Manifestaciones maxilofaciales en una familia chilena con adenomatosis poliposa familiar / Maxillofacial manifestations in a Chilean family with familial adenomatous polyposis

RESUMEN: La Poliposis Adenomatosa Familiar (PAF) es un síndrome hereditario autosómico dominante causado por la mutación del gen APC. En su forma clásica se desarrollan más de 100 pólipos adenomatosos intestinales que progresan a cáncer colorrectal en casi el 100% de los casos no tratados. Dentro de las manifestaciones extracolónicas de PAF, se encuentran las maxilofaciales, como: osteomas y alteraciones dentales, que pueden preceder por años al desarrollo de poliposis colónica. A pesar de que en Chile hay estudios de PAF y cáncer de colon, son escasos los reportes de manifestaciones maxilofaciales en estos pacientes. En la familia en estudio se encontró manifestaciones descritas previamente como: odontoma, osteomas y malformaciones de incisivos; adicionalmente tags mucosos que no se han asociado previamente al síndrome.

ABSTRACT: Familial adenomatous polyposis (FAP) is an autosomal dominant hereditary syndrome caused by the mutation of the APC gene. In its classic form, more than 100 intestinal adenomatous polyps progress to colorectal cancer in almost 100% of cases if they are not treated. Within the extracolonic manifestations of FAP are the maxillofacial, such as: osteomas and dental alterations, which may precede the development of colonic polyposis. Although studies of colonic adenomatous polyposis and colon cancer exist in Chile, there are few reports of maxillofacial manifestations in these patients. In the family under study, previously described manifestations were found, such as: odontoma, osteomas and dental malformations; mucosal tags were also observed, with no previous association with the syndrom.

Efecto de miconazol sobre el recuento de levaduras en candidiasis asociada a estomatitis protésica / Effect of miconazole on the yeast count in candidiasis associated with denture stomatitis

RESUMEN: Introducción: Estomatitis Subprotésica, proceso inflamatorio crónico de la mucosa adyacente a prótesis removible. 71,4% de los sujetos con esta condición es portador de Candida y la severidad se relaciona con la presencia de esta levadura. Para su tratamiento se indica antimicóticos tópicos de la familia de polienos o de azoles. El propósito del estudio fue determinar el recuento de levaduras del género Candida en adultos mayores con candidiasis oral, antes y después de ser tratados con miconazol. Materiales y métodos: Se consignaron antecedentes sistémicos y locales en 32 adultos mayores con estomatitis subprotésica. Se determinó recuento de levaduras del género Candida en saliva, antes y después del tratamiento tópico con Miconazol 2%. Se aceptaron diferencias estadísticamente significativas con un error alfa igual o menor a 0.05%. Resultados: Los recuentos de levaduras del inicio del estudio disminuyeron significativamente a los días 8 y 15 después del tratamiento (mediana 6.800, 163, 60, respectivamente). 56,2% de los individuos presentó persistencia de levaduras después del tratamiento; 21,8% de ellos con recuentos superiores a 400 UFC/ml de saliva. Conclusiones: En el 56,2% de los individuos del estudio se observó persistencia de levaduras del género Candida luego de 2 semanas de tratamiento con miconazol al 2%.

ABSTRACT: Introduction: Denture stomatitis is a chronic inflammatory process of the mucosa adjacent to removable prosthesis. 71.4% of the subjects with this condition are carriers of Candida and the severity is related to the presence of this yeast. Topical antimycotics belonging to the polyene or azole family are indicated for its treatment. Efficacy of miconazole is reported to be from 80% to 100%, although resistance is described in isolates of Candida. The purpose of the study was to determine the count of Candida in older adults with oral candidiasis, before and after being treated with miconazole. Methodology: Systemic and local antecedents were recorded in 32 elderly adults with denture stomatitis. Differences in number of the colony forming units of Candida yeast, were determined before and after topical treatment with Miconazole 2%. Statistical significances were set at a value of p < 0.05. Results: Yeast counts at the start of the study significantly decreased 8 and 15 days after treatment (median 6,800, 163, 60, respectively). 56.2% of the subjects presented persistence of yeasts after treatment; 21.8% of them with counts higher than 400 CFU / ml saliva. Conclusion: In 56.2% of the study subjects, persistence of Candida yeasts was observed after 2 weeks of treatment with 2% miconazole.

Evaluation of the effectiveness of a chamomile (Matricaria chamomilla) and linseed (Linum usitatissimum) saliva substitute in the relief of xerostomia in elders.

OBJECTIVE: The aim of this study was to determine the efficacy of a chamomile (Matricaria chamomilla) and linseed (Linum usitatissimum) saliva substitute in the relief of xerostomia in older participants. BACKGROUND: In elders, xerostomia is a permanent and progressive condition that significantly affects their quality of life. The treatment for progressive xerostomia is currently restricted to palliative measures, and saliva substitutes are indicated. A lack of evidence on the effectiveness of the saliva substitutes in the relief of symptoms of xerostomia has been reported. MATERIALS AND METHODS: Seventy-four elderly participants presenting xerostomia of diverse origin were selected. Herbal saliva substitute and carboxymethyl cellulose conventional saliva substitute were tested using a double-blind, randomised, cross-sectional clinical trial. RESULTS: Every participant of the study exhibited dry mouth sensation. A sensation of thick saliva was described in 59.5% of the participants. The need for liquid intake to swallow food, the sensation of difficulty in swallowing and the burning sensation in the tongue were observed in 54.1, 56.8 and 27.0% of the participants, respectively. The most prevalent diseases were hypertension, depressive symptoms and arthritis. Results of the clinical tests showed that the herbal saliva substitute produced a greater relief of dry mouth symptoms, thick saliva sensation and the sensation of difficulty in swallowing than the conventional substitute (Wilcoxon test p < 0.05). CONCLUSIONS: New chamomile- and linseed-based saliva substitute was effective in relieving xerostomia symptoms in older participants of this study.

Prevalence of Candida albicans and carriage of Candida non-albicans in the saliva of preschool children, according to their caries status.

OBJECTIVE: This study was conducted to establish associations among the Candida carriage rate, the diversity of Candida species carried and the different caries status of preschool children. MATERIALS AND METHODS: Sixty-one children between 2 and 5 years of age were examined by a single expert examiner and were divided into three groups, the caries-free, moderate caries and severe caries groups, according to the criteria of the International Caries Detection and Assessment System II (ICDAS). Saliva samples were obtained from the members of each group and were plated on Sabouraud agar plates to assess the Candida carriage rates. CHROMagar Candida medium was used for the preliminary screening. Biochemical testing or PCR/sequencing was conducted to identify the different Candida species in the samples. The differences observed were considered significant if the p value was <0.05. RESULTS: The Candida carriage rate and the number of species of this fungus carried were higher in the group with the highest level of caries severity (p < 0.05). Whereas Candida albicans was the most predominant Candida species in the saliva of all of the children, C. dubliniensis was identified only in the most caries-affected group in addition to other rare species of Candida non-albicans. CONCLUSIONS: A high salivary Candida carriage rate and the presence of specific species of this fungus (such as C. albicans and C. dubliniensis) appear to be related to the severity of caries experienced by preschool children.

Reporte preliminar sobre el efecto de un sustituto salival a base de manzanilla (Matricaria chamomilla) y linaza (Linum usitatissimum) en el alivio de la xerostomía en adultos mayores / Preliminary report on the efficacy of a chamomile (Matricaria chamomilla) and linseed (Linum usitatissimum) based saliva substitute formulated for the relief of xerostomia in the elderly

Introducción: La xerostomía es una condición crónica que afecta a un alto porcentaje de adultos mayores, que deben ser tratados paliativamente mediante el uso de sustitutos salivales; sin embargo estos productos no se encuentran disponibles en el mercado nacional. Objetivos Evaluar la eficacia de un nuevo sustituto salival a base de manzanilla y semillas de linaza en la disminución de la sintomatología asociada a xerostomía en individuos adultos mayores. Metodología Se incluyeron 34 voluntarios adultos mayores con xerostomía de diverso origen. Un nuevo sustituto salival a base de manzanilla y semillas de linaza y un sustituto convencional a base de carboximetilcelulosa fueron testados en un ensayo clínico aleatorizado, cruzado, con período de blanqueamiento. Resultados El 100 por ciento de los sujetos presentó sensación de boca seca, el 58,8 por ciento sensación de saliva espesa, el 52,9 por ciento necesitaba beber líquidos para deglutir los alimentos y tenía sensación de dificultad para tragar. La sensación de ardor lingual se registró en el 23,5 por ciento de los individuos. Las enfermedades más frecuentes en la muestra analizada fueron la hipertensión arterial y la artritis. Los resultados del ensayo clínico indican que el sustituto salival a base de manzanilla y semillas de linaza disminuye significativamente la sensación de boca seca y la sensación de saliva espesa (test de Wilcoxon p < 0,05). Conclusión El nuevo sustituto salival a base de manzanilla y semillas de linaza es efectivo en el alivio de la sintomatología asociada a xerostomía en adultos mayores, por lo que puede contribuir a mejorar la calidad de vida de la población afectada por esta condición.

Introduction: Xerostomia is a common chronic health condition that affects a great number of elderly people. Palliative treatment, such as salivary substitutes should be used, but these products are not accessible in the Chilean market. Objectives To evaluate the efficacy of a new Chamomile and linseed based saliva substitute in the reduction of xerostomía-associated symptomatology in elderly people. Methodology Forty elderly subjects presenting with xerostomia of various origins were selected. Chamomile and linseed based saliva substitute and a carboxymethylcellulose based conventional artificial saliva were tested using a double-blind, randomized, cross-over clinical trial with an intervining wash out period. Results All (100 percent) of subjects had a sensation of dry mouth, and 58.8 percent mentioned a sensation of thick saliva, 52.9 percent needed to drink liquids to swallow, and with a sensation of swallowing difficulty. Burning tongue sensation was recorded in 23.5 percent of the patients. The most frequent pathologies in the sample were arterial hypertension and arthritis. Results of the clinical tests showed that Chamomile and linseed based saliva substitute significantly relieves the sensation of dry mouth and the sensation of thick saliva (Wilcoxon test P < .05). Conclusion New chamomile and linseed based saliva substitute was effective in relieving xerostomia symptoms in elderly people, and could improve the quality of life of population affected by this condition.

Association between the occurrence of matrix metalloproteinases 2 and 9 in parotid saliva with the degree of parotid gland damage in juvenile recurrent parotitis.

OBJECTIVE: The study was aimed to investigate whether the occurrence of matrix metalloproteinases (MMP) 2 and 9 in parotid saliva of juvenile recurrent parotitis (JRP) patients is associated with the degree of glandular involvement. STUDY DESIGN: Thirty-three JRP patients were included. Involvement of parotid gland was assessed by sialography. Parotid saliva was assayed for MMP-2 and MMP-9 by zymography. Medical charts were examined for number of recurrences, disease laterality, and time of follow-up. Logistic regression analysis between occurrence of either MMP, the clinical parameters, and sialographic staging was conducted. RESULTS: None of the clinical parameters under analysis were found to be associated with degree of sialographic involvement. Statistical associations were found between presence of MMP-9 and MMP-2 in parotid saliva and sialographic stage (P = .017; odds ratio [OR] 6.5, 95% confidence interval [CI] 1.4-30.4; and P = .009; OR 6.1; 95% CI 1.6-23.7; respectively). CONCLUSIONS: Occurrence frequency of MMP-2 and MMP-9 in parotid saliva from affected glands of JRP patients was associated with degree of gland damage.

Molecular alterations of parotid saliva in infantile chronic recurrent parotitis.

Infantile chronic recurrent parotitis (ICRP) is an insidious disease whose etiopathogenesis remains an enigma. Alterations in the physical appearance of parotid saliva from ICRP patients have been frequently reported. However, sialochemical studies in regard to ICRP are very rare. The aim of this study was to determine whether saliva of ICRP patients presents major physicochemical and biochemical alterations compared with saliva from paired healthy controls. Parotid, whole, and submandibular/sublingual saliva was collected at an asymptomatic stage from 33 ICRP patients (5-16 y old, both sexes) and from 33 sex- and age-matched healthy controls. Saliva was analyzed for protein concentration, mode of protein diffusion on cellulose membranes, unidimensional sodium dodecylsulfate (SDS)-polyacrylamide gel electrophoresis protein profiles and zymographic profiles of metalloproteinase 2 (MMP-2) and metalloproteinase 9 (MMP-9). Parotid saliva of ICRP patients showed an increased protein concentration, altered mode of protein diffusion, a higher frequency of polypeptide bands of 43, 37, 33, 29, 26, 16, and 10 kD, higher asymmetry in the polypeptide profiles of both contralateral parotid saliva, and an increase in the frequency of MMP-2 and MMP-9. Parotid saliva of patients with ICRP is molecularly altered with respect to normal saliva. Some of the molecular differences could be related to the etiopathogenesis of the disease.