Clinical and Pathological Features of Osteosarcomas of the Jaws: A Retrospective Study.

INTRODUCTION: Osteosarcomas of the jaw (OSJs) are rare tumors with distinct characteristics from osteosarcomas affecting other bones. This study aims to analyze the clinical, pathological, and therapeutic characteristics of OSJs. METHODS: A retrospective, descriptive cross-sectional study including patients diagnosed with OSJ registered at the "La Paz" University Hospital, Madrid, was performed. RESULTS: Data of eight patients with a diagnosis of OSJ were obtained during the study period of 22 years (2002-2024). The mean age of the patients was 41 years. The distribution was 1:1 between the maxilla and mandible. Painful inflammation was the most frequent clinical manifestation. Conventional osteoblastic osteosarcoma was the most predominant histological type. Survival rate at 5 years was 50%, which decreased to 25% at 10 years. CONCLUSIONS: OSJs differ from conventional osteosarcomas of long tubular bones. Surgery continues to be the mainstay of treatment. However, more studies are needed through which more standardized protocols can be proposed for adjuvant therapeutic management.

Resilience and psychological factors among dentistry students who received face-to-face lectures during the COVID-19 pandemic.

BACKGROUND: This research evaluated whether the relationships between factors of resilience, self-esteem, depression, and anxiety in dental students with changes in teaching and learning methods. We also studied the psychological impact of face-to-face lectures during the COVID-19 pandemic. METHODS: This cross-sectional descriptive study used Google Forms to collect data with the Rosenberg Self-Esteem Scale (RSE), Connor-Davidson Risk Resilience Scale (CD-RISC), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI and BDI-II). An open-ended question was also asked about important learning difficulties. RESULTS: The analysis revealed very high levels of resilience (30.23 ± 5.84), self-esteem in the normal range (29.08 ± 4.03), minimal depression levels (12.32 ± 8.05), and low anxiety levels (17.20 ± 12.41). There were no significant differences between sociodemographic variables ranges in regard to all psychological questionnaires. No high levels of depression and anxiety were found. CONCLUSIONS: The levels were low compared to other studies in which online teaching was used, which is explained by the fact that the students retained adequate resilience and self-esteem thanks to being able to contact teachers and, above all, their own peers.

Effect of the 2008 economic crisis on oral health in Spain: analysis of serial cross-sectional, population-based health surveys.

OBJECTIVES: To evaluate the impact of the economic crisis on the oral health of individuals in Spain based on variables including sex, unemployment, social class and educational level. DESIGN: This was an analysis of serial cross-sectional, population-based health surveys conducted before the crisis (2003 and 2006) and during the crisis (2011, 2014 and 2017). SETTING: National Health Surveys of Spain and the European Health Survey in Spain.ParticipantsA total of 189 543 participants were recruited. OUTCOME MEASURES: The independent variables were sex, employment, social class and educational level. The dependent variables were related to oral health. Descriptive statistics, χ2 tests and the Cochran-Mantel-Haenszel test were performed. RESULTS: The results showed that there were differences (p<0.001) in all oral health indicators before and after the crisis. Compared with the precrisis period, men had a higher probability of tooth extractions (OR 1.41, 95% CI 1.37 to 1.45), dental fillings (OR 1.30, 95% CI 1.27 to 1.34), prostheses (OR 1.04, 95% CI 1.01 to 1.07) and missing teeth (OR 1.35, 95% CI 1.31 to 1.39). Unemployed individuals were more likely to have dental caries (OR 1.08, 95% CI 1.00 to 1.16) and missing teeth (OR 1.36, 95% CI 1.27 to 1.46). Working class individuals had a higher probability of tooth extractions (OR 1.63, 95% CI 1.59 to 1.67), bleeding gums (OR 1.04, 95% CI 1.01 to 1.07), prostheses (OR 1.05, 95% CI 1.02 to 1.07) and missing teeth (OR 1.36, 95% CI 1.33 to 1.39). Participants with a basic or intermediate level of education had a higher probability of dental mobility (OR 1.13, 95% CI 1.07 to 1.19), prostheses (OR 1.11, 95% CI 1.08 to 1.14) and missing teeth (OR 1.42, 95% CI 1.38 to 1.46). CONCLUSIONS: The economic crisis affected the oral health of the Spanish population, with a more significant deterioration among men, working class individuals and unemployed individuals.

Advances in the Diagnosis, Monitoring, and Progression of Oral Cancer through Saliva: An Update.

The early detection of cancer, and in particular oral cancer, has been a priority objective of study in recent years. Saliva has been proposed as an easy-to-obtain means of providing the necessary information to diagnose malignant lesions in the oral cavity, since it can be obtained very easily and completely noninvasively. There are a number of molecules, known as biomarkers, which may be involved in the malignant transformation of oral lesions, and which have different natures. The involvement of proteins ("proteomics"), metabolites ("metabolomics"), and even certain genes in the structural changes of altered tissue has been investigated in order to establish validated parameters for the early diagnosis of oral cancer. In addition, the development of new analytical assay methods that can reduce costs and obtain better results in terms of sensitivity and specificity has been a key point in recent research in this field. Even though there are numerous biomarkers with results showing high sensitivity and specificity, there is still a need for more studies, with a larger sample and with analytical methods that can constitute a real advance in time and cost. Although salivary biomarkers are a promising new diagnostic tool for oral cancer, for the moment they do not replace biopsy as the "gold standard".

Association between Oral Cancer and Diet: An Update.

Oral cancer, included within head and neck cancer, is the sixth most common malignant neoplasm in the world. The main etiological factors are tobacco and alcohol, although currently, diet is considered an important determinant for its development. Several dietary nutrients have specific mechanisms of action, contributing to both protection against cancer and increasing the risk for development, growth, and spread. Foods such as fruits, vegetables, curcumin, and green tea can reduce the risk of oral cancer, while the so-called pro-inflammatory diet, rich in red meat and fried foods, can enhance the risk of occurrence. Dietary factors with a protective effect show different mechanisms that complement and overlap with antioxidant, anti-inflammatory, anti-angiogenic, and anti-proliferative effects. The main limitation of in vivo studies is the complexity of isolating the effects related to each one of the nutrients and the relationship with other possible etiological mechanisms. On the contrary, in vitro studies allow determining the specific mechanisms of action of some of the dietary compounds. In conclusion, and despite research limitations, the beneficial effects of a diet rich in vegetables and fruits are attributed to different micronutrients that are also found in fish and animal products. These compounds show antioxidant, anti-inflammatory, anti-angiogenic, and anti-proliferative properties that have a preventive role in the development of oral and other types of cancer.

Self-reported prevalence of periodontal disease among the Spanish population and immigrants: 2006, 2011/12 and 2017: a population-based study.

BACKGROUND: Periodontal disease is one of the most common pathologies in the population. Self-reporting has been used as a diagnostic tool in large populations, among other reasons, to detect the needs of potentially vulnerable groups. This study evaluated the prevalence of periodontal disease in people of Spanish nationality and immigrants in Spain. METHODS: This population-based, cross-sectional study was carried out using data obtained from National Health Interview Surveys (NHSs) carried out in 2006, 2011/2012 and 2017 in Spain. Subjects aged 16 years and older were included in the NHS-2006 and aged 15 years and older were included in the other NHSs. The following variables were self-reported by the participants: gum bleeding, tooth mobility, tooth extraction and missing teeth. Chi-square homogeneity tests were performed to assess the main associations between the independent variable (nationality) and the dependent variables (bleeding gums, tooth mobility, tooth extraction and missing teeth). Multinomial logistic regression models were constructed to evaluate the influences of the variables age and sex and their interactions on the main associations. RESULTS: A total of 115,123 participants were included in the NHS-2006 (n = 37,327, 11.38% immigrants), NHS-2011/12 (n = 38,727, 14.39% immigrants) and NHS-2017 (n = 39,069, 13.71% immigrants). The variables directly related to periodontal disease were gum bleeding and tooth mobility. These were significantly associated with nationality in the NHS-2006 and NHS-2017 cohorts. In the NHS-2011/12 cohort, only tooth mobility was associated with nationality. After adjustments for sex, age, and their interactions, immigrant status was associated with increased odds of bleeding in only the NHS-2006 cohort (RR = 1.65, 95% CI 1.38-1.99, p = 0.000). CONCLUSION: Immigrants in Spain have a lower probability of developing signs associated with periodontal disease than the Spanish population. Among the immigrant cohort, females and those in adult age groups had lower prevalence rates than their counterparts.

Mucocele de retención. Revisión a propósito deun caso / Retention mucocele. A case report

El mucocele oral es una lesión de los tejidos blandos con alta prevalencia en la cavidad oral, siendo motivo de consulta dadas las alteraciones funcionales y es-téticas asociadas al mismo. Su etiología está relacionada con la alteración en las glándulas salivales, correspondiendo la localización más frecuente al labio inferior. Su tratamiento, aunque en la mayoría de los casos es expectante, consiste en la extirpación quirúrgica debido a que pue-den llegar a ser de tamaño considerable. A continuación se describe el caso de un paciente varón, de avanzada edad, que presenta un mucocele de gran tamaño localizado en el labio inferior, región en la que se practicó su remoción quirúrgica y posterior análisis histopatológico

The oral mucocele is a soft tissue lesion with high prevalence in the oral cavity, the oral mucocele can be find associated with functional and aesthetic alterations. The etiology is related to the alteration in the salivary glands, the most frequent location corresponding to the lower lip. The treatment consists in surgical removal because they can be of considerable size. The following describes the case of a male patient, of advanced age, who has a large mucocele located in the lower lip, a region in which surgical removal was performed and subsequent histopathological análisis

Oral squamous cell carcinoma of tongue: Histological risk assessment. A pilot study

Background: More than 90% of malignant tumors diagnosed in the oral cavity are Oral Squamous Cell Carcinomas (OSCC) whose preferred location is the tongue. Classically, this disease has affected men preferentially, although recent studies suggest that trends are changing and the proportion of women with OSCC is increasing. In addition, the prevalence of oral cancer is also determined by some risk factors as alcohol consumption and to-bacco. Currently, the Tumor, Node, Metastasis (TNM) classification is employed to defined tumor stage and based on this guide specific treatments are established. However, 5-year-survival does not exceed 50% of cases. The objective of this study is to determine whether a histological risk pattern indicative of higher recurrence might be present in T1-T2 tumors located in the anterior two thirds of the tongue. Material and Methods: Samples from 26 patients with OSCC were analyzed and histological risk pattern of recur-rent and non-recurrent tumors were compared. We have analyzed histological variables described in Anneroth and Brandwein-Gensler classifications. Additionally, we have also examined both clinical variables such as age, sex or comorbidities, as well as habits such as tobacco or alcohol consumption. Results: We found that sex (male) and keratinization degree (high or moderate) are directly related with OSCC recurrence. In fact, free illness time is lower in men and higher in those cases with minimal or no keratinization. Conclusions: Based on the variables analyzed, it has not been possible to establish a histological risk pattern that, complementary to the TNM classification, could have a predictive role in these early-stage tongue carcinomas

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Dolor orofacial en la clínica odontológica / Orofacial pain in the dental clinic

La mayor parte de las consultas odontológicas están relacionadas con dolores intraorales que afectan a estructuras dentarias, periodontales y mucosas. Aunque generalmente la causa originaria del dolor y la estructura afectada coinciden en la localización, en ocasiones el dolor orofacial y, particularmente, el dolor oral, es referido. Esto es, el dolor puede deberse a procesos de origen extraoral localizados fuera del territorio maxilofacial. De igual manera, determinados trastornos orales, como un desequilibrio oclusivo, pueden afectar también estructuras extraorales, ocasionando tensión y dolor en cuello, cabeza y espalda. La investigación en dolor orofacial es, sin embargo, una disciplina emergente en comparación con otras áreas anatómicas, quizás debido, en parte, a que el dolor tiende a remitir con el tiempo o con la sanación del tejido afectado (si hubiera una lesión). Sin embargo, la mitad de los pacientes con algún tipo de dolor orofacial lo sufre de manera crónica y, a diferencia del dolor agudo, remitente, el dolor crónico no es ya un síntoma, sino una patología de difícil manejo, con escasa o ninguna relación con los mecanismos que lo originaron. Además, la falta de una adecuada anamnesis y exploración clínica, nomenclaturas inapropiadas o la dificultad de diagnóstico, hacen complicado en ocasiones un óptimo abordaje terapéutico. La mayoría de las clasificaciones de dolor oral siguen atendiendo a la estructura anatómica afectada más que al propio mecanismo nociceptivo. Por otra parte, la etiología exacta de muchas algias denominadas atípicas o del síndrome de boca ardiente sigue siendo desconocida. Esta revisión pretende describir los principales motivos de consulta por dolor en la clínica dental, poniendo particular énfasis en el tipo de dolor desde el punto de vista de su mecanismo: nociceptivo, inflamatorio, neuropático, psicogénico o mixto

Most dental consultations are related to intraoral pain disorders affecting dental, periodontal and mucosal structures. Although the originating cause of pain and the anatomical structure frequently co-localise, orofacial pain and particularly oral pain are sometimes referred. That is, pain may be caused by extraoral processes out of the maxillofacial territory. Likely, some intraoral conditions such as an occlusal imbalance may also affect extraoral structures, leading to tension and pain on the neck, head, and back. Orofacial pain research is however an emerging discipline in comparison to other anatomical regions. This may be due, in part, to the fact that oral pain tends to recede over time or after tissue healing -in case there was an injury-. Notwithstanding, half of the patients reporting any sort of orofacial pain suffers chronically. And unlike acute receding pain, chronic pain is no longer a symptom, but a diffi cult-to-manage pathology, with scarce or none relation to the mechanisms that caused it. Moreover, the lack of appropriate anamnesis and clinical examinations, inaccurate pain syndrome nomenclatures or difficulty in diagnosis hamper sometimes an optimal therapeutic approach. Most oral pain classifications are still based on the affected anatomical structure rather than on the nociceptive mechanism itself. On the other hand, the precise aetiology of most of the so-called atypical algiae or the burning mouth syndrome is still unknown. The present review article aims to describe the main reasons for pain consultation at the dental clinic, with particular emphasis on the type of pain from a mechanistically point of view: nociceptive, inflammatory, neuropathic, psychogenic or mixed

[OROPHARYS CANCER: THE SQUAMOUS CELL]. / CÁNCER OROFARINGEO: LA CÉLULA ESPINOSA.

The Diffuse Large B-Cell Lymphoma is the most frequent non Hodgkin Lymphoma. The role of CT/PET in this relatively homogeneous group of lymphomas is controversial. It rarely changes the management of the patients in the initial staging. Recents publications, clinical trials and experts consensus meetings have demonstrated its utility in the evaluation of the response at the end of the treatment. The interest of CT/PET in the evaluation of the response during the treatment, with the objective of implement a "Risk Adapted Therapy", in increasing.

Adenoma pleomorfo palatino. Caso clínico, revisión de la literatura y puesta al día / Pleomorphic Adenoma in the Palatine. Cinical case, literature review and update

El adenoma pleomorfo es el tumor benigno más frecuente de las glándulas salivales, desarrollándose más frecuentemente en la parótida. Las manifestaciones clínicas varían dependiendo de las glándulas salivales involucradas, así como también del grado de afectación, tamaño, tiempo de evolución y de su crecimiento evolutivo. Tiene mayor prevalencia en mujeres entre la tercera y la sexta década de la vida, siendo infrecuente en niños. Presenta un crecimiento lento y continuo e histológicamente es muy variable, estando constituido por elementos epiteliales y células mioepiteliales, recubierto o no por una pseudocápsula que puede ser atravesada por prolongaciones del tumor. El diagnóstico precoz mediante pruebas de imagen y estudio histológico, es muy importante debido a sus posibles complicaciones, ya que a pesar de ser un tumor benigno, puede presentar transformación maligna en ocasiones. El tratamiento consiste en la exéresis quirúrgica del tumor. Se presenta un caso de un varón de 25 años, que consulta por la presencia de una tumoración asintomática en paladar de 4 años de evolución. Tras la exéresis completa de la lesión, el estudio histológico confirmó el diagnóstico de adenoma pleomorfo. Se exponen la evolución, tratamiento, las complicaciones inmediatas y la evolución a 24 meses del caso. Se revisan los conceptos actuales clínico-patológicos y de enfoque terapéutico sobre el adenoma pleomorfo, con especial énfasis en su localización intraoral (..) (AU)

Pleomorphic adenoma is the most frequent benign tumour of the salivary glands, most frequently developing in the parotid. The clinical manifestations vary depending on the salivary glands involved, as well as the degree of presentation, size, evolution time and its evolutionary growth. It is more prevalent in women in the third and sixth decade of life, and is infrequent in children. It has a slow and continuous growth and histologically it is very variable, consisting of epithelial elements and my oepithelialcells, coated or not by a pseudocapsule that can be pierced by extensions of the tumour. Its early diagnosis through imaging tests and histological study is very important due to its possible complications, since despite being a benign tumour, it can become malignant on occasion. The treatment consists of the surgical excision of the tumour. There is a discussion of a case of a 25 years old male, who came for a consultation due to the presence of an asymptomatic tumour in the palate which had been developing for 4 years. After the complete removal of the lesion, the (..) (AU)

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La epiglotis o el cartílago epiglótico es una lámina delgada, flexible, ovalada de cartílago elástico localizada en la parte antero superior de la laringe y posteriormente al cartílago tiroides. Su función principal es la de protegerlas vías aéreas durante la deglución, evitando la entrada de sólidos y líquidos en las mismas (figura1). Está formada por una cara posterior recubierta de mucosa de la laringe; una cara anterior que se relaciona con otras estructuras como el cartílago tiroideo, la membrana tirohioidea, hueso hiodes y base de la lengua y unos bordes laterales. Deriva de la porción caudal de la eminencia hipobranquial, apareciendo hacia la 3ª semana y se diferencia de la base de la lengua hacia la 6ª semana. En cuanto a su situación y como parte de la laringe, al comienzo de su desarrollo se coloca cranealmente y luego se desplaza progresivamente en sentido caudal. Este desplazamiento caudal va a perdurar durante el nacimiento y los primeros años de vida. Durante la lactancia, la epiglotis alcanza la nasofaringe y se coloca por detrás de la cara superior del velo palatino. Esto es importante ya que el neonato debe respirar y beber al mismo tiempo. En la infancia, la extensión del cuello eleva el paladar blando permitiendo la ventilación oral en vez de la respiración nasal propia del neonato, permitiendo el descenso de la epiglotis así como de otras estructuras como el cuerpo del hioides, la glotis, el margen inferior del cricoides y la bifurcación traqueal. Siendo esta evolución más marcada en hombres que en mujeres debido a los cambios estructurales propios del desarrollo y los cambios fonatorios. Por su localización la epiglotis es una estructura que rara vez puede observarse a la exploración oral sin la utilización de espejo laríngeo. Si bien durante la infancia puede ser observada en algunos casos, los posteriores cambios anatómicos y el desarrollo de la voz dificultan su visualización directa en la edad adulta (AU)

Bifurcación del conducto mandibular con conducto y foramen retromolar / No disponible

El conducto mandibular es un canal que recorre la mayor parte de la extensión del hueso maxilar inferior. Nace en la cara interna de la rama ascendente mandibular, inmediatamente por detrás de la espina de Spix, desde donde se dirige hacia abajo y adelante. A la altura de los premolares se divide en dos ramas: una rama externa o mentoniana y otra rama interna o incisiva. En su interior discurren la vena y arteria dentaria inferior, así como el nervio dentario inferior, rama tributaria de la rama mandibular del nervio trigémino (Vc), que recoge la sensibilidad del hueso mandibular, dientes, periostio y encía vestibular (excepto periostio y encía vestibular de los molares y zona del trígono retromolar, inervados por el nervio bucal, también rama del Vc). Este conducto puede presentar variaciones anatómicas con implicaciones de importancia clínica. Así, podemos encontrarnos con las bifurcaciones y la presencia de forámenes accesorios, alteraciones que, en ocasiones, se pueden objetivar con técnicas radiográficas convencionales. El foramen retromolar es una variación anatómica de la mandíbula que se sitúa a nivel del trígono retromolar. Se trata de un conducto que, originándose en el conducto dentario inferior, asciende hasta finalizar distal al tercer molar inferior. Contiene vasos y filetes del nervio mandibular inferior que nutren e inervan al tercer molar inferior y al área retromolar. Presentamos la ortopantomografía de una paciente de 18 años en la que se observa una bifurcación unilateral del conducto mandibular izquierdo, que continúa por un conducto accesorio hasta terminar a nivel retromolar. La identificación de la situación del conducto mandibular, así como el conocimiento de cualquier variación anatómica, es importante debido a las implicaciones clínicas que se pueden producir, como son el fallo en la técnica anestésica, neuropatías yatrógenas, sangrado profuso, etc. Situaciones especialmente a tener en cuenta durante los procedimientos quirúrgicos que abarquen esta zona anatómica (AU)

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Lichenoid reaction caused by Clopidogrel, a new anti-platelet drug.

The case is described of a 71-year-old woman presenting with acute erosive lichen planus. The lesions appeared one week after starting treatment with clopidogrel (Plavix), a new antiplatelet drug, for the prevention of cerebral thrombosis. The patient presented erosive lesions on both jugal mucosal surfaces and the lateral sides of the tongue, associated with intense pain. The clinical diagnosis of erosive lichen planus induced by clopidogrel was confirmed by histological biopsy evaluation. Clopidogrel was replaced by aspirin, which was the antiplatelet drug previously used by the patient, and 0.1% triamcinolone acetonide in orabase was prescribed in combination with systemic corticoids. The erosive lesions and pain disappeared as a result, though asymptomatic reticular lesions typical of lichen planus persisted.

Human repercussions of foot and mouth disease and other similar viral diseases.

Foot and mouth disease is a frequent viral zoonosis in livestock that may occasionally also affect humans. Transmission to man usually occurs as a result of the consumption of unprocessed milk. The clinical manifestations include fever, headache, weakness, muscle pain, and the development of vesicles and ulcers throughout the oral mucosa. Vesicular stomatitis is another zoonosis similar to foot and mouth disease that can likewise affect humans with similar clinical manifestations, in which the presence of aphthae is highly suggestive. In turn, hand, foot and mouth disease and herpangina are two exclusively human diseases caused by different enteroviruses, with a special predilection for children under five years of age, and characterized by the presence of vesicles and ulcerations in the oral cavity. The present study provides a brief review of the salient characteristics of foot and mouth disease and of other similar viral diseases with which the differential diagnosis should be established.

Repercusiones humanas de la fiebre aftosa y otras enfermedades víricas afines / Human repercussions of foot and mouth disease and other similar viral diseases

La fiebre aftosa es una zoonosis vírica frecuente en el ganado y que en ocasiones también puede afectar al ser humano. La transmisión al hombre se produce principalmente por la ingesta de leche cruda y entre sus manifestaciones clínicas se incluyen fiebre, cefalea, postración, dolores musculares, así como vesículas y úlceras en toda la mucosa oral. La estomatitis vesicular es otra zoonosis parecida a la fiebre aftosa y que también puede afectar al hombre con un cuadro similar, en el cual también las aftas son muy sugerentes. La enfermedad boca-mano-pie y la herpangina son otras dos enfermedades del ser humano producidas por diferentes enterovirus, que afectan exclusivamente al ser humano, con una especial predilección por niños menores de cinco años y caracterizadas por la aparición de vesículas y úlceras en la cavidad oral (AU)

Reacción liquenoide tras la administración de Clopidogrel, un nuevo antiagregante plaquetario / Lichenoid reaction caused by Clopidogrel, a new antiplatelet drug

Presentamos el caso de una mujer de 71 años de edad que presentó un cuadro agudo de liquen plano erosivo aparecido a la semana de comenzar tratamiento con un nuevo antiagregante plaquetario, Clopidogrel (Plavix® ), como prevención de trombosis cerebral. La paciente presentaba lesiones erosivas en ambas mucosas yugales y bordes laterales de la lengua acompañadas de dolor intenso. El diagnóstico clínico de liquen plano erosivo provocado por la toma de Clopidogrel, fue confirmado mediante biopsia y estudio histopatológico. Se decidió sustituir el Clopidogrel por AAS, que era el antiagregante plaquetario que tomaba previamente, y se prescribió tratamiento con acetónido de triamcinolona al 0,1 por ciento en orabase que tuvo que ser complementado con corticoides sistémicos, consiguiendo así la desaparición de las lesiones erosivas y la sintomatología dolorosa, aunquepermanecieron las lesiones reticulares asintomáticas típicas del liquen plano (AU)