The aim of this systematic review was to investigate the malignant transformation of oral leukoplakia (OL) infected with Candida. Literature search was conducted using Medical Subject Heading terms 'leukoplakia', 'neoplasms', 'Candida', 'malignant transformation' and 'oral' and included all results until February 2017. The initial search identified 372 articles, which was consolidated to 16 articles after applying inclusion and exclusion criteria. The occurrence of candidal infection in OL ranged from 6.8% to 100.0%. Only 3 of 16 studies reported malignant transformation rates of leukoplakia with Candida infection. The overall malignant transformation rates reported in these studies were 2.5%, 6.5% and 28.7%. This review supports the contention that candidal infection promotes cellular and dysplastic changes in OL. However, further follow-up studies are recommended to confirm the role of Candida infection in malignant transformation of OL lesions.

Dental extractions are a common part of general dental practice. While dentists routinely screen for medical contraindications during the preoperative assessment, undiagnosed coagulopathies have the potential to severely complicate a seemingly routine extraction. We report a case of surgical removal of a mandibular third molar in a patient with undiagnosed Von Willebrand Disease.

Introduction The present systematic review assesses the literature which identifies an association between surgical adjunctive procedures for accelerating tooth movement (SAPATM) during orthodontic therapy and orthodontically induced external root resorption (OIERR). By determining the level of association, the results may provide clinical evidence for minimising the deleterious effects of orthodontic tooth movement. Methods Electronic databases including Medline, PubMed, Embase, Scopus, CINAHL, Worldcat, OpenGrey, and the Cochrane Library were searched and followed by further searches from citations of included articles. Searches were undertaken with no restrictions on year, publication status, nor language. The selection criteria included randomised controlled trials (RCTs) conducted using surgical procedures to accelerate orthodontic therapy in conjunction with fixed orthodontic appliances on human patients. The quality of the included studies was assessed using the Cochrane Risk of Bias (RoB) Tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Inter-rater agreement of the review authors was used for the inclusion of primary articles, RoB assessment and evaluation of the quality of evidence (GRADE) and was calculated using Cohen’s kappa statistic. Results A total of 1118 articles were retrieved in the initial search. After the review process, 13 article trials met the inclusion criteria. Sample sizes ranged from 20 to 52 patients. Two studies showed a statistically significant reduction in OIERR, with a third showing both an increase and decrease of OIERR on different roots of the same maxillary molar tooth. A significant decrease in treatment time was shown by four studies, while six studies showed increased tooth movement. All included studies were classified as having low to minor concerns of bias and a low quality of evidence. Conclusions There is an apparent shortage of well-designed and reported RCTs on the effect of SAPATM on OIERR. However, there is some evidence to suggest OIERR is reduced following SAPATM. The use of SAPATM is also shown to increase tooth movement and reduce overall treatment time, but its benefits may be considered limited to the initial post-operative period.

Objective: The objective of this review is to evaluate the effectiveness of perioperative prophylactic tranexamic acid for reducing blood loss in orthognathic surgery in healthy patients. Introduction: Orthognathic surgery can cause significant hemorrhage, which requires postoperative blood transfusions. The most widely studied pharmaceutical adjunct for reducing blood loss is tranexamic acid, a synthetic amino acid that reversibly inhibits plasminogen activation. It is widely used and validated in other surgical procedures to limit blood loss; however, it is not a gold standard in orthognathic surgery. Inclusion criteria: We will include clinical trials comparing tranexamic acid to appropriate controls. The primary outcomes are intraoperative blood loss, change in hematocrit/hemoglobin level, and need for blood transfusion. Secondary outcomes include operating time, length of hospital stay, and adverse reactions. Studies of patients with pre-existing coagulopathies and those undergoing only minor orthognathic surgery (eg, genioplasty) will be excluded. Methods: We will search 3 electronic databases (PubMed, Embase, and Cochrane Library) from database inception. Titles, abstracts, and full-text papers will be assessed against the inclusion criteria by 2 independent reviewers. Risk of bias will be assessed using the Cochrane Risk of Bias 2.0 tool. Data will be extracted by 2 independent reviewers. Meta-analysis will be conducted for all outcomes where appropriate, with weighted mean differences used for intraoperative blood loss, changes in hematocrit/hemoglobin levels, operation time, and length of stay; and risk ratio for transfusion rates and adverse outcomes. Certainty of the evidence will be presented using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Systematic review registration number: PROSPERO CRD42022314403