Use or abuse of antibiotics as prophylactic therapy in oral surgery: A systematic review.

BACKGROUD: Antibiotics are a type of medication routinely prescribed by dental professionals; however, it is very common that the administration is not justified. Around 15% of dentists admit that they have administered antibiotics unnecessarily more than once a week. The objective of this project is to identify the effectiveness of the use of antibiotics as prophylactic therapy in oral surgery, and to carry out an analysis of the alternatives to pharmacological therapy. METHODS: The search strategy was carried out in the PubMed, Scopus, and ScienceDirect databases. For study selection, a first filter was carried out by title and abstract, which mentioned the use of prophylactic antibiotics in some type of oral surgery. To establish the risk of bias, the JBI Critical Appraisal Checklist for Randomized Controlled Trials was utilized. RESULTS: The type of antibiotics most prescribed as prophylactic therapy were beta-lactams, which were indicated in 100% of the studies. Penicillins predominated, observing amoxicillin as the most indicated drug in 54.1% of the studies (n = 13) followed by the use of amoxicillin in conjunction with clavulanic acid in 33.3% of the studies (n = 8). Of the 21 studies included, 17 mention that there is insufficient evidence to support the use of antibiotics as prophylactic therapy in patients who will undergo some type of oral surgery. CONCLUSIONS: Without a doubt, the biggest challenge is to develop academic update strategies aimed at dentists with active clinical practice and dental students from educational and government institutions to provide updated information about the correct use of prescription drugs.

Análisis inmunohistoquímico de MMP-1, MMP-2 y MMP-9 en ameloblastoma convencional / Immunohistochemical analysis of MMP-1, MMP-2, MMP-9 in conventional ameloblastoma

Introducción: las metaloproteinasas son enzimas que participan en la remodelación tisular y su función se relaciona con procesos fisiológicos y patológicos, como la invasión y la metástasis. El ameloblastoma convencional (AMC) es una neoplasia epitelial benigna odontogénica intraósea caracterizada por una progresión lenta y localmente invasiva, cuyo crecimiento se ha vinculado con el recambio ósea y la remodelación de la matriz extracelular. El objetivo del presente trabajo fue determinar la presencia inmunohistoquímica de MMP-1, MMP-2 y MMP-9 en el AMC. Material y métodos: se realizó un estudio piloto observacional analítico utilizando cinco muestras de AMC. Los especímenes fueron recolectados aleatoriamente del archivo del Departamento de Patología Oral y Maxilofacial, de la Escuela Nacional de Estudios Superiores (ENES) Unidad León, UNAM. Como grupo control se emplearon dos especímenes de folículo dental, obtenido de pacientes con indicación de su extracción por motivos ortodóncicos. Se realizó la técnica de inmunohistoquímica por peroxidasa, recolectando el nivel y proporción de inmunoexpresión de manera semicuantitativa. Resultados: cuatro pacientes fueron de género masculino y uno femenino, la edad promedio fue de 40.6 ± 14.9 años. Todas las muestras fueron obtenidas de la región mandibular posterior. Se observaron dos especímenes con patrón folicular y tres con plexiforme. Las MMP-2 y MMP-9 se detectaron sólo en uno de los cinco especímenes y únicamente en el parénquima de la lesión, con una proporción de 100%. Conclusión: según nuestro análisis inmunohistoquímico, las MMP-2 y MMP-9 son las metaloproteinasas que presentaron expresión positiva dentro de la patogénesis del AMC comparado a la MMP-1; no obstante, es necesario realizar este tipo de estudios en una población mayor (AU)

Introduction: metalloproteinases are enzymes involved in tissue remodeling and their function is related to physiological and pathological processes, such as invasion and metastasis. These enzymes are capable of degrading components of the extracellular matrix, which may promote tumor progression. Conventional ameloblastoma (CA) is described as a benign intraosseous epithelial odontogenic neoplasm characterized by a slow and locally invasive progression, whose growth has been linked to bone turnover and extracellular matrix remodeling. The aim of the present work was to determine the immunohistochemical presence of MMP-1, MMP-2 and MMP-9 in CA. Material and methods: an analytical observational pilot study was performed using 5 CA, randomly collected from the archive of the Department of Oral and Maxillofacial Pathology, Escuela Nacional de Estudios Superiores (ENES) Unidad León, UNAM. The control group used were two dental follicle samples, obtained from patients with extraction indication for orthodontic treatment. The peroxidase immunohistochemistry assay was performed, collecting semiquantitatively level and proportion of immunoexpression. Results: four patients were male and one female, the average age was 40.6 ± 14.9 years. All specimens were obtained from the posterior mandibular region. Two specimens were observed with follicular pattern and three with plexiform pattern. MMP-2 and MMP-9 were detected only in one of the five specimens, with presence in the parenchyma of the lesion, with a proportion of 100% of the cell analyzed. Conclusion: according to our immunohistochemical analysis, MMP-2 and MMP-9 are the metalloproteinases that presented positive expression within the pathogenesis of CA compared to MMP-1; however, it is necessary to perform this type of studies in a larger population (AU)

Evaluación antifúngica del ozono contra Candida albicans: estudio in vitro / Antifungal evaluation of ozone against Candida albicans: in vitro study

Introducción: la Candida albicans (C. albicans) es un patógeno fúngico que puede causar infecciones superficiales o potencialmente mortales. Los biofilms de C. albicans muestran rasgos fenotípicos únicos, el más destacado es su notable resistencia a una amplia variedad de agentes antimicóticos. Una de las alternativas para inhibir el crecimiento de este microorganismo es el ozono debido a sus propiedades bactericidas, fungicidas y virucidas; sin embargo, escasa información ha sido reportada en C. albicans. Objetivo: el objetivo de este estudio fue evaluar el efecto fungicida del ozono en C. albicans. Material y métodos: la metodología consistió en agregar ozono a tubos de ensayo con medios de caldo nutritivo en diversas concentraciones y tiempos de ozonización. El efecto fungicida fue determinado con la determinación del número de colonias de C. albicans en agar nutritivo a través de procedimiento microbiológicos estandarizados por triplicado. Resultados: todas las muestras con ozono mostraron adecuados niveles de inhibición de crecimiento del microorganismo. Además, el efecto fungicida del ozono se encontró para ser significativamente dependiente del tiempo de ozonización y de la concentración. Conclusión: el uso de terapia con ozono podría tener potencial en el control de infecciones micóticas causadas por la presencia de C. albicans (AU)

Introduction: Candida albicans (C. albicans) is a fungal pathogen that can cause superficial or life-threatening infections. Biofilms of C. albicans display unique phenotypic traits, the most prominent being their remarkable resistance to a wide variety of antifungal agents. One of the alternatives to inhibit the growth of this microorganism is ozone due to its bactericidal, fungicidal and virucidal properties; however, little information has been reported on C. albicans. Objective: the objective of this study was to evaluate the fungicidal effect of ozone on C. albicans. Material and methods: the methodology consisted in adding ozone to test tubes with nutrient broth media in various concentrations and ozonation times. The fungicidal effect was determined by determining the number of colonies of C. albicans in nutrient agar through standardized microbiological procedures in triplicate. Results: all the ozone samples showed adequate levels of growth inhibition of the microorganism. Furthermore, the fungicidal effect of ozone was found to be significantly dependent on ozonation time and concentration. Conclusion: the use of ozone therapy could have potential in the control of fungal infections caused by the presence of C. albicans (AU)

Tumor invasion front in oral squamous cell carcinoma.

Oral squamous cell carcinoma is a neoplasm that originates from the epithelial mucosa. It is usually more frequent between the fifth and sixth decades of life, and more than 90% of carcinomas of the oral cavity are squamous cell carcinoma. It is an invasive neoplasia with a significant recurrence rate; 40% of patients present with metastases in the cervical lymph nodes at the time of diagnosis. The tumor invasion front is a characteristic of tumor growth, which can be infiltrative or noninvasive. The histopathological parameters examined include the number of mitoses, depth of the tumor, invasion pattern, degree of keratinization, and nuclear pleomorphism. For the pathologist, these parameters are routinely evaluated but are not reported to the treating physician in all cases, which we consider to be useful information when determining the therapeutic route.

Nanopartículas de plata contra bacterias presentes en biofilm dental de pacientes pediátricos / Silver nanoparticles against bacteria present in dental biofilm of pediatric patients

Introducción: el biofilm dental microbiano es el precursor de diversas enfermedades orales, una de ellas la caries, ésta representa la enferme- dad oral más significativa a nivel mundial, con una incidencia de 1.76 billones de niños afectados. Las nanopartículas de plata (AgNPs) se están usando como alternativa para el control y prevención del biofilm dental, ya que poseen propiedades antimicrobianas contra bacterias relacionadas a estas enfermedades. Sin embargo, no hay estudios que evalúen este comportamiento en pacientes pediátricos. Objetivo: eva- luar la actividad antimicrobiana de las AgNPs en bacterias de aislados clínicos tomados de pacientes pediátricos. Material y métodos: se tomó muestra del biofilm dental de 22 pacientes pediátricos, el efecto micro- biológico se evaluó mediante ensayos microbiológicos estandarizados internacionalmente por triplicado, usando dos diferentes tamaños de AgNPs. Resultados: los dos tamaños de AgNPs mostraron inhibición bacteriana, sin embargo, sólo se vio una diferencia estadísticamente significativa entre el género (p < 0.05), además, en general, hubo una correlación positiva significativa en relación a la concentración de las AgNPs y la velocidad del crecimiento bacteriano (p < 0.05). Conclusión: las AgNPs se pueden considerar como una alternativa para la prevención del biofilm dental y de esta manera para el control de diferentes enfermedades orales (AU))

Introduction: dental biofilm is the precursor of oral diseases, one of them dental caries, this represents the most significant oral disease worldwide with an incidence of 1.76 billion affected children. Silver nanoparticles (AgNPs) are being used as an alternative for the control and prevention of dental biofilm since they have antimicrobial properties against bacteria related to these diseases. However, there are no studies evaluating this behavior in pediatric patients. Objective: to evaluate the antimicrobial activity of AgNPs in bacteria from clinical isolates taken from pediatric patients. Material and methods: a sample of dental biofilm was taken from 22 pediatric patients, the microbiological effect was evaluated by international standardized microbiological tests in triplicate, using two different sizes of AgNPs. Results: the two sizes of AgNPs showed bacterial inhibition, however, only a statistically significant difference was seen between gender (p < 0.05), in addition, in general, there was a significant positive correlation in relation to the concentration of AgNPs and the speed bacterial growth (p < 0.05). Conclusion: AgNPs can be considered as an alternative for the prevention of dental biofilm and thus for the control of different oral diseases (AU)

Evaluación de lesiones orales en pacientes intubados y su asociación con el motivo de hospitalización / Evaluation of oral lesions in intubated patients and its association with the reason of hospitalization

asistencia ventilatoria cuando la vía aérea y la consciencia están comprometidas. Los elementos utilizados en este procedimiento se encuentran en contacto directo con estructuras dentofaciales, causando diversos tipos de lesiones, principalmente bucales. Aunque existen cuidados clínicos durante procesos de intubación, hay poca información, particularmente de la zona norte del país donde se hayan evaluado las posibles asociaciones entre los motivos de consulta más frecuentes y las diversas características, tanto clínicas como no clínicas de pacientes que han sido intubados. Objetivo: Identificar las alteraciones bucodentales más frecuentes en pacientes intubados, así como explorar las posibles asociaciones de acuerdo con los motivos de intubación más frecuentes. Material y métodos: Se realizó un estudio observacional, transversal y comparativo en el cual se evaluaron alteraciones bucodentales y sistémicas de pacientes intubados. Los grupos de estudio se desarrollaron de acuerdo con el motivo de intubación y la determinación de las asociaciones fue con cada una de las alteraciones bucodentales y sistémicas. Resultados: El motivo de intubación más frecuente fue el evento cerebral vascular (EVC) y las alteraciones dentofaciales más prevalentes fueron caries, lengua saburral y cálculo dental, entre otras. Además, se encontraron diferencias significativas entre pacientes con EVC, mostrando una mayor frecuencia en tabaquismo, hipertensión arterial y diabetes mellitus, así como en la presencia de gingivitis y úlceras. Pacientes con traumatismo craneoencefálico (TCE) tuvieron mayor frecuencia en la presencia de periodontitis. Conclusión: El motivo de hospitalización y las condiciones sistémicas preexistentes pueden ser un factor de riesgo para desarrollar lesiones bucales específicas antes y durante el periodo de intubación (AU)

Introduction: Intubation is a procedure that allows ventilatory assistance when the airway and consciousness are compromised. The elements used in this procedure are in direct contact with dentofacial structures causing various types of injuries, mainly oral. Although there is clinical care during intubation processes, there is little information, particularly from the northern part of the country where the possible associations between the most frequent reasons for consultation and the various clinical and non-clinical characteristics of patients who have been intubated have been evaluated. Objective: The objectives of the present study were to identify the most frequent oral alterations in intubated patients, as well as to explore possible associations according to the most frequent reasons for intubation. Material and methods: An observational, cross-sectional and comparative study was carried out in which oral and systemic alterations of intubated patients were evaluated. The study groups were formed according to the reason for intubation and the association was determined with each of the oral and systemic disorders. Results: The most frequent reason for intubation was the vascular cerebral event (CVA) and the most prevalent dentofacial alterations were caries, coated tongue, and dental calculus, among others. In addition, significant differences were found between patients with CVA, showing a higher frequency in smoking, hypertension, and diabetes mellitus, as well as in the presence of gingivitis and ulcers. Patients with traumatic brain injury (TBI) had a higher frequency in the presence of periodontitis. Conclusion: The reason for hospitalization and pre-existing systemic conditions can be a risk factor for developing specific oral lesions before and during the intubation period (AU)

Stem Cells as a Model of Study of SARS-CoV-2 and COVID-19: A Systematic Review of the Literature.

BACKGROUND: The SARS-CoV-2 virus is the cause of the latest pandemic of the 21st century; it is responsible for the development of COVID-19. Within the multiple study models for both the biology and the treatment of SARS-CoV-2, the use of stem cells has been proposed because of their ability to increase the immune response and to repair tissue. Therefore, the objective of this review is to evaluate the role of stem cells against SARS-CoV-2 and COVID-19 in order to identify their potential as a study model and as a possible therapeutic source against tissue damage caused by this virus. Therefore, the following research question was established: What is the role of stem cells in the study of SARS-CoV-2 and the treatment of COVID-19? MATERIALS AND METHODS: A search was carried out in the electronic databases of PUBMED, Scopus, and ScienceDirect. The following keywords were used: "SARS-CoV-2," "COVID-19," and "STEM CELL," plus independent search strategies with the Boolean operators "OR" and "AND." The identified reports were those whose main objective was the study of stem cells in relation to SARS-CoV-2 or COVID-19. For the development of this study, the following inclusion criteria were taken into account: studies whose main objective was the study of stem cells in relation to SARS-CoV-2 or COVID-19 and clinical case studies, case reports, clinical trials, pilot studies, in vitro, or in vivo studies. For assessment of the risk of bias for in vitro studies, the SciRAP tool was used. The data collected for each type of study, clinical or in vitro, were analyzed with descriptive statistics using the SPSS V.22 program. RESULTS: Of the total of studies included (n = 39), 22 corresponded to in vitro investigations and 17 to human studies (clinical cases (n = 9), case series (n = 2), pilot clinical trials (n = 5), clinical trials (n = 1)). In vitro studies that induced pluripotent stem cells were the most used (n = 12), and in clinical studies, the umbilical stem cells derived were the most reported (n = 11). The mean age of the study subjects was 58.3 years. After the application of stem cell therapy, the follow-up period was 8 days minimum and 90 days maximum. Discussion. The mechanism by which the virus enters the cell is through protein "S," located on the surface of the membrane, by recognizing the ACE2 receptor located on the target cell. The evidence that the expression of ACE2 and TMPRSS2 in stem cells indicates that stem cells from bone marrow and amniotic fluid have very little expression. This shows that stem cell has a low risk of infection with SARS-CoV-2. CONCLUSION: The use of stem cells is a highly relevant therapeutic option. It has been shown in both in vitro studies and clinical trials that it counteracts the excessive secretion of cytokines. There are even more studies that focus on long-term follow-up; thus, the potential for major side effects can be analyzed more clearly. Finally, the ethical use of stem cells from fetal or infant origin needs to be regulated. The study was registered in PROSPERO (no. CRD42021229038). The limitations of the study were because of the methodology employed, the sample was not very large, and the follow-up period of the clinical studies was relatively short.

Spindle cell carcinoma of the maxillary sinus with extension to the oral cavity.

Spindle cell carcinoma (SCC) is a rare variant of squamous cell carcinoma characterized by elongated and pleomorphic epithelial cells that resemble a sarcoma. Due to its rareness, and histological resemblance to various sarcomas, the diagnosis of this neoplasia is challenging. Herein we present the case of an 82-year-old female with a polypoid, ulcerated, soft tissue mass located on the left side of the maxilla. The tomographic examination showed a hyperdense mass that infiltrated the orbital cavity, ethmoidal cells, middle and lower nasal concha, maxillary sinus, zygomatic arch, and mandibular ramus on the left side. Histopathologically, the tumor was composed of spindle cells that were sarcomatous in appearance, with aberrant mitosis, along with a group of pleomorphic cells with a more epithelioid and hyperchromatic appearance on a stroma of densely vascularized fibrous tissue. The immunohistochemistry panel used to determine the lineage of the tumor rendered the diagnosis of SCC. The diagnosis of SCC is challenging to the pathologist since its morphology can resemble a sarcoma. Thus, immunohistochemistry is a valuable resource to support the diagnosis. We propose that SCC should be considered when examining a biphasic neoplasm with the aforementioned histological characteristics and markers.

Evaluación de higiene oral y características periodontales en pacientes con obesidad: estudio de casos y controles / Evaluation of oral hygiene and periodontal characteristics in patients with obesity: case-control study

Introducción: La obesidad sigue siendo considerada un serio problema de salud pública en el mundo. Aunque es bien sabido que esta condición puede aumentar el riesgo para desarrollar o agravar otras condiciones sistémicas; hoy en día, sigue siendo escasa la información que determine los niveles de asociación entre esta enfermedad sistémica con enfermedades orales como la periodontitis. Objetivo: El objetivo de este estudio fue medir la asociación de pacientes obesos con el desarrollo de periodontitis, así como hábitos de higiene oral. Material y métodos: Se realizó un estudio de casos y controles en 24 pacientes obesos y 24 pacientes sin obesidad. Las variables evaluadas fueron hábitos de higiene bucal, profundidad al sondeo, nivel de inserción clínica y nivel de inflamación gingival. Resultados: Los pacientes obesos tuvieron mayor riesgo para desarrollar bajas frecuencias de cepillado bucal diario (70.8%) y un incremento en la presencia de enfermedad periodontal (70.8%) comparado con los sujetos no obesos (25.0 y 58.3%, respectivamente), lo cual determinó asociaciones estadísticamente significativas (baja frecuencia de cepillado RM = 7.2, IC 95% = 2.0-26.1) y presencia de enfermedad periodontal (RM = 1.7, IC 95% = 0.5-5.7). Conclusiones: Es posible que la obesidad actúe como un factor que facilite la aparición de periodontitis por deficiencias en el cepillado dental diario (AU)

Introduction: Obesity is still considered a serious public health problem in the world. Although it is well known that this condition may increase the risk of developing or aggravating other systemic conditions; nowadays, the information that determines the levels of association between this systemic disease with oral diseases such as periodontitis still scarce. Objective: The objective of this study was to measure the association of obese patients with the development of periodontitis as well as oral hygiene habits. Material and methods: A case-control study was conducted in 24 obese patients and 24 patients without obesity. The variables evaluated were oral hygiene habits, depth of probing, clinical attachment level and gingival inflammation. Results: Obese patients had a higher risk of developing low frequencies of daily oral brushing (70.8%) and an increase in the presence of periodontal disease (70.8%) compared to non-obese subjects (25.0 and 58.3%, respectively) determining statistically significant associations (low frequency of brushing RM = 7.2, 95% CI = 2.0-26.1) and presence of periodontal disease (RM = 1.7, 95% CI = 0.5-5.7). Conclusions: It is possible that obesity acts as a factor that facilitates the presence of periodontitis due to deficiencies in daily toothbrushing (AU)

Evaluación de la adhesión de sistemas adhesivos de grabado total en esmalte dental bovino usando un agente desproteinizante: un estudio in vitro / Evaluation of adhesion of total etch adhesive systems on bovine dental enamel using a deproteinizing agent: an in vitro study

Introducción: Hoy en día, la mayoría de los pacientes requieren tratamiento de ortodoncia fija convencional, la cual utiliza procedimientos adhesivos afines con la superficie amelodentinaria. Aunque existen diferentes técnicas adhesivas que pueden ofrecer adecuados niveles de resistencia al desalojo, el uso del hipoclorito de sodio (NaClO) como agente desproteinizante no ha sido bien definido en materiales de cementación en aparatología ortodóncica convencional. Objetivo: El objetivo de este estudio fue determinar los niveles de resistencia al desalojo con pruebas de microtensión y análisis topográfico con microscopia electrónica de barrido. Material y métodos: 20 bloques de esmalte bovino fueron expuestos superficialmente a soluciones acondicionadoras (ácido ortofosfórico al 37%) con y sin agente desproteinizante (NaClO al 5.25%); finalmente, brackets individuales de ortodoncia fueron cementados con sistemas adhesivos y resinas compuestas de casas comerciales (Ormco y 3M). Las pruebas de resistencia al desalojo fueron realizadas con una máquina de fuerzas universales y el análisis topográfico con microscopia electrónica de barrido. Resultados: El uso del NaClO al 5.25% y la marca Ormco tuvieron estadísticamente los mejores niveles de adhesión que el grupo sin desproteinización y la casa comercial 3M, respectivamente. La topografía adamantina expuesta al agente desproteinizante mostró características de superficie relacionadas con el patrón de grabado tipo I. Conclusión: El uso de un agente desproteinizante (NaClO 5.25%) así como una marca comercial (Ormco) en particular podrían definir el aumento en los niveles de adhesión en superficies adamantinas con aparatología ortodóncica convencional (AU)

Introduction: Nowadays, patients require conventional fixed orthodontic treatment, which uses adhesive procedures related to the dentinal denture surface. Although there are different adhesive techniques that can offer adequate levels of bonding resistance, the use of NaClO as a deproteinizing agent has not been well defined in cementing materials in conventional orthodontic appliances. Objective: The objective of this study was to determine the levels of bond resistance using micro tension tests and topographic analysis with scanning electron microscopy. Material and methods: Twenty-blocks of bovine enamel were exposed superficially to conditioning solutions (37% orthophosphoric acid) with and without deproteinizing agent (5.25% NaClO); finally, individual orthodontic brackets were cemented with adhesive systems and resin composites of different trademarks (Ormco and 3M). Bonding resistance tests were performed with a universal force machine and topographic analysis was made with scanning electron microscopy. Results: The use of 5.25% NaClO and the Ormco brand had statistically better levels of adhesion than the group without deproteinization and the 3M brand, respectively. Adamantine topography exposed to the deproteinizing agent showed surface characteristics related to the type I etching pattern. Conclusion: The use of a deproteinizing agent (NaClO 5.25%) as well as a trademark (Ormco) in particular conditions could define the increase in adhesion levels on adamantine surfaces with conventional orthodontic appliances (AU)

Primary maxillary chondrosarcoma: A case report.

BACKGROUND: Sarcomas of the head and neck region are rare tumors, constituting less than 1% of malignant neoplasms in this area, of which few cases (20%) originate from bone or cartilage. Chondrosarcoma is a malignant neoplasm that develops in bone, with a predilection for the pelvis, chest wall, and scapula, and is uncommon in the maxilla and jaw. Although this type of lesion has locally aggressive behavior, destroying the affected bone, it can metastasize when it is not diagnosed early and compromise the patient's life. CASE SUMMARY: On intraoral examination of a 32-year-old female with a tumor in the middle third of the face, a well-defined rise in volume of approximately 3 cm in diameter was observed. Computed tomography with 3-dimensional reconstruction was performed, and we observed that the osteolytic lesion affected the vestibular cortex as the palatal bone. Hematoxylin and eosin staining revealed an appearance that was similar to mature hyaline cartilage, hypercellularity, nuclear and cellular pleomorphism, and multinucleated cells, with significant vacuolization. CONCLUSION: Determination of the clinical and histopathological characteristics of rare neoplasms in the maxillofacial region, such as chondrosarcomas, allows the pathologist and surgeon to make the appropriate therapeutic decisions, optimizing the patient's prognosis.

Hyalinizing clear cell carcinoma-a rare entity in the oral cavity: A case report.

BACKGROUND: Hyalinizing clear cell carcinoma (HCCC) is an uncommon tumor that originates in the salivary glands. This neoplasia constitutes less than 1% of minor salivary gland tumors. CASE SUMMARY: A 67-year-old female visited the maxillofacial surgery department owing to a smooth, slightly yellowish protruding mass on the left side of the floor of the mouth, at the level of the molars; the tumor mass had a soft consistency on palpation and did not adhere to deep planes. The microscopical analysis of the excisional biopsy showed that the lesion was composed of sheets and cords of clear cells separated by thick eosinophilic bands of hyaline collagen. Normal glandular tissue was absent, periodic acid-Schiff with and without diastase stains, and immunohistochemical reactions were performed to confirm the diagnosis. This is the second case reported in the literature of HCCC arising in the floor of the mouth. CONCLUSION: HCCC is a rare salivary gland tumor that has not been studied extensively. Its diagnosis is usually challenging, because clinically, it can be confused with a benign neoplasm.

Spindle cell carcinoma of the maxillary sinus with extension to the oral cavity

Spindle cell carcinoma (SCC) is a rare variant of squamous cell carcinoma characterized by elongated and pleomorphic epithelial cells that resemble a sarcoma. Due to its rareness, and histological resemblance to various sarcomas, the diagnosis of this neoplasia is challenging. Herein we present the case of an 82-year-old female with a polypoid, ulcerated, soft tissue mass located on the left side of the maxilla. The tomographic examination showed a hyperdense mass that infiltrated the orbital cavity, ethmoidal cells, middle and lower nasal concha, maxillary sinus, zygomatic arch, and mandibular ramus on the left side. Histopathologically, the tumor was composed of spindle cells that were sarcomatous in appearance, with aberrant mitosis, along with a group of pleomorphic cells with a more epithelioid and hyperchromatic appearance on a stroma of densely vascularized fibrous tissue. The immunohistochemistry panel used to determine the lineage of the tumor rendered the diagnosis of SCC. The diagnosis of SCC is challenging to the pathologist since its morphology can resemble a sarcoma. Thus, immunohistochemistry is a valuable resource to support the diagnosis. We propose that SCC should be considered when examining a biphasic neoplasm with the aforementioned histological characteristics and markers.

Frecuencia de Lesiones y Condiciones Orales en Pacientes Mayores de 18 Años en una Clínica de Atención Primaria en México / Frequency of Lesions and Oral Conditions in Patients Older than 18 Years in a Primary Care Clinic in Mexico

RESUMEN: La patología oral es el área de la odontología que se especializa en el diagnóstico y tratamiento de enfermedades orales. Se realizó un estudio transversal, en el cual fueron incluidos pacientes mayores de 18 años que acudieron a una clínica de atención primaria del departamento de estomatología de la universidad Autónoma de Ciudad Juárez, en México y a los cuales independientemente del motivo de consulta se les realizo historia clínica y exploración intraoral detallada. Fueron examinados 650 pacientes (424 mujeres y 226 hombres) con un rango de edad de 18 a 89 años (media=42.27). Las lesiones más frecuentes fueron la queratosis friccional (30,46 %) e hiperplasia fibrosa (6,92 %), la melanosis fisiológica (42,92 %) y los gránulos de Fordyce (36,46 %) fueron las condiciones más identificadas. En las lesiones de la mucosa oral que identificamos estuvo presente el factor traumático de manera crónica, es importante que el odontólogo este familiarizado con las lesiones más frecuentes, con su etiología, características clínicas y tratamiento de cada una de ellas.

ABSTRACT: Oral pathology it's the branch of medicine that focuses on the diagnosis and treatment of oral diseases. A cross-sectional study was carried out in which patients older than 18 years was included, that were attended in the primary care clinic at the stomatology department of the Autonomous University of Ciudad Juárez, in Mexico, and regardless of the reason for consultation the clinical history and intraoral examination was done We examined 650 patients (424 women and 226 men) with an age range of 18 to 89 years (mean=42.27). The most frequent oral lesion was the frictional keratosis (30.46 %), fibrous hyperplasia (6.92 %), physiological melanosis (42.92 %), and fordyce granules (36.46 %). In the oral mucosal lesions identified was present a chronic traumatic factor, it is important that the dental staff knows about the most frequent injuries, their etiology, clinical characteristics and treatment of each one.

Frecuencia de lesiones orales y variantes de lo normal en pacientes del Departamento de Estomatología de la Universidad Autónoma de Ciudad Juárez / Frequency of oral lesions and variants of the normal in patients from the Department of Stomatology, Autonomous University of Ciudad Juarez

Introducción: La exploración intraoral detallada es la clave en el diagnóstico temprano de lesiones potencialmente agresivas; de estamanera, se le ofrece al paciente un tratamiento adecuado y oportuno,reduciendo al máximo posibles complicaciones que pongan en peligrosu integridad y deterioren su calidad de vida. Objetivo: Determinar la frecuencia de lesiones y condiciones de la mucosa bucal en pacientes mayores de 18 años de la clínica de diagnóstico del Departamento de Estomatología de la Universidad Autónoma de Ciudad Juárez, Chihuahua...

Introduction: A detailed intraoral examination is key in the early diagnosis of potentially aggressive lesions; in this way, the patient isoff ered an adequate and timely treatment, reducing to the maximumpossible complications that could endanger his integrity and deterioratehis quality of life. Aim: To determine the frequency of lesions and conditions of the buccal mucosa in patients older than 18 years of the diagnostic clinic of the Department of Stomatology at the Autonomous University of Ciudad Juarez, Chihuahua...

Periimplantitis: revisión de la literatura / Peri-Implantitis: literature review

El uso de implantes ha tomado un gran auge en los últimos años, sin embargo así como se ha visto un aumento en la demanda también se ha visto un incremento en el fracaso de los mismos, existen múltiples razones que intervienen para esto como son; deficiencias en la cantidad y calidad de hueso, patologías óseas preexistentes, mala técnica quirúrgica, implante inadecuado, hábito tabáquico, entre otras. La mucositis periimplantaria y la periimplantitis son las primeras causas de complicaciones en los implantes, los pacientes con enfermedades crónico degenerativas, fumadores y con mala higiene son considerados pacientes de riesgo para presentar periimplantitis. La literatura ofrece tratamientos quirúrgicos y no quirúrgicos los cuales van enfocados a la eliminación de microorganismos y a la desinfección de la superficie del implante, el tratamiento quirúrgico como la debridación y curetaje tienen la finalidad de eliminar la placa bacteriana, desinfectar la superficie del implante así como retirar el tejido dañado por el proceso inflamatorio, el realizar una adecuada historia clínica y valoración previa, permitirá identificar a los pacientes con mayor o menor riesgo de desarrollar periimplantitis, las citas de mantenimiento ayudan a detectar oportunamente posibles complicaciones.

The use of implants has taken a giant leap in recent years, however, greater demand has also resulted in an increase in the failure of these procedures. There are multiple reasons involved such as; deficiencies in the amount and quality of bone, preexisting bone disease, poor surgical technique, improper implant, tobacco habit, among others. The peri-implant mucositis and peri-implantitis are the main causes of complications in implants, patients with chronic degenerative diseases, smokers and patients with poor oral hygiene are considered risk patients to present peri-implantitis. The literature provides surgical and nonsurgical treatments which are focused on the elimination of microorganisms and the disinfection of the implant surface; surgical treatment as debridement and curettage are designed to remove plaque, disinfect the implant surface and remove damaged tissue caused by the inflammatory process, the performance of an adequate medical history and prior assessment will identify patients with greater or lesser risk of developing peri-implantitis, maintenance appointments help in the early detection of possible complications.

Evaluación de la enfermedad periodontal e hiperglucemia asociados con diabetes mellitus tipo 2 en pacientes del estado de Durango, México / Evaluation of periodontal disease and hyperglycemia associated to type 2 diabetes mellitus in patients from Durango State, Mexico

Antecedentes: la diabetes mellitus es considerada un problema de salud pública en todo el mundo Este padecimiento afecta órganos y sistemas, incluyendo la cavidad oral; sin embargo, hay pocos informes en la literatura de los efectos de la diabetes mellitus en la cavidad bucal en la población del estado de Durango. Objetivo: El objetivode este estudio fue determinar la asociación de diversas enfermedadesorales, el índice de masa corporal, así como el nivel de glucosa en sangre en pacientes con diabetes mellitus. Material y métodos: Se realizó un estudio de casos y controles para identifi car la prevalencia de las enfermedades orales en individuos con y sin diabetes mellitus.Los sujetos con diabetes mellitus tipo 1 o 2 se definieron como casos y aquellos con otras enfermedades fueron defi nidos como controles. El índice de masa corporal y la concentración de glucosa en sangre fueron evaluados en todos los sujetos. El análisis estadístico incluyólas pruebas chi cuadrada y promedio y desviación estándar de los datos. esultados: Se evaluaron 312 personas, 38 pacientes con diabetes mellitus tipo 1, 79 con diabetes mellitus tipo 2 y 195 sin diabetes mellitus. Diferencias signifi cativas fueron encontradas en individuos con DM2, que mostraron una mayor frecuencia de periodontitis, así como diferencias significativas entre este tipo de diabetes y niveles elevadosde glucosa en sangre...

Background: Diabetes mellitus is considered a public health problem worldwide and one that affects organs and systems alike, including the oral cavity. However, there are few reports in the literature on the effects of diabetes mellitus on the oral cavity of the population in the north of Mexico. Objective: The aim of this study was to determine the link between various oral diseases, body mass index, and blood glucose level in patients with diabetes mellitus. Material and methods:A case-control study was conducted to identify the prevalence of oral diseases in patients with and without diabetes mellitus. Patients with type 1 or type 2 diabetes mellitus were defi ned as cases and patients with other diseases were defi ned as controls. The body mass index and blood glucose concentration of all subjects were measured. Statistical analysis included chi-squared tests, and the average and standard deviation of the data. Results: 312 subjects were assessed: 38 patients with type 1 diabetes mellitus, 79 with type 2 diabetes mellitus, and 195 without diabetes mellitus. Signifi cant differences were found in DM2 patients, who were more likely to exhibit periodontitis and high blood glucose levels. Furthermore, the presence of obesity and hypertension in patients with type 2 diabetes was found to be a risk factor for de-veloping periodontitis...

Hermangioma intraóseo: reto diagnóstico. Presentación de un caso y revisión de la literatura / Intraosseous hemangioma: a diagnostic challenge. Report of a case and review of the literature

Los hemangiomas son neoplasias benignas de origen endotelial, formadoras de vasos. Los hemangiomas intraóseos son condiciones raras que comprenden del 0.5 a 1% de todos los tumores intraóseos. Su localización más común es la columna vertebral y los huesos del cráneo. Aquéllos que se presentan en los maxilares son tumores muy raros. Dos tercios de éstos se localizan en la mandíbula, con una proporción de mujer a hombre de 2:1. El objetivo de este artículo es reportar un caso signifi cativo de un hemangioma central de grandes dimensiones de la rama de la mandíbula del lado derecho, el cual fuetratado exitosamente con resección quirúrgica y ligadura de vasos nutricionales. Caso clínico: Paciente de 14 años que presenta un área radiolúcida unilocular en la rama mandibular del lado derecho. Clínicamente se observa aumento de la cara difuso, que causa asimetría facialasintomática de tres años de evolución. Conclusiones: La importancia del hemangioma intraóseo de los maxilares radica en su proximidad con los dientes, lo que representa un alto riesgo de sangrado debido a cualquier traumatismo por intento de extracción. El diagnóstico de hemangioma intraóseo, debido a su baja incidencia e inusual manera de presentación, es un reto diagnóstico...

Tumor de Warthin: Una experiencia del Hospital «General Calixto García¼. La Habana, Cuba / Warthin's tumor: An experience of the General Hospital «Calixto García¼. Havana, Cuba

Antecedentes: El tumor de Warthin -tumor benigno de glándulas salivales- fue reportado por primera vez en 1895 por Hildebrand y posteriormente en 1929 Warthin lo describió ampliamente. Es la segunda neoplasia más frecuente de las glándulas salivales, representando el 10% de todos los tumores de glándulas salivales. Métodos: Se realizó un estudio retrospectivo de tumores de glándulas salivales del Departamento de Anatomía Patológica del Hospital «Calixto García¼ de La Habana, Cuba, durante el periodo de enero del 2001 a diciembre del 2008. Los casos fueron rediagnosticados por dos expertos en patología bucal, basados en los criterios diagnósticos propuestos por la Organización Mundial de la Salud en el 2005. Resultados: De 159 casos, 113 (71.1%) fueron tumores benignos (48 hombres, 65 mujeres; promedio de edad 50.8 [± 15], rango de edad 20-80 años). El tumor más frecuente fue el adenoma pleomorfo con 77 casos (68.1%), seguido del tumor de Warthin con 33 casos, que constituyen el 20.7% del total de tumores de glándulas salivales incluidos y el 29.2% del total de los tumores benignos. Conclusiones: En nuestro estudio la proporción del tumor de Warthin está dentro de las más altas, acorde a lo reportado en la literatura de los últimos años.

Background: Warthin's tumor, a benign tumor of the salivary glands, was first described by Dr. Hildrebrand in 1896. It was later extensively described by Dr. Warthin in 1929. It represents the second most frequent neoplasia found in the salivary glands. It constitutes 10% of all salivary glands tumors. Methods: A salivary gland retrospective study was conducted at the Pathological Anatomy Department of the «Calixto García¼ Hospital in Havana, Cuba. The study was conducted in the period comprised between January 2001 and December 2008. Two oral pathology experts re-diagnosed the cases following diagnostic criteria proposed in 2005 by the World Health Organization (WHO). Results: Out of 159 studied cases, 113 (71.1%) were benign tumors (48 male patients, 65 female, average age 50.8 [± 15], age range 20-80 years). Most frequently found tumor was pleomorphic adenoma, which counted 77 cases (68.1%) followed by Warthin's tumor with 33 cases (20.7%) of all included salivary glands tumors and 29.2% of benign tumors. Conclusions: The present study revealed the fact that Warthin's tumor proportion is among the highest reported in recent years in scientific literature.

Detección de células cebadas y basófilos en lesiones periapicales experimentales tratadas con piroxicam / Detection of mast cells and basophils in experimental periapical lesions treated with piroxicam

En este estudio, se reportó la respuesta del tejido periapical ante la exposición prolongada del tejido pulpar y el efecto de la administración de un antiinflamatorio no esteroide (piroxicam), sobre dos tipos celulares involucrados en la respuesta inflamatoria e inmunológica local como son las células cebadas y los basófilos, utilizando ratas Long Evans a las cuales se les provocó exposición pulpar previo a la administración del piroxicam. Los hallazgos fueron: en el área de los abscesos en el grupo experimental, a los 8 días las células cebadas se encontraron en un porcentaje del 50.0 disminuyendo a 16.6 por ciento a los 15 días, mientras que en el grupo control a los 8 días se presentaron en 11.1 por ciento, aumentando a 22.2 por ciento a los 15 días en el total de los animales. Con respecto a los basófilos en la misma zona se observó en el grupo control a los 8 días un porcentaje de 61.1 disminuyendo a 33.3 por ciento a los 15 días, siendo lo contrario en el grupo experimental, donde de 16.6 por ciento aumentó a 33.3 por ciento en el transcurso del tratamiento; la degranulación fue raramente observada en ambos tipos celulares probablemente por efecto del antiinflamatorio en estudio