The Accuracy of Bone Assessment Distal to Lower Second Molars Using Panoramic Radiography: A Systematic Review and Meta-Analysis.

Panoramic radiography (OPG) evaluates mandibular third molar impaction (MTMI). This systematic review aimed to investigate the diagnostic accuracy of OPG in detecting bone loss distal to the lower second molars. The associated bone loss with different impaction positions and the most prevalent positions of MTMI were investigated as secondary outcomes. In January 2023, PubMed, Scopus, and Cochrane were searched to identify studies published between January 2012 and January 2023. Two examiners blindly selected the eligible studies for data extraction and quality assessment. Of 427 studies, 8 were suitable for data extraction. All studies reported bone loss distal to the second molar using OPG, ranging from 4.9 to 62.9%. The most frequent position of MTMI is mesioangular. The distal bone loss in the vertical and horizontal positions is statistically significant compared to typically positioned third molars and those that are fully erupted or impacted, but in a normal orientation (p-value 0.005 and 0.02, respectively). Bone loss was not statistically significant in the mesioangular position compared to other impacted positions (p-value 0.14). The risk of bias ranges between 66 and 88%. Despite its limitations, OPG is still considered a valuable tool to assess bone loss distal to the lower second molar in cases of an impacted mandibular third molar.

The prevalence of elongated styloid process in the population of Barcelona: a cross-sectional study & review of literature.

BACKGROUND: Styloid process (SP) is a cylindrical bony projection that originates from the inferior part of the petrous temporal bone just anteriorly to the stylomastoid foramen. Several nerves, muscles, and ligaments are related closely to the (SP). It is considered elongated when the measurement exceeds 30 mm. The overall prevalence of the styloid process is between 3.3% to 84.4%. The elongation of the styloid process (ESP) is associated with the manifestation of Eagle's Syndrome (ES) which is characterized by various types of pain in the head and neck region such as headache, tinnitus, otalgia, and trigeminal neuralgia. Eagle's syndrome occurs in 4-10.3% of individuals with an elongated styloid process (ESP). The objective of the study is to determine the prevalence of (ESP) in the patients who were treated in the Dental Hospital University of Barcelona (HOUB), to review the literature to spot the light on the different demographic data worldwide. METHODS: The archived panoramic image in the University of Barcelona dental Hospital were consecutively retrieved to investigate the prevalence of (ESP). Of all digital panoramic radiographs (OPG), 400 met the inclusion criteria and were furtherly analyzed. The results are correlated with the participant's gender, age, and occurrence. Age is subcategorized into three groups. A chi-square test is used to measure the significant differences and the P-value is set at < 0.05 for the level of significance. RESULTS: Among the included 400, we found 291 demonstrating (ESP). The prevalence of (ESP) which exceeds 30 mm is 72.75%. It is found that the most common morphological type is type 1 which is regarded as the uninterrupted (ESP) regardless of gender and age group. Concerning the calcification pattern, the most prevalent is the partial calcified (ESP) despite genders and age groups. CONCLUSION: (OPG) is a sufficient tool for the screening of the elongated styloid process. Regarding the prevalence, our results are considered higher than previously reported prevalence in different populations using (OPG) radiography tool. A study on a wider spectrum of the Spanish population is recommended to further investigate the correlation between the elongated styloid process and the occurrence of Eagle's syndrome.

Role of selected salivary inflammatory cytokines in the diagnosis and prognosis of oral squamous cell carcinoma. A Systematic Review and Meta-analysis

Background: Oral squamous cell carcinoma (OSCC) is gradually increasing its incidence in our society. Unfortunately, this entity is diagnosed at an advanced stage in most patients, a fact that implies greater difficulty in its treatment and a worse prognosis. This systematic review aims to assess whether the cytokines IL-6, IL-8 and TNF-α are potential salivary biomarkers that allow early diagnosis of cancer. Material and methods: An electronic search was performed in three databases (Pubmed, Scopus and Web of Science). We used the following keywords: "salivary cytokines", "saliva cytokines", "salivary interleukins", "biomarkers", "oral squamous cell carcinoma" and "diagnosis", combined with the Boolean operators "AND" and "OR". Results: 128 publications were found and finally 23 articles were included in the review and 15 in the meta-analysis. It has been observed that the majority of OSCC patients express higher salivary concentrations of IL-6, IL-8 and TNF-α compared to the control (CL) and premalignant lesion (OPML) groups. It has also been observed that the different premalignant lesions do not have statistically significant differences in the salivary concentration of the cytokines, and on the other hand, differences have been observed between the different TNM stages. The meta-analysis has shown that the difference in concentration of IL-6, IL-8 and TNF-α is statistically significant between the CL group and the OSCC, and also between the CL group and OPML. Conclusions: There is sufficient evidence to affirm that IL-6, IL-8 and TNF-α are useful salivary cytokines in the early diagnosis and prognosis of OSCC. Although future studies are necessary to establish greater reliability of these biomarkers and thus be able to develop a valid diagnostic test. (AU)

Transoral robotic surgery vs open surgery in head and neck cancer. A systematic review of the literature

BACKGROUND: TORS has become one of the latest surgical alternatives in the treatment of oropharynx squamous cell carcinomas (OPSCC) and has become increasingly accepted by surgeons as a treatment option. Surgical robots were designed for various purposes, such as allowing remote telesurgery, and eliminating human factors like trembling. The study aimed to compare systematic review of the available literature in order to evaluate the safety and efficacy of Transoral Robotic Surgery (TORS) compared with open surgery. MATERIAL AND METHODS: We performed a systematic review of the available literature in order to evaluate the safety and effectiveness of TORS compared with open surgery. We compared TORS and open surgery based on 16 outcomes divided in to 3 groups: intraoperative complications, post-operative complications, and functional and oncologic outcomes. An electronic search of observational studies was carried out using the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Oral Health Group Trials Register, and Scielo. Data analysis was carried out in accordance to Preferred Reporting Items for Systematic Reviews and Metanalysis (PRISMA) and the quality of the studies were evaluated using the Newcastle-Ottawa Scale. No language restrictions were imposed. RESULTS: From the 4 studies identified (Newcastle-Ottawa Scale mean score 6.5), 371 patients were revised (186 patients were treated with TORS and 185 with conventional surgery). Overall, TORS, when compared with open surgery, appears to have better functional results (less hospital time, decannulation) and fewer intraoperative and post-operative complications. There is no significant difference when assessing the oncological outcomes (positive margins, survival rate) when comparing both techniques. CONCLUSIONS: TORS has an overall better functional outcome, and less intraoperative and postoperative complications with no difference in positive margins and survival rate when compared with conventional therapy

No disponible

Comparison of Marginal Bone Loss Between Implants with Internal and External Connections: A Systematic Review.

PURPOSE: The objective of this systematic review was to compare the loss of marginal bone between implants with internal and external connections by analyzing results reported in studies published after 2010. MATERIALS AND METHODS: A literature search in MEDLINE with the keywords "dental implant connections, external internal implant connection, bone loss implant designs, internal and external connection implant studies in humans" was conducted. Clinical trials on human beings, comparing both connections and published in English, from 2010 to 2016 were selected. Their methodologic quality was assessed using the Jadad scale. RESULTS: From the initial search, 415 articles were obtained; 32 were chosen as potentially relevant based on their titles and abstracts. Among them, only 10 finally met the inclusion criteria. A total of 1,523 patients with 3,965 implants were analyzed. Six out of 10 studies observed that internal connections showed significantly less bone loss compared with external connections. The remaining four articles did not find statistically significant differences between the two connections. CONCLUSION: According to this systematic review and considering its limitation due to the degree of heterogeneity between the included studies, both internal and external connections present high survival rates. To assess whether marginal bone loss differs significantly between the two connections, more homogenous clinical studies are needed with identical implant characteristics, larger samples, and longer follow-up periods. Studies included in this review and characterized by long-term follow-ups showed that the external connection is a reliable connection on a long-term basis.

Manejo quirúrgico-endodóncico de una reabsorción cervical invasiva clase III empleando composite / Endo-surgical management of a class III invasive cervical resorption using composite

La reabsorción cervical invasiva (RCI) es un tipo de reabsorción radicular insidiosa y agresiva que se origina en la superficie radicular externa. Típicamente, suele pasar inadvertida puesto que en la mayoría de los casos es asintomática. El uso de la tomografía computarizada con haz cónico (CBCT) mejora el diagnóstico y la planificación y la utilización dental mejora la realización del tratamiento. El objetivo principal de un tratamiento óptimo de ICR es la eliminación e inactivación del proceso de reabsorción y la reconstrucción del defecto. Entre los materiales empleados en la literatura para el sellado del defecto, el composite parece ser una opción válida. En el presente caso clínico se describe el tratamiento combinado quirúrgico-endodóncico de una reabsorción cervical invasiva clase III de Heithersay sellada con composite. Después de un año de seguimiento, el paciente se mostraba asintomático y la rarefacción ósea peri radicular ha disminuido significativamente no existiendo recidiva de la reabsorción

Invasive cervical resorption (ICR) is an aggressive type of radicular resorption that originates in the external radicular surface. It can typically go unnoticed since it is often asymptomatic. The use of cone beam computed tomography (CBCT) increases in a greater diagnostic and planning and a dental microscope increases the proper execution of the treatment. The main objective of an optimal treatment of ICR is the elimination and inactivation of the resorptive process, and the reconstruction of the defect. Among the dental material used in the literature for sealing the defect, composite seems to be a valid option. The present case-report describes a combined surgical and endodontic treatment of a Heithersay class III invasive cervical resorption sealed with dental composite. A one-year follow-up shows the patient to be asymptomatic, and the bone rarefaction to have decreased significantly, with no evidence of a resorption recurrence

Open flap versus flapless placement of dental implants. A randomized controlled pilot trial.

The aim of this study was to compare the immediate postoperative period of participants rehabilitated with dental implants placed with a conventional technique or with a minimally invasive technique, without a mucoperiosteal flap elevation (flapless). Participants who needed implant placement were divided into two groups: one group was operated using a mucoperiosteal flap elevation (G_A), and the other with a flapless surgical technique (G_B). Objective clinical parameters including oral hygiene, mouth opening, inflammation (facial perimeter), surgical time and analgesic consumption, as well as subjective parameters of pain and degree of satisfaction with the procedure, were evaluated. 48 implants were placed in 30 participants (15 participants per group). Oral hygiene index, maximum interincisal opening, pain and analgesic consumption values had a significant difference between groups favoring the flapless technique at 24 h and 7 days but at the 15 days' follow-up the differences were only significant for oral hygiene and pain (P < 0.05); there were no statistically significant differences between groups in terms of facial perimeter values and surgical time (P > 0.05). Average on the degree of satisfaction was of 2.6 (SD 0.8) for G_A and 3.6 (SD 1.02) for G_B (P = 0.06). One implant placed in G_A (2.0%) failed before prosthetic loading due to mobility and pain at 3 months' follow-up. Participants operated for implant placement with flapless surgical technique go through less postoperative discomfort. Both techniques show high success rates, but to perform a flapless technique patients must be properly selected.

Boca seca, mal aliento y síndrome de boca ardiente. Actualización / Dry mouth, breath malodour and burning mouth syndrome. Update

La xerostomía o boca seca como síntoma y la hiposialia como signo, afecta a la calidad de vida de muchos pacientes y no siempre es diagnostica y tratada de manera adecuada. Sabemos que el síndrome de boca seca es muy frecuente en la población adulta. En recientes estudios, se afirma que el 30% de la población mayor de 65 años la sufre, y en nuestro país esta cifra supone más de 1,5 millones de personas afectadas con un crecimiento casi exponencial en las próximas décadas. Puede estar producido, entre otras causas, por enfermedades sistémicas y tratamientos oncológicos, destacando de manera especial el consumo de medicamentos. La disminución de saliva se encuentra íntimamente relacionada con dos cuadros frecuentes en patología oral, la halitosis y el síndrome de boca ardiente. En el presente monográfico que refleja los resultados de un seminario realizado en la universidad de Barcelona con la colaboración de la empresa Biocosmetics, se actualizan, en primer lugar, los aspectos más relevantes de la boca seca y de la boca ardiente. Después se incide de manera detallada en la etiopatogenia y diagnóstico de la boca seca, la patología oral asociada a la xerostomía y finalmente se actualiza su tratamiento. A continuación se revisa el tratamiento del síndrome de boca ardiente. En una tercera etapa se repasa la etiopatogenia de la halitosis haciendo especial hincapié en la importancia de los compuestos sulfurados y de la cubierta lingual y se actualizan los aspectos terapéuticos. Finalmente se presenta por la doctora Margarita Martín un trabajo que nos repasa de manera específica la xerostomía postradioterapia y nos presenta los resultados de un ensayo clínico en pacientes irradiados que tiene como base el tratamiento con un producto a base aceite de oliva, betaína y xilitol (AU)

Xerostomia or dry mouth as a symptom and hyposalivation as a sign affects the quality of life of many patients and it is not always diagnosed and treated adequately. We know that the dry mouth syndrome is very frequent in the adult population. in recent studies it has been shown that 30% of the population over 65 years suffers from it, and in our country this figure represents more than 1.5 million affected people, with an almost exponential growth in the coming decades. It can be produced, among other causes, due to systemic diseases and cancer treatments, emphasizing especially on the consumption of medicines. The decrease in saliva is found closely related to two common forms in oral pathology, halitosis and the burning mouth syndrome. In the present monographic which reflects the results of a seminar held at the university of Barcelona in collaboration with the company Biocosmetics, the most relevant aspects of dry mouth and burning mouth were updated first of all. Afterwards, a detailed account of the etiopathogenesis and diagnosis of dry mouth, oral pathology associated with xerostomia and finally its treatment, were updated. In continuation, the treatment of the burning mouth syndrome was reviewed. In a third stage, the etiopathogenesis of halitosis with particular emphasis on the importance of sulphur compounds and of the lingual cover were reviewed and the therapeutic aspects were updated. Finally Dr. Margarita Martín presented her work specifically reviewing xerostomia post-radiotherapy and presented the results of a clinical trial in irradiated patients which is based on treatment with a product containing olive oil, betaine and xylitol (AU)

Relationship between oral cancer and implants: clinical cases and systematic literature review

The use of implants for oral rehabilitation of edentulous spaces has recently been on the increase, which has also led to an increase in complications such as peri-implant inflammation or peri-implantitis. Chronic inflammation is a risk factor for developing oral squamous cell carcinoma (OSCC).Objectives: To review the literature of cases that associate implant placement with the development of oral cancer. Study design: We present two clinical cases and a systematic review of literature published on the relationship between oral cancer and implants. Results: We found 13 articles published between the years 1996 and 2009, referencing 18 cases in which the osseointegrated implants are associated with oral squamous cell carcinoma. Of those, 6 articles were excluded because they did not meet the inclusion criteria. Of the 18 cases reported, only 7 cases did not present a previous history of oral cancer or cancer in other parts of the body. Conclusions: Based on the review of these cases, a clear cause-effect relationship cannot be established, although it can be deduced that there is a possibility that implant treatment may constitute an irritant and/or inflammatory cofactor which contributes to the formation and/or development of OSCC (AU)

Relationship between oral cancer and implants: clinical cases and systematic literature review.

UNLABELLED: The use of implants for oral rehabilitation of edentulous spaces has recently been on the increase, which has also led to an increase in complications such as peri-implant inflammation or peri-implantitis. Chronic inflammation is a risk factor for developing oral squamous cell carcinoma (OSCC). OBJECTIVES: To review the literature of cases that associate implant placement with the development of oral cancer. STUDY DESIGN: We present two clinical cases and a systematic review of literature published on the relationship between oral cancer and implants. RESULTS: We found 13 articles published between the years 1996 and 2009, referencing 18 cases in which the osseointegrated implants are associated with oral squamous cell carcinoma. Of those, 6 articles were excluded because they did not meet the inclusion criteria. Of the 18 cases reported, only 7 cases did not present a previous history of oral cancer or cancer in other parts of the body. CONCLUSIONS: Based on the review of these cases, a clear cause-effect relationship cannot be established, although it can be deduced that there is a possibility that implant treatment may constitute an irritant and/or inflammatory cofactor which contributes to the formation and/or development of OSCC.

Oral tongue squamous cell carcinoma (OTSCC): alcohol and tobacco consumption versus non-consumption. A study in a Portuguese population.

There has been an increase in the incidence of carcinoma of the tongue, particularly among alcohol and tobacco non-users. However, the number of studies that would allow a better understanding of etiological factors and clinical features, particularly in the Portuguese population, is very limited. This study was based on patients with squamous cell carcinoma of the anterior two thirds of the tongue that were treated at the Department of Head and Neck Surgery of the "Instituto Portugues de Oncologia de Lisboa - Francisco Gentil" (IPOLFG) in Lisbon, Portugal, between January 1, 2001 and December 31, 2009. The patients were divided in alcohol and tobacco users and non-users in order to evaluate the differences between these 2 groups based on gender, age, tumor location, denture use, and tumor size, metastasis and stage. Of the 354 cases, 208 were users and 146 were non-users. The main location in both groups was the lateral border of the tongue. Denture use showed no significant effect in both study groups. It was possible to conclude that patients who did not drink or smoke were older and presented with smaller tumor size, lower incidence of ganglion metastasis and lower tumor stage compared with alcohol and tobacco users.

Oral tongue squamous cell carcinoma (OTSCC): alcohol and tobacco consumption versus non-consumption. A study in a Portuguese population

There has been an increase in the incidence of carcinoma of the tongue, particularly among alcohol and tobacco non-users. However, the number of studies that would allow a better understanding of etiological factors and clinical features, particularly in the Portuguese population, is very limited. This study was based on patients with squamous cell carcinoma of the anterior two thirds of the tongue that were treated at the Department of Head and Neck Surgery of the “Instituto Portugues de Oncologia de Lisboa - Francisco Gentil” (IPOLFG) in Lisbon, Portugal, between January 1, 2001 and December 31, 2009. The patients were divided in alcohol and tobacco users and non-users in order to evaluate the differences between these 2 groups based on gender, age, tumor location, denture use, and tumor size, metastasis and stage. Of the 354 cases, 208 were users and 146 were non-users. The main location in both groups was the lateral border of the tongue. Denture use showed no significant effect in both study groups. It was possible to conclude that patients who did not drink or smoke were older and presented with smaller tumor size, lower incidence of ganglion metastasis and lower tumor stage compared with alcohol and tobacco users.

Um aumento do carcinoma da língua, particularmente entre os não consumidores de álcool e tabaco tem se verificado recentemente. No entanto, o número de estudos que permitam uma melhor compreensão dos fatores etiológicos e características clínicas, particularmente na população Portuguesa, é muito limitado. Este estudo foi baseado em pacientes com carcinoma de dois terços anteriores da lingual que foram atendidos e tratados no Departamento de Cabeça e Pescoço do “Instituto Portugues de Oncologia de Lisboa, Francisco Gentil” (IPOLFG), Portugal, entre 1 de janeiro de 2001 e 31 de dezembro de 2009. Eles foram divididos em usuários de álcool e tabaco e não usuários, a fim de avaliar as diferenças entre estes 2 grupos com base no sexo, idade, localização do tumor, o uso de prótese dentária, tamanho do tumor, metástase e estágio. Dos 354 casos estudados, 208 eram usuários de álcool e tabaco e 146 eram não-usuários. A localização principal, em ambos os grupos, foram a bordos laterais da língua. O uso de prótese dentária mostrou não ter um efeito significativo em ambos os grupos de estudo. Pode-se concluir que os não-usuários de álcool e tabaco eram mais velhos e apresentaram carcinoma de menores dimensões, menor incidência de metástases ganglionares e um estágio mais inicial da doença do que os etilistas e fumantes.

Bifid condyle: review of the literature of the last 10 years and report of two cases.

Bifid mandibular condyle is a rare anomaly; there are several theories about its etiology, and it has been studied in both prehistoric and historic skulls, as well as in living human beings. It is a frequent, although unexpected, finding in asymptomatic individuals during radiological treatment. Presented here is a review of the literature over the past 10 years and two new cases of unilateral bifid condyle. Computerized tomography is usually considered the test of choice for establishing the differential diagnosis, although in certain cases, its use seems questionable. The distinction between bifid condyle and condylar notch or cleft has been described in the literature, it is proposed a criteria for defining bifid condyle depending on the level of the two heads. It is suggested that further testing such as MRI or CT be carried out only in cases where the therapeutic approach involves an active treatment. It is proposed that bifid condyle is described as that which presents two condylar heads emerging from the neck of the condyle or further down.

Materiales de relleno en el área orofacial / No disponible

Existe hoy en día una gran demanda de estética por parte de la población. Los materiales de relleno se utilizan para restaurar y remodelar el volumen facial. Deben ser fáciles de implantar, duraderos y con mínimos efectos adversos para el huésped. Los materiales de relleno se clasifican, clásicamente según su permanencia en el tejido en: reabsorbibles de corta duración (entre 3 meses y 1 año),semipermanentes (más de 18 meses) y permanentes. La elección del material adecuado depende del área donde se quiera implantar, del defecto que se pretende tratar, y de la experiencia del profesional (AU)

Nowadays there is a high demand on esthetic treatments. Filling materials are used for restoring and restructuring the facial volume. Such materials must be easy to implant, durable and with the minimum side effects. Filling materials are classified depending on their permanence on the tissue in: materials that reabsorb in a short time period (between 3 months and 1 year), semipermanents (more than 18 months) and permanents. The adequate material choice depends on the area where it wants to be implanted, on the defect wanted to be treated and on the physician’s experience (AU)

Esclerosis tuberosa y manifestaciones orales. Caso clínico / Tuberous sclerosis and its oral manifestations. A clinical case

La esclerosis tuberosa (ET) es una anomalía congénita del desarrollo embrionario que se transmite de forma autosómica dominante y tiene diferentes formas de expresión clínica. Se clasifica dentro de las denominadas facomatosis (phakos "mancha" y oma "tumor"), que son anomalías del desarrollo, susceptibles de originar tumores y/o hamartomas del sistema nervioso. Es importante destacar que las lesiones del sistema nervioso se acompañan, prácticamente siempre, de anomalías cutáneas. En este trabajo presentamos el caso de una paciente de 55 años de edad, diagnosticada desde hace años de esclerosis tuberosa, que cursa con lesiones intraorales compatibles clínicamente con fibromas. Estas lesiones de aspecto fibromatoso se presentan sobre todo en el labio inferior y en ambas mucosas yugales, localización poco referenciada para esta manifestación en la enfermedad de base que nos ocupa. La anatomía patológica sugiere lesiones compatibles con angiomiolipoma. También repasamos los datos referentes a la ET, se describen las implicaciones orales de la misma y en base al resultado histopatológico obtenido se revisa el significado del término angiomiolipoma (AU)

Tuberous sclerosis (TS) is a congenital anomaly in the development of the embryo which is transmitted through the autosomal dominant gene. It has various forms of clinical expression. It is classified as one of what are known as Phacomatoses (phakos stain and oma tumour), which are development anomalies that can originate tumours and/or hamartomas in the nervous system. Lesions in the nervous system are nearly always accompanied by cutaneous anomalies. In this study we introduce the case of a woman patient aged 55, diagnosed several years earlier with Tuberous Sclerosis, who attended for intraoral lesions which were clinically compatible with fibromata. These lesions of fibrous appearance occurred above all on the lower lip and in both cheeks' mucous membra-nes, little mentioned in the literature as a site for such a manifestation of TS. The pathological anatomy suggested lesions compatible with Angiomyolipoma.In addition, the data referring to TS are reviewed; its implications for the mouth are described; and histopathological results are used to examine the significance of the word Angiomyolipoma (AU)

Tuberous sclerosis and its oral manifestations. A clinical case.

Tuberous sclerosis (TS) is a congenital anomaly in the development of the embryo which is transmitted through the autosomal dominant gene. It has various forms of clinical expression. It is classified as one of what are known as Phacomatoses (phakos stain and oma tumour), which are development anomalies that can originate tumours and/or hamartomas in the nervous system. Lesions in the nervous system are nearly always accompanied by cutaneous anomalies. In this study we introduce the case of a woman patient aged 55, diagnosed several years earlier with Tuberous Sclerosis, who attended for intraoral lesions which were clinically compatible with fibromata. These lesions of fibrous appearance occurred above all on the lower lip and in both cheeks' mucous membranes, little mentioned in the literature as a site for such a manifestation of TS. The pathological anatomy suggested lesions compatible with Angiomyolipoma. In addition, the data referring to TS are reviewed; its implications for the mouth are described; and histopathological results are used to examine the significance of the word Angiomyolipoma.

Importance of diet in the prevention of oral cancer.

Oral cancer represents 2-4% of all diagnosed cancers, showing an annual increase of 5,000 new cases. Unfortunately, due to delays in diagnosis the 5-year survival rate is only 25%. For this reason, any measures to restrict the consumption of tobacco and alcohol and that will help preserve oral health and maintain a balanced diet will lead to benefits in terms of a reduction in the occurrence of this pathology. There are many articles that warn us of the implications of smoking, of oral infections from Candida or papillomavirus, of the consequences of iron or folic acid deficiencies, all elements considered to favour the development of oral cancer. On the other hand, less well known are dietary aspects, the study of which called our attention. In this article we summarize some of the more relevant knowledge on carcinogenesis and the phases in which certain groups of foods and nutrients act as preventive factors.

Appearance and culture: oral pathology associated with certain "fashions" (tattoos, piercings, etc.).

Humans are characterized by a compulsive tendency to distinguish themselves from the rest: differences in clothes, hairstyle or "decorative" details are used to this effect, based on highly diverse criteria. Such differentiating practices may be aimed at identification with a certain ideological group, for example, or with a concrete "fashion", and involve the use of jewelry, clothes, unusual attire, hairstyles, mutilations, etc. In this context, the present review addresses certain aspects of mutilation practices from both the general and specifically dental perspectives. Mutations imply permanent or lasting sectioning or lesions of a part of the body, and comprise skeletal deforming, dental mutilations, circumcision, ablation of the clitoris, scarification, tattoos, and perforations (particularly of the soft tissues). In this sense, tattoos and perforations or piercings are popular -- particularly among adolescents. This trend may be interpreted as a form of communication, identity expression, or as a type of body cult (i.e., so-called "body art"). Such mutilating practices reflect different motivations including fashion, rebelliousness, differentiation, sexual motives, the remembering of events, physical sensations, and ethnic or tribal influences. However, these practices can cause complications such as infections, laceration and soft and hard tissue damage, hypersensitivity reactions and other alterations of variable severity. Under these premises, questions are raised concerning the competence of those who perform these mutilations, the preventive measures adopted, and the legal conditions under which tattoos and piercings are made in our society.

Evaluación y prevención de las complicaciones orales en los pacientes trasplantados de médula ósea. Estudio clínico / Evaluation and prevention of oral complications in patients subjected to bone marrow transplantation. A clinical study

Objetivo: Analizar la relación entre el grado de inflamación gingival de un grupo de pacientes trasplantados de médula ósea y el tipo de mucositis que presentan. Diseño: Se estudian 58 pacientes con enfermedad hematológica que son trasplantados de médula ósea. La población se clasifica en tres grupos: grupo A (pacientes vistos antes y después de la infusión), grupo B (pacientes explorados sólo después de la infusión) y grupo C (todos los pacientes vistos después de la infusión). Se realiza un protocolo de exploración antes, durante y después del tratamiento. Los resultados se procesan mediante el paquete estadístico SPSS+ Windows, realizándose un análisis descriptivo. Resultados: El CAOd registrado es de 10,7. El índice de sangrado antes de la infusión es del 10 por ciento, pasando al 15 por ciento post-infusión (22 por ciento si se considera el grupo C). El índice gingival pre-tratamiento es de 1,6 (grupo A), pasando a 1,3 post-trasplante y siendo de 1,9 para él grupo B. El índice de placa pasa de 1,8 a 1,4 en el grupo A y es de 2,1 en el grupo B. El 82 por ciento de los pacientes presentan mucositis de gradó II, III ó IV. La correlación entre índice gingival mayor o menor de 1,5 y grado de mucositis presentado es estadísticamente significativa, con una p<0,000.Conclusiones: La visita previa al paciente que será transplantado implica un mejor índice gingival post-trasplante. El mayor grado de inflamación gingival conlleva un mayor grado de mucositis. Es importante controlar la inflamación gingival como medida para prevenir la mucositis (AU)