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Platelet-rich plasma (PRP) in dental and oral surgery: from the wound healing to bone regeneration.

Platelet-rich plasma (PRP) is a new approach to tissue regeneration and it is becoming a valuable adjunct to promote healing in many procedures in dental and oral surgery, especially in aging patients. PRP derives from the centrifugation of the patient's own blood and it contains growth factors that influence wound healing, thereby playing an important role in tissue repairing mechanisms. The use of PRP in surgical practice could have beneficial outcomes, reducing bleeding and enhancing soft tissue healing and bone regeneration. Studies conducted on humans have yielded promising results regard

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… The results of a recent systematic review regarding the efficacy of PRP in periodontal therapy have revealed that it is capable of improving gingival recession but not clinical attachment level in chronic periodontitis [ 42 ]. … However, no significant benefit of PRP was found for the treatment of gingival recession [ 44 ]. …

Should oral foci of infection be removed before the onset of radiotherapy or chemotherapy?

Pretreatment dental screening aims to locate and eliminate oral foci of infection in order to eliminate local, loco-regional, or systemic complications during and after oncologic treatment. An oral focus of infection is a pathologic process in the oral cavity that does not cause major infectious problems in healthy individuals, but may lead to severe local or systemic inflammation in patients subjected to oncologic treatment. As head and neck radiotherapy patients bear a lifelong risk on oral sequelae resulting from this therapy, the effects of chemotherapy on healthy oral tissues are essentia

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… We suggest, based on the literature, that the following should be considered as an oral focus of infection in HNC patients: deep caries in which excavation may lead to pulpal exposure; active periodontal disease with pockets ≥ 6 mm, furcation > grade 1, mobility > grade 1, gingival recession ≥ 6 mm … recessions ≥6 mm | Initial periodontal therapy Tooth extraction Tooth extraction | Initial periodontal therapy Initial periodontal therapy Only recession requires no treatment Impacted teeth or roots fully covered by bone without radiographic abnormalities | No treatment If problems are expected in …

Gaucher: A Systematic Review on Oral and Radiological Aspects.

Background and Objectives: Gaucher disease (GD) is a lysosomal storage disorder with the genetic autosomal recessive transmission. Bone involvement is a prevalent finding in Gaucher disease. It causes deformity and limits daily activities and the quality of life. In 75% of patients, there is bone involvement. This review aims to evaluate the principal findings in the jaw by a Cone-beam computed tomography (CBTC) and X-ray orthopantomography; Materials and Methods: PubMed, Web of Science, Lilacs and Scopus were systematically searched until 31 December 2022. In addition, a manual search was per

A real-world disproportionality analysis of FDA adverse event reporting system (FAERS) events for denosumab.

BACKGROUND: Denosumab is authorized to treat several diseases, including cancer and bone disorders. Nevertheless, its use in clinical practice has been affected by safety concerns. The work retrospectively investigated adverse events (AEs) of denosumab to better understand toxicities. METHODS: The FAERS data base data from Q1 of 2010 to Q3 of 2023 was chosen. The definition of Medical Dictionary for Regulatory Activities (MedDRA) was dependent on preferred terms (PTs) and system organ class (SOCs). Following the removal of duplicate reports, a disproportionality analysis was conducted to iden

Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri-implant diseases.

BACKGROUND: Periodontitis and peri-implant diseases are chronic inflammatory conditions occurring in the mouth. Left untreated, periodontiti … treatment: probing pocket depth (PPD), bleeding on probing (BOP), clinical attachment level (CAL), gingival recession (REC), pocket closure and adverse effects related to aPDT. We were also interested in change in bone level (for participants with peri-implantitis), and participant satisfaction and quality of life. MAIN RESULTS: We included 50 RCTs with 1407 parti …

Oral Hygiene Management of Hematologic Patients Undergoing Auto-Transplantation: An Observational Study.

Background/Objectives: The present study evaluated the effectiveness of a prevention protocol involving oral hygiene, instructions, and motivation in patients eligible for hematopoietic stem cell transplantation (HSCT). Methods: Consecutive patients scheduled for HSCT were enrolled. All patients received a complete dental examination aimed at assessing periodontal health status through periodontal charting and registration of the levels of plaque and inflammation. Subsequently, patients received professional oral hygiene care and were instructed on and motivated toward oral prophylaxis prior t

Safety Profile and Predictors of Adverse Events of Incadronate Disodium in Treating Breast Cancer Patients with Bone Metastases: A Retrospective Study.

PURPOSE: Bone metastasis is a common complication in advanced breast cancer. Bisphosphonates like incadronate disodium have shown potential in reducing bone resorption and skeletal-related events. We therefore performed a retrospective study to evaluate the safety profile of incadronate disodium in breast cancer patients with bone metastases. PATIENTS AND METHODS: This retrospective study was conducted involving 84 breast cancer patients with bone metastases who received incadronate disodium treatment between February 2022 and August 2024 in our center. The primary endpoint was the incidence

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… However, our primary concern was the occurrence of dental-related issues potentially induced by the medication, defined as newly developed symptoms such as gingival recession or swelling, tooth sensitivity, tooth looseness, or fractures, with osteonecrosis of the jaw (MRONJ) representing the most severe … The most common symptoms included gingival recession or swelling, tooth sensitivity, fractures, and jaw pain. Notably, only one patient (1.2%) was definitively diagnosed with osteonecrosis, and the medication was discontinued in this case. …

Mining the FAERS database reveals new safety signals for 120 mg denosumab in oncology practice.

OBJECTIVE: To detect and quantify adverse drug event (ADE) signals linked to 120 mg denosumab in the real world. METHODS: We queried the US Food and Drug Administration Adverse Event Reporting System (FAERS) for reports on 120 mg denosumab, standardized, and categorized these events with Preferred Terms (PT) and System Organ Classes (SOC) from MedDRA version 27.1. Disproportionality analysis was performed using the reporting odds ratio (ROR) and Bayesian confidence propagation neural network (BCPNN). RESULTS: We identified 10,963 ADE reports for 120 mg of denosumab. Among 10 963 reports, 41.

Hematology

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Glanzmann's thrombasthenia: pathogenesis, diagnosis, and current and emerging treatment options.

Glanzmann's thrombasthenia (GT) is a genetic platelet surface receptor disorder of GPIIb/IIIa (ITG αIIbβ3), either qualitative or quantitative, which results in faulty platelet aggregation and diminished clot retraction. Spontaneous mucocutaneous bleeding is common and can lead to fatal bleeding episodes. Control and prevention of bleeding among patients with GT is imperative, and remains challenging. Local measures, including anti-fibrinolytic therapy, with or without platelet transfusions, used to be the mainstay of therapy. However, in recent years the use of recombinant factor VIIa (rFVIIa

Anti-resorptive therapy in the osteometabolic patient affected by periodontitis. A joint position paper of the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP).

This joint report from the Italian Society of Orthopaedics and Traumatology (SIOT) and the Italian Society of Periodontology and Implantology (SIdP) aims for a consensus around the scientific rationale and clinical strategy for the management of osteoporotic patients affected by periodontitis who are undergoing anti-resorptive (AR) therapy to manage the risk of the occurrence of a medication-related osteonecrosis of the jaws (MRONJ). Osteoporosis and periodontitis are chronic diseases with a high prevalence in aging patients, and they share some of the same pathogenetic mechanisms based upon i

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… Unlike dental caries, periodontitis causes not only the loss of a tooth, but also the loss of the surrounding supportive tissues, including severe alveolar bone loss and gingival recessions. …

Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants-A Narrative Review.

Dental implants are, nowadays, established surgical devices for the restoration of lost teeth. Considered as an alternative for traditional prosthetic appliances, dental implants surpass them in reliability and patient feedback. Local drug delivery around the implants promotes osseointegration and reduces peri-implantitis. However, there are currently no methods of a multiple, precise topical administration of drugs to the implant area. Engineering coatings on the implants, drug application on carriers during implantation, or gingival pockets do not meet all requirements of dental surgeons. Th

A randomized controlled trial of manual versus powered tooth brushing during haematopoietic stem cell transplantation.

AimTo compare manual and powered tooth brushing (MT and PT) with respect to patient compliance to brushing frequency advice, plaque removal and severity of oral mucositis (OM) in patients undergoing hematopoietic stem cell transplantation (HSCT) after high-dose chemotherapy.Materials & methodsA randomized controlled trial was conducted. Forty-six patients scheduled to receive myeloablative conditioning regimen before autologous HSCT were included and randomly assigned to control (MT, n = 23) or test (PT, n = 23) groups. Starting at day 1 (day of hospital admission for HSCT), brushing frequency

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… Scores are based on the presence of bleeding (1), combined with retention factors such as calculus (2), presence of pockets of 4–5 mm without (3‐) or with (3+) gingival recession, or presence of pockets of ≥6 mm (4). …

Skin manifestations associated with systemic diseases - Part II.

The skin, by reflecting internal processes, externalizes what happens inside the body in many diseases. Thus, the skin, as an organ, extrapolates its functions of protection, barrier and signals the existence of systemic diseases, expanding the importance of the dermatologist beyond the skin surface. Thus, the dermatologist investigates diagnostic hypotheses for conditions related to all systems and refers patients to the appropriate specialty. Combined with examination by a trained eye, the skin, due to its easy access, is still the ideal place for performing biopsies, which often clarify the

Hypophosphatasia.

Hypophosphatasia (HPP) is an inherited metabolic disease caused by loss-of-function mutations in the tissue non-specific alkaline phosphatase (TNAP) gene. Reduced activity of TNAP leads to the accumulation of its substrates, mainly inorganic pyrophosphate and pyridoxal-5'-phosphate, metabolic aberrations that largely explain the musculoskeletal and systemic features of the disease. More than 400 ALPL mutations, mostly missense, are reported to date, transmitted by either autosomal dominant or recessive mode. Severe disease is rare, with incidence ranging from 1:100,000 to 1:300,000 live births

Autoinflammatory Keratinization Diseases-The Concept, Pathophysiology, and Clinical Implications.

Recent advances in medical genetics elucidated the background of diseases characterized by superficial dermal and epidermal inflammation with resultant aberrant keratosis. This led to introducing the term autoinflammatory keratinization diseases encompassing entities in which monogenic mutations cause spontaneous activation of the innate immunity and subsequent disruption of the keratinization process. Originally, autoinflammatory keratinization diseases were attributed to pathogenic variants of CARD14 (generalized pustular psoriasis with concomitant psoriasis vulgaris, palmoplantar pustulosis

Effect of leaving chronic oral foci untreated on infectious complications during intensive chemotherapy.

BackgroundLeukaemic patients receiving intensive chemotherapy and patients undergoing autologous stem-cell transplantation (ASCT) are routinely screened for oral foci of infection to reduce infectious complications that could occur during therapy. In this prospective study we assessed the effect of leaving chronic oral foci of infection untreated on the development of infectious complications in intensively treated haematological patients.MethodsWe included and prospectively evaluated all intensively treated leukaemic patients and patients undergoing ASCT who were referred to our medical centr

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… Periodontal examination including probing pocket depth measurements, gingival recession, mobility and furcation measurements. Plaque and bleeding scores were assessed as a percentage of the total number of sites with plaque, respectively, bleeding on probing. …

Hematology

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The Role of Platelet Dysfunctions in the Pathogenesis of the Hemostatic-Coagulant System Imbalances.

Platelet dysfunction plays a critical role in the pathogenesis of various disorders affecting the hemostatic-coagulant system. This review aims to explore the mechanisms by which platelet dysfunctions contribute to the disruption of hemostasis, leading to an increased risk of both thrombosis and bleeding. Platelets, traditionally known for their role in clot formation, can exhibit altered functionality under pathological conditions such as cardiovascular diseases, metabolic disorders, and autoimmune diseases, impacting their interaction with coagulation factors and vascular endothelium. The re

Medication-Related Osteonecrosis of the Jaw: Successful Medical Management of Complex Maxillary Alveolus with Sinus Involvement.

Medication-related osteonecrosis of the jaw (MRONJ) in cancer patients presents a considerable challenge in management. Current management is primarily based on interventions in a limited number of cases assessing a single approach. Medical management typically is reported to include antimicrobial therapy with or without surgery. Advances in the understanding of pathogenesis have led to the investigation of additional medical interventions for early-stage necrosis. We present 3 patients with advanced-stage MRONJ of the maxilla using combined medical modalities including antimicrobial therapy,