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Alessandro Villa - One of the best experts on this subject based on the ideXlab platform.

  • world workshop on Oral Medicine vii prognostic biomarkers in Oral leukoplakia a systematic review of longitudinal studies
    Oral Diseases, 2019
    Co-Authors: Alessandro Villa, Douglas E Peterson, Antonio Celentano, Ingrid Glurich, Wenche S Borgnakke, Siri Beier Jensen, Konstantina Delli, David Ojeda, Arjan Vissink
    Abstract:

    Objective To identify the prognostic biomarker candidates for stratification and long-term surveillance of Oral leukoplakia progressing to cancer via a systematic literature review. Materials and methods Systematic searches with no date restrictions were conducted on March 29, 2018, targeting the databases PubMed (Ovid), EMBASE (Ovid), EBM (Ovid), and Web of Science (ISI). Bias was assessed using the Quality in Prognosis Studies tool. Biomarkers were stratified based on hallmarks of cancer. Results Inclusion criteria were met by 25 of 3,415 studies. A range of biomarkers were evaluated experimentally for risk stratification, prognosis, and surveillance of Oral leukoplakia in tissue, blood, and saliva. However, the studies were highly heterogeneous and require further validation. Biomarkers reported in these studies included inflammatory or oxidative markers, growth factors, ion channels, genetic and cellular regulatory factors, and epigenetic biomarkers. Studies tended to include small sample sizes, under-reported or variably reported histopathological data, did not address potential confounding, reported limited/variable follow-up data, or lacked a control group. Inclusion of subsets from chemoprevention trials may have introduced bias regarding reported malignant transformation rates and accuracy of prognostic biomarkers. Conclusions This review identified insufficient longitudinal evidence to support validated prognostic biomarkers for Oral leukoplakia. Further studies are needed to identify molecular targets with the potential to mitigate risk of malignant transformation.

  • evaluation of a community based dental screening program prior to radiotherapy for head and neck cancer a single center experience
    Supportive Care in Cancer, 2019
    Co-Authors: Elizabeth Waring, Hani Mawardi, Sookbin Woo, Nathaniel S Treister, Danielle N Margalit, Jennifer Frustino, Alessandro Villa
    Abstract:

    PURPOSE Oral toxicities following radiation therapy (RT) for head and neck (HN) cancer can be profound and are associated with poor health outcomes. The Division of Oral Medicine and Dentistry at Brigham and Women's Hospital and Dana-Farber Cancer Institute therefore implemented a dental evaluation program designed for community-based (CB) dentists to evaluate and treat patients scheduled for HN RT. The aim of this retrospective single-center cohort study was to assess the compliance of CB dentists with this pre-RT dental evaluation program. METHODS A retrospective analysis of dental evaluations completed by CB dentists from December 2013 to December 2015 was performed. Descriptive statistics were used to determine compliance. RESULTS A total of 186 dental evaluations were received. Compliance with completion of dental treatment was as follows: scaling and prophylaxis: 94.5% (172/182); dental restorations: 78.7% (48/61); endodontic therapy: 76.9% (10/13); and dental extractions: 76.9% (30/39). Compliance of CB dentists with all requested components of the pre-RT evaluation and treatment was 77.4% (144/186). The median distance traveled by patients to the CB dentist and to the hospital was 5.2 miles (range 0.03-66.0) and 46.5 miles (range 0.8-1457; p < 0.01), respectively. CONCLUSION In this study, the majority of patients completed their necessary dental treatment in a timely manner by their CB dentist in collaboration with an Oral Medicine specialist. Given the high compliance of CB dentists, this program could serve as a model for other cancer centers to optimize Oral and dental health prior to RT.

  • a simpl application to assess Oral Medicine residents performance and level of autonomy
    Oral Surgery Oral Medicine Oral Pathology and Oral Radiology, 2018
    Co-Authors: Revathi Shekar, Brian C George, Jordan D Bohnen, Alessandro Villa
    Abstract:

    Objectives The aim of this study was to evaluate a smartphone application, SIMPL, to optimize faculty guidance and Oral Medicine residents' performance, and to measure resident–faculty agreement for performance and supervision levels. Study Design Raters used the 5-level “Performance” scale to assess resident's readiness for independent practice and the 4-level Zwisch scale to assess faculty guidance, between June 2016 and June 2017. Junior residents were trainees with less than 18 months of training, and senior residents had more than 18 months of training. Descriptive statistics were used to analyze supervision and autonomy. Performance and supervision agreement was estimated as percentage-agreement and measured using κ and 95% confidence intervals. Results A total of 660 evaluations were performed by 6 residents and 6 faculty members. Senior residents received higher performance scores compared with junior residents (P for trend  Conclusions SIMPL can feasibly be used for real-time assessment of residents' performance and autonomy.

  • world workshop on Oral Medicine vi a systematic review of medication induced salivary gland dysfunction
    Oral Diseases, 2016
    Co-Authors: Alessandro Villa, Andy Wolff, Nagamani Narayana, Colin Dawes, Doron J Aframian, A Lynge M Pedersen, Arjan Vissink, Ardita Aliko, Ying Wai Sia
    Abstract:

    The aim of this paper was to perform a systematic review of the pathogenesis of medication-induced salivary gland dysfunction (MISGD). Review of the identified papers was based on the standards regarding the methodology for systematic reviews set forth by the World Workshop on Oral Medicine IV and the PRISMA statement. Eligible papers were assessed for both the degree and strength of relevance to the pathogenesis of MISGD as well as on the appropriateness of the study design and sample size. A total of 99 papers were retained for the final analysis. MISGD in human studies was generally reported as xerostomia (the sensation of Oral dryness) without measurements of salivary secretion rate. Medications may act on the central nervous system (CNS) and/or at the neuroglandular junction on muscarinic, α-and β-adrenergic receptors and certain peptidergic receptors. The types of medications that were most commonly implicated for inducing salivary gland dysfunction were those acting on the nervous, cardiovascular, genitourinary, musculoskeletal, respiratory, and alimentary systems. Although many medications may affect the salivary flow rate and composition, most of the studies considered only xerostomia. Thus, further human studies are necessary to improve our understanding of the association between MISGD and the underlying pathophysiology.

  • the functions of human saliva a review sponsored by the world workshop on Oral Medicine vi
    Archives of Oral Biology, 2015
    Co-Authors: C Dawes, Alessandro Villa, Doron J Aframian, Arjan Vissink, Anne Marie Lynge Pedersen, J Ekstrom, Gordon Proctor, Richard Mcgowan, Ardita Aliko
    Abstract:

    This narrative review of the functions of saliva was conducted in the PubMed, Embase and Web of Science databases. Additional references relevant to the topic were used, as our key words did not generate references which covered all known functions of saliva. These functions include maintaining a moist Oral mucosa which is less susceptible to abrasion, and removal of micro-organisms, desquamated epithelial cells, leucocytes and food debris by swallowing. The mucins form a slimy coating on all surfaces in the mouth and act as a lubricant during such processes as mastication, formation of a food bolus, swallowing and speaking. Saliva provides the fluid in which solid tastants may dissolve and distributes tastants around the mouth to the locations of the taste buds. The hypotonic unstimulated saliva facilitates taste recognition. Salivary amylase is involved in digestion of starches. Saliva acts as a buffer to protect Oral, pharyngeal and oesophageal mucosae from Orally ingested acid or acid regurgitated from the stomach. Saliva protects the teeth against acid by contributing to the acquired enamel pellicle, which forms a renewable lubricant between opposing tooth surfaces, by being supersaturated with respect to tooth mineral, by containing bicarbonate as a buffer and urea and by facilitating clearance of acidic materials from the mouth. Saliva contains many antibacterial, antiviral and antifungal agents which modulate the Oral microbial flora in different ways. Saliva also facilitates the healing of Oral wounds. Clearly, saliva has many functions which are needed for proper protection and functioning of the human body.

Giovanni Lodi - One of the best experts on this subject based on the ideXlab platform.

  • world workshop on Oral Medicine vii immunobiologics for salivary gland disease in sjogren s syndrome a systematic review
    Oral Diseases, 2019
    Co-Authors: Luiz Alcino Monteiro Gueiros, Jane Setterfield, Thomas P. Sollecito, Sookbin Woo, Rachael Posey, Jacqueline W Mays, Barbara Carey, Donna A Culton, Aimee S Payne, Giovanni Lodi
    Abstract:

    Objective This systematic review evaluated the efficacy of immunobiologics for the management of Oral disease in Sjogren's syndrome (SS). Materials and methods MEDLINE® , Embase, Scopus, and the Cochrane Library were searched for evidence on the use of immunobiologics for management of glandular disease in SS. Primary outcomes were xerostomia and salivary gland dysfunction, assessed via visual analogue scales, disease-specific scales for SS, measurement of salivary flow, ultrasound data, and quality of life measures. Results Seventeen studies (11 randomized controlled trials and 6 observational studies) met inclusion criteria. Rituximab showed efficacy in improving salivary gland function but not xerostomia. Abatacept showed promise in improving both xerostomia and salivary flow. Belimumab exhibited long-term improvement of salivary flow and subjective measures. The novel agent CFZ533 improved both disease activity and patient-reported indexes. Conclusions There is strong evidence pointing to the efficacy of rituximab in the management of Oral disease in SS. Future controlled trials may elucidate the efficacy of belimumab and abatacept. The new drug CFZ533 is a promising alternative for the management of SS and its salivary gland involvement. In considering these agents, the promise of efficacy must be balanced against the harmful effects associated with biologic agents.

  • report on world workshops on Oral Medicine wwom iv and v research themes and citation impact wwom vi steering committee
    Oral Diseases, 2015
    Co-Authors: Douglas E Peterson, Giovanni Lodi, David Wray, Alexander Ross Kerr, T A Hodgson, Beier S Jensen, Peter B Lockhart
    Abstract:

    The first World Workshop on Oral Medicine (WWOM) was held in 1988. The portfolio has continued to expand in scope and impact over the past 26 years. Five World Workshops were conducted between 1988 and 2010, focusing on creation of systematic reviews in bioMedicine and health care of importance to the international Oral Medicine community. WWOM VI was conducted in April 2014 and further extended this modeling. This most recent Workshop also fostered creation of the inaugural joint meeting between the American Academy of Oral Medicine and the European Association of Oral Medicine, together with The British Society for Oral Medicine and the Oral Medicine Academy of Australasia. The goal of the WWOM portfolio is to strategically enhance international Oral Medicine research, education, and clinical practice. To this end, this report summarizes subject areas for WWOM IV (2004) and research recommendations for WWOM V (2010), as well as citation metrics relative to publications from these two conferences. The information is designed to provide research and clinical context for key issues in Oral Medicine as delineated by the WWOM portfolio over the past 10 years, as well as for projected outcomes of WWOM VI over the next 12 months.

  • iatrogenic cushing s syndrome and topical steroid therapy case series and review of the literature
    Journal of Dermatological Treatment, 2014
    Co-Authors: S Decani, Veronica Federighi, E Baruzzi, Andrea Sardella, Giovanni Lodi
    Abstract:

    Topical corticosteroids are considered first-line therapy in patients with chronic inflammatory Oral mucosal diseases; among them, clobetasol propionate is one of the most widely used in Oral Medicine. Under physiological conditions, the transmucosal application is characterized by a significantly greater absorption than the skin application. Contrary to many publications about the side effects of topical corticosteroids in dermatology, few studies have investigated the systemic effects due to local application of these drugs on Oral mucosa. Although topical steroid therapy for the management of Oral diseases is generally associated with local adverse effects (candidiasis, stomatopyrosis, and hypogeusia), these drugs can also lead to systemic side effects, such as suppression of the hypothalamic-pituitary-adrenal axis and Cushing's syndrome. This review reports five cases of systemic adverse effects caused by clobetasol propionate topical treatment.

Ying Wai Sia - One of the best experts on this subject based on the ideXlab platform.

  • world workshop on Oral Medicine vi a systematic review of medication induced salivary gland dysfunction
    Oral Diseases, 2016
    Co-Authors: Alessandro Villa, Andy Wolff, Nagamani Narayana, Colin Dawes, Doron J Aframian, A Lynge M Pedersen, Arjan Vissink, Ardita Aliko, Ying Wai Sia
    Abstract:

    The aim of this paper was to perform a systematic review of the pathogenesis of medication-induced salivary gland dysfunction (MISGD). Review of the identified papers was based on the standards regarding the methodology for systematic reviews set forth by the World Workshop on Oral Medicine IV and the PRISMA statement. Eligible papers were assessed for both the degree and strength of relevance to the pathogenesis of MISGD as well as on the appropriateness of the study design and sample size. A total of 99 papers were retained for the final analysis. MISGD in human studies was generally reported as xerostomia (the sensation of Oral dryness) without measurements of salivary secretion rate. Medications may act on the central nervous system (CNS) and/or at the neuroglandular junction on muscarinic, α-and β-adrenergic receptors and certain peptidergic receptors. The types of medications that were most commonly implicated for inducing salivary gland dysfunction were those acting on the nervous, cardiovascular, genitourinary, musculoskeletal, respiratory, and alimentary systems. Although many medications may affect the salivary flow rate and composition, most of the studies considered only xerostomia. Thus, further human studies are necessary to improve our understanding of the association between MISGD and the underlying pathophysiology.

  • world workshop on Oral Medicine vi a systematic review of medication induced salivary gland dysfunction prevalence diagnosis and treatment
    Clinical Oral Investigations, 2015
    Co-Authors: Alessandro Villa, Andy Wolff, Nagamani Narayana, Doron J Aframian, Arjan Vissink, Ardita Aliko, J Ekstrom, Gordon Proctor, Richard Mcgowan, Ying Wai Sia
    Abstract:

    Objectives Medication-induced salivary gland dysfunction (MISGD) causes significant morbidity resulting in decreased quality of life. This systematic review assessed the literature on the prevalence, diagnosis, treatment, and prevention of MISGD.

Crispian Scully - One of the best experts on this subject based on the ideXlab platform.

  • Oral Medicine stomatology across the globe birth growth and future
    Oral Surgery Oral Medicine Oral Pathology and Oral Radiology, 2016
    Co-Authors: Crispian Scully, Ivan Alajbeg, Craig S Miller, Josemanuel Aguirre Urizar, Oslei Paes De Almeida, Jose V Bagan, Catalena Birek, Qianming Chen, Camile S Farah, Jose Pedro Figueirido
    Abstract:

    Oral Medicine (stomatology) is a recognized and increasingly important dental specialty in many parts of the world that recognizes and fosters the interplay between medical health and Oral health. Its dental activities rely greatly on the underlying biology of disease and evidence-based outcomes. However, full recognition of the importance of Oral Medicine to patient care, research, and education is not yet totally universally acknowledged. To address these shortcomings, we outline the birth, growth, and future of Oral Medicine globally, and record identifiable past contributions to the development of the specialty, providing an accurate, unique, and valuable resource on Oral Medicine. Although it was challenging to gather the data, we present this information as a review that endeavors to summarize the salient points about Oral Medicine, based on MEDLINE, other internet searches, communication with Oral Medicine and stomatological societies across the world, the web page http://en.wikipedia.org/wiki/List_of_dental_organizations, and discussions with a wide range of key senior persons in the specialty.

  • Oral Medicine update for the dental practitioner orofacial pain
    British Dental Journal, 2006
    Co-Authors: Crispian Scully, D H Felix
    Abstract:

    Oral Medicine This series provides an overview of current thinking in the more relevant areas of Oral Medicine for primary care practitioners, written by the authors while they were holding the Presidencies of the European Association for Oral Medicine and the British Society for Oral Medicine, respectively. A book containing additional material will be published. The series gives the detail necessary to assist the primary dental clinical team caring for patients with Oral complaints that may be seen in general dental practice. Space precludes inclusion of illustrations of uncommon or rare disorders, or discussion of disorders affecting the hard tissues. Approaching the subject mainly by the symptomatic approach — as it largely relates to the presenting complaint — was considered to be a more helpful approach for GDPs rather than taking a diagnostic category approach. The clinical aspects of the relevant disorders are discussed, including a brief overview of the aetiology, detail on the clinical features and how the diagnosis is made. Guidance on management and when to refer is also provided, along with relevant websites which offer further detail.

  • vesiculo erosive Oral mucosal disease management with topical corticosteroids 1 fundamental principles and specific agents available
    Journal of Dental Research, 2005
    Co-Authors: Miguel Angel Gonzalezmoles, Crispian Scully
    Abstract:

    Vesiculo-erosive diseases of the Oral mucosa pose a major challenge in Oral Medicine, because they are chronic, painful, and interfere with the daily activities and quality of life of the patients, including disturbing eating, drinking, talking, and personal relationships. Many are autoimmune diseases, and corticosteroid therapy is currently central to their treatment. These diseases present with inflammation and alterations to epithelial integrity, through cell and/or humOral immunity-mediated attack on epithelial-connective tissue targets. Until recently, despite their serious adverse effects, it was necessary to prescribe systemic corticosteroids to control severe erosive Oral diseases. Now, however, many of these diseases can be controlled by high-potency topical corticosteroids, which have proved to be highly efficacious and to cause fewer adverse effects compared with systemic corticosteroids. Nevertheless, although topical corticosteroids are still the most widely used drugs in the practice of Oral Medicine, the scientific body of evidence for their use in the Oral cavity is virtually non-existent, and therefore many of the protocols followed are, of necessity, drawn from experience of their use in a dermatological setting. This review aims to set out the key aspects of the use of topical corticosteroids in Oral Medicine. The issues covered include the indications and basic rules for their use, the types of corticosteroids, the drug selection, and the specific formulations.

  • an audit of the efficacy of the Oral brush biopsy technique in a specialist Oral Medicine unit
    Oral Oncology, 2004
    Co-Authors: Timothy Poate, Crispian Scully, Jag Buchanan, T A Hodgson, P M Speight, A W Barrett, David R Moles, Stephen Porter
    Abstract:

    The diagnosis of Oral epithelial dysplasia has traditionally been based upon histopathological evaluation of a full thickness biopsy specimen from lesional tissue. It has recently been proposed that cytological examination of "brush biopsy" samples is a non-invasive method of determining the presence of cellular atypia, and hence the likelihood of Oral epithelial dysplasia. The present audit determined, retrospectively the sensitivity, specificity and positive and negative predictive values of the Oral brush biopsy technique in the diagnosis of potentially malignant disease in a group of 112 patients attending a specialist Oral Medicine unit. The sensitivity of detection of Oral epithelial dysplasia or squamous cell carcinoma of the Oral brush biopsy system was 71.4% while the specificity was 32%. The positive predictive value of an abnormal brush biopsy result (positive or atypical) was 44.1%, while the negative predictive value was 60%. It is concluded that not all potentially malignant disease is detected with this non-invasive investigative procedure.

  • clinical virology in Oral Medicine and dentistry
    1992
    Co-Authors: Crispian Scully, L P Samaranayake
    Abstract:

    List of contributors Preface Part I. Fundamental Virology: 1. Structure, classification and replication of viruses 2. Cellular and molecular biological aspects M. Cox and C. Scully 3. Pathogenesis of viral infections 4. Diagnosis of viral infections J. Peiris and C. Madeley 5. Prevention and treatment of viral infections Part II. Clinical Virology: 6. Viruses important mainly because of Oral or periOral manifestations 7. Viruses particularly important in relation to control of cross-infection (i) hepatitis viruses 8. Viruses particularly important in relation to control of cross-infection (ii) human immunodeficiency viruses 9. Viruses particularly important in relation to control of cross-infection (iii) other viruses 10. Viruses and salivary gland disease 11. Control of cross-infection S. Porter Part III. Other Orofacial Disease with a Possible Viral Aetiology: 12. Aphthae and related disorders 13. Dermatoses that can be associated with Oral lesions 14. Keratoses 15. Malignant neoplasms 16. Bone diseases 17. Neurological and related diseases 18. Maxillary sinusitis 19. Salivary gland disorders with a possible viral aetiology.

Miguel Angel Gonzalezmoles - One of the best experts on this subject based on the ideXlab platform.

  • vesiculo erosive Oral mucosal disease management with topical corticosteroids 2 protocols monitoring of effects and adverse reactions and the future
    Journal of Dental Research, 2005
    Co-Authors: Miguel Angel Gonzalezmoles, C M Scully
    Abstract:

    Although topical corticosteroids (TCs) are the most widely used drugs in Oral Medicine, and specifically in the treatment of vesiculo-erosive Oral mucosal disease, there are few evidence-based data for the correct use of these drugs. In this review, we outline the most widely used protocols, the most common reasons for treatment failure, and the adverse effects documented in the literature.

  • vesiculo erosive Oral mucosal disease management with topical corticosteroids 1 fundamental principles and specific agents available
    Journal of Dental Research, 2005
    Co-Authors: Miguel Angel Gonzalezmoles, Crispian Scully
    Abstract:

    Vesiculo-erosive diseases of the Oral mucosa pose a major challenge in Oral Medicine, because they are chronic, painful, and interfere with the daily activities and quality of life of the patients, including disturbing eating, drinking, talking, and personal relationships. Many are autoimmune diseases, and corticosteroid therapy is currently central to their treatment. These diseases present with inflammation and alterations to epithelial integrity, through cell and/or humOral immunity-mediated attack on epithelial-connective tissue targets. Until recently, despite their serious adverse effects, it was necessary to prescribe systemic corticosteroids to control severe erosive Oral diseases. Now, however, many of these diseases can be controlled by high-potency topical corticosteroids, which have proved to be highly efficacious and to cause fewer adverse effects compared with systemic corticosteroids. Nevertheless, although topical corticosteroids are still the most widely used drugs in the practice of Oral Medicine, the scientific body of evidence for their use in the Oral cavity is virtually non-existent, and therefore many of the protocols followed are, of necessity, drawn from experience of their use in a dermatological setting. This review aims to set out the key aspects of the use of topical corticosteroids in Oral Medicine. The issues covered include the indications and basic rules for their use, the types of corticosteroids, the drug selection, and the specific formulations.