Medication-related osteonecrosis of the jaw (MRONJ) is a side effect of antiresorptive drugs. In this online survey, the awareness and knowledge of dentists regarding MRONJ was evaluated, and potential implications for oncologists are discussed. Questionnaires were emailed to dentists from Germany, Austria, Switzerland, and South Tyrol to evaluate disease-related knowledge and management. In addition to the overall score, a separate score was calculated for knowledge (maximum score: 15 points) and management (maximum score: 6 points) questions, and 1197 valid replies with completed questionnaires were received. The mean overall score was 10.45 ± 3.97 points, the mean knowledge score was 7.68 ± 3.05 points, and the mean management score was 2.76 ± 1.77 points. Factors influencing the outcome of the overall score were age, specialization, continuous professional education, and the number of dental screening exams in patients before antiresorptive therapy. Due to the considerable lack of knowledge regarding MRONJ among dentists, MRONJ patients and subjects at risk should be guided towards specialists for dental screening, treatment, and follow-up. This is important from an oncologic point of view to avoid any delay for treatment start of antiresorptives, and to reveal a potentially emerging osteonecrosis at an early stage, thus, avoiding the need for interruption or even cancellation of antiresorptive therapy.
Purpose To assess the validity, reliability, reproducibility, and objectivity of measurements on stone casts of patients with mixed dentitions compared to measurements on three-dimensional (3D) digital models derived from surface scans of the stone casts. Methods Pairs of stone casts of 30 young patients in their mixed dentition stage were included and processed into 3D digital models using an intraoral scanner (iTero Element 2; Align Technology, San Jose, CA, USA). Then an experienced and an inexperienced examiner independently performed measurements of five defined parameters, each in triplicate, both on the digital models with analysis software (OnyxCeph3™; Image Instruments, Chemnitz, Germany) and on the original casts with a vernier calliper. Paired t-tests were used for validity and interexaminer objectivity, Pearson correlation coefficients for intermethod reliability, and intraclass correlation coefficients (ICCs) for reproducibility testing. Results Significant (p < 0.05) intermethod differences were identified for four parameters, but only the differences for overbite and intermolar distance exceeded the threshold of clinical relevance (≥ 0.5 mm). Intermethod reliability was high and method error invariably lower for the digital measurements and for the experienced examiner. Both examiners achieved ICCs > 0.907 with both methods. Interexaminer variation involved significant differences for all parameters but one (intermolar distance) on the stone casts and for three parameters on the digital models. Conclusion Measurements performed on digital models of mixed dentitions can yield clinically acceptable outcomes with OnyxCeph3™ software. Both the digital and the analogue measurements were highly reproducible and reliable. Objectivity of the measurements could not be confirmed, as operator experience did make a difference.
Under aerobic conditions, some cancers switch to glycolysis to cover their energy requirements. Taking advantage of this process, functional imaging techniques such as PET-CT can be used to detect and assess tumorous tissues. The aim of this study was to investigate standardized uptake values and mitochondrial DNA mutations in oral squamous cell carcinoma. A cohort of 57 patients underwent 18[F]FDG-PET-CT and standardized uptake values were collected. In 15 patients, data on mitochondrial DNA mutations of the tumor were available. Kaplan–Meier curves were calculated, and correlation analyses as well as univariate Cox proportional hazard models were performed. Using ROC analysis to determine a statistical threshold for SUVmax in PET investigations, a cut-off value was determined at 9.765 MB/mL. Survival analysis for SUVmax in these groups showed a Hazard Ratio of 4 (95% CI 1.7–9) in the high SUVmax group with 5-year survival rates of 23.5% (p = 0.00042). For SUVmax and clinicopathological tumor features, significant correlations were found. A tendency towards higher mtDNA heteroplasmy levels in high SUVmax groups could be observed. We were able to confirm the prognostic value of SUVmax in OSCC, showing higher survival rates at lower SUVmax levels. Correlations between SUVmax and distinct tumor characteristics were highly significant, providing evidence that SUVmax may act as a reliable diagnostic parameter. Correlation analysis of mtDNA mutations suggests an influence on metabolic activity in OSCC.
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