Le complicanze del piercing orale e il ruolo dell’odontoiatra nella loro prevenzione: revisione della letteratura

Objectives

The work reports about the complications of oral piercing and the role of dentist in their prevention.

Materials and methods

The authors conducted a systematic review of the literature through the Medline database by entering “oral piercing”, “piercing and complications”, “piercing and hygiene” as keywords. Articles published between 1988 and 2012 were considered.

Results

Oral piercing is linked to several potential complications. Many of them are due to scarce awareness of the risk, bad habits and inadequate oral care.

Conclusions

The dentist should motivate patients with oral piercing to maintain a good oral care, provide instructions and conduct periodic inspections to secure their understanding and implementation in order to prevent complications.     

Knowledge,Attitude and Awareness of Speciality of Oral and Maxillofacial Surgery Amongst Medical Consultants of Vadodara District in Gujarat State

Background and Aim

Aim of this study was to survey the knowledge, attitude and awareness of the subject of oral and maxillofacial surgery speciality amongst the consultants and practitioners of medicine in district of Vadodara.

Materials and Methods

List of members of various specialities in medical faculty were obtained from Indian Medical Association, Baroda branch and staff members of medical colleges of Vadodara district. A questionnaire survey was made which was distributed and their options were noted.

Results

Surgical removal of third molar, oral submucous fibrosis and implants were the problems where oral surgeons were preferred. For maxillofacial trauma plastic surgeons and orthopaedic surgeons were preferred than oral surgeons. For maxillofacial pathology E.N.T surgeons were mostly preferred. There is low awareness regarding oral and maxillofacial surgery amongst the general practitioners and medical consultants in Vadodara district.

Conclusion

Survey shows that our training needs to be upgraded and revamped so that our trainees (post graduates in oral surgery) and have a greater “hands-on” exposure during their postgraduate training. They will then be able to handle increasingly complex cases in a multispecialty setup when they graduate and earn the mutual respect of the medical and dental fraternity and also the general public. MBBS students during their dental postings should be made aware of the depth and scope of oral surgery branch.     

Incidence and types of complications after ablative oral cancer surgery with primary microvascular free flap reconstruction

Background

The aims of the study were 1) to evaluate the incidence and types of postoperative complications after ablative oral cancer surgery with primary free flap reconstruction and 2) identify prognostic variables for postoperative complications.

Material and Methods

Desired data was retrieved from a computer database at the department of Oral and Maxillofacial Department, Queen Elisabeth hospital Birmingham, United Kingdom, between June 2007 and October 2012. Logistic regression was used to study relationships between preoperative variables and postoperative outcomes.

Results

The study population consisted 184 patients, comprising 189 composite resections with reconstruction. Complications developed in 40.2% of the patients. Three patients (1.6%) died, 11.1% returned to the operating room, 5.3% developed donor site complications and 6.9% flap complications of which 3.2% total flap failure. In the multivariable analysis systemic complications were associated with anaesthesia time and hospital stay with red cell transfusion.

Conclusions

A significant proportion of the patients with primary free flap reconstructions after oral cancer surgery develops postoperative complications. Prolonged anaesthesia time and red cell transfusion are possible predictors for systemic complications and hospital stay respectively. Preoperative screening for risk factors is advocated for patient selection and to have realistic information and expectations. Key words:Free flap, complications, oral cancer, risk factors, reconstruction.     

A SURVEY OF CROSS-INFECTION CONTROL PROCEDURES: KNOWLEDGE AND ATTITUDES OF TURKISH DENTISTS

Objectives:

The objective of this study was to investigate the knowledge, attitudes and behavior of Turkish dentists in Samsun City regarding cross-infection control.

Material and methods:

A questionnaire was designed to obtain information about procedures used for the prevention of cross-infection in dental practices and determine the attitudes and perceptions of respondent dental practitioners to their procedures. The study population included all dentists in the city of Samsun, Turkey, in April 2005 (n=184). The questionnaire collected data on sociodemographic characteristics, knowledge and practice of infection control procedures, sterilization, wearing of gloves, mask, use of rubber dam, method of storing instruments and disposal methods of contaminated material, etc. Questionnaire data was entered into a computer and analyzed by SPSS statistical software.

Results:

From the 184 dentists to whom the questionnaires were submitted, 135 participated in the study (overall response rate of 73.36%). As much as 74.10% dentists expressed concern about the risk of cross-infection from patients to themselves and their dental assistants. Forty-three percent of the participants were able to define "cross-infection" correctly. The greatest majority of the respondents (95.60%) stated that all patients have to be considered as infectious and universal precautions must apply to all of them. The overall responses to the questionnaire showed that the dentists had moderate knowledge of infection control procedures.

Conclusions:

Improved compliance with recommended infection control procedures is required for all dentists evaluated in the present survey. Continuing education programs and short-time courses about cross-infection and infection control procedures are suitable to improve the knowledge of dentists.     

Knowledge,perceptions, and attitudes of dental students towards obesity

Aims

Obesity is a chronic medical condition associated with various oral health problems. The aim of this study was to assess the knowledge, perceptions, and attitudes of dental students towards obesity.

Material and methods

Second-, third-, and fourth-year dental students completed a self-administered questionnaire. An ethics committee approved the study. Participants were asked questions focused on three areas: (i) knowledge, (ii) perceptions, and (iii) attitudes about obesity. Data analyses were carried out using SPSS version 20.

Results

Among the dental students, 78.9% received 0–1 h of formal education about obesity. The mean score of the total time allocated for obesity-related education was 1.31 ± 0.23 h. Eighty-nine percent of the dental students agreed that obesity is a chronic medical condition, 30% agreed that they would modify their equipment and office furniture to accommodate obese patients, and 46.8% were interested in learning more about obesity in dental school.

Conclusion

Obesity-related education should be implemented as a formal component of dental student training. Oral health practitioners should also provide their patients with information about how weight loss is beneficial to both general and oral health.     

Comparison of Management of Mandibular Angle Fractures by Three Approaches

Background and Objectives

Various methods have been reported in the literature for treating mandibular angle fractures comparing extra oral, intra oral and transbuccal approaches for achieving the goals of restoration of anatomic form, maintenance of segment position and bony union.

Materials and Methods

This study was conducted to assess the simple and effective surgical approach in treating mandibular angle fractures and the outcome by means of three approaches i.e. intra oral, transbuccal and extra oral approaches.

Results/Conclusion

A total of 45 patients with mandibular angle fracture were divided into three groups. Group I—intra oral approach—15 patients, Group II—transbuccal with intraoral approach—15 patients, Group III—extra oral approach—15 patients. The results of our study found intraoral approach to be much better because it is simple, precise, duration is short, and post operative complications are less with minimal morbidity and pain.     

Awareness About Needle Stick Injures and Sharps Disposal: A Study Conducted at Army College of Dental Sciences

Background

The present study aims to assess the knowledge and attitude about needle stick injuries and sharps disposal.

Methods

A self designed questionnaire of 15 questions was handed out to 200 participants including undergraduate students (group 1), postgraduate students (group 2), faculty members (group 3) and auxiliary staff members (group 4). The data was collected and analyzed using Chi square test.

Results

Sixty-one percent of total participants reported of experiencing needle stick injury and 25.5 % knew that there could be several causes for this. Only 22 % of total population studied got the source tested. Immunization status of group 4 was very low and they also lacked the knowledge of sharps disposal and hepatitis C being spread by needle stick injuries. 57 % participants confirmed that there was no reporting facility and 66 % were not familiar with the guidelines of reporting.

Conclusions

There is a definite scope of improvement in terms of reporting and prevention of needle stick injuries. There is a need to improve knowledge and awareness of dental health care workers about the post exposure protocol.     

Evaluation of Inter Incisal Mouth Opening for Airway Maintenance in Oral Submucous Fibrosis

Purpose

Determination of difficult airway maintenance preoperatively holds a great significance in different intubation techniques and also surgical exploration of airway. No data is available for relation of airway maintenance and preoperative interincisal mouth opening in oral submucous fibrosis patients.

Methods

20 oral submucous fibrosis patients were evaluated pre operatively for general anaesthesia. Direct nasotracheal intubation, fiberoptic laryngoscopy guided intubation or awake blind nasal intubation technique, or combination of above techniques were used.

Results

Mean pre operative inter incisal mouth opening for direct nasotracheal intubation (nine patients) is 15.44 mm, fiberoptic guided laryngoscopy (six patients) is 9.0 mm and blind nasal intubation (five patients) is 5.2 mm.

Conclusion

Benefits of avoiding a surgical exploration of airway was significant.     

Nasotracheal Intubation: An Overview

Introduction

Nasotracheal intubation is the commonest method used to induce anaesthesia in oral surgery patients. It has a distinct advantage of providing good accessibility for oral surgical procedures.

Anatomy and procedure

One must know the anatomy involved, the pathway and procedure of intubation, the pre-anaesthetic medication and complications which may be seen at the time of intubation. The surgeon must have the knowhow of the tube and the procedure which are explained in detail in the article.

Complications

Several complications can arise while performing the procedure which may be operator induced or arising due to anatomical variations.

Conclusion

It is prudent for the oral surgeon to know the basics of nasotracheal intubation in order to form a useful team member for management of complications arising from anaesthesia. Recent years have seen improvement in the armamentarium. These help negate the blindness of the procedure.     

Attachment systems for mandibular implant overdentures: a systematic review

PURPOSE

The aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate, prosthetic maintenance and complications, and patient satisfaction.

MATERIALS AND METHODS

A systematic literature search was conducted using PubMed and hand searching of relevant journals considering inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures until August, 2010 were selected if more than one type of overdenture attachment was reported. Twenty four studies from 1098 studies were finally included and the data on implant survival rate, prosthetic maintenance and complications, patient satisfaction were analyzed relative to attachment systems.

RESULTS

Four studies presented implant survival rates (95.8 - 97.5% for bar, 96.2 - 100% for ball, 91.7% for magnet) according to attachment system. Ten other studies presented an implant survival rate ranging from 93.3% to 100% without respect to the attachment groups. Common prosthetic maintenance and complications were replacement of an assay for magnet attachments, and activation of a matrix or clip for ball or bar attachments. Prosthetic maintenance and complications most commonly occurred in the magnet groups. Conflicting findings were found on the rate of prosthetic maintenance and complications comparing ball and bar attachments. Most studies showed no significant differences in patient satisfaction depending upon attachment systems.

CONCLUSION

The implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by attachment systems. However patient satisfaction may be independent of the attachment system.     

Oral and dental complications of intra-oral piercing

Abstract –  The present study assessed the prevalence of oral piercing among young adults and revealed the types and rate of complications following oral piecing, as well as the awareness of the complications. The study included 400 consecutive patients, who randomly arrived at a military dental office. Before dental examination, patients were requested to fill out a questionnaire regarding oral piercing, their awareness of its complications, and the occurrence of complications related to piercing. Intra-oral examination included special attention to piercing-related complications, such as tooth fractures, gingivitis, bleeding, infections, gingival recessions, etc. A total of 389 patients, 210 (54%) males and 179 (46%) females agreed to participate (97.3% response rate), with an average age of 20.08 ± 1.1 years. Of the participants, 79 (20.3%) reported having at least one type of oral piercing; lingual piercing was the most common. Swelling and bleeding after piercing were reported by 41 (51.9%) and 36 (45.7%) participants, respectively. Among the participants, 225 (57.8%) were unaware of the dangers of intra-oral piercing. Clinical examination revealed 15 fractured teeth in 11 (13.9%) participants with piercing. Gingival recessions were observed in 21 (26.6%), mostly in the mandibular incisor area. Dentists should be aware of the increasing number of patients with pierced intra- and peri-oral sites and to provide appropriate guidance to patients who contemplate body piercing involving oral sites.     

Dental practitioner’s knowledge,opinions and methods of management of oral premalignancy and malignancy

Objectives

The present study outlines the results of a pilot study to determine the knowledge and awareness of a cohort of dentists in United Arab Emirates (UAE) regarding aetiology, clinical features and appropriate early management of oral premalignant and malignant lesions.

Materials and methods

A self-administered questionnaire was constructed and posted to 300 UAE Dental Practitoners (DPs), selected randomly from the register of Emirates Dental Association. The present report details the responses of this cohort.

Results

182 questionnaires were completed and returned (response rate 60.6%). One hundred and twenty-seven (69.8%) of the responding dentists were male and the median age of the DPs was 40 years (range 24–75 years). The majority (84%) practised or had practised in or around Dubai and Sharjah, 75% had graduated from a dental school after 1980. Eighty-two respondents (45.0%) had attended specific courses on premalignant or malignant oral lesions. During their undergraduate training 70% of DPs had witnessed more than 10 patients with oral SCC. Only 60.4% of respondents indicated that the tobacco and alcohol use were the principle causes of oral SCC while 19.7% suggested that HIV disease was a risk factor for oral SCC. 29% of DPs routinely recorded the tobacco or alcohol use of their patients and only 3.8% offered advice to patients regarding modification of these habits. Eight-three percent of the respondents suggested that clinical screening was an effective means of reducing the frequency of premalignant and malignant oral lesions.

Conclusions

In view of the gradual rise in oral malignancy worldwide there is an increased need for DPs to be able to recognize the signs and symptoms of oral malignancy and premalignancy, provide appropriate preventive advice and be aware of the appropriate early management of patients with such oral lesions.     

Number of implants for mandibular implant overdentures: a systematic review

PURPOSE

The aim of this systematic review is to address treatment outcomes of Mandibular implant overdentures relative to implant survival rate, maintenance and complications, and patient satisfaction.

MATERIALS AND METHODS

A systematic literature search was conducted by a PubMed search strategy and hand-searching of relevant journals from included studies. Randomized Clinical Trials (RCT) and comparative clinical trial studies on mandibular implant overdentures until August, 2010 were selected. Eleven studies from 1098 studies were finally selected and data were analyzed relative to number of implants.

RESULTS

Six studies presented the data of the implant survival rate which ranged from 95% to 100% for 2 and 4 implant group and from 81.8% to 96.1% for 1 and 2 implant group. One study, which statistically compared implant survival rate showed no significant differences relative to the number of implants. The most common type of prosthetic maintenance and complications were replacement or reattaching of loose clips for 2 and 4 implant group, and denture repair due to the fracture around an implant for 1 and 2 implant groups. Most studies showed no significant differences in the rate of prosthetic maintenance and complication, and patient satisfaction regardless the number of implants.

CONCLUSION

The implant survival rate of mandibular overdentures is high regardless of the number of implants. Denture maintenance is likely not inflenced substantially by the number of implants and patient satisfaction is typically high again regardless os the number of implants.     

Dental patients’ awareness and knowledge in using dental implants as an option in replacing missing teeth: A survey in Riyadh,Saudi Arabia

Aim

The purpose of this survey was to assess the level, sources, and need for information about dental implants among a selected sample of dental patients in Riyadh, Saudi Arabia.

Materials and methods

Patients’ knowledge and awareness in using dental implants as an option in replacing missing teeth were evaluated through a standardized self- explanatory questionnaire distributed in two places in Riyadh: Military Hospital and College of Dentistry, King Saud University (Darraiyah campus). The questionnaires were handed to the patients during their regular dental visits. A total of 379 subjects were included in this survey.

Results

The results of this study indicate that 66.4% of the subjects knew about dental implants. The subjects’ friends and their relatives were the main source of information about dental implants for 31.5% of the subjects, and dentists were the secondary source for 28.3% of the sample. About 82.4% of the subjects need more information about dental implants and 85.2% of them chose the dentist to be the desired source for such information, followed by the internet in 28.5% of the cases. Almost 74.4% of those surveyed did not know if their regular dentists use dental implants. High cost was the major factor in preventing patients from choosing implants in 86.5% of the cases while the long treatment time and fear of surgery was the factor in 71% and 68.6% of the subjects, respectively.

Conclusion

The results of this survey showed an acceptable level of awareness about dental implants among a selected sample of dental patients in Riyadh. It also showed the need for providing more general and accurate information to the patients about this treatment modality.     

Prevalence of salivary epstein-barr virus in potentially malignant oral disorders and oral squamous cell carcinoma

Background

To analyze the presence of salivary Epstein-Barr virus (EBV) DNA in oral squamous cell carcinoma and potentially malignant oral disorders.

Material and Methods

Three groups were studied: Group 1 (12 oral squamous cell carcinomas (OSCC)), Group 2 (12 potentially malignant oral disorders (PMD)) and Group 3 (47 healthy controls). EBV DNA salivary analysis was performed by PCR.

Results

The highest percentage of positive salivary EBV DNA corresponded to the OSCC group (58.3%), followed by the PMD group (41.7%) and the controls (40.4%). The differences between groups were not statistically significant, however (p>0.05).

Conclusions

Salivary EBV DNA was more prevalent in OSCC than in PMD or the controls. Key words:EBV DNA, saliva, oral squamous cell carcinoma, oral leukoplakia.     

CATASTROPHIZING IN PATIENTS WITH BURNING MOUTH SYNDROME

Background

Burning mouth syndrome (BMS) is an idiopathic painful condition which manifests with burning sensations in the oral cavity in patients with clinically normal oral mucosa and without any local and/or systemic causative factor. Catastrophizing is defined as an exaggerated negative orientation toward pain stimuli and pain experience. The aim of this study was to examine the association between catastrophizing and clinical parameters of BMS, and to examine the association between catastrophizing and the quality of life in patients with BMS.

Materials and methods

Anonymous questionnaire consisting of 3 parts (demographic and clinical data with 100 mm visual analogue scale (VAS), Croatian version of the Oral Health Impact Profile (OHIP-14) scale and Croatian version of the Pain Catastrophizing scale (PC), was distributed to 30 patients diagnosed with BMS.

Results

A higher level of catastrophizing was clinically significant in 30% of the patients. Total catastrophizing score and all three subcomponents of catastrophizing significantly correlated with the intensity of symptoms, but did not correlate with the duration of symptoms. Gender and previous treatment did not affect the catastrophizing.

Conclusion

Obtaining the information about catastrophizing could help a clinician to identify patients with negative behavioural patterns. Additional psychological intervention in these individuals could reduce/eliminate negative cognitive factors and improve coping with chronic painful condition such as BMS.     

Association between general and oral health-related quality of life in patients treated for oral cancer

Background

Less is known about the association between general health-related quality of life (HRQoL) and oral HRQoL (OHRQoL) among patients with specific diseases. The aim of this study was to assess the association between patient-centered outcome measurements (HRQoL and OHRQoL) of oral cancer patients at least 6 months after treatment.

Material and Methods

HRQoL was measured with the 12-Item Short Form Health Survey (SF-12); OHRQoL was evaluated using the Oral Health Impact Profile (OHIP-14) and the Oral Impacts on Daily Performances (OIDP).

Results

Higher OHRQoL scores were associated with lower SF-12 domains scores. The OHIP-14 explained 16.5 % of the total variance of SF-12 Physical Component Summary (PCS) and the OIDP explained 16.1 %. In the SF-12 Mental Component Summary (MCS), the total variance explained was 23.9 % by the OHIP-14 and 21.8 % by the OIDP.

Conclusions

There was a significant association between long-term OHRQoL and HRQoL in oral and oropharyngeal cancer patients. These results may help to carry out new interventions aiming to improve patient´s life overall. Key words:Mouth neoplasms, quality of life, health status, oral health.     

Peripheral Osteoma of the Maxillofacial Region Diagnosis and Management: A Study of 06 Cases

Background

Osteomas are benign neoplasm often associated with facial asymmetry, pain and surface ulceration. Peripheral osteomas are more common in the cranio-maxillofacial region. It is prevalent at younger age but maximum seen in the sixth decade, with a female to male ratio is 1:2. The aim of this study was to review the clinical presentations and management protocol of such lesions in cranio-maxillofacial region.

Materials and Methods

The study was conducted at Command Military Dental Centre (EC) during May 2004 to May 2007. Six serving soldiers and their families (four males, two females), age group ranging between 13 and 56 years, mean age 34.5 years were recruited in this study. The tumors were excised using extra oral, intra oral and combined approaches; no complications were reported during post op period.

Results

All the cases were operated under GA through extra oral, intra oral and combined approaches with satisfactory results. HPE report was benign in all our cases with no post operative complications reported during follow up.

Conclusion

Cranio-maxillofacial osteomas are exclusively benign tumors and not very common entities. Proper diagnosis and precision management alleviates symptoms without any post surgical complications. In our series of six cases the tumors were diagnosed and managed as per standard surgical protocol with excellent result.     

Risk factors for postoperative complications following oral surgery

Objective

The objective of this study was to clarify significant risk factors for postoperative complications in the oral cavity in patients who underwent oral surgery, excluding those with oral cancer.

Material and Methods

This study reviewed the records of 324 patients who underwent mildly to moderately invasive oral surgery (e.g., impacted tooth extraction, cyst excision, fixation of mandibular and maxillary fractures, osteotomy, resection of a benign tumor, sinus lifting, bone grafting, removal of a sialolith, among others) under general anesthesia or intravenous sedation from 2012 to 2014 at the Department of Oral and Maxillofacial Reconstructive Surgery, Hiroshima University Hospital.

Results

Univariate analysis showed a statistical relationship between postoperative complications (i.e., surgical site infection, anastomotic leak) and diabetes (p=0.033), preoperative serum albumin level (p=0.009), and operation duration (p=0.0093). Furthermore, preoperative serum albumin level (<4.0 g/dL) and operation time (≥120 minutes) were found to be independent factors affecting postoperative complications in multiple logistic regression analysis results (odds ratio 3.82, p=0.0074; odds ratio 2.83, p=0.0086, respectively).

Conclusion

Our results indicate that a low level of albumin in serum and prolonged operation duration are important risk factors for postoperative complications occurring in the oral cavity following oral surgery.