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BACKGROUND: To evaluate whether the long-term use of complete dentures (CD) into promotes significant changes in the oral health-related quality of life (OHRQoL) in edentulous patients. METHODS: A systematic review and meta-analysis was conducted. A broad search in Pubmed, Web of Science, Scopus, Cochrane Library, Grey Literature, clinical trials registers and manual search was done. The eligibility criteria were based on population, intervention, comparisons and outcome: (P) edentulous patients, (I) CDs rehabilitation, (C) OHRQoL after CD, (O) change in scores of OHRQoL. Two independent reviewers applied the eligibility criteria, collected qualitative data, performed methodological quality and evaluated the certainty of the evidence (grading of recommendations assessment, development and evaluation). The meta-analysis was analyzed in RevMan 5.4 with 95% confidence intervals (CIs) and P < 0.05. RESULTS: A total of 2452 records were identified. Twenty-four articles were included in qualitative synthesis. Nineteen studies were qualified as good, 3 as fair and 2 as poor quality. Twelve studies were included in quantitative analysis (meta-analysis). The use of CD did not improved OHRQoL in a period of 3 months through the assessment of the Geriatric Oral Health Assessment Index (GOHAI) instrument (P = 0.55; CI; 6.86 [-15.60, 29.31]), and Oral Health Impact Profile-14 (OHIP-14) (P = 0.05; CI; -14.91 [-29.87, 0.04]), with very low certainty of evidence. In a long term, 6 months, GOHAI instrument (P < 0.00001; CI; 16.22 [10.70, 21.74]), OHIP 20 (P = 0.02; CI; -11.09 [-20.54, -1.64]) and OHIP-EDENT (P = 0.0004; CI; -8.59 [-13.32, -3.86]) showed improvement on OHRQoL, with very low and low evidence of certainty, respectively. CONCLUSION: CD has the strong potential to contribute to oral health-related quality of life in long-term.
RESUMO
OBJECTIVE: It has been suggested that oral clefts and cancer share a common genetic background. This study aimed to investigate the epidemiological and molecular association between oral clefts and cancer. METHODS: One hundred forty-eight nuclear families with oral clefts and 162 subjects with no birth defect were recruited. Data on self-reported family history of cancer among first, second, and third degree relatives of each patient were collected via a structured questionnaire. We also investigated the association between polymorphisms in the genes AXIN2, BMP2, BMP4, BMP7, DLX1, DLX2, and MMP3 and oral cleft with and without history of cancer. Markers in these genes were genotyped using real time PCR. Chi-square and t-test were used to assess the differences about self-reported family history of cancer between oral cleft and non-cleft individuals. The transmission disequilibrium test (TDT) was used to analyze the distortion of the inheritance of alleles from parents to their affected offspring. RESULTS: Families with oral clefts had an increased risk of having a family history of cancer (p=0.01; odds ratio=1.79; 95% confidence interval, 1.07-1.87). TDT results showed an association between DLX1 and cleft lip and palate, in which the A allele was undertransmited (p=0.022). For MMP3, G was undertransmited among affected progeny (p=0.019) in cleft palate subgroup. CONCLUSION: Oral clefts were associated with positive self-reported family history of cancer and with variants in DLX1 and MMP3. The association between oral clefts and cancer raises interesting possibilities to identify risk markers for cancer.