Traumatic dental injuries sustained during Chile's civil unrest: A case series study.

BACKGROUND/AIM: During Chile's period of social unrest, numerous people suffered physical trauma due to the use of police force. However, there have been no reports regarding traumatic dental injuries (TDIs) suffered in this context. This study aims to describe the dental trauma of patients injured by police during the social unrest period in Chile from 2019 to 2021. MATERIAL AND METHODS: A case series methodology was employed. Following informed consent, clinical records of patients admitted to the Ocular and Dentomaxillofacial Prosthetic Care and Rehabilitation Program, who were affected by the violence of state agents during social mobilizations, were reviewed from October 2019 to December 2021. Information on the sociodemographic characteristics of the patients and the TDI diagnoses with their treatment needs were collected. A descriptive analysis was performed. RESULTS: Forty-six patients were identified, nine of whom agreed to the informed consent. Most were male, with a mean age of 28 years, public health insurance, and a high educational level. The most common causes of injury were kinetic impact projectiles (KIPs) and the use of physical force (punches, kicks, or pushes). Of the nine cases described, 26 teeth were affected by TDI. The most affected teeth were the central upper incisors and, in most cases, they presented lesions in both injury categories: NA0D.0 (the tooth and pulp) and NA0D.1 (periodontal tissues). Treatment needs varied and included some complex procedures, such as implant-retained crowns and removable dental prostheses. CONCLUSIONS: The use of force by police during the period of social unrest in Chile caused TDIs among demonstrators, which were mainly due to physical force from less-than-lethal weapons. Most cases presented injuries affecting the incisors with multiple teeth requiring complex treatments.

Evaluation of the effectiveness of a chamomile (Matricaria chamomilla) and linseed (Linum usitatissimum) saliva substitute in the relief of xerostomia in elders.

OBJECTIVE: The aim of this study was to determine the efficacy of a chamomile (Matricaria chamomilla) and linseed (Linum usitatissimum) saliva substitute in the relief of xerostomia in older participants. BACKGROUND: In elders, xerostomia is a permanent and progressive condition that significantly affects their quality of life. The treatment for progressive xerostomia is currently restricted to palliative measures, and saliva substitutes are indicated. A lack of evidence on the effectiveness of the saliva substitutes in the relief of symptoms of xerostomia has been reported. MATERIALS AND METHODS: Seventy-four elderly participants presenting xerostomia of diverse origin were selected. Herbal saliva substitute and carboxymethyl cellulose conventional saliva substitute were tested using a double-blind, randomised, cross-sectional clinical trial. RESULTS: Every participant of the study exhibited dry mouth sensation. A sensation of thick saliva was described in 59.5% of the participants. The need for liquid intake to swallow food, the sensation of difficulty in swallowing and the burning sensation in the tongue were observed in 54.1, 56.8 and 27.0% of the participants, respectively. The most prevalent diseases were hypertension, depressive symptoms and arthritis. Results of the clinical tests showed that the herbal saliva substitute produced a greater relief of dry mouth symptoms, thick saliva sensation and the sensation of difficulty in swallowing than the conventional substitute (Wilcoxon test p < 0.05). CONCLUSIONS: New chamomile- and linseed-based saliva substitute was effective in relieving xerostomia symptoms in older participants of this study.

Dendritic cell chimerism in oral mucosa of transplanted patients affected by graft-versus-host disease.

OBJECTIVE: Graft-versus-host disease (GVHD) is one of the main complications after haematopoietic stem cell transplantation. Clinical features of GVHD include either an acute (aGVHD) or a chronic (cGVHD) condition that affects locations such as the oral mucosa. While the involvement of the host's dendritic cells (DCs) has been demonstrated in aGVHD, the origin (donor/host) and mechanisms underlying oral cGVHD have not been completely elucidated. In this study, we intend to determine the origin of DCs present in mucosal tissue biopsies from the oral cavity of transplanted patients affected by cGVHD. METHODS: We purified DCs, from oral biopsies of three patients with cGVHD, through immunobeads and subsequently performed DNA extraction. The origin of the obtained DCs was determined by PCR amplification of 13 informative short tandem repeat (STR) alleles. We also characterised the DCs phenotype and the inflammatory infiltrate from biopsies of two patients by immunohistochemistry. RESULTS: Clinical and histological features of the biopsies were concordant with oral cGVHD. We identified CD11c-, CD207- and CD1a-positive cells in the epithelium and beneath the basal layer. Purification of DCs from the mucosa of patients affected by post-transplantation cGVHD was >95%. PCR-STR data analysis of DCs DNA showed that 100% of analysed cells were of donor origin in all of the evaluated patients. CONCLUSION: Our results demonstrate that resident DCs isolated from the oral tissue of allotransplanted patients affected by cGVHD are originated from the donor. Further research will clarify the role of DCs in the development and/or severity of oral cGVHD.

Human papillomavirus infection in oral squamous cell carcinomas from Chilean patients.

Human papillomavirus (HPV) is the causal agent of cervical, anogenital and a subset of oropharyngeal carcinomas. In addition, the role of HPV in oral carcinogenesis has been suggested, although the findings are inconclusive. In this study, using conventional polymerase chain reaction (PCR) and genotyping by specific PCR and DNA sequencing, we analyzed the HPV presence in 80 oral squamous cell carcinomas (OSCCs) from Chilean subjects. In addition, we determined the expression of p16, p53, pRb and Ki-67 using immunohistochemistry (IHC). The CDKN2A (p16) promoter methylation was evaluated using methylation-specific PCR (MSP). HPV sequences were found in 9/80 (11%) OSCCs. Non-statistically significant association with p53, pRb, Ki-67 and p16 levels were found (p=0.77; 0.29; 0.83; 0.21, respectively). HPV-16 and 18 were the most prevalent HPV genotypes in 8/9 (89%) OSCCs. In addition, CDKN2A (p16) was methylated in 39% of OSCCs. No association with HPV presence (p=0.917) was found. These results suggest that HPV positive OSCCs are entities that do not resemble the molecular alterations of HPV-associated tumors in a Chilean population. More studies are warranted to determine the role of HPV in OSCCs.

Increased nuclear ß-catenin expression in oral potentially malignant lesions: A marker of epithelial dysplasia.

BACKGROUND: Deregulation of ß-catenin is associated with malignant transformation; however, its relationship with potentially malignant and malignant oral processes is not fully understood. The aim of this study was to determine and compare the nuclear ß-catenin expression in oral dysplasia and oral squamous cell carcinoma (OSCC). MATERIAL AND METHODS: Cross sectional study. Immunodetection of ß-catenin was performed on 72 samples, with the following distribution: 21 mild dysplasia, 12 moderate dysplasia, severe dysplasia 3, 36 OSCC including 19 well differentiated, 15 moderately differentiated and 2 poorly differentiated. Through microscopic observation the number of positive cells per 1000 epithelial cells was counted. For the statistical analysis, the Kruskal Wallis test was used. RESULTS: Nuclear expression of ß-catenin was observed in all samples with severe and moderate dysplasia, with a median of 267.5, in comparison to mild dysplasia whose median was 103.75. Only 10 samples (27.7%) with OSCC showed nuclear expression, with statistically significant differences between groups (p < 0.05). CONCLUSIONS: Our results are consistent with most of the reports which show increased presence of ß-catenin in severe and moderate dysplasia compared to mild dysplasia; however the expression of nuclear ß-catenin decreased after starting the invasive neoplastic process. This suggests a role for this protein in the progression of dysplasia and early malignant transformation to OSCC. Immunodetection of ß-catenin could be a possible immune marker in the detection of oral dysplasia.

Invisible, Uncontrollable, Unpredictable: Illness Experiences in Women with Sjögren Syndrome.

Background/Objectives: Sjögren's Syndrome (SS) is a chronic degenerative rheumatic disease. Because of its chronic nature, it significantly affects the quality of life of those who suffer from it. Methods: This qualitative study investigated disease experience among women suffering from SS to understand its impact on their overall well-being. In-depth interviews were conducted with 15 women who suffer from SS. Interviews were analyzed using the Grounded Theory methodology, using open, axial, and selective coding. Results: Three central phenomena of disease experience were identified: invisibility; uncontrollability; and unpredictability. Conclusions: SS disease experience has a strong imprint on emotional well-being and sense of self-control among middle-aged women. Understanding SS impacts on women's lives is important to better understand the disease and contribute to recognizing potential areas of management and social support in relevant windows of opportunity within the health-disease continuum.

Illness Experience and Quality of Life in Sjögren Syndrome Patients.

Sjögren's syndrome (SS) is a disease with autoimmune features that affects mainly women and compromises the health-related quality of Life (HRQoL); it is important to evaluate illness experience for a better understanding of the life situation of the patient. The aim of the study was to summarize the individual life experiences and determine the impact of HRQoL and oral health-related quality of life (OHRQoL) and their correlation with health self-assessment in women with SS. The life experiences evaluation employed a concept mapping design to structure qualitative content obtained from semi-structured interviews. Hierarchical cluster analysis was used to analyze the patient's experiences. EQ-5D-5L and OHIP-14Sp were used. The correlation between appreciation of the general health status and OHIP-14 was evaluated. The experience classification by patients were analyzed and a dendrogram was obtained, identifying 10 clusters of disease experiences of SS, being limitations, pain and difficulties, coping and attitudes towards treatment the most common. Pain/discomfort in EQ-5D-5L and physical pain and psychological discomfort in OHIP-14 were the most affected dimensions in the patients. The results support the theoretical perspective that the experience of illness is relevant to describing the main difficulties of patients with SS and how it affects their quality of life.

Defining a new candidate gene for amelogenesis imperfecta: from molecular genetics to biochemistry.

Amelogenesis imperfecta is a group of genetic conditions that affect the structure and clinical appearance of tooth enamel. The types (hypoplastic, hypocalcified, and hypomature) are correlated with defects in different stages of the process of enamel synthesis. Autosomal dominant, recessive, and X-linked types have been previously described. These disorders are considered clinically and genetically heterogeneous in etiology, involving a variety of genes, such as AMELX, ENAM, DLX3, FAM83H, MMP-20, KLK4, and WDR72. The mutations identified within these causal genes explain less than half of all cases of amelogenesis imperfecta. Most of the candidate and causal genes currently identified encode proteins involved in enamel synthesis. We think it is necessary to refocus the search for candidate genes using biochemical processes. This review provides theoretical evidence that the human SLC4A4 gene (sodium bicarbonate cotransporter) may be a new candidate gene.

Illness Experiences of Chilean Women With Sjögren's Syndrome: The Patient Perspective.

OBJECTIVE: Sjögren's syndrome (SS) challenges everyday functioning and well-being. The aim of this study was to structure and summarize the life experiences of Chilean women with SS in an integrated model. METHODS: Interviews from a previous study yielded 75 experiences of living with SS. A sample of 30 women with SS sorted these experiences by content and rated their level of agreement with each experience. A hierarchical cluster analysis was used to structure the experiences of the participants with SS in a comprehensive overview. A team-based consensus analysis was used to define the number of clusters. The level of agreement was examined with Wilcoxon's signed rank test. RESULTS: Ten clusters were identified and grouped into 6 main categories: symptoms (clusters: mucosal dryness and related symptoms), social environment, emotion management (clusters: fears and sadness), information (clusters: uncertainty and lack of knowledge), coping strategy (clusters: resilience and self-care), and health staff relationship. The clusters that describe the more common experiences among patients were resilience, self-care, uncertainty, lack of knowledge, health staff relationship, and mucosal dryness. CONCLUSION: This study provided an integrated and structured overview of disease experiences comprising both biomedical and psychosocial aspects as being of vital importance for the health of patients with SS. The overview can be used to get a quick impression of disease experiences that are important for an individual patient, in a therapeutic goal setting, and in the construction and evaluation of medical and nonmedical interventions or education.

Oral malignant tumours: a report on 728 cases in Chile.

The objective of this study was to describe the main clinical characteristics and the relative frequency of each type of oral malignancies received at the Oral Pathology Reference Institute (IREPO) of the Faculty of Odontology; University of Chile, since 1975 to 2006. Studies were performed of 728 cases of biopsies recorded in the IREPO data base with a diagnosis corresponding to some type of Oral Malignant Tumour (OMT) and which counted with all required clinical and demographic data. Histological sections were observed by two oral pathologists with the purpose of confirming the original diagnosis. 61.6% of OMTs were observed in males and 38.4% in females. Patients average age was 65.3 years, and the most frequent localization was the alveolar/gums ridge (20% of the cases) being the squamous cell carcinoma (SCC) the most frequent pathology (58.4%) These results are similar to the frequencies of oral malignancies reported for other countries as to distribution per gender, age, histological diagnosis. Nevertheless, frequency distribution of each of the OMTs is different to that indicated in most publications.

Experiencia cotidiana de personas con trauma ocular y maxilo facial producto de violencia por agentes del Estado en el contexto del estallido social chileno: aproximaciones desde una perspectiva de derechos humanos / Experiência cotidiana de pessoas com trauma ocular e maxilofacial resultante de violência por agentes do Estado no contexto da crise social chilena: aproximações a partir de uma perspectiva de direitos humanos / Daily experience of people with ocular and maxillofacial trauma as a result of violence by State agents in the context of the Chilean social outbreak: approaches from a human rights perspective

Resumen Introducción La violenta represión ocurrida en Chile durante el estallido social (2019-2020) dejó un número sin precedentes de personas lesionadas con resultado de trauma ocular y maxilofacial producto de la acción de agentes del Estado, desatando una crisis socio-sanitaria que requirió del abordaje las problemáticas de salud con énfasis en el daño estructural y funcional. Objetivo Analizar la experiencia cotidiana de personas afectadas por trauma ocular y/o maxilofacial desde una perspectiva de derechos humanos, con énfasis en aportar antecedentes que contribuyan a los procesos de apoyo funcional y psicosocial. Método Estudio de enfoque cualitativo, considerando el análisis de 3 entrevistas en profundidad centradas en la experiencia cotidiana producida a raíz de la violencia policial. Éstas se analizaron en base a la técnica de análisis de contenido, con una posterior triangulación. Resultados Se apreciaron una serie de interferencias y repercusiones cotidianas producto del trauma, generando el fenómeno de una cotidianidad interferida, además del extrañamiento de sí misma/o. Se discutió sobre el contraste entre las experiencias y expectativas de la atención en salud y procesos de reparación, que resultan aún insuficientes y tienden hacia la revictimización. Conclusión El acceso a rehabilitación funcional y psicosocial es parte fundamental de los procesos de reparación integral de las personas que vivieron estas experiencias traumáticas durante el estallido social. Es fundamental que los dispositivos sanitarios y judiciales profundicen abordajes desde una perspectiva de derechos humanos incorporando el enfoque de género para cumplir los principios de verdad, justicia, reparación y garantías de no repetición.

Resumo Introdução A violenta repressão ocorrida no Chile durante a crise social (2019-2020) deixou um número sem precedentes de pessoas feridas por traumas oculares e maxilofaciais, produto da ação de agentes do Estado, desencadeando uma crise sociossanitária que exigiu a abordagem dos problemas de saúde com ênfase nos danos estruturais e funcionais. Objetivo Analisar a experiência cotidiana de pessoas acometidas por traumas oculares e/ou maxilofaciais sob a ótica dos direitos humanos, com ênfase no fornecimento de informações básicas que contribuam para os processos de apoio funcional e psicossocial. Método Estudo com abordagem qualitativa, considerando a análise de três entrevistas em profundidade, focadas na experiência cotidiana produzida em decorrência da violência policial. Estas foram analisadas ​​com base na técnica de análise de conteúdo, com posterior triangulação de dados. Resultados Observou-se uma série de interferências e repercussões cotidianas em decorrência do trauma, gerando o fenômeno de uma cotidianidade interferida, além do estranhamento de si mesma/o. Discutiu-se o contraste entre as experiências e expectativas da atenção em saúde e processos de reparação, que ainda são insuficientes e tendem à revitimização. Conclusão O acesso à reabilitação funcional e psicossocial é parte fundamental dos processos de reparação integral e psicossocial das pessoas que vivenciaram essas experiências traumáticas durante a crise social. É fundamental que os dispositivos sanitários e judiciais aprofundem as abordagens desde uma perspectiva dos direitos humanos, incorporando o enfoque de gênero para cumprir os princípios de verdade, justiça, reparação e garantias de não repetição.

Abstract Introduction The violent repression that occurred in Chile during the social outbreak (2019-2020) left an unprecedented number of people injured as a result of ocular and maxillofacial trauma as a result of the action by state agents, unleashing a socio-sanitary crisis that required the approach of health problems with an emphasis on structural and functional damage. Objective To analyze the daily experience of people affected by ocular and/or maxillofacial trauma from a human rights perspective, with emphasis on providing background information that contributes to functional and psychosocial support processes. Method Study with a qualitative approach, considering the analysis of three in-depth interviews focused on the daily experience produced as a result of police violence. These were analyzed based on the content analysis technique, with subsequent triangulation. Results A series of interferences and daily repercussions as a result of the trauma were observed, generating the phenomenon of an interfered daily life in addition to self-estrangement. The contrast between the experiences and expectations of health care and reparation processes was discussed, which are still insufficient and tend towards re-victimization. Conclusion Access to functional and psychosocial rehabilitation is a fundamental part of the processes of integral and psychosocial repair for the people who lived through these traumatic experiences during the social outbreak. It is essential that health and judicial mechanisms deepen approaches from a human rights perspective, incorporating the gender approach to comply with the principles of truth, justice, reparation, and guarantees of non-repetition.

Oral metastasis of renal cell carcinoma, presentation of a case.

The oral cavity constitutes a site of low prevalence for metastasis of malignant tumors. Nevertheless, it has a high prevalence for metastasis of renal origin. Besides the kidneys, there are other primary sites with high prevalence of metastasis to the oral mucosa, such as the lungs, skin and breasts. Metastasis is common in patients with a background of treated renal tumors, thereby, it is proper to determine the possibility of oral metastasis as part of the protocol of attention. However, it constitutes a diagnostic challenge when it presents in patients with no renal antecedents. It is in this type of patients that the diagnosis of carcinoma is achieved by means of a metastasis. Survival rate in these patients is short because at the time of the metastasis diagnosis, the general compromise is high. The following report describes a case referred from the Rheumatology Unit with an intraoral tumor, that was finally diagnosed as a Metastasic Renal Cell Carcinoma with multiple metastasis.

Illness Experiences in Women with Oral Dryness as a Result of Sjögren's Syndrome: The Patient Point of View.

BACKGROUND: Sjögren's syndrome and the associated dryness can have multiple consequences. The aim of the present qualitative study was to give an in-depth account of the life experiences of women with primary Sjögren's syndrome (pSS) and health-related behaviours, and to summarize these experiences in an integrated model. METHODS: Twelve women diagnosed with pSS who regularly attended the Hospital of the University of Chile participated in detailed interviews. The data were analysed using qualitative methods based on the principles of grounded theory. RESULTS: Selective coding identified three categories: illness experience, social interaction and psychological response. An integrated model was developed connecting these dynamic aspects and suggesting how they could lead to a life cycle crisis in cases of maladjustment. We found that problem-solving strategies, reconstruction of identity, acceptance and a social support may prevent this life cycle crisis. DISCUSSION: Xerostomia and other consequences of pSS can have a profound influence on daily life. However, the severity of the consequences depends on individual experiences with the illness, social influences and the psychological responses of the patient. Physicians, dentists and other healthcare professionals can help the patient by listening to their problems and exploring solutions based on a psychological approach.

Validez y confiabilidad del cuestionario de ansiedad y miedo dental IDAF -4C+ en adultos mayores / Validity and reliability of the Index of Dental Anxiety and Fear (IDAF-4C+) in Chilean older adults

RESUMEN: Objetivo: Determinar la validez aparente, validez de constructo y confiabilidad del cuestionario IDAF-4C+ versión en español, en adultos mayores de dos servicios de atención primaria de la Región Metropolitana, Chile. Materiales y métodos: Estudio descriptivo, transversal aplicado a 42 adultos mayores de dos servicios de atención primaria de la Región Metropolitana. La validez aparente se determinó mediante el juicio de expertos, la validez de constructo a través del análisis exploratorio confirmatorio, mientras que la confiabilidad se determinó por consistencia interna, exploratorio a través del coeficiente alfa de Cronbach. Resultados: El juicio de expertos no realizó modificación al IDAF-4C+ versión en español. El análisis exploratorio confirmó la presencia de un solo factor, el cual explicó el 60,1% de la varianza, mientras que la confiabilidad arrojó un alfa de Cronbach de 0,901, considerado excelente. Conclusiones: El cuestionario IDAF-4C+ presentó una adecuada validez de contenido, validez aparente y una confiabilidad excelente. Se recomienda su uso para la medición de ansiedad dental en adultos mayores que acuden a los servicios de atención primaria evaluados.

ABSTRACT Objective: To determine the face validity, construct validity and reliability of the Spanish version of the IDAF-4C + in older adults, patients in two primary health care from the Metropolitan Region, Chile. Material and methods: Descriptive cross-sectional study, 42 older adults from two primary health care centres from the Metropolitan Region set up the sample. Face validity was determined by experts' judgment, construct validity was determined by a confirmatory factorial analysis and reliability was determined by internal consistency exploratory through Cronbach's alfa. Results: The experts did not modify the Spanish version of the IDAF-4C+. The factorial analysis confirmed the presence of only one factor which explains the 60,1% of the variance, and Cronbach's alfa resulted in 0,901, considered as excellent. Conclusions: The Spanish version of IDAF-4C+ is valid and reliable for the measurement of dental anxiety and fear and its use is recommended among older adults who visit primary health care centres in the Metropolitan Region.

Dental Experience, Anxiety, and Oral Health in Low-income Chilean Children.

PURPOSE: The purpose of this study was to evaluate the relationship between early dental experiences and clinical indicators of oral health and dental anxiety upon admission to a comprehensive oral health program for six-year-old children in Chile. METHODS: One hundred twenty-nine six-year-old children were enrolled in the Recreo Family Health Center of the Municipality of San Miguel, Santiago, Chile. Oral health status was assessed based on the decayed, extracted, or filled teeth index, simplified oral hygiene index, and Streptococcus mutans score. Dental anxiety was assessed using the facial image scale and Frankl scale. Early dental experience was classified as: no previous dental visits; preventive control; restorative treatment; and emergency visit. RESULTS: Children who had previous experience of restorative treatment and emergency visits showed greater dental caries damage (Kruskal-Wallis, P <.01). Those who had emergency visits had the highest S. mutans score. There was no relationship between the type of prior dental experience and the anxiety level or oral hygiene index. CONCLUSIONS: Invasive dental treatment resulted in greater susceptibility to dental caries damage; however, these experiences did not influence dental anxiety levels.

Validez de contenido, de constructo y confiabilidad del Dental Anxiety Scale en adultos chilenos / Content validity, construct validity and reliability of the Dental Anxiety Scale in Chilean adults

INTRODUCCIÓN: La ansiedad dental impacta profundamente en la salud oral de un paciente, determinando el pronóstico y adherencia a tratamiento, sin embargo, existe poca información de instrumentos validados que evalúen este constructo. El OBJETIVO de este estudio es evaluar las propiedades psicométricas del Dental Anxiety Scale versión en español en adultos en servicios de atención primaria de la Región Metropolitana, Chile. MATERIAL Y MÉTODO: Estudio transversal descriptivo aplicado a 169 adultos acompañantes de un servicio de atención primaria. La validez de contenido se determinó con metodología Delphi, la validez de constructo a través del análisis factorial confirmatorio y la confiabilidad a través de análisis de consistencia interna mediante Alfa de Cronbach. RESULTADOS: El juicio de expertos no modificó la versión en español. El análisis factorial confirmó la presencia de un solo factor, el cual explicó el 65,44% de la varianza, mientras que la confiabilidad arrojó un alfa de Cronbach de 0,822, considerado bueno. DISCUSIÓN: El Dental Anxiety Scale presentó una adecuada validez de contenido, validez de constructo y buena confiabilidad. Se recomienda su uso para la medición de ansiedad dental en adultos que acuden a servicios de atención primaria en la Región Metropolitana.

INTRODUCTION: Dental anxiety can strongly affect oral health, modifying the prognosis and treatment's adherence. The level of dental anxiety has to be considered when proposing a treatment plan. The AIM of this study is to measure the psychometric properties of the Dental Anxiety Scale in the Spanish version, applied to adults in primary health institutions of the Metropolitan Region, Chile METHODS: 169 adults were recruited. To determine content validity, the Delphi method was used; the confirmatory factor analysis was used to demonstrate the construct validity. Reliability was measured in terms of internal consistency with the Cronbach's alpha coefficient. RESULTS: The experts did not modify the Spanish version of DAS. The factorial analysis confirmed that there was a single factor that accounted for 65,44% of variance. A 0,882 Cronbach's alfa is considered as good reliability. CONCLUSION: Dental Anxiety Scale presents an appropriate construct and content validity, and a good reliability. It is a proper instrument to be used in adults in primary health care centers in the Metropolitan Region.

Higher blood vessel density in comparison to the lymphatic vessels in oral squamous cell carcinoma.

INTRODUCTION: Oral squamous cell carcinoma (OSCC) is characterized by local invasion and the development of cervical metastasis. In the tongue, an association between the invasion of the lymphatic vessels and the development of metastasis in the regional lymph nodes has been demonstrated. Moreover, invasion of the blood vessels is associated with greater recurrence and poorer prognoses. Therefore, the presence and density of lymphatic and blood vessels in intra- and peritumoral tissues should play an important role in the progression, dissemination and metastasis of carcinomas. However, the evidence regarding OSCC is inconclusive. The aim of this study was to determine the comparison and association between the lymphatic (D2-40) and blood vessel (CD34) densities in intratumoral OSCC tissue. MATERIALS AND METHODS: Thirty-seven cases diagnosed as OSCC between the years 2000 and 2008 were obtained from the Anatomic Pathology Service of the School of Dentistry, University of Chile. The immunohistochemical markers D2-40 and CD34 were used, and the densities (mm(2)) of lymphatic vessels (LVD) and blood vessels (BVD) in the intratumoral region were determined. The relationship between LVD and BVD values was evaluated. RESULTS: There were significant association between the CD34 and D2-40 expression (rho=0.4, P<0.05) and between the LVD and the location in the tongue (P=0.019). The BVD was greater (128.0 vessels/mm(2)) than the LVD (42.9 vessels/mm(2)), and there was a positive correlation between the LVD and BVD. CONCLUSIONS: In OSCC, the BVD is greater than the LVD, and there is a moderate correlation between the two quantities.

α-2-macroglobulin in saliva is associated with glycemic control in patients with type 2 diabetes mellitus.

BACKGROUND: Subjects with type 2 diabetes mellitus (DM2) require an adequate glycemic control to avoid diabetic complications. Currently, saliva biomarkers are used as a diagnostic tool and can be indicative of the degree of progression and control of various diseases. Several studies indicate that α-2-macroglobulin levels are elevated in diabetic patients. METHODS: 120 subjects with DM2 were enrolled and classified into two groups according to their glycemic control (percentage of glycated hemoglobin-A1c (HbA1c), <7% adequate glycemic control group; >7% inadequate glycemic control group). The relationship between α-2-macroglobulin levels from saliva samples and HbA1c was subsequently evaluated. RESULTS: We found a positive correlation between α-2-macroglobulin and HbA1c (r = 0.778 and P < 0.0001). Area under the receivers operating characteristic (ROC) curve of α-2-macroglobulin indicated a positive discrimination threshold of α-2-macroglobulin (AUC = 0.903, CI 95%: 0.847-0.959, P < 0.0001) to diagnose glycemic control. CONCLUSIONS: Our data strongly suggest that the level of saliva α-2-macroglobulin is an indicator for the degree of glycemic control in diabetic patients and represents a promising alternative method to evaluate this parameter.

Sarcomatoid (spindle cell) carcinoma of tongue: a report of two cases.

Sarcomatoid Carcinoma (SC) is an unusual and aggressive variant of squamous cell carcinoma, which frequently recurs and metastasizes; for this reason, the right diagnosis is very important. It is considered to be a biphasic tumor made up of cells from squamous and spindle cells carcinoma with a sarcomatous aspect, but of epithelial origin. The diagnosis often represents a clinical-pathological challenge where the study with immunohistochemical technique (IHC) is key to the histopathological diagnosis. The reported cases related to oral mucosa are limited. In this work we present two SC cases where the use of IHC allowed us to achieve a conclusive diagnosis.

Salivary gland dysfunction markers in type 2 diabetes mellitus patients.

BACKGROUND: Diabetes mellitus (DM) is a chronic disease of the carbohydrate metabolism that, when not rigorously controlled, compromises systemic and organ integrity, thereby causing renal diseases, blindness, neuropathy, arteriosclerosis, infections, and glandular dysfunction, including the salivary glands. The aim of this study was to determine the relationship between the qualitative and quantitative parameters of salivary alteration, which are indicators of salivary gland dysfunction, and the level of metabolic control of type 2 diabetes patients. MATERIAL AND METHODS: A convenience sample of 74 voluntary patients with type 2 DM was selected, each of whom donated a sample of unstimulated saliva. Salivary parameters such as salivary flow rate, protein concentration, pH, and xerostomia were studied. RESULTS: There is a positive relationship between the level of metabolic control measured with HbA1 and the protein concentration in saliva (Spearman rho = 0.329 and p = 0.004). The same assay showed an inverse correlation between HbA1 and pH (Spearman rho = -0.225 and p = 0.05). CONCLUSIONS: The protein concentration in saliva and, to a lesser extent, the pH may be useful as glandular dysfunction indicators in DM2 patients. KEY WORDS: Saliva, type 2 diabetes mellitus, pH, protein concentration, xerostomia.