The Effect of an Informative Video upon Anxiety and Stress in Patients Requiring an Oral Biopsy: A Randomized Controlled Study

Objective: The use of multimedia tools improves patient understanding of surgical procedures, reduces anxiety and increases satisfaction. The present study evaluates the impact of an audiovisual intervention (video) upon anxiety and stress in patients requiring an oral biopsy. Material and methods: A prospective randomized clinical trial was carried out in patients requiring an oral biopsy. The control group (n = 60) received verbal standard information while the experimental group (n = 60) received information in the form of a video. The following data were recorded: gender, age, educational level and hemodynamic parameters (blood pressure, heart rate and blood oxygen saturation). The following questionnaires were used to assess anxiety and stress before and after the biopsy procedure: Corah’s Modified Dental Anxiety Scale (MDAS), the State-Trait Anxiety Inventory (STAI) and the Hospital Anxiety and Depression Scale (HADS). Results: The final study sample consisted of 120 patients, of which 65.8% were women and 34.2% men, with a mean age of 40.5 ± 15.3 years. At the end of the study, the experimental group presented a significantly lower MDAS score than the control group (p = 0.041). The STAI score also showed a significant decrease with respect to the control group at the end of the study (p = 0.012). There were no statistically significant changes in the hemodynamic parameters in either group. Conclusions: The video constituted a useful and easy tool for reducing anxiety among patients requiring an oral biopsy.

Utility of nail enamel for inking of surgical margins in oral biopsy: a comparative study

Background: India Ink is the most commonly used ink in surgical pathology. The main disadvantages of India Ink are longer drying time, monochrome, toxicity and cost. Because of these disadvantages, alternative materials have been suggested to replace India ink. The aim of this study is to evaluate the effectiveness of nail enamel for inking of surgical margin and to compare it with India ink. Materials and methods: N = 20, which included 10 mucosal and 10 skin samples. Each selected margin is divided into 2 equal halves and one is inked with India ink and the other with nail enamel (Vernis A Ongles: Dark green). After routine processing and staining, the effectiveness of nail enamel and India ink were compared based on macroscopic and microscopic parameters. Results: Less drying time and visibility on paraffin wax block were excellent for nail enamel. Microscopic visibility of nail enamel was comparable with that of India ink. However, processing fluids contamination is the main drawback of nail enamel. Conclusion: Nail enamel can be used as an alternative to India ink because of its less drying time, ease of application, good visibility on wax blocks and microscopically, availability in multiple colours, cost effectiveness and non-toxicity.

735 An Unusual Case of Cervical Potts Disease in A Pediatric Patient

Pott’s disease is a form of extrapulmonary tuberculosis (TB) affecting the spine. Approximately 10% of individuals with extrapulmonary TB will have skeletal manifestations with the most common area affected being the spine, followed by the hip and knee. Within the spine, Pott’s disease has a predilection for affecting the thoraco-lumbar region, with the cervical spine being the least affected. Here, we report a case of cervical Pott’s disease in a 16-year-old child, with no risk factors for TB, presenting with neck pain and stiffness. Initial blood results were unremarkable, but a CT scan showed a C5 vertebral body fracture and mild canal stenosis. A sagittal MRI scan demonstrated canal stenosis and a pathologic compression fracture of the C5 vertebrae, a soft tissue mass extending into the epidural and prevertebral spaces and associated cervical cord compression. A trans-oral biopsy confirmed TB and a diagnosis of Pott’s disease. She underwent HALO placement and needed further fusion surgery. She was started on anti-tuberculous therapy and made a good recovery post-operatively.

Special care for oral tissue samples after biopsy: Proper storage and transport — A comparative Study.

Objective: Biopsy is the gold standard for the diagnosis of oral lesions. Correct management and care of biopsy at all steps (before, during and after obtaining a biopsy) is highly important to provide proper tissue samples for microscopic assessment by pathologists. This study aimed to assess and compare the knowledge of dental students (DSs) and general dentists (GDs) on post-oral biopsy instructions. Material and Methods: A questionnaire including two parts was used: 1) Demographic data and self-evaluation of biopsy knowledge by the participants and 2) 11 items about the correct oral biopsy storage and transport to a histopathology laboratory. The data collected from the questionnaires were analyzed by STATA. Results: 48 GDs and 131 DSs participated in this study. The knowledge score of the DSs (5.43±2.01) was significantly lower than GDs (8.33±1.78) (p<0.05). Moreover, there was no significant relationship between GDs' knowledge and their working experience, age, gender and the university they graduated from. However, there was a significant relationship between DSs' school year and their knowledge. Conclusion: The findings showed that the knowledge of DSs was lower than GDs. Since, these students will care for the oral and dental health of the community in the future, upgrading their training (by improving the quantity and quality of theoretical and practical training) is necessary to both understand the different aspects of biopsy, and to be familiar enough with proper oral biopsy storage and transport processes.

Immunophenotyping for Diagnosis of Oral Lesions: Is It an Important Tool?

Aims: To report two cases of onco-hematologic diseases diagnosed by oral biopsy and subsequent flow cytometry immunophenotyping. Presentation of Case: Case 1: A 36-year-old woman, HIV +, referred to the Hospital Dentistry Center presenting an extensive, ulcerated and painless lesion in the left maxilla involving teeth #24, #25, #26 and #27. A fine needle aspiration and incisional biopsy were performed and one sample was sent to anatomopathological analysis and other to immunophenotyping. Immunophenotyping revealed 31.2% of aberrant plasma cells with phenotype suggestive of plasmablastic lymphoma. Case 2: 62-year-old male patient attended Hospital Emergency presenting extra and intraoral swelling on the left side of maxilla. Fine needle aspiration and incisional biopsy were performed, followed by pathological analysis and immunophenotyping. Immunophenotyping revealed 40.7% of large mature B cells with phenotype suggestive of diffuse large B-cell lymphoma. Both patients presented histopathological and immunophenotyping results leading to the same diagnosis. After definitive diagnosis, both patients underwent antineoplastic treatment through cycle of chemotherapy. Conclusion: Immunophenotyping is a well-established method for the diagnosis of onco-hematologic diseases and has been shown to be effective for the rapid diagnosis of oral tumors.

Knowledge, Attitude and Practice of Oral Biopsy Procedures among Dental Surgeons Registered with Nepal Dental Association

Background: Oral biopsy procedures are rarely practiced by dental surgeons around the world though they should be able to perform the biopsies for the diagnosis of oral lesions. Our objective was to access the knowledge, attitude and practice of oral biopsy procedures among the dental surgeons who are members of Nepal Dental Association.Methods: A cross sectional study was conducted from December 2018 to March 2019, among the dental surgeons who were registered in Nepal Dental Association till September 2018. A standard pretested questionnaire was prepared using Google forms, was emailed to 374 dental surgeons. Two reminder emails were sent at an interval of 1 month. The non-responding dental surgeons who were reachable through mobile number (N=274) were contacted after the third 3rd email. Out of 274, 10 dental surgeons had completed postgraduation, so 264 of them were included in the study. A reminder call was made after one week. The data was entered in SPSS version 20 software and analyzed using descriptive statistics.Results: There were 160 responses to the emails after the conversation through mobile phone. The response rate was 60.6% with the predominance of female responders (66.9%). Though the majority of dental surgeons (96.2%) had encountered one or the other lesions requiring biopsy, only few of them (7.5%) had performed the biopsy which was mainly due to lack experience and skill (75.6%).Conclusions: Most of the dental surgeon are not comfortable performing biopsy with majority seem to lack expereice and skill. There is need to organize training to Dental Surgeons to enhance their practical skills. Keywords: Dental surgeon; lesion; oral biopsy