Alpha lipoic acid efficacy in burning mouth syndrome. A controlled clinical trial.

BACKGROUND: A double-blind placebo-controlled trial was conducted in order to evaluate the efficacy of alpha lipoic acid (ALA) and determine the statistical significance of the outcome variables. Burning mouth syndrome (BMS) is defined as an oral burning sensation in the absence of clinical signs which could justify the syndrome. Recent studies suggest the existence of neurological factors as a possible cause of the disease. MATERIAL AND METHODS: 60 patients with BMS, in two groups: case group with 600 mg/day and placebo as control group; with follow up of 2 months. RESULTS: 64% of ALA patients reported some level of improvement, with a level of maintenance of 68.75% one month after treatment. 27.6% of the placebo group also demonstrated some reduction in BMS symptoms. CONCLUSIONS: Long-term evolution and the intensity of symptoms are variables that reduce the probability of improvement with ALA treatment.

The use of toluidine blue in the detection of pre-malignant and malignant oral lesions.

INTRODUCTION: The purpose of this study was to evaluate the efficacy of the toluidine blue (TB) test as a diagnostic tool in the detection of malignant and dysplastic lesions of the oral cavity. This study was carried out because of a lack of consensus among different authors on the utility of TB, as well as to determine useful adjuncts to detect oral pre-cancer and cancer. MATERIALS AND METHODS: The study included 160 patients with oral mucosal disorders that included suspicious or malignant lesions detected at clinical visual examination, confirmed by histopathological evaluation. All lesions were submitted to TB staining. RESULTS: The sensitivity and specificity for the detection of malignant or dysplastic lesions by this test were 65.5% and 73.3%, respectively. Overall, the detection rate with TB (sensitivity) was slightly lower compared with those reported by other authors but the specificity was comparable to several reports. Positive predictive value (35.2%) was also lower than previous studies, whereas negative predictive value (90.6%) was similar. CONCLUSIONS: The simplicity of the test procedure and the validity of derived values suggest TB staining can be a valuable adjunct to the diagnostic process, as long as it is carefully correlated with the clinical characteristics of the mucosal disorder and histopathological diagnosis.

Cellular senescence in oral cancer and precancer and treatment implications: a review.

INTRODUCTION: Recent studies have demonstrated the capacity of the human organism to prevent the growth of potentially carcinogenic cells by paralyzing them. This antitumor mechanism is known as cellular senescence and is defined as an emergency defence system for cells on the way to becoming cancerous. RESULTS: This review of the literature suggests that oncogene-induced senescence may be a response to oncogenic activation, acting as a natural barrier against tumorigenesis at a premalignant stage. Thus, a large number of cells enter senescence in premalignant lesions but none do so in malignant tumors, due to the loss of senescent pathway effectors such as p16(INK4a) or ARF-p53. Potential senescence markers in oral precancerous lesions include p21(WAF1), p16(INK4a), pRb, Maspin, RAR-beta, G-actin, p15(INK4b), DCR2, and DEC1, some of which are currently under study. CONCLUSION: In the short term, the study of this mechanism may yield valuable data for the management of oral cancer and precancer, for which no effective diagnostic or prognostic markers are yet available.

Genotypic determination by PCR-RFLP of human papillomavirus in normal oral mucosa, oral leukoplakia and oral squamous cell carcinoma samples in Madrid (Spain).

BACKGROUND: Human papillomaviruses (HPVs), especially genotypes 16 and 18, are considered to be human carcinogens by the International Agency for Research on Cancer (IARC). They are the most important etiological agents of uterine cervix cancer but their true role in oral carcinogenesis is controversial. OBJECTIVES: To detect the presence of HPV genome genotypes in oral leukoplakia and oral squamous cell carcinoma (OSCC) and analyze their relationship with clinicopathological variables. MATERIALS AND METHODS: Presence of genome ofHPV types 6, 11, 16, 18, 31, 33, 39, 42, 45, and 52 was studied by polymerase chain reaction in samples of normal mucosa (30 controls), oral leukoplakia (35 cases) and OSCC (33 cases). Results were compared between groups and differences were examined in relation to clinical and histological variables. RESULTS: HPV genome was detected in 23.3% of controls, 45.7% of oral leukoplakias, and 39.4% of OSCCs. Only HPV-16 was significantly (p=0.0005) more frequently detected in leukoplakias (40%) and OSCCs (33.3%) versus controls (0%). No significant relationship was found between the presence of viral genome and the main clinicopathological variables. CONCLUSION: According to these findings, the presence of HPV-16 is significantly associated with oral leukoplakia and OSCC lesions, therefore in our setting this virus may be a carcinogenic element in this disease.

Patología (pseudopatología) lingual observada en la facultad de odontología de la UCM / Lingual pathology [and pseudopathology] observed in [he UCM Dental School [Madrid, Spain]

Se ha realizado un estudio descriptivo, retrospectivo y transversal sobre la patología (pseudopatología) lingual observada en el Departamento de Medicina y Cirugía Bucofacial de la Facultad de Odontología de la UCM y se han comparado los resultados con otros estudios similares. De un total de 1313 historias clínicas revisadas, 54 (4,11 por ciento) presentaron una o varias alteraciones linguales. La lengua geográfica fue la entidad más frecuentemente encontrada, en un 2,13 por ciento de los pacientes, seguida de la lengua fisurada, 1,07 por ciento, y de la hipertrofia de las papilas foliadas con un 0,53 por ciento. Las condiciones englobadas en el grupo de pseudopatología, son entidades muy próximas a la normalidad, con un diagnóstico que se solapa en ocasiones con lenguas sanas. El diagnóstico se produjo en un 27,8 por ciento de los casos de forma casual, no siendo el motivo de consulta del paciente al acudir al Departamento (AU)

Corticoids: their use in the pathology of the oral mucosa.

The etiology of a great number of processes that affect the oral mucosa is yet quite unclear. It is generally known that many of them develop into a chronic and unspecific inflammatory process, occasionally of possible immunologic cause. Treatment therefore is not aimed on their cause but on their symptoms. Due to their anti-inflammatory and immunosuppressive properties, corticoids continue to be the first drug of choice. However, the chronicity of these types of processes together with the wide variety of adverse effects that corticoids can cause on a long-term basis, make their use complex and empirical. Guidelines of variable application are used depending on the clinical manifestations, the individual susceptibility and the evolution of the disease. The most commonly used corticoids in oral pathology, the different routes of administration and the possible guidelines and precautions proposed by diverse authors to control the disease and to decrease the possible adverse effects derived from corticotherapy are described.

Procesos reactivos y neoplásicos de los tejidos periodontales / Reactive and neoplasic processes in periodontal tissues

En el presente artículo se pretende exponer y relacionar los diferen-tes procesos reactivos y neoplásicos que pueden originarse o expresarse a nivel de los tejidos periodontales. Para ello, se describen las consideraciones epidemiológicas de interés, así como las características clínicas, radiográficas e histológicas de cada proceso en concreto, con el fin de establecer un diagnóstico diferencial adecuado y poder planificar de tal manera una terapia efectiva (AU)