ANALISI DELL’ESPRESSIONE DI POKEMON IN LINEE CELLULARI DI CARCINOMA SQUAMOCELLULARE DEL CAVO ORALE

Challenges and Controversies in the Diagnosis of MRONJ

Medication-related osteonecrosis of the jaw (MRONJ) is a relatively rare but potentially seriousand debilitating complication [...]

Studio di prevalenza e di associazione tra disturbi respiratori notturni in età evolutiva e disgnazie

HIGH PREVALENCE OF VULVAL LICHEN PLANUS IN A COHORT OF ORAL LICHEN PLANUS AFFECTED PATIENTS.

Overexpression of Nicotinamide n-Methyl- transferase in HSC-2 OSCC cell line: effect on apoptosis and cell proliferation

Frequency of young patients with oral leukoplakia (OL) and oral lichen planus (OLP) in a population of Western Sicily

Eating disorders:a threat for women's health.Oral manifestations in a comprehesive overview

Halitosis and HCV-related liver disease:true association

The patient-doctor relationship: new insights in light of the current Ministerial recommendations regarding Phase 2 of the COVID-19 pandemic

Following the publication of the italian Ministerial recommendations relating to dentistry in Phase 2 of the coViD-19 pandemic (focusing on operational protocols for all dental staff), we believe that the patient/dentist relationship should increasingly take into account the heightened fears and anxious thoughts of patients. this particularly regards patients who are about to undergo dental work. Moreover, dentists should also pay close attention to recent events, which have determined the new recommendations regarding SarS-coV-2 biocontainment. Furthermore, the authors of this paper consider it appropriate to make suggestions and develop interventionist techniques regarding the interface w…

Detenzione della Survivina nella saliva quale marker diagnostico nel carcinoma squamocellulare del cavo orale

A Teledentistry system for the second opinion

In this paper we present a Teledentistry system aimed to the Second Opinion task. It make use of a particular camera called intra-oral camera, also called dental camera, in order to perform the photo shooting and real-time video of the inner part of the mouth. The pictures acquired by the Operator with such a device are sent to the Oral Medicine Expert (OME) by means of a current File Transfer Protocol (FTP) service and the real-time video is channeled into a video streaming thanks to the VideoLan client/server (VLC) application. It is composed by a HTML5 web-pages generated by PHP and allows to perform the Second Opinion both when Operator and OME are logged and when one of them is offline.

Farmacovigilanza attiva sul ruolo dei farmaci antiangiogenetici nell’osteonecrosi dei mascellari

Farmacovigilanza attiva sul ruolo dei farmaci antiangiogenetici nell’osteonecrosi dei mascellari Ilaria Morreale1, Maria Meli1, Olga Di Fede2, Giuseppina Campisi2, Natale D’Alessandro1 1Centro di consulenza sulle reazioni avverse da farmaci in oncologia della Regione Sicilia – U.O.C. di Farmacologia Clinica e 2Gruppo P.R.O.Ma.B. (Prevenzione e Ricerca sull’Osteonecrosi dei Mascellari da Bisfosfonati) - Settore di Medicina Orale "Valerio Margiotta" - AOUP “P. Giaccone” di Palermo Obiettivi L’uso dei bisfosfonati (BP) in oncologia e anche nell’osteoporosi è stato definitivamente associato ad una complicazione relativamente rara ma grave come l’osteonecrosi dei mascellari (ONJ). La patogenesi …

Prevenzione e management odontoiatrico dei pazienti oncologici a rischio di osteonecrosi delle ossa mascellari da farmaci.

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Adverse Reactions to Anticancer Drugs in the Oral Cavity

The development, testing, and adoption into clinical practice of anticancer medications have revolutionized cancer care over the past decades. A better understanding of the biology of cancer has translated into development of novel systemic agents, as well a more effective use of older chemotherapy agents. As a consequence, cancer mortality continues to decrease. However, greater cure and disease control rates come at a price of an increased risk of adverse effects, which often affects the mouth and related structures including the oral mucosa, salivary glands, jawbones, and cranial nerves. Oral mucositis, hyposalivation, dysgeusia, and osteonecrosis of the jaw (ONJ) are some examples of th…

Proceedings of the Closed Round Table and Italian Consensus on the Medication-Related Osteonecrosis of Jaws (MRONJ) at the Symposium of Italian Society of Oral Pathology and Medicine (SIPMO) Ancona, 20 October 2018 - Part III

Candidosi orale. Fattori predisponenti sistemici e locali: Update

Adverse drug reactions in the oral cavity

Several drugs may have a number of adverse reactions (ADRs) involving the oro-facial region. The dose of the drug and the time required for the reaction to take place are relevant parameters; nonetheless, ADRs mechanisms are not always known and ADRs are not always predictable since aspects other than drug pharmacodynamics and/or pharmacokinetics, as well as various interacting variables contribute to the final outcome. All tissues and many functions of the oral cavity can be affected. In particular, salivary function is fre- quently involved and hypo-salivation is the main manifestation; several mucosal lesions with different morphology (ulcerations, vesiculo- bullous lesions, white lesion…

Salivary Biomarkers for Oral Squamous Cell Carcinoma Diagnosis and Follow-Up: Current Status and Perspectives.

Oral cancer is the sixth most common cancer type in the world, and 90% of it is represented by oral squamous cell carcinoma (OSCC). Despite progress in preventive and therapeutic strategies, delay in OSCC diagnosis remains one of the major causes of high morbidity and mortality; indeed the majority of OSCC has been lately identified in the advanced clinical stage (i.e., III or IV). Moreover, after primary treatment, recurrences and/or metastases are found in more than half of the patients (80% of cases within the first 2 years) and the 5-year survival rate is still lower than 50%, resulting in a serious issue for public health. Currently, histological investigation represents the “gold stan…

Human papillomavirus:Its identikit and controversial role in oral oncogenesis,premalignant an malignant lesions(Review)

Human papillomaviruses (HPVs) are a group of host-specific DNA viruses, with a remarkable epithelial cell specificity: they have been reported principally in the ano-genital tract, urethra, skin, larynx, tracheo-bronchial and oral mucosa. More than 100 different HPV types have been identified and classified as high (e.g. 16, 18, 31) or low (e.g. 11, 42, 36) -risk (HR and LR), based on their association with cervical carcinoma. The carcinogenic role of HR-HPV revolves mainly around two of its oncoproteins: HPV-E6 which promotes degradation of the p53 tumour suppressor gene product and HPV-E7 which modifies the pRb tumour suppressor gene product, inhibiting the activity of TGF-beta2. Since th…

Osteonecrosis of the jaw after long-term oral bisphosphonates, followed by short-term denosumab treatment for osteoporosis: a case report

Bisphosphonates and denosumab are antiresoptive agents and are mainly used for management of metastatic bone cancer, osteoporosis and other diseases. Bisphosphonates (BP) can reduce skeletal related events (SRE) by 30–50%1; denosumab (D) has been found even more effective than BP2. BP and D have been both associated to osteonecrosis of the jaw (ONJ). We report a case of an osteoporotic woman (62 yrs), complaining maxillary intense pain after a recent tooth molar extraction, observed in July 2013 at our centre. She mentioned previous treatments with monthly ibandronate (Bonviva ® 150 mg) per os (from January 2003 to April 2010), risedronate (35 mg weekly, from May 2010 to May 2012) and two a…

Impact of medications on salivary flow rate in patients with xerostomia: a retrospective study by the Xeromeds Consortium

OBJECTIVES: This study evaluates the impact of systemic medications and polypharmacy on unstimulated (UWS) and chewing-stimulated whole saliva (SWS) flow rates in patients with xerostomia.MATERIAL AND METHODS: This cross-sectional multicenter study is based on data of patients referred to five oral medicine outpatient practices in Europe and USA from January 2000 and April 2014. Relevant demographic, social, medical history and current medications were collected.RESULTS: The study included 1144 patients, 972 (85%) females, with a mean (SD) age of 59 (14.1) years. In unmatched patients, the UWS flow rate was lower in patients taking a medication (vs. not taking a medication) from the followi…

Amiloidosi AL e mieloma multiplo:un raro caso di primaria manifestazione a livello della cavità orale e periorale

Mucosal healing following PRP (Platelet-Rich Plasma) application in post-extraction socket in patients treated with aminobisphosphonates

Lesioni gengivali desquamative-revisione della letteratura

PRIMARY ORAL MUCOSA MELANOMA: A REPORT OF AN UNUSUAL CLINICOPATHOLOGICAL CASE

Primary oral melanoma is a rare malignancy with an aggressive behaviour. Up to date, the wide clinicalhistological variability of this oncological entity does not clarify the etiopathogenetic characteristics of these cancers and limit the therapeutic strategies. We report a case of a 64-year-old white female referred to the Dept. of Surgical, Oncological and Oral Sciences for a pigmented lesion of the mandibular gingiva, already arising 20 years ago but dimensionally increased in the last three months. Clinically, a black plaque-like pigmentation of the vestibular alveolar mucosa of the mandible (from 3.6 to 3.3) was observed. This lesions was still painless. CT dentalscan and ecography of …

Protocol of BRONJ prevention: successful use of antiseptics during oral surgical procedures

Aim: The overall prevention and treatment of Bisphosphonates related osteonecrosis of the jaws (BRONJ) have been the goals of our project structured (labelled PROMaB) within the hospital AOUP “P. Giaccone” (Italy) in order to make better quality life of patients in therapy with amminobisphosphonates (NBP). Material and Methods: Among all procedures, in case of preprogrammed oral surgical procedure, oral antimicrobial rinses (i.e. chlorexidine 0,2% mouthwash and 0,5% gel, three times/day) plus oral systemic antibiotic therapy –e.g. amoxicilin/clavulanate- have been used to reduce the risk of BRONJ in secondary prevention (1 day before and 6 days after). Three hundred and twenty-one patients …

L'infezione da papilloma virus umano (HPV) in medicina orale

Oral manifestations in patients with gastro-oesophageal reflux disease: a single-center case-control study

OBJECTIVE: To assess the occurrence of oral pathological changes and symptoms in patients affected by gastro-oesophageal reflux disease (GERD). PATIENTS AND METHODS: 200 patients with GERD and 100 matched healthy controls were studied. Thorough visual examination of the dental and oral mucosal tissues was performed and medical history relevant to oral symptoms was collected. The primary outcome was defined as a statistically significant difference, between the study group and controls, in the presence of the following indicators: soft/hard palate and uvula erythema, tooth wear, xerostomia, oral acid/burning sensation, subjective halitosis and dental sensitivity. Statistical analysis include…

ORAL MANIFESTATIONS IN GASTROESOPHAGEAL REFLUX DISEASE

The gastroesophageal reflux (passage of gastric contents into the oesophagus and the mouth) is the main sign/symptom of a very frequent gastroesophageal reflux disease. Thus, acid regurgitation originates from stomach and it is responsible of the onset of tipical symptoms and mucosal injury. Also in oral cavity the noxious acid agent is able to injure oral cavity (soft and hard tissues). These involvementes are described from international literature, even if a greater interest has shown to date only for hard tissue injury.

The Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ): A Systematic Review with a Pooled Analysis of Only Surgery versus Combined Protocols

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents, and it is also a potentially painful and debilitating condition. To date, no specific studies have prospectively evaluated the efficacy of its treatment and no robust standard of care has been established. Therefore, a systematic review (2007–2020) with a pooled analysis was performed in order to compare MRONJ surgical techniques (conservative or aggressive) versus combined surgical procedures (surgery plus a non-invasive procedure), where 1137 patients were included in the pooled analysis. A statistically significant difference in the 6-month improvement rate, comp…

Findings of osteonecrosis of the jaw under combined bisphosphonate and antiangiogenic therapies: an emergent problem?

Low Frequency of Human Papillomavirus in Strictly Site-Coded Oral Squamous Cell Carcinomas, Using the Latest NHI/SEER-ICD Systems: A Pilot Observational Study and Critical Review.

Simple Summary The incidence of oropharyngeal squamous cell carcinomas (OPSCCs) has increased in the last decades, and this seems to be correlated to the infectious epidemiological trend of human papillomavirus (HPV). The prevalence of HPV-positive OPSCCs is approximately 70%, with involvement mainly of the tonsillar area. On the role of HPV in oral squamous cell carcinoma (OSCC), very few studies have investigated the prevalence of HPV in strictly site-codified OSCC, excluding the base of the tongue as distinct oropharyngeal entity. As a result, an inappropriate estimation of HPV infection in OSCC has been observed. We investigated HPV status, using a combination of detection methods, in a…

Nuove prospettive nel Managment dei pazienti con osteonecrosi dei mascellari da bifosfonati

Association of oral lichen planus with thyroid disease in a Finnish population: A retrospective case-control study: "A different finding from a Mediterranean area".

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ALITOSI - UPDATE IN TEMA DI EZIOLOGIA E CLINICA

Chronic inflammation and immune activation in vesciculobullous disease could be a trigger factor for oral cancer? A case report

Lesioni gengivali desquamative

RE: MEDICATION-RELATED OSTEONECROSIS OF THE JAW (MRONJ)

Oral candidosis: role of predisposing factors by Fuzzy Logic

Evidence of field cancerization of oral squamous cell carcinoma: a case report

Objectives. From 1953 (1) the term “field cancerization” has been used to describe an “increased risk of cancer de- velopment in the entire upper aerodigestive tract due to multiple genetic abnormalities in the whole region after pro- longed exposure to carcinogen” (2). This phenomenon implies the occurrence of multiple primary tumors/potentially malignant disorders as results of cell-molecular aberrations in different independent sites (polyclonal theory) or from the same site through widespread expansion or later spread across the mucosa (monoclonal theory). Case report. A 63-year-old female patient referred in June of 2014 for exophytic/ulcerative lesion in the hard palate. At the same t…

UPDATE SULLA CANDIDOSI ORALE

Proceedings of the Closed Round Table and Italian Consensus on the Medication-Related Osteonecrosis of Jaws (MRONJ) at the Symposium of Italian Society of Oral Pathology and Medicine (SIPMO) Ancona, 20 October 2018 - Part I.

On 20 October 2018 a Closed Round Table brought together a wide range of stakeholders from several medical disciplines, including academic experts, dentists, oncologists, maxillo-facial surgeons, oral surgeons, radiologists, under the technical and scientific coordination of Giuseppina Campisi (for SIPMO) and Giacomo Oteri (for Italian Society of Oral Surgery- SIdCO).

Description of a new protocol with application of PRP in post-extraction sockets of a patient treated with aminobisphosphonate

Background. Platelet-rich plasma (PRP), an autologous product rich of growth factors, is an adjunctive bio-material able to promote healing in dental surgery, especially in elderly. It is also used for treating bisphosphonate-related osteonecrosis of the jaw (BRONJ) and for application in post-extraction alveolar site in order to obtain mucosa healing and reduce BRONJ risk. Aim. To describe a dental extraction PRP enriched protocol adopted in a patient treated with aminobisphosphonate in order to evaluate the healing of the post-extraction alveolar site. Case report. An osteoporotic woman (71 yrs), treated with alendronate per os for 10 years and suspended from 1 year, currently with vitami…

In vivo optical coherence tomography imaging in a case of mucous membrane pemphigoid and a negative Nikolsky's sign.

There is currently a growing interest in new diagnostic tools of the oral cavity and mucosa which are non-invasive, repeatable and reliable. A diagnosis of a suspected, autoimmune pathology was made regarding a 57-year-old patient with desquamative gingivitis. However, a negative Nikolsky's sign did not seem to indicate a diagnosis of mucous membrane pemphigoid neither was there any indication as to the optimum location for an incisional biopsy. As an imaging method, the use of optical coherence tomography (OCT) has enabled the obtaining of tomographic (cross-sectional) scans of tissue. Such images are acquired prior to and after verifying Nikolsky's sign, thereby enabling the clinician to …

Hypoxia inducible factor-1 alpha expression is increased in infected positive HPV16 DNA oral squamous cell carcinoma and positively associated with HPV16 E7 oncoprotein.

Abstract Background There is increasing evidence for the role of High Risk (HR) Human PapillomaVirus (HPV) in the pathogenesis of Oral Squamous Cell Carcinoma (OSCC). The E6 and E7 oncogenes from HR HPVs are responsible for the deregulation of p53 and pRB proteins involved in cell cycle and apoptotic pathways. In cell lines experiments, the HPV E7 protein seems to be able to enhance Hypoxia Inducible Factor-1 alpha (HIF-1α) activity, normally involved in the response to hypoxia and able to enhance angiogenesis. Results We studied tumor specimens from 62 OSCC; a higher prevalence of tumors in TNM stage II and also in pT2 class between OSCC infected positive HPV16 DNA than non-infected ones w…

Could the Combined Administration of Bone Antiresorptive Drug, Taxanes, and Corticosteroids Worsen Medication Related Osteonecrosis of the Jaws in Cancer Patients?

The study presents a report of 58 metastatic cancer patients who developed osteonecrosis of the jaws after being treated with zoledronic acid and taxanes, plus corticosteroids. A retrospective analysis of data registered in the archives of two Italian osteonecrosis of the jaws treatment centers, who are based at the University of Messina and at the University of Palermo, was performed in order to study, in these patients, demographic data and characteristics such as frequency of cancer location, lines of therapy, frequency of cancer drugs, presence/absence of oral trigger, number, location, and stage of jaw osteonecrosis. It was found that the majority of patients developed advanced stages …

Application of Ozone Therapy in the Conservative Surgical Treatment of Osteonecrosis of the Jaw: Preliminary Results

The main goals of the management of osteonecrosis of the jaw (ONJ) are to slow the progressionof the disease and, when it is achievable, to remove all the necrotic bone promoting the tissues’healing [...]

OralChroma vs Halimeter.Accuratezza diagnostica a confronto:studio pilota

Protection of Patient Data in Digital Oral and General Health Care: A Scoping Review with Respect to the Current Regulations

The use of digital health technologies, including telemedicine and teledentistry, has become a necessity in healthcare due to the SARS-CoV-19 pandemic. These technologies allow for the reduction of the workload of healthcare providers and the improvement of patient outcomes in cases of remote monitoring, diagnosis, and communication. While there are no doubtful benefits, there are some counterparts, such as concerns about clinical risks, data security, and privacy protection. This paper aims to review the regulations regarding the use of digital health apps and software in healthcare. This scoping review followed the PRISMA-ScR guidelines and the five-step framework of Arksey and O’Malley. …

Human papillomavirus: Its identikit and controversial role in oral oncogenesis, premalignant and malignant lesions (Review)

Human papillomaviruses (HPVs) are a group of host-specific DNA viruses, with a remarkable epithelial cell specificity: they have been reported principally in the ano-genital tract, urethra, skin, larynx, tracheo-bronchial and oral mucosa. More than 100 different HPV types have been identified and classified as high (e.g. 16, 18, 31) or low (e.g. 11, 42, 36) -risk (HR and LR), based on their association with cervical carcinoma. The carcinogenic role of HR-HPV revolves mainly around two of its oncoproteins: HPV-E6 which promotes degradation of the p53 tumour suppressor gene product and HPV-E7 which modifies the pRb tumour suppressor gene product, inhibiting the activity of TGF-beta2. Since th…

The combination of laser-assisted surgery with PRP for the treatment of BRONJ in cancer patient. A pilot study

Aim. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a well-known potential complication of bisphosphonates (BPs) therapy and its treatment could reckon on different approaches. Recently, encouraging results for BRONJ were showed from some clinical studies using Er, Cr: YSGG laser-assisted surgery. Platelet-Rich Plasma (PRP), a new approach to promote tissue regeneration and healing, may be a promising complementary therapy. The aim of this pilot study is to study the effectiveness, in terms of clinical healing, of a combined treatment (laserassisted surgery and topical PRP) for BRONJ in a group of cancer patients. Methods. Ten oncological patients (3 males, 7 females; aged 69-89…

The preventive care of medication-related osteonecrosis of the jaw (MRONJ): a position paper by Italian experts for dental hygienists

Abstract Purpose The prevention and early diagnosis of medication-related osteonecrosis of the jaw (MRONJ) is fundamental to reducing the incidence and progression of MRONJ. Many in the field believe that dental hygienists should play an integral role in primary and secondary MRONJ prevention. However, to date, very few publications in the literature have proposed standardised MRONJ protocols, which are dedicated to dental hygienists. The aim of this study was to provide guidance to the health care providers managing MRONJ. Methods The expert opinion in this study was developed by dental hygienists from the main Italian technical-scientific associations (Italian Dental Hygienists Associatio…

GENGIVITE DESQUAMATIVA.IGIENISTA DENTALE E PROTOCOLLO DI IGIENE ORALE DOMICILIARE AD HOC

HPV INFECTION AND MARKERS OF PROLIFERATION AND APOPTOSIS IN ORAL LEUKOPLAKIA: ANALYSIS BY CONVENTIONAL STATISTICAL ANALYSIS AND FUZZY LOGIC MODELING

ALITOSI ed EPATOPATIE: vera associazione o luogo comune? Studio pilota

What happens to the BRONJ patients when re-classified according to the novel SICMF-SIPMO recommendations? Our experience

Background. Since 2009, according to the American Association of Oral and Maxillofacial Surgeons staging system (AAOMS-SS), Bisphosphonate Related Osteonecrosis of the Jaw (BRONJ) has been defined by the presence of bone exposition; in absence of this condition, patients presenting other unspecific clinical and/or radiological signs of disease were classified into the “stage 0”. In 2012, the Italian Society of Maxillo-Facial Surgery (SICMF) and the Italian Society of Oral Pathology and Medicine (SIPMO) redefined BRONJ, as an adverse drug event, with several clinical forms (exposed and not-exposed), and updated the staging system, abolishing the stage 0. Aim of this study was to re-classify …

USE OF FUZZY NEURAL NETWORKS IN MODELING RELATIONSHIPS OF HPV INFECTION WITH APOPTOTIC AND PROLIFERATION MARKERS IN POTENTIALLY MALIGNANT ORAL LESIONS

To evaluate in oral leukoplakia the relationship between HPV infection and markers of apoptosis (bcl-2, survivin) and proliferation (PCNA), also conditionally to age, gender, smoking and drinking habits of patients, by means of Fuzzy neural networks (FNN) system 21 cases of oral leukopakia, clinically and histologically diagnosed, were examined for HPV DNA presence, bcl-2, survivin and PCNA expression. HPV DNA was investigated in exfoliated oral mucosa cells by nested PCR (nPCR: MY09-MY11/GP5-GP6), and the HPV genotype determined by direct DNA sequencing. All markers were investigated by means of standardised immunohistochemistry procedure. Data were analysed by chi-square test, crude OR an…

Fuzzy neural networks to evacuate expression of cell cycle markers in OSCC HPV-positive.

Disfagia in medicina orale

Lesioni oro-dentali in corso di GERD

GERD patients: a risk group for xerostomia and oral lesions? A case-control syudy

Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020

The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). The present paper reports the update of the conclusions from the Consensus Conference—held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)—after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SI…

Osteonecrosis of the jaw after adjuvant endocrine therapy plus alendronate in a breast cancer patient

Background. Bisphosphonates-associated osteonecrosis of the jaws (BRONJ) is a serious complication, which has been defined by Bedogni et al. (1) as an adverse drug reaction consisting of progressive destruction and death of bone that affects the mandible and/or maxilla of patients exposed to the treatment with nitrogen-containing bisphosphonates (NBPs) in absence of a previous radiation treatment. Generally, IV NBPs have a strong association with BRONJ than oral NBPs as evidenced by the higher incidence of BRONJ (0-10%) in patients treated with IV drugs than in patients in oral therapy (<1%). Objectives. The aim of this study was to report a clinical case of BRONJ in an oncologic patient wh…

CBCT in the diagnosis of osteonecrosis of the jaws

Short Summary: ONJ is associated with bisphosphonates, and recently with antiangiogenic drugs. Another cause is radiotherapy. Few papers have previously investigated the value of CBCT in the diagnosis of ONJ. Purpose/Objectives: To describe the CBCT findings in the diagnosis of osteonecrosis of the jaws (ONJ) according to a new staging system of ONJ. Methods and Materials: 9 patients (5 women, 4 men, 54-76 yrs.) affected by ONJ were studied with a CBCT device (90 kV, 12.5 mA, 0.25 mm voxel size) in 2012-2013. 7/9 patients were treated with bisphosphonates (5 for bone metastasis, 2 for osteoporosis), 1/9 patient was treated with an antiangiogenic drug, 1/9 patient received radiotherapy. Pati…

Unexpected high frequency of genital involvement in women with clinical and hostological features of oral lichen planus

The main aims of this cross-sectional study were: (i) to assess the frequency of genital (vulval) lichen planus (VLP) and vulval lichen sclerosus (VLS) in women affected with oral lichen planus (OLP), regardless of the genital symptoms reported; and (ii) to verify whether any demographic, clinical, or histological features of OLP are associated with a higher risk of vulvo-vaginal involvement. Fifty-five women, presenting OLP, consecutively underwent gynaecological examination and, if they demonstrated positive clinical signs of VLP, underwent biopsy. After a drop-out of 14 subjects, 31/41 (75.6%) were found to have signs of genital involvement, of which 13/31 (44.0%) were asymptomatic. Foll…

Osteoporosi e Bifosfonati per os:nuova emergenza per l'Odontoiatra

Saliva:its value as biological matrix and current methods of sampling

Lichen Planus Vulvare - Uno studio su popolazione selezionata

Early onset ONJ in patient treated with denosumab and bevacizumab: case report

Umanizzazione delle cure in odontostomatologia. Una tendenza emergente

OBIETTIVI Scopo del presente lavoro è fornire agli specialisti della salute orale la descrizione delle caratteristiche del colloquio narrativo, inteso come differente dalla tradizionale anamnesi e in grado di rilevare l’universo del paziente, alla base del processo di umaniz-zazione delle cure in odontostomatologia, e illustrare un modello di umanizzazione di cure odontoiatriche. METODI Nell’articolo vengono descritti i punti chiave del processo di umanizzazione delle cure e come tale pratica sia stata integrata nella U.O. di Medicina Orale, A.O.U. P. Giaccone di Palermo per l’approccio al paziente fragile. La comunità scientifica ha già messo in discussione il tradizionale approccio medico…

Altosi ed Epatopatie: vera associazione o luogo comune?Studio pilota

L'infezione da papillomavirus in Medicina Orale

Epidemiology, clinical manifestations, risk-reduction and treatment strategies of jaw osteonecrosis in cancer patients exposed to antiresorptive agents

Osteonecrosis of the jaws (ONJ) is an adverse side event of bisphosphonates and denosumab, antiresorptive agents that effectively reduce the incidence of skeletal-related events in patients with metastatic bone cancer and multiple myeloma. Available data suggest that 0–27.5% of individuals exposed to antiresorptive agents can develop ONJ. There is increasing evidence that avoidance of surgical trauma and infection to the jawbones can minimize the risk of ONJ, but there are still a significant number of individuals who develop ONJ in the absence of these risk factors. Bone necrosis is almost irreversible and there is no definitive cure for ONJ with the exclusion, in certain cases, of surgica…

COULD SALIVA CHANGES PLAY A CASUAL ROLE IN GERD?A CASE CONTROL STUDY.

Manifestazioni orali da reflusso gastroesofageo-Cross sectional survey in progress

Salivary Microbiota Composition in Patients with Oral Squamous Cell Carcinoma: A Systematic Review.

Background: Oral squamous cell carcinoma (OSCC) is one of the most prevalent cancers worldwide. Despite recent advances in diagnosis and treatment, in recent years, an increase in the incidence of OSCC has been registered, and the mortality rate is still high. This systematic review aims to identify a potential association between the composition of salivary microbiota and OSCC. Materials and Methods: The protocol for this study was designed following the PRISMA guidelines. Records were identified using different search engines (e.g., Medline/PubMed). Observational studies, in human subjects with histological diagnosis of OSCC, concerning the analysis of salivary microbiota, were selected. …

Appropriateness in Dentistry: A Survey Discovers Improper Procedures in Oral Medicine and Surgery

Objectives. The aim of this study was to assess appropriateness of diagnostic exams, treatments, and procedures among Italian dental practitioners.Materials and Methods. A questionnaire with multiple responses on topics of dentistry and oral medicine was administered to a sample of 198 Italian dental practitioners. Information on characteristics of the respondents was also collected. Descriptive statistics and multiple correspondence analysis (MCA) were applied. Data were analyzed using R software (version 3.3.2).Results. The survey respondents included Doctors of Medicine (MD) (54/198 = 27%) with or without specialty in dentistry (33% versus 67%), Doctors of Dental Surgery (DDS) (144/198 =…

High prevalence of vulvar liche planus in a cohort of oral liche planus affected patients

Follow-up of non-exposed ONJ related to bisphosphonate: a two-year study

Aim. Osteonecrosis of the jaw (ONJ) is a serious sideeffect of amine bisphosphonate (NBP) and/or other antiresorptive agents frequently used in the management of osteometabolic and cancer-related condition. The traditional ONJ definition exclude patients who present the non-exposed variant. However, according to recent data, staging and monitoring of ONJ should be closely linked to clinical and radiological manifestation regardless of the presence of bone exposed. The aim of this study was a descriptive analysis of a case series of patients with non-exposed ONJ (exclusively related to NBP) monitoring for two years. Methods. From 2012 to 2014, 16 patient [7 oncological (F/M=3/4; mean age=66,…

La gestione delle ulcere orali persistenti

Oral lesions as primary manifestations of acute agranulocytosis related to metamizole: a case report

Mucocutaneous Leishmaniasis Mimicking Squamous Cell Carcinoma

Leishmaniasis is a parasitic infectious disease caused by protozoan species belonging to the [...]

Oral and genital lesions in women affected by lichen planus association or coincidence ?

Site-Coded Oral Squamous Cell Carcinoma Evaluation by Optical Coherence Tomography (OCT): A Descriptive Pilot Study

Optical Coherence Tomography (OCT) is an emerging non-invasive method for oral diagnostics, proving to be a practicable device for epithelial and subepithelial evaluation. The potential validity of OCT in oral cancer assessment has been explored but, to date, there are very few investigations conducted with a systematic comparison between clinical/histological and OCT parameters, especially in strict reference to the anatomical site-codification of the oral mucosa. In this regard, our study performed a two-steps evaluation (in vivo OCT and histological investigations) of suspected OSCCs, progressively recruited, using as references the OCT images of the same site-coded healthy mucosa, to pr…

Unexpected high prevalence of vulvar involvement in Oral Lichen Planus (OLP) females

Use of Optical Coherence Tomography in Patients with Desquamative Gingivitis: A Case Series

A Cemento-ossifying fibroma of the mandible in an 18 years old female patient: a case report

Second Opinion System for Intraoral Lesions

In this paper we present the prototype of a teledentistry system to perform the remote diagnosis of oral diseases. It makes use of a particular device called intra-oral (or dental) camera properly designed to shoot video and take pictures of the inner part of the mouth. The intra-oral cameras can be connected via USB to a common PC and they are very cheap, unlike the intra-oral photography kit for DSLR cameras. Usually this kind of devices are used in dentistry studies for local visualization by means of specialized software. The novelty of our system is that the real-time video produced by this device is canalized into a video streming by means of Video LAN client server (VLC) and pictures…

Spontaneous healing of osteonecrosis of the jaw after interruption of target therapy in a patient with lung cancer

Osteonecrosi dei mascellari associata a bisfosfonati,denosumab e farmaci anti-angiogenetici nei pazienti oncologici e osteoporotici: prevenzione dentale e sicurezza dei trattamenti odontoiatrici

Obiettivi. Proporre protocolli di gestione odontoiatrica per il paziente che assume o che assumerà farmaci (per esempio bisfosfonati, denosumab e anti-angiogenetici) correlati all’insorgenza di osteonecrosi dei mascellari (OsteoNecrosis of the Jaws, ONJ). Materiali e metodi. Gli autori del lavoro, recentemente estensori e collaboratori – su mandato della Società Italiana di Chirurgia Maxillo-Facciale (SICMF) e della Società Italiana di Patologia e Medicina Orale (SIPMO), delle Raccomandazioni clinicoterapeutiche sull’osteonecrosi delle ossa mascellari associata a bisfosfonati e sua prevenzione – hanno esaminato le informazioni in rapporto con le procedure odontoiatriche. Risultati e conclus…

Nonexposed Variant of Bisphosphonate-associated Osteonecrosis of the Jaw: A Case Series

Abstract Purpose To report a case series of patients with the nonexposed variant of bisphosphonate-associated osteonecrosis of the jaw—a form of jaw osteonecrosis that does not manifest with necrotic bone exposure/mucosal fenestration. Methods Among 332 individuals referred to 5 clinical centers in Europe because of development of jawbone abnormalities after or during exposure to bisphosphonates, we identified a total of 96 patients who presented with the nonexposed variant of osteonecrosis. Relevant data were obtained via clinical notes; radiological investigations; patients' history, and referral letters. Results The most common clinical feature of nonexposed osteonecrosis was jaw bone pa…

Contemporary diagnosis of mucoepidermoid carcinoma of the hard palate and intracranial cavernous angioma: a case report of a young adult

Gengivite desquamativa:primo segno clinico di malattie mucocutanee a patogenesi immune

RARO CASO DI ORAL HAIRY LEUKOPLAKIA (OHL) IN SOGGETTO IMMUNOCOMPETENTE, IN ASSENZA DI RIATTIVAZIONE SIEROLOGICA DI EBV.

Strategie preventive e management odontoiatrico nel paziente a rischio di osteonecrosi delle ossa mascellari associata a farmaco

Osteonecrosis of the jaw (ONJ) drug related is an uncommon but serious and debilitating disease, whose epidemiology and pathogenesis are still unclear. However, in the recent years, knowledge regarding ONJ risk factors has lead to substantial progress in ONJ prevention. Anti-resorptive medicines (e.g. bisphosphonates, denosumab) and anti-angiogenic medicines (e.g bevacizumab, sunitinib) are being used in the treatment of various cancers and in the treatment of several non-oncological conditions, mainly for the osteoporosis. Despite the higher frequencies of ONJ cases in cancer patients, ONJ is becoming more frequent in everyday practice in osteometabolic patients. This due to the higher num…

DIAGNOSI DI INFEZIONE DA HPV IN MEDICINA ORALE:METODOLOGIA DI CAMPIONAMENTO E INDAGINE

Bilateral palatal swelling as frst sign of recurrence of a mantle cell lymphoma: a case report

Stress psico-fisico e malattie del cavo orale

Proceedings of the Closed Round Table and Italian Consensus on the Medication-Related Osteonecrosis of Jaws (MRONJ) at the Symposium of Italian Society of Oral Pathology and Medicine (SIPMO) Ancona, 20 October 2018 - Part II

On 20 October 2018 a Closed Round Table brought together a wide range of stakeholders from several medical disciplines, including academic experts, dentists, oncologists, maxillo-facial surgeons, oral surgeons, radiologists, under the technical and scientific coordination of Giuseppina Campisi (for SIPMO) and Giacomo Oteri (for Italian Society of Oral Surgery- SIdCO)

Oral manifestations in patients with gastro-oesophageal reflux disease: a single-center-case-control study

A case of osteonecrosis of the jaws in epidermolysis bullosa patient treated with rituximab.

We report a case of a patient with EBA, who developed ONJ after Rituximab treatment.

Osteonecrosis of the Jaw in Patients With Metastatic Renal Cell Cancer Treated With Bisphosphonates and Targeted Agents: Results of an Italian Multicenter Study and Review of the Literature.

Osteonecrosis of the jaw (ONJ) associated with the use of bisphosphonates has been rarely reported in metastatic renal cell cancer (RCC) patients. Since the introduction of combined therapies consisting of nitrogen-containing bisphosphonates (NBPs) and targeted agents, an increasing number of RCC patients were reported to develop ONJ, suggesting that therapeutic angiogenesis suppression might increase the risk of ONJ in NBPs users. We performed a multicenter retrospective study and reviewed literature data to assess the occurrence and to investigate the nature of ONJ in RCC patients taking NBPs and targeted agents. Nine Italian Centers contributed to the data collection. Patients with expos…

Platelet-Rich Plasma (PRP) in Dental Extraction of Patients at Risk of Bisphosphonate-Related Osteonecrosis of the Jaws: A Two-Year Longitudinal Study

: Dental extraction has often been described as the main trigger event of osteonecrosis of the jaws (ONJ). This longitudinal hospital-based study aimed to evaluate the outcome at 2 years of a standardized medical-surgical protocol for dental extraction, combined with platelet rich-plasma (PRP) application, compared with conventional protocol not combined with PRP or any other autologous platelet concentrate in cancer (ONC) and osteometabolic (OST) patients, at risk of bisphosphonate (BP)-related ONJ. Twenty patients were consecutively recruited: six received BPs for cancer skeletal-related events (34.17 &plusmn

Patologie orali in seguito a trapianto di midollo osseo. GRAFT VERSUS HOST DISEASE (GVHD)

The dental management of patients at risk of medication-related osteonecrosis of the jaw: New paradigm of primary prevention

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents; it is a potentially painful and debilitating condition that can considerably affect the quality of life of patients. Furthermore, even if its epidemiology and pathogenesis have still not been fully clarified, several risk factors related to MRONJ have been recognized in prevention protocols. Three main risk factors are as follows: (i) the type of ONJ-related medications: antiresorptive (e.g., Bisphosphonates, Denosumab) and antiangiogenic drugs (e.g., Bevacizumab, Sunitinib); (ii) the category of patient at MRONJ risk: cancer versus non-cancer patient; (iii) the typ…

Painful oral aphthous-like lesions in patient with kidney cancer after target therapy and bisphosphonate administration: a case report of adverse drug reaction.

Aim. Tyrosine kinase inhibitors (TKIs) targeting tu- mor angiogenesis and mammalian target of rapamycin inhibitors (mTOR) are indicated for the management of several cancer types, as for renal cell carcinoma (RCC). Oral ulcerations are reported as common adverse drug reactions of mTOR inhibitors and are currently classified as mTOR inhibitor associated stomatitis (mIAS). Interestingly, these lesions appear as aphthous-like stoma- titis rather than the mucositis seen with chemotherapy agent. Case report. A 49 years old male patient underwent to the left radical nephrectomy in May 2014 for clear RCC. From July to October 2014 he was treated with Pazopanib, a tyrosine kinase inhibitor. In Dece…

Osteoporosis, jawbones and periodontal disease

The association between osteoporosis and jawbones remains an argument of debate. Both osteoporosis and periodontal diseases are bone resorptive diseases; it has been hypothesized that osteoporosis could be a risk factor for the progression of periodontal disease and vice versa. Hypothetical models linking the two conditions exist: in particular, it is supposed that the osteoporosis-related bone mass density reduction may accelerate alveolar bone resorption caused by periodontitis, resulting in a facilitated periodontal bacteria invasion. Invading bacteria, in turn, may alter the normal homeostasis of bone tissue, increasing osteoclastic activity and reducing local and systemic bone density …

Dental Erosions and Halitosis as Oral Manifestations of GERD

Osteonecrosis of the jaws in patients assuming oral bisphosphonates for osteoporosis: A retrospective multi-hospital-based study of 87 Italian cases

Abstract Background Bisphosphonates (BPs) are currently the chief drugs for the prevention/treatment of osteoporosis; one of their adverse effects is the osteonecrosis of the jaw (BRONJ). The primary endpoints of this multi-center cross-sectional study are: i) an observation of the clinical features of BRONJ in 87 osteoporotic, non-cancer patients; and ii) an evaluation of their demographic variables and comorbidities. Methods 87 BRONJ patients in therapy for osteoporosis with BPs from 8 participating clinical Italian centers were consecutively identified and studied. After BRONJ diagnosis and staging, comorbidities and data relating to local and drug-related risk factors for BRONJ were col…

The Humanization of Health Care: In-Depth Knowledge Regarding the Ethics of Dental Care in Oncological Patients

This chapter provides an illuminating insight into the processes of the humanization of care in order to increase specialist knowledge regarding the nature of the doctor-patient relationship. It will deal with the notion of care and its various aspects, including the existential dimension of the process of caregiving by means of a narrative (storytelling) interview. After a brief analysis of the changes which have affected medical science in past centuries, the focus of the paper will be directed to the remarkable transformation which clinical practice has undergone, by virtue of which the concept of the taking care of the patient has gained increasing attention. Thus, care can be provided …

Optical coherence tomography in oral medicine: preliminary in vivo study

To introduce an OCT (Optical Coherence Tomography) in vivo database of oral diseases, by means of the VivoSight! OCT (Michelson diagnosis) scanner.

Histological findings of osteonecrosis spotted prior to tooth extractions. Should we consider tooth extraction still the main trigger event?

Osteonecrosis of the jaw (ONJ) is an adverse drug reaction described as the progressive destruction and death of bone that affects the mandible and maxilla of patients exposed to the treatment with medications known to increase the risk of disease, in the absence of a previous radiation treatment. Tooth extraction often precedes the manifestation of ONJ; indeed, it is sometimes called trigger event and it have also been considered as risk factors for the onset of ONJ. As a consequence, some of the guidelines recommend avoiding tooth extractions in patients at risk of ONJ; however, a growing body of evidence indicates that dental/periodontal infection prior to extraction, rather than dental …

Doctoral: A smartphone-based decision support tool for the early detection of oral potentially malignant disorders

Oral potentially malignant disorders can be defined as mucosal lesions and conditions with an increased risk of malignant transformation. Oral potentially malignant disorders are a significant health burden, and they are often diagnosed late due to scant attention to routine dental practice and the low number of specialized oral medicine centres. This report summarizes the DoctOral experience, a research initiative, providing a free smartphone-based decision support tool for the general medical/dental practitioner; the tool is based on the clinical appearance of oral lesions. Captured, oral pictures can be immediately examined via interactive decision trees and constructed on the smartphon…

Prevenzione primaria, counselling anti-fumo, comunicazione odontoiatra-paziente

Il carcinoma a cellule squamose, la più frequente neoplasia maligna del cavo orale, è gravato da un elevato tasso di mortalità, spesso correlato a ritardo diagnostico, e da un forte impatto sulla qualità della vita nei pazienti che ne sono affetti. Si tratta di una malattia con fattori di rischio noti, prevenibile e facilmente diagnosticabile, nei confronti della quale, tuttavia, non sono messe in atto misure preventive appropriate sia di prevenzione primaria (controllo dei fattori di rischio) che di prevenzione secondaria (diagnosi precoce). L’incidenza di tale neoplasia, infatti, è aumentata negli ultimi decenni; parimenti, non sono stati rilevati significativi miglioramenti nei tassi di …

Topical therapies for oral lichen planus management and their efficacy: a narrative review.

Oral Lichen Planus (OLP) is a chronic inflammatory condition implicating T cell-mediated cytotoxicity, and involving oral mucosal surfaces. Several therapeutic regimens have been evaluated to treat OLP and pain related, but often without high level of evidence. Topical formulations are the favourite for the majority of cases; bioadhesive formulations have been considered very useful and practical for local drug delivery in oral mucosa, due to the increased residence time on the oral mucosa of the dosage forms and better therapeutic efficacy. In this narrative review, authors try to illustrate the current topical managements for OLP from the accessible literature on this topic. Steroids are …

L-PRF application in extraction sockets of bisphosphonate-treated patients: preliminary results

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a severe adverse event related to bisphosphonates (BPs) therapy; tooth extraction has been described as the main trigger. Autologous platelet concentrates, such Leukocyte-Platelet Rich Fibrin (L-PRF, Intraspin !) are designed to release platelet growth factors, improving the tissue healing in oral surgery. The aim of this study was to evaluate the efficacy and safety of our dental extraction protocol applied in BPs patients.

Oral squamous cell carcinoma mimicking osteonecrosis of the jaw: a case report

Osteonecrosis of the jaw (ONJ) is a well-known adverse drug reaction to bisphosphonate (BP) treatment. ONJ diagnosis is usually based on the patient’s medical/medication histories and on the clinical/radiological features of necrotic bone (frequently exposed). Furthermore, in case of mandibular involvement, patients may present pain and/or hypesthesia of the inferior alveolar nerve. There are no pathognomonic clinical and radiological signs of ONJ, and in doubtful cases, the histologic examination is recommended. We report a case of a woman attending to our sector of Oral Medicine (AOUP “P. Giaccone” Palermo, Italy) with a mandibular bone exposure after implants loss and a medical history o…

Development of OloHealth, a teledentistry program for the enhancement of oral health in Sicilian policemen: preliminary reports

Mucoadhesive polymers for oral transmucosal drug delivery: a review.

The oral mucosa offers an interesting site for the application of dosage forms that release drugs within/throughout the oral mucosa, by assuring a high drug bioavailability for topic and systemic effects. However, the relative permeability of the oral mucosa and the washing effect related to the oral fluids and mechanical stresses must be considered in the formulation of oral dosage forms. Since a sustained drug release can be guaranteed only if dosage forms remain in contact with the oral site of absorption/application for a prolonged time, the development of mucoadhesive dosage forms is mandatory. The mucoadhesion is a complex phenomenon and the mucoadhesive bond consists of two different…

Il dolore muscolare nelle disfunzioni temporo-mandibolari durante l'attività sportiva

Immune-Mediated Desquamative Gingivitis and Optical Coherence Tomography Diagnostic Patterns: Clinical Implication from a Systematic Review

Desquamative Gingivitis (DG) comprises heterogeneous clinical manifestations of numerous immune-mediated muco-cutaneous diseases. Optical Coherence Tomography (OCT) has been proposed as a valuable diagnostic support even if, to date, there are no standardized OCT-diagnostic patterns applicable to DGs. A systematic review was performed to detect existing data on in vivo OCT diagnostic patterns of the most common immune-mediated DGs (i.e., pemphigus vulgaris, mucous membrane pemphigoid and oral lichen planus). It has been found that OCT exhibits specific patterns that address the diagnosis of DG by pemphigus vulgaris (i.e., intraepithelial unilocular blister, reduced epithelial thickness, pre…

FUZZY NEURAL NETWORKS TO EVALUATE EXPRESSION OF CELL CYCLE MARKERS I OSCC HPV-POSITIVE

Mandibular brown tumor as the first manifestation of primary hyperparathyroidism: a case report

Halitosis: could it be more than mere bad breath?

Halitosis is a generic term used to describe unpleasant odor emanating from the mouth air and breath, independent of the source where the odor substances originate. It affects between 50 and 65% of the population, but despite its frequency, this problem is often unaccepted and declared as taboo. Ninety percent of patients suffering from halitosis have oral causes: a small, but important percentage, of oral malodor cases have an extra-oral etiology, very often falling into the category of "blood-borne halitosis". Several systemic diseases have been found to provoke malodor or to be a cofactor; bad breath may be an early sign of a serious local or systemic condition. A psychogenic halitosis a…

Lesioni odontostomatologiche in corso di malattia celiaca

Aloin delivery on buccal mucosa: ex vivo studies and design of a new locoregional dosing system

Context: Chemoprevention of potential malignant disorders or cancerous lesions that affect oral mucosae requires extended duration of treatment. Locoregional delivery of natural products could represent a promising strategy for this purpose. Objective: To investigate the aptitude of aloin to permeate through, or accumulate in, the buccal mucosa and to develop a new prolonged oro-mucosal drug delivery system. Materials and Methods: Permeation/accumulation of aloin from Curacao Aloe (containing 50% barbaloin) was evaluated ex vivo, using porcine buccal mucosa as the most useful model to simulate human epithelium. Oro-mucosal matrix tablets were prepared by dispersing aloin (10% w/w) in Eudrag…

Idiopathic osteonecrosis of the mandible in a 49 healthy male patient: a rare and interesting case report

Hastening of wound healing of mucosa by means of aminoacids combined to sodium hyaluronate after oral biopsy: an open trial.

Sodium hyaluronate has been widely used in order to promote wound healing in oral cavity for its anti-inflammatory effects. Aim of this clinical trial was to evaluate the efficacy of aminoacids added to topical sodium hyaluronate, in minor oral surgery. After surgery by means of Quantic molecular resonance scalpel, in 27 patients a gel with sodium hyaluronate has been applied directly on the surgical wound, in order to favorite healing by secondary intention. Furthermore, gel has been applied 3-4times/day, after meals and oral hygiene. Hemostatic effect, edema and pain symptoms by VAS (Visual Analogue Scale;0-100), and clinical healing (full, partial, absent) have been evaluated at T#1(2hrs…

Ozone Infiltration for Osteonecrosis of the Jaw Therapy: A Case Series

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction, mainly due to bone-modifying agents (BMA), and it is a potentially painful and debilitating condition. To date, the literature has reported a 90% rate of successful outcomes for MRONJ patients undergoing surgical treatment. Particularly for patients with advanced disease stages who are unsuitable for surgery, prolonged medical treatment is required, with a consequent risk of the overuse of antibiotics and antibiotic resistance. The aim of this study is to evaluate the efficiency and safety of ozone, via oral mucosal infiltrations, in seven cancer patients with MRONJ, who are not eligible for surgery. The prot…

Comment on “Medication-Related Osteonecrosis of the Jaw (MRONJ)” by Elie M. Ferneini in the Section “Simply Put: JOMS Information for Patients”

We read with great interest the contribute to the section “Simply Put: JOMS Information for Patients” named “Medication-Related Osteonecrosis of the Jaw (MRONJ)” by Elie M. Ferneini.

Periodontal clinical and microbiological data in desquamative gingivitis patients.

Objectives: A series of patients affected by desquamative gingivitis (DG) was investigated in order to evaluate relation patterns among clinical parameters relevant to plaque induced periodontitis, periodontal microbiological data and the presence of DG lesions. Patients and methods: Eight oral lichen planus (OLP) and four mucous membrane pemphigoid (MMP) patients were examined. Periodontal measurements (performed at six sites per tooth on all teeth) included probing depth (PD), gingival recession (REC), clinical attachment loss (CAL) and full mouth plaque (FMPS) and bleeding (FMBS) scores; the presence and the exact location (site by site) of DG lesions were carefully recorded. Sub-gingiva…

Mandibular torus as known OnJ risk factor: a case report of osteonecrosis of the jaw

Conservative Surgical Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw with Er,Cr:YSGG Laser and Platelet-Rich Plasma: A Longitudinal Study

Introduction. The management of bisphosphonate-related osteonecrosis of the jaw (BRONJ), with no evidence-based guidelines, remains controversial. We aimed to evaluate the efficiency of a conservative surgical treatment combining Er,Cr:YSGG laser and platelet-rich plasma (PRP) for the treatment of BRONJ in cancer patients. Methods. We performed a longitudinal cohort study. Inclusion criteria were (1) age ≥ 18 years; (2) cancer diagnosis; (3) treatment with NBP because of the underlying cancer. Results. We consecutively recruited ten patients diagnosed with BRONJ in stage I or II. These patients underwent a surgical laser-assisted therapy together with autologous PRP. At the latest follow-up…

RESTITUTIO AD INTEGRUM IN A CASE OF ONJ RELATED TO BEVACIZUMAB

Aim. Bevacizumab is a humanized recombinant monoclonal antibody that blocks vascular endothelial growth factor (VEGF). The activity of VEGF is the ability to promote the vascular endothelial cells proliferation inducing the formation of new blood vessels. Bevacizumab is used in the treatment of selected advanced colon, lung, renal and central nervous system tumours and plays a developing role in the management of breast and ovarian cancers. It is also injected intraocularly for treatment of macular degeneration. Recently, bevacizumab has been reported as responsible of drug-related osteonecrosis of the jaw (ONJ), showing a histological pattern similar to bisphosphonate-related ONJ. Moreover…

Orthopedic-orthodontic treatment of the patient with Turner's syndrome: Review of the literature and case report.

Aims Turner syndrome (TS) patients have phenotypical variable presentations and they are more susceptible to endocrine, auto-immune, and structural anomalies. Typical clinical characteristics are short stature and premature ovarian insufficiency. Patients with TS show a typical cranial-facial morphology with bi-maxillary bi-retrusion, high-arched palate, micrognathia, and class II malocclusion. Aim of our study is to present the orthopedic-orthodontic treatment approach of a young TS patient and data of stability after 7 years. Methods and results A careful analysis of anamnestic data was performed. After extraoral and intraoral examination, cephalometric measurements and examination of mod…

Oral squamous cell carcinoma mimicking osteonecrosis of the jaw: a case report