Connexin 43 expression in tooth germ and benign odontogenic tumors.

OBJECTIVE: The aim of this study was to investigate and compare the immunohistochemical expression of connexin 43 (Cx43) in tooth germs (TGs), ameloblastic fibromas (AFs), ameloblastic fibro-odontomas (AFOs), and conventional ameloblastomas (AMs). STUDY DESIGN: Nine TGs, 12 AFs, 12 AFOs, and 27 AMs were evaluated for Cx43 expression by immunohistochemistry. RESULTS: Most of the TGs expressed Cx43 in the mesenchyme (77.6%) and in the late stages of odontogenesis. Cx43 was more highly expressed (P < .05) in the mesenchymal layer of all groups than in the epithelial layer except for the AFOs. When comparing the expression of Cx43 in the different layers of the analyzed groups, statistically significant differences were observed between AFO vs AM (*P = .0158) in the epithelial layer and between AF vs AFO (P** = .0046) in the mesenchymal layer. CONCLUSIONS: The results obtained in this study showed that Cx43 is a protein with important expression in the mesenchymal layer of the embryonic and odontogenic tissues studied. It could be speculated that Cx43 participates in mineralization events based on the relationship of the expression of this protein between the epithelial and mesenchymal layers of odontogenic tissues.

Self-Reported Periodontal Disease and Its Association with SARS-CoV-2 Infection.

Introduction: Knowledge of the oral manifestations associated with SARS-CoV-2 infection, the new coronavirus causing the COVID-19 pandemic, was hindered due to the restrictions issued to avoid proximity between people and to stop the rapid spread of the disease, which ultimately results in a hyperinflammatory cytokine storm that can cause death. Because periodontal disease is one of the most frequent inflammatory diseases of the oral cavity, various theories have emerged postulating periodontal disease as a risk factor for developing severe complications associated with COVID-19. This motivated various studies to integrate questions related to periodontal status. For the present work, we used a previously validated self-report, which is a useful tool for facilitating epidemiological studies of periodontal disease on a large scale. Methodology: A blinded case-control study with participants matched 1:1 by mean age (37.7 years), sex, tobacco habits and diseases was conducted. After the diagnostic samples for SARS-CoV-2 detection were taken in an ad hoc location at Guadalajara University, the subjects were interviewed using structured questionnaires to gather demographic, epidemiological and COVID-19 symptom information. The self-reported periodontal disease (Self-RPD) questionnaire included six questions, and subjects who met the criteria with a score ≥ 2 were considered to have periodontal disease. Results: In total, 369 participants were recruited, with 117 participants included in each group. After indicating the subjects who had self-reported periodontal disease, a statistically significant difference (p value ≤ 0.001) was observed, showing that self-reported periodontal disease (n = 95, 85.1%) was higher in SARS-CoV-2-positive individuals than in controls (n = 66, 56.4%), with an OR of 3.3 (1.8-6.0) for SARS-CoV-2 infection in people with self-reported periodontal disease. Cases reported a statistically higher median of symptoms (median = 7.0, Q1= 5.5, Q3 = 10.0) than controls (p value ≤ 0.01), and cases with positive self-RPD had a significantly (p value ≤ 0.05) higher number of symptoms (median = 8.0, Q1 = 6.0, Q3 = 10.0) in comparison with those who did negative self-RPD (median = 6.0, Q1 = 5.0, Q3 = 8.0). Conclusions: According to this study, self-reported periodontal disease could be considered a risk factor for SARS-CoV-2 infection, and these individuals present more symptoms.

Fluoruros en agua de consumo al norte y occidente de México / Fluorides in water for consumption in northern and western Mexico

La cantidad de fluoruros en el agua en algunas regiones de México representa un problema de salud pública. El objetivo de este trabajo fue realizar una revisión sistemática de estudios originales que reportaran niveles de fluoruros en agua corriente y embotellada de la región norte y occidente de México. Esta revisión sistemática se elaboró utilizando el sistema PRISMA en las bases de datos de PubMed, Scopus, Medigraphic y Scielo. Se implementaron las palabras clave de fluoride OR fluorosis AND water AND Mexico, y se incluyeron y excluyeron registros de acuerdo con los criterios previamente establecidos. Fueron revisados aquellos artículos publicados entre el 1 de enero del 2010 y el 30 de marzo del 2021. Se identificaron 36 registros en total. La mayoría mostraban datos encontrados en la región occidente del país (n = 23) mientras que los restantes fueron realizados al norte. Ambas regiones se mostraron con rangos máximos y medias muestrales por encima de lo sugerido por la Organización Mundial de la Salud y los organismos reguladores nacionales. De acuerdo con los estudios aquí analizados en México, las regiones Norte y Occidente del país muestran una situación preocupante por los elevados niveles de fluoruros que reportan los autores en agua corriente y embotellada, los niveles se encuentran casi en su totalidad por encima de los recomendados a nivel nacional e internacional lo cual significa un problema de salud pública que requiere de atención.

The amount of fluoride in water in some regions of Mexico represents a public health problem. The aim of this study was to conduct a systematic review of original studies that report fluoride levels in tap and bottled water from the northern and western regions of Mexico. A systematic review was conducted using the PRISMA method in PubMed, Scopus, Medigraphic and Scielo databases. The keywords fluoride OR fluorosis AND water AND Mexico were used for the search and the records found were included and excluded according to the previous established criteria. We reviewed data in articles published between January 1st, 2010 and March 30th, 2021. We identified a total of 36 records. Most showed data found in the western region (n = 23), while the rest reported data found in the north. Both regions reported maximum and mean sample ranges above those suggested by the World Health Organization and national regulations. According to the analyzed data, in Mexico, the northern and western regions of the country show a concerning situation due to the high levels of fluoride reported by many authors in tap and bottled water. Almost all authors reported data above those recommended for national and international regulations, which represent an important public health problem that requires attention.

Higiene oral deficiente como factor de riesgo de cáncer oral / Poor oral hygiene as a risk factor for oral cancer

Introducción: Los principales factores de riesgo con los que se asocia el carcinoma oral de células escamosas son el hábito de tabaco y alcohol. La inflamación también es un factor de riesgo importante en el desarrollo del cáncer, ésta posiblemente inducida por el acúmulo de bacterias que se refleja en la placa bacteriana (biofilm microbiano) y posterior cálculo dental debido a una higiene oral deficiente. Objetivo: Asociar la higiene oral deficiente como factor de riesgo del carcinoma oral de células escamosas. Material y métodos: Estudio de casos y controles en el que se utilizó el índice de higiene oral simplificado para biofilm y cálculo como instrumento de medida. Se registraron los hábitos de tabaco y alcohol. El riesgo fue estimado obteniendo Odds Ratio y la significancia estadística fue tomada con base a χ2. Resultados: La higiene oral deficiente con altos niveles de placa bacteriana fue identificada como factor de riesgo de carcinoma oral de células escamosas, los factores de riesgo conocidos (tabaco y alcohol) fueron también identificados en nuestra población; sin embargo, el riesgo fue menor en contraste con la higiene oral deficiente. Conclusión: La higiene oral deficiente es un factor de riesgo significativo que contribuye a la presencia de cáncer oral y puede ser mayor en comparación con el consumo de tabaco y alcohol.

Epithelial-Mesenchymal Transition Associated with Head and Neck Squamous Cell Carcinomas: A Review.

Head and neck squamous cell carcinomas (HNSCCs) are aggressive, recurrent, and metastatic neoplasms with a high occurrence around the world and can lead to death when not treated appropriately. Several molecules and signaling pathways are involved in the malignant conversion process. Epithelial-mesenchymal transition (EMT) has been described in HNSCCs, a major type of aggressive carcinoma. EMT describes the development of epithelial cells into mesenchymal cells, which depends on several molecular interactions and signaling pathways that facilitate mesenchymal conversion. This is related to interactions with the microenvironment of the tumor, hypoxia, growth factors, matrix metalloproteinases, and the presence of viral infections. In this review, we focus on the main molecules related to EMT, their interactions with the tumor microenvironment, plasticity phenomena, epigenetic regulation, hypoxia, inflammation, their relationship with immune cells, and the inhibition of EMT in the context of HNSCCs.

Experiencia de caries dental en trabajadores universitarios: su asociación con variables sociodemográficas / Caries experience in university workers: its association with sociodemographic data

Objetivo. Evaluar la experiencia de caries en trabajadores universitarios y su asociación con variables sociodemográficos. Métodos. Estudio transversal, observacional y analítico con un grupo de trabajadores de la Universidad de Guadalajara, México. Se recopilaron datos de las variables sociodemográficas mediante un cuestionario y a través del examen clínico el índice CPOD. Se realizaron pruebas estadísticas de Chi-cuadrado, t-Student, ANOVA de una vía y post-hoc con significancia de 0,05. Resultados. Doscientos no-venta participantes accedieron a la exploración oral, con un promedio de edad de 36,2 ± 0,6, 55,9% fueron mujeres. El CPOD de la muestra evaluada fue de 8,3±5,3. El análisis de Chi-cuadrado en la evaluación etaria y los niveles de CPOD mostraron significancia estadística (p=0,0001). De forma similar, en las pruebas de ANOVA de una vía en el grupo de hombres (p=0,0001) y en los que residen en Tonalá (p=0,022), el componente cariados del índice se vio significativamente aumentado. Se observó también, un índice aumentado de dientes obturados en los participantes con nivel máximo de posgrado (p=0,001). El grupo de fumadores mostró significancia estadística (p=0,034) en el índice de caries. Conclusiones.El índice CPOD poblacional se encontró en nivel bajo, estando el grupo de mayor edad significativamente por encima de los dos grupos de menor edad. Los niveles del componente cariados fueron más bajos en los habitantes de las regiones foráneas del estado y los que tenían escolaridad de posgrado (p=0,022 y p=0,02 respec-tivamente).

Objective. To evaluate caries experience in university workers and to associate it with sociodemographic data. Methods. It was performed a descriptive cross-sectional, ob-servational and analytic study in university workers from the University of Guadalajara, Mexico. Sociodemographic data was collected through a questionnaire and the DMFT index, through clinical evaluations. Statistical analysis of χ2, T-student, one-way ANO-VA and Post-hoc were performed working with CI of 95%. Results. 290 participants agreed to oral examination, the average age of the interviewed workers was 36.2 ± 0.6. Women represented 55.9%. The DMFT of the evaluated sample was 8.3± 5.3. The χ2 analysis of the evaluated age ratio, showed statistical significance (p=0.0001). Similarly, the decay component of the index was increased in the one-way ANOVA test of the male group (p=0,0001) and of those who reside in Tonala (p=0.022). Additionally, an increased number of filled teeth was found in participants with postgraduate education (p=0.001). The smokers group showed statistical significance (p=0.034) in caries index. Conclusions. The broad DMFT index was found at a low level, however, the older age group was significantly different, being at the high level, well above the two younger age groups. The caries component of the DMFT index was significantly lower in the out of the region residents and those who had postgraduate degree (p=0.022 and p=0.02 respectively).

Current concepts in ameloblastoma-targeted therapies in B-raf proto-oncogene serine/threonine kinase V600E mutation: Systematic review.

BACKGROUND: Ameloblastomas are common benign epithelial odontogenic neoplasms that present an aggressive and unpredictable behavior that may modify treatment strategies. Different signaling pathways that participate in the progression of these tumors have been identified. B-raf proto-oncogene serine/threonine kinase (BRAF) is a protein involved in the behavior of ameloblastomas, and it is related to many cell mechanisms. BRAF gene mutations have been identified in ameloblastomas, of which the BRAF V600E (valine substituted by glutamic acid at amino acid 600) mutation has been the most common and can be present concomitantly with other mutations that may be involved in its behavior. Targeted therapies have been used as an alternative in the case of resistance or contraindications to conventional treatments. AIM: To document the presence of BRAF V600E and additional mutations, their behavior, and targeted therapies in these tumors. METHODS: An electronic literature search was conducted according to PRISMA guidelines in PubMed/MEDLINE, Cochrane, EMBASE, and SpringerLink using the terms "ameloblastomas", "BRAF V600E", "additional mutations", and "targeted therapies". Ameloblastomas were classified according to WHO guidelines. Inclusion criteria were articles in English, published not more than 10 years ago, and studies with laboratory works related to BRAF V600E. Articles were evaluated by two independent reviewers and retrieved for full-text evaluation. The EBLIP Critical Appraisal Checklist was used to evaluate the quality of the eligible studies. Descriptive statistical analysis was performed. RESULTS: Two independent reviewers, with a substantial concordance indicated by a kappa coefficient of k = 0.76, evaluated a total of 19 articles that were included in this study. The analysis registered 521 conventional ameloblastomas (AM), 81 unicystic ameloblastomas (UA), 13 ameloblastic carcinomas (AC), three metastatic ameloblastomas (MA), and six peripheral ameloblastomas (PA), of which the histopathological type, anatomic location, laboratory tests, expression of BRAF mutation, and additional mutations were registered. The BRAF V600E mutation was found in 297 AM (57%), 63 UA (77.7%), 3 AC (23%), 1 MA (50%), and 5 PA (83.3%). Follicular type predominated with a total of 116 cases (40%), followed by plexiform type with 63 cases (22.1%). Furthermore, both types presented additional mutations, in which alterations in JAK3 P132T, SMARCB1, PIK3CA, CTNNB1, SMO, and BRAF G606E genes were found. Four case reports were found with targeted therapy to BRAF V600E. CONCLUSION: The identification of BRAF V600E and additional mutations as an aid in targeted therapies has been a breakthrough in alternative treatments of ameloblastomas where surgical treatments are contraindicated.

Molecular Markers of Anticancer Drug Resistance in Head and Neck Squamous Cell Carcinoma: A Literature Review.

This manuscript provides an update to the literature on molecules with roles in tumor resistance therapy in head and neck squamous cell carcinoma (HNSCC). Although significant improvements have been made in the treatment for head and neck squamous cell carcinoma, physicians face yet another challenge-that of preserving oral functions, which involves the use of multidisciplinary therapies, such as multiple chemotherapies (CT) and radiotherapy (RT). Designing personalized therapeutic options requires the study of genes involved in drug resistance. This review provides an overview of the molecules that have been linked to resistance to chemotherapy in HNSCC, including the family of ATP-binding cassette transporters (ABCs), nucleotide excision repair/base excision repair (NER/BER) enzymatic complexes (which act on nonspecific DNA lesions generated by gamma and ultraviolet radiation by cross-linking and forming intra/interchain chemical adducts), cisplatin (a chemotherapeutic agent that causes DNA damage and induces apoptosis, which is a paradox because its effectiveness is based on the integrity of the genes involved in apoptotic signaling pathways), and cetuximab, including a discussion of the genes involved in the cell cycle and the proliferation of possible markers that confer resistance to cetuximab.

Differences in E-Cadherin and Syndecan-1 Expression in Different Types of Ameloblastomas.

Ameloblastomas are a group of benign, locally aggressive, recurrent tumors characterized by their slow and infiltrative growth. E-Cadherin and syndecan-1 are cell adhesion molecules related to the behavior of various tumors, including ameloblastomas. Ninety-nine ameloblastoma samples were studied; the expression of E-cadherin and syndecan-1 were evaluated by immunohistochemistry. E-Cadherin and epithelial syndecan-1 were more highly expressed in intraluminal/luminal unicystic ameloblastoma than in mural unicystic ameloblastoma and solid/multicystic ameloblastoma, whereas the stromal expression of syndecan-1 was higher in mural unicystic ameloblastoma and solid/multicystic ameloblastoma. Synchronicity was observed between E-cadherin and epithelial syndecan-1; the expression was correlated with intensity in all cases. There was a strong association between expression and tumor size and recurrence. The evaluation of the expression of E-cadherin and syndecan-1 are important for determining the potential aggressiveness of ameloblastoma variants. Future studies are required to understand how the expression of these markers is related to tumor aggressiveness.

Manifestaciones de la cavidad bucal por infección del virus de la inmunodeficiencia humana: reporte de caso clínico / Oral manifestations of the HIV virus: report of a clinical case

Las manifestaciones orales por la infección del virus de la inmunode-ficiencia humana son en ocasiones el primer signo de la enfermedad yen muchos casos un indicador de la progresión de la infección hacia elsíndrome de inmunodeficiencia adquirida. Las ulceraciones indoloras,diferentes tipos de gingivitis agresivas y la leucoplasia vellosa, se desarrollan muy fácilmente en individuos cuyo sistema inmunológico está comprometido, como el de los pacientes que sufren del virus deinmunodeficiencia adquirida.

Oral manifestations caused by the human immunodefi ciency virusare often the fi rst indication that the person is infected and oftenan indicator of its progression into AIDS. Painless ulcers, assortedtypes of aggressive gingivitis, and hairy leukoplakia develop easilyin individuals whose immune system is compromised, such as thoseinfected with HIV.

Comparison between Manual and Automated Methods for Ki-67 Immunoexpression Quantification in Ameloblastomas.

Ameloblastoma is a common and unpredictable odontogenic tumor with high relapse rates. Several studies assessing the proliferative capacity of these neoplasms have been published, mainly using the protein Ki-67. Cell counts must be completed to determine the cell proliferation rate. Multiple methods have been developed for this purpose. The most widely used method is the labeling index, which has undergone changes over time to better facilitate cell counting. Here, we compared manual cell counting methods with automated cell counting (ImmunoRatio) to determine the relative effectiveness of these methods. The results suggest that ImmunoRatio, a free software tool, may be highly advantageous and provide results similar to manual cell counting methods when used with the appropriate calibration. However, ImmunoRatio has flaws that may affect the labeling index results. Therefore, this automated cell counting method must be supplemented with manual cell counting methods.

Manejo odontológico de las complicaciones orales como resultado de la terapia contra el cáncer / Dental management of oral complications of cancer therapy

La atención dental debe acompañar a los pacientes que reciben terapia contra el cáncer de cabeza y cuello debido a que existen efectos secundarios relacionados con la radioterapia y un mal estado bucal, así como secuelas por la cirugía ablativa. Los principales efectos desarrollados por la radioterapia incluyen xerostomía y mucositis, seguidos por trismus, caries por radiación y osteorradionecrosis. Para disminuir el riesgo de desarrollar estos padecimientos es necesaria la visita alcirujano dentista previa al tratamiento para realizar los procedimientos bajo los requerimentos de un paciente con cáncer y hacer la toma de decisiones ante dientes cariados, restauraciones extensas, enfermedad periodontal o dientes posteriores inaccesibles para una higiene diaria. Sin embargo, puede ser desafi ante llevar a cabo estas tareas en el corto periodo entre el diagnóstico del paciente y el inicio de su tratamiento. De igual manera los pacientes que han terminado el tratamiento deberán ser atendidos con consideraciones especiales por la posibilidad de desarrollar osteorradionecrosis...

La candidiasis bucal como marcador clínico de falla a la terapia antirretroviral altamente efectiva en pacientes infectados con VIH/sida / Oral candidiasis as a clinical marker of highly active antiretroviral treatment failure in HIV-infected patients

Introducción: La candidiasis bucal es una infección oportunista fácilmente detectable en la clínica, por lo que se ha utilizado para valorar tanto el estado inmunológico de los pacientes con VIH como la efectividad de la terapia antirretroviral, altamente efectiva debido a que se encuentra sujeta a diversos factores para lograr el éxito terapéutico. Objetivo: Determinar la frecuencia de candidiasis bucal entre indicadores asociados al éxito de la terapia antirretroviral. Material y método: Estudio transversal, analítico en donde inicialmente se realizaron grupos de acuerdo al uso o no de la terapia antirretroviral para proseguir con un interrogatorio que incluía preguntas sobre otros factores relacionados con la infección por cándida, así como la medición del flujo salival y la evaluación clínica de la cavidad bucal para determinar la frecuencia de la candidiasis. Resultados: La diferencia en la frecuencia de la candidiasis bucal entre los grupos con y sin terapia antirretroviral fue significativa, además de obtener una OR = 2,6 (1,58-4,48) y la asociación con la disminución en el conteo de linfocitos de CD4. Discusión: La resistencia a la terapia antirretroviral constituye uno de los problemas fundamentales en el éxito del tratamiento, en los pacientes infectados con virus de la inmunodeficiencia humana, al igual que las toxicidades y los problemas de adherencia. Los sensores clínicos como la candidiasis bucal son parámetros de fácil acceso para la detección temprana de falla en la terapia.

Introduction: Oral candidiasis is an opportunistic infection that is readily detectable in the clinic. It has been used to assess the immune status of HIV patients as well as the effectiveness of highly active antiretroviral therapy. Objective: To determine the frequency of oral candidiasis infection among various indicators associated with antiretroviral therapy effectiveness. Material and methods: Cross-sectional and analytical study, in which groups were initially created based on the use or not of antiretroviral therapy. Participants were subjected to questions on factors related to Candida infection, salivary flow measurements and a clinical examination of the oral cavity to determine the frequency of candidiasis Results: The difference in the frequency of oral candidiasis between groups with and without antiretroviral therapy was significant (OR 2.6 IC95% 1.5-4.4). There were also a significant association with decreased number of CD4 lymphocytes.. Discussion: Resistance to anti-retroviral therapy constitutes one of the fundamental barriers to a successful treatment in patients infected with the human immunodeficiency virus, as do toxicities and adherence problems. Clinical markers such oral candidiasis is an easily and accesible parameter for the early detection of treatment failure.

Estomatitis aftosa recurrente mayor tipo C: reporte de un caso / Recurrent type C major aphthous stomatitis: report of a case

La estomatitis aftosa recurrente (EAR) ha sido descrita como la enfermedad de la mucosa bucal más común en América. Se considera una enfermedad inflamatoria no infecciosa de la mucosa bucal, de etiología aún desconocida. Las úlceras de la EAR se distinguen por su forma, tamaño, localización (herpetiforme, menor y mayor) y estrategias de manejo (tipos A, B y C), lo que permite diferenciarlas de las diversas enfermedades ulcerativas infecciosas (por ej. las producidas por el virus herpes), y así dirigir el tratamiento adecuado, ya que la EAR afecta en gran medida la calidad de vida del paciente.