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Language Medicina oral, patología oral y cirugía bucal. Ed inglesa. 2017. Vol. 22, no. 3
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- Masticatory muscle activity evaluation by electromyography in subjects with zygomatic implants(2017) de Rossi, Moara; Palinkas, Marcelo; Lucas, Bárbara; Santos, Carla; Semprini, Marisa; Oliveira, Ligia; Regalo, Isabela; Bersani, Edmilson; Migliorança, Reginaldo; Siéssere, Selma; Regalo, SimoneZygomatic implants are an alternative treatment in the rehabilitation of atrophic maxilla to promote stability in the stomatognathic system. The aim of this study was to compare the electromyographic (EMG) activity of masseter and temporalis muscles in controls and in individuals with complete implant-supported dentures anchored in the zygomatic bone. Fifty-four volunteers of both genders (mean age 52.5 years) were selected and distributed into two groups: Individuals with zygomatic implant (ZIG; n=27) and fully dentate patients (CG; n=27). MyoSystem-BR1 was used to assess masseter and temporalis muscles EMG activity in different mandibular movements: protrusion, clenching, maximal voluntary contraction (MVC) with Parafilm M®, right and left laterality and chewing (peanuts and raisins). Data was processed, normalized (MVC) and analyzed using the SPSS 21.0. Student t-test (P ? 0.05) was used for group comparison. The results were statistically significant (P ? 0.05) for protrusion, clenching, right and left laterality and raisin chewing. For the mandibular posture conditions, the ZIG obtained higher EMG activity patterns when compared to CG. For the masticatory performance during chewing of peanuts and raisins, the ZIG showed higher EMG mean values when compared to CG. The zygomatic implant promoted an active response of the muscle fibers (hyperactivity) during both mandibular posture and chewing conditions, probably due to the absence of periodontal receptors, which play a significant role for preparing a bolus for swallowing.
- Electromyographic activity of the jaw muscles and mandibular kinematics in young adults with theoretically ideal dental occlusion : reference values(2017) Campillo, Bárbara; Martín, Conchita; Palma, Juan Carlos; Fuentes, Aler-Daniel; Alarcón, Jose AntonioA necessary step to use neuromuscular analysis as diagnostic tool is to establish normal reference values for the physiological range in a healthy population. Surface electromyographic (sEMG) activity of the jaw muscles and mandibular kinematics were measured in young adults with theoretically ideal dental occlusion to determine normal reference values during different tasks. Differences between the sexes were evaluated. Forty young adults (20 men, 20 women; mean age 22.8 ± 3.9 years) with theoretically ideal dental occlusion were selected using very restrictive criteria. sEMG activity of the anterior temporalis (AT), posterior temporalis, masseter (MA), and suprahyoid muscles were evaluated in the rest position and during swallowing, mastication, and clenching. Mandibular kinematics in the rest position and during maximum excursions were assessed. Asymmetry, activity, and torque indices and MA/AT ratios were calculated. For all muscles, sEMG values were 1.01-3.57 µV at rest, 3.50-10.85 µV during swallowing, and 41.04-86.59 µV during mastication. During clenching, values were 230.08-243.55 µV for the AT and MA muscles. Mean total asymmetry, activity, and torque indices at rest were 20.34 %, -15.04 %, and 19.02 %, respectively; during clenching, these values were 6.14 %, -2.62 %, and 4.46 %. MA/AT ratios were near 1. Kinematic measurements during lateral excursion, protrusive and maximum opening were 7.54, 8.44, and 37.38 mm respectively; lateral mandibular shift was 1.41 mm; free way and lateral displacement at rest were 1.40 and 0.26 mm. Right MA activity during mastication and clenching was higher in men than women. Reference values for sEMG activity and mandibular kinematics were determined. Some muscular asymmetry and torque were observed.
- Evaluation of strain values of critical anatomic regions for two different pterygomaxillary approaches in Le Fort I osteotomy : an experimental study(2017) Ozdemir, Yusuf Bugra; Dolanmaz, Dogan; Esen, Alparslan; Terzioglu, Hakan; Saglam, HaciThe purpose of this experimental study was to measure stresses both on the pterygoid plates and the skull base following two different pterygomaxillary approaches in Le Fort I osteotomy. The prepared skull models were randomly divided into 2 groups of 7. In the first group (A), the pterygomaxillary area was left intact. In the second group (B), pterygomaxillary separation was performed with a fine bur. The stresses were measured by using strain gauges. These strain gauges were attached to 6 different anatomical sites. The skull models were mounted on a servo-hydraulic testing unit. Each model was then subjected to a continuous linear tension until a plastic deformation was seen. The statistical analyses showed that there were no significant differences (p >.05) between the 2 groups regarding the strain values. Moreover, no statistical differences (p >.05) were found between the two groups in terms of maximum applied forces. Considering the clinical conditions, the present study shows that when Le Fort I osteotomy performed without pterygomaxillary separation, there is no significant stress on the skull base during the downfracture. Moreover, it is considered that there is no need for an excessive force applied to perform downfracture in Le Fort osteotomies without pterygomaxillary separation.
- Radiodensitometric study for evaluation of bone mineral density around dental implants after zoledronic acid treatment in ovariectomized rats(2017) Dikicier, Sibel; Dikicier, Emre; Karacayli, Umit; Erguder, BurakThe purpose of this study was to evaluate the effects of intravenous zoledronic acid applied systemically on osseointegration of dental implants and the surrounding bone mineral density (BMD) in the ovariectomized rats. 36 rats were divided into three groups: control (CTRL), ovariectomy (OVX), and ovariectomy-zoledronic acid (OVX/ZOL). The rats in the CTRL group underwent sham surgery, while rats in OVX and OVX / ZOL group underwent ovariectomy. After 12 weeks, rats from OVX / ZOL were injected with 0.04 mg/kg ZOL intravenously once a week for 6 weeks. The rats from CTRL and OVX groups were injected with 0.9% NaCl. Implants were placed in the left tibia. After 8 weeks, rats were sacrificed and tibia bones were removed for radiodensitometric examination. Digital radiographs of bones? lateral surface were taken. The BMD was measured by using radiographic analysis software. Statistically significant differences were found between all groups (p<0.05). While highest mean BMD values were observed in the CTRL group, the lowest were in the OVX group. The systemic use of ZOL has increased the bone density around the implants inserted osteoporotic rat tibia.
- A 5-year retrospective longitudinal study on the incidence and the risk factors of osteonecrosis of the jaws in patients treated with zoledronic acid for bone metastases from solid tumors(2017) Manfredi, Maddalena; Mergoni, Giovanni; Goldoni, Matteo; Salvagni, Stefania; Merigo, Elisabetta; Meleti, Marco; Vescovi, PaoloBackground: The aim of this study was to evaluate the incidence and the risk factors of osteonecrosis of the jaw (ONJ) in a group of patients treated with zoledronic acid (ZA) for bone metastases from solid tumors and enrolled in a preventive dental program. Material and Methods: This 5-year retrospective longitudinal study included all consecutive oncological patients who underwent at least one infusion with ZA between 2004 and 2011 for bone metastases due to solid neoplasms. Results: Of the 156 patients enrolled in the study, 17 developed ONJ (10.89%). At the multivariate analysis, severe periodontal disease (P=0.025), tooth extraction (P<0.0001) and starting the preventive dental program after the beginning of ZA therapy (P=0.02) were the only factors which showed a significant association with the occurrence of ONJ. Conclusions: This study demonstrated the importance of beginning dental prevention before zoledronic acid exposure in reducing ONJ occurrence, especially in the long term. The results of this research show that control of periodontal disease and an increase in the time between tooth extraction and the first ZA administration are recommended in order to reduce the risk of ONJ development
- Importance of absorbable surgical sutures for the prevention of stitch abscess after surgery in patients with oral squamous cell carcinoma(2017) Yamamoto, Noriaki; Takahashi, Yoshihiro; Kono, Tatsuyuki; Abe, Ayaka; Kawamura, Kazuhiro; Joujima, Takaaki; Wakasugi Sato, Nao; Nishimura, Shun; Oda, Masafumi; Tanaka, Tatsurou; Kito, Shinji; Kawano, Kenji; Morimoto, YasuhiroTo elucidate the significance of absorbable surgical sutures in the occurrence of stitch abscess after surgery in patients with oral squamous cell carcinoma (SCC). The subjects were 251 patients who underwent excision and/or reconstruction and/or neck dissection for oral SCC using absorbable surgical sutures. Detection rates and characteristics of patients with stitch abscess were retrospectively evaluated by comparing between our present and previous data. There was only one stitch abscess among the 251 patients. A significant difference in the incidence of stitch abscess was found between the present data and our previous data. Of course, no significant correlations were found between the occurrence of stitch abscess using absorbable surgical sutures and the various factors seen in our previous analysis. A complete switch of surgical sutures from silk to absorbable surgical sutures is needed for surgery in patients with oral SCC.
- Primordial odontogenic tumor : an immunohistochemical profile(2017) Bologna Molina, Ronell; Mikami, Toshinari; Pereira Prado, Vanesa; Pires, Fábio-Ramôa; Carlos, Román; Mosqueda Taylor, AdalbertoPrimordial Odontogenic Tumor (POT) is a recently described odontogenic tumor characterized by a variably cellular loose fibrous tissue with areas similar to the dental papilla, covered by cuboidal to columnar epithelium that resembles the internal epithelium of the enamel organ, surrounded at least partly by a delicate fibrous capsule. The purpose of this study was to investigate the possible histogenesis and biological behavior of this rare tumor by means of a wide immunohistochemical analysis of its epithelial and mesenchymal components. The immunoexpression of twenty-three different antibodies were evaluated in four cases of POT. The epithelial cells that cover the periphery of the tumor showed immunopositivity for Cytokeratins 14 and 19, while Amelogenin, Glut-1, MOC-31, Caveolin-1. Galectin-3, PITX2, p53, Bax, Bcl-2, Survivin and PTEN were variably expressed in focal areas. The mesenchymal component of the tumor was positive for Vimentin, Syndecan-1, PITX2, Endoglin (CD105), CD 34, Cyclin D1, Bax, Bcl-2, Survivin and p53. PTEN and CD 90 showed a moderate positivity. BRAF V600E and Calretinin were negative in all samples. Cell proliferation markers (Ki-67, MCM-7) were expressed in <5% of the tumor cells. According to these immunohistochemical findings, we may conclude that POT is a benign odontogenic tumor in which there is both epithelial and mesenchymal activity during its histogenesis, as there is expression of certain components in particular zones in both tissues that suggests this tumor develops during the immature (primordial) stage of tooth development, leading to its inclusion within the group of benign mixed epithelial and mesenchymal odontogenic tumours in the current World Health Organization classification of these lesions.
- Oral Thrombus : report of 122 cases with clinically descriptive data(2017) Tobouti, Priscila Lie; Pigatti, Fernanda Mombrini; Martins Mussi, Maria Carolina; Sousa, Suzana COM deThe aim of the present study was to assess the frequency and characterize clinic-pathologic aspects of thrombus occurring as a single lesion or in association with other oral pathologies. 122 cases of thrombus from the oral cavity were retrieved. Information regarding site of the lesion, age, sex and clinical diagnosis or hypothesis and associated lesions were collected from the patients´ records. The lesions occurred in a wide age range but the 5th decade was the most prevalent and female patients were more affected. The most frequent site for the lesion was the lip, followed by tongue, buccal mucosa, alveolar ridge, gingiva, floor of the mouth and vestibule. Thirty-five cases were associated with other vascular anomalies or actinic cheilitis. Microscopically, typical thrombus morphology was present. Organized thrombus presented neovascularization and fibroblasts, associated with hemorrhagic areas. Only 4 cases of oral thrombus have been described in the oral cavity. Given the limited number of cases reported, the importance of a thrombus in the oral cavity is not well established. This study contributes to establishing the profile of patients presenting oral thrombus, a lesion not rare but not well documented.
- Orbital apex syndrome affecting head and neck cancer patients : a case series(2017) Ribeiro, Ana-Carolina-Prado; Luiz, Ana-Claudia; Montezuma, Marco Aurelio; Mak, Milena Perez; Santos Silva, Alan Roger; Brandao, Thais-BiancaOrbital apex syndrome (OAS) is a complex and uncommon disorder that typically damages multiple cranial nerves in association with optic nerve dysfunction. OAS is associated with several different pathologies, however; only a few cases have been reported in association with head and neck cancer (HNC) so far. A case series of HNC patients diagnosed with OAS is described including clinicopathological data, image findings, and disease outcome. Ptosis and diplopia were diagnosed in four male patients with mean age of 61.2 years who were undergoing treatment for late-stage carcinomas of the tongue, larynx, and nasopharynx, eventually leading to the diagnosis of OAS. The mean overall survival rate after the diagnosis of OAS was 9.5 months. The current study reinforces evidence that OAS indicates poor prognosis and highlights the importance of early diagnosis.
- Metastatic carcinoma of the oral region : an analysis of 21 cases(2017) Lee, Yeon Hee; Lee, Jae-IlMetastatic carcinoma to the jaws and oral region are very rare, representing less than 1% of all oral tumors. Unfortunately, oral metastasis is usually manifestation of an advanced stage of primary cancer, and indicates widespread disease and poor prognosis. In this retrospective study, a total of 2039 patients with history of oral malignant tumor between 1980 and 2012 at Seoul National University Dental Hospital were evaluated. We analyzed the dental and medical records, and histopathological database of 2039 patients to assess the prevalence of oral metastasis of carcinoma in terms of sex and age, as well as, the most common origin of primary cancer, and prevalent site and histopathological type of metastatic carcinoma. Among 2039 patients, 21 (1.03%) were finally diagnosed with metastatic carcinoma of the jaws and oral region. Among the 21 patients, only 11 had a working diagnosis as oral metastasis upon clinical evaluation before performing a biopsy. The mean age at the time of diagnosis with a metastatic carcinoma was 56.86, and there was a male preponderance. Metastatic carcinoma was more frequent in the jaws than in the soft tissue, especially in the mandible compared to the maxilla. The most frequent primary site was the lungs, followed by the liver and breasts. The predominant histopathological types were hepatocellular carcinoma and adenocarcinoma. Patient outcomes indicated a poor prognosis with the time from the appearance of the metastasis to death was only 12 months. According to these cases, oral metastases of carcinoma were exceedingly rare in Koreans. It can allow the clinicians take into account the possible presence of metastases and lead to early diagnosis.
- Comparative histological and immunohistochemical study of ameloblastomas and ameloblastic carcinomas(2017) Martinez-Martinez, Marisol; Mosqueda Taylor, Adalberto; Carlos, Román; Pires, Fábio-Ramôa; Delagado Azañero, Wilson; Neves-Silva, Rodrigo; Aldape Barrios, B.; Almeida, Oslei Paes deThis study aimed to compare the histological and immunohistochemical characteristics of ameloblastomas (AM) and ameloblastic carcinomas (AC). Fifteen cases of AM and 9 AC were submitted to hematoxilin and eosin and immunohistochemical analysis with the following antibodies: cytokeratins 5,7,8,14 and 19, Ki-67, p53, p63 and the cellular adhesion molecules CD138 (Syndecan-1), E-cadherin and ?-catenin. The mean score of the expression of Ki-67 and p53 labelling index (LIs) were compared between the groups using the t test. A value of p<0.05 was considered to be statistically significant. All cases were positive for CKs 5, 14 and 19, but negative for CKs 7 and 8. CKs 5 and 19 were positive mainly in the central regions of the ameloblastic islands, while the expression in AC was variable in intensity and localization. CK14 was also variably expressed in both AM and AC. Ki-67 (P=.001) and p53 (P=.004) immunoexpression was higher in AC. All cases were positive for p63, but values were higher in AC. CD138 was mainly expressed in peripheral cells of AM, with a weak positivity in the central areas, while it was positive in most areas of ACs, except in less differentiated regions, where expression was decreased or lost. E-cadherin and ?-catenin were weakly positive in both AM and AC. These results shows that Ki-67, p53 and p63 expression was higher in AC as compared to AM, suggesting that these markers can be useful when considering diagnosis of malignancy, and perhaps could play a role in malignant transformation of AM. Pattern of expression of CKs 5 and 19 in AC were different to those found in AM, suggesting genetic alterations of these proteins in malignant cells. It was confirmed that CK19 is a good marker for benign odontogenic tumors, such as AM, but it is variably expressed in malignant cases.
- Impact of early childhood caries and its treatment under general anesthesia on orofacial function and quality of life : a prospective comparative study(2017) Collado, Valérie; Pichot, Hélène; Delfosse, Caroline; Eschevins, Caroline; Nicolas, Emmanuel; Hennequin, MartineEarly Childhood Caries (ECC) has become a major public health concern worldwide, mostly affecting children from disadvantaged families in increasingly severe forms. This condition has been frequently reported to alter children?s nutrition, growth and general development. It negatively impacts their quality of life, through painful episodes and severe eating difficulties. While this period is crucial for oral praxes development, the impact of dental state on oro-facial functions is poorly documented. This study evaluated the impact of ECC and its treatment under general anesthesia on oro-facial functions and quality of life in pre-school children. The dysfunction and quality of life scores from 25 children with ECC were evaluated before treatment (T0), one month (T1) and three months after treatment (T2), using the Nordic Orofacial Test-Screening (NOT-S) and the Early Childhood Oral Health Impact Scale (ECOHIS), respectively, in comparison with 16 caries-free children. The number and extent of inter-arch dental contacts were also observed. The pre-operative higher NOT-S score observed in children with ECC decreased to reach the control level at T2. The mastication item was the most affected in the ECC group throughout the study. Their mean ECOHIS score also significantly decreased post-operatively and differences remaining between both groups were no longer clinically relevant. In addition, in children with ECC, values of functional inter-arch surfaces tended to increase over the follow-up period. Oro-facial functions and quality of life, altered by ECC, could be restored through a conservative treatment approach. Relations between dental state, orofacial functions and particularly chewing, and nutrition should be investigated further.
- Histopathological characterization of the oral lichenoid disease subtypes and the relation with the clinical data(2017) Alberdi Navarro, Javier; Marichalar Mendia, Xabier; Lartitegui Sebastián, María José; Gainza Cirauqui, María Luisa; Echebarria Goicouria, María Ángeles; Aguirre Urízar, José ManuelThe aim of the study was to analyze the histopathological characteristics of samples with a diagnosis of oral lichenoid disease (OLD) and their link with the location and the type of clinical lesion, and the clinicopathological subtypes. Retrospective study on 85 consecutive patients diagnosed with OLD (58 women and 27 men, mean age of 57.7 years). Clinical and histopathological characterization of each case (modified WHO criteria). Collection of the clinical and histopathological data of the lesions. Descriptive and comparative statistical analysis of the results. The 78.8% of the cases were considered clinically typical while the 21.2% were considered compatible. Histologically, 52.9% were classified as typical and 47.1% as compatible. Biopsies from ?plaque-like? lesions presented hyperkeratosis (p<0.001) and epithelial dysplasia (p=0.06) more frequently. Furthermore, acute inflammation was more evident in erosive-ulcerative lesions (p=0.001). Differences regarding the location of the biopsy were statistically non-significant. However, 42.9% of the tongue biopsies showed epithelial dysplasia. The histopathological aspect of this disorder is not specific and does not allow us to differentiate between the main subtypes. Therefore, the main reasons to perform a biopsy in this disorder are to define the differential diagnosis and to rule out epithelial dysplasia or a carcinoma. The final histopathological result may be subject to the type of lesion that is biopsied.
- Oral diseases : a 14-year experience of a Chilean institution with a systematic review from eight countries(2017) Rivera, Cesar A.; Jones-Herrera, Carolina; Vargas, Pablo; Venegas Rojas, Bernardo; Droguett, DanielRetrospective studies to assess the distribution of oral diseases (ODs) are helpful in estimating the prevalence of oral diagnoses in the population, and thus help in preventive and curative services. Prevalence and frequency data for ODs are available from many countries, but information from Chile is scarce. This study investigated the frequency of ODs in a Chilean population. For this, we included all patients treated at the University of Talca (UTALCA, Chile) between 2001 and 2014. Patient characteristics were retrieved from medical files. To contextualize our results, we conducted a systematic review (SystRev) using Publish or Perish software (PoP), Google Scholar and MEDLINE/PubMed. One hundred sixty-six ODs were diagnosed, and the most prevalent groups were soft tissue tumours, epithelial pathology and salivary gland pathology. Individually, irritation fibroma, oral lichen planus (OLP) and mucocele were the most common diagnoses. ODs frequently affected unspecified parts of the mouth (including cheek, vestibule and retromolar area), gum, lips, tongue and palate. In the SystRev, the more studied diagnoses were leukoplakia, OLP and recurrent aphthous stomatitis; prevalent lesions included Fordyce?s spots, recurrent aphthous stomatitis and fissured tongue. Chilean patients and SistRev shared almost all ODs. The results reflect ODs diagnosed in a specialized service of oral pathology and medicine in Chile and will allow the establishment of preventive/curative policies, adequate health services and dentistry curriculum.
- Ultrasound hyperthermia induces apoptosis in head and neck squamous cell carcinoma : an in vitro study(2017) Ren, Guoxin; Jv, Houyu; Tian, Zhuowei; Gvetadze, Shalva R.; Hu, Jingzhou; Zhao, Mei; Zhou, Ge; Zhang, Chenping; Zhang, ZhiyuanHyperthermia is considered an efficient complement in the treatment of head and neck squamous cell carcinoma (HNSCC). Hyperthermia induces cell apoptosis in a temperature- and time-dependent manner. However, the molecular mechanism of hyperthermia remains unclear. The aim of this study was to investigate the mechanism of apoptosis induced by ultrasound hyperthermia in HNSCC cell lines HN-30 and HN-13. We examined the dynamic changes of early apoptosis and secondary necrosis in HN-30 and HN-13 cells treated by hyperthermia at 42°C for 10 min. We further examined mitochondrial membrane potential in vitro by ultrasound hyperthermia for different heating temperatures (38-44°C, 10 min) and heating times (42°C, 10-50 min). After heating by ultrasound at 42°C for 10 min, the apoptosis index achieved its highest level at 8 h after treatment, decreased rapidly and remained constant at a reduced level at 12 h. The level of secondary necrosis increased with the level of early apoptosis but remained at a higher level until 14 h. The level of secondary necrosis correlated with the level of early apoptosis (HN-13: r=0.7523, P=0.0030; HN-30: r=0.6510, P=0.016). The fractions of cells with low mitochondrial membrane potential (??) in the heating-temperature grads group and heating-time grads group decreased significantly over time. Therefore, HN-30 and HN-13 cells developed apoptosis after ultrasound hyperthermia treatment with decreases in the mitochondrial transmembrane potential level. Ultrasound hyperthermia induces apoptosis in HN-30 and HN-13 cells, possibly via the mitochondrial caspase pathway.
- Probiotics and oral health : a systematic review(2017) Seminario Amez, Maria; López López, José; Estrugo Devesa, ALbert; Ayuso Montero, Raúl; Jane Salas, EnricProbiotics are microorganisms, mainly bacteria, which benefit the host?s health. Many studies support the role of probiotics as a contributor to gastrointestinal health, and nowadays many authors are trying to prove its influence in oral health maintenance. To review the published literature with the purpose of knowing the importance of using probiotics as a preventive and therapeutic method for oral infectious diseases management. An electronic search in PubMed database with the keywords ?oral health AND probiotics AND dentistry? was conducted. The inclusion criteria were: randomized clinical trials (RCTs) that assess the action of any probiotic strain in the treatment and / or prevention of an infectious oral disease, RCTs that assess the action of any probiotic strain on counting colony forming units (CFU) of oral pathogens, systematic reviews and meta-analysis. The Jadad scale was used to assess the high quality of RCTs. Fifteen articles were considered for this review. Of which, 12 were RCTs of good / high quality (Jadad scale), two meta-analysis and one systematic review. The literature reviewed suggests probiotics usage could be beneficial for the maintenance of oral health, due to its ability to decrease the colony forming units (CFU) counts of the oral pathogens. However, randomized clinical trials with long-term follow-up periods are needed to confirm their efficacy in reducing the prevalence/incidence of oral infectious diseases. Furthermore, the recognition of specific strains with probiotic activity for each infectious oral disease is required, in order to determine exact dose, treatment time and ideal vehicles.
- Clear cell changes in salivary gland neoplasms : a 20-year retrospective study(2017) Woods, Tina; Fitzpatrick, Sarah; Cohen, Donald; Islam, Mohammed; Bhattacharyya, IndraneelClear cells are observed histopathologically in both benign and malignant neoplasms but their presence in salivary gland tumors has not been extensively documented. With IRB approval, the archive of the University of Florida College of Dentistry oral pathology biopsy service was retrospectively searched from 1994-2014 for all benign and malignant salivary tumors. Epidemiological data, tumor location and duration, and type of tumor were recorded. A four reviewer panel examined the original slides. Reviewers scaled each case as 0 (no clear cells present), 1 (few to focal clear cells), 2 (less than 50% clear cells), and 3 (greater than 50% clear cells). A total of 535 cases were included of which 48% of tumors displayed 0 clear cells (257/535), 31.4% (168/535) scored 1, 13.6% (73/535) scored 2, and 7% (37/535) scored 3. Of the 251 (47%) malignant neoplasms, 64% (160/251) demonstrated 0-1 clear cell change, while 36% (91/251) showed a score of 2-3. For the total 284 (53%) benign tumors, 93% (265/535) scored 0-1 and 7% (19/535) scored a 2-3 range. No statistical difference was noted for gender, age, or duration of time present in regards to presence or absence of clear cells. Statistically significant differences in clear cell presence were found between location groups, between benign and malignant diagnosis, and between specific diagnostic groups. This study demonstrates the frequent presence of increased numbers of clear cells in oral salivary malignancies and highlights salivary gland differential diagnoses when presented with clear cell changes.
- Salivary MMP-9 in the detection of oral squamous cell carcinoma(2017) Peisker, Andre; Raschke, Gregor-Franziskus; Fahmy, Mina D.; Guentsch, Arndt; Roshanghias, Korosh; Hennings, Joschka; Schultze Mosgau, StefanOral squamous cell carcinoma (OSCC) is the most common malignant tumour of the oral cavity. Detection of OSCC is currently based on clinical oral examination combined with histopathological evaluation of a biopsy sample. Direct contact between saliva and the oral cancer makes measurement of salivary metalloproteinase- 9 (MMP-9) an attractive alternative. In total, 30 OSCC patients and 30 healthy controls were included in this prospective study. Saliva samples from both groups were collected, centrifuged and supernatant fluid was subjected to ELISA for assessment of MMP-9. The median salivary MMP-9 values with interquartile range (IQR) of OSCC patients and the control group were statistically analysed using the Mann-Whitney U-test. The receiver operating characteristic (ROC) curve was constructed and the area under curve (AUC) was computed. The median absorbance MMP-9 value of the OSCC group was 0.186 (IQR=0.158) and that of control group was 0.156 (IQR=0.102). MMP-9 was significantly increased in the OSCC patients than in the controls by +19.2% (p=0.008). Median values in patients with recurrence and in patients with primary event were 0.233 (IQR=0.299) and 0.186 (IQR=0.134) respectively. MMP-9 was significantly increased in patients with primary event (p=0.017) compared to controls by +19.2%. No significant increase of MMP-9 level was detected when comparing patients with recurrence and healthy controls (+49.4%; p=0.074). The sensitivity value of MMP-9 was 100% whereas the specificity value was 26.7% with AUC of 0.698. The present data indicates that the elevation of salivary levels of MMP-9 may be a useful adjunctive diagnostic tool for detection of OSCC. However, further studies are necessary to provide scientific and clinical validation.
- The use of topical corticosteroides in the treatment of oral lichen planus in Spain : a national survey(2017) Piñas Caballero, Laura; García García, Abel; Pérez-Sayáns, Mario; Suárez Fernández, Ricardo; Alkhraisat, Mohammad-Hamdan; Anitua Aldecoa, EduardoExplore the treatment of oral lichen planus with topical corticosteroids by the healthcare professionals in Spain. A questionnaire targeted health professionals who treat OLP, in particular maxillofacial surgeons, dermatologist and dentist. The dissemination of the questionnaires was conducted through professional associations and dental and medical societies. The questionnaire was previously evaluated by means of a cognitive pre-test procedure to ensure that the questions were opportune and appropriate, understandable and acceptable among the professionals. Of the 890 questionnaires sent a total of 190 questionnaires were answered by 90 dentists, 60 dermatol gists and 40 by maxillofacial surgeons. The most frequent treatment was 0.1% triamcinolone acetonide in orobase 3 times a day. The effectiveness of the topical corticosteroid treatment was 6.68 (SD= 2.26) in a scale of 1 to 10. The 30% of the dentists and 10.49% of maxillofacial surgeons combined treatment with other drugs. The most frequent one (80%) was nystatin (100,000 IU per millimetre). Dermatologists did not use other treatments in combination with corticosteroids. There is a need for national guidelines in treatment for oral lichen planus (treatment criteria, drug, dose, treatment time and method of application of corticosteroid) that can be applied by all professionals who treat this disease.
