Tumor glómico del espacio masticatorio que imita patología mandibular / Glomus tumour of the masticatory space mimicking oral mandibular pathology

El tumor glómico es una neoplasia mesenquimal derivada de la célula muscular lisa modificada del aparato glómico. Solo se han descrito 39 casos en la cavidad oral. Una mujer de 32 años presentó dolor intenso e hipoestesia en el área del nervio mandibular. El examen físico oral reveló un abultamiento suave sensible a la palpación. La ortopantomografía mostró una imagen radiolúcida y bien definida en la rama mandibular que sugiere un trastorno óseo. Sin embargo, el TC y el angio-TC mostraron una lesión hipervascular en el espacio masticatorio derecho. Se optó por un abordaje quirúrgico intraoral de la lesión. El análisis histopatológico mostró una positividad difusa y fuerte para la vimentina. La actina del músculo liso, la actina específica del músculo y la cadena pesada de miosina del músculo liso también fueron positivas, pero la inmunorreactividad para los marcadores varió en extensión e intensidad entre las diferentes áreas tumorales. Calponina mostró inmunotinción focal y débil. El índice de proliferación (Ki67-MIB1) fue inferior al 1 %.Basado en estos hallazgos morfológicos e inmunohistoquímicos, el tumor se diagnosticó como un tumor glómico (tipo sólido). Esta primera descripción de un tumor glómico en el espacio masticatorio nos hace incluirlo en el diagnóstico diferencial de las neoplasias en esta área. (AU)

Glomus tumour is a mesenchymal neoplasm from modified smooth muscle cell of the glomus apparatus. Only 39 cases have been reported in the oral cavity. A 32-year-old female presented with intense pain and hypoaestesia in the mandibular nerve area. Oral physical examination revealed a soft bulging tender to palpation. Orthopantomography showed a radiolucent, well-defined image in the mandibular ramus suggesting an osseous disorder. However, CT and angio-CT showed a hypervascular lesion in the right masticatory space. An intraoral surgical approach to the lesion was chosen. Histopathological analysis showed diffuse and strong positivity for vimentin. Smooth muscle actin, muscle specific actin, and smooth muscle myosin heavy-chain were also positive, but immunoreactivity for markers varied in extension and intensity between different tumour areas. Calponin showed focal and weak immunostaning. Proliferation index (Ki67-MIB1) was less than 1 %.Based on these morphological and immunohistochemical findings, the tumour was diagnosed as a glomus tumour (solid type). This first description of a glomus tumour in the masticatory space makes us include it in the differential diagnosis of neoplasms in this area. (AU)

Epigallocatechin-3-gallate reduces damage to osteoblast-like cells treated with Zoledronic acid.

OBJECTIVE: analyze the effect of zoledronic acid (ZA) alone and in combination with epigallocatechin-3-gallate (EGCG) on human osteoblast cells. METHODS: SAOS-2 osteoblastic phenotype cell line treated with different doses (0.01-10 µM) of ZA or ZA + EGCG underwent cell viability, mineralization, collagen synthesis and cell migration tests. RESULTS: Micromolar (1 and 5 µM) doses of ZA reduced cell viability (p < 0.001), mineralization (p < 0.001), and collagen synthesis (p < 0.001), while nanomolar doses (0.1 µM) did not produce any effect. EGCG application partly reversed the inhibition produced by ZA, and even increased mineralization (p < 0.001). CONCLUSIONS: the data obtained shows that ZA at micromolar doses produces negative effects on osteoblast at all parameters measured, while at nanomolar levels ZA only affected cell migration and had no other effects on osteoblasts. The addition of EGCG partly reversed the effects produced by ZA, suggesting that this might be a promising preventative measure against BRONJ.

Prevalence of black stain and associated risk factors in preschool Spanish children.

BACKGROUND: In pediatric clinical practice, it is common to be asked about the presence of black stains on teeth in children and teenagers. According to controversial etiology, it is known to be related to a low rate of caries. The aim of this study was to determine the prevalence of black stain and associated risk factors in Spanish preschool children. METHODS: A total of 3272 children aged 6 years old (3058 non-emigrant and 214 immigrant children) living in Oviedo (Spain), were enrolled in the present study. RESULTS: The prevalence of black stain was 3.1% in the whole group. The index of primary decayed, missing, and filled teeth (dmft index) associated with black stain was 0.35 ± 1.123. A statistical association between black stain and the consumption of iron supplements was noted. CONCLUSIONS: The regular consumption of foods rich in iron and the use of iron supplements during pregnancy and early childhood, could favor the development of chromogenic microbiota. The prevalence of black stain did not differ significantly between non-emigrant and immigrant children in Spain.

Knowledge of oral cancer and preventive attitudes of Spanish dentists. Primary effects of a pilot educational intervention

Objective: To assess the knowledge and preventive attitudes that Spanish dentists have towards oral cancer, beforeand after an educational intervention.Methods: A quasi-experimental study based on a nationwide intervention. All Spanish dentists were offered anon-site course on oral cancer. An individual questionnaire was administered before and after attending the course.The main outcome measures were systematic examination of the oral cavity, promotion of healthy habits andknowledge of clinical aspects.Results: 440 GDPs entered the study. Age: 40.7±10.7, range 21-74. Professional experience: 13.9±8.9 years, range0-45. Of those who participated in the study, 53.1% had never attended a course on oral cancer, 72.4% stated thatthey perform a systematic examination of the oral mucosa, 88.2% provided systematic counselling on tobaccocessation, and 54.7% reported that they did the same for alcohol. In addition, 32.3% advised patients to eat fruitsand vegetables high in antioxidants.Professional experience was significantly associated with oral mucosa systematic examination (t= 2.9; p=0.003),advice on alcohol consumption (t=5.0; p=0.000), and on fruit and vegetable intake (t=5.1; p<0.001). None of thesepractices were specifically associated with knowledge on oral cancer. All areas of knowledge examined showedstatistically significant improvement after the educational intervention.Conclusions: The intervention appears to have improved the GDP´s knowledge, confirming the importance of thisnational campaign (AU)

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Diagnostic clinical aids in oral cancer.

Conventional oral exploration (visual and palpation examination) constitutes the current gold standard for oral cancer screening, while biopsy and histopathological examination represents the indispensable study for the detection of cases in patients with an identified lesion. Imaging techniques (DPT, CT, and MRI) are frequently used to supplement the clinical evaluation and staging of the primary tumour and regional lymph nodes. There are also a number of techniques that may contribute to the diagnosis of oral cancer: toluidine blue test has been used as a diagnostic aid for the detection of oral cancer over decades. Recently developed light-based detection systems have progressively improved in sensitivity and specificity, but multicentre controlled studies conducted by general dental practitioners must be designed in order to justify their application. The oral brush biopsy appears to overestimate dysplastic lesions and produces a high number of false-positive results. In the near future, immunological and biochemical alterations in the serum (e.g., circulating immune complexes, carcinoembryonic antigen, squamous cell carcinoma associated antigen, inhibitor of apoptosis, cytokeratin fragments, and annexin A1) as well as specific saliva analysis (e.g., cancer related cytokines, metalloproteinases, epithelial tumour markers, DNA promoter hypermethylation, and saliva micro-RNA) may become important tools for the detection of oral cancer.

Knowledge of oral cancer and preventive attitudes of Spanish dentists. Primary effects of a pilot educational intervention.

OBJECTIVE: To assess the knowledge and preventive attitudes that Spanish dentists have towards oral cancer, before and after an educational intervention. METHODS: A quasi-experimental study based on a nationwide intervention. All Spanish dentists were offered an on-site course on oral cancer. An individual questionnaire was administered before and after attending the course. The main outcome measures were systematic examination of the oral cavity, promotion of healthy habits and knowledge of clinical aspects. RESULTS: 440 GDPs entered the study. Age: 40.7+/-10.7, range 21-74. Professional experience: 13.9+/-8.9 years, range 0-45. Of those who participated in the study, 53.1% had never attended a course on oral cancer, 72.4% stated that they perform a systematic examination of the oral mucosa, 88.2% provided systematic counselling on tobacco cessation, and 54.7% reported that they did the same for alcohol. In addition, 32.3% advised patients to eat fruits and vegetables high in antioxidants. Professional experience was significantly associated with oral mucosa systematic examination (t= 2.9; p=0.003), advice on alcohol consumption (t=5.0; p=0.000), and on fruit and vegetable intake (t=5.1; p<0.001). None of these practices were specifically associated with knowledge on oral cancer. All areas of knowledge examined showed statistically significant improvement after the educational intervention. CONCLUSIONS: The intervention appears to have improved the GDP s knowledge, confirming the importance of this national campaign.

Speech and swallowing impairment after treatment for oral and oropharyngeal cancer.

OBJECTIVES: To assess the prevalence of speech and swallowing impairment after radical surgery for oral and oropharyngeal cancer from the patient's viewpoint and to examine the association of these functional alterations with selected clinical characteristics regarding patients, tumors, and oncologic treatment. DESIGN: Cross-sectional, multicenter study using a self-administered questionnaire. SETTING: Forty-three hospitals in Germany, Switzerland, and Austria. PATIENTS: A total of 3894 questionnaires about rehabilitation problems after treatment for oral and oropharyngeal squamous cell carcinoma were sent to patients. Of these, 1652 were filled out and returned, and 1334 (80.8%) met the inclusion criteria. MAIN OUTCOME MEASURES: Morbidity associated with treatment of oral and oropharyngeal cancer. RESULTS: Speech problems were reported by 851 patients (63.8%), and swallowing problems were reported by 1006 patients (75.4%). The variables that presented a significant association with speech and swallowing impairment were sex, tumor location, pTNM stages, stage of tumor, treatment modality, and reconstruction type. CONCLUSIONS: This survey, based on patient perception, suggests that those who undergo radiotherapy associated with the surgical removal of a tumor, have late-stage tumors (III-IV), or have tumors located in the floor of the mouth should be informed of the greater risk of persistent severe speech and swallowing problems.

¿Existen riesgos al utilizar los concentrados de Plasma Rico en Plaquetas (PRP) de uso ambulatorio? / Do ambulatory-use platelet-rich plasma (PRP) concentrates present risks?

Los concentrados de PRP han sido ampliamente utilizados en la última década como complemento en las técnicas de regeneración de tejidos. Los autores que han empleado clínicamente el PRP aseguran que no existen riesgos de infección o transmisión de enfermedades y niegan la existencia de algún tipo de efecto indeseable. Sin embargo, se ha relacionado la sobreexpresión de factores de crecimiento (GFs, Growth Factors) y sus receptores en tejidos tumorales y displásicos. Esto nos lleva a formularnos algunas preguntas en relación a las posibles coincidencias entre el proceso carcinogenético y la vía mitogénica que utilizan los GFs. El objetivo del presente trabajo ha sido efectuar una revisión ibliográfica sobre los posibles efectos de las aplicaciones terapéuticas de los GFs (incluido el PRP) en el proceso de la carcinogénesis, su influencia sobre tejidos con displasia epitelial o carcinoma oral y su relación con el crecimiento e invasión tumoral (AU)

A study of pathology associated with short lingual frenum.

Ankyloglossia is a developmental anomaly of the tongue characterized by a short, thick, lingual frenum resulting in limitation of tongue movement. The frenum is attached to the tip of the tongue in varying degrees. This study evaluates short lingual frenum and other associated pathologies (dentofacial anomalies and lingual dysglossia) and investigates whether ankyloglossia is related to speech problems. A thorough intraoral examination was carried out using the WHO regulations for dentofacial anomalies and occlusion problems and a new scale of lingual mobility. This article also discusses the difficulty in diagnosing this condition and finally following to the results of our study, describes the indications for nonsurgical and surgical treatment of this anomaly.

La prescripción farmacológica en Odontoestomatología. Clasificación y nomenclatura de los medicamentos / Pharmacological prescription in dentistry. Classification and nomenclature of medications

Fundamento: La existencia de diferentes denominaciones de un mismo medicamento (selva terapéutica), dificulta su reconocimiento y puede confundir al odontoestomatólogo en el proceso de seleccionar un fármaco, posibilitando la producción de errores en la prescripción farmacológica. Material y método. Se ha realizado una selección de las principales clasificaciones de los medicamentos. Se han recopilado las principales simi-litudes y diferencias entre las principales denominaciones comunes de los medicamentos Se han descrito las diferentes denominaciones que reciben las especialidades farmacéuticas, desde el inicio de su elaboración hasta su comercialización. Conclusiones. Se recomienda a los odontoestomatólogos conocer y usar las denominaciones comunes internacionales de las especialidades farmacéuticas, en detrimento de otras denominaciones y evitar el empleo de símbolos y de abreviaturas confusas en las recetas con el fin de incre-mentar la seguridad en las prescripciones farmacológicas (AU)