Salivary cortisol determination in patients from the Basque Country with recurrent aphthous stomatitis. A pilot study.

OBJECTIVES: Stress and anxiety are controversial factors involved in the complex pathogenesis of Recurrent Aphthous Stomatitis (RAS). The determination of salivary cortisol is a useful, simple and safe test to detect states of high stress or anxiety. The aim of this study is to check for changes in salivary cortisol levels in patients with RAS during periods of active disease. STUDY DESIGN: A measurement of cortisol employing Enzyme-Linked Immuno Sorbent Assay (ELISA) was carried out in samples of unstimulated saliva from 20 patients with active lesions of RAS and 10 healthy individuals used as controls. RESULTS: Increased levels of salivary cortisol were detected in 3 cases, all of them within the group of patients with RAS. In none of the control group patients the level of salivary cortisol was increased. The mean level of salivary cortisol was 0.64 mg / dl (range 0.2 to 1.62) for patients with RAS and 0.57 mg / dl (range 0.25 to 1.09) for controls. CONCLUSION: Salivary cortisol levels are not statistically higher in patients with active lesions of RAS.

Gingival lymphatic malformation. An atypical case report.

Lymphatic malformations are a rare pathology that presents a highly variable clinical expression. Intraorally, it mainly affects the dorsum of the tongue. The objective of this work is to present a case of lymphatic malformation in an atypical location. A 20-year-old male who attended the clinic for multiple vesicular lesion in attached gingiva, asymptomatic and of unknown evolution. Removal of the lesion and subsequent histological analysis were performed, which showed a microcystic lymphatic vascular lesion. Immunohistochemistry for D2-40 was performed, which corroborated the lymphatic origin of the lesion. At 6 months, no recurrence of the lesion was recognized. Clinicians should include lymphatic malformations in the differential diagnosis of multiple vesicular lesions. Knowing the oral manifestations of this entity is essential for its proper diagnosis and clinical management. Key words:Gingiva, oral lymphatic malformation, diagnosis.

Salivary levels of Tumour Necrosis Factor-alpha in patients with recurrent aphthous stomatitis.

OBJECTIVES: Recurrent aphthous stomatitis (RAS) is a common pathology of the oral mucosa with a complex and multifactorial etiology. Tumour Necrosis Factor-alpha (TNFα) is a cytokine with an important but not well-known role in the development of new lesions in RAS patients. Modifications of salivary levels of TNFα in RAS patients during the active periods of the disease have been measured in this work. The possible implication of TNFα in RAS etiology is also discussed. STUDY DESIGN: The study group was composed of 20 patients previously diagnosed with RAS and randomly selected. As a control group 10 healthy patients were also randomly selected. In both groups a TNFα assessment was carried out in non stimulated saliva. All the patients in the study group presented active lesions at the moment of the salivary sample collection. Values oscillating between 0 and 8.1 pg/ml were considered as normal. RESULTS: Salivary TNFα levels are 2 to 5 times higher in RAS patients than those of healthy patients. CONCLUSIONS: TNFα has a possible implication in the RAS etiology and it may also have an important role in the search of new treatments for this disease.

Clinical practice guideline of the Spanish society of oral surgery for dental care in patients with oral cancer / Guía de práctica clínica de la sociedad española de cirugía bucal para el cuidado dental en pacientes con cáncer oral

Background: Oral cancer is the sixteenth most common malignant neoplasm worldwide, with a high mortalityrate, greater than 50% at five years, and high morbidity. The effect of oncological treatment in the oral cavity isbroad and has multiple levels, therefore knowing these effects and preventing them is essential for avoiding anincrease in the oral pathology related with oncological therapy, maintaining the quality of life of the patient, andimproving the efficacy of the treatment itself.Material and Methods: A group of experts belonging to the fields of Dentistry, Maxillofacial Surgery and Oncol-ogy of the University of Seville and the Virgen del Rocío University Hospital of Seville in collaboration with theUniversity of Valencia, University of Barcelona, and University of the Basque Country, developed this ClinicalPractice Guideline for the proper clinical management of patients diagnosed with oral cancer. The clinical ques-tions were formulated in PICO format. The databases consulted were Medline/PubMed and Embase/Elsevier. Thesystematic reviews published on the topic were identified on Tripdatabase, Cochrane Library and CRD (Centre forReviews and Dissemination). The recommendations were prepared based on the GRADE methodology.Results: Various recommendations were defined, derived from the 21 PICO questions, referring to prevention,treatment and care for alterations arising from the pathology of oral cancer itself and its treatment.Conclusions: The preparation of this clinical practice guideline allows recommendations to be generated basedon the scientific evidence available, on dentistry actions in patients with oral cancer and undergoing oncologicaltreatment, which may be of use to the multidisciplinary team treating this type of patient.(AU)

Primary oral squamous cell carcinoma arising around dental osseointegrated implants mimicking peri-implantitis.

Prosthodontic rehabilitation using dental implants has become a common practice in dentistry at the present time. The number of complications related to dental osseointegrated implants has increased according to the generalization of its use along the last decade. Among the most common of these complications are chronic inflammatory conditions affecting both hard and soft tissues around dental implants. Although severe complications are uncommon, in recent years several cases of oral squamous cell carcinoma adjacent to dental implants have been published. In this paper we present a new unusual case of primary oral squamous cell carcinoma arising around a dental fixed prosthesis over osseointegrated implants in a 76 male patient with no previous history of malignance and no risk factors related to oral cancer.

Salivary cortisol determination in patients from the Basque Country with recurrent aphthous stomatitis. A pilot study

Objectives: Stress and anxiety are controversial factors involved in the complex pathogenesis of Recurrent Aphthous Stomatitis (RAS). The determination of salivary cortisol is a useful, simple and safe test to detect states of high stress or anxiety. The aim of this study is to check for changes in salivary cortisol levels in patients with RAS during periods of active disease. Study design: A measurement of cortisol employing Enzyme-Linked Immuno Sorbent Assay (ELISA) was carried out in samples of unstimulated saliva from 20 patients with active lesions of RAS and 10 healthy individuals used as controls. Results: Increased levels of salivary cortisol were detected in 3 cases, all of them within the group of patients with RAS. In none of the control group patients the level of salivary cortisol was increased. The mean level of salivary cortisol was 0.64 mg / dl (range 0.2 to 1.62) for patients with RAS and 0.57 mg / dl (range 0.25 to 1.09) for controls. Conclusion: Salivary cortisol levels are not statistically higher in patients with active lesions of RAS (AU)

Salivary levels of Tumour Necrosis Factor-alpha inpatients with recurrent aphthous stomatitis

Objetives: Recurrent aphthous stomatitis (RAS) is a common pathology of the oral mucosa with a complex and multifactorial etiology. Tumour Necrosis Factor-alpha (TNFá) is a cytokine with an important but not well-knownrole in the development of new lesions in RAS patients. Modifications of salivary levels of TNFá in RAS patients during the active periods of the disease have been measured in this work. The possible implication of TNFá inRAS etiology is also discussed. Study design: The study group was composed of 20 patients previously diagnosed with RAS and randomly selected. As a control group 10 healthy patients were also randomly selected. In bothgroups a TNFá assessment was carried out in non stimulated saliva. All the patients in the study group presented active lesions at the moment of the salivary sample collection. Values oscillating between 0 and 8.1 pg/ml were considered as normal. Results: Salivary TNFá levels are 2 to 5 times higher in RAS patients than those of healthypatients. Conclusions: TNFá has a possible implication in the RAS etiology and it may also have an important rolein the search of new treatments for this disease (AU)

Primary oral squamous cell carcinoma arising around dental osseointegrated implants mimicking peri-implantitis

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Prosthodontic rehabilitation using dental implants has become a common practice in dentistry at the present time. The number of complications related to dental osseointegrated implants has increased according to the generalization of its use along the last decade. Among the most common of these complications are chronic inflammatory conditions affecting both hard and soft tissues around dental implants. Although severe complications are uncommon, in recent years several cases of oral squamous cell carcinoma adjacent to dental implants have been published. In this paper we present a new unusual case of primary oral squamous cell carcinoma arising around a dental fixed prosthesis over osseointegrated implants in a 76 male patient with no previous history of malignance and no risk factors related to oral cancer (AU)