Oral squamous cell carcinoma of tongue: Histological risk assessment. A pilot study.

BACKGROUND: More than 90% of malignant tumors diagnosed in the oral cavity are Oral Squamous Cell Carcinomas (OSCC) whose preferred location is the tongue. Classically, this disease has affected men preferentially, although recent studies suggest that trends are changing and the proportion of women with OSCC is increasing. In addition, the prevalence of oral cancer is also determined by some risk factors as alcohol consumption and tobacco. Currently, the Tumor, Node, Metastasis (TNM) classification is employed to defined tumor stage and based on this guide specific treatments are established. However, 5-year-survival does not exceed 50% of cases. The objective of this study is to determine whether a histological risk pattern indicative of higher recurrence might be present in T1-T2 tumors located in the anterior two thirds of the tongue. MATERIAL AND METHODS: Samples from 26 patients with OSCC were analyzed and histological risk pattern of recurrent and non-recurrent tumors were compared. We have analyzed histological variables described in Anneroth and Brandwein-Gensler classifications. Additionally, we have also examined both clinical variables such as age, sex or comorbidities, as well as habits such as tobacco or alcohol consumption. RESULTS: We found that sex (male) and keratinization degree (high or moderate) are directly related with OSCC recurrence. In fact, free illness time is lower in men and higher in those cases with minimal or no keratinization. CONCLUSIONS: Based on the variables analyzed, it has not been possible to establish a histological risk pattern that, complementary to the TNM classification, could have a predictive role in these early-stage tongue carcinomas.

A propósito del tratamiento de la halitosis / About a bad breath treatment

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Presence of lichen planus during a course of interferon alpha-2a therapy for a viral chronic C hepatitis.

We present the case of a 66-year-old woman with a diagnosis of chronic active viral C hepatitis, for whom a course of interferon alpha-2A was prescribed at a dose of 4.5 MU per day for a 2 month period, followed by the same dose on alternate days for 4 months. After completion of a month of therapy, the patient presented with painful oral lesions that made normal oral food intake impossible. These lesions persisted, in spite of withdrawal of interferon therapy. Intraoral examination revealed erosive intraoral lesions in both yugal mucosae, the upper vestibular gum, the floor of the mouth, the ventral region of the tongue, and the lower lip. A diagnosis of erosive lichen planus induced by interferon therapy was established. The prescribed treatment was 0.1% triamcinolone acetonide in orabase applied 3 times a day for 4 weeks. Following the therapeutical course, the erosive lesions disappeared, and the symptoms stopped, although the reticular lesions remained visible.

Treatment of xerostomia. A review.

Saliva plays a fundamental role in the maintenance of oral health. Xerostomia is defined as a subjective sensation of oral dryness that usually implies a marked decrease in saliva secretion and may be due to a number of causes. Oral equilibrium is affected as a result, and buccal problems may develop. The present study reviews the different treatment modalities available for the management of xerostomia, destined to stimulate the production of saliva by chewing, administering gustatory substances, prescribing sialogogues such as pilocarpine, or using saliva substitutes or artificial saliva. The adoption of one treatment option or other in turn depends on the cause underlying xerostomia and on the functionality of the salivary glands. The review also evaluates preventive therapeutic measures and addresses the complications that may develop secondary to oral dryness.

Dolor dental

El dolor dental constituye una causa frecuente de consulta en atención primaria. Aunque en la mayoría de los casos la actuación por parte del médico general se limita a la aplicación de medidas terapéutico-paliativas del dolor y la inflamación, resulta interesante conocer las diferentes formas de presentación del dolor dental y las posibles causas que lo producen, con el fin de mejorar la comprensión del problema y la utilización de los fármacos, en ocasiones innecesarios, si se recurre al tratamiento por parte del odontólogo (AU)

Un síndrome de boca ardiente

El síndrome de boca ardiente es un cuadro relativamente frecuente en la consulta de atención primaria, caracterizado por la sensación de ardor o dolor en alguna zona de la mucosa oral sin ningún signo clínico evidente. Este trabajo revisa los posibles factores etiopatogénicos, su clínica, así como las diferentes actitudes diagnósticas y terapéuticas (AU)

[Clinical and clinico-histological markers in chronic destructive adult periodontitis]. / Estudio de marcadores clínicos y clínico-histológico en la periodontitis crónica destructiva del adulto.

This study was designed to evaluate the significance and interrelationship of clinical parameters and their association with histologic changes in advanced destructive periodontitis. 158 patients with PDI greater than 4 (Ramfjord) were selected, evaluating the size, contouring, bleeding, consistency, colour and gingival pain. Epithelial ulceration of soft periodontal pockets were also evaluated. The results showed a statistically significant association between purplish colour and gingival fibrosis and advanced stage of the disease. Gingival bleeding on probing was the most important clinical parameter in advanced phases of the disease, either alone or in association with other parameters such as the presence of epithelial ulcerations. The Periodontal Disease Index (Ramfjord) has proven effective in the evaluation of generalized patterns of disease.