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To assess (i) the prevalence of oral colonization by Candida spp. in patients with psoriasis and (ii) the prevalence of oral lesions associated with Candida spp. in patients with psoriasis and identify the risk factors for oral lesions. A systematic review was conducted in accordance with PRISMA criteria. The PROSPERO registration code is CRD42019127178. PubMed, Scopus and Web of Science were used as search engines. Meta‐analyses and trial sequential analyses were performed. Among the 5805 retrieved records, nine articles were included. Among 530 psoriatic patients, 255 patients had an oral Candida spp. colonisation with an odds ratio (OR) = 3.44 (95% CI:2.38–5.00). Among 490 psoriatic patients, 43 patients developed oral Candida spp. lesions with an OR = 5.31 (95% CI:1.04–27.23). Among the patients without the main predisposing factors for infections, psoriatic patients had a higher OR (3.48, 95% CI: 2.0–6.0) for Candida spp. colonization, but not for Candida spp. infection, when compared with healthy controls (p‐value > 0.05). Meta‐analysis showed a higher risk of Candida spp. colonisation in patients with psoriasis. Patients who received immunosuppressive therapies were also at higher risk of developing oral lesions. Further studies are needed to understand these associations. [ABSTRACT FROM AUTHOR]

Purpose: Crohn's disease (CD) is a chronic inflammatory bowel disease characterised by localised areas of nonspecific, noncaseating granulomas. Approximately 1/3 of CD patients develop extraintestinal manifestations in the course of their disease. This review focuses on oral manifestations of CD to understand if oral lesions could help clinicians in the diagnosis of systemic CD.Materials and Methods: Literature for the review was retrieved using PubMed Medline, Ebsco Library and Web of Science.Results: After a careful preliminary evaluation, only 43 articles were eligible for inclusion in the qualitative evaluation, whereas only 7 mentioned oral CD as the first sign of a systemic disease and were included in the quantitative evaluation.Conclusions: Oral manifestations of CD can be classified as specific and non-specific. The aetiology of oral CD seems to be linked to particular bacterial infections. Although the evidence from the literature is weak, it seems that in some cases the inspection of the mouth could assist in the diagnosis of a systemic Crohn's disease. [ABSTRACT FROM AUTHOR]

Objectives: To analyze psychological profiles, pain, and oral symptoms in patients with oral lichen planus (OLP). Materials and methods: 300 patients with keratotic OLP (K‐OLP; reticular, papular, plaque‐like subtypes), 300 patients with predominant non‐keratotic OLP (nK‐OLP; erythematosus atrophic, erosive, ulcerative, bullous subtypes), and 300 controls were recruited in 15 universities. The number of oral sites involved and oral symptoms were recorded. The Numeric Rating Scale (NRS), Total Pain Rating Index (T‐PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM‐D and HAM‐A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered. Results: The OLP patients, especially the nK‐OLP, showed higher scores in the NRS, T‐PRI, HAM‐D, HAM‐A and PSQI compared with the controls (p‐value <.001**). A positive correlation between the NRS, T‐PRI, HAM‐A, HAM‐D, and PSQI was found with the number of oral symptoms and number of oral sites involved. Pain was reported in 67.3% of nK‐OLP and 49.7% of K‐OLP cases with poor correspondence between the site of lesions and the site of the symptoms. Conclusions: Mood disorders are frequently associated with OLP with an unexpected symptomatology correlated with the number of oral symptoms and with the extension of disease suggesting a peripheral neuropathy. [ABSTRACT FROM AUTHOR]

Background: The wellbeing of oral lichen planus patients (OLPs) may be strongly influenced by a poor quality of sleep (QoS) and psychological impairment. The aims were to analyze the prevalence of sleep disturbance, anxiety, and depression in OLPs and to validate the Pittsburgh Sleep Quality Index (PSQI) in OLPs. Methods: Three hundred keratotic OLPs (K‐OLPs), 300 with predominant non‐keratotic OLP (nK‐OLPs), and 300 controls were recruited in 15 Italian universities. The PSQI, Epworth Sleepiness Scale (ESS), Hamilton Rating Scales for Depression and Anxiety (HAM‐D and HAM‐A), Numeric Rating Scale (NRS), and Total Pain Rating Index (T‐PRI) were administered. Results: Oral lichen planus patients had statistically higher scores than the controls in the majority of the PSQI sub‐items (p‐values < 0.001**). Moreover, OLPs had higher scores in the HAM‐D, HAM‐A, NRS, and T‐PRI (p‐values < 0.001**). No differences in the PSQI sub‐items' scores were found between the K‐OLPs and nK‐OLPs, although nK‐OLPs suffered from higher levels of anxiety, depression, and pain (p‐values: HAM‐A, 0.007**, HAM‐D, 0.009**, NRS, <0.001**, T‐PRI, <0.001**). The female gender, anxiety, depression (p‐value: 0.007**, 0.001**, 0.020*) and the intensity of pain, anxiety, and depression (p‐value: 0.006**, <0.001**, 0.014*) were independent predictors of poor sleep (PSQI > 5) in K‐OLPs and nK‐OLPs, respectively. The PSQI's validation demonstrated good internal consistency and reliability of both the total and subscale of the PSQI. Conclusions: The OLPs reported an overall impaired QoS, which seemed to be an independent parameter according to the regression analysis. Hence, clinicians should assess QoS in OLPs and treat sleep disturbances in order to improve OLPs management. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this systematic review was to estimate the osteoradionecrosis rate in patients with head and neck cancer due to teeth extraction performed before radiotherapy and to identify possible risk factors. Material and Methods: PRISMA protocol was used to evaluate and present the results. PubMed, Scopus and Web of Science were used as search engines: English full‐length papers of clinical studies, in peer‐reviewed journals, were investigated. Cumulative meta‐analysis was performed with a random effects model (PROSPERO registration code: CRD42018079986). Results: Among 2,020 records screened, 8 were included in this review. Sixteen of 494 patients who underwent tooth extraction before radiotherapy developed osteoradionecrosis, with an osteoradionecrosis incidence of 2.2% (95% Confidence of Interval = 0.6–3.9, p <.185, I2 = 3,044%). All cases were reported in the mandible. No other clinical risk factor for osteoradionecrosis was detected. Conclusions: Even if it is generally recommended to remove oral foci before radiotherapy, this systematic review confirmed that teeth extractions before radiotherapy represent a risk factor for osteoradionecrosis; the considerable amount of missing data prevented us from identifying other possible risk factors for osteoradionecrosis onset. Major efforts should be done to perform sounder methodological clinical investigations. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated the efficacy of an anatomical-radiologic-surgical protocol for the extraction of erupted maxillary third molars (EMTMs). Methods and Materials: 166 EMTMs were extracted according to two different extraction techniques. Group 1 (G1, 97 teeth) was treated with the proposed protocol: multiple roots with forceps DG 117/DG 118; single roots with DG 250; tapered roots with DG 270; curved roots with Apexo 303 elevator. Group 2 (G2, 69 teeth) was treated with straight elevator and forceps DG 250 or DG 270. Extraction time and total number of complications (TNCs) were the main outcomes; TNCs were also divided in complications during the extraction (CDEs) and complications after the extraction (CAEs) as secondary outcomes. Results: Differences between G1 and G2 were detected for extraction time (146.8 vs 225.6 seconds; P < .05) and for complications (G1, 13.4% vs G2, 47.8%; P < .001). Multivariate analysis showed that extraction time and smoking habit were independent risk factors for TNCs (P < .001); furthermore, “not applying the proposed extraction protocol” increases almost 7 times (6.86; 95% CI, 1.41–33.32; P < .02) the possible onset of CAEs. Conclusion: The proposed protocol can be helpful for the general dental practitioner in planning the extraction of EMTMs, shortening the extraction time, and diminishing the complications, especially those occurring after the extraction. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to systematically review the literature to determine: (a) the malignant transformation rate (TR) of oral lichen planus (OLP) and its risk factors; (b) whether or not oral lichenoid lesions (OLL) have a different malignant TR. Materials and Methods: PubMed, Scopus, and Web of Science were used as search engines: only observational, full‐length, English language studies were investigated. PRISMA protocol was used to evaluate and present results. PROSPERO registration code is CRD42016048529. Results: Among 7,429 records screened, only 21 were included in this review. Ninety‐two of 6,559 patients developed oral squamous cell carcinoma, with an overall TR of 1.40% (1.37% for OLP and 2.43% for OLL), an annual TR of 0.20%. Female gender, red clinical forms, and tongue site seem to slightly increase the transformation risk. Conclusions: This systematic review confirms that both OLP and OLL, the latter with a slightly higher TR, may be considered potentially malignant disorders and suggest that erosive type, female gender and tongue site should be considered as risk factors for OLP transformation. Major efforts should be done to establish strict clinical and histological criteria to diagnose OLP and to perform sounder methodological observational studies. [ABSTRACT FROM AUTHOR]