(1) Objectives: This systematic review and meta-analysis aimed to summarize current evidence regarding the prognostic role of perineural invasion (PNI) in patients with oral squamous cell carcinoma (OSCC). (2) Methods: We searched Cochrane Central, ProQuest, PubMed, Scopus, Science Direct, and Web of Science, using relevant keywords to identify eligible articles. Two independent reviewers conducted two-stage screening, data extraction, and quality assessment. The risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) criteria. All analyses were performed using comprehensive meta-analysis (CMA; version 3.3.070) software. (3) Results: The study included 101 published articles encompassing 26,062 patients. The pooled analyses showed that PNI was associated with significantly worse overall survival (OS; HR = 1.45, 95% CI: 1.32–1.58; p < 0.001), worse disease-specific survival (DSS; HR = 1.87, 95% CI: 1.65–2.12; p < 0.001), and worse disease-free survival (DFS; HR = 1.87, 95% CI: 1.65–2.12; p < 0.001). Similarly, both local recurrence-free survival (LRFS) and regional recurrence-free survival (RRFS) were worse in patients with PNI (HR = 2.31, 95% CI: 1.72–3.10, p < 0.001; and HR = 2.04, 95% CI: 1.51–2.74, p < 0.001), respectively. The random-effect estimate of three studies demonstrated that the presence of PNI was associated with worse failure-free survival (FFS; HR = 2.59, 95% CI: 1.12–5.98, p < 0.001). (4) Conclusions: The current evidence suggests that PNI can be used as an independent predictor of the prognosis for patients with OSCC. The presence of PNI was associated with worse OS, DFS, DSS, FFS, and with recurrence. Asian patients and patients with extra-tumoral or peripheral PNI invasion were associated with worse prognosis.

Teledentistry has emerged as a new communication tool in various dental disciplines around the world. The aim of this study was to investigate the applicability and reliability of teledentistry in the field of diagnostic dentistry and explore the perception of Saudi dentists of its benefits and concerns. An electronic survey with 40 questions was developed, validated and distributed electronically by email and social media channels to dentists from different specialty in Saudi Arabia. Collected data were analyzed for statistical significance. A total of 148 dentists completed the survey. The current data demonstrated that 50% of study participants have had applied teledentistry in their clinical practice. Out of all, 90% have computers in their dental offices and 72% have been using electronic medical records in which radiographs and clinical images are uploaded. Most participants had smart phones (91%), in which they were used more commonly (74.3%) than conventional cameras (54.1%) to capture and share patients' clinical images over communication applications (74.3%) and less likely through emails (62.2%). Overall, 83% were confident that teledentistry can improve daily dental practice, specifically in the fields of oral radiology followed by endodontics and oral medicine. Teledentistry is an emerging tool with potential to improve the delivery of diagnostic dental care for communities with limited or no access to dental specialists. As of today, teledentistry has not been truly implemented by the Saudi dental community. Development of national programs to educate the public and promote teledentistry among dental practitioners are warranted.

Background: COVID-19, caused by SARS-CoV-2, has impacted the world in an unprecedented way since December 2019. SARS-CoV-2 was found in the saliva of patients, and entry points for the virus may have been through the numerous angiotensin-converting enzyme 2 receptors in the oral cavity. Oral manifestations of COVID-19 could contribute to the burden of oral disease. Objective: To determine the prevalence of oral manifestations of COVID-19 in patients and their association with disease severity. Methods: Interviews were conducted with adult participants diagnosed with COVID-19 between October 2021 and March 2022 to document their demographic and health status data, symptoms, and the presence of oral manifestations of COVID-19. Chi-square and the Fisher’s exact test were used to compare data on the presence or absence of oral manifestations of COVID-19. Results: Of 195 participants interviewed, 33% were 18 to 24 years old, 33% were 25 to 34 years old, and 75% were female. A total of 57 (29%) had oral manifestations; the most common were taste disorders (60%), xerostomia (42%), and oral ulcers (11%). There was no relationship between the severity of COVID-19 and the presence of the oral manifestations. Conclusion: Oral manifestations of COVID-19 were common among female patients and linked to certain general COVID-19 symptoms regarding frequency and extent.

Background: Medication-induced oral hyperpigmentation is an oral condition that impacts patients’ quality of life and has been linked to many systemic therapeutic agents. The exact pathogenesis of tissue pigmentation varies greatly and is not completely known. This systematic review aimed to present data on the causal association between medications and the development of oral/mucosal pigmentation as an adverse drug reaction. Methods: A systematic review and analysis of literature were conducted using the following databases: PubMed, Science Direct, ProQuest, Web of Science, and Scopus. The systematic review included original articles written in English and published between January 1982 and June 2020. Following the PRISMA statement, eligible articles were systematically reviewed, and data were extracted from eligible studies and analyzed. Results: A total of 235 articles were identified, of which 57 met the inclusion criteria and were included in this review. The mean age of included patients was 46.2± 16.38 years (range: 10– 90 years) with a male to female ratio of 1:1.45. Oral mucosal hyperpigmentation was reported following the use of several classes of medications such as antiviral (eg, zidovudine), antibiotic (eg, minocycline), antimalarial (eg, chloroquine), anti-fungal (eg, ketoconazole), antileprotic (eg, clofazimine), antihypertensive (eg, amlodipine), chemotherapeutic, and antineoplastic drugs. The risk of developing oral pigmentation was significantly higher with antimalarial medications, antibiotics, antineoplastic and chemotherapeutic agents. Medication-induced oral hyperpigmentation was most frequent among women and in the hard palate. Conclusion: Future research is warranted to better understand the pathogenesis and risk factors for medication-induced oral hyperpigmentation in order to reassure patients during prescription and management.

Rationale: Obesity and diabetes of different types are considered global health risks with rising prevalence. In addition to low-calorie diet and daily exercise, several treatment options have been introduced to help patient in needs. Semaglutide (Ozempic) is one popular agent, which attracted the attention of both physicians and patients due to its positive outcome in improving glucose control and weight loss. However, no reports on the effect of semaglutide use on the oral cavity and specifically xerostomia are available in the literature. We are reporting 3 cases for patients who were using semaglutide and developed secondary xerostomia. Patient concerns: Three female patients with median age of 34 (range 27–46) presented to the oral medicine clinic with chief complaint of xerostomia. All patients were overweight with a mean body mass index of 35.6 (range 35–37) and have been using semaglutide for weight loss for a mean duration of 11.3 weeks (range 6–16). Diagnoses: All 3 patients had severe dryness in the mouth with minimal frothy saliva with mean modified Schirmer test of 9 mL at 3 minutes (range 8–10 mL). Following exclusion of other possible underlying medical problems, the diagnosis of semaglutide-induced hyposalivation was given to all patients. Interventions: The patients’ management varied between discontinuation of the drug, the use of pilocarpine, and conservative symptomatic management. Outcomes: The patients resumed acceptable salivary flow. Lessons: We are reporting for the first time hyposalivation associated with the use of semaglutide. Further prospective, larger studies are warranted to confirm these findings.

Background: The use of artificial intelligence (AI), especially large language models (LLMs), is increasing in health care, including in dentistry. There has yet to be an assessment of the diagnostic performance of LLMs in oral medicine. Objective: We aimed to compare the effectiveness of ChatGPT (OpenAI) and Microsoft Copilot (integrated within the Microsoft 365 suite) with oral medicine consultants in formulating accurate differential and final diagnoses for oral lesions from written clinical scenarios. Methods: Fifty comprehensive clinical case scenarios including patient age, presenting complaint, history of the presenting complaint, medical history, allergies, intra- and extraoral findings, lesion description, and any additional information including laboratory investigations and specific clinical features were given to three oral medicine consultants, who were asked to formulate a differential diagnosis and a final diagnosis. Specific prompts for the same 50 cases were designed and input into ChatGPT and Copilot to formulate both differential and final diagnoses. The diagnostic accuracy was compared between the LLMs and oral medicine consultants. Results: ChatGPT exhibited the highest accuracy, providing the correct differential diagnoses in 37 of 50 cases (74%). There were no significant differences in the accuracy of providing the correct differential diagnoses between AI models and oral medicine consultants. ChatGPT was as accurate as consultants in making the final diagnoses, but Copilot was significantly less accurate than ChatGPT (P=.015) and one of the oral medicine consultants (P<.001) in providing the correct final diagnosis. Conclusions: ChatGPT and Copilot show promising performance for diagnosing oral medicine pathology in clinical case scenarios to assist dental practitioners. ChatGPT-4 and Copilot are still evolving, but even now, they might provide a significant advantage in the clinical setting as tools to help dental practitioners in their daily practice.