Géraldine Lescaille

Objectives: Osteonecrosis of the jaws (MRONJ) is a frequent side effect of antiresorptive (AR) drugs used in oncology. MRONJ may have endodontic consequences, as reported in this clinical case. Material and Methods: A 64‐year‐old woman being treated with antiresorptive (AR) drugs targeting bone metastasis of a primitive breast cancer consulted at the dental service of Pitié‐Salpêtrière Hospital. She first experienced symptomatic apical periodontitis followed by symptomatic irreversible pulpitis, which were initially explained as resulting from occlusal trauma. Despite endodontic treatment, exacerbation of the symptomatology was noted. MRONJ was suspected, and the affected tooth was extracted. Results: The presence of necrotic bone during the surgery confirmed the diagnosis. Surgical treatment led to complete healing and total disappearance of clinical and radiological signs at 4 months. Conclusions: MRONJ can induce alterations in adjacent tooth vascularization and secondary pulpal disease. Early diagnosis is difficult because early‐stage MRONJ occurs without clear radiographic signs.

Introduction: Oral haemorrhages (OH) represent a relatively rare reason for an emergency consultation, among dental pain, infectious processes and traumas. Various haemorrhagic risk factors are described, particularly those related to a general medical context or local factors. It is common to associate OH with haemorrhagic risk patients. Current studies mainly focus on patients considered at risk, but there is limited data on the characteristics of OH in patients without known haemorrhagic risk.Method: We conducted a 2‐year retrospective study in a dental emergency department to identify OH occurring in patients without known haemorrhagic risk and to study their characteristics.Results: OH accounted for approximately 2% of the reasons for consultation among all consultations carried out for dental emergencies. Their frequency was similar in the population of patients without hemorrhagic risk and those with a confirmed risk. They mainly occurred in young patients, without medical history. They also led to the diagnosis of an underlying pathology in about 1% of cases.Conclusion: This study underscores the importance of accurately documenting patients' medical history during preoperative consultations, as well as identifying associated risk factors. It also highlights that OH can be an early sign of a systemic disorder.

Introduction: Oral squamous cell carcinoma (OSCC) presents a significant global health challenge. The integration of artificial intelligence (AI) and computer vision holds promise for the early detection of OSCC through the analysis of digitized oral photographs. This literature review explores the landscape of AI‐driven OSCC automatic detection, assessing both the performance and limitations of the current state of the art.Materials and Methods: An electronic search using several data base was conducted, and a systematic review performed in accordance with PRISMA guidelines (CRD42023441416).Results: Several studies have demonstrated remarkable results for this task, consistently achieving sensitivity rates exceeding 85% and accuracy rates surpassing 90%, often encompassing around 1000 images. The review scrutinizes these studies, shedding light on their methodologies, including the use of recent machine learning and pattern recognition approaches coupled with different supervision strategies. However, comparing the results from different papers is challenging due to variations in the datasets used.Discussion: Considering these findings, this review underscores the urgent need for more robust and reliable datasets in the field of OSCC detection. Furthermore, it highlights the potential of advanced techniques such as multi‐task learning, attention mechanisms, and ensemble learning as crucial tools in enhancing the accuracy and sensitivity of OSCC detection through oral photographs.Conclusion: These insights collectively emphasize the transformative impact of AI‐driven approaches on early OSCC diagnosis, with the potential to significantly improve patient outcomes and healthcare practices.

Médecine/sciences (M/S), revue internationale dans le domaine de la recherche biologique, médicale et en santé

Key Clinical Message: Cytomegalovirus (CMV) ulcerations are rare clinical entities, but their occurrence is favored in immunocompromised patients who present a favorable environment for opportunistic infections. We describe the case of a patient treated for a systemic lupus erythematosus suffering from deep oral ulcerations. The case illustrates the complexity of establishing a precise etiological diagnosis of CMV lesions, as the diagnostic hypothesis can be varied: related to an immunodeficiency disorder or drug‐induced toxidermia.

Rodriguez I, et al. J Dent Anesth Pain Med. 2022 Aug;22(4):255-266. https://doi.org/10.17245/jdapm.2022.22.4.255

Congrès de la SFCO, SFCO, Société Française de Chirurgie Orale, EDP Sciences