RESUMEN
Objective: Pigmented fungiform papillae of the tongue (PFPT) are infrequently encountered and inadequately documented pigmented lesions that pose challenges in diagnosis and subsequent treatment planning. The study was aimed at analyzing dentists' knowledge and attitudes regarding PFPT morphologies, to determine diagnosis and subsequent treatment planning. Methods: A cross-sectional study was conducted among dentists in East Java through an online questionnaire. Four clinical photographs of PFPT were presented, accompanied by seven questions assessing dentists' knowledge of PFPT, including lesion types, tongue structure involvement, Holzwanger classification, lesion patterns, suspected diagnoses and the nature of the lesion (benign or malignant). Additional questions to evaluate attitudes included prior experience with PFPT in practice, potential malignant transformation, diagnostic investigation and required treatment. Knowledge-associated attitude differences were statistically analyzed with the Mann-Whitney test with a threshold of p < 0.05. Result: A total of 117 dentists participated, most of whom were women (69.23%) and were 26-30 years of age (44.44%). Dentists 41-50 years of age had superior knowledge to those 20-30 years of age (p = 0.005). Practitioners with 1-5 years of experience showed significant differences in knowledge regarding PFPT (p < 0.05). No significant differences in knowledge level and attitudes were observed, particularly regarding PFPT treatment and supporting investigation (p > 0.05). However, prior encounters with PFPT cases were significantly associated with treatment decisions and supporting investigations for diagnosis (p < 0.05). Conclusion: Most participating dentists had substantial knowledge of PFPT cases. Dentists' understanding, as reflected in their attitudes toward investigating and treating PFPT, was notably influenced by prior encounters with PFPT cases.
RESUMEN
OBJECTIVE: The pathogenesis of recurrent aphthous stomatitis (RAS) is related to an increase of pro-inflammatory cytokine, namely tumor necrosis factor α (TNF-α). This cytokine plays an important role in the development of ulcer lesions, both in saliva, tissues and blood. This systematic review analyzed the differences of TNF-α in lesions, salivary and blood and can be used as a reliable method of diagnosis for RAS. METHODS: A comprehensive search of PubMed, Scopus databases, Web of Science, Scielo, Google Scholar and Embase with keywords. The inclusion criteria were studies that assessed the saliva, serum, and RAS lesion, with the outcome reporting the mean of saliva, serum and tissue expression of TNF-α. The risk of bias was also assessed. RESULT: Healthy individuals showed significantly lower TNF-α than RAS (SMD = -1.517, 95% CI [-2.25, -0.78]). Although there is a significant difference between sample (i.e., saliva, serum) and detection type (i.e., cytometry bead array, ELISA), both methods can detect a significant difference in TNF-α between healthy individuals and RAS patients. CONCLUSIONS: The TNF-α is a useful diagnostic marker for RAS. We encourage saliva to detect changes in TNF-α during ulceration as it provides accuracy, reliability, and non-invasive procedure compared to a blood draw.