Acta Scientific Dental Sciences (ASDS)(ISSN: 2581-4893)

Case Report Volume 7 Issue 4

Axial Attachment Retained Mandibular Overdenture - A Case Report

Nikolovski Bruno1*, Radojkova Nikolovska Vera2, Evrosimovska Biljana2, Veleska Stevkovska Daniela2 and Zafirova Biljana2

1Faculty of medical sciences, University “Goce Delcev”, Stip, North Macedonia
2Faculty of dentistry, University “Ss. Cyril and Methodius”, Skopje, North Macedonia

*Corresponding Author: Nikolovski Bruno, Faculty of medical sciences, University “Goce Delcev”, Stip, North Macedonia.

Received: March 07, 2023; Published: March 30, 2023


Oral cancer is a preventable disease. In 2021, the International Agency for Research on Cancer by World Health Organization, presents the number of 377713 new cases of oral cancer in 2020, making it the 16th most common malignant disease in the world, unfortunately with poor prognosis after treatment because of the late stage of the disease [1].

Aim: to explore the accuracy/efficacy, specificity and sensitivity, the positive and negative predicted values of the oral exfoliative cytology (brush biopsy) as a closest, but less invasive method to the tissue biopsy, respected as a gold standard in the diagnostic procedures.

Material and Methods: 60 patients divided into two study groups (30 of them with potentially malignant oral lesions and a second consisted of another 30 patients with previous oral malignant disease) were examined with brush biopsy and underwent to histopathological confirmation - tissue biopsy, selected under certain inclusion and exclusion criteria.

Results: Sensitivity of brush biopsy in the group of examinees with oral potentially malignant lesions is 100%, its specificity is 66.67%, the positive predictive value is 92.31% and the negative predictive value is 100%. The accuracy of the Brush biopsy method is 93.33%.

The sensitivity, in the group of patients with previous oral malignant disease, is 100%, specificity is 0%, the positive predictive value is 100% and the negative predictive value is 0%. The accuracy of this method is 100%.

Conclusion: The accuracy reaches a total value of 100% for the group with previous malignant lesions (relapse) and sets the thesis that brush biopsy as screening method for oral cancer or premalignant tissue changes is enough valuable for the patients with oral epithelial changes but may be combined with some other type of screening procedures, easy to perform and less invasive ones, in order to gain relevant results applicable in the everyday clinical practice.

Keywords: Subtotal Edentulousness; Axial Attachment; Cekapreci Line; Retention


  1. Ferlay J., et al. “Global Cancer Observatory: Cancer Today”. Lyon: International Agency for Research on Cancer (2020).
  2. SEER Cancer Statistics Review. 1973-1998.
  3. Rivera C. “Essentials of oral cancer”. International Journal of Clinical and Experimental Pathology 8.9 (2015): 11884-11894.
  4. Jacobson JJ., et al. “The cost burden of oral, oral pharyngeal, and salivary gland cancers in three groups: Commercial insurance, medicare, and medicaid”. Head and Neck Oncology 4 (2012): 15.
  5. Guo Y., et al. “Racial disparity in oral and pharyngeal cancer in Florida in 1991-2008: Mixed trends in stage of diagnosis”. Community Dentistry and Oral Epidemiology 41 (2013): 110-119.
  6. Watson JM., et al. “Factors associated with early-stage diagnosis of oral and pharyngeal cancer”. Community Dentistry and Oral Epidemiology 37 (2009): 333-341.
  7. Holmes JD., et al. “Is detection of oral and oropharyngeal squamous cancer by a dental health care provider associated with a lower stage at diagnosis?”Journal of Oral Maxillofacial Surgery 61 (2003): 285-291.
  8. Howell JL., et al. “Barriers to oral cancer screening: A focus group study of rural black american adults”. Psychooncology 22 (2013): 1306-1311.
  9. Parkin DM., et al. “Estimating the world cancer burden: Globocan 2000”. International Journal of Cancer 94.2 (2001): 153-156.
  10. American Cancer Society: Cancer Facts and Figures (2005).
  11. Wolff K-D., et al. “The diagnosis and treatment of oral cavity cancer”. Deutsches Arzteblatt international 109.48 (2012): 829-835.
  12. Souza FB., et al. “Oral cancer from a health promotion perspective: experience of a diagnosis network in Ceará”. Brazilian Oral Research 28 (2014): 1-8.
  13. Rocha TAH., et al. “Oral primary care: an analysis of its impact on the incidence and mortality rates of oral cancer”.BMC Cancer 17.1 (2017): 706.
  14. Driemel O., et al. “Diagnosis of oral squamous cell carcinoma and its precursor lesions (in English and German)”. Journal Der Deutschen Dermatologischen Gesellschaft 5.12 (2007): 1095-1100.
  15. Mehrotra R., et al. “Application of cytology and molecular biology in diagnosing premalignant or malignant oral lesions”. Molecular Cancer 5 (2006): 11.
  16. Frist S. “The oral brush biopsy: separating fact from fiction”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 96.6 (2003): 654-655.
  17. Eisen D. “Brush biopsy ‘saves lives”. The Journal of the American Dental Association 133.6 (2002): 688-692.
  18. Eisen D and Frist S. “The relevance of the high positive predictive value of the oral brush biopsy”. Oral Oncology 41.7 (2005): 753-755.
  19. UK National Screening Committee. Criteria for appraising the viability, effectiveness and appropriateness of a Screening programme.
  20. Jaeschke R., et al. “Users’ guides to the medical literature. III. How to use an article about a diagnostic test. A Are the results of the study valid? Evidence-Based Medicine Working Group”. JAMA 271.5 (1994): 389-391.
  21. Mehrotra R., et al. “The use of an oral brush biopsy without computer-assisted analysis in the evaluation of oral lesions: a study of 94 patients”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 106.2 (2008): 246-253.
  22. Queiroz JB., et al. “Exfoliative cytology of the oral mucosa: Comparison of two collection methods”. General Dentistry 58.5 (2010): e196-e9.
  23. Rick GM and Slater L. “Oral brush biopsy: the problem of false positives”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 96 (2003): 252.
  24. Fedele S. “Diagnostic aids in the screening of oral cancer”. Head and Neck Oncology 1.1 (2009): 5.
  25. Sciubba JJ. “Improving detection of precancerous and cancerous oral lesions. Computer-assisted analysis of the oral brush biopsy. U.S. Collaborative OralCDx Study Group”. Journal of the American Dental Association 130.10 (1999): 1445-1457.
  26. Mehrotra R., et al. “The efficacy of oral brush biopsy with computer-assisted analysis in identifying precancerous and cancerous lesions”. Head and Neck Oncology 3 (2011):
  27. Poate TW., et al. “An audit of the efficacy of the oral brush biopsy technique in a specialist Oral Medicine unit”. Oral Oncology 40.8 (2004): 829-834.
  28. Svirsky JA., et al. “Comparison of computer-assisted brush biopsy results with follow up scalpel biopsy and histology”. General Dentistry 50.6 (2002): 500-503.
  29. Kosicki DM., et al. “[OralCDx brush biopsy--a tool for early diagnosis of oral squamous cell carcinoma]”. Schweizer Monatsschrift für Zahnmedizin 117.3 (2007): 222-227.
  30. Bhoopathi V., et al. “Low positive predictive value of the oral brush biopsy in detecting dysplastic oral lesions”. Cancer115.5 (2009): 1036-1040.
  31. Singh V., et al. “Evaluation of Role of Visual Inspection Using Acetic Acid (VIA) and Exfoliative Cytology in Screening and Early Detection of Oral Premalignant Lesions and Oral Cancer”. Asian Pacific Journal of Cancer Prevention 22.7 (2021): 2273-2278.
  32. Neumann FW., et al. “Retrospective evaluation of the oral brush biopsy in daily dental routine - an effective way of early cancer detection”. Clinical Oral Investigations 26 (2022): 6653-6659.
  33. Su YF., et al. “Current Insights into Oral Cancer Diagnostics”. Diagnostics (Basel) 11.7 (2021): 1287.


Citation: Nikolovski Bruno., et al. “Diagnostic and Prognostic Implications of the Oral Exfoliative Cytology in Oral precancer And Cancer Detection".Acta Scientific Dental Sciences 7.4 (2023): 129-136.


Copyright: © 2023 Nikolovski Bruno., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.278

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is April 30th, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US