Effects of Vape Use on Oral Health: A Review of the Literature.

Background and Objectives: The widespread use of tobacco has evolved with the popularity of vapes, especially among young people, despite the lack of clarity in warnings about their risks. Studies indicate the need for more effective communication about the oral risks of vaping. In addition to systemic, respiratory, and cardiovascular effects, vaping is associated with an increased risk of gingivitis and periodontal disease as well as reduced antioxidant capacity of saliva. The objectives of this narrative review are to summarize the existing information in the literature on the effects of vaping at the oral level and to bring together knowledge about the mechanism of action of vaping in oral tissues. Materials and Methods: In the present study, articles were searched in PubMed, Elsevier Scopus, and Web of Science using the keywords "oral health", "vaping", and "vape". Studies published in the last 6 years that addressed the effects of oral vaping were selected, including comparisons among vape users, smokers, and non-smokers. Repeated articles, prior to 2017 and in languages other than English, were excluded. Two review authors (A.M.I and M.F.E.M) independently selected the papers based on titles and abstracts and conducted a full review of the remaining papers. In cases of disagreement, a third reviewer was used. Results: A total of 113 results were obtained, distributed as 16 from PubMed, 35 from Web of Science, and 62 from Elsevier Scopus. After removing duplicates, 67 articles were filtered by reviewing titles and abstracts, and finally, 22 articles were selected for comprehensive reading. Subsequently, eight of these articles were chosen for qualitative synthesis and are presented in standardized tables. The sample size of all included studies was composed of 31,647 participants, (14,477 male and 17,170 female) with a mean of 35.016 ± 7.57 years of age. Conclusions: This review indicates that the use of vapes is associated with an increased risk of periodontitis and caries. Although users experience more oral problems than non-smokers, these are less severe than those of traditional smokers. The widespread prevalence, especially among young people, highlights the urgency of awareness campaigns to warn of risks and understand potential harm.

Keratocyst Capnocytophaga superinfection.

INTRODUCTION: Capnocytophaga spp are Gram-negative bacteria that cause severe infections in immunosuppressed patients. This situation is extremely rare in immunocompetent patients. CASE REPORT: This clinical report describes the unusual infection of an immunocompetent patient with Capnocytophaga spp. The imaging studies showed the existence of a cyst in the left jawbone. After treatment and a microbiological study of the content, it was found to be an outbreak of septicaemia. DISCUSSION: Capnocytophaga spp, commensal bacteria of the oral cavity, can lead to serious illness and that is why an empirical treatment is needed until a diagnostic confirmation can be obtained.

Intervención para la mejora del conocimiento de los factores de riesgo para el desarrollo de osteonecrosis maxilar en pacientes a tratamiento con bisfosfonatos. Ensayo clínico aleatorizado / Intervention to improve awareness of the risk factors for osteonecrosis of the jaw in patients under treatment with bisphosponates. Randomised clinical trial

Objetivo: Evaluar la efectividad de un programa de educación para la salud sobre el conocimiento y modificación de los factores de riesgo de aparición de osteonecrosis maxilar en pacientes tratados con bisfosfonatos. Método: Estudio experimental del tipo «grupo control sin intervención», con 60 pacientes que iniciaron tratamiento con bisfosfonatos en el Hospital Universitario de León de octubre a diciembre de 2014. Los pacientes pertenecientes al grupo experimental recibieron una intervención educativa estructurada en dos sesiones. La recogida de datos se llevó a cabo mediante un cuestionario heteroadministrado, al inicio y al final del período de estudio, para ambos grupos. Resultados: La intervención educativa diseñada mejoró significativamente la práctica de medidas básicas de higiene oral, como el control mecánico de la placa y el uso de clorhexidina previa a procedimientos orales invasivos. Ningún paciente declaró haber sido advertido de la necesidad de poner su boca en salud antes del inicio del tratamiento. Tras la intervención se determinan porcentajes elevados de reconocimiento de medidas de diagnóstico precoz partiendo de una situación basal de desconocimiento total de las mismas. No resultaron concluyentes los datos recogidos sobre el uso de prótesis dental, hábitos tóxicos o control metabólico en pacientes con diabetes mellitus. Conclusiones: La mejora de la adhesión a conductas saludables relacionadas con la salud bucodental tras la intervención educativa, así como su contribución a la identificación precoz de los signos de alarma de osteonecrosis maxilar, remarca la importancia del empleo de la educación para la salud como herramienta en la práctica clínica habitual (AU)

Purpose: To evaluate the effectiveness of a health education programmer on knowledge and reduction of the risk factors for bisphosphonate-related osteonecrosis of the jaw. Methods: An experimental study control group without intervention was performed with 60 subjects who had started treatment with bisphosphonates in the University Hospital of León from October to December 2014. Patients in the experimental group received a structured education intervention in two sessions. The data was collected from a heteroadministered questionnaire at the beginning and at the end of the study period for both groups. Results: The educational intervention designed showed a significantly increased adherence to healthy behaviours related to oral hygiene such as mechanical control of plaque and the use of clorhexidine prior to invasive oral procedures. All subjects reported that they had not been advised to maintain a good level of oral health before starting treatment. After the intervention high percentages of recognition of early diagnostic measures starting from a baseline total ignorance of them were determined. No conclusive information about the use of removable dental prostheses, toxic habits or maintaining proper metabolic control in patients with diabetes mellitus was observed. Conclusions: Improving adherence to healthy behaviours related to oral health following the intervention, as well as their contribution to the early identification of warning signs of jaw osteonecrosis, stresses the importance of the use of health education as a tool in routine clinical practice (AU)

Intervention to improve awareness of the risk factors for osteonecrosis of the jaw in patients under treatment with bisphosponates. Randomised clinical trial. / Intervención para la mejora del conocimiento de los factores de riesgo para el desarrollo de osteonecrosis maxilar en pacientes a tratamiento con bisfosfonatos. Ensayo clínico aleatorizado.

PURPOSE: To evaluate the effectiveness of a health education programme on knowledge and reduction of the risk factors for bisphosphonate-related osteonecrosis of the jaw. METHODS: An experimental study control group without intervention was performed with 60 subjects who had started treatment with bisphosphonates in the University Hospital of León from October to December 2014. Patients in the experimental group received a structured education intervention in two sessions. The data was collected from a heteroadministered questionnaire at the beginning and at the end of the study period for both groups. RESULTS: The educational intervention designed showed a significantly increased adherence to healthy behaviours related to oral hygiene such as mechanical control of plaque and the use of clorhexidine prior to invasive oral procedures. All subjects reported that they had not been advised to maintain a good level of oral health before starting treatment. After the intervention high percentages of recognition of early diagnostic measures starting from a baseline total ignorance of them were determined. No conclusive information about the use of removable dental prostheses, toxic habits or maintaining proper metabolic control in patients with diabetes mellitus was observed. CONCLUSIONS: Improving adherence to healthy behaviours related to oral health following the intervention, as well as their contribution to the early identification of warning signs of jaw osteonecrosis, stresses the importance of the use of health education as a tool in routine clinical practice.

Sentinel Node in Oral Cancer: The Nuclear Medicine Aspects. A Survey from the Sentinel European Node Trial.

PURPOSE: Nuclear imaging plays a crucial role in lymphatic mapping of oral cancer. This evaluation represents a subanalysis of the original multicenter SENT trial data set, involving 434 patients with T1-T2, N0, and M0 oral squamous cell carcinoma. The impact of acquisition techniques, tracer injection timing relative to surgery, and causes of false-negative rate were assessed. METHODS: Three to 24 hours before surgery, all patients received a dose of Tc-nanocolloid (10-175 MBq), followed by lymphoscintigraphy. According to institutional protocols, all patients underwent preoperative dynamic/static scan and/or SPECT/CT. RESULTS: Lymphoscintigraphy identified 723 lymphatic basins. 1398 sentinel lymph nodes (SNs) were biopsied (3.2 SN per patient; range, 1-10). Dynamic scan allowed the differentiation of sentinel nodes from second tier lymph nodes. SPECT/CT allowed more accurate anatomical localization and estimated SN depth more efficiently. After pathological examination, 9.9% of the SN excised (138 of 1398 SNs) showed metastases. The first neck level (NL) containing SN+ was NL I in 28.6%, NL IIa in 44.8%, NL IIb in 2.8%, NL III in 17.1%, and NL IV in 6.7% of positive patients. Approximately 96% of positive SNs were localized in the first and second lymphatic basin visualized using lymphoscintigraphy. After neck dissection, the SN+ was the only lymph node containing metastasis in approximately 80% of patients. CONCLUSIONS: Best results were observed using a dynamic scan in combination with SPECT/CT. A shorter interval between tracer injection, imaging, and surgery resulted in a lower false-negative rate. At least 2 NLs have to be harvested, as this may increase the detection of lymphatic metastases.

Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer.

PURPOSE: Optimum management of the N0 neck is unresolved in oral cancer. Sentinel node biopsy (SNB) can reliably detect microscopic lymph node metastasis. The object of this study was to establish whether the technique was both reliable in staging the N0 neck and a safe oncological procedure in patients with early-stage oral squamous cell carcinoma. METHODS: An European Organisation for Research and Treatment of Cancer-approved prospective, observational study commenced in 2005. Fourteen European centres recruited 415 patients with radiologically staged T1-T2N0 squamous cell carcinoma. SNB was undertaken with an average of 3.2 nodes removed per patient. Patients were excluded if the sentinel node (SN) could not be identified. A positive SN led to a neck dissection within 3 weeks. Analysis was performed at 3-year follow-up. RESULTS: An SN was found in 99.5% of cases. Positive SNs were found in 23% (94 in 415). A false-negative result occurred in 14% (15 in 109) of patients, of whom eight were subsequently rescued by salvage therapy. Recurrence after a positive SNB and subsequent neck dissection occurred in 22 patients, of which 16 (73%) were in the neck and just six patients were rescued. Only minor complications (3%) were reported following SNB. Disease-specific survival was 94%. The sensitivity of SNB was 86% and the negative predictive value 95%. CONCLUSION: These data show that SNB is a reliable and safe oncological technique for staging the clinically N0 neck in patients with T1 and T2 oral cancer. EORTC Protocol 24021: Sentinel Node Biopsy in the Management of Oral and Oropharyngeal Squamous Cell Carcinoma.

Bases teóricas y aplicación clínica de las proteínas morfogenéticas óseas en cirugía maxilofacial / Base Theories and the clinical application of bone morphogenetic proteins in maxillofacial surgery

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Los implantes MG-Osseous. Estudio multicéntrico retrospectivo / MG-Osseous implants. A multicentric retrospective study

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Prognostic significance of p53 expression in oral squamous cell carcinoma without neck node metastases.

BACKGROUND: Aberrations of the p53 gene and overexpression of its protein are widely recognized markers of malignancy including oral squamous cell carcinomas. This study was performed to evaluate the relationship of immunoexpression of p53 protein in series of 91 squamous cell carcinomas of the oral cavity with clinicopathologic parameters and to investigate whether p53 immunoexpression might influence the clinical outcome of the disease. METHODS: From a group of 287 consecutive patients, 91 surgically treated ones were randomly selected. P53 protein expression was investigated by means of immunohistochemistry. Clinical and histopathologic data were gathered, and the patient survival was analyzed. RESULTS: Of the oral carcinomas, 52.7% (n = 48) overexpressed p53, using a threshold of 10% stained cell nuclei. There was a negative correlation of p53 immunoexpression with a histologic grade of differentiation (r = -0.236, p =.06) but not with clinical variables. Overall survival rate was 59% at 5 years. In univariate analysis, tumor size, node status, and advanced clinical stage were significantly associated with shortened overall survival. In patients without neck node metastases, p53 showed a strong correlation with survival (p =.01). In multivariate analysis performed only on N0 patients, tumor extension and p53 immunoexpression were found to be the only independent prognostic parameters with relative risks of 1.9 and 4.3, respectively. CONCLUSIONS: A strong relationship was observed between p53 immunoexpression and poor prognosis in patients with oral squamous cell carcinomas without neck node metastases.

Infección por el virus de la hepatitis C y riesgo de transmisión en cirugía oral / Hepatitis C virus infection and risk of transmission in oral surgery

La hepatitis viral es la principal causa de enfermedad hepatica. Aproximadamente el 85 por ciento de los individuos infectados por el virus de la hepatitis C (VHC) progresa a una infección crónica y, de estos, entre el 1 y el 4 por ciento cada año desarrolla un carcinoma hepatocelular. Además de la lesión hepática, el virus C puede afectar a tejidos y órganos extrahepáticos dando lugar a diferentes manifestaciones, como el líquen plano oral, sialadenitis y quizá cáncer oral.El objetivo de este trabajo es revisar el riesgo ocupacional de la infección por VHC entre dentistas y cirujanos orales. Ambos deben saber como incorporar el diagnóstico de infección por VHC en el plan de tratamiento quirúrgico programado. También se revisarán la historia natural y la transmisión de este virus vehiculizado por la sangre. (AU)

Neck schwannomas.

Schwannomas are peripheral nerve tumours of nerve sheath origin. Twenty-five to 45 percent of extracranial schwannomas occur in the head and neck region. We present 2 cases of schwannomas that arise from the vagus and cervical plexus. These lesions are uncommon and most often present as asymptomatic solitary neck mass. Preoperative diagnosis can be difficult and conservative surgical excision remains the treatment of choice, often requiring sacrifice of a portion of the nerve.

Schwannomas cervicales / Neck Schwannomas

Los schwannomas son tumores de los nervios periféricos originados a partir de las vainas neurales. Entre el 25 per cent y el 45 per cent de los schwannomas originados en el nervio vago y en el plexo cervical. Estas lesiones son infrecuentes y suelen presentarse como masas cervicales solitarias asintomáticas. El diagnóstico preoperatorio puede ser difícil y la exéresis quirúrgica conservadora constituye el tratamiento de elección, si bien a menudo requiere el sacrificio de una porción del nervio de origen (AU)

Carcinoma escamoso oral en pacientes trasplantados. Estado actual de la cuestión / Oral squamous carcinoma in solid organ transplant recipients. New perspectives

Los cánceres de cabeza y cuello representan el 15 por ciento de todos los tumores malignos en los pacientes trasplantados. La principal causa que justifica este incremento de incidencia con relación a la población general, es el significativo aumento de los cánceres de labio. En el presente trabajo se documentan dos casos de carcinoma epidermoide oral desarrollados en pacientes sometidos a un trasplante renal. Se realiza una revisión sobre la cuestión, definiendo aquellos aspectos de mayor trascendencia clínica para el odonto-estomatólogo. (AU)

Carcinoma fusocelular de la cavidad oral. A propósito de un caso / Spindle cell carcinoma of the oral cavity. Report of a case

El carcinoma fusocelular es una variedad del carcinoma de células escamosas, de infrecuente presentación e histogénesis controvertida. Aunque puede afectar a cualquier parte de la economía, se localiza más frecuentemente en las vías aerodigestivas superiores. La mayoría de los ubicados en la cavidad oral son invasores y tienen mal pronóstico.Presentamos un caso de carcinoma de células fusiformes que afectaba al espacio masticador, encontrándose la mucosa supraadyacente libre de neoplasia. Hacemos especial hincapié en la metodología histológica e inmunohistoquímica (positividad para las citoqueratinas de bajo peso molecular y, con menor intensidad, para las citoqueratinas de alto peso molecular y la vimentina) empleada para su diagnóstico, así como una valoración de los factores pronósticos y las posibilidades terapéuticas que ofrece esta infrecuente neoplasia (AU)