Effects of Vape Use on Oral Health: A Review of the Literature.

Background and Objectives: The widespread use of tobacco has evolved with the popularity of vapes, especially among young people, despite the lack of clarity in warnings about their risks. Studies indicate the need for more effective communication about the oral risks of vaping. In addition to systemic, respiratory, and cardiovascular effects, vaping is associated with an increased risk of gingivitis and periodontal disease as well as reduced antioxidant capacity of saliva. The objectives of this narrative review are to summarize the existing information in the literature on the effects of vaping at the oral level and to bring together knowledge about the mechanism of action of vaping in oral tissues. Materials and Methods: In the present study, articles were searched in PubMed, Elsevier Scopus, and Web of Science using the keywords "oral health", "vaping", and "vape". Studies published in the last 6 years that addressed the effects of oral vaping were selected, including comparisons among vape users, smokers, and non-smokers. Repeated articles, prior to 2017 and in languages other than English, were excluded. Two review authors (A.M.I and M.F.E.M) independently selected the papers based on titles and abstracts and conducted a full review of the remaining papers. In cases of disagreement, a third reviewer was used. Results: A total of 113 results were obtained, distributed as 16 from PubMed, 35 from Web of Science, and 62 from Elsevier Scopus. After removing duplicates, 67 articles were filtered by reviewing titles and abstracts, and finally, 22 articles were selected for comprehensive reading. Subsequently, eight of these articles were chosen for qualitative synthesis and are presented in standardized tables. The sample size of all included studies was composed of 31,647 participants, (14,477 male and 17,170 female) with a mean of 35.016 ± 7.57 years of age. Conclusions: This review indicates that the use of vapes is associated with an increased risk of periodontitis and caries. Although users experience more oral problems than non-smokers, these are less severe than those of traditional smokers. The widespread prevalence, especially among young people, highlights the urgency of awareness campaigns to warn of risks and understand potential harm.

Role of Dentistry in Humanitarian Projects: Knowledge and Perspective of Future Professionals on the World of Volunteering in Spain.

Non-governmental organizations (NGOs) in dentistry seek to promote the improvement on oral health in the most disadvantaged regions. The objective of this study is to identify the level of knowledge, expectations, and motivations that dental school students have about volunteering in dentistry, as well as to evaluate possible differences in these variables depending on their level of dental training. During the month of September 2022, a voluntary and anonymous online survey was carried out among all the students at the Dentistry School of Oviedo University. There were 5 questions to judge knowledge about global oral health course. 12 additional questions were included to assess the willingness to volunteer in international setting, the volunteer profile, as well as the most effective means to improve oral health in host communities. None of the students from our center had participated as a volunteer in dental NGOs, but up to 64.4% of them had considered their collaboration. The level of knowledge about global oral health obtained was low, with the percentage of correct answers ranging between 14.4% (in the question about the ideal patient/dentist ratio) and 57.8% (in the question about the fluoride concentration in drinking water). Majority of dental students (98.9%) were not aware that basic package of oral care was created by WHO. Significantly, the students of the clinical courses showed a greater motivation to volunteer.

Usefulness of Computed Tomography Angiography in the Preoperative Workup of Patients With Colorectal Cancer.

OBJECTIVES: The objective of this study is to analyze the main patterns of branching of the inferior mesenteric artery (IMA) and to determine if your knowledge changes the surgical strategy in the colorectal cancer. METHODS: This retrospective study included 63 patients with cancer of the sigmoid or rectum. We assessed the patterns of IMA in 3 subtypes: type A (independent left colic artery [LCA]), type B (LCA and sigmoid artery arising in a common trunk) and type C (LCA, sigmoid artery, and superior rectal artery with a common origin). Colorectal surgeons evaluated how the vascular map changed the type of IMA ligation. RESULTS: Inferior mesenteric artery branching was classified as type A in 55.6% patients, type B in 23.8%, and type C in 20.6%. Knowledge of the vascular map changed the type of ligation from high to low in 20 of the 50 patients who were candidates for surgery. The change was possible in tumors located in the sigmoid colon and the rectosigmoid junction with the type A or B branching. CONCLUSIONS: Preoperative Multidetector Computed Tomography angiography can define the pattern of IMA branching. Based on this information, a low ligation can be performed in tumors located in sigmoid colon and rectosigmoid junction with IMA branching types A and B.

"Rectal cancer survival: A retrospective analysis of MRI features and their association with prognosis".

PURPOSE: To assess rectal cancer aggressiveness using magnetic resonance (MR) imaging features and to investigate their relationship with patient prognosis. MATERIALS AND METHODS: Clinical information and Pelvic MR scans of 106 consecutive patients with primary rectal cancer (RC) were analyzed. Clinical symptoms, age, sex, tumor location, and patient´s survival were recorded. The variables investigated by MR were: depth or mural/extramural tumor involvement, distance to mesorectal margin, lymph node involvement, vascular, peritoneal or sphincter complex infiltration. The association between imaging features and disease-free survival (DFS) was also assessed using a Kaplan-Meier model. Differences between survival curves were tested for significance using the Mantel-Cox LogRank test. RESULTS: The final study population was 106 patients (65 males, 41 females). The median age was 69.5 years (range, 39-92 years). No significant differences were found between death risk and sex, age or tumor location (p>0,05). However, the relative risk (RR) of tumor mortality increased significantly with the presence of the variables: vascular infiltration (×5), T4 tumors (× 4.57), N2 lymph node involvement (more than 3 affected nodes × 4.11) and mesorectal fascia involvement (× 3,77). CONCLUSION: Tumor extension, number of pathological lymph nodes, mesorectal fascia involvement and vascular infiltration values obtained on initial MR imaging staging showed a significant difference for disease-free survival in RC at six years of control.

Influence of the teaching program on the learning in knowledge and practice of osteonecrosis of the jaws produced by antireasorptives in dental students of the Principality of Asturias (Spain).

BACKGROUND: This study aims to evaluate the influence of changes in the teaching contents on medication-related osteonecrosis of the jaw may have on the knowledge and the capacity for practical case resolution about this pathology. MATERIAL AND METHODS: A cross-sectional descriptive study was conducted through a survey divided into four sections: degree of means of knowledge acquisition, habitual practice and ability to solve clinical cases. The total number of respondents (n = 225) was divided into two groups: Group A (Year 2015-2016) and Group B (Year 2016-2017). The students in Group B received more teaching content on the subject than group A. RESULTS: A total of 175 survey responses were collected. The internet was the preferred tool for continuing education in both groups. The best known bisphosphonates (BPs) were Alendronate (Fosamax®: 56.9% Group A, 67.5% Group B) and Zoledronic Acid (Zometa®: 56.9% Group A, 51.8% Group B). A low percentage of students (37.9% Group A, 43.4% Group B) acknowledged the existence of other drugs that could also cause osteonecrosis of the jaws. Regarding the correct resolution of practical cases, the respondents of Group B reached a significantly higher score (5.67) than the score observed in Group A (4.04). CONCLUSIONS: Training on medication-related osteonecrosis among dental students is susceptible to improvement. Introducing minor changes in the teachings allows this goal to be successfully achieved. Key words:Osteonecrosis of the jaw (ONJ), bisphosphonate-related osteonecrosis of the jaws (BRONJ), medication-related osteonecrosis of the jaw (MRONJ), dental education.

Epidemiología, farmacología y caracterización clínica de la osteonecrosis de los maxilares. Un estudio retrospectivo de 70 casos / Epidemiology, pharmacology and clinical characterization of bisphosphonate-related osteonecrosis of the jaw. A retrospective study of 70 cases

Introducción y objetivos: Los bisfosfonatos son fármacos con un amplio espectro de indicaciones cuya principal capacidad es la inhibición de la función osteoclástica. En el año 2003 se ha descrito una complicación asociada a su empleo, la osteonecrosis de los maxilares por bisfosfonatos (ONMB). Los objetivos del presente estudio son identificar los casos recogidos de ONMB en un hospital de tercer nivel durante 8 años, evaluando las principales variables en relación con la enfermedad, el bisfosfonato empleado y los factores de riesgo locales o generales que pudieran actuar como desencadenante en la patogénesis de la ONMB. Material y método: Se procedió a la selección los pacientes diagnosticados de ONMB en un centro de referencia para una población de 1.100.000 habitantes. Las variables analizadas se dividieron en 3 grupos: pacientes, fármaco (incluyendo el análisis de la dosis aplicada y la ponderación dosis/potencia) y osteonecrosis. Resultados: Se recogieron 70 casos (44 mujeres y 26 varones), con una media de 66,8 años. Dieciocho pacientes habían recibido un aminobisfosfonato oral y 52 por vía intravenosa. El tiempo medio de administración fue de 26,53 meses. En el 67,1% de los pacientes se pudo identificar un factor local desencadenante, siendo el más frecuente la exodoncia (48,6%). Aunque la exposición ósea estaba presente en el 75,7% de los casos, 8 enfermos padecieron una osteonecrosis sin exposición, manifestando la presencia de dolor y/o fístula crónica. El 58,6% experimentaron una resolución completa con un tiempo medio de control de 16,28 meses. Conclusiones: El 25% de las ONMB en nuestra serie se relacionaron con la administración de un bisfosfonato oral, especialmente el alendronato. El ácido zoledrónico es el agente que menos miligramos precisa para desarrollar la enfermedad. La exposición ósea solitaria fue el dato clínico más habitual, afectando especialmente a sectores posteriores mandibulares en pacientes con enfermedad metastásica (AU)

Background and objectives: Bisphosphonates are widely prescribed drugs whose principal capacity is inhibiting the osteoclast function. In 2003 a complication related to their administration, bisphosphonate-related osteonecrosis of the jaw (BRONJ), was described. The objectives of this study were to identify diagnosed cases of BRONJ in a third-level hospital over 8 years, evaluating the main features in relation to the disease, the bisphosphonate and the presence of local or general risk factors that could trigger the BRONJ. Material and method: Patients diagnosed with BRONJ in a centre of reference for a population of 1,100,000 inhabitants were selected. Variables analysed were classified into 3 groups: patients, bisphosphonate (focusing on dose and weighting dose/potency) and osteonecrosis. Results: Seventy cases were studied —44 women and 26 men—, with a mean age of 66.8 years. Eighteen patients received bisphosphonates orally and 52, intravenously. The mean time of administration was 26.53 months. In 67.1% of the patients it was possible to identify a local trigger, with the most common being tooth extraction (48.6%). Bone exposure was present in 89.2% of the cases, while 12 patients developed BRONJ without exposed bone, with only pain and/or chronic sinus tracts. Complete resolution was achieved in 58.6% of the patients, with a mean time of control of 16.28 months. Conclusions: 25% of the BRONJ cases were related to the administration of oral bisphosphonates, especially alendronate. Zoledronic acid was the bisphosphonate that required the fewest milligrams to induce osteonecrosis. Single bone exposure was the most common clinical finding, especially in the molar mandibular region in patients with metastatic disease (AU)

Epidemiology, pharmacology and clinical characterization of bisphosphonate-related osteonecrosis of the jaw. A retrospective study of 70 cases.

BACKGROUND AND OBJECTIVES: Bisphosphonates are widely prescribed drugs whose principal capacity is inhibiting the osteoclast function. In 2003 a complication related to their administration, bisphosphonate-related osteonecrosis of the jaw (BRONJ), was described. The objectives of this study were to identify diagnosed cases of BRONJ in a third-level hospital over 8 years, evaluating the main features in relation to the disease, the bisphosphonate and the presence of local or general risk factors that could trigger the BRONJ. METHODS: Patients diagnosed with BRONJ in a centre of reference for a population of 1,100,000 inhabitants were selected. Variables analysed were classified into 3 groups: patients, bisphosphonate (focusing on dose and weighting dose/potency) and osteonecrosis. RESULTS: Seventy cases were studied -44 women and 26 men-, with a mean age of 66.8 years. Eighteen patients received bisphosphonates orally and 52, intravenously. The mean time of administration was 26.53 months. In 67.1% of the patients it was possible to identify a local trigger, with the most common being tooth extraction (48.6%). Bone exposure was present in 89.2% of the cases, while 12 patients developed BRONJ without exposed bone, with only pain and/or chronic sinus tracts. Complete resolution was achieved in 58.6% of the patients, with a mean time of control of 16.28 months. CONCLUSIONS: 25% of the BRONJ cases were related to the administration of oral bisphosphonates, especially alendronate. Zoledronic acid was the bisphosphonate that required the fewest milligrams to induce osteonecrosis. Single bone exposure was the most common clinical finding, especially in the molar mandibular region in patients with metastatic disease.

Oral bisphosphonates-associated osteonecrosis in rheumatoid arthritis

Adverse effects associated with the use of bisphosphonates are infrequent and consist of pyrexia, renal function impairment, and hypocalcemia. Bisphosphonates-associated osteonecrosis of the jaws is an uncommon but potentially serious complication of intravenous bisphosphonate therapy in cancer patients. The degree of risk for osteonecrosis in patients taking oral bisphosphonates, such as alendronate, is uncertain and warrants careful monitoring. Oral bisphosphonates-associated osteonecrosis can occur in patients with rheumatoid arthritis. We report a case of mandibular osteonecrosis in a patient who received alendronate for 3.8 years. The pathology im- proved after bisphosphonate therapy discontinuation and sequestrectomy. To our knowledge there are only three cases published in the literature relating bisphosphonates-associated osteonecrosis of the jaws in patients with rheumatoid arthritis. All the cases published, including our case, have reported association between methotrex-ate, prednisone and alendronate sodium (Fosamax®) therapy. Corticosteroid therapy and dental surgery could increase the risk of developing bisphosphonates-associated osteonecrosis of the jaws in these patients (AU)

Expression of Bcl-2 but not Bax has a prognostic significance in tongue carcinoma.

BACKGROUND: Among the molecular mechanisms involved in carcinogenesis, defects in the regulation of programmed cell death (apoptosis) make important contributions to the pathogenesis and progression of cancer. Apoptosis regulatory genes include the antiapoptotic bcl-2 gene and the proapoptotic bax gene. The aim of this study was to determine the spectrum of Bax and Bcl-2 expression, and to correlate these findings with clinicopathologic variables and prognosis. METHODS: In this study we have evaluated the immunohistochemical expression of Bcl-2 and Bax proteins in a series of 35 squamous cell carcinomas of the tongue. RESULTS: Immunoreactivity for Bax was detected in 37.1% and for Bcl-2 in 8.6% of cells, and for both proteins the staining was cytoplasmic and granular. Bcl-2 and Bax expression was mainly seen in peripheral cells of epithelial tumor islands with decreasing immunoreactivity toward the center of the neoplastic nests. Bax immunoexpression was significantly correlated with histologic grading (P=0.05), but not with the remaining clinicopathologic variables. Bcl-2 immunoreactivity was significantly correlated with N-stage (P=0.01) and survival. Patients with Bcl-2-negative tumors [mean survival: 73.97 months; 95% confidence interval (CI): 59-88] vs. Bcl-2-positive ones (mean survival: 17.67 months; 95% CI: 6-29) had a longer survival (P=0.01; odds ratio=6.9). CONCLUSIONS: Bcl-2 is associated with aggressive disease, neck lymph node metastasis, and poor prognosis. Whereas Bax is related with histologic grade.

Odontoma intraóseo erupcionado: una infrecuente patología / Intraosseus odontoma erupted into the oral cavity: an unusual pathology

Objetivos: Los odontomas que afectan a los tejidos blandos sonmuy infrecuentes, pudiendo presentarse bajo dos formas clinicas:odontoma periférico y odontoma erupcionado. Se documenta uncaso de odontoma erupcionado con el objetivo de discutir entreambas formas de presentación clínica de esta patología.Diseño del estudio: Estudio de caso.Resultados: Se presenta el caso de un varón con una masa duralocalizada en la región posterior del reborde alveolar izquierdodel maxilar superior, de un año de evolución y lento crecimiento.La ortopantomografía mostró la presencia de una tumoración radiodensaen la región posterior del maxilar izquierdo. El estudiohistológico de la pieza operatoria fue de odontoma complejo.Conclusiones: Hasta el momento se han documentado 11 casosde odontoma erupcionado en la literatura. A diferencia delodontoma periférico, el odontoma erupcionado suele ser del tipocomplejo, afectando a pacientes de mayor edad

Objectives: Odontoma arising in the extraosseous soft tissue isextremely uncommon. Two forms of odontoma are presentlyrecognized: peripheral odontoma and erupted odontoma. Wereport an erupted odontoma arising in the posterior maxilla,and discuss the main differences between both forms of clinicalpresentation.Study design: Case study.Results: A 23-year-old man presented with a firm gingival masson the left posterior maxilla, that had gradually enlarged overone year. Orthopantomography showed a dense radiopaquemass occupying the posterior portion of the left maxilla. Thepathology was reported as complex odontoma.Conclusions: This is the eleventh reported case of eruptedodontoma. Unlike peripheral odontoma, erupted odontoma isgenerally a complex odontoma, and affects older patients

Intraosseous odontoma erupted into the oral cavity: an unusual pathology.

OBJECTIVES: Odontoma arising in the extraosseous soft tissue is extremely uncommon. Two forms of odontoma are presently recognized: peripheral odontoma and erupted odontoma. We report an erupted odontoma arising in the posterior maxilla, and discuss the main differences between both forms of clinical presentation. STUDY DESIGN: Case study. RESULTS: A 23-year-old man presented with a firm gingival mass on the left posterior maxilla, that had gradually enlarged over one year. Orthopantomography showed a dense radiopaque mass occupying the posterior portion of the left maxilla. The pathology was reported as complex odontoma. CONCLUSIONS: This is the eleventh reported case of erupted odontoma. Unlike peripheral odontoma, erupted odontoma is generally a complex odontoma, and affects older patients.

Primary malt lymphoma of the tongue.

Primitive malignant lymphoma mucosa associated lymphoid tissue (MALT) on the tongue are rare entities. We report here a case of an old woman (80 years old) with a tumor in the dorsum of the tongue, which was histologically diagnosed as an extra-nodal marginal B cell lymphoma. An inflammatory reaction resembling myoepithelial sialoadenitis was observed in the minor salivary glands adjacent at the tumour, suggesting a possible derivation of the lymphoma from a previous reactive process of unknown origin.

Linfoma malt primario de la lengua / Primary malt limphoma of the tongue

Los linfomas derivados de los tejidos linfoides asociados a las mucosas (MALT) primarios de la lengua son infrecuentes. Se documenta el caso de una paciente de 80 años de edad, con un tumor en el dorso de la lengua filiado histológicamente como linfoma extranodal de células B. Se sugiere como posible origen del linfoma un proceso reactivo de origen desconocido, al presentar las glándulas salivales menores adyacentes al tumor un cuadro compatible con una sialadenitis mioepitelial (AU)

Primitive malignant lymphoma mucosa associated lymphoid tissue (MALT) on the tongue are rare entities. We report here a case of an old woman (80 years old) with a tumor in the dorsum of the tongue, which was histologically diagnosed as an extra-nodal marginal B cell lymphoma. An inflammatory reaction resembling myoepithelial sialoadenitis was observed in the minor salivary glands adjacent at the tumour, suggesting a possible derivation of the lymphoma from a previous reactive process of unknown origin (AU)

Distraction of oral scars contractures following caustic ingestion. A form of conservative treatment.

The chemical burns in the oral mucosa as consequence of accident of suicide attempt are relatively frequent. The evolution of the repairing process is conditioned by the quality and concentration of the caustic as by the location and time exposure of the affected region. At this report, we document a form of conservative treatment for the limitation of mouth opening, which the patient presented after swallowing a detergent acid. In order to obtain a minimal oral opening, a screwed cone, whose action mechanism was acting as a cradle between both jaws, was used. Once achieved a 10 mm opening, it was possible to use an external distractor to accomplish a continuous traction.

Limitación de la abertura oral secundaria a la investigación de cáusticos. Una forma de tratamiento conservador / Distraction of oral scars contractures following caustic ingestion. A form of conservative treatment

Las quemaduras químicas en la mucosa oral como consecuencia de accidentes o intentos de suicidio, con relativamente frecuentes. La evolución del proceso de reparación está condicionada por la cantidad y concentración del cáustico, así como por la localización y tiempo de exposición de la región afecta. En el presente trabajo, se documenta una forma de tratamiento conservador para la limitación de la abertura oral que presentaba una enferma, tras la ingesta de un detergente ácido. Para obtener una mínima abertura oral se utilizó un cono atornillado, cuyo mecanismo de acción era actuar de cuña entre los dos maxilares. Una vez obtenida una abertura de unos 10 mm., fue posible utilizar un distractor externo para realizar una tracción continua (AU)