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Shaashi Uday H, Pethagounder Thangavelu R, Rajaram Mohan K, Fenn SM, Appusamy K. Evaluation of Nicotine Dependence Among Smokeless Tobacco Users Using the Fagerstrom Nicotine Dependence Scale for Smokeless Tobacco. Cureus 2023; 15:e38639. [PMID: 37288236 PMCID: PMC10243400 DOI: 10.7759/cureus.38639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 06/09/2023] Open
Abstract
Nicotine dependence is a current indwelling and challenging health burden among smokeless tobacco users as it involves the compulsive use of a substance despite its known harmful effects. The evaluation of nicotine dependence is challenging as it involves physical and psychological dependence due to nicotine in smokeless tobacco. AIM AND OBJECTIVE The primary aim is to assess the nicotine dependence in a group of smokeless tobacco by using a six-question Fagerstrom Test for Nicotine Dependence for Smokeless Tobacco (FTND-ST) and to assess the nicotine dependence among three groups, namely Group - 1, who were exclusively pan masala, gutka chewers, Group - 2, who were exclusively Hans users, and Group - 3, who were exclusively betel quid with smokeless tobacco chewers. MATERIALS AND METHODS Only those who use smokeless tobacco in the age groups between 21 to 70 years were randomly selected. The total sample size is 100 patients. The age groups were divided into 21-28, 29-35, 36-42, 43-49, 50-56, 57-63, and 64-70. Informed consent was obtained from the participants of the study. RESULTS The Hans chewers are predominantly females. Pan masala and gutka chewers are predominantly males. CONCLUSION Smokeless tobacco chewers like pan masala were found to have high mean nicotine dependence Fagerstrom score than Hans and betel quid with smokeless tobacco chewers.
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Affiliation(s)
- Hiremath Shaashi Uday
- Department of Oral Medicine and Radiology, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND
| | - Ravikumar Pethagounder Thangavelu
- Department of Oral Medicine and Radiology, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND
| | - Karthik Rajaram Mohan
- Department of Oral Medicine and Radiology, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND
| | - Saramma Mathew Fenn
- Department of Oral Medicine and Radiology, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND
| | - Kumar Appusamy
- Department of Oral Medicine and Radiology, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND
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Gupta S, Subbappa A, Singh S, Sharma P, Singh A, Kumar A, Sandhu H, Nadar K. Challenges in the classification of oral submucous fibrosis and proposing a new classification based on systematic review of literature. J Int Soc Prev Community Dent 2023; 13:17-31. [PMID: 37153926 PMCID: PMC10155876 DOI: 10.4103/jispcd.jispcd_207_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/06/2023] [Accepted: 01/25/2023] [Indexed: 03/11/2023] Open
Abstract
Aims and Objectives Oral submucous fibrosis is one of the common oral potentially malignant disorders that can result in severe morbidity. Due to its widespread involvement in the oral cavity and high risk of malignant transformation, the diagnosis and treatment of this disease at an early stage is essential to prevent further complications. This research was carried out to review various classification systems of oral submucous fibrosis documented in the literature to date, including their benefits and drawbacks, thus focusing on a need to discover some reliable classification systems. Materials and Methods An electronic search of the published English literature was performed without publication year limitation in PubMed/Medline, Science Direct, Web of Science, Google Scholar, and Scopus databases using keywords like ('Oral submucous fibrosis' OR 'Oral submucous fibroses'), AND ('Classification' OR 'Grade' OR 'Stage'), AND ('Clinical', OR/ AND 'Histological', OR/AND 'Functional') following PRISMA guidelines. A manual search of all related Dental and Medical journals was also performed. We also checked the reference lists of the relevant articles for any other possible information on the subject. Results The search strategy revealed 31 relevant articles and it could be appreciated that oral submucous fibrosis has been classified in seven different ways. Each system is enclosed with its own limitations and benefits. Conclusion From this research, it can be concluded that despite the existence of several classification systems for oral submucous fibrosis, at present, no classification scheme is considered to be reliable that could help in the accurate assessment of the progression of the disease and classifying oral submucous fibrosis still remains a challenging task for clinicians, surgeons, and pathologists. We have postulated a proposed new classification system based on our literature research, but still robust research is needed in this aspect.
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Gupta S, Jawanda MK. Laser as a promising non-invasive technique to treat oral submucous fibrosis: A systematic review of the literature. Saudi Dent J 2021; 33:413-423. [PMID: 34803281 PMCID: PMC8589611 DOI: 10.1016/j.sdentj.2020.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 01/13/2023] Open
Abstract
Background Oral submucous fibrosis (OSMF) is one of the common oral potentially malignant disorders that can result in severe morbidity. Depending upon the stage of disease, multiple management therapies exist which include medicinal and surgical approaches. Although the surgical approach is preferred in severe conditions, numerous studies have reported its post-surgical deteriorating outcomes including increased fibrotic changes. To reduce these post-surgical complications, Light amplification by stimulated emission of radiation (Laser) has been introduced and studied as a non-invasive technique to treat oral submucous fibrosis. However, there exists a lack of knowledge about ‘which laser shows a better post-treatment outcome’. Accordingly, this review aims to answer this question. Materials and methods A systematic review of the published literature was performed using an electronic search in PubMed/Medline, Science Direct, Web of Science, Embase, J- STAGE, Google Scholar, and Scopus databases, from 1952 till 2019 using keywords like, ‘Oral submucous fibrosis’, ‘Treatment’, ‘Laser’, ‘Trismus’, ‘ Fibrosis’, ‘Surgical’, ‘Non-invasive’, and ‘Postoperative results’. Results The search strategy revealed 20 relevant published studies in which laser had been used to treat 250 patients of OSMF. Effective results were found without any complications in all the cases after follow up. Conclusion Observing the current literature, it can be concluded that laser might be used as a potential non-invasive approach in the management of OSMF, however, large scale studies are required to investigate the efficacy and other effects of this technology.
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Key Words
- AN, Areca nut
- CO2, Carbon-dioxide
- CTGF/CCN2, Connective tissue growth factor
- Er Cr YS GG, Erbium Chromium: Yttrium – Scandium – Gallium – Garnet
- Er, YAG Erbium: Yttrium–Aluminium–Garnet
- GA, General anaesthesia
- GaAs, Gallium Arsenic
- H2O, Water
- HA, Hydroxyapatite
- IF- ά, Interferon ά
- KTP, Potassium titanyl phosphate
- LA, Local anaesthesia
- LPLI, Low-power laser irradiation
- Laser
- Laser, Light amplification by stimulated emission of radiation
- MMP2, Matrix metalloproteinases 2
- ND-YAG, Neodymium – doped: Yttrium- Aluminium Garnet
- Non-invasive
- OSMF, Oral submucous fibrosis
- Oral sub mucus fibrosis
- PGs, Prostaglandins
- TGF- β, Transforming Growth Factor β
- TNF, Tumor necrosis factor
- Technique
- Treatment
- UUO, Unilateral ureteral obstruction
- WHO, World Health Organization
- cAMP, Cyclic adenosine monophosphate
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Affiliation(s)
- Sonia Gupta
- Dept. of Oral Pathology and Microbiology & Forensic odontology, Rayat Bahra Dental college and hospital, Mohali, Punjab, India
| | - Manveen Kaur Jawanda
- Dept. of Oral Pathology and Microbiology & Forensic odontology, Luxmi bai institute of dental sciences and hospital, Patiala, Punjab, India
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Raut T, Keshwar S, Rimal J, Lamsal M, Shrestha A. Biochemical status of serum iron in histopathological grades of oral submucous fibrosis. J Oral Biol Craniofac Res 2020; 10:753-757. [PMID: 33117643 DOI: 10.1016/j.jobcr.2020.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/05/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022] Open
Abstract
Background Oral submucous fibrosis is a multifactorial, chronic disease of oral mucosa characterized by mucosal atrophy and fibrosis leading to functional morbidity; amongst many iron deficiency is considered as one of the risk factor. Also the iron level is considered to be depleted due to increased utilization during collagen synthesis. This study was conducted to evaluate the level of iron in patients with fibrosis and correlate with different histopathological grades. Methods A total of 40 clinically diagnosed and histopathologically confirmed cases of submucous fibrosis were considered. Clinical data were recorded and status of iron was estimated through serum iron and total iron binding capacity by ferrozine method using a digital auto-analyzer. The level of iron was correlated with the histopathological grades and epithelial dysplasia. Result The mean age of patients was 37.07 ± 14.63 years with the male to female ratio of 6.5:1. Areca nut consumption was associated with all the cases among which 87.5% of cases were exposed to commercial forms. 37.5% of cases were in early grade whereas 60% in moderately advanced histopathological grade. The level of mean serum iron and total iron binding capacity was higher in moderately advanced than in early grade. However no statistically significant difference was observed within the histopathological grades. Conclusion Iron is influenced by many factors like dietary intake, food habits, metabolic reactions, chronic diseases, etc. Serum iron is reduced in patients with oral submucous fibrosis which should be supplemented to impede the carcinogenic potential and improve the treatment outcome.
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Affiliation(s)
- Toniya Raut
- Department of Oral Pathology, BP Koirala Institute of Health Sciences, Nepal
| | - Shashi Keshwar
- Department of Oral Pathology, BP Koirala Institute of Health Sciences, Nepal
| | - Jyotsna Rimal
- Department of Oral Medicine and Radiology, BP Koirala Institute of Health Sciences, Nepal
| | - Madhab Lamsal
- Department of Biochemistry, BP Koirala Institute of Health Sciences, Nepal
| | - Ashish Shrestha
- Department of Oral Pathology, College of Dental Surgery, BP Koirala Institute of Health Sciences, Nepal
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More CB, Jatti Patil D, Rao NR. Medicinal management of oral submucous fibrosis in the past decade- A systematic review. J Oral Biol Craniofac Res 2020; 10:552-568. [PMID: 32939334 PMCID: PMC7479289 DOI: 10.1016/j.jobcr.2020.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/08/2020] [Accepted: 08/09/2020] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Oral submucous fibrosis (OSMF) is a potentially malignant disorder with a high rate of malignant transformation. It is associated with chewing of areca nut and tobacco products with a high global prevalence, particularly in the southeast Asian countries. A wide range of treatment modalities are available, ranging from corticosteroids, antioxidants, nutritional supplements to herbal medicines but lacks a reliable treatment regimen. AIM This systematic review will comprehensively analyze the medicinal treatment for OSMF from 2011 to 2020, apprise the literature with new clinical studies, and initiate a discussion about other potential medicines. MATERIAL AND METHODS A comprehensive electronic search was conducted in Pubmed, Scopus, and other databases from January 2011 to June 2020 according to the PRISMA guidelines, to identify all the clinical studies for the medicinal management of OSMF with definite keywords and defined criteria. RESULTS Among the thirty-two included clinical studies 23 were randomized controlled studies and 9 were case-control studies. The treatment outcomes were diverse, and the majority of the studies showed improvement in the subjective signs and symptoms of OSMF. Only a few studies noticed the side effects. CONCLUSION No single treatment modality is effective in the management of OSMF. The concurrent use of triple therapy is efficacious. The naturally occurring herbal medicines have an immense potential in the management of OSMF. Therefore, high-quality, longitudinal, multi-center randomized controlled trials with larger samples need to be conducted to further assess the efficacy of various medicinal formulations in conjunction with physiotherapy in the management of OSMF.
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Affiliation(s)
- Chandramani B. More
- Department of Oral Medicine and Radiology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| | - Deepa Jatti Patil
- Department of Oral Medicine and Radiology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
| | - Naman R. Rao
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA, USA
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Efficacy of lycopene in management of Oral Submucous Fibrosis- A systematic review and meta-analysis. J Oral Biol Craniofac Res 2020; 10:690-697. [PMID: 33072506 DOI: 10.1016/j.jobcr.2020.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/07/2020] [Accepted: 09/14/2020] [Indexed: 01/15/2023] Open
Abstract
Purpose To evaluate the efficacy of lycopene in the management of Oral Submucous Fibrosis (OSMF). Study design A comprehensive search was done in MEDLINE via PubMed, Cochrane, EBSCO-host and Google scholar from July 31st, 1999 to July 31st, 2019 to identify OSMF related clinical trials (Randomized and Non-randomized) involving lycopene as one of the intervention. Results 16 randomized control trials and 3 non-randomized control trials comprising 1181 subjects were included. The results of meta-analysis showed non-significant differences between lycopene and other interventions used in the treatment of OSMF. Conclusion The present review suggests that lycopene is a safe and equally effective therapeutic modality as compared to other interventions for patients with OSMF. Further well-designed clinical trials are required to accurately assess the effectiveness of lycopene as compared to other medicinal treatments in the management of OSMF.
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Tarsariya VM, Mehta DN, Raval N, Patadiya HH, Vachhrajani K, Ashem A. Evaluation of serum immunoglobulin (IgG, IgM, IgA) in potentially malignant disorders of oral cavity - A case control study. J Oral Biol Craniofac Res 2020; 10:665-669. [PMID: 33005564 DOI: 10.1016/j.jobcr.2020.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 11/30/2022] Open
Abstract
Background Only few studies have been done to evaluate level of serum immunoglobulins (IgG,IgM,IgA) in patients with Potentially Malignant Disorders (PMD) like Leukoplakia, Oral Submucous Fibrosis (OSMF) and Oral Lichen Planus (OLP) as tumour markers. Aims and objectives To estimate the serum immunoglobulins level (IgG, IgM, IgA) in leukoplakia, OSMF and oral lichen planus (OLP) patients and its comparison with levels among control groups and Weather these values can be used to predict severity of disease or not. Materials and methods 30 patients with different potentially malignant disorders like leukoplakia, OSMF and oral lichen planus and 30 healthy controls were selected at random and subjected for analysis of serum IgG, IgA, IgM. Statistical methods employed were mean, standard deviation and ANOVA test. Results We observed significant elevated levels of all the immunoglobulins in leukoplakia, OSMF and oral lichen planus when compared with the control group and levels were increasing with clinical stages of OSMF (p < 0.05). Conclusions All these immunoglobulins are indicative of tumour burden or transformation of malignancy in higher stage and might be employed as prognostic indicators in these disorders.
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Affiliation(s)
- Vivek M Tarsariya
- Shantabaa Medical College & General Hospital, Amreli, Gujarat, India
| | - Dhaval N Mehta
- Dept. of Oral Medicine & Radiology, Narsinhbhai Patel Dental College & Hospital, Visnagar, Gujarat, India
| | - Nilesh Raval
- Dept. of Oral Medicine & Radiology, Karnavati School of Dentistry, Uvarsad, Gandhinagar, Gujarat, India
| | - Hiren H Patadiya
- Boston University, Henry M Goldman School of Dental Medicine, Boston, USA
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Rao NR, More CB, Brahmbhatt RM, Chen Y, Ming WK. Causal inference and directed acyclic graph: An epidemiological concept much needed for oral submucous fibrosis. J Oral Biol Craniofac Res 2020; 10:356-360. [PMID: 32714788 DOI: 10.1016/j.jobcr.2020.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/11/2020] [Accepted: 06/21/2020] [Indexed: 11/28/2022] Open
Abstract
Oral submucous fibrosis (OSMF), although already established as an oral potentially malignant disorder (OPMD), still stands over a weak bridge because of its controversial pathogenesis. There has been tremendous work on this disease since 1962, surprisingly, we are unsuccessful in finding the exact causation of OSMF. The potential cause for this is either a lack of systematically performed clinical observational studies or over-interpreted inferences of the presented results. Accordingly, the literature is piled with complex data that is being followed by emerging researchers. Hence, this conceptual paper is presented to focus and explain only the epidemiological concepts of causal inference and the construction of DAGs. These concepts will help to encode our subject matter knowledge and assumptions regarding the causal structure problem, classify the source of systematic bias, identify the potential confounders, potential issues in the study design, and guide the data analysis.
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Affiliation(s)
- Naman R Rao
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Chandramani B More
- Department of Oral Medicine and Radiology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth University, Vadodara, Gujarat, India
| | - Rahi M Brahmbhatt
- College of Liberal Arts and Sciences, University of Illinois at Chicago, USA
| | - Youbai Chen
- Harvard Medical School, Harvard University, Boston, MA, USA.,Department of Plastic and Reconstructive Surgery, Chinese PLA General Hospital, Beijing, China
| | - Wai-Kit Ming
- Faculty of Medicine, International School, Jinan University, Guangzhou, China.,The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
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More CB, Rao NR, Hegde R, Brahmbhatt RM, Shrestha A, Kumar G. Oral submucous fibrosis in children and adolescents: Analysis of 36 cases. J Indian Soc Pedod Prev Dent 2020; 38:190-199. [PMID: 32611867 DOI: 10.4103/jisppd.jisppd_173_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Oral submucous fibrosis (OSMF) is a chronic debilitating irreversible oral potentially malignant disorder affecting any part of the oral cavity. It is usually seen in adults but rarely noticed in children and adolescents. Since the paucity of the cases, there exists a gap of knowledge in the causative habits, root reasons of habit initiation, age of habit initiation, and the common clinical representation of this disorder. The current article aims to bridge this gap by presenting unusual 36 cases of children and adolescents reported at the tertiary care hospital of Vadodara, Gujarat, India, with specific areca nut chewing habit and distinct features of OSMF. Furthermore, the present case series is the first of its kind in the scientific literature with a high number of OSMF cases in children and adolescents.
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Affiliation(s)
- Chandramani Bhagwan More
- Department of Oral Medicine and Maxillofacial Radiology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed University, Vadodara, Gujarat, India
| | - Naman R Rao
- Harvard Medical school, Harvard University; Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Rahul Hegde
- Director, Ajinkya D Y Patil University, Pune, Maharashtra, India
| | - Rahi M Brahmbhatt
- Department of Neuroscience, University of Illinois at Chicago, Illinois, USA
| | - Ashish Shrestha
- Department of Oral Pathology, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Gyanendra Kumar
- Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Rao NR, Villa A, More CB, Jayasinghe RD, Kerr AR, Johnson NW. Oral submucous fibrosis: a contemporary narrative review with a proposed inter-professional approach for an early diagnosis and clinical management. J Otolaryngol Head Neck Surg 2020; 49:3. [PMID: 31915073 PMCID: PMC6951010 DOI: 10.1186/s40463-020-0399-7] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/01/2020] [Indexed: 12/24/2022] Open
Abstract
Oral Submucous fibrosis (OSMF) has traditionally been described as “a chronic, insidious, scarring disease of the oral cavity, often with involvement of the pharynx and the upper esophagus”. Millions of individuals are affected, especially in South and South East Asian countries. The main risk factor is areca nut chewing. Due to its high morbidity and high malignant transformation rate, constant efforts have been made to develop effective management. Despite this, there have been no significant improvements in prognosis for decades. This expert opinion paper updates the literature and provides a critique of diagnostic and therapeutic pitfalls common in developing countries and of deficiencies in management. An inter-professional model is proposed to avoid these pitfalls and to reduce these deficiencies.
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Affiliation(s)
- Naman R Rao
- Harvard Medical School, Harvard University, Boston, MA, USA.
| | - Alessandro Villa
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.,Harvard School of Dental Medicine, Boston, MA, USA
| | - Chandramani B More
- Department of Oral Medicine and Radiology, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth University, Vadodara, Gujarat, India
| | - Ruwan D Jayasinghe
- Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Alexander Ross Kerr
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY, USA
| | - Newell W Johnson
- Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
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