Periodontal disease and diabetes.

Diabetes is considered to be a genetically and environmentally based chronic metabolic and vascular syndrome caused by a partial or total insulin deficiency with alteration in the metabolism of lipids, carbohydrates and proteins culminating with different manifestations in different organisms. In humans hyperglycemia is the main consequence of defects in the secretion and/or action of insulin, and its deregulation can produce secondary lesions in various organs, especially kidneys, eyes, nerves, blood vessels and immune systems. Periodontal disease is an entity of localized infection that involves tooth-supporting tissues. The first clinical manifestation of periodontal disease is the appearance of periodontal pockets, which offer a favorable niche for bacterial colonization. The etiology of periodontal disease is multifactorial, being caused by interactions between multiple micro-organisms (necessary but not sufficient primary etiologic factors), a host with some degree of susceptibility and environmental factors. According to current scientific evidence, there is a symbiotic relationship between diabetes and periodontitis, such that diabetes is associated with an increased incidence and progression of periodontitis, and periodontal infection is associated with poor glycaemic control in diabetes due to poor immune systems. Hence, for a good periodontal control it is necessary to treat both periodontal disease and glycaemic control.

Host defence mechanisms against bacterial aggression in periodontal disease: Basic mechanisms.

Periodontal diseases are complex bacteria-induced infections characterised by an inflammatory host response to plaque microbiota and their by-products. Most of these microorganisms have virulence factors capable of causing massive tissue destruction both directly, through tissue invasion and the production of harmful substances, or indirectly, by activation of host defense mechanisms, creating an inflammatory infiltrate of potent catabolic activity that can interfere with normal host defense mechanisms. In response to the aggression, host defense mechanisms activate innate and adaptive immune responses. Our aim is to offer a general overview of the main mechanisms involved in the host response to bacterial aggression in periodontitis, such as lipopolysaccharide receptor CD14, complement system, polymorphonuclear neutrophils, antibodies and immunoglobulins.

Importance of apoptotic mechanisms in inflammatory infiltrate of oral lichen planus lesions.

BACKGROUND: Oral lichen planus (OLP) is an autoimmune disease produced by T lymphocyte attack on basal epithelial cells. OLP can undergo malignant transformation that may be linked to an increased proliferative activity and decreased apoptosis rate of the epithelial cells, phenomena that may be influenced by the inflammatory infiltrate. The objectives of this study were to assess the quantitative importance of apoptosis in the inflammatory infiltrate of OLP and to discuss its influence on the persistence of this infiltrate and on the malignant transformation of this disease. MATERIALS AND METHODS: In 32 patients with OLP and 20 controls, apoptosis was studied by TUNEL assay and caspase-3 determination, while cell cycle arrest and senescence were studied by measurement of p21 expression. RESULTS: There was a low frequency of lymphocytic apoptosis according to both TUNEL (34.5% of cases negative, 65.5% with mild expression) and caspase-3 expression (42.9% of cases negative, 50% with mild expression) findings. P21 expression was also negative (9.7% of cases) or mild (80.6% of cases) in most cases. CONCLUSION: The absence or low rate of apoptosis observed in inflammatory cells in OLP appears to contribute to the persistence of the inflammatory infiltrate, potentiating the onset of molecular disorders in epithelial cells and favouring cancer development.

[Side effects of drugs on the oral cavity]. / Reacciones adversas a medicamentos en la cavidad oral.

Although drugs are the most powerful therapeutic tools we have for improving the quality of life of the population, their use is not free of adverse effects. Today there are many polymedicated patients, and it is difficult to find the cause of their adverse effects that increase exponentially when more than 4 drugs are combined. There are a large number of drugs that can result in numerous adverse effects in the oral cavity. The most common are xerostomia, altered taste, gingival enlargement and mucositis caused by cancer treatment. We also review other disorders of the salivary glands, oral mucosal changes, pigmentations, halitosis, osteonecrosis, opportunistic infections and bleeding diathesis.

[Clinical manifestations of hematological non-neoplastic diseases in Dentistry]. / Manifestaciones clínicas de las hemopatías no neoplásicas en Odontología.

Systemic disease can cause clinical manifestations in the oral and maxillofacial area, which is important to recognize because it could be the first symptom of an undiagnosed illness. There are different oral signs that could suggest the clinician a blood disorder, such as pallor, petechiae, ecchymosis, ulcerations, gingival hypertrophy or spontaneous gingival bleeding. In addition, blood disorders will determine the dental management of these patients and the protocol for limiting possible complications that may arise due to the treatment itself. This paper reviews the oral manifestations and dental management of non-neoplastic alterations of red cells, white cells and hemostasis, with emphasis on two-way relationship that must exist between the dentist and the patient's hematologist for making a treatment plan.

Epidemiological study of oral cancer patients in Alava province, Spain.

The authors conducted a retrospective study of oral squamous cell carcinoma (OSSC) patients in the province of Alava, Spain, to investigate the various epidemiological factors involved. The study included data on 30 patients referred to the Otolaryngology Department of our hospital. The authors identified epidemiological data, including age, symptoms, localization, tumor size, risk factors, tumor stage, treatment and outcome. An elevated percentage of risk factors was found, underlining the importance of early diagnosis. The highest prevalence was in the sixth decade of life. The most frequent symptom was pain, and the localization was in the tongue in 70% of cases. Tumor size ranged from 2 to 3 cm, and 85% of patients underwent surgical resection. Risk factors of smoking and drinking affected 50% of the patients.

Reacciones adversas a medicamentos en la cavidad oral / Side effects of drugs on the oral cavity

A pesar de que los fármacos son la herramienta terapéutica más potente de la que disponemos para mejorar la calidad de vida de la población, su uso no está exento de efectos adversos. Hoy en día son muchos los pacientes polimedicados, siendo complicado encontrar la causa de los efectos adversos generados por la medicación y aumentando estos de manera exponencial cuando se combinan más de 4 fármacos. Existe un amplio número de fármacos que pueden dar lugar a numerosos efectos adversos en la cavidad bucal. Los más frecuentes son la xerostomía, las alteraciones del gusto, el agrandamiento gingival y las mucositis producidas por el tratamiento oncológico. También se revisan otras alteraciones de las glándulas salivales, las alteraciones de la mucosa oral, las pigmentaciones, la halitosis, la osteonecrosis, las infecciones oportunistas y las diátesis hemorrágicas (AU)

Although drugs are the most powerful therapeutic tools we have for improving the quality of life of the population, their use is not free of adverse effects. Today there are many polymedicated patients, and it is difficult to find the cause of their adverse effects that increase exponentially when more than 4 drugs are combined. There are a large number of drugs that can result in numerous adverse effects in the oral cavity. The most common are xerostomia, altered taste, gingival enlargement and mucositis caused by cancer treatment. We also review other disorders of the salivary glands, oral mucosal changes, pigmentations, halitosis, osteonecrosis, opportunistic infections and bleeding diathesis (AU)

Manifestaciones clínicas de las hemopatías no neoplásicas en Odontología / Clinical manifestations of hematological non-neoplastic diseases in Dentistry

Las enfermedades sistémicas pueden provocar manifestaciones clínicas en el área oral y maxilofacial, que es importante conocer puesto que podrían ser el primer síntoma de una enfermedad no diagnosticada. Hay diferentes signos que pueden aparecer en la cavidad oral y que deben hacer pensar al clínico en un trastorno hematológico, como por ejemplo la palidez, las petequias, las equimosis, las ulceraciones, la hipertrofia gingival o la gingivorragia espontánea. Además, las alteraciones hematológicas van a determinar el tratamiento odontológico de estos pacientes y el protocolo a seguir para limitar las posibles complicaciones que puedan aparecer debidas al tratamiento en sí. En este trabajo se revisan las manifestaciones orales y el manejo odontológico de los cuadros no neoplásicos de la serie roja, blanca y la hemostasia, haciendo hincapié en la relación bidireccional que ha de existir entre el odontólogo y el hematólogo del paciente para la confección de un plan de tratamiento adecuado al mismo (AU)

Systemic disease can cause clinical manifestations in the oral and maxillofacial area, which is important to recognize because it could be the first symptom of an undiagnosed illness. There are different oral signs that could suggest the clinician a blood disorder, such as pallor, petechiae, ecchymosis, ulcerations, gingival hypertrophy or spontaneous gingival bleeding. In addition, blood disorders will determine the dental management of these patients and the protocol for limiting possible complications that may arise due to the treatment itself. This paper reviews the oral manifestations and dental management of non-neoplastic alterations of red cells, white cells and hemostasis, with emphasis on two-way relationship that must exist between the dentist and the patient's hematologist for making a treatment plan (AU)

Host defence mechanisms against bacterial aggression in periodontal disease: Basic mechanisms

Periodontal diseases are complex bacteria-induced infections characterised by an inflammatory host response toplaque microbiota and their by-products. Most of these microorganisms have virulence factors capable of causingmassive tissue destruction both directly, through tissue invasion and the production of harmful substances, or indirectly,by activation of host defense mechanisms, creating an inflammatory infiltrate of potent catabolic activitythat can interfere with normal host defense mechanisms. In response to the aggression, host defense mechanismsactivate innate and adaptive immune responses. Our aim is to offer a general overview of the main mechanismsinvolved in the host response to bacterial aggression in periodontitis, such as lipopolysaccharide receptor CD14,complement system, polymorphonuclear neutrophils, antibodies and immunoglobulins (AU)

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