Hypovitaminosis D, oral potentially malignant disorders, and oral squamous cell carcinoma: a systematic review.

BACKGROUND: Oral squamous cell carcinoma (OSCC) and potentially malignant oral disorders (OPMDs) could be associated with low levels of vitamin D. This systematic review aimed to determine the relationship between serum levels of vitamin D with OPMDs and OSCC. MATERIAL AND METHODS: This review was conducted according to Cochrane guidelines (PROSPERO CRD42020207382) on literature retrieved from the PubMed, Cochrane, and Web of Science databases. The antecedents extracted were study design, methodology, sample (country, number of patients, age, and sex), oral manifestations (type of lesion, location, prevalence, and follow-up), serum vitamin D levels or use of vitamin D supplements, results, and conclusions. RESULTS: Twelve articles were selected. Some of the most relevant findings were alterations in vitamin D could favor the progress of OPMDs to OSCC. Higher levels of vitamin D can increase levels of anti-inflammatory mediators, CD4+ T lymphocytes and CD8+ T lymphocytes and CD3+ T lymphocytes in intratumoral tissue. The normalization of vitamin D levels in patients with OSCC can increased cytotoxic activity of natural killer cells, favoring antitumor immune response. Vitamin D supplemented can lower adverse effects associated with chemotherapy like mucositis and pain. Tobacco can increase risk of developing OSCC altering vitamin D levels. CONCLUSIONS: Hypovitaminosis D could increase risk of developing OSCC from OPMDs, thus altering the immune response and it is associated with a lower survival rate in patients with OSCC, a greater recurrence of tumors in patients who underwent surgical treatment, and an increase in adverse reactions to chemotherapy. The use of vitamin D supplements can be a complement to primary therapy to prevent the recurrence of lesions and reduce adverse events associated with treatment.

Bioética y asignación de recursos para la atención odontológica del adulto mayor en Chile / Bioethics and dental health care resource allocation for elderly people in Chile

Una creciente preocupación entre quienes reconocen que los recursos sanitarios son finitos y que el deseo de beneficios en salud puede ser ilimitado, ha promovido una discusión sobre qué es una distribución justa y equitativa de los servicios en salud. En este escenario, la asignación de recursos para la atención sanitaria de adultos mayores es objeto de debate. La planificación de programas odontológicos para adultos mayores, necesita conocer la magnitud y distribución de las patologías en la población y costo-efectividad de las terapias. Sin embargo, una discusión que justifique la asignación de recursos debe ser planteada previamente, y más que datos demográficos y epidemiológicos, requiere incluir las consideraciones éticas que sostengan estas políticas. En esta revisión se expone brevemente las principales características de la salud oral de los adultos mayores en Chile. Posteriormente, se analizan algunas consideraciones bioéticas que pueden limitar o sustentar la asignación de recursos en este grupo de edad. Finalmente, se concluye que los fundamentos de Justicia en Salud y Bioética de la Protección deben aplicarse a la discusión sobre la asignación de recursos para programas de atención odontológica en los adultos mayores y otros grupos susceptibles que deberían ser el foco de la protección.

A growing concern among those who recognize that healthcare resources are finite and that desire for health benefits can be unlimited has promoted in recent years a policy of cost reduction, accountability, and an analysis of what is a fair and equitable health service. In this scenario, the resource allocation for health care for older adults has been debated. Planning for dental programs for older adults, like any other, needs to know the magnitude and distribution of diseases in the population and what are the cost-effective therapies. However, a discussion justifying the allocated resources should be raised previously. This requires ethical considerations that support these policies more than demographic and epidemiological data. This article outlines the oral health of older adults in Chile and subsequently, bioethical considerations that may limit or support health care resource allocation in this group. Finally, it can be concluded that Justice in Health and Protection Bioethics must be applied to the discussion about resources allocation in dental health care program for elderly people and other susceptible groups that should be the focus of protection.

Hábitos de higiene oral en estudiantes de odontología de la Universidad de Chile / Oral health habits in dental students at the University of Chile

Los estudiantes de odontología son agentes involucrados en la educación de los cuidados bucodentales. No se han publicado estudios nacionales que describan sus hábitos de higiene oral. Objetivo: Describir la proporción de estudiantes de odontología de la Universidad de Chile con hábitos de higiene oral saludables según sexo, nivel socioeconómico y años de estudios. Material y método: Estudio transversal descriptivo. Se seleccionaron, por muestreo aleatario simple con afijación proporcional 150 estudiantes entre 1er- 4to año. Se aplicó un cuestionario sobre hábitos de higiene oral, que incluía uso y frecuencia de cepillado, seda dental y enjuagatorio bucal, tiempo transcurrido desde la última visita al dentista y variables sociodemográficas. Se construyó un índice Hábitos de Higiene Oral que incluía cepillado por lo menos dos veces al día, uso de seda dental diariamente y visita al dentista por lo menos una vez por año. Resultados: Un 98 por ciento se cepillaba los dientes por lo menos dos veces al día, 37 por ciento usaba seda dental diariamente y 74 por ciento había acudido al dentista por lo menos una vez en el último año. Sólo un 30 por ciento presentó un resultado positivo para el índice Hábitos de Higiene Oral. No se detectaron diferencias significativas según sexo, nivel socioeconómico y años de estudios. Conclusiones: Los estudiantes de odontología de la Universidad de Chile presentan alta frecuencia de cepillado dental y consultan frecuentemente al dentista, sin embargo, el uso de seda dental es bajo. Estudios futuros deberían analizar otras variables involucradas en un mejor cuidado de la salud bucal en este grupo.

Dental students are agents involved in the education of oral care. There are no published studies that describe their oral hygiene habits in Chile. Objective: To describe the proportion of dental students at the University of Chile with healthy oral hygiene habits by sex, socioeconomic status and years of study. Material and methods: A descriptive cross-sectional study on 150 students from 1st-4th year of dentistry studies were selected by simple sampling with proportional allocation. A questionnaire on oral hygiene habits that included questions about the use and frequency of brushing and flossing, mouthwashes use, time since the last dental visit and sociodemographic variables were used. An index about oral hygiene was constructed including brushing at least twice a day, flossing at least once a day and visiting your dentist at least once a year. Results: About 98 percent of students brushing teeth at least twice daily, 37 percent used dental floss daily and 74 percent had visited the dentist at least once in the past year. Only 30 percent of students had a positive outcome for the oral hygiene index. No significant differences by gender, socioeconomic status and years of study were observed. Conclusions: Dental students at the University of Chile show high frequency of tooth brushing and frequently visit to the dentist, however, flossing is low. Future studies should also analyze other variables involved in better oral health care in this group.

Quiste de Gorlin asociado a odontoma: reporte de un caso con su tratamiento quirúrgico / Gorlin cyst associated with odontoma: Case report with surgical treatment

El quiste de Gorlin es un quiste odontogénico que puede presentarse en dos variedades, una quística rodeada por epitelio y de carácter benigno, y una neoplásica localmente agresiva. Se presenta elcaso de una mujer de 18 años con aumento de volumen facial indoloro en regióninfraorbitaria izquierda. Se realiza la exéresis total de la lesión. Con el estudio histopatológico se obtiene el diagnóstico definitivo de quiste de Gorlin asociado a odontoma. Luego de controles por 3 años, se observa el restablecimiento de la simetría facial, una adecuada regeneración ósea y de los tejidos adyacentes, sin signos de recidiva

Gorlin cyst is an odontogenic cyst that may appear astwo types, one cystic and surrounded by epithelium of a benign nature, and the other a locally aggressive neoplasm. The case is presented of an 18-year-old female that had experienced an increase in facial volume in the left infraorbital area that was painless. Total exeresis of the lesion was carried out. The histopathologicstudy provided the definitive diagnosis of Gorlin cyst associated with odontoma. After a follow-up of three years, facial symmetry was reestablished, there was adequate regeneration of bone and of the adjacent tissue, and there were no signs of relapse