Category: Nevin Manimala

J Plast Reconstr Aesthet Surg. 2023 May 28;84:176-181. doi: 10.1016/j.bjps.2023.05.050. Online ahead of print.

ABSTRACT

BACKGROUND: Gender-affirming mastectomies are a growing necessity for transgender and gender-diverse patients. The preoperative evaluation and surgical outcome must be tailored to the individual, taking into consideration previous medical history, medications, hormonal therapy, patient anatomy, and expectations. Although non-binary patients constitute a significant portion of patients referring for gender-affirming mastectomies, current literature rarely acknowledges them as a separate patient category from trans-masculine patients.

METHODS: Retrospective cohort, demonstrating the single-surgeon experience with gender-affirming mastectomies over the course of 2 decades.

RESULTS: A total of 208 patients were included in this cohort, patients identifying as “non-binary” in gender accounted for 30.8% of the cohort. Non-binary patients were found to be younger (P value<0.001) at the time of surgery, at the time of HRT initiation (P value<0.001), at the first feeling of gender dysphoria, coming out to society, and use of non-female pronouns (P value = 0.04,<0.001 and<0.001, accordingly). In the non-binary patient group, a shorter period of time passed from the first feeling of gender dysphoria to initiation of HRT and surgery (P value<0.001 and<0.001, accordingly). However, the average time from HRT initiation to surgery and from the first use of non-female pronouns to HRT initiation or surgery did not statistically differ (P value= 0.34, 0.06, and 0.08, accordingly).

CONCLUSION: Non-binary patients demonstrate a significantly different timeline from trans-masculine patients in terms of gender development. In order to accommodate their needs, caregivers must take the information into consideration and develop appropriate guidelines and courses of action.

PMID:37331039 | DOI:10.1016/j.bjps.2023.05.050

Int J Paediatr Dent. 2023 Jun 18. doi: 10.1111/ipd.13096. Online ahead of print.

ABSTRACT

BACKGROUND: Early childhood caries (ECC) is one of the most common dental problems, which often require dental rehabilitation with general anesthesia (DRGA).

AIM: To assess the short- and long-term effects of DRGA on children and their families’ oral health-related quality of life (OHRQoL) in preschool children, the incidence of complications on the first day, and the factors affecting them and parental satisfaction.

DESIGN: A total of 150 children treated for ECC under DRGA were included in the study. OHRQoL was assessed on the day of DRGA, 4 weeks, and 1 year after treatment using the Early Childhood Oral Health Impact Scale (ECOHIS). The incidence of complications and parental satisfaction with DRGA were evaluated. The data were analyzed for statistical significance (p<0.05).

RESULTS: In total, 134 patients were re-evaluated at the end of the 4th week and 120 at the end of the 1st year. The average ECOHIS scores before and after DRGA (4 weeks and 1 year) were 18.1±8.5, 3.1±3.9, 5.9±6.2, respectively. After DRGA, 29.2% of the children reported at least one complication. 91% of the parents reported that they were satisfied with DRGA.

CONCLUSION: DRGA has a positive effect on the OHRQoL of Turkish preschool children with ECC and is highly evaluated by their parents.

PMID:37331006 | DOI:10.1111/ipd.13096

J Neurol. 2023 Jun 18. doi: 10.1007/s00415-023-11824-w. Online ahead of print.

ABSTRACT

BACKGROUND: New diagnostic criteria of Progressive Supranuclear Palsy (PSP) have highlighted the interest of Eye Movement Records (EMR) at the early stage of the disease.

OBJECTIVES: To investigate the metabolic brain correlates of ocular motor dysfunction using [18F] Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in early PSP.

METHODS: Retrospective observational descriptive study on longitudinal data with patients who underwent EMR and FDG-PET at the stage of suggestive and possible PSP according to Movement Disorders Society criteria. Longitudinal follow-up enables to confirm diagnosis of probable PSP. Using the Statistical Parametric Mapping software, we performed whole-brain voxel-based correlations between oculomotor variables and FDG-PET metabolism.

RESULTS: Thirty-seven patients with early PSP who fulfilled criteria of probable PSP during the follow-up were included. Decrease in the gain of vertical saccades correlated with reduced metabolism in Superior Colliculi (SC). We also found a positive correlation between mean velocity of horizontal saccades and SC metabolism as well as dorsal nuclei in the pons. Finally, increase in horizontal saccades latencies correlated with decrease of posterior parietal metabolism.

CONCLUSIONS: These findings suggest the early involvement of SC in saccadic dysfunction in the course of PSP.

PMID:37330976 | DOI:10.1007/s00415-023-11824-w

Med Oral Patol Oral Cir Bucal. 2023 Jun 18:26018. doi: 10.4317/medoral.26018. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study is to investigate predisposing factors for the head and neck infections (HNIs), regarding to the demographic data, anatomical spaces, microbiology and antibiotic sensitivity for affected patients.

MATERIAL AND METHODS: A 13-year of retrospective study evaluating 470 patients with HNIs, treated as inpatient management in the Department of Oral and Maxillofacial Surgery of KyungHee University school of Dentistry, Seoul, Korea, from January 2009 to February 2022. Statistical analysis of demographic, time-related, anatomic, microbiologic, and treatment variables were investigated for each patient.

RESULTS: The frequency of HNIs was significantly higher in 50’s in males, followed by 70’s in females. High Severity score (SS) were significantly associated with increased LOH (Length of hospital stay) and LOM (Length of medication), while LOH showed more intensive relationship compared with LOM. The most frequently involved space in abscess was submandibular space, though incidence and severity of HNIs shows declining tendency throughout 13-year research. Streptococcus viridans was the most predominant species isolated from pus culture growth, and a combination of ampicillin and sulbactam was the 1st choice of antibiotics intravenously. According to the comparison analysis between recommended antibiotics from resistance testing result and clinically administered antibiotics, final coincidence rate was estimated about 55%.

CONCLUSIONS: Due to HNIs being multifactorial, predicting progression and management of HNIs is still a challenge for oral and maxillofacial surgeons. The present study showed several predisposing factors of SHNIs and their correlations, which could contribute to earlier diagnosis and more effective treatment planning for clinicians, thereby leading to the improvement of prognosis for patients, ultimately.

PMID:37330958 | DOI:10.4317/medoral.26018

Med Oral Patol Oral Cir Bucal. 2023 Jun 18:26011. doi: 10.4317/medoral.26011. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of our study is to evaluate the usability of the Free Gingival Graft (FGG) procedure, which is included in YouTube videos, in both patient information and student education.

MATERIAL AND METHODS: A search was performed on YouTube on December 1, in 2022, using the search term ”Free Gingival Graft”. First 150 videos were pre-evaluated, and 67 videos were included in the study. The length of the videos, the number of views, the number of likes, the presence of animation and the number of months after uploading were evaluated. The quality of the videos was evaluated and analyzed with The Global Quality Score (GQS), Usefulness Score (US) and The Journal of American Medical Association (JAMA) scores.

RESULTS: A positive correlation was found between viewer interaction, video duration and quality scores. The median values of the quality scores were 2 for the GQS, 2 for the JAMA score and 1 for the Usefulness score. The level of quality scores was found to be insufficient (poor quality). There is a high level, positive and statistically significant correlation between the GQS and the Usefulness score (r=0.858 and p<0.001).

CONCLUSIONS: YouTube videos containing the FGG procedure were found to be insufficient for both student education and patient information purposes.

PMID:37330957 | DOI:10.4317/medoral.26011

Med Oral Patol Oral Cir Bucal. 2023 Jun 18:25950. doi: 10.4317/medoral.25950. Online ahead of print.

ABSTRACT

BACKGROUND: The use of graphic novels is a trending topic in health communication as a new form of visual storytelling which explores narratives of health care, cancer, healing, and disability. The objective of the present study was to evaluate – for the first time in the literature – the effect of graphic novels in reducing the anxiety of patients waiting for an incisional biopsy in an oral oncology setting.

MATERIAL AND METHODS: This open-label randomized clinical trial comprised 50 patients with a clinical suspicion of oral potentially malignant disorders. Twenty-five patients were randomly allocated to the test group, and a colourful graphic novel was provided. Subsequently, the Beck Depression Inventory and the Depression Anxiety Stress Scales-21 were administered to all 50 recruited patients, after which a biopsy was performed on each patient.

RESULTS: No statistically significant difference was observed between the test and control groups for the variables regarding the demographic data (p>0.2). There was a significant difference after the introduction of the graphic novel, regardless of which questionnaire was used. The graphic novel demonstrated an improvement in the ability of the test group to tolerate anxiety while waiting for an oral biopsy in both psychological tests (p<0.05).

CONCLUSIONS: In light of these initial positive results, the authors of this study would like to suggest the use of graphic novels in oral oncology, dentistry, and medicine with the aim of reducing patient anxiety.

PMID:37330956 | DOI:10.4317/medoral.25950

Med Oral Patol Oral Cir Bucal. 2023 Jun 18:25707. doi: 10.4317/medoral.25707. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate the prevalence and clinicopathological features of a large series of gingival neoplasms in Brazil.

MATERIAL AND METHODS: All gingival benign and malignant neoplasms were retrieved from the records of six Oral Pathology Services in Brazil, during a 41-year period. Clinical and demographic data, clinical diagnosis, and histopathological data were collected from the patients’ clinical charts. For statistical analysis, the chi-square, median test of independent samples and the U Mann-Whitney tests were used, considering a significance of 5%.

RESULTS: From 100,026 oral lesions, 888 (0.9%) were gingival neoplasms. There were 496 (55.9%) males, with a mean age of 54.2 years. Most cases (70.3%) were malignant neoplasms. Nodules (46.2%) and ulcers (38.9%) were the most common clinical appearance for benign and malignant neoplasms, respectively. Squamous cell carcinoma (55.6%) was the most common gingival neoplasm, followed by squamous cell papilloma (19.6%). In 69 (11.1%) malignant neoplasms, the lesions were clinically considered to be inflammatory or of infectious origin. Malignant neoplasms were more common in older men, appeared with larger size, and with a time of complaint shorter than benign neoplasms (p<0.001).

CONCLUSIONS: Benign and malignant tumors may appear as nodules in gingival tissue. In addition, malignant neoplasms, especially squamous cell carcinoma, should be considered in the differential diagnosis of persistent single gingival ulcers.

PMID:37330954 | DOI:10.4317/medoral.25707

Med Oral Patol Oral Cir Bucal. 2023 Jun 18:26015. doi: 10.4317/medoral.26015. Online ahead of print.

ABSTRACT

BACKGROUND: There are different surgical techniques to remove Oral mucoceles, including conventional surgery with scalpel, removal of the lesion with CO2 laser, and micro marsupialization. The present systematic review was conducted with the aim of comparing the recurrence rate of different surgical techniques for treatment of the oral mucoceles.

MATERIAL AND METHODS: An electronic search for randomized controlled trials published in English until September 2022 related to different surgical methods for the treatment of oral mucocele was performed in Medline/PubMed, Web of Science, Scopus, Embase and Cochrane databases. A random-effects meta-analysis was conducted to compare the recurrence rate of different techniques.

RESULTS: Among 1204 papers initially identified, after the removal of duplicate articles and screening of the titles and abstracts, fourteen full-text articles were reviewed. Seven articles comparing the recurrence rate of oral mucocele in different surgical techniques were found. Seven studies were included in qualitative studies, and five articles were included in the meta-analysis. The risk of mucocele recurrence in the micro-marsupialization technique was 1.30 times that of the surgical excision with scalpel technique, which was not statistically significant. The risk of mucocele recurrence in the CO2 Laser Vaporization technique was 0.60 times that of the Surgical Excision with Scalpel technique, which was not statistically significant.

CONCLUSIONS: The results of this systematic review showed that there is no significant difference between the recurrence rate of surgical excision, CO2 laser and marsupialization techniques for the treatment of oral mucoceles. Although more randomized clinical trials are needed for definitive results.

PMID:37330953 | DOI:10.4317/medoral.26015

Med Oral Patol Oral Cir Bucal. 2023 Jun 18:25859. doi: 10.4317/medoral.25859. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study is to explore whether decreasing the number of sutures can improve the quality of life after inferior third molar extraction.

MATERIAL AND METHODS: This study used a three-arm randomized design that included 90 individuals. Patients were randomized and divided into three groups-the airtight suture group (traditional), the buccal drainage group, and the no-suture group. Postoperative measurements, including treatment time, visual analog scale, questionnaire on postoperative patient quality of life, and details about trismus, swelling, dry socket, and other postoperative complications were obtained twice and the mean values were recorded. To verify the normal distribution of the data, the Shapiro-Wilk test was performed. The statistical differences were evaluated using the one-way ANOVA and the Kruskal-Wallis test with Bonferroni post-hoc correction.

RESULTS: The buccal drainage group showed a significant decrease in postoperative pain and better speech ability than the no-suture group on the 3st day, with a mean of 1.3 and 0.7 (P < 0.05). The airtight suture group also showed similar eating and speech ability, which was better than the no-suture group, with a mean of 0.6 and 0.7 (P < 0.05). However, no significant improvements were noted on the 1st and 7th days. The surgical treatment time, postoperative social isolation, sleep impairment, physical appearance, trismus, and swelling showed no statistical difference between the three groups at all measured times (P > 0.05).

CONCLUSIONS: Based on the above findings, the triangular flap without a buccal suture may be superior to the traditional group and no-suture group in less pain, and better postoperative patient satisfaction in the first 3 days and may be a simple and viable option in clinical practice.

PMID:37330952 | DOI:10.4317/medoral.25859

Med Oral Patol Oral Cir Bucal. 2023 Jun 18:25804. doi: 10.4317/medoral.25804. Online ahead of print.

ABSTRACT

BACKGROUND: The insertion torque of dental implants will depend on a combination of different factors such as bone density, the design of the implant and the drilling protocol used. However, it is not clear how the interaction of these factors affects the final insertion torque and which drilling protocol should be used in each clinical situation. The aim of this work is to analyse the influence of bone density, implant diameter and implant length on the insertion torque using different drilling protocols.

MATERIAL AND METHODS: An experimental study was carried out in which the maximum insertion torque was measured, in standardised polyurethane blocks (Sawbones Europe AB) of four densities, for M12 Oxtein dental implants (Oxtein, Spain) with diameters of 3.5, 4.0, 4.5 and 5mm, and lengths of 8.5mm, 11.5mm and 14.5mm. All these measurements were carried out following four drilling protocols, a standard protocol, adding a bone tap, cortical drill or conical drill. In this way, a total of 576 samples were obtained. For the statistical analysis, the table of confidence intervals, mean, standard deviation and covariance was carried out, in total and grouped by the parameters used.

RESULTS: The insertion torque for D1 bone obtained very high levels, reaching 77 6.95 N/cm, these values improved with the use of conical drills. In D2 bone, the mean torque obtained was 37.89± 13.70N/cm, with values within the standard. In D3 and D4 bone significantly low torques were obtained with values of 14.97± 4.40N/cm and 9.88± 4.16N/cm (p>0.001) respectively.

CONCLUSIONS: In D1 bone, conical drills must be incorporated in drilling to avoid excessive torque, while in D3 and D4 bone, these would be contraindicated, as they drastically decrease the insertion torque, which may compromise the treatment.

PMID:37330951 | DOI:10.4317/medoral.25804