Salivary Cytokines in patients with Head and Neck Cancer (HNC) treated with Radiotherapy.
Background Head and Neck cancer (HNC) is the sixth most common cancer in the world. The 5-year survival rate depends on early diagnosis and appropriate therapy. Typically, late diagnosis requires not only surgical intervention, but also radiotherapy treatment combined or not with chemotherapy. Ionizing radiation is known to increase the expression of a number of cytokines involved in inflammation, wound healing and toxicity areas. Salivary cytokines have promising features to be used as biomarkers for disease screening and outcome prediction in this malignancy. The aim of this article is to analyze the role of salivary inflammatory response elements in HNC patients treated with radiotherapy…
Lack of association between proliferative verrucous leukoplakia and human papillomavirus infection.
Purpose To analyze proliferative verrucous leukoplakia (PVL) for the presence of human papillomavirus (HPV) in different stages of the disease. Materials and Methods We studied 13 patients with PVL. In 10 patients (76.9%), a lesional biopsy was taken and frozen at −40°C. Four patients were instructed to mouth rinse with sterile sera. The biopsy and rinse samples were analyzed for HPV by PCR. Results We did not detect HPV infection in the PVL tissue or in the oral rinse of any of the 13 patients in any stage of the disease analyzed, neither in oral squamous cell carcinoma nor in the simple hyperkeratosis. Conclusion There was no association between PVL and HPV infection in our patients.
Proliferative verrucous leukoplakia: a proposal for diagnostic criteria.
Proliferative verrucous leukoplakia (PVL) is a rare form of oral leukoplakia, which was first described in 1985 by Hansen et al. Since then, various published case series have presented PVL as a disease with aggressive biological behaviour due to its high probability of recurrence and a high rate of malignant transformation, usually higher than 70%. PVL is a long-term progressive condition, which is observed more frequently in women and elderly patients over 60 years at the time of diagnosis. Eventually, PVL tends to become multifocal with a progressive deterioration of the lesions, making it more and more difficult to control. Tobacco use does not seem to have a significant influence on th…
Linfoma angiocéntrico localizado en paladar
Resumen Los linfomas angiocentricos son neoplasias muy poco frecuentes en nuestra area geografica. Suelen presentarse en la region oronasal como lesiones de tipo necrotico, en concreto en la zona mediofacial, con una evolucion rapida y un pronostico sombrio. Inmunohistoquimicamente se ha detectado que en estas neoplasias las celulas malignas corresponden a linfocitos T. Ademas estudios recientes apoyan la hipotesis del posible papel del virus de Epstein-Barr como posible factor etiologico. Presentamos en este articulo el caso clinico de un hombre de 67 anos con una lesion ulcerada en el paladar, de corto tiempo de evolucion y que tras estudio histopatologico e inmunohistoquimico se confirmo…
Potential Non-Invasive Biomarkers for Early Diagnosis of Oral Squamous Cell Carcinoma
This study aimed to investigate the role of a panel of salivary cytokines as biomarkers for early detection oral squamous cell carcinoma (OSCC), comparing their levels among healthy individuals, patients with oral leukoplakia (OL), and malignant lesions. Cytokine profiling analysis performed in a minimally invasive sample was correlated with clinicopathological variables in our patient cohorts. Unstimulated saliva was obtained from subjects with OSCC at early (n = 33) and advanced (n = 33) disease, OL with homogeneous (n = 33) and proliferative verrucous (n = 33) clinical presentations, and healthy controls (n = 25). Salivary IL-1α, IL-6, IL-8, IP-10, MCP-1, TNF-α, HCC-1, and PF-4 levels we…
Effect of nonsurgical periodontal treatment in patients with periodontitis and rheumatoid arthritis: a systematic review
Background: Periodontitis has been regarded as a potential risk factor for rheumatoid arthritis (RA). A systematic review is made to determine whether nonsurgical periodontal treatment in patients with RA offers benefits in terms of the clinical activity and inflammatory markers of the disease. Material and Methods: A search was made of the Medline-PubMed, Cochrane, Embase and Scopus databases to identify studies on the relationship between the two disease processes, and especially on the effects of nonsurgical treatment in patients of this kind. The search was based on the following keywords: rheumatoid arthritis AND periodontitis (MeSH), rheumatoid arthritis AND periodontal treatment . Re…
Utility of imaging techniques in the diagnosis of oral cancer.
Abstract Purpose Imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT), and positron emission tomography (PET) are often used to complement the clinical exploration and staging of oral squamous cell carcinoma (OSCC). Which of these techniques is best in establishing correct staging and treatment planning is not clear, however. This study aims to determine which technique is most appropriate for diagnosing the primary tumor and for detecting bone invasion and neck metastases. Material and methods A Medline literature search was made over the last 10 years. In each selected study, we recorded the sample size and sensitivity, specificity and precision. Strengths…
Retinoids and proliferative verrucous leukoplakia (PVL). A preliminary study.
Objective. A study is made of the efficacy and adverse effects of retinoid therapy applied to the white lesions of proliferative verrucous leukoplakia (PVL). Material and methods. The results of retinoid therapy were evaluated in 17 patients diagnosed with PVL. Topical retinoids were used in 5 patients, in the form of two daily applications of 0.1% 13-cis-retinoic acid in orabase for an average of 6.17+/-3.13 months. Systemic retinoids were used in 11 patients, with the administration of 25 mg/day of acitretin in tablet form for an average of 5.41+/-2.02 months. One patient successively received the topical and systemic retinoid formulations. The course and results were evaluated on a blind…
CYP2C8 gene polymorphism and bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma
Osteonecrosis of the jaw is an uncommon but potentially serious complication of bisphosphonate therapy in multiple myeloma. Previous studies showed that the presence of one or two minor alleles of the cytochrome P450, subfamily 2C polypeptide 8 gene (CYP2C8) polymorphism rs1934951 was an independent prognostic marker associated with development of osteonecrosis of the jaw in multiple myeloma patients treated with bisphosphonates. The aim of this study was to validate the frequency of SNP rs193451 in 79 patients with multiple myeloma. In 9 (22%) patients developing osteonecrosis of the jaw, a heterozygous genotype was found, in contrast with those who did not develop osteonecrosis of the jaw…
Biomarkers to predict the onset of biphosphonate-related osteonecrosis of the jaw: A systematic review
Background: The goal of this paper was to identify available biomarkers to predict the onset of biphosphonate-related osteonecrosis of the jaw (BRONJ). Material and Methods: Case-control studies comparing the different concentrations of a series of molecules detected in serum and urine as matrices of BRONJ affected patients vs. non-affected were included. PRISMA guidelines for systematic reviews were used for the present paper. Two reviewers independently screened electronic databases (Medline, Web of science, and The Cochrane Library) and performed hand searches. Risk of bias assessment of selected studies was performed by the Newcastle-Ottawa Scale. This study is registered as PROSPERO CR…
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…
Cytological changes in the oral mucosa after use of a mouth rinse with alcohol. A prospective double blind control study
Aim: The aim of this preliminary study was to detect cytological changes in the oral mucosa after using a mouth wash with alcohol. Material and Methods: A prospective double-blind, controlled study was performed, for 6 months. Group 1 consisted of 30 subjects who used a mouth rinse with 26.9% of alcohol [Listerine®] and Group 2 consisted of 30 subjects who used a mouth rinse with the same ingredients but with no alcohol. We obtained three cytological samples from the oral mucosa. The presence of cytological atypia, binucleation and karyorrhesis, and type of cells were studied. We also used a fluorescent in situ hybridization technique (FISH) in 15 samples in each group, for the micronucleus…
Recurrences following treatment of proliferative verrucous leukoplakia: A systematic review and meta-analysis.
Objective A systematic review and meta-analysis was made of the incidence of recurrences in patients with proliferative verrucous leukoplakia subjected to different types of treatment. Methods The study was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. A literature search was made in the Medline (PubMed), EMBASE and Web of Science databases, together with a manual search, covering the period from 1985 to January 2020, with no language restrictions. Studies were included if they described treatments applied to at least 10 patients with the corresponding outcomes. Methodological quality was evaluated using Jadad sca…
Osteonecrosis of the jaws by intravenous bisphosphonates and osteoradionecrosis : a comparative study
Aims: We analyze the possible clinical differences between bone jaw exposed areas in ONJ (osteonecrosis of the jaws) and ORN (osteoradionecrosis). Patients and method: Group 1 was composed with 53 ONJ cases and group 2 with 20 ORN cases. In both groups we analyzed, the major size of the exposed bone areas, the number of exposed areas, the location on the jaws and the presence of others associated and severe complications, such as skin fistulas and jaw fractures. We also investigated the possible local aetiology or trigger factor of the lesions. Results: The major size of the bone exposed areas was 2.29±2.02(mean ± std.dev) in group 1 and 2.7±2.9 (mean ± std.dev) in group 2 (p>0.05). The num…
Ewing sarcoma of the oral cavity. A review
Objectives A review is made of the clinical, diagnostic, therapeutic and survival characteristics of Ewing sarcoma (ES) of the oral cavity. Material and methods A systematic literature search was carried out, with restrictions referred to time (1960-2014), language (English and Spanish) and type of study (case reports, letters, datasets, reviews). The following MeSH terms and boolean operators were used: Ewing AND Sarcoma AND [tongue, jaw, maxilla, cheek, condyle OR temporomandibular, floor AND mouth, gum OR gingiva, palate OR palatal, lip, uvula, head AND neck]. Results Seventy-one cases of ES of the oral cavity were documented from 53 articles. The main differences versus ES of other loca…
Assembling a consensus on actinic cheilitis: A Delphi study.
Aims: To discuss the terminology to define and classify actinic cheilitis (AC) and to build a consensus on the diagnostic and therapeutic approaches to AC. Methods: Two-round Delphi study using a questionnaire including 34 closed sentences (9 on terminology and taxonomy, 5 on potential for malignant transformation, 12 on diagnostic aspects, 8 on treatment) and 8 open questions. Experts’ agreement was rated using a Likert scale (1–7). Results: A consensus was reached on 24 out 34 statements (73.5%) and on 5 out of 8 (62.5%) close-ended questions. The response rate was identical in both rounds (attrition of 0%). AC is the term with the highest agreement (median of 7 (strongly agree; IQR: 6–7)…
Epstein-Barr virus in oral proliferative verrucous leukoplakia and squamous cell carcinoma : a preliminary study
The aim of this study was to analyze proliferative verrucous leukoplakia (PVL) and oral squamous cell carcinoma (OSCC) for the possible presence of Epstein-Barr virus (EBV). We studied three groups: Sub-Group 1 was composed of 10 patients with PVL, (6 of whom had developed OSCC); Sub-Group 2 comprised 5 patients with OSCC but no preceding PVL; and Sub-Group 3 were 5 controls with clinically normal oral mucosa. Oral biopsies from all cases were examined for Epstein-Barr virus (EBV) by nested PCR. EBV was detected in 60% of Sub-Group 1 patients (PVL ) and in 40% of Sub-Group 2 (OSCC), but in 0% of SubGroup 3 (controls).
Maxillofacial nodular fasciitis: a report of 3 cases.
Number IV Erythema multiforme
Erythema multiforme (EM) is an acute mucocutaneous hypersensitivity reaction characterised by a skin eruption, with or without oral or other mucous membrane lesions. Occasionally EM may involve the mouth alone. EM has been classified into a number of different variants based on the degree of mucosal involvement and the nature and distribution of the skin lesions. EM minor typically affects no more than one mucosa, is the most common form and may be associated with symmetrical target lesions on the extremities. EM major is more severe, typically involving two or more mucous membranes with more variable skin involvement - which is used to distin- guish it from Stevens-Johnson syndrome (SJS), …
Temporomandibular disorders : a case-control study
Objective: To compare the risk factors and clinical manifestations of patients with temporomandibular disorders (TMDs) diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (axis I) versus an age and gender matched control group. Study Design: A total of 162 patients explored according to the RDC/TMD (mean age 40.6±18.8 years, range 7-90; 11.1% males and 88.9% females) were compared with 119 controls, measuring differences in TMD risk factors (sleep disturbances, stress, psychoactive medication, parafunctions, loss of posterior support, ligament hyperlaxity) and clinical variables (joint sounds, painful muscle and joint palpation, maximum aperture…
Intravenous bisphosphonate-related osteonecrosis of the jaws: Influence of coadjuvant antineoplastic treatment and study of buccodental condition
Objectives: To determine whether coadjuvant antineoplastic treatment can influence the number and size of bone exposures among patients with intravenous bisphosphonate-related osteonecrosis of the jaws (iBRONJ), and to analyze the buccodental condition of these patients. Material and methods: The study sample comprised 67 patients with iBRONJ, 53 patients without iBRONJ receiving treatment with intravenous bisphosphonates, and 36 healthy subjects. In all three groups, measurements were made of the CAO index and of resting whole saliva and stimulated whole saliva. In the patients with iBRONJ, the size (cm) and number of bone exposures were recorded. The data obtained were subjected to analys…
Malignant peripheral nerve sheath tumor of the maxila
Summary We present a case of a malignant peripheral nerve sheath tumor [MPNST] of the maxilla corresponding to a 12 year old male who had a painful, ulcerated rapid growing tumor. Histology revealed the presence of a tumor consisting of fusiform cells with abundant mitosis, with negative cytokeratins, actin, desmin, myoglobin and factor VIII. In contrast, the protein S-100 was positive. MPNST was not associated with signs of Neurofibromatosis Type 1. The patient was surgically intervened and received radiotherapy, then died within 10 months posterior to surgical intervention after suffering recurrence.
Acyclovir treatment in 2 patients with benign trigeminal sensory neuropathy
Clinical Presentation and Differential Diagnosis of Oral Cancer
Over 90% of oral cancers are squamous cell carcinomas (OSCCs) which are of epithelial origin. Other types of malignancies account for the small remaining 10%. In this chapter, we describe the clinical characteristics of early- and advanced-stage OSCC and also consider the differential diagnosis of early-stage OSCC. The priority concern is to establish an early diagnosis, in order to secure the best possible prognosis and highest survival rate among oral cancer patients.
Oral microbiome in Proliferative Verrucous Leukoplakia exhibits loss of diversity and enrichment of pathogens.
Abstract Objectives Oral microbiome plays an important role in oral diseases. Among them, proliferative verrucous leucoplakia (PVL) is an uncommon form of progressive multifocal leukoplakia with a worryingly rate of malignant transformation. Here, we aimed to characterize the oral microbiome of PVL patients and compare it with those of healthy controls. Material and methods Oral biopsies from ten PVL patients and five healthy individuals were obtained and used to compare their microbial communities. The sequence of the V3-V4 region of 16S rRNA gene was used as the taxonomic basis to estimate and analyze the composition and diversity of bacterial populations present in the samples. Results O…
Graft-versus-host disease affecting oral cavity. A review
Graft versus host disease (GVHD) is one of the most frequent and serious complications of hematopoietic stem cell transplantation, and is regarded as the leading cause of late mortality unrelated to the underlying malignant disease. GVHD is an autoimmune and alloimmune disorder that usually affects multiple organs and tissues, and exhibits a variable clinical course. It can manifest in either acute or chronic form. The acute presentation of GVHD is potentially fatal and typically affects the skin, gastrointestinal tract and liver. The chronic form is characterized by the involvement of a number of organs, including the oral cavity. Indeed, the oral cavity may be the only affected location i…
Osteonecrosis of the jaws in patients treated with bisphosphonates.
The literature describes an increasing presence of bisphosphonate-induced osteonecrosis of the jaws (ONJ), characterized by the exposure for over 8 weeks of necrotic bone in the maxillofacial region, after bisphosphonate therapy, in the absence of prior maxillary radiotherapy. The present literature review examines the etiopathogenesis, risk factors, clinical forms, diagnosis, treatment and prevention of bisphosphonate-induced ONJ. In addition, a review is made of all the series involving over 15 patients diagnosed with this disorder between 1 January 2011 and 15 May 2011. A PubMed-Medline search was carried out with the following key words: “bisphosphonates” and “osteonecrosis”. The appear…
Head and Neck Lymphomas in HIV Patients: a Clinical Perspective
Introduction Because of the many HIV-related malignancies, the diagnosis and treatment of lymphoma in patients infected with human immunodeficiency virus are challenging. Objective Here, we review current knowledge of the pathogenesis, epidemiology, symptomatology, diagnosis, and treatment of head and neck lymphomas in HIV patients from a clinical perspective. Data Synthesis Although Hodgkin's lymphoma is not an AIDS-defining neoplasm, its prevalence is ten times higher in HIV patients than in the general population. NHL is the second most common malignancy in HIV patients, after Kaposi's sarcoma. In this group of patients, NHL is characterized by rapid progression, frequent extranodal inv…
Serum levels of RANKL and OPG, and the RANKL/OPG ratio in bisphosphonate-related osteonecrosis of the jaw: Are they useful biomarkers for the advanced stages of osteonecrosis?
We determined whether serum levels of Receptor Activator for Nuclear Factor κ B Ligand (RANKL), Osteoprotegerin (OPG), and the RANKL/OPG ratio could be useful biomarkers for the severity of oral lesions in bisphosphonate-related osteonecrosis of the jaw (BRONJ). A case-control study in which Group 1 consisted of 41 patients with BRONJ due to bisphosphonates, and Group 2 consisted of 44 healthy control cases. The plasma levels of RANKL and OPG were analyzed by an ELISA assay. The OPG/RANKL ratio was also calculated. We determined if the mean serum values differed among the different stages of BRONJ. Serum levels of RANKL were lower in Group 1 than in Group 2 (p =0.01), and serum levels of OP…
Multidimensional approach to the differences between muscular and articular temporomandibular patients: Coping, distress, and pain characteristics
Objective This study analyzes the differences in psychological variables and symptomatology between temporomandibular disorder diagnosis subgroups. Study design The sample included 114 temporomandibular disorder patients that were evaluated in coping, distress, and temporomandibular characteristics. Diagnostic muscular (n = 58) and articular (n = 56) subgroups were compared in these variables through a MANCOVA. Results Muscular patients show a higher level of general distress, specifically in the anxiety and somatization subscales and a more active coping style, with a tendency of a minor use of humor and a higher number of parafunctional habits, specifically, biting nails, hangnails, and l…
Oral medicine practice in Europe and Australia: Identifying practitioner characteristics and their clinical activity
Oral Medicine is a young dental specialty born almost a century ago and deals with orofacial conditions not directly attributable to the most prevalent tooth pathologies such as dental caries or periodontal diseases. Presentations may reflect local disease or orofacial manifestations of more widespread pathology affecting other parts of the body. Due to its recency as a distinct discipline and to heterogeneous global settings, Oral Medicine has not yet achieved a shared scope and definition, as well as a recognized status across the globe. The current report presents survey data gathered from Oral Medicine practitioners in Europe and Australia and aimed to identify practitioner characterist…
Complement activation product C4d in oral and oropharyngeal squamous cell carcinoma
OBJECTIVE: Complement C4d-containing fragments have been proposed as diagnostic markers for lung cancer. The purpose of this study was to evaluate the presence of C4d in oropharyngeal (OPSCC) and oral (OSCC) squamous cell carcinomas. SUBJECTS AND METHODS: C4d staining was analyzed by immunohistochemistry in 244 OPSCC surgical specimens. C4d levels were quantified by ELISA in resting saliva samples from 48 patients with oral leukoplakia and 62 with OSCC. Plasma samples from 21 patients with leukoplakia and 30 with oral carcinoma were also studied. RESULTS: C4d staining in OPSCC specimens was associated with nodal invasion (P = 0.001), histopathologic grade (P = 0.014), disease stage (P = 0.0…
Placement of endosseous implants in patients with oral epidermolysis bullosa.
Abstract Objective: To evaluate the feasibility of placing endosseous implants in patients with recessive dystrophic epidermolysis bullosa. This article reports on 4 patients subjected to follow-up. Study Design: Implants were placed in 4 cases. All patients have marked oral involvement, with devastating alterations in the soft and hard tissues in all cases. Results: A total of 15 implants (7 maxillary, 8 mandibular) were placed. All implants integrated successfully and have been restored. The average follow-up from implant placement was 2.5 years (range, 1-4). Conclusions: Our preliminary findings suggest that endosseous implants can be successfully placed and can provide support for prost…
Osteonecrosis of the jaws associated with denosumab : study of clinical and radiographic characteristics in a series of clinical cases
Background The objective of this study was to describe the clinical and radiographic characteristics of our series of medication-related osteonecrosis of the jaws (ONJ) associated with denosumab. Material and methods We presented 15 cases of ONJ associated with denosumab; 11 received treatment for their osteoporosis and four for cancer treatments. We recorded the most frequent clinical findings, symptoms and radiographic characteristics in our patient group, as well as local and systemic contributing factors. Results The mean time of treatment with denosumab was 23.83 ± 12.84 months. 40% of the patients had a previous history of treatment with bisphosphonates. The most common local factor w…
Idiopathic Trigeminal Neuropathies: A Presentation of 15 Cases
Purpose The aim of this study is to present a clinical series of patients with trigeminal neuropathy and their treatment. Patients and Methods We present a retrospective study of 15 cases of idiopathic trigeminal neuropathies, with unilateral involvement of 1 or more divisions of the trigeminal nerve. The clinical, radiologic, and laboratory data of the patients, in addition to the treatment and clinical evolution, were reviewed. The patients were followed up for a mean of 34.4 months (range, 12-120 months). Results The study consisted of 11 women and 4 men. The numbness was predominantly located in the innervated mental area and extended in some cases to the first and second trigeminal div…
Interleukin‐6 concentration changes in plasma and saliva in bisphosphonate‐related osteonecrosis of the jaws
To determine the plasma and saliva levels of IL-6 in patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ) and to investigate whether there is a correlation between more advanced stages of BRONJ and levels of IL-6.We studied three groups: group 1 consisted of 30 patients with BRONJ due to intravenous bisphosphonates (ivBP), group 2 consisted of 25 patients treated with ivBP but without BRONJ, and group 3 consisted of 15 healthy controls. In each case, we assayed plasma and saliva IL-6 samples using an ELISA test.Significantly, higher IL-6 values were found in both saliva and plasma in group 1 vs groups 2 and 3 (P 0.01). Group 1 showed no differences in plasma or saliva IL-…
Changes in smoking habit among patients with a history of oral squamous cell carcinoma (OSCC)
Objective: To determine the changes in smoking habit among patients with oral squamous cell carcinoma (OSCC) diagnosed and treated in the Service of Stomatology (Valencia University General Hospital. Valencia, Spain). Material and methods: The study involved 123 patients with a history of OSCC interviewed by telephone on their smoking habits at the time of the diagnosis and modifications in habits subsequently. The mean age at diagnosis was 60 years and 9 months (standard deviation, SD ± 12 years and 2 months). Males predominated (61.8%) over females (38.2%). The mean time from the diagnosis of OSCC to the survey was 4 years and 6 months (SD ± 3 years and 6 months). Results: Almost one-half…
Evaluation of the immediate post-operative procedure after dental intervetions. 24 hours follow up study. epico study
Objectives: The purpose of this study was to make a descriptive approximation of the therapeutic management of the different dental interventions in clinical practice today, and to analyze the degree of consensus among the specialists participating in the study. Study Design: A total of 447 odontologists, stomatologists or maxillofacial surgeons from 43 Spanish provinces participated in the study. The study sample consisted of patients aged 18 years old or over attending the clinic for a dental intervention. The type of intervention carried out and treatments administered before and after the intervention were recorded. At 24 hours after the intervention, intensity of pain experienced by th…
Current treatment of oral candidiasis: a literature review
Candidiasis or oral candidosis is one of the most common human opportunistic fungal infections of the oral cavity. This pathology has a wide variety of treatment which has been studied until these days. The present study offers a literature review on the treatment of oral candidiasis, with the purpose of establish which treatment is the most suitable in each case. Searching the 24 latest articles about treatment of candidiasis it concluded that the incidence depends on the type of the candidiasis and the virulence of the infection. Although nystatin and amphotericin b were the most drugs used locally, fluconazole oral suspension is proving to be a very effective drug in the treatment of ora…
Benign tumors of the oral mucosa: A study of 300 patients
Objectives: To analyze the frequency and type of the most common benign tumors of the oral mucosa found at the Hospital Stomatology Service, and to study the clinical characteristics and possible etiological factors. Material and Methods: This is a retrospective study of 300 patients with histologically diagnosed benign tumors of the oral mucosa. Data was compiled for each case, documenting information relating to age, gender, medication, habits (smoking, oral hygiene), anamnesis (reason for consultation, symptomatology, evolution), and the characteristics of the lesion (site, color, size, surface, consistency, and base). Results: Of all the tumors studied, 53% were histologically diagnosed…
Conservative Surgical Management of Stage I Bisphosphonate-Related Osteonecrosis of the Jaw
Purpose. To report the efficacy of conservative surgical treatment for stage I bisphosphonate-related osteonecrosis of the jaw (BRONJ).Materials and Methods. This study reports the clinical outcomes of 63 patients treated for BRONJ stage I (according to Ruggiero's staging system) at the Oral Pathology and Laser-Assisted Surgery Unit of the University of Parma between January 2004 and January 2011. Surgical interventions were performed, under local analgesia, in patients unresponsive for a period of six months to noninvasive treatments such as cycles of local or systemic antibacterial therapy combined or not to low level laser therapy, ozone therapy, or Hyperbaric Oxygen Therapy. All interve…
Documento de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos dentales
La profilaxis antibiótica en Odontología tiene como objetivo prevenir la aparición de infección a partir de la puerta de entrada que produce la actuación terapéutica, por lo que se encuentra indicada siempre que exista un riesgo importante de infección, ya sea por las características mismas de la operación o por las condiciones locales o generales del paciente. Sin embargo, los ensayos clínicos con antibióticos en patologías dentarias responden poco a los criterios metodológicos requeridos, y además no son lo suficientemente numerosos. Se presentan los Resultados de una conferencia de expertos integrada por los Presidentes de Sociedades científicas españolas más representativas que han anal…
Salivary inflammatory proteins in patients with oral potentially malignant disorders
Cytokines are a group of small proteins involved in the regulation of infection, immune responses and inflammation. Since altered cytokine responsiveness has been linked to Oral Squamous Cell Carcinoma (OSCC), research to date indicates the possibility of using salivary pro- and anti-inflammatory proteins for screening of oral disorders. OSCC is a multistep neoplasia in which many genetic and epigenetic changes have been correlated to cancerous transformation of oral potentially malignant disorders (OPMD) such as oral leukoplakia, erythroplakia and lichen planus. The goal of the innovative salivary diagnostics is the identification of a single or multiple biomarkers that will serve as a cli…
Oral cancer on the gingiva in patients with proliferative leukoplakia: A study of 30 cases
Background Proliferative verrucous leukoplakia, recently coined as proliferative leukoplakia (PL), is associated with a strong tendency to recur after treatment and an elevated rate of malignant transformation. We compared the clinical characteristics of patients with gingival PL with and without progression to oral squamous cell carcinoma. Methods The patients were divided into two groups: group 1 included 33 patients with gingival PL that did not progress to cancer, and group 2 included 30 patients with PL who developed malignant transformation during follow-up. We compared age, sex, tobacco habit, clinical characteristics of gingival PL lesions, and location, tumor-node-metastasis (TNM) …
Dental implants in patients with oral mucosal alterations : an update
Objective: To determine whether a series of diseases of the oral mucosa - Sjogren syndrome, ectodermal dysplasia, epidermolysis bullosa and lichen planus - reduce the survival rate of dental implants. Material and Method: A Medline search was carried out using the key words: "Sjogren syndrome", "ectodermal dysplasia", "epidermolysis bullosa", "lichen planus" and "dental implants", including those publications involving clinical series comprising more than one patient with the mentioned disorders and treated with dental implants, in the last 10 years. Results: The study included three articles involving patients with Sjogren syndrome subjected to dental implant treatment, representing a tota…
<p>Floor of the mouth hemorrhage subsequent to dental implant placement in the anterior mandible</p>
Complications in dental implant surgery are possible. Bleeding complications have been described that may be serious, particularly in the floor of the mouth. We present two cases of sublingual hematomas during dental implant osteotomies that impeded but did not close the airway. The clinical courses of these patient's complications are reviewed. One patient had immediate hematoma formation while the other developed a hematoma overnight, presenting the next day. The treatment rendered was a precautionary in-hospital tracheotomy for the first patient and only compression control for the second. Bleeding complications during dental implant placement in the anterior mandible can be serious issu…
Oxidative stress in bisphosphonate-related osteonecrosis of the jaws
Objectives To analyze whether oxidative stress (OS) changes are present in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ) versus controls. Materials and Methods Oxidative stress was analyzed in serum and unstimulated saliva of three groups: Group 1 consisted of 24 patients who had been treated with intravenous bisphosphonates (ivBPs) and developed BRONJ, group 2 consisted of 20 patients who had received ivBPs and did not develop BRONJ, and group 3 comprised 17 control subjects. Reduced glutathione (GSH), malondialdehyde (MDA), oxidized glutathione (GSSG), and 8–oxo-7,8-dihydro-2-deoxyguanosine (8-oxo-dG) levels, as well as the GSSG/GSH ratio, were measured. Results Me…
Pseudotumors and tumors of the temporomandibular joint. A review.
Objective: To review the pseudotumors and tumors of the temporomandibular joint (TMJ) published in journals included in Journal Citation Reports (JCR), and to evaluate whether there are clinical and radiological signs capable of differentiating between pseudotumors and tumors and between malignant and benign tumors. Material and Methods: A systematic Medline search was made of clinical cases of tumors and pseudotumors of the TMJ covering a 20-year period and published in journals included in JCR. Only cases with histological confirmation were included. A description is provided of the general characteristics of TMJ tumors, with comparison of the clinical, diagnostic, therapeutic and evoluti…
Retrospective study of a series of 850 patients with temporomandibular dysfunction (TMD). Clinical and radiological findings
Objective: To define the clinical and radiological characteristics of the four most common presentations of temporomandibular dysfunction-myofascial pain (MFP), disc displacement with reduction (DDWR), disc displacement without reduction (DDWoR), and osteoarthrosis (OR)-and to identify the differences among them. Material and methods: The study comprised a series of 850 patients (121 males and 729 females) seen between May 2003 and December 2006 in Valencia University General Hospital (Spain) for temporomandibular joint disease (TMJD). An analysis was made of the possible etiological factors (stress, traumatisms, sleep disturbances, parafunctional habits, reason for consultation), possible …
Biomaterials coated by dental pulp cells as substrate for neural stem cell differentiation
[EN] This study is focused on the development of an in vitro hybrid system, consisting in a polymeric biomaterial covered by a dental pulp cellular stroma that acts as a scaffold offering a neurotrophic support for the subsequent survival and differentiation of neural stem Cells. In the first place, the behavior of dental pulp stroma on the polymeric biomaterial based on ethyl acrylate and hydroxy ethyl acrylate copolymer was studied. For this purpose, cells from normal human third molars were grown onto 0.5-mm-diameter biomaterial discs. After cell culture, quantification of neurotrophic factors generated by the stromal cells was performed by means of an ELISA assay. In the second place, s…
Dental and periodontal lesions in patients with gastro-oesophageal reflux disease.
Dental erosion has been considered an extraesophageal manifestation of gastro-oesophageal reflux disease, but few reports have studied the relationship between this disease and other periodontal or dental lesions. The aim of this study was to investigate the prevalence of dental and periodontal lesions in patients with gastro-oesophageal reflux disease.A total of 253 subjects were prospectively studied between April 1998 and May 2000. Two study groups were established: 181 patients with gastro-oesophageal reflux disease and 72 healthy volunteers. Clinical assessment, including body mass index and consumption of tobacco and alcohol, was performed in all subjects, as well as a dental and peri…
Rapid progression from oral leukoplakia to carcinoma in an immunosuppressed liver transplant recipient
Immunosuppression used to avoid graft rejection in solid organ transplantation recipients leads to a variety of side-effects, and an increased rate of infections and de novo malignancies. Oral conditions usually associated with immunosuppressive drugs include fungal and viral infection, and lip lesions, but intra-oral carcinoma has not been reported as having a high incidence. This report deals with a male liver transplant recipient receiving FK506 (5 mg/day) and prednisone (20 mg/day) who was diagnosed with a homogeneous leukoplakia on the floor of the mouth 4 months after transplantation, and 4 months later with a squamous cell carcinoma growth at the site of this lesion. The rapid transf…
Number VII Behcet's disease (Adamantiades syndrome)
Behçet's syndrome (BS; Adamantiades syndrome) is the association of the triple symptom complex of recurrent aphthous stomatitis (RAS) with genital ulceration, and eye disease (especially iridocyclitis) though a number of other systemic manifestations may also be seen. BS mainly affects young adult males, and there is an association with HLA-B5 and HLA-B51 (B5101). Features such as arthralgia and leucocytoclastic vasculitis suggest an immune-complex mediated basis, which is supported by finding circulating immune complexes and, although the antigen responsible is unidentified, heat shock proteins have been implicated. An inflammatory disorder, BS is now considered as a systemic vasculitis, c…
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 …
Post-traumatic trigeminal neuropathy. A study of 63 cases.
Introduction. Trigeminal neuropathy is most often secondary to trauma. The present study explores the underlying causes and the factors that influence recovery. Material and methods. A retrospective case study was made involving 63 patients with trigeminal neuropathy of traumatologic origin, subjected to follow-up for at least 12 months. Results. Fifty-four percent of all cases were diagnosed after mandibular third molar surgery. In 37 and 19 patients the sensory defect was located in the territory innervated by the mental and lingual nerve, respectively. Pain was reported in 57% of the cases, and particularly among the older patients. Regarding patient disability, quality of life was not a…
Lower-half facial migraine: a report of 11 cases.
Purpose Vascular pain of the face constitutes a variant of pain of the head, and includes migraine, cluster headache, paroxysmal hemicrania, and a facial variant of the so-called lower-half migraine. Lower-half facial migraine is a condition difficult to classify; according to the international classifications it could not be found as an individual entity. The objective of the present study is to determine the difficulties we encountered in diagnosis, the ineffective treatments provided, and the pharmacologic treatment effect. Patients and methods A study is made of 11 cases of lower-half facial migraine, corresponding to 10 women and 1 man (mean age, 35 years), commenting on the clinical c…
Cytometric analysis of oral scrapings of patients with oral lichen planus
A. Acha-Sagredo, Y. Jimenez, J. V. Bagan, M. A. Echebarria-Goicouria and J. M. Aguirre-Utric analysis of oral scrapings of patients with oral lichen planus Objective: Aneuploidy has been associated with malignant and premalignant oral lesions. In the past few years, its application in oral precancerous lesions and its prognostic meaning have been controversial issues. The aim of our study was to characterize alterations in DNA content by automated DNA image cytometry in oral scrapings of patients with oral lichen planus. Methods: Cytological samples from 40 patients clinicopathologically diagnosed with oral lichen planus were analysed by DNA image cytometry. Results: All the cases were c…
Linfoma no-hodgkin intraoral. presentación de 4 casos clínicos
The non-Hodgkin lymphomas (NHL) represent an heterogeneous group of malignancies of lymphoreticular histogenesis. In most cases, they initially arise within lymph nodes but so-called extranodal lymphomas are also found. The NHL has low incidence in the oral cavity. It may involve bone and/or soft tissues as a primary or secondary manifestation. We present a review of the literature and four clinical cases of intraoral NHL. The first couple of cases are primary forms, the third one is associated to HIV infection and the last one is an oral presentation as a component of more widely disseminated disease.
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…
Differentially methylated genes in proliferative verrucous leukoplakia reveal potential malignant biomarkers for oral squamous cell carcinoma
Objectives: To explore the pathophysiology of proliferative verrucous leucoplakia (PVL) through a methylated DNA immunoprecipitation and high-throughput sequencing (MeDIP-seq) case-control study. Materials and & nbsp; Methods: Oral biopsies from ten PVL patients and five healthy individuals were obtained and used to compare their epigenetic patterns. Network biology methods and integrative analyses of MeDIP-seq and RNAseq data were applied to investigate functional relations among differentially methylated genes (DMGs). The value of selected genes as malignant biomarkers was evaluated in a large cohort of oral squamous cell carcinoma (OSCC) patients from TCGA.& nbsp; Results: A total of 464…
Multiple sclerosis as first manifestation in oral and facial area: presentation of four cases.
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system, whose etiology is unknown, and which is characteristic by the appearance of a diverse neurological symptomatology consisting of outbreaks or gradual deterioration and lesions in any location of the brain?s white matter which may provoke the after-effect of a definitive demyelination of the area. The disease affects young people, with its appearance being most frequent between 20 and 40 years of age, in temperate and cold climates, and with a man-woman rate of 0.46 / 0.67. The magnitude of this disease lies in the fact that it is the primary cause for permanent disablement among young adults. We are pres…
Efficacy of mometasone furoate microemulsion in the treatment of erosive-ulcerative oral lichen planus: pilot study
Background: Oral lichen planus (OLP) is a frequent immunological chronic disease, having different clinical forms: asymptomatic and symptomatic. Symptomatic OLP has been palliated with topical corticosteroids with different levels of efficacy and safety. The purpose of this pilot phase II clinical trial was to determine the efficacy of mometasone furoate microemulsion upon the symptoms and signs of erosive-ulcerative OLP. Methods: Forty-nine patients with clinical and histologically confirmed erosive-ulcerative OLP were enrolled in this study (36 women and 13 men). Their average age was 56.4 years (from 28 to 78). The treatment consisted of 0.1% mometasone furoate microemulsion mouthwash …