Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

{"title":"Enamel pits and enamel developmental defects in tuberous sclerosis complex: A descriptive synthesis and pooled prevalence analysis.","authors":"H Nakagawa","doi":"10.4317/medoral.28247","DOIUrl":"10.4317/medoral.28247","url":null,"abstract":"<p><strong>Background: </strong>Enamel pits and enamel developmental defects have been reported in patients with tuberous sclerosis complex (TSC), but prevalence estimates and phenotypic descriptions vary widely. A standardized synthesis has been lacking. Recent updates in TSC clinical reviews and dermatologic-dental guidelines highlight the diagnostic relevance of subtle oral findings, underscoring the need for an updated synthesis.</p><p><strong>Material and methods: </strong>A systematic review with quantitative integration was conducted in accordance with PRISMA 2020 guidelines. Electronic databases were searched from inception to March 2026. Eligible studies reporting enamel pits or enamel developmental defects in TSC were reviewed, and pooled prevalence was calculated using a random‑effects model. Meta‑analytic procedures, including Forest and funnel plot generation, were performed using EZR (version 1.7). Heterogeneity was assessed using the I² statistic, and subgroup analyses explored sources of variability. A phenotype‑oriented classification system was developed based on recurring enamel features. Representative clinical cases were included only as qualitative supplementary material. Recent literature on TSC diagnostic criteria and enamel defects in systemic or dermatologic conditions was additionally incorporated to contextualize methodological variability.</p><p><strong>Results: </strong>Seven studies involving 217 patients were included. Enamel pits and related defects were frequently reported. The pooled prevalence of enamel pits was 66%, with substantial heterogeneity (I²=77%). Individual estimates ranged from 0% in deciduous dentition to 100% in studies using staining or SEM. Funnel plot asymmetry suggested potential publication bias and small‑study effects. Variability was partly associated with dentition type, age, diagnostic criteria, and assessment methods. These findings align with contemporary evidence emphasizing that enamel abnormalities may be under‑recognized depending on examination methods and clinical context.</p><p><strong>Conclusions: </strong>This review synthesizes current evidence on enamel abnormalities in TSC and highlights considerable variability in reported prevalence. The proposed phenotype‑oriented classification provides a pragmatic descriptive framework, but findings should be interpreted cautiously due to methodological heterogeneity. Contemporary literature supports the diagnostic relevance of enamel pits as a recognized minor feature of TSC, reinforcing the need for standardized assessment.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e751-e757"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient delay in oral cancer in North-Western Spain: Where do we stand?","authors":"H Sánchez-Ortega, P Varela-Centelles, J Seoane, J-L López-Cedrún, A Bilbao-Alonso, L García-Caballero, A Blanco-Hortas, J-M Seoane-Romero","doi":"10.4317/medoral.28246","DOIUrl":"10.4317/medoral.28246","url":null,"abstract":"<p><strong>Background: </strong>Timely diagnosis remains a major challenge in oral cancer, with more than half of cases diagnosed at advanced stages. Although the patient interval has been suggested as a key component of the diagnostic pathway, its relative contribution and temporal evolution remain insufficiently characterized. This study aimed to quantify diagnostic and treatment intervals in oral cancer and to evaluate the relative contribution of the patient interval using the Aarhus Statement framework, comparing current data with a historical cohort recruited a decade earlier in North-Western Spain.</p><p><strong>Material and methods: </strong>A hospital-based ambispective observational study was conducted including consecutive incident cases of histologically confirmed oral squamous cell carcinoma diagnosed in 2025 at a tertiary referral center. Time intervals from first symptom to treatment initiation were defined according to the Aarhus Statement. Recall bias was minimized through triangulation of patient interviews, relatives' reports, and clinical records. Median intervals and interquartile ranges were calculated, and comparisons were performed with a historical cohort recruited in 2015 under identical methodological criteria. Ratios between intervals were estimated to assess the relative contribution of the patient interval.</p><p><strong>Results: </strong>The median patient interval decreased slightly in 2025 compared with 2015 (25 vs. 31.5 days). Primary care and diagnostic intervals were shorter, whereas specialist and pre-treatment intervals increased. The total pre-treatment interval remained stable between cohorts. Ratio analyses showed that the patient interval represented a limited proportion of the total diagnostic and treatment pathway, with no significant temporal differences.</p><p><strong>Conclusions: </strong>Temporal changes in the oral cancer pathway were heterogeneous, suggesting a redistribution of delays toward later intervals of care. The patient interval was not the main contributor to overall time to treatment, highlighting the need for system-level strategies targeting specialist assessment and treatment initiation phases.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e744-e750"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the socket shield technique on alveolar ridge dimensional changes in sites with thin buccal bone phenotype: A randomized clinical trial.","authors":"L-M Sáez-Alcaide, C Cobo-Vázquez, F Pérez-González, J González-Serrano, J López-Quiles, J-T García-Denche","doi":"10.4317/medoral.28158","DOIUrl":"10.4317/medoral.28158","url":null,"abstract":"<p><strong>Background: </strong>Post-extraction alveolar ridge remodeling is a major challenge for implant therapy, particularly in sites with a thin buccal bone phenotype. Although immediate implant placement has been proposed to limit ridge resorption, buccal dimensional changes remain frequent. The socket shield technique has been proposed to preserve the periodontal ligament-bundle bone complex and reduce post-extraction bone loss. This randomized clinical trial aimed to compare alveolar ridge dimensional changes following the socket shield technique versus immediate implant placement in sites with buccal bone thickness <1.5mm.</p><p><strong>Materials and methods: </strong>This parallel-arm randomized controlled clinical trial included patients requiring extraction of a single-rooted tooth and presenting a thin buccal bone phenotype (BBT <1.5mm). Participants were randomly allocated to receive either socket shield technique (SST) or immediate implant placement (IIP). Horizontal, vertical, and volumetric alveolar ridge changes were assessed using CBCT superimposition at baseline and 1 year. Marginal bone levels were evaluated at implant placement, prosthetic loading, and 1-year follow-up using standardized periapical radiographs. Intergroup comparisons were performed using analysis of covariance (ANCOVA) adjusting for baseline values.</p><p><strong>Results: </strong>Forty patients completed the study. The SST group demonstrated significantly lower horizontal ridge reduction and buccal vertical bone loss compared with the IIP group at all evaluated levels (p<0.001). Volumetric analysis demonstrated significantly greater overall bone loss in the IIP group (p<0.001). Marginal bone loss did not differ between groups at implant placement; however, significantly greater marginal bone loss progression was observed in the IIP group at prosthetic loading and 1-year follow-up (p<0.001).</p><p><strong>Conclusions: </strong>In extraction sites presenting a thin buccal bone phenotype, the socket shield technique significantly reduced horizontal and buccal vertical ridge resorption, limited volumetric bone loss, and resulted in improved marginal bone stability compared with immediate implant placement. These findings suggest that SST may represent a predictable strategy for preserving peri-implant hard tissues in anatomically compromised sites.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e707-e715"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of high-risk patients and metastatic progression in primary c/pN0 oral squamous cell carcinoma.","authors":"R Eloranta, R Nikkilä, S Vilén, T Wilkman, T Salo, J Snäll","doi":"10.4317/medoral.28176","DOIUrl":"10.4317/medoral.28176","url":null,"abstract":"<p><strong>Background: </strong>Metastasis significantly decreases survival in oral cavity squamous cell carcinoma (OSCC). Even patients initially staged as cN0 may develop cervical or distant metastases during follow-up. Risk factors contributing to metastasis in this group are not fully understood.</p><p><strong>Materials and methods: </strong>A retrospective cohort study was conducted on patients with primary cN0 OSCC treated between 2016 and 2020.</p><p><strong>Results: </strong>Of the 195 N0 OSCC patients included, 19 (9.7%) developed metastasis. Heavy alcohol use (HR 4.05, 95% CI:1.38-11.92, p=0.011) and depth of invasion (DOI) (HR 1.10, 95% CI:1.01-1.20, p=0.021) were significantly associated with the development of metastasis. Age, gender, site, neck procedure, radiotherapy, and T-class were not statistically significant predictors in this analysis.</p><p><strong>Conclusions: </strong>Metastases occurred in nearly 10% of c/pN0 patients. Alcohol use and DOI were independent predictors, highlighting the need for individualized follow-up strategies and further research into alcohol-related OSCC.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e728-e737"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate implant placement in infected extraction sockets: A scoping review of case selection, decontamination protocols, clinical outcomes and complications.","authors":"F-M Espada-Salgado, M-M Iuga, B Oprea","doi":"10.4317/medoral.28256","DOIUrl":"10.4317/medoral.28256","url":null,"abstract":"<p><strong>Background: </strong>This scoping review aimed to map the extent and nature of the evidence on immediate implant placement in infected extraction sockets, with emphasis on case selection, decontamination protocols, adjunctive interventions, clinical outcomes, and complications.</p><p><strong>Material and methods: </strong>This review was conducted in accordance with Joanna Briggs Institute guidance for scoping reviews and reported following PRISMA-ScR. Searches were performed in Scopus, Web of Science Core Collection, PubMed/MEDLINE, LILACS via BVS, SciELO, and ClinicalTrials.gov up to 17 March 2026. After removal of duplicates, 72 records were screened independently by two reviewers, and 24 clinical studies published between 2015 and 2025 met the inclusion criteria.</p><p><strong>Results: </strong>The included evidence comprised case reports, case series, retrospective studies, prospective cohort studies, one split-mouth study, and one randomized trial. Most studies evaluated infected sockets associated with endodontic or periapical lesions, whereas periodontal and mixed lesions were less frequently addressed. Across studies, atraumatic extraction, meticulous socket debridement, and achievement of primary stability were consistently reported as key procedural steps. Adjunctive measures included systemic antibiotics, chlorhexidine decontamination, bone grafts, barrier membranes, platelet concentrates, laser therapy, vestibular socket techniques, and immediate provisionalization. Although most studies reported favorable implant survival, marginal bone stability, and esthetic outcomes, the evidence was heterogeneous, largely observational, and frequently non-comparative.</p><p><strong>Conclusions: </strong>The available evidence suggests that immediate implant placement in infected extraction sockets may be feasible in carefully selected cases when meticulous debridement and adequate primary stability are achieved. However, due to the heterogeneity, limited comparative evidence, and variability in infection definitions and treatment protocols, no standardized clinical protocol can currently be recommended. Further well-designed comparative studies with standardized reporting are needed.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e758-e771"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aberrant expression and subcellular localization of laminin 332 in oral squamous cell carcinoma: Implications for invasive front assessment.","authors":"N-A-T Nguyen, H-T Nguyen, N-H Nguyen, T-T Luu, H-N Truong","doi":"10.4317/medoral.28040","DOIUrl":"10.4317/medoral.28040","url":null,"abstract":"<p><strong>Background: </strong>Laminin 332 (LM332) is a primary component of the epithelial BM. During malignant transformation, loss of continuity and cytoplasmic redistribution have been documented during tumor progression. This study aimed to evaluate LM332 expression at the basement membrane (BM) and in the cytoplasm of oral squamous cell carcinoma (OSCC) and to investigate its association with histopathological characteristics.</p><p><strong>Material and methods: </strong>A cross-sectional study was conducted on 130 patients utilizing immunohistochemical techniques to examine LM332 expression.</p><p><strong>Results: </strong>In OSCC, LM332 expression at the BM was frequently fragmented in 62% of cases and absent in 18%. Conversely, LM332 was significantly overexpressed in the cytoplasm, with 95% of cases exhibiting positive staining (≥1+ based on the semi-quantitative scoring system). A statistically significant difference was observed between LM332 expression and the histological grade of OSCC (p<0.05).</p><p><strong>Conclusions: </strong>LM332 immunohistochemical expression patterns may serve as an adjunctive marker reflecting histopathological progression in malignant oral epithelium.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e631-e638"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping scientific knowledge on the association between periodontal disease and rheumatoid arthritis: A bibliometric and altmetric analysis of the 100 most-cited articles.","authors":"L-G Silvestrini, M-F Santos, B-D Rodrigues, L-M Gonzaga, H Martelli-Júnior, G-M Fabri, M-P Maia-Lima, L-M Ferreira","doi":"10.4317/medoral.28134","DOIUrl":"10.4317/medoral.28134","url":null,"abstract":"<p><strong>Background: </strong>A bidirectional relationship between periodontal disease (PD) and rheumatoid arthritis (RA) has been widely investigated, highlighting the potential impact of oral diseases on systemic health. This bibliometric and altmetric analysis aimed to evaluate the 100 most-cited articles exploring the association between PD and RA.</p><p><strong>Materials and methods: </strong>A bibliometric review was conducted in accordance with the BIBLIO guidelines. The Scopus database was searched to identify the 100 most-cited articles, and citation counts were cross-validated in the Web of Science database. Data collected included publication year, citation counts, journals, authors, institutions, countries, study design, and collaboration patterns. Bibliometric networks were visualized using VOSviewer, altmetric data were obtained from the Dimensions platform, and public interest trends were analyzed using Google Trends.</p><p><strong>Results: </strong>The selected articles accumulated 14,753 citations (mean: 147.5 citations per article). Scientific output increased in the 1990s, peaked between 2005 and 2015, and declined thereafter. Research production was concentrated in high-income countries, particularly the United States, the United Kingdom, and Australia, and the resulting articles were published in high-impact journals. The literature primarily focused on molecular mechanisms and biomarkers, whereas clinical trials were comparatively scarce. Altmetric scores demonstrated a weak but statistically significant (p=0.001) positive correlation with citation counts.</p><p><strong>Conclusions: </strong>This is a well-established, interdisciplinary research field whose academic influence and public relevance are well documented. Nevertheless, limited geographic diversity and a relative paucity of interventional studies remain. Future multicenter and translational investigations are warranted to address these gaps and further advance clinical understanding.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e685-e696"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of oral and maxillofacial lesions in children and adolescents in a southeastern Brazilian population: A retrospective study including the COVID-19 pandemic period.","authors":"I-K Darella, J-P de Paiva, A-R Santos-Silva, J Jorge, M-A Lopes, P-A Vargas","doi":"10.4317/medoral.28139","DOIUrl":"10.4317/medoral.28139","url":null,"abstract":"<p><strong>Background: </strong>This retrospective study analyzed the frequency of oral and maxillofacial lesions in a pediatric population from an oral pathology service in southeastern Brazil (2015-2024).</p><p><strong>Materials and methods: </strong>We reviewed all histopathological reports from this period, which included the COVID-19 pandemic. Demographic and clinicopathological data were collected and summarized using descriptive statistics. Associations were assessed using Pearson's chi-squared, Fisher's exact, Cramer's V, and multinomial logistic regression tests.</p><p><strong>Results: </strong>Among 1,578 pediatric biopsies (patients aged 0-19 years), which represented 8.78% of the service's total caseload, adolescents were the predominant group (76.68%), with a balanced gender distribution. A significant decrease in pediatric cases was observed following the COVID-19 pandemic, although the most frequent lesion types remained consistent. Of the 1,414 conclusive diagnoses, salivary gland pathologies were most common (31.12%), followed by odontogenic cysts (18.74%) and mucosal pathologies (12.02%). Mucocele was the single most prevalent lesion (25.67%), followed by dentigerous cyst (8.17%). Statistical analysis revealed a significant association between patient age and diagnostic category, indicating distinct, developmentally dependent patterns.</p><p><strong>Conclusions: </strong>Our findings confirm the predominance of benign, reactive, and cystic lesions in pediatric patients, including during the COVID-19 pandemic, underscoring the value of current epidemiological data to guide clinical practice and preventive strategies.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e697-e706"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunoexpression of CXCL12 and CXCR4 in giant cell granulomas of the jaws and giant cell tumor of bone.","authors":"V-A de Medeiros, C-R Ferreira, J-L Silva-Cunha, É-J da Silveira, M-A Gordón-Núñez, P-M Alves, C-F Nonaka","doi":"10.4317/medoral.28299","DOIUrl":"10.4317/medoral.28299","url":null,"abstract":"<p><strong>Background: </strong>Chemokines are proteins involved in various cellular processes; however, their participation in the pathogenesis of lesions containing multinucleated giant cells (MGC) has not been fully elucidated. This study investigated the immunoexpression of chemokine CXCL12 and its receptor CXCR4 in giant cell granulomas of the jaws (central giant cell granuloma [CGCG] and peripheral giant cell granuloma [PGCG]) and giant cell tumor of bone (GCTB).</p><p><strong>Material and methods: </strong>Forty-five giant cell granulomas of the jaws (15 non-aggressive CGCG, 15 aggressive CGCG, and 15 PGCG) and 15 GCTB were selected. The percentages of cytoplasmic (CXCL12 and CXCR4) and nuclear (CXCR4) positivity in mononuclear cells (MC) and in non-cannibalistic (ncMGC) and cannibalistic MGC (cMGC) were determined.</p><p><strong>Results: </strong>All groups exhibited low median percentages of positivity for CXCL12 in MC (p>0.05). In ncMGC and cMGC, the highest median percentages of CXCL12 positivity were observed in GCTB (p>0.05). Cytoplasmic immunoexpression of CXCR4 was observed in all groups evaluated, with high median percentages of positivity in ncMGC and cMGC. Compared to non-aggressive CGCG, GCTB exhibited significantly higher cytoplasmic expression of CXCR4 in ncMGC (p<0.05). In MC, the highest median percentage of CXCR4 positivity was observed in GCTB, with a statistically significant difference compared to PGCG (p<0.05). All groups showed low median percentages of nuclear expression of CXCR4. Compared to PGCG, GCTB exhibited higher nuclear expression of CXCR4 in MC (p<0.05). Strong positive correlations were found between cytoplasmic and nuclear expression of CXCR4 in MC of non-aggressive CGCG, PGCG, and GCTB (p<0.05).</p><p><strong>Conclusions: </strong>The results suggest the potential involvement of CXCR4 in the pathogenesis of giant cell granulomas of the jaws and GCTB. This chemokine receptor may also contribute to differences in the biological behavior of these MGC-containing lesions. The relevance of CXCL12 for the development of the giant cell lesions studied appears to be variable.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e772-e781"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional validation of a preoperative multidimensional assessment tool for third molar extraction using machine learning.","authors":"A Sánchez-Torres, X Arias-Huerta, B Pérez-Iglesias, E Gómez-Reig, R Figueiredo, E Valmaseda-Castellón, J-A Conejero, C Gay-Escoda","doi":"10.4317/medoral.28065","DOIUrl":"10.4317/medoral.28065","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the correlation between a preoperative difficulty assessment form and surgery time in third molar extractions. Secondary aims included analyzing the relationship between the form's global score and surgical technique, surgeon-perceived difficulty, and postoperative complications. Machine learning models were also explored.</p><p><strong>Material and methods: </strong>A cross-sectional study was conducted on patients requiring a third molar extraction between April 2022 and May 2023, operated by students of the master's degree in Oral Surgery and Implantology (University of Barcelona, Spain). Three previously calibrated investigators completed the preoperative difficulty evaluation form, which included clinical, radiological and surgical variables. Descriptive and bivariate analyses were performed using the Stata/IC 15.1. Machine learning models were applied to predict surgery time and surgeon-perceived difficulty.</p><p><strong>Results: </strong>A total of 205 patients, 75 males (36.6%) and 130 females (63.4%), with a mean age of 28.5±14.1 years were included; 49 (23.9%) were upper and 156 (76.1%) lower third molars. The global score of the form was significantly correlated to surgery time (Spearman's rho=0.640; P<0.001), perceived difficulty (Spearman's rho=0.395; P<0.001) and the surgical technique according to Parant's classification (P<0.001). Postoperative complications were associated to higher scores on the difficulty evaluation form (P=0.012).</p><p><strong>Conclusions: </strong>The preoperative assessment form is a valid tool for estimating third molar extraction difficulty. Its global score is positively associated with surgery time, perceived difficulty, surgical technique, and postoperative complications. Machine learning models showed better performance at modeling surgery time than surgical difficulty.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e659-e668"},"PeriodicalIF":2.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}