Stimulated whole salivary flow rate: The most appropriate technique for assessing salivary flow in Sjögren syndrome / Caudal salival total estimulado: la técnica más adecuada para evaluar el flujo salival en el síndrome de Sjögren

Background: We sought to determine the most appropriate method for measuring salivary flow to aid the diag-nosis of Sjögren's syndrome (SS). Specifically, we compared the unstimulated whole salivary flow rate (UWSFR)with the stimulated whole salivary flow rate (SWSFR).Material and Methods: This case-control study comprised one group of 103 patients with SS and a control group of50 healthy people. We measured the UWSFR and SWSFR in both groups according to the guidelines establishedby Navacet (1993).Results: The UWSFR and SWSFR were significantly lower in the patient group compared with the controls ( p <0.01). Among the participants in the patient group, we found a decreased UWSFR in 84 individuals (81.5%) and adecreased SWSFR in 90 individuals (87.4%). We encountered difficulties obtaining saliva in 37 (35.9%) patientsduring the UWSFR test, and in 12 (11.7%) patients during the SWSFR test. There was no significant statisticaldifference in the UWSFR or SWSFR between patients with primary and secondary SS.Conclusions: Compared with the UWSFR, the SWSFR is a more suitable and effective method for measuringsalivary flow in patients with SS, as well as for qualitative analysis of the obtained saliva.(AU)

Second primary tumors in proliferative verrucous leukoplakia: a series of 33 cases.

OBJECTIVES: To describe the number of second primary malignancies in a series of 33 patients with proliferative verrucous leukoplakia (PVL), detailing the mean time between primary malignancies and their clinical characteristics. MATERIALS AND METHODS: Two groups of patients were included in this study: group 1 comprised 33 PVL patients who had developed ≥ 2 oral squamous cell carcinoma (OSCC) and group 2 comprised 48 PVL patients without malignant degeneration. We compared the groups with regard to age, gender, oral location, and number of oral sites affected. For patients in group 1, we determined the locations, clinical forms, and TNM stages of oral cancers. We also recorded the intervals of time between instances of oral cancer for all patients. RESULTS: The groups did not differ significantly in age; however, group 1 included more women (p < 0.05). The follow-up period and number of oral PVL locations were greater in group 1 (p < 0.01). Moreover, in group 1, as the number of OSCCs increased, the intervals between them became shorter. The gingiva was the most common site. The mean number of cancers in group 1 was 3.15; five second primary tumors were diagnosed in one patient. CONCLUSIONS: Multiple cancers in PVL patients were more frequently located on the gingiva in the form of erythroleukoplastic areas. In addition, the interval between new cancers decreased over time. CLINICAL RELEVANCE: This is the series with the highest number of cases described with second primary tumors in PVL.

Oral cancer on the gingiva in patients with proliferative leukoplakia: A study of 30 cases.

BACKGROUND: Proliferative verrucous leukoplakia, recently coined as proliferative leukoplakia (PL), is associated with a strong tendency to recur after treatment and an elevated rate of malignant transformation. We compared the clinical characteristics of patients with gingival PL with and without progression to oral squamous cell carcinoma. METHODS: The patients were divided into two groups: group 1 included 33 patients with gingival PL that did not progress to cancer, and group 2 included 30 patients with PL who developed malignant transformation during follow-up. We compared age, sex, tobacco habit, clinical characteristics of gingival PL lesions, and location, tumor-node-metastasis (TNM) stage, and clinical characteristics of gingival malignancy between groups. RESULTS: Female sex was predominant in the group with gingival cancer, and simultaneous involvement of the buccal mucosa, tongue, and palate was more common in this group than in the group without cancer. PL lesions were also largest in the group of patients with cancer. Most gingival cancer occurred in areas with teeth and took the form of oral ulceration. TNM stage I was most common. CONCLUSIONS: The simultaneous presence of lesions on the buccal mucosa, grade of lesion extension, and presence of ulcerative lesion were significantly associated with gingival cancer in patients with PL.

Exposed necrotic bone in 183 patients with bisphosphonate-related osteonecrosis of the jaw: Associated clinical characteristics

Background: The main objective of our study was to identify oral symptoms and signs most likely to be associated with the exposure of necrotic bone in bisphosphonate-related osteonecrosis of the jaw (BRONJ). Material and Methods: The study group consisted of 183 patients with BRONJ. We recorded data on the underlying disease, bisphosphonate used, location of osteonecrosis, symptoms, pain, fistula development, suppuration, infection, exposed necrotic bone, and BRONJ stage. Results: The mean age of the patients was 68.22 ± 12.19 years. The sample included 118 (64.5%) women. Breast cancer and multiple myeloma were the most common underlying diseases, and 50 patients received oral bisphosphonates for osteoporosis. Dental extractions (69.4%) and mandibular location (74.3%) predominated. The only two variables influencing the possibility of necrotic bone exposure were intravenous bisphosphonate administration and the presence of an intraoral fistula (p < 0.05). Conclusions: Intravenous bisphosphonate use and intraoral fistula presence were associated with a major predisposition to bone exposure in patients with BRONJ (AU)

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Prevalence of salivary epstein-barr virus in potentially malignant oral disorders and oral squamous cell carcinoma

BACKGROUND: To analyze the presence of salivary Epstein-Barr virus (EBV) DNA in oral squamous cell carcinoma and potentially malignant oral disorders. MATERIAL AND METHODS: Three groups were studied: Group 1 (12 oral squamous cell carcinomas (OSCC)), Group 2 (12 potentially malignant oral disorders (PMD)) and Group 3 (47 healthy controls). EBV DNA salivary analysis was performed by PCR. RESULTS: The highest percentage of positive salivary EBV DNA corresponded to the OSCC group (58.3%), followed by the PMD group (41.7%) and the controls (40.4%). The differences between groups were not statistically significant, however (p > 0.05). CONCLUSIONS: Salivary EBV DNA was more prevalent in OSCC than in PMD or the controls

Prevalence of salivary Epstein-Barr virus in potentially malignant oral disorders and oral squamous cell carcinoma.

BACKGROUND: To analyze the presence of salivary Epstein-Barr virus (EBV) DNA in oral squamous cell carcinoma and potentially malignant oral disorders. MATERIAL AND METHODS: Three groups were studied: Group 1 (12 oral squamous cell carcinomas (OSCC)), Group 2 (12 potentially malignant oral disorders (PMD)) and Group 3 (47 healthy controls). EBV DNA salivary analysis was performed by PCR. RESULTS: The highest percentage of positive salivary EBV DNA corresponded to the OSCC group (58.3%), followed by the PMD group (41.7%) and the controls (40.4%). The differences between groups were not statistically significant, however (p>0.05). CONCLUSIONS: Salivary EBV DNA was more prevalent in OSCC than in PMD or the controls.

Salivary and serum interleukin-6 levels in proliferative verrucous leukoplakia.

BACKGROUND: Cytokines and chemokines have been analysed in patients with oral squamous cell carcinoma and potentially malignant disorders. We selected interleukin-6 (IL-6) because it is a multifunctional interleukin reported to be altered in potentially malignant oral disorders and in malignant lesions. To date, this has not been evaluated or tested in proliferative verrucous leukoplakia (PVL), however. OBJECTIVES: This study aimed to analyse the differences in serum and saliva IL-6 levels among patients with PVL, oral squamous cell carcinoma (OSCC) and healthy controls and to examine the relationship between salivary IL-6 levels and the extent of the verrucous area. METHODS: Using an enzyme-linked immunosorbent assay, we determined the serum and saliva IL-6 levels in three groups: 20 patients with PVL, 20 with OSCC and 20 healthy controls. RESULTS: There were significant (p < 0.01) differences in the serum and saliva IL-6 levels among the three groups and among the three grades of extent of the verrucous areas (p = 0.01). In the OSCC group, there was a significant difference in the saliva IL-6 levels between patients with and without lymph node metastasis at diagnosis (p = 0.02). CONCLUSIONS: We found that patients with OSCC had the highest salivary and serum IL-6 levels, while PVL had lower values than OSCC, but higher than the controls, and these altered levels were associated with the extent of the verrucous areas. CLINICAL RELEVANCE: Salivary and plasma IL-6 are altered in patients with PVL, with more extensive verrucous areas being associated to the highest IL-6 levels. This could be a significant tool for monitoring patients with PVL, their progression to more advances stages and their recurrences.

Epidermal growth factor receptor copy number in potentially malignant oral disorders and oral squamous cell carcinoma: a short communication and preliminary study.

INTRODUCTION: This preliminary study compared the epidermal growth factor receptor (EGFR) copy number in patients with potentially malignant oral disorders (PMODs) and oral squamous cell carcinoma (OSCC). MATERIAL AND METHODS: Group 1 comprised 20 patients with oral leukoplakia and group 2 comprised 19 cases of OSCC. We estimated the EGFR copy number in both groups using real-time reverse-transcription polymerase chain reaction assays. We used laser microdissection (LMD) for EGFR amplification, and overexpression was performed. RESULTS: The EGFR copy number was higher in group 2 (9.1 ± 6.2) than in group 1 (3.8 ± 1.5). The greatest copy number was found in the non-homogeneous leukoplakias, but the difference in homogeneous cases was not significant (Mann-Whitney test, P>0.05). In group 2, the EGFR copy number was higher in advanced stages than in early stages, but again lacked statistical significance. CONCLUSIONS: The EGFR copy number may be a useful biomolecular marker to differentiate PMODs from OSCC. The EGFR was higher in non-homogeneous leukoplakias and in the advanced stages of OSCC.

Malignant transformation of proliferative verrucous leukoplakia to oral squamous cell carcinoma: a series of 55 cases.

In this study, we compared clinical differences between patients with proliferative verrucous leukoplakia (PVL) who did and did not develop oral cancer. This was a retrospective study of 55 PVL cases. All patients were followed for at least 1year, with a mean follow-up of 7.53 (SD=4.18) years. The mean age of the patients was 61.69 (SD=11.76) years. There were 36 (65.5%) females and 19 (34.5%) males. Group 1 included the 28 PVL patients who did not develop oral squamous cell carcinoma (OSCC) during the period. Group 2 included the 27 PVL patients who developed at least one OSCC during the period. The latter group was subdivided into patients with PVL who developed one (Subgroup 2a; n=16) or more than one (Subgroup 2b; n=11) OSCC during follow-up. There was no statistical difference in age or oral location of the PVL between Groups 1 and 2. Females had a greater tendency to develop cancer than males (58.3% vs. 31.6%). In Group 2, only six (22.2%) were smokers. There was no difference between Subgroups 2a and b in terms of age, gender, and oral location of the PVL. Subgroup 2b included fewer smokers, had higher gingival involvement rate, and lower frequency of PVL on the tongue. The PVL patients who develop oral cancers were more commonly female and non-smokers. Those patients who developed more than one OSCC were most likely to develop lesions of the gingiva.

Eritema multiforme. Revisión y puesta al día / Erythema multiforme. Revision and update

El eritema multiforme es una enfermedad de la piel y las mucosas que se manifiesta con lesiones eritematosas y de tipo vesículo-ampollar. Las lesiones vesiculo-ampollares y erosivas a nivel de la cavidad oral y la piel pueden ser causadas por un amplio grupo de patologías. La etiología de las mismas también puede ser muy variable, desde una causa traumática o química por contacto, hasta una causa autoinmune. Dado que en ocasiones es difícil hacer un diagnóstico diferencial para discernir la etiología de las lesiones, es importante conocer los detalles clínicos y los aspectos epidemiológicos e histopatológicos de cada una de ellas. En este artículo se hace una revisión de los aspectos epidemiológicos, etiopatogénicos, clínicos, histopatológicos, de tratamiento y pronóstico del eritema multiforme (AU)

Carcinoma intraóseo primario originado en un quiste mandibular / Primary intraosseous carcinoma arising in a mandibular cyst

El carcinoma intraóseo primario de la mandíbula es un tumor poco común, aunque no es tan raro como se cree. Teóricamente pueden originarse de novo, presumiblemente de restos odontogénicos, o bien, surgir de la transformación maligna del revestimiento de un quiste o un tumor odontogénico. El diagnóstico es difícil, basándose principalmente en el estudio radiológico y en el anatomopatológico. Su pronóstico es favorable, especialmente cuando el origen es un quiste odontogénico. Es un tumor localmente agresivo que metastatiza en los ganglios regionales. Presentamos el caso de un paciente de 70 años de edad con un carcinoma intraóseo primario escamoso de la mandíbula desarrollado en un quiste odontogénico (AU)

Angioma cavernoso cervicofacial gigante. A propósito de un caso / Giant cavernous angioma of the head and neck. A case report

El angioma cavernoso es un tumor vascular benigno y una de las lesiones congenitas mas comunes. Presenta una alta incidencia en cabeza y cuello, y es más frecuente en las mujeres. Tiene un buen pronóstico, siendo recomendable su extirpación en los casos de tumores grandes y con riesgo de hemorragia importante. El tratamiento quirúrgico parece el más efectivo, aunque existen diversas posibilidades terapéuticas que frecuentemente se asocian a la resección de la tumoración. Presentamos el caso clínico de un paciente varón de 55 años con una tumoración cervicofacial de predominio lingual y de grandes dimensiones, analizando los diversas diagnósticos diferenciales y los aspectos clínicos, patológicos y terapéuticos de este tipo de lesiones (AU)