Saliva: Its value as a biological matrix and current methods of sampling

Saliva is a non-invasive medium, its analysis is useful to measure a wide range of hormones, drugs, narcotics, antibodies, host, microbial, fungal and viral DNA up to salivary mRNA; hence, it has been suggested to be an easy and reliable biomarker in disease diagnostics, such as inflammatory mouth infections/diseases, and in normal health surveillance. In light of this potential, our primary endpoint is to review the current knowledge on saliva analyses and its recent methods of sampling.

Is resective surgery still the best practice for ONJ stage III? A case report of a conservative therapy

DOCTORAL: THE FREE APP FOR TUTORING IN SUPPORTIVE ORAL CARE

To introduce the version 2.0 of DoctOral free app, created for tutoring medical/dental professionals (and students) in the clinical recognition of oral lesions and dental treatment planning in patients at risk of ONJ drug- related.

GOTeC: INTERDISCIPLINARY TUMOR BOARD FOR THE DIAGNOSIS AND TREATMENTS OF HEAD AND NECK CANCERS

Legal liability in bisphosphonate-related osteonecrosis of the jaw

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an adverse reaction that may occur in patients administered with bisphosphonates (BP). This condition can cause high morbidity and hinder quality of life. Its treatment is complex and often unsatisfactory, and prevention strategies may have limited effectiveness, if any. Thus, managing patients treated with BP may result in exposure of the practitioner to legal liability or malpractice claims: legal actions pursuant to BRONJ are reported to be underway on three continents. Nonetheless, the attribution of liability, if any, is a complex process requiring, on the basis of current knowledge, a robust and pragmatic approach to the facts…

Positive pressure irrigation (PPI) vs. passive ultrasonic irrigation (PUI), analysis to reduce vapour lock effect. Sistematic review and meta-analysis

Expression of salivary biomarkers in patients with oral mucositis: evaluation by SELDI-TOF/MS.

Objective: This study aims to evaluate changes in proteomic salivary profile of patients with oral mucositis after adjuvant cancer treatments. Materials and Methods: Samples were collected from patients after adjuvant cancer therapies, and were analyzed by means of SELDI/TOF. Patients were separated in two groups: patients affected by mucositis (MUCOSITIS) and patient without mucositis (NO MUCOSITIS). All patients were divided in function of the anticancer treatment: patients who had radiotherapy (MUCOSITIS RADIO), had not radiotherapy (MUCOSITIS NO RADIO), had chemotherapy (MUCOSITIS CHEMO), and those who had not chemotherapy (MUCOSITIS NO CHEMO). Statistical evaluation PCA (Principal Comp…

L’odontoiatria a misura del paziente con patologia osteometabolica a rischio di osteonecrosi delle ossa mascellari da farmaci.

L’osteonecrosi delle ossa mascellari (ONJ) da farmaci è una severa patologia odontoiatrica, recentemente defi nita come «una reazione avversa farmacocorrelata, caratterizzata dalla progressiva distruzione e necrosi dell’osso mandibolare e/o mascellare di soggetti esposti al trattamento con farmaci per cui sia accertato un aumentato rischio di malattia, in assenza di un pregresso trattamento radiante»1-3. I pazienti osteometabolici a rischio di sviluppare l’ONJ sono quelli sottoposti a terapia con bisfosfonati (in particolare aminobisfosfonati o Nitrogen-containing BisPhosphonate/NBP) e, più recentemente, con denosumab (anticorpo monoclonale anti-RANKL)4. Tali farmaci antiriassorbitivi carat…

Conservative surgical treatment of medication-related osteonecrosis of the jaws with Leukocyte-Platelet Rich Fibrin: preliminary results at nine months

Osteonecrosi dei mascellari associata a bisfosfonati, denosumab e farmaci anti-angiogenetici nei pazienti oncologici e osteoporotici: diagnosi e terapia

Riassunto Obiettivi Fornire un percorso utile alla diagnosi e al trattamento dell’osteonecrosi delle ossa mascellari (solitamente definita ONJ, OsteoNecrosis of the Jaws). Materiali e metodi Gli autori del lavoro, recentemente estensori e collaboratori – su mandato della Societa Italiana di Chirurgia Maxillo-Facciale (SICMF) e della Societa Italiana di Patologia e Medicina Orale (SIPMO), delle Raccomandazioni clinico-terapeutiche sull’osteonecrosi delle ossa mascellari associata a bisfosfonati e sua prevenzione – hanno esaminato le informazioni scientifiche disponibili in merito alla ONJ associata all’assunzione sia di bisfosfonati sia di denosumab e/o anti-angiogenetici, e revisionato l’ep…

Differential diagnosis of diffused oral mucosal pigmented lesion: a case of Dubreuilh’s melanosis

Oral squamous cell carcinoma as a complication of chronic graft-versus-host disease: a case report

Objectives. Chronic Graft-Versus-Host Disease (cGVHD) is an immunoregulatory disorder which occurs after allogeneic hematopoietic-cell transplantation (HCT) and often shares features of autoimmunity and immunodeficiency. GVHD related oral manifestations include severe oral pain, xerostemia, ulcerative lesions, and mucositis. Furthermore,a major late suggested complication of HSCT is the dramatically increased risk of secondary malignancies including oral cancer and oral cGVHD-releted inflammation may be considered a potential risk factor. Case report. A 51-year-old male patient referred in 1994 to our surgery for cGVHD oral lesions secondary to HCT for acute myelogenous leukemia developed i…

Optical Coherence Tomography (OCT) and Oral Potentially Malignant Disorders: critical review on potential diagnostic patterns

Time to onset of bisphosphonate-related osteonecrosis of the jaws: a multicentre retrospective cohort study

Objectives: Osteonecrosis of the jaw (ONJ) is a potentially severe adverse effect of bisphosphonates (BP). Although the risk of ONJ increases with increasing duration of BP treatment, there are currently no reliable estimates of the ONJ time to onset (TTO). The objective of this study was to estimate the TTO and associated risk factors in BP-treated patients. Subjects and Methods: Retrospective analysis of data from 22 secondary care centres in seven countries relevant to 349 patients who developed BP-related ONJ between 2004 and 2012. Results: The median (95%CI) TTO was 6.0 years in patients treated with alendronate (n = 88) and 2.2 years in those treated with zoledronate (n = 218). Multiv…

knowledge, practice and attitude about OSCC prevention among Calabrian primary care physicians: an observational study

Prevalence of vulval lichen planus in a cohort of women with oral lichen planus: an interdisciplinary study

Summary Background  Lichen planus (LP) is a mucocutaneous inflammatory dermatosis that frequently involves the oral and genital mucosae. Patients with LP affecting these sites are often seen by oral medicine specialists or gynaecologists who work in isolation and depend heavily on histopathologists to help them in confirming the diagnosis. There are few studies in the literature combining the experiences of these specialists who share the care of patients with both oral and genital LP. Objectives  To estimate the prevalence of vulval LP (VLP) in a cohort of patients with histologically confirmed oral LP (OLP). Methods  The study group consisted of 42 women histologically diagnosed with OLP.…

Reciprocal altered expression of E-cadherin and P-cadherin in mucous membrane pemphigoid.

E- and P- cadherins are involved in the selective adhesion of epidermal cells. To gain insight into the role of cadherins on the acantholysis of keratinocytes and further investigate the pathogenesis of Mucous Membrane Pemphigoid, we examined the expression of P-cadherin and E-cadherin, in normal human oral mucosa, lesional and peri-lesional mucosa in MMP. Twenty-nine samples from paraffin-embedded specimens of MMP were used for the study. Five specimens of healthy oral mucosa were evaluated as control group. To evaluate the E- and P-Cadherin expression, a mean percentage of positive cells was determined from the percentage of positive cells derived from the analysis of 100 cells in ten ra…

Bisphosphonate-related osteonecrosis of the jaw (BRONJ): run dental management designs and issues in diagnosis

Recently, jawbone osteonecrosis has been largely reported as a potential adverse effect of bisphosphonate (BP) administration. Because of the peculiar pharmacokinetic and pharmacodynamic features of the BF (mainly for i.v. administration), their efficacy and large use, some major issues have to be taken into account extendedly both by oncologists and by dentists: 1) therapeutic dental protocol for patients with diagnosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ); 2) dental strategies for patients in former or current i.v. BF treatment and in absence of BRONJ signs; 3) strategies for patients before i.v. BF treatment. Clinical features and guidelines for the management of th…

Oral manifestations of eating disorders: a critical review.

Background:  Eating disorders (ED) are a group of psychopathological disorders affecting patient relationship with food and her/his own body, which manifests through distorted or chaotic eating behavior; they include anorexia nervosa, bulimia nervosa and ED not otherwise specified and may be burdened with life-threatening complications. As oral manifestations of ED can occur in many phases of disease progression, they play a significant role in assessment, characterization and prognosis of ED. Methods:  Mucosal, dental, and salivary abnormalities associated with ED have been reviewed. Relations between oral menifestations and pathogenesis, management and prognosis of ED have been critically…

Demographic and behavioural profiles of patients with common oral mucosal lesions by a homogeneity analysis

Oral Diseases (2012) 18, 396–401 Objective:  The aim of this study is to assess the main oral mucosal lesions (OMLs) within a hospital base and to provide an anamnestic, diagnostic model based on homogeneity analysis of some variables. Methods:  The demographic and behavioural data (i.e. gender, age, smoking status, alcohol consumption and therapeutic drug usage) of 1753 patients with at least one OML were considered. Multiple correspondence analysis (MCA) and multivariate tests of the simultaneous marginal homogeneity hypothesis (SMH) were used to analyse the evidence of any differences between the demographic and behavioural profiles relating to OMLs diagnoses. Statistical significance of…

Ozone insufflation and l-prf application in an idiopathic and recurrent case of osteonecrosis of the maxilla

Surgical treatment of medication-related osteonecrosis of the jaws with addiction of L-PRF: preliminary results

Osteonecrosis of the jaw related to everolimus and bisphosphonate: a unique case report?

Osteonecrosis of the jaw (ONJ) is a rare but serious lesion of the jaw, characterized mainly by exposed necrotic bone;it is related to various drugs, usually used for treating patients with advanced malignancies. Drugs implicated in ONJ are: nitrogen-containing bisphosphonates (NBPs), denosumab, anti-angiogenic drugs (e.g bevacizumab, sunitinib,sorafenib) and the selective mammalian target of rapamycin mTOR, everolimus. Previous data regarding the combining of NBPs with antiangiogenic agents conflict with some reports (indicating a similar risk of ONJ compared with the use of NBPs alone1); other reports show significantly higher rates (18% vs 1% with NBPs alone) of the incidence of ONJ2. Th…

Early detection of amyloid light-chain amyloidosis: a case report of oral primary manifestation

Saliva variations in gastro-oesophageal reflux disease.

Abstract Objectives The protective role of saliva in the case of oesophageal exposition to gastric acid has long been studied but some contradictions still remain. The main end-point of this study was to evaluate if a qualitative and quantitative alteration in salivary secretion exists in patients affected by GERD. Methods One hundred and twenty patients (T group) with clinically and endoscopically diagnosed GERD, and 98 healthy subjects (C group) have been evaluated; salivary tests (i.e. basal flow rate, stimulated flow rate, pH, [Na + ] and [K + ]) were performed, socio-demographical variables and oral GERD-related symptoms were taken into account. SPSS 10.5 software was used for statisti…

Odontoiatria di genere: la condizione femminile nella pratica odontoiatrica

Obiettivi: scopo del presente studio è quello di esaminare la condizione femminile in relazione alla professione odontoiatrica, quelle condizioni patologiche orali che possono colpire in particolare il sesso femminile e i trattamenti relativi. Materiali e metodi: oltre alla propria esperienza e al contributo personale, sono state effettuate ricerche sui motori di ricerca scientifica PubMed, Embase e Scopus. Risultati e conclusioni: è stata esaminata la figura della odontoiatra donna e la sua collocazione nell'ambito professionale, nonché le sue caratteristiche lavorative sia in relazione ai pazienti sia in relazione alla propria famiglia. Sono state analizzate poi le più comuni condizioni p…

Bisphosphonate related osteonecrosis of the jaws in Italy: an observational report of 24 cases

Development of OloHealth, a teledentistry platform for the ONJ prevention in Sicily: preliminary reports

Interventions for treating osteonecrosis of the jaw stage III: may conservative surgical management be a viable option?

Epithelial-myoepithelial carcinoma of the minor salivary glands: a case report

Dual localization of oral Kaposi’s sarcoma in HIV-negative patient: a rare case report

Not available

BRONJ in patients with rheumatoid arthritis: A multicenter case series

Objective: Osteonecrosis of the jaw (ONJ) is a potentially severe adverse effect of various medications (bisphosphonates, anti-resorptive, and anti-angiogenic drugs). ONJ pathogenesis is still unclear although some risk factors have been recognized. Of these, rheumatoid arthritis (RA) has been hypothesized as a potential risk factor for developing ONJ. This observational study will describe a multicenter case series of patients affected with RA and ONJ, and it will attempt to evaluate the association between features of ONJ and pharmacological, systemic, and site variables. Methods: Demographic, pharmacological, and clinical data from 18 RA patients with ONJ were collected and registered fr…

Concept therapy: Interdisciplinary tumor board for the diagnosis and treatments of head and neck cancer

Prevalence of vulval lichen planus in a cohort of women with oral lichen planus:an interdisciplinary study

BACKGROUND: Lichen planus (LP) is a mucocutaneous inflammatory dermatosis that frequently involves the oral and genital mucosae. Patients with LP affecting these sites are often seen by oral medicine specialists or gynaecologists who work in isolation and depend heavily on histopathologists to help them in confirming the diagnosis. There are few studies in the literature combining the experiences of these specialists who share the care of patients with both oral and genital LP. OBJECTIVES: To estimate the prevalence of vulval LP (VLP) in a cohort of patients with histologically confirmed oral LP (OLP). METHODS: The study group consisted of 42 women histologically diagnosed with OLP. The mea…

Oral lichen planus, hepatitis C virus, and HIV: no association in a cohort study from an area of high hepatitis C virus endemicity

Abstract Objectives We sought to assess the age-specific prevalence of oral lichen planus (OLP) in Mediterranean patients with chronic hepatitis C virus (HCV) and to evaluate the features of OLP in relation to sex, smoking, HCV genotype, HIV-1 coinfection, and antiviral treatments. Methods In all, 178 anti-HCV-positive adults (60 women and 118 men; age range 20-66 years) recruited from two cohorts (104 HIV-negative patients and 74 patients with HIV coinfection) underwent oral examination. Results Overall prevalence of OLP was 2.8% (5 of 178) (male/female ratio 0.2; odds ratio=0.119; 95% confidence interval=0.013-1.106), only among HIV-negative participants, always in the reticular pattern, …

Human buccal mucosa as an innovative site of drug delivery.

The authors review the ultra-structural aspects and permeability features of normal human oral mucosa, after having recently tested and used it as a new site of systemic drug delivery. The pertinent scientific literature from 1975 through 2009 has been analysed and discussed. Buccal epithelium is a relatively permeable, robust non-keratinized tissue and blood vessels drain directly into the jugular vein; due to its particular features, it has been of increasing interest to researchers as an alternative site of drug administration. The review describes the structure and function of the buccal mucosa, the rationale for transbuccal drug delivery and the main transmucosal drug delivery systems.…

Osteonecrosis of the jaw prevention in oncological patients: preliminary results from a teledentistry sicilian project

PREVENTION OF THE DRUG-RELATED OSTEONECROSIS OF THE JAW (ONJ): PRELIMINARY DATA OF THE PROMaF PROTOCOL

Oro-genital lichen planus in a child: a case report

HCV infection and oral lichen planus: a weak association when HCV is endemic.

Oral lichen planus (OLP), an immune-mediated disorder, has been reported as an extra-hepatic manifestation of Hepatitis C virus (HCV) infection, especially in HCV hyperendemic areas such as southern Europe and Japan. The aim of this study was to investigate from an epidemiological standpoint whether HCV infection is an important factor affecting the relative risk of OLP in a Mediterranean population or whether this relates to the degree of HCV endemicity. Two cohorts of OLP patients resident in two different regions of southern Italy (Campania and Sicily; n = 859) were evaluated for HCV infection status and categorized into five age classes to respective region-matched controls. No signific…

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

Riassunto Obiettivi Proporre protocolli di gestione odontoiatrica per il paziente che assume o che assumera 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 Societa Italiana di Chirurgia Maxillo-Facciale (SICMF) e della Societa 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 scientifiche disponibili in merito alla ONJ (associata a…

BRUXISM IN CHILDREN AND ADOLESCENTS WITH DOWN SYNDROME: A COMPREHENSIVE REVIEW