Saliva metabolomics: concepts and applications in oral disorders.

OBJECTIVES: The purpose of this review was to present the basic concepts of metabolomics methodology and the use of saliva for diagnostic, prognostic, and predictive strategies. MATERIAL AND METHODS: This review followed the focus in: "saliva metabolomics" and "oral diseases". The authors searched studies on PubMed database. The inclusion criteria were original studies and reviews that assessed metabolomics techniques. A descriptive analysis was performed considering the study design, approach system, clinical steps, and tools for the determination of profile or biomarkers metabolites, and the advantages and disadvantages. RESULTS: Metabolomic analyses use a combination of analytical instrumentation and informatic tools to provide information on metabolite characteristics. In this review we described different technologies applied and the advantages and limitations of each technique. Furthermore, in the literature search, we retrieved 25 studies that investigated saliva metabolites in oral diseases: 8 studies used targeted analysis and 17 untargeted metabolomics approaches. Most studies included patients with periodontal diseases, oral squamous cell carcinoma, and Sjögren Syndrome. The most frequently reported metabolites were glycine, leucine, phenylalanine, dipeptides, linoleic acid, arachidonic acid, tyrosine, choline, taurine, lactate, valine, and proline. CONCLUSIONS: Metabolomics analysis has emerged as a powerful tool for tumor diagnosis and to enhance tumor classification, including salivary gland tumors (SGTs). It also holds promise for developing personalized treatment plans and defining more precise prognostic categories. CLINICAL RELEVANCE: Metabolomics is the most functional and comprehensive technique for monitoring and understanding gene functions and identifying the biochemical state of an organism in response to genetic and environmental changes.

Oral Problems in Brazilian Individuals with Rare Genetic Diseases That Affect Skeletal Development.

The present study aimed to compare the prevalence of oral problems between individuals with rare genetic diseases that affect skeletal development and individuals without rare diseases. A cross-sectional study was conducted with 210 individuals between two and fifty-four years of age: 105 with rare genetic diseases (27 with mucopolysaccharidosis [MPS] and 78 with osteogenesis imperfecta [OI]) and 105 without rare diseases. The rare genetic disease group was recruited from hospital units that provide care for patients with MPS and OI in five states of Brazil, and the other group was recruited from the same location. The participants were examined with regards to malocclusion, dental anomalies, dental caries, and gingivitis. A questionnaire was administered addressing individual, sociodemographic, and behavioral characteristics as well as dental history. A descriptive analysis was performed, followed by unadjusted and adjusted binary logistic regression analyses. The mean age was 14.1 ± 12.2 years. Individuals with a rare disease were 12.9-fold more likely to have some type of oral problem (95% CI: 3.7-44.7) compared to the group without rare diseases. The prevalence of oral problems was higher among Brazilians with MPS and OI compared to normotypical individuals.

Accuracy and consistency of ChatGPT-3.5 and - 4 in providing differential diagnoses in oral and maxillofacial diseases: a comparative diagnostic performance analysis.

OBJECTIVE: To investigate the performance of ChatGPT in the differential diagnosis of oral and maxillofacial diseases. METHODS: Thirty-seven oral and maxillofacial lesions findings were presented to ChatGPT-3.5 and - 4, 18 dental surgeons trained in oral medicine/pathology (OMP), 23 general dental surgeons (DDS), and 16 dental students (DS) for differential diagnosis. Additionally, a group of 15 general dentists was asked to describe 11 cases to ChatGPT versions. The ChatGPT-3.5, -4, and human primary and alternative diagnoses were rated by 2 independent investigators with a 4 Likert-Scale. The consistency of ChatGPT-3.5 and - 4 was evaluated with regenerated inputs. RESULTS: Moderate consistency of outputs was observed for ChatGPT-3.5 and - 4 to provide primary (κ = 0.532 and κ = 0.533 respectively) and alternative (κ = 0.337 and κ = 0.367 respectively) hypotheses. The mean of correct diagnoses was 64.86% for ChatGPT-3.5, 80.18% for ChatGPT-4, 86.64% for OMP, 24.32% for DDS, and 16.67% for DS. The mean correct primary hypothesis rates were 45.95% for ChatGPT-3.5, 61.80% for ChatGPT-4, 82.28% for OMP, 22.72% for DDS, and 15.77% for DS. The mean correct diagnosis rate for ChatGPT-3.5 with standard descriptions was 64.86%, compared to 45.95% with participants' descriptions. For ChatGPT-4, the mean was 80.18% with standard descriptions and 61.80% with participant descriptions. CONCLUSION: ChatGPT-4 demonstrates an accuracy comparable to specialists to provide differential diagnosis for oral and maxillofacial diseases. Consistency of ChatGPT to provide diagnostic hypotheses for oral diseases cases is moderate, representing a weakness for clinical application. The quality of case documentation and descriptions impacts significantly on the performance of ChatGPT. CLINICAL RELEVANCE: General dentists, dental students and specialists in oral medicine and pathology may benefit from ChatGPT-4 as an auxiliary method to define differential diagnosis for oral and maxillofacial lesions, but its accuracy is dependent on precise case descriptions.

Oral focal mucinosis: A systematic review.

Oral focal mucinosis (OFM) is a rare lesion first described in 1974, but the aetiology remains unknown. Clinically, OFM presents as an asymptomatic nodular lesion and the similarity of clinical features to other soft tissue injuries makes the diagnosis difficult. The aim of this study was to integrate the demographic, clinical, and histopathological characteristics from previously published cases of OFM into a systematic review. Electronic searches without publication date restriction were performed in the following databases: Embase, PubMed, Medline, Web of Science, and Scopus. Case reports or case series of OFM published in English and presenting enough clinical and histopathological information were included. This systematic review identified 42 studies from 12 countries, comprising 113 cases of OFM. This lesion affected more females than males, usually in the fourth decade of life. The gingiva was the most common anatomical location, followed by the palate. Clinical presentation was most often an asymptomatic nodule. Imaging exams revealed that most cases did not have bone involvement. Surgical removal was the treatment of choice for most cases and only one recurrent case was reported. In conclusion, OFM is an uncommon pathology, and its diagnosis depends on histopathological analysis. The lesion could be included as a differential diagnosis of benign soft tissue lesions of the oral cavity, especially those affecting the gingiva.

Oral Leishmaniasis in HIV-Positive and HIV-Negative Patients: A Comparative Analysis with Two New Case Reports.

PURPOSE: This case report examines the clinical presentation, diagnosis, treatment, and outcomes of mucocutaneous leishmaniasis with primary oral involvement in HIV-positive and HIV-negative patients diagnosed in Brazil. METHODS: We discuss the clinical manifestations, diagnostic methods, and therapeutic strategies, highlighting the clinical and histopathologic diagnostic features and distinct progression patterns based on HIV status. Our findings are compared with patterns observed in other countries, emphasizing the differences between the Americas and Europe, Asia, and Africa. RESULTS: In the Americas, particularly in Brazil, mucocutaneous leishmaniasis often presents with localized oral lesions, even in the presence of systemic immunosuppression, whereas in the Europe, Asia, and Africa, oral involvement is typically associated with visceral leishmaniasis in immunocompromised patients. These differences were due to variations in the parasite species involved. CONCLUSION: This comparison underscores the importance of regional and immunological factors in diagnosing and managing this neglected infectious disease.

Pierre Fauchard's Contribution to Oral Medicine and Oral and Maxillofacial Pathology: An historical essay.

Pierre Fauchard, considered the father of dentistry, contributed to the development of different fields of dentistry that we know today. However, the contribution of this important individual to the fields of oral medicine and oral and maxillofacial pathology is unknown. This study aimed to identify Pierre Fauchard's contribution to these areas of dentistry. We focused on "Le Chirurgien Dentiste, or Traité des Dents" in both French and English, looking for information about the oral diseases diagnosed and treated by Fauchard. Information on patient history, disease description, treatment applied, and clinical follow-up was collected. A contemporary analysis of the diseases was performed, and the collected data were systematized, reported, and analyzed descriptively, according to the current literature on the addressed topics. Information on conditions such as scurvy, parulides, epulides, oral ulcers, dentoalveolar abscesses, dental alterations, and post-exodontia incidents were elucidated. Findings indicated that Pierre Fauchard described, diagnosed, and treated different soft and hard tissue diseases of great interest to the fields of oral medicine and oral and maxillofacial pathology.

Co-occurrence of oral pemphigus vulgaris and herpes simplex virus infection in a young patient with Crohn's disease: report of a rare case of oral lesions during anti-TFN alpha and immunomodulator therapy.

BACKGROUND: Pemphigus vulgaris (PV) is a potentially life-threatening mucocutaneous autoimmune disease that affects desmoglein-1 and desmoglein-3, leading to intraepithelial vesiculobullous lesions. In the oral mucosa, PV lesions can mimic other diseases such as mucous membrane pemphigoid, other forms of pemphigus, recurrent aphthous stomatitis, erythema multiforme, Stevens-Johnson syndrome, and virus-induced ulcers like herpes simplex virus (HSV), making diagnosis challenging. The co-occurrence of PV with Crohn's disease is rare and predominantly seen in younger patients. The therapeutic mainstay for both PV and Crohn's disease usually involves systemic corticosteroids combined with immunosuppressants and immunobiological drugs. Literature indicates that the use of these drugs, particularly TNF-alpha inhibitors, for managing autoimmune diseases like Crohn's can potentially induce other autoimmune diseases known as autoimmune-like syndromes, which include episodes of lupus-like syndrome and inflammatory neuropathies. There are few cases in the literature reporting the development of PV in individuals with CD undergoing infliximab therapy. CASE REPORT: A young female with severe Crohn's disease, treated with the TNF-alpha inhibitor infliximab, developed friable pseudomembranous oral ulcerations. Histopathological and immunofluorescence analyses confirmed these as PV. The treatment included clobetasol propionate and low-level photobiomodulation, which resulted in partial improvement. The patient later experienced severe intestinal bleeding, requiring intravenous hydrocortisone therapy, which improved both her systemic condition and oral lesions. Weeks later, new ulcerations caused by herpes virus and candidiasis were identified, leading to treatment with oral acyclovir, a 21-day regimen of oral nystatin rinse, and photodynamic therapy, ultimately healing the oral infections. To manage her condition, the gastroenterologists included methotrexate (25 mg) in her regimen to reduce the immunogenicity of infliximab and minimize corticosteroid use, as the patient was in remission for Crohn's disease, and the oral PV lesions were under control. CONCLUSION: Young patients with Crohn's disease should be referred to an oral medicine specialist for comorbidity investigation, as oral PV and opportunistic infections can arise during immunosuppressive therapy. The use of TNF-alpha inhibitors in patients treated for inflammatory bowel disease, such as Crohn's, should be carefully evaluated for potential side effects, including oral PV.

Prevalence of oral diseases in patients under palliative care: a systematic review and meta-analysis.

PURPOSE: Oral alterations are frequently observed in patients undergoing palliative care and are linked to the direct or indirect effects of the primary medical condition, comorbidities and medical management, leading to oral pain, impacting oral intake, and affecting quality of life. This systematic review aims to assess the prevalence of oral disease in palliative care patients. METHODS: The protocol was registered at the PROSPERO database, and a systematic review of the literature was performed based on the PRISMA statement. A thorough evaluation of studies from five databases and gray literature was conducted. The risk of bias in each study was assessed using the Joanna Briggs Institute checklist for cross-sectional and case-control studies. A quantitative analysis was conducted on five studies using meta-analysis, and the degree of certainty in the evidence was determined using the GRADE tool. RESULTS: The sample consisted of 2,502 patients, with a slight male predominance (50.43%). The average age was 66.92 years. The prevalence of oral diseases among palliative care patients was as follows: caries 32% (95% CI, 0.11-0.56; I2 = 93%), and oral candidiasis 17% (95% CI,0.11-0.25; I2 = 74%). Gingivitis and stomatitis were also reported, but with less frequency. CONCLUSION: Dental intervention should take place as early as possible, ideally from the time of the patient's initial admission to palliative care, with regular monitoring of oral health. This approach can enhance the patient's comfort and quality of life and help prevent more severe complications in the future.

Prevalence of HPV16 L1 protein in oral biopsies: A diagnostic study from Ecuador.

This study was designed to investigate the expression of HPV16 L1-protein in biopsies of oral mucosa samples. The expression of HPV16 L1 protein was investigated in biopsies taken from oral mucosa from patients who required pathological diagnosis of oral lesions. Seventy-two samples were incubated with anti-L1 protein monoclonal antibodies and protein detection was revealed with diaminobenzidine. Expression of L1 protein was performed by a pathologist blinded for tissue diagnosis under light microscopy. Most of the lesions of oral mucosa were present in lining mucosa (75 %) and the most frequent lesion were mucocele (n = 17, 23.6 %), epithelial hyperplasia (n = 6, 8.33 %), fibroma (n = 5, 6.9 %) and inflammatory hyperplasia (n = 5, 6.9 %). L1 protein expression was observed only in five (6.9 %) samples (two squamous cell carcinomas, two epithelial hyperplasia, and one gingival hyperplasia). We concluded that L1 expression in oral biopsies presented a low frequency in oral mucosal biopsies samples.

Prevalencia de la automedicación en odontología en adultos de Macas, Ecuador / Prevalence of self-medication in dentistry in adults in Macas, Ecuador

Introducción: el hecho de que una persona no puede acceder a un servicio de salud puede favorecer la automedicación, que es la administración de fármacos según la autopercepción del individuo sobre su posible diagnóstico y solución. Aunque es una situación considerada como problema de salud pública, por medio de la educación o futuras investigaciones que generen propuestas, se podrá erradicar las barreras al acceso de la salud oral. Objetivo: determinar la prevalencia de la automedicación en odontología en adultos de Macas, Ecuador, durante el año 2021. Material y métodos: estudio descriptivo, cuantitativo, documental, comunicacional y transversal actual, donde se trabajó sobre la población de edad adulta de Macas, Ecuador; los datos se recolectaron mediante una encuesta online, para luego ser analizados en prevalencia, frecuencia y chi cuadrado. Resultados: 49% de los encuestados respondió que se automedican, los analgésicos fueron el tipo de medicamento más consumido (44.2%); 27% de los individuos respondió que el dolor dental era una causa para tomar medicamentos sin receta, el principal motivo para automedicarse y no acudir al odontólogo fue por indicación del técnico de farmacia (26%). Conclusiones: los datos epidemiológicos obtenidos en esta investigación demuestran la marcada tendencia de las personas a consumir medicinas sin receta médica, por lo que, se deduce que existe una barrera para acceder a los servicios de salud oral; por ello, debería darse la importancia y atención oportuna (AU)

Introduction: the fact that a person cannot access a health service, may favor self-medication, which is the administration of drugs according to the individual's self-perception about their possible diagnosis and solution. Although, it is a situation considered as a public health problem, through education or future research that generates proposals, it will be possible to eradicate the barriers to oral health access. Objective: to determine the prevalence of self-medication in dentistry in adults in Macas, Ecuador, during the year 2021. Material and methods: a descriptive, quantitative, documentary, communicational and current cross-sectional study was carried out on the adult population of Macas, Ecuador; data were collected by means of an online survey and then analyzed in terms of prevalence, frequency and chi-square. Results: 49% of those surveyed responded that they self-medicate, analgesics were the most consumed type of medicine (44.2%), 27% of the individuals responded that dental pain was a cause for taking medicines without prescription, the main reason for self-medicating and not going to the dentist was because of the indication of the pharmacy technician (26%). Conclusions: the epidemiological data obtained in this investigation show us the marked tendency of people to take medicines without a medical prescription; therefore, it can be deduced that there is a barrier to accessing oral health services, and for this reason it should be given importance and timely attention (AU)

Oral Lesions of Immune-Mediated and Autoimmune Diseases: A 12-year Experience at a Single Brazilian Referral Center.

BACKGROUND: Oral lesions of immune-mediated and autoimmune diseases have been well-documented, but studies from Brazil are limited. The varied spectrum of oral lesions within this demographic group poses challenges to clinicians, particularly when they occur in isolation. This study aimed to evaluate the occurrence, clinical characteristics, and management of patients with oral lesions of immune-mediated and autoimmune diseases at a single center in Brazil. METHODS: A retrospective cross-sectional study was conducted from 2010 to 2022. Clinicodemographic data, histopathological features, and treatment modalities were analyzed descriptively and analytically. RESULTS: Of the 3,790 oral and maxillofacial lesions diagnosed, 160 (4.2%) were confirmed as immune-mediated or autoimmune diseases. The population surveyed predominantly consisted of women (73.7%), with a mean age of 60.2 years. Oral lichen planus (51.3%), mucous membrane pemphigoid (MMP) (23.7%), and pemphigus vulgaris (PV) (19.4%) were the most prevalent lesions. The buccal mucosa (59.4%) was predominantly affected, with pain reported in 46.2% of cases, notably in individuals with PV and MMP. The average time to disease stabilization post-local and/or systemic corticosteroid therapy was 15.8 months for systemic lupus erythematosus, 8.7 months for MMP, and 6.5 months for PV. CONCLUSION: Although oral lesions related to immune-mediated and autoimmune diseases are uncommon, their diverse clinicopathological aspects require multidisciplinary management.

O impacto do cigarro eletrônico na saúde bucal de pacientes adultos jovens / The impact of electronic cigarettes on oral health of young adult patients

O cigarro eletrônico (CE) surgiu como uma alternativa ao uso do cigarro convencional (CC) atuando como um meio de combate ao tabagismo. Apesar de ser considerado menos prejudicial à saúde do que o cigarro convencional, por muitos autores, seu uso não é isento de riscos. O presente estudo visa discutir e elucidar os impactos do uso de cigarros eletrônicos na saúde oral de pacientes adultos jovens. Esta revisão de literatura foi elaborada através da seleção de artigos científicos nos idiomas português e inglês, que abordam os temas de cigarro eletrônico e saúde oral. Utilizaram-se os bancos de dados Biblioteca Virtual em Saúde (BVS), PubMed e Google acadêmico, a busca foi baseada nos seguintes descritores de saúde: cigarro eletrônico, vaping e saúde bucal, e os respectivos em inglês, com limite temporal de 2019 a 2023. Diversas pesquisas relatam os efeitos dos cigarros eletrônicos na saúde bucal, como a xerostomia, halitose, cárie dental, perda e avulsão de elementos dentários, doença periodontal e diversas patologias orais. Além disso, os componentes químicos presentes nos líquidos dos cigarros eletrônicos também podem afetar a saúde bucal, podendo levar a danos no esmalte dentário e riscos desconhecidos as células e tecidos da cavidade oral. Logo, é necessário abordar o impacto que os cigarros eletrônicos causam e seus riscos à saúde bucal, além dos riscos já conhecidos para saúde geral dos usuários. Os profissionais de saúde devem estar atentos a essa questão e incluir informações sobre o uso de cigarros eletrônicos em suas avaliações e orientações aos pacientes.

The electronic cigarette (EC) emerged as an alternative to conventional cigarette (CC) use, acting as a means to combat smoking. Despite being considered less harmful to health than conventional cigarettes by many authors, its use is not without risks. The present study aims to discuss and elucidate the impacts of electronic cigarette use on the oral health of young adult patients. This literature review was conducted through the selection of scientific articles in Portuguese and English languages, addressing the topics of electronic cigarettes and oral health. The databases used included the Virtual Health Library (BVS), PubMed, and Google Scholar. The search was based on the following health descriptors: electronic cigarette, vaping, and oral health, and their English equivalents, with a time limit from 2019 to 2023. Several studies report the effects of electronic cigarettes on oral health, such as xerostomia, halitosis, dental caries, tooth loss and avulsion, periodontal disease, and various oral pathologies. Furthermore, the chemical components present in electronic cigarette liquids can also impact oral health, potentially leading to dental enamel damage and unknown risks to oral cavity cells and tissues. Therefore, it is necessary to address the impact and risks of electronic cigarettes on oral health, in addition to the known risks to users' overall health. Health professionals should be attentive to this issue and include information about electronic cigarette use in their assessments and patient guidance.

Salivary cortisol levels in patients with potentially malignant oral disorders and oral mucosal cancer: a case-control study.

BACKGROUND: The relationship between salivary cortisol secretion and the presence of cancer in the oral cavity has not been completely clarified. Due to this, we proposed carrying out a study to determine salivary cortisol levels in patients with potentially malignant disorders (PMD), oral squamous cell carcinoma (OSCC) and healthy individuals. MATERIAL AND METHODS: Cross-sectional case-control study, among 80 patients seen at the Faculty of Dentistry of the National University of Rosario, Argentina, between January 2018 and April 2020. 40 cases represented by Leukoplakia, Lichen, Erythroplakia and SCC and 40 controls were included. Smoking habit and alcohol consumption were included. The presence of stress was determined. Morning salivary cortisol levels were measured with the Roche electrochemiluminescence method (Traceability: St by ID-MS). RESULTS: Patients with SCC presented elevated salivary cortisol values. Individuals with stage III tumors showed levels higher than 8.74 ng/ml in all cases. A significant association between cortisol levels and stress was detected in patients in the control group (p<0.005) and in individuals with PMD (p=0.009). This association was not significant in patients with SCC (p=0.999). After applying the logistic regression method, when adjusting odds ratios according to tobacco and alcohol consumption and the presence of stress, the association between cortisol levels and presence of stress was highly significant (p<0.001). The possibility of presenting undetectable cortisol results was 94% lower in patients with stress. CONCLUSIONS: The increase in salivary cortisol levels in patients with PMD and SCC, is related to stress conditions, being able to generate alterations tending to immunosuppression of the cellular microenvironment.

Evaluation of the main disorders and microbiota of the oral cavity of capuchin monkeys (Sapajus apella) under human care.

BACKGROUND: Although critical to the overall condition of animals under human care, there is still limited information about oral health in neotropical primates. METHODS: We analyzed the main oral conditions and microbiota using mass spectrometry from 13 capuchin monkeys (Sapajus apella) under human care. The findings were registered on odontograms following the Triadan system. RESULTS: The most prevalent conditions were dental fractures (n = 9), mainly enamel fractures, and periodontal disease (n = 8), mainly grade 1 calculi. When exanimating teeth, alterations were identified in 90 out of the 416 evaluated pieces, being periodontal disease the most common (n = 60), followed by enamel fracture (n = 15) and missing teeth (n = 10). In the oral microbiota analyses, Staphylococcus and Streptococcus species were the most prevalent, although no obvious association was observed between isolated organisms and oral conditions. CONCLUSIONS: These findings hold the potential to prevent oral disorders, including fractures and periodontal diseases, contribute to molecular identification of oral microbiota, and to improve the well-being of primates under human care.

Acinetobacter baumannii as an oro-dental pathogen: a red alert!!

OBJECTIVES: This review highlights the existence and association of Acinetobacter baumannii with the oro-dental diseases, transforming this systemic pathogen into an oral pathogen. The review also hypothesizes possible reasons for the categorization of this pathogen as code blue due to its stealthy entry into the oral cavity. METHODOLOGY: Study data were retrieved from various search engines reporting specifically on the association of A. baumannii in dental diseases and tray set-ups. Articles were also examined regarding obtained outcomes on A. baumannii biofilm formation, iron acquisitions, magnitude of antimicrobial resistance, and its role in the oral cancers. RESULTS: A. baumannii is associated with the oro-dental diseases and various virulence factors attribute for the establishment and progression of oro-mucosal infections. Its presence in the oral cavity is frequent in oral microbiomes, conditions of impaired host immunity, age related illnesses, and hospitalized individuals. Many sources also contribute for its prevalence in the dental health care environment and the presence of drug resistant traits is also observed. Its association with oral cancers and oral squamous cell carcinoma is also evident. CONCLUSIONS: The review calls for awareness on the emergence of A. baumannii in dental clinics and for the need for educational programs to monitor and control the sudden outbreaks of such virulent and resistant traits in the dental health care settings.

Oral mucormycosis associated with COVID-19 and diabetes mellitus: Case report and literature review / Mucormicosis oral asociada a COVID-19 y diabetes mellitus: descripción de un caso.

Mucormycosis is an invasive opportunistic fungal infection with high mortality, mainly detected in people with COVID-19, especially those with underlying diseases such as diabetes mellitus. Mucormycosis prevalence is 0.005 to 1.7 cases per million inhabitants, and it has been increasing in countries like India and Pakistan. This mycosis can affect different organs, and clinical manifestations reflect the transmission mechanism. Frequent forms are rhino-orbital-cerebral and pulmonary. This disease should be suspected in patients with necrotic injuries on mucous membranes or skin. We present a case of a patient with diabetes mellitus and diagnosed with oral mucormycosis associated with COVID-19.

La mucormicosis es una infección fúngica oportunista e invasiva, con una elevada tasa de mortalidad. Se ha detectado principalmente en pacientes con COVID-19, especialmente en personas con enfermedades concomitantes como la diabetes mellitus. La prevalencia de las mucormicosis es de 0,005 a 1,7 casos por millón de habitantes y ha ido en aumento en países como India y Pakistán; puede afectar diferentes órganos y su forma clínica refleja el mecanismo de transmisión. Entre las formas frecuentes están la rino-orbital-cerebral y la pulmonar, por ello, debe sospecharse mucormicosis en los pacientes con lesiones necróticas en mucosas o piel. Se presenta el caso de un paciente con antecedentes de diabetes mellitus que fue diagnosticado con mucormicosis oral asociada a la COVID-19.

Oral lesions of systemic lupus erythematosus: A collaborative Latin American study.

BACKGROUND: Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease that may affect the oral mucosa. The variable spectrum of oral lesions observed in SLE can pose challenges in diagnosis, particularly when the lesions occur in isolation. The aim of this study was to describe the oral lesions occurring in patients with SLE from Latin America. METHODS: This collaborative record-based study involving 11 oral and maxillofacial pathology and medicine services across Venezuela, Argentina, Chile, Brazil, and Mexico describes the clinicopathological profile of SLE-related oral lesions. RESULTS: Seventy patients with SLE and oral lesions were included in the study. The majority were females (75.7%; female/male ratio: 3.1:1) and white (62.1%), with a mean age of 38.4 years (range: 11-77 years). The most common site of oral lesions was the hard/soft palate (32.0%). Clinically, oral lesions predominantly presented as ulcers (26.6%), erosions (26.6%), and white lesions (23.4%). Isolated oral lesions occurred in 65.2% of individuals, while cutaneous manifestations occurred in 80.3%. The main clinical diagnostic hypothesis in 71.4% of cases was an immune-mediated disease. Oral biopsies followed by histopathological analysis were performed in 50 cases. CONCLUSION: Oral lesions of SLE exhibit a variety of clinical and histopathological features. A key point in diagnosis is that unusual oral changes without an obvious local cause may indicate a possible systemic condition presenting with oral lesions. A multidisciplinary approach, which includes regular oral examination, is warranted to identify oral lesions and provide treatment.

Efectos de la marihuana en la salud bucal / Effects of marijuana on oral health

Aun cuando las autoridades del Sector Salud en México no se han declarado respecto al uso medicinal de la marihuana, con el objetivo de conocer el estado actual internacional sobre sus riesgos y usos terapéuticos, investigamos los avances reportados en la actualidad, así como las comunidades que han despenalizado su uso. Se presenta su origen como elemento terapéutico, pueblos involucrados, diversas denominaciones, historicidad, las diversas preparaciones, farmacodinamia, sus efectos nocivos a la salud en general y particularmente en boca, sus posibles usos en odontología tomando en cuenta sus propiedades terapéuticas. ampliamente reseñadas en relación a otros lugares del organismo. Finalmente, la propuesta de investigación en odontología con especial énfasis en aquellas especialidades donde la inflamación y el dolor agudo estén presentes de manera significativa (AU)

Although health authorities in Mexico have not officially declared their stance on the medicinal use of marijuana, our research aims to explore the current international status regarding its risks and therapeutic uses. We have investigated the latest reported advancements and examined communities that have decriminalized its usage. This presentation encompasses its therapeutic origin, involved communities, various designations, historical context, diverse preparations, pharmacodynamics, its adverse effects on overall health and particularly oral health, as well as its potential applications in dentistry, considering its widely documented therapeutic properties in comparison to other areas of the body. Finally, our research proposal in dentistry places special emphasis on specialties where inflammation and acute pain are significantly present (AU)