In Silico Analysis of Genes Associated with the Pathogenesis of Odontogenic Keratocyst.

Odontogenic keratocyst (OK) is a benign intraosseous cystic lesion characterized by a parakeratinized stratified squamous epithelial lining with palisade basal cells. It represents 10-12% of odontogenic cysts. The changes in its classification as a tumor or cyst have increased interest in its pathogenesis. OBJECTIVE: Identify key genes in the pathogenesis of sporadic OK through in silico analysis. MATERIALS AND METHODS: The GSE38494 technical sheet on OK was analyzed using GEOR2. Their functional and canonical signaling pathways were enriched in the NIH-DAVID bioinformatic platform. The protein-protein interaction network was constructed by STRING and analyzed with Cytoscape-MCODE software v 3.8.2 (score > 4). Post-enrichment analysis was performed by Cytoscape-ClueGO. RESULTS: A total of 768 differentially expressed genes (DEG) with a fold change (FC) greater than 2 and 469 DEG with an FC less than 2 were identified. In the post-enrichment analysis of upregulated genes, significance was observed in criteria related to the organization of the extracellular matrix, collagen fibers, and endodermal differentiation, while the downregulated genes were related to defensive response mechanisms against viruses and interferon-gamma activation. CONCLUSIONS: Our in silico analysis showed a significant relationship with mechanisms of extracellular matrix organization, interferon-gamma activation, and response to viral infections, which must be validated through molecular assays.

Conventional Ameloblastoma. A Case Report with Microarray and Bioinformatic Analysis.

Ameloblastoma is a rare benign epithelial odontogenic neoplasm, but with great clinical implications, as despite its benignity and slow growth, most cases are locally aggressive with a significant recurrence rate. Histological, cellular, or molecular analyses of its pathogenesis have confirmed the complexity of this neoplasm. We present the case of a 20-year-old patient with a suggestive clinical and radiographic diagnosis of ameloblastoma. An incisional biopsy was obtained confirming the diagnosis of conventional ameloblastoma. Left hemimandibulectomy and plate reconstruction were performed. Histopathological analysis of the surgical specimen confirmed the conventional ameloblastoma with a plexiform pattern and significant areas of cystic degeneration and amyloid-like-like deposits. Additionally, a microarray was carried out with bioinformatic analysis for the enrichment, protein interaction, and determination of eight hub genes (CRP, BCHE, APP, AKT1, AGT, ACTC1, ADAM10, and APOA2) related to their pathogenesis.

Mucormicosis rino-órbito-cerebral: casuística en un hospital de tercer nivel en méxico, en 3 años / Rhino-orbit-cerebral mucormycosis: casuistic in a third level hospital in Mexico, in 3 years

Introducción: La mucormicosis es una infección producida por hongos aerobios saprofitos oportunistas de distintos géneros, pertenecientes al orden de los mucorales, patógenos que, bajo condiciones de inmunocompromiso como diabetes y SIDA, producen enfermedades. Existen varias formas de presentación clínica: rinocerebral, pulmonar, mucocutánea, gastrointestinal y diseminada. La presentación rinocerebral es frecuentemente fatal, con una morbimortalidad del 85-100 %, a pesar del uso de la anfotericina B, terapia hiperbárica y resección quirúrgica agresiva. Es primordial el diagnóstico temprano y el soporte sistémico del paciente. La disponibilidad limitada de tratamientos contemporáneos constituye una barrera para los pacientes en entornos de países subdesarrollados. Pacientes y métodos: El objetivo es realizar una breve revisión de la literatura acerca de la mucormicosis rino-órbito-cerebral, su incidencia y mortalidad en un hospital de tercer nivel de México. Resultados: En un periodo de 3 años (julio de 2018-julio de 2021) se trataron tres pacientes con diagnóstico de mucormicosis rino-órbito-cerebral. Los tres casos revisados presentaron diagnóstico de diabetes mellitus tipo 2 con un mal control de la enfermedad. Dos de los tres pacientes atendidos fallecieron durante su episodio de hospitalización a pesar del manejo multidisciplinario que incluyó soporte multiorgánico y tratamiento quirúrgico radical en todos los casos. (AU)

Introduction: Mucormycosis is an infection produced by opportunistic aerobic saprophytic fungi of different genera, belonging to the order of the Mucorales; pathogens that, under immunocompromised conditions such as diabetes and AIDS, produce diseases. There are several forms of clinical presentation: rhinocerebral, pulmonary, mucocutaneous, gastrointestinal and dissemi­nated. The rhinocerebral presentation is frequently fatal, with a morbidity and mortality of 85-100 % despite the use of amphotericin B, hyperbaric therapy, and aggressive surgical resection. Early diagnosis and systemic patient support are essential. The limited availability of contemporary treatments constitutes a barrier for patients in underdeveloped country settings. Patients and methods: The objective is to carry out a brief review of the literature about rhino-orbital-cerebral mucormycosis, its incidence and mortality in a tertiary hospital in Mexico. Results: In a period of 3 years (July 2018-July 2021), three patients with a diagnosis of rhino-orbital-cerebral mucormycosis were treated. All the cases presented a diagnosis of type 2 diabetes mellitus with poor control of the disease. Two of three patients died during their hospitalization episode despite multidisciplinary management that included multi-organ support and radical surgical treatment in all cases. (AU)

Multiple approaches to oral epithelial dysplasia degree analyses: a pilot study.

BACKGROUND: Oral epithelial dysplasia (OED) is the presence of cells of an abnormal type within a tissue, which may signify a stage preceding the development of cancer. Our aim was to determine the interrelation between the expression of multiple molecular markers and the histological features of oral dysplasia. METHODS: Fifteen samples of OED (five for each severity degree) were analyzed through software assisted image cytometry nuclear morphology. p53 (wild-type and mutated form), Bax and Bcl2 expression was immunohistochemically determined, and the gene expression of MMP1, MMP2, MMP9 and hTERT was determined by RT-PCR. The mean, standard deviation, ANOVA and Fisher's Exact Test (P<0.05) were performed. RESULTS: Our analysis indicated congruence between the software-assisted measurement of nuclear morphology and severity degree. Only five samples were positive to p53-mutated form; and Bax was more expressed than Bcl-2. hTERT expression was significantly expressed in relation to severity, and MMP1 was predominantly expressed, followed by MMP9 and MMP2. CONCLUSIONS: Our results reinforce that software-assisted measurement is an alternative to severity degree determination. MMP1 is an important marker for severity dysplasia degree; however, the predominant expression of Bax over Bcl-2 suggests that this pro-apoptotic state could be used to minorize the progression, perhaps, as a future therapeutic target.

Neuroma mentoniano traumático. Reporte de caso clínico / Traumatic mental neuroma. Clinical case reporth

El neuroma traumático no es una verdadera neoplasia sino una proliferación reactiva del tejido neural después de la transección u otro daño de un haz de nervios. Pueden desarrollarse en cualquier lugar, pero son más comunes en el área del foramen mentoniano, la lengua y el labio inferior. La formación de neuromas traumáticos es una causa importante de dolor neuropático, que sigue siendo un problema difícil al que se enfrentan los cirujanos. El mecanismo exacto del dolor asociado al neuroma aún no se comprende completamente y la prevención de su formación es primordial para evitarlo. Hasta la fecha el tratamiento más efectivo ha sido la extirpación quirúrgica. Se reporta el caso de un paciente de sexo femenino de 23 años de edad que presenta un aumento de volumen en el fondo de surco vestibular a nivel de los dientes 44 y 45, así como dolor espontáneo de tipo ardoroso con una evolución de aproximadamente cinco meses. Se decide realizar la resección quirúrgica de la lesión y el resultado histopatológico fue de un neuroma traumático. A los 7 días de seguimiento, se observa un ligero edema en la región bucal y mentoniana; así como anestesia a nivel de la piel del mentón y labio inferior. A 10 meses de seguimiento persistió la anestesia y no se observaron datos de recidiva.

Traumatic neuroma is not a true neoplasm but rather a reactive proliferation of neural tissue after transection or other damage to a nerve bundle. They can develop anywhere but are most common in the area of the mental foramen, tongue, and lower lip. Traumatic neuroma formation is a major cause of neuropathic pain, which remains a difficult problem for surgeons. The exact mechanism of the pain associated with the neuroma is still not fully understood and the prevention of its formation is essential to avoid it. To date the most effective treatment has been surgical removal. We report the case of a 23-year-old female patient who presented an increase in the volume of the vestibular sulcus at the level of teeth 44 and 45, as well as spontaneous burning pain with an evolution of approximately five months. It was decided to perform the surgical resection of the lesion and the histopathological result was a traumatic neuroma. At 7 days of follow-up, slight edema is observed in the oral and mental region; as well as anesthesia at the level of the skin of the chin and lower lip. A 10-month follow-up anesthesia persisted, and no recurrence data were observed.

Terapia láser de baja frecuencia en el manejo del dolor en pacientes con osteonecrosis mandibular / Low level laser therapy in the management of pain in patients with osteonecrosis of the jaw

La terapia láser de baja frecuencia (TLBF) o fotobioestimulación es aquella que cuya luz provoca la regeneración y remodelación ósea, la restauración de la función neural, la disminución del dolor y la modulación del sistema inmune; esta terapia es un coadyuvante junto a la terapia conservadora y/o quirúrgica. Se considera un estándar de oro para el manejo del dolor en la osteonecrosis en aquellos pacientes que consumen o han consumido bifosfonatos como terapia para inhibir la resorción ósea. La Sociedad Americana de Investigación de Hueso y Minerales (SAIHM) definió la osteonecrosis mandibular como «un área de hueso expuesto en la región maxilofacial que no cicatriza dentro de las ocho semanas posteriores a la identificación, en un paciente que está recibiendo o ha estado expuesto a bifosfonatos y que no ha recibido radioterapia en la región craneofacial¼. En este reporte presentamos dos casos de pacientes con osteonecrosis mandibular relacionada a bifosfonatos tratados con TLBF. Se evaluó el dolor antes y después de la terapia con la escala visual análoga (EVA). Ambos casos tuvieron disminución del dolor al 100%. Se presentan los métodos de diagnóstico clínico y radiográfico, el tratamiento elegido y los resultados obtenidos (AU)

Low level laser therapy (LLLT) or photobiostimulation is one whose light causes bone regeneration and remodeling, restoration of neural function, reduction of pain, and modulation of the immune system; this therapy is an adjuvant together with conservative and / or surgical therapy. It is considered a gold standard for pain management in osteonecrosis in those patients who consume or have used bisphosphonates as antiresorptive therapy. The American Society for Bone and Mineral Research (ASBMR) defined osteonecrosis of the jaw as «an area of exposed bone in the maxillofacial region that does not heal within eight weeks after identification by a health care provider, in a patient who was receiving or had been exposed to a BP and who has not received radiation therapy to the craniofacial region¼. In this report we present two cases of patients with mandibular osteonecrosis related to bisphosphonates treated with LLLT. Pain before and after visual analogue scale (VAS) was evaluated. Both cases had pain reduction at 100%. The methods of clinical and radiographic diagnosis, the treatment chosen and the results obtained are presented (AU)