Objective Inter-observer agreement in the context of oral epithelial dysplasia (OED) grading has been notoriously unreliable and can impose barriers for developing new molecular markers and diagnostic technologies. This paper aimed to report the details of a 3-stage histopathology review and adjudication process with the goal of achieving a consensus histopathologic diagnosis of each biopsy. Study Design Two adjacent serial histological sections of oral lesions from 846 patients were independently scored by two different pathologists from a pool of four. In instances where the original two pathologists disagreed, a third, independent adjudicating pathologist conducted a review of both sections. If a majority agreement was not achieved, the third stage involved a face-to-face consensus review. Results Individual pathologist pair kappa values ranged from 0.251 – 0.706 (fair – good) before the 3-stage review process During the initial review phase, the two pathologists agreed on a diagnosis for 69.9% of the cases. After the adjudication review by a third pathologist, an additional 22.8% of cases were given a consensus diagnosis (agreement of 2 out of 3 pathologists). Following the face-to-face review, the remaining 7.3% of cases had a consensus diagnosis. Conclusion The use of the defined protocol resulted in a substantial increase (30%) in diagnostic agreement and has the potential to improve the level of agreement for establishing gold standards for studies based on histopathologic diagnosis.

Background: To evaluate dimensional bone alterations following horizontal ridge augmentation using guided bone regeneration (GBR) with or without autogenous block graft (ABG) for the rehabilitation of atrophic jaws with dental implants.Materials and Methods: Forty-two patients, with 42 severe horizontal bone atrophy sites in the maxilla or mandible were randomly assigned to two groups: ABG or GBR. The ABG group received a combination of ABG with particulate xenograft, covered by a collagen membrane, while the GBR group received particulate xenograft alone, covered by a collagen membrane.After 6-9 months of healing, implants were inserted. All implants were definitively restored 6 months after implant placement. Radiographic examination (cone-beam computed tomograms) was performed immediately after bone grafting procedure (T0), at 6 months (T6), and at 18 months (T18), to evaluate the amount of horizontal bone width (HBW) gain. Patient demographic information, amount of ridge width augmentation, implant survival, complications, and contributing factors were gathered and analyzed.Results: Thirty-nine patients completed the study. Both groups developed enough bone ridge width for implant placement. A total of 65 implants were placed. Implant survival rate was 100% in both groups at T18. Mean increases in HBW amounted to 5.6 ± 1.35 mm in GBR sites and 4.8 ± 0.79 mm in ABG sites at T18. There was no statistically significant difference in HBW gain obtained in the GBR group when compared to the ABG group at 6 months (P = 0.26) or 18 months (P = 0.26). However, the ABG group had a statistically significant higher prevalence of sensory disturbances (P = 0.02) and hematomas (P = 0.002) compared to the GBR group.

The augmented sinuses in this study that exhibited MSMPs that occurred during the SAP (which were treated during surgery) show SS greater vital bone percentages compared with the non-perforated sinus group. There were no SS differences in implant survival in the perforated versus non-perforated groups. In this study, sinus MSMPs, when properly repaired during surgery, do not appear to be an adverse complication in terms of vital bone production or implant survival.