CN7) cranial nerves is a rare manifestation of this condition. The aim of this study was to analyze risk factors for baroneuropathies of CN5 and CN7., Methods: A search of PubMed and Cochrane Library databases was conducted to identify all published cases of CN5 and CN7 neuropathies. Only original case reports and series that documented events of neuropathies associated with the trigeminal nerve or facial nerve while flying, diving, or mountain climbing were included. Assessed variables included sex, medical history, age, setting (flight or diving), atmospheric pressure changes, number of episodes, symptoms, treatment, and recovery., Results: We identified a total of 48 articles described >125 episodes in 67 patients. Mean age was 33.5 ± 12.1 years with a male predominance (76.1 %). Cases were equally distributed between flight and diving (50.7 %, 46.3 %, respectively). CN5 involvement was observed in 77.6 % of patients, with ear pain and facial numbness as the most common symptoms. The latter was correlated with positive otolaryngology medical history. CN7 was involved in 88.1 % of patients. Flying, as opposed to diving was correlated with spontaneous resolution of symptoms (86.7 % vs. 42.3 % of cases resolved spontaneously, respectively, p = 0.001)., Conclusions: Flight is an equal risk factor to diving with respect to CN5 and CN7 barotrauma. Involvement of CN7 was observed in most cases, but possibly due to report-bias. Positive medical history is a risk factor for facial numbness., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Inc. All rights reserved.)