Capacidad pronóstica del PIV (pan-immune-inflammation value) en pacientes con carcinoma escamoso de cabeza y cuello / Prognostic capacity of PIV (pan-immune-inflammation value) in patients with head and neck squamous cell carcinoma

Introducción: El PIV (pan-immune-inflammation value), un índice que resulta del cociente (neutrófilos×monocitos×plaquetas) / linfocitos, ha sido propuesto como un biomarcador con capacidad pronóstica en diferentes modelos tumorales. El objetivo del presente estudio es analizar la capacidad pronóstica del PIV en pacientes con carcinoma escamoso de cabeza y cuello. Pacientes y métodos: Estudio retrospectivo de 1.187 pacientes con carcinoma escamoso de cabeza y cuello tratados en nuestro centro durante el periodo 2000-2017. Se obtuvo el valor del PIV a partir de un análisis realizado en un intervalo inferior a las 3 semanas previas al inicio del tratamiento. Resultados: El valor del PIV se relacionó de forma significativa con el consumo de tóxicos (p=0,001), la localización del tumor (0,0001), la extensión tumoral (0,0001), y el grado histológico (0,016). Mediante un análisis de partición recursiva se definieron 4 categorías en función del valor del PIV: categoría i: PIV<136,3 (n=118; 9,9%), categoría ii: PIV 136,3-451,1 (n=594, 50,0%); categoría iii: PIV 451,1-1.141,2 (n=357; 30,1%); categoría iv: PIV>1.141,2 (n=118; 9,9%). Se pudo observar una reducción ordenada y significativa de la supervivencia específica a medida que se incrementaba la categoría en el valor del PIV. Esta disminución en la supervivencia se produjo de forma independiente al tipo de tratamiento, la extensión del tumor, o la localización del tumor primario. La categoría en el valor del PIV se relacionó de forma significativa con la supervivencia específica en un estudio multivariable. Conclusiones: El PIV es un biomarcador con capacidad pronóstica en los pacientes con carcinoma escamoso de cabeza y cuello.(AU)

Introduction: The pan-immune-inflammation value (PIV), an index that results from the following ratio: (neutrophils×monocytes×platelets) / lymphocytes, has been proposed as a prognostic biomarker in different tumor models. The aim of this study is to analyze the prognostic capacity of PIV in patients with head and neck squamous cell carcinoma. Patients and methods: Retrospective study of 1,187 patients with head and neck squamous cell carcinoma treated at our center between 2000-2017. PIV value was obtained from an analysis performed within 3 weeks prior to the start of treatment. Results: PIV value was significantly associated with toxic consumption (0.001), tumor location (0.0001), tumor extension (0.0001), and histological grade (0.016). Four categories were defined based on PIV value using a recursive partitioning analysis: category i: PIV<136.3 (n=118, 9.9%), category ii: PIV 136.3-451.1 (n=594, 50.0%), category iii: PIV 451.1-1,141.2 (n=357, 30.1%), and category iv: PIV>1,141.2 (n=118, 9.9%). A significant and ordered decrease in disease-specific survival was observed as the PIV category increased. This decrease in survival was independent of the type of treatment, tumor extension, or location of the primary tumor. The PIV category was an independent prognostic factor of disease-specific survival in a multivariable study. Conclusions: PIV is a prognostic biomarker in patients with head and neck squamous cell carcinoma.(AU)

Perceived surgical difficulty of mandibular third molar extraction. A comparative cross-sectional study of dentists with postgraduate qualificationin oral surgery and maxillofacial surgeons in a Spanish subpopulation

Background: Mandibular third molar (MTM) extraction is one of the most frequently performed surgeries in the oral cavity. Establishing the level of surgical difficulty pre-operatively is an essential step to ensure correct treatment planning. In Spain, MTM extraction - especially in cases presenting greater difficulty - is normally performed by doctors specializing in oral and maxillofacial surgery, or by dentists with postgraduate qualifications in oral surgery. The present work set out to analyze the extent to which perceptions of surgical difficulty of the said intervention vary in relation to professional training. Material and Methods: This cross-sectional, descriptive, observational study took the form of a survey. Using a visual analog scale (VAS), participants evaluated both the perceived difficulty of 30 cases of MTM extraction described by means of digital panoramic radiographs and the perceived difficulty deriving from a series of factors conditioning MTM extraction. The results underwent statistical analysis with SPSS Statistics 28.0 software. Nonparametric tests (Mann Whitney test for independent samples and the Kruskal-Wallis test) were applied. Results: A total of 213 surveys were available for analysis. Both groups awarded the greatest importance to clinical experience, followed by anatomical and radiographic factors, root morphology obtaining the highest score among anatomical factors (9.01±1.42), while proximity of the MTM to the inferior alveolar nerve was regarded as the least important anatomical factor (8.11 ±2.54). Significant differences were only found for patient age, whereby maxillofacial surgeons awarded this factor more importance than dentists. Conclusions: The different training received by dentists specialized in oral surgery and maxillofacial surgeons did not influence either perceptions of surgical difficulty of MTM extraction, or opinions as to the factors influencing surgical difficulty. (AU)

Relationship between transcriptional expression of pyruvate dehydrogenase and local control of disease in patients with oral cavity carcinomas / Relación entre la expresión transcripcional de piruvato deshidrogenasa y el control local de la enfermedad en pacientes con cáncer en la cavidad oral

Background The altered cellular metabolism is one of the hallmarks of the cancer cells, favoring the process of aerobic glycolysis, known as the Warburg effect. The pyruvate dehydrogenase (PDH) complex is one of the elements involved in this metabolic process. The present study aims to evaluate the relationship between the transcriptional expression of PDHB and the risk of local recurrence in patients with oral cavity carcinomas. Methods We determined the transcriptional expression of PDHB in biopsies from 41 patients with oral cavity carcinomas treated with surgery. The PDHB expression was categorized according to the local control of the disease with a recursive partitioning analysis. Results During the follow-up period 13 patients (31.7%) had a local recurrence of the tumor. Considering local disease control as the dependent variable, the recursive partitioning analysis classified the patients in two categories according to high (n=16, 39.0%) or low (n=25, 61.0%) PDHB expression. Five-year local recurrence-free survival for patients with high PDHB expression was 84.8% (95% CI: 65.2-100%), and for patients with low expression it was 54.3% (95% CI: 34.3–74.2 %) (P=0.034). The results of multivariate analysis showed that patients with a low PDHB expression had a 4.90 times higher risk of local recurrence of the tumor (95% CI: 1.02–22.68, P=0.042). Conclusion There is a relationship between the metabolic characteristics of the tumor and its aggressiveness. According to our results, patients with oral cavity carcinomas with low transcriptional expression levels of PDHB have a significantly higher risk of local tumor recurrence. (AU)

Antecedentes La alteración del metabolismo celular es una de las características distintivas de las células cancerígenas, y favorece el proceso de la glucólisis aeróbica, conocido como efecto de Warburg. El complejo de piruvato deshidrogenasa (PDH) es uno de los elementos implicados en este proceso metabólico. El objetivo del presente estudio es evaluar la relación entre la expresión transcripcional de PDHB y el riesgo de recidiva local en los pacientes con cáncer en la cavidad oral. Métodos Determinamos la expresión transcripcional de PDHB en biopsias de 41 pacientes con cáncer en la cavidad oral tratados con cirugía. Se categorizó la expresión de PDHB de acuerdo con el control local de la enfermedad, con un análisis de partición recursiva. Resultados Durante el periodo de seguimiento, trece pacientes (31,7%) tuvieron una recidiva local del tumor. Considerando el control de la enfermedad local como variable dependiente, el análisis de partición recursiva clasificó a los pacientes en dos categorías, de acuerdo con la expresión de PDHB alta (n=16, 39%) o baja (n=25, 61%). La tasa de supervivencia libre de enfermedad a cinco años con expresión alta de PDHB fue del 84,8% (95% IC: 65,2–100%), siendo del 54,3% (95% IC: 34,3–74,2%) (P=0,034) para los pacientes con expresión baja. Los resultados del análisis multivariante reflejaron que los pacientes con expresión baja de PDHB tuvieron un riesgo 4,90 veces mayor de recidiva local del tumor (95% IC: 1,02–22,68, P=0,042). Conclusión Existe una relación entre las características metabólicas del tumor y su agresividad. Conforme a nuestros resultados, los pacientes con cáncer en la cavidad oral y bajos niveles transcripcionales de PDHB tienen un riesgo significativamente mayor de recidiva local del tumor. (AU)

Características odontométricas de las primeras molares permanentes del maxilar superior e inferior en estudiantes de odontología de la Universidad Nacional Federico Villarreal. Lima-Perú / Odontometric characteristics of the first permanent molars of the upper and lower maxilla in dentistry students of the Federico Villarreal National University. Lima Peru

Objetivo: Determinar los diámetros mesiodistal, vestíbulo palatino y vestíbulo lingual, de las primeras molares permanentes de ambos maxilares para la estimación del sexo, en los estudiantes de Odontología de la Universidad Nacional Federico Villarreal, Lima-Perú. Material y métodos: El tipo de investigación empleado fue descriptivo con un diseño no experimental, la técnica aplicada fue la observación directa, la población estuvo constituida por 605 estudiantes. Se realizó la toma de impresiones de ambos maxilares con silicona de condensación para obtener los modelos de estudio, se utilizó un calibrador vernier digital para hacer las medidas mesiodistal y vestíbulo palatino y vestíbulo lingual, las medidas se realizaron a una muestra de 207 modelos de ambos sexos. Resultados: La característica odontométrica con respecto al diámetro vestíbulo -palatino/lingual de ambos maxilares, para el sexo masculino tuvo un diámetro de 11.2mm (pza.16), 11.3mm (pza.26), 11.01mm (pza.36) y 11.02mm (pza.46) y valores de 10.88mm (pza16), 10.93mm (pza.26), 10.77mm (pza.36), y 10.74mm (pza.46), en el sexo femenino; en lo referente a la característica odontométricas mesio-distal se encontró un diámetro de 10.8mm (pza.16), 10.76mm (pza.26), 11.44mm (pza.36) y 11.45mm (pza.46) para el sexo masculino y valores de 10.56mm (pza. 16), 10.58mm (pza.26), 11.10 mm (pza.36), y 11.2mm (pza.46), en el sexo femenino. Conclusión: Los diámetros mesiodistales y vestíbulo palatino fueron mayores en el sexo masculino. (AU)

Objective: To determine the mesiodistal, palatal vestibule and lingual vestibule diameters of the first permanent molars of both jaws for the estimation of sex, in Dentistry students of the Federico Villarreal National University, Lima-Peru. Material and methods: The type of research used was descriptive with a non-experimental design, the applied technique was direct observation, the population consisted of 605 students. Impressions of both jaws were made with condensation silicone to obtain the study models, a digital vernier caliper was used to make the mesiodistal and palatal vestibule and lingual vestibule measurements, the measurements were made on a sample of 207 models of both sexes. Results: The odontometric characteristic with respect to the vestibule-palatal/lingual diameter of both jaws, for the male sex had a diameter of 11.2mm (pza.16), 11.3mm (pza.26), 11.01mm (pza.36) and 11.02mm (pza.46) and values of 10.88mm (pza.16), 10.93mm (pza.26), 10.77mm (pza.36), and 10.74mm (pza.46), in the female sex; Regarding the mesio-distal odontometric characteristic, a diameter of 10.8mm (pza.16), 10.76mm (pza.26), 11.44mm (pza.36) and 11.45mm (pza.46) was found for the male sex. and values of 10.56mm (pza.16), 10.58mm (pza.26), 11.10mm (pza.36), and 11.2mm (pza.46), in the female sex. Conclusion: The mesiodistal and palatal vestibule diameters were greater in males. (AU)

Déficit adquirido de Factor XIII como causa de hemorragia masiva con compromiso de vía aérea superior en cirugía oncológica de cavidad oral / Acquired Factor XIII deficiency as a cause of massive hemorrhage with upper airway compromise in oncological surgery of the oral cavity

El diagnóstico etiológico de una hemorragia postoperatoria persistente en pacientes adultos sin antecedentes médicos de interés supone un reto a día de hoy. Dentro de las distintas causas encontramos el déficit adquirido del Factor XIII (F. XIII) de la coagulación. El déficit de este factor suele pasar desapercibido al no ser valorado en el estudio preoperatorio rutinario. Presentamos el caso de un varón de 70 años con déficit de F. XIII adquirido, no diagnosticado previamente, que tras ser intervenido por un carcinoma epidermoide de suelo de boca sufrió un sangrado de cavidad oral y cervical bilateral con compromiso de la vía aérea. (AU)

The etiological diagnosis of persistent postoperative bleeding in adult patients with no relevant medical history is currently a challenge. Among the different causes, we find the acquired deficiency of Factor XIII (F. XIII) of coagulation. The deficit of this factor usually goes unnoticed as it is not tested in the routine preoperative studies. We present the case of a 70-year-old man with previously undiagnosed acquired F. XIII deficiency who, after undergoing surgery for squamous cell carcinoma of the floor of the mouth, suffered oral and bilateral cervical bleeding causing airway compromise. (AU)

Manifestaciones bucales en cuidados paliativos: importancia, estrategias terapéuticas y su eficacia / Oral manifestations in palliative care: importance, therapeutic strategies and their effectiveness

Introducción y objetivo: En los cuidados paliativos, las afecciones de la boca son muy frecuentes e interfieren con la calidad de vida del paciente. La boca es un lugar que aún merece poca atención por parte de los profesionales de la salud. El objetivo del presente estudio es caracterizar los trastornos bucales en pacientes de cuidados paliativos, investigar estrategias farmacológicas y no farmacológicas y analizar su eficacia. Material y métodos: Estudio exploratorio, observacional y correlacional sobre trastornos bucales en pacientes hospitalizados en un servicio de cuidados paliativos en Portugal, entre el 6 de noviembre de 2019 y el 31 de julio de 2020. El instrumento de recolección de datos incluyó un cuestionario y consulta del expediente clínico de los enfermos. Resultados: En este estudio (n = 46), el grupo de edad más representativo fue el de 71-90 años (56,52 %). La mayoría presentaba enfermedad oncológica (84,78 %) y estaban polimedicados. De estos, el 95,65 % presentaba dentición incompleta, y el 41,30 % asumía que rara vez realizaba cuidados de higiene bucal. La xerostomía fue reportada por el 89,13 % de la muestra, se observó candidiasis bucal en el 76,09 %, lengua saburral en el 23,91 % y mucositis bucal en el 10,87 %. Los pacientes con patología oncológica están más predispuestos a las alteraciones bucales (p = 0,047) en comparación con los pacientes no oncológicos. Los pacientes con hábitos de higiene bucal frecuentes tienen menos trastornos bucales (rS = –0,54; p = 0,028). Hubo una mejora considerable en la lengua saburral con el aumento en la frecuencia del cuidado de la higiene bucal (p = 0,004). Conclusiones: La implementación de estrategias farmacológicas y no farmacológicas desempeña un papel central en el bienestar y calidad de vida de la persona. Es fundamental que los profesionales de la salud conozcan las afecciones bucales y sus síntomas, lo cual es fundamental para la promoción de su bienestar. (AU)

Introduction and objectives: In palliative care, there are many mouth disorders that arise, interfering with the patient’s quality of life. The mouth is a place that still deserves little attention by health professionals. The present study aimed to characterize mouth disorders in palliative care patients; to identify the etiology of mouth disorders; to investigate pharmacological and non-pharmacological strategies, and to analyse its efficacy. Materials and methods: an exploratory, observational and correlational study on the mouth disorders of patients hospitalized in a palliative care service in Portugal between November 6, 2019 and July 31, 2020. The data collection instrument included a questionnaire and the consultation of the patient’s clinical file. Results: In this study (n = 46), the most representative age group was from 71 to 90 years (56.52 %). Most of them had oncological disease (84.78 %) and were polymedicated. Of these, 95.65 % had incomplete dentition and 41.30 % rarely performed oral hygiene care. Xerostomia was reported by 89.13 % of the sample; oral candidiasis was found in 76.09 %; tongue coating in 23.91 %, and oral mucositis in 10.87 %. Patients with oncological pathology were more predisposed to mouth disorders (p = 0.047) when compared to non-cancer patients. Patients with frequent oral hygiene habits had fewer mouth disorders (rS = –0.54; p = 0.028). There was considerable improvement in tongue coating with increased frequency of oral hygiene care (p = 0.004). Conclusions: The implementation of pharmacological and non-pharmacological strategies plays a central role in patient comfort and quality of life. It is essential that health professionals are aware of mouth conditions and their symptoms, this being essential for the promotion of well-being. (AU)

Entre la estética y la medicina: el cuidado del cuerpo en el Breviarium de Johannes de Sancto Paulo / [Between aesthetics and medicine: care of the body in the Breviarium of Johannes de Sancto Paulo]

El Breviarium de Johannes de Sancto Paulo, compuesto en el entorno de la Escuela de Salerno en la segunda mitad del XII, presenta las características propias del género médico de los compendios o prácticas medievales, una suerte de vademécum que describe en latín los signos, las causas y el tratamiento de las principales enfermedades ordenadas a capite ad calcem. Pese a contar con una importante tradición manuscrita —se han encontrado hasta el momento 36 códices que se conservan en diversas bibliotecas de todo el mundo— el Breviariumes una obra inédita, pues nunca llegó a imprimirse en el Renacimiento. Entre sus capítulos, hallamos algunos dedicados al cuidado y a la higiene del cuerpo (teñido del cabello, manchas y pústulas en el rostro, halitosis, mal olor en las axilas, blanqueamiento de dientes). Todos ellos presentan recetas y experimenta para combatir estos problemas no solo desde un punto de visto médico, sino también estético. El objetivo de nuestro trabajo, por tanto, consiste en analizar estos capítulos, contextualizarlos dentro de la producción médica salernitana, rastrear sus fuentes y atestiguar su pervivencia en tratados posteriores. (AU)

Lesiones papilomatosas orales: hiperplasia epitelial focal / Oral papillomatous lesions: Focal epithelial hyperplasia

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Angiosarcoma metastásico de la cavidad oral: a propósito de un caso / Metastatic angiosarcoma of the oral cavity: report of a case

El angiosarcoma oral es un tumor endotelial raro que, debido a su presentación clínica, requiere ser comparada con varias lesiones similares como diagnóstico diferencial. Presentamos un paciente de 66 años en tratamiento por múltiples episodios hemorrágicos digestivos, derivada al Servicio de Cirugía Oral y Maxilofacial del Hospital de Carabineros de Santiago de Chile debido a la presencia de lesiones vasculares intraorales. Se diagnostican inicialmente como lesiones metastásicas de un tumor estromal gastrointestinal, siendo el diagnóstico histopatológico final de un angiosarcoma agresivo y diseminado. La presentación clínica de este tipo de lesiones dificulta el diagnóstico definitivo y, en consecuencia, el manejo de este tipo de pacientes. (AU)

Oral angiosarcoma is a rare endothelial tumour that requires to be included as a differential diagnosis of several similar lesions due to its clinical presentation. We present a 66-year-old patient undergoing treatment for multiple digestive bleeding episodes, referred to the oral and maxillofacial surgery service of the Hospital de Carabineros de Santiago de Chile due to the presence of intraoral vascular lesions initially diagnosed as metastatic lesions of a gastrointestinal stromal tumour, with the final histopathological diagnosis being an aggressive and disseminated angiosarcoma. The clinical presentation of these lesions makes the diagnosis and, consequently, the management of this type of patient difficult. (AU)

Factores asociados a la presencia del virus de Epstein-Barr en la cavidad oral de adolescentes de la ciudad de Cali (Colombia) / Factors associated with the presence of the Epstein-Barr virus in the oral cavity of high school students from the city of Cali (Colombia)

IntroducciónEl virus de Epstein-Barr (VEB) está clasificado como carcinógeno del grupo 1. Su principal vía de transmisión es la oral, a través de la saliva. Determinamos la frecuencia de detección del VEB en la cavidad oral en estudiantes de secundaria en Cali (Colombia).Materiales y métodosEstudio transversal analítico para estimar la frecuencia de detección del genoma del VEB en la cavidad oral, las razones de prevalencia y su asociación con diversos factores en 1.565 individuos. Las variables analizadas fueron factores sociodemográficos, de higiene y salud oral, comportamiento sexual, consumo de cigarrillos e ingesta de alcohol. La asociación entre la detección y las variables evaluadas se realizó mediante un modelo de regresión lineal generalizado con vínculo logarítmico y distribución de Poisson con varianza robusta.ResultadosLa exposición al VEB en la cavidad oral fue del 38,40% (IC 95%: 36,02-40,84). La frecuencia de presentar exposición al VEB fue un 22% mayor en los varones, y el riesgo se incrementó según el comportamiento sexual. Se encontró asociación inversa con el grado escolar: los participantes de undécimo grado tuvieron un 27% menos frecuencia de exposición al VEB que los de grados inferiores (sexto a octavo). Cuando se utilizó el modelo logístico para estudiar la asociación entre la detección del VEB y las variables independientes, se sobreestimó la asociación. El rango de sobreestimación fue entre el 27-47% según el tipo de variable.ConclusiónLa frecuencia de detección del VEB en la cavidad oral de estudiantes sanos fue similar a la previamente descrita. Factores asociados al comportamiento sexual incrementan el riesgo de oportunidad para la exposición al VEB.

IntroductionThe Epstein-Barr virus (EBV) is classified as a group 1 carcinogen. The main route of EBV transmission is oral, through saliva. The present study aimed to determine the frequency of EBV detection in the oral cavity in high school students in the city of Cali (Colombia).Materials and methodsAnalytical cross-sectional study in order to determine the frequency of EBV detection in the oral cavity, the reasons for its prevalence and its association with several factors, in 1,565 individuals. The variables analyzed were sociodemographic factors, oral hygiene, oral health, sexual behavior, cigarrete smoking and alcohol intake. The association between the EBV detection and the variables evaluated was done through a generalized linear regression model with logarithmic linkage and Poisson distribution with robust variance.ResultsThe percentage of exposure to EBV in the oral cavity was 38.40% (CI 95%: 36.02-40.84). The frequency of presenting EBV exposure was 22% higher in men and the risk increased according to sexual behaviour. An inverse association with the school grade was found: the eleventh-grade participants had 27% less frequency of exposure to EBV than the lower grades (sixth to eighth). When analyzing the logistic model to study the association between EBV detection and independent variables, the association was overestimated. The overestimation ranged from 27 to 47% depending on the type of variable.ConclusionsThe frequency of EBV detection in the oral cavity of healthy students was similar to that previously described. Factors associated to sexual behavior increased the risk of opportunity to be exposed to EBV.

HIV-related non-Hodgkin lymphomas affecting the oral cavity: a clinicopathologic study of 11 cases

Background: HIV-related non-Hodgkin lymphomas of the oral cavity are rare lesions with aggressive clinical behaviour. The aim of this study is to describe the clinicopathological features of a series of HIV-related oral non-Hodgkin lymphomas. Material and Methods: Eleven cases of oral lymphomas affecting HIV-positive patients were retrieved from 2012 to 2019. Clinicopathological features regarding age, sex, tumour location, clinical presentation, laboratory findings, disease stage and follow-up were obtained. Histologic, immunohistochemical and in situ hybridization for EBV detection were done for diagnosis confirmation. Overall survival was estimated by Kaplan–Meier curve. Results: Males predominated, with a mean age of 40.3 years-old. Maxilla and mandible were the mostly affected. Plasmablastic lymphoma and diffuse large B-cell lymphoma not otherwise specified (NOS) were the main histological types. Lesions presented as reddish ulcerated swellings, representing the first sign of AIDS in six cases. Stage IV were common (7 cases) and the mean HIV viral load was 10,557 copies/mL, with a mean of 266 CD4+ cells/mm3, 1,278 CD8+ cells/mm3 and a CD4+/CD8+ ratio of 0.26. Eight patients died of the disease (72.7%). Overall survival revealed that 78.2% of the patients died after 21 months of follow-up. Conclusions: HIV-related oral lymphomas present a poor prognosis usually diagnosed in advanced stages and in our series plasmablastic lymphoma was the most common subtype.(AU)

Traumatismos bucodentales en la práctica del rugby: a propósito de un caso / Oral trauma in rugby practice: about a case

Introducción: La participación en el rugby se ha visto incrementada con el paso de los años, especialmente en países donde la práctica de este deporte no era habitual, lo que ha arrojado como consecuencia un aumento en la incidencia de lesiones, dada la naturaleza de alto impacto del mismo. Diversos estudios epidemiológicos han evaluado la incidencia de traumatismos bucodentales como consecuencia de accidentes deportivos, en los que se hace referencia a las fracturas dentarias como aquellas más comúnmente producidas dentro de la práctica de este tipo de deportes. Descripción del caso clínico: Se presenta el caso clínico de un paciente varón de 18 años de edad, sin antecedentes médicos de interés, remitido al servicio de Cirugía Bucal del Hospital Viamed Virgen de la Paloma de Madrid, quién presentaba una lesión de tejidos blandos, además de luxación palatina del sector dentario anterosuperior, como consecuencia de un traumatismo durante un partido de rugby, para el cual se prescribió tratamiento farmacológico combinado con una ferulización, permitiéndose así la cicatrización espontánea de los tejidos. Discusión y conclusiones: Se observa una alta incidencia de lesiones producidas durante la práctica del rugby debido al escaso equipamiento protector usado por los jugadores, donde la cara y sus tejidos blandos constituyen las zonas con mayor frecuencia de afectación, pudiendo considerarse como el deporte de alto impacto con mayor prevalencia de lesiones de cabeza y cuello. (AU)

Introduction: Participation in rugby has increased over the years, especially in countries where the practice of this sport was not common, which has resulted in an increase in the incidence of injuries given its high-impact nature. Various epidemiological studies have evaluated the incidence of oral trauma as a result of sports accidents, in which dental fractures are referred to as those most commonly produced within the practice of this type of sports. Description of the clinical case: We present the clinical case of an 18-yearold male patient, with no relevant medical history, referred to the Oral Surgery Service of the Virgen de la Paloma Viamed Hospital in Madrid, who presented a soft tissue lesion in addition to a palatal dislocation of the dental sector anterosuperior as a result of trauma during a rugby match, for which drug treatment combined with splinting was prescribed, thus allowing spontaneous tissue healing. Discussion and conclusions: A high incidence of injuries produced during rugby practice is observed due to the scarce protective equipment used by the players, where the face and its soft tissues constitute the areas with the highest frequency of affectation and can be considered as the high-impact sport with the highest prevalence of head and neck injuries. (AU)

What is the frequency of floor of the mouth lesions? A descritive study of 4016 cases / ¿Cuál es la frecuencia de las lesiones del suelo de la boca? Un estudio descriptivo de 4016 casos

Background: The aim of this study was to investigate the frequency of oral lesions in the floor of the mouth fromrepresentative oral pathology centres in Latin America.Material and Methods: This study was conducted on biopsies obtained from January of 1978 to December of 2018at nine Latin America oral and maxillofacial pathology centres. Gender, age and histopathological diagnosis wereevaluated. Data were analysed using descriptive methods. Chi-square test was used for pairwise comparisons.Results: From 114,893 samples, 4,016 lesions (3.49%) occurred in the floor of the mouth. Brazil showed 3,777 cases(94%), Mexico 182 cases (4.5%) and Argentina 57 cases (1.4%). Benign lesions represented 65.1% (2,617 cases),followed by 34.9% (1,404 cases) of malignant disorders. Lesions of epithelial origin were more frequent (1,964) cases; 48.9%), followed by salivary glands (1,245 cases; 31%) and soft tissue lesions (475 cases; 11.7%). The mostcommon histological subtypes were oral squamous cell carcinoma (1,347 cases; 33.5%), ranula (724 cases; 18%), oralleukoplakia (476 cases; 11.8%) and inflammatory fibrous hyperplasia (239 cases; 5.9%). The lesion affected males in2,129 cases and females in 1,897 cases.Conclusions: In the current study, lesions in the floor of the mouth represented 3.49% of biopsies submitted to oralpathology services and oral squamous cell carcinoma, ranula and leukoplakia were the most common lesions.(AU)

The genotypes and virulence attributes of C. albicans isolates from oral leukoplakia / Los genotipos y atributos de virulencia de aislamientos de C. albicans de leucoplasia oral

Background: There is a debate as to whether some types of oral leucoplakias (OL) are caused by Candida species,and whether they contribute to the malignant transformation, associated with a minority of such lesions. As nodetailed population analysis of yeast isolates from OL is available, we evaluated the virulence attributes, and geno-types of 35 C. albicans from OL, and compared their genotypes with 18 oral isolates from healthy individuals.Material and Methods: The virulence traits evaluated were esterase, phospholipase, proteinase, haemolysin andcoagulase production, and phenotypic switching activity, and yeast adherence and biofilm formation. DNA fromOL and control yeasts were evaluated for A, B or C genotype status.Results: Phospholipase, proteinase, and coagulase activity and biofilm formation was observed in 80%, 66%, 97% and 77 % of the isolates, respectively. Phenotypic switching was detected in 8.6%, while heamolytic, and ester-ase activity and adherence were noted in all isolates.Conclusions: The genotype A was predominant amongst both the OL and control groups. Due to the small samplesize of our study a larger investigation to define the role of candidal virulent attributes in the pathogenicity of OLis warranted, and the current data should serve as a basis until then.(AU)

Buccal fat pad excision for cheek refinement: A systematic review / Escisión de la almohadilla de grasa bucal para refinar las mejillas: Una revisión sistemática

Background: Buccal Fat Pad (BFP) excision has become an aesthetic surgical procedure. Although this procedureis quite common, it is important to bear in mind that the scientific evidence supporting the efficacy of this treat-ment is scarce and of low quality. The purpose of this systematic review was to analyse all relevant data to assessthe efficacy and safety of BFP excision for improving midface aesthetics.Material and Methods: A thorough search of MEDLINE (PubMed), Scopus and Cochrane Library databases wasconducted. The PICO approach was used where healthy patients seeking cheek slimming and facial silhouetterefining undergo BFP excision and were compared before and after surgery in terms of BFP volume reduction,adverse effects and patient satisfaction.Results: Of the 1,413 references identified, 4 were included in the qualitative synthesis. Only one study reportedBFP volume reduction, which was 3.10 mL (95%CI: 2.38 to 3.80; P < 0.001), and the mean volume of the excisedtissue was 2.74 ± 0.69 mL (range, 1.8-4.9 mL). 84.6% of the patients stated that their facial contour was much bet-ter and the remaining 15.4% noticed that the appearance of their cheeks following BFP excision was better. Sevencomplications were reported in the 134 cheek refinement procedures. Conclusions: BFP removal has an initially favorable outcome for facial aesthetics and a low postoperative complica-tion rate, however, there are many procedures being performed with poor quality methodology and there is also alack of published data on its long-term follow-up results.(AU)

Oral mucositis. Is it present in the immunotherapy of the immune checkpoint pd1/pd-l1 against oral cancer? A systematic review / Mucositis bucal. ¿Está presente en la inmunoterapia del punto de control inmunológico pd1/pd-l1 contra el cáncer oral? Una revisión sistemática

Background: Oral mucositis (OM) is a painful lesion that takes place in the mucosa of the oral cavity, usually itsetiology is associated with drug therapies in cancer patients. It is presented as well-defined ulcers whose painfulsymptomatology sometimes implies the suspension of oncological treatment or parenteral feeding, being there-fore an important adverse effect, marking the evolution of these types of therapies against cancer. The presentwork aim is to know the prevalence of oral mucositis in oral cancer immunotherapy compared to its prevalencein standard therapy.Material and Methods: A protocol was developed for a systematic review following PRISMA® guidelines and afocused question (PICO) was constructed. A comprehensive literature search was conducted on electronic data-bases including PubMed, the SCOPUS database, the Cochrane library and the Web of Science (WOS).Results: Six clinical trials were included that met the different inclusion criteria. In these articles, a discrepancybetween the prevalence of OM in patients treated with chemotherapy and patients treated with immunotherapyrelated to the immune checkpoint PD-1/PD-L1 (Nivolumab and Pembrolizumab) was observed. Conclusions: The prevalence of oral mucositis is lower in new immunotherapy with monoclonal antibodies againstoral cancer than drugs used so far (chemotherapy drugs [methotrexate, cisplatin] as well as cetuximab). However,more studies should be carried out to confirm these data.(AU)