Is expression of p120ctn in oral squamous cell carcinomas a prognostic factor?

OBJECTIVES: p120ctn is a component of the catenin family. To date, there have only been two studies examining expression levels of p120ctn in oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Paraffined specimens of 113 OSCCs and 12 of normal mucosa were examined by immunohistochemistry. Frozen samples of 20 OSCCs and 5 of normal mucosa were examined by Western blot (WB). Results were correlated with clinicopathological parameters. Five cell lines were examined by immunofluorescence, immunocytochemistry, and WB to show immunoreactivity and cellular localization of p120ctn. RESULTS: Altered p120ctn expression was observed in 109/113 cases of OSCC. Heterogenous cytoplasmic/nuclear expression was associated with loss of membranous distribution (88/113 cases). Complete loss of expression was noted in 21/113 cases. Increased cytoplasmic expression was evident in all positive cases, without significant correlation among p120ctn staining/pattern and grading/stage. Reduction/absence of p120ctn expression was related to poor prognosis (P < .05). CONCLUSION: p120ctn delocalization/loss of expression could be an independent prognostic marker in OSCC.

Documento de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos dentales / Condensus document on the use of antibiotic prophylaxis in dental surgery and procedures

La profilaxis antibiótica en Odontología tiene como objetivo prevenir la aparición de infección a partir de la puerta de entrada que produce la actuación terapéutica, por lo que se encuentra indicada siempre que exista un riesgo importante de infección, ya sea por las características mismas de la operación o por las condiciones locales o generales del paciente. Sin embargo, los ensayos clínicos con antibióticos en patologías dentarias responden poco a los criterios metodológicos requeridos, y además no son lo suficientemente numerosos. Se presentan los resultados de una conferencia de expertos integrada por los Presidentes de Sociedades científicas españolas más representativas que han analizado la bibliografía existente y han aportado sus valiosas experiencias profesionales. Se describen las circunstancias técnicas, se analizan los fundamentos biológicos y farmacológicos y se aplican a las situaciones médicas más representativas. Se concluye quela profilaxis antibiótica en Odontología cuenta con indicaciones bien fundamentadas y precisas, ofreciendo a la comunidad científica internacional un protocolo práctico de actuación (AU)

The goal of antibiotic prophylaxis in Odontology is to prevent the onset of infections through the entranceway provided by the therapeutic action, therefore it is indicated providing there is a considerable risk of infection, either because of the characteristics of the operation itself or the patient’s local or general condition. Nonetheless, clinical trials with antibiotics in dental pathologies have had scant regard for the required methodological criteria and, in addition, are not sufficiently numerous. This text presents the results of an expert conference comprising the Presidents of the most representative Scientific Societies in Spain who have analyzed the existing literature and have drawn on their valuable professional experience. It describes the technical circumstances, analyzes the biological and pharmacological foundations and their application to the most representative medical situations. It is concluded that antibiotic prophylaxis in Odontology has certain well-founded, precise indications and offers the international scientific community a practical protocol for action (AU)

High resolution image in bone biology II. Review of the literature.

Bone microstructure has usually been assessed by obtaining samples invasively and analyzing them with conventional histomorphometric methods. Improvements in high-resolution image acquisition systems have enabled non-invasive assessment of bone morphology and a more precise 3-D evaluation by means of "virtual biopsies", permitting bone assessment in regeneration or remodeling processes. Among other applications, this imaging technique can be used for the ultrastructural analysis of bone and for studies of regeneration techniques, biomechanics in bone physiotherapy, and periimplant bone healing. This review describes the different applications of high-resolution imaging techniques in bone biology and the morphometric results obtained with these images in mechanobiology in general and maxillary bone in particular.

High resolution image in bone biology II. Review of the literature

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Bone microstructure has usually been assessed by obtaining samples invasively and analyzing them with conventional histomorphometric methods. Improvements in high-resolution image acquisition systems have enabled non-invasive assessment of bone morphology and a more precise 3-D evaluation by means of “virtual biopsies”, permitting bone assessment in regeneration or remodeling processes. Among other applications, this imaging technique can be used for the ultrastructural analysis of bone and for studies of regeneration techniques, biomechanics in bone physiotherapy,and periimplant bone healing. This review describes the different applications of high-resolution imaging techniques in bone biology and the morphometric results obtained with these images in mechanobiology in general and maxillary bone in particular

High resolution image in bone biology I. Review of the literature.

Bone microstructure has usually been assessed by obtaining samples invasively and analyzing them with conventional histomorphometric methods. Improvements in high-resolution image acquisition systems have enabled non-invasive assessment of bone morphology and a more precise 3-D evaluation by means of "virtual biopsies", permitting bone assessment in regeneration or remodeling processes. This review describes the characteristics and limitations of bone assessment using different high-resolution image systems (synchrotron-radiation computed tomography, micro-computed tomography, acoustic scanning microscope; micro-magnetic resonance imaging). Morphometric variables that can be obtained from these images are reported and compared with conventional histomorphometric variables.

High resolution image in bone biology I. Review of the literature

La valoración de la microestructura ósea se ha realizado habitualmente mediante la obtención invasiva de muestras y el procesado y evaluación de las mismas con métodos convencionales histomorfometricos. La mejora de los sistemas de obtención de imágenes con alta resolución permite la valoración no invasiva de la morfología ósea con evaluaciones tridimensionales más precisas, con las denominadas “biopsias virtuales” que permiten realizar la valoración del hueso en procesos de regeneración o remodelación. Este trabajo de revisión describe las características y limitaciones de la evaluación ósea de diferentes sistemas de imagen de alta resolución (Tomografia computerizada mediante radiación sincrotrón; Micro tomografía computerizada; Microscopio de escaneado acústico; Micro imagen por resonancia). También se describen diversas variables morfométricas que pueden ser obtenidas a partir de las imágenes obtenidas y que pueden ser comparadas con las variables histomorfométricas convencionales

Bone microstructure has usually been assessed by obtaining samples invasively and analyzing them with conventional histomorphometric methods. Improvements in high-resolution image acquisition systems have enabled non-invasive assessment of bone morphology and a more precise 3-D evaluation by means of “virtual biopsies”, permitting bone assessment in regeneration or remodeling processes. This review describes the characteristics and limitations of bone assessment using different high-resolution image systems (synchrotron-radiation computed tomography, micro-computed tomography, acoustic scanning microscope; micro-magnetic resonance imaging). Morphometric variables that can be obtained from these images are reported and compared with conventional histomorphometric variables

Levels of metalloproteinase-2 and -9 and tissue inhibitor of matrix metalloproteinase-1 in gingival crevicular fluid of patients with periodontitis, gingivitis, and healthy gingiva.

OBJECTIVE: To compare the levels of matrix metalloproteinase-2 and -9 (MMP-2 and MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in patients with gingivitis and periodontitis and in healthy controls. METHODS: Levels of MMP-2, MMP-9, and TIMP-1 were determined by ELISA in patients with healthy gingiva (n = 16), gingivitis (n = 18), and periodontitis (n = 25). The subjects with periodontitis were examined before and 1 month after basic periodontal therapy. RESULTS: Slightly higher concentrations of MMP-9 were observed in patients with periodontitis but without statistical significance. MMP-2 was found to be slightly diminished in these patients. The lowest concentrations of MMP inhibitor (TIMP-1) were observed in patients with periodontitis, in whom the concentrations increased after periodontal treatment. CONCLUSION: The reduction in TIMP-1 concentrations in disease situations suggests a breakdown of the balance between the amount of MMPs and their inhibitor.

Update on gingival overgrowth by cyclosporine A in renal transplants.

Severe gingival overgrowth is one of the most frequent side effects in renal transplant patients associated with assumption of cyclosporine A. Several associations with age, sex, dosage, duration of therapy or interval since transplantation have been hypothesized. The introduction of alternative immunosuppressant drugs have been suggested to permit better long-term transplant outcomes and a decrease in incidence of gingival overgrowth. The aim of the present paper is to summarize current knowledge regarding aetiology, pathogenesis and management of gingival overgrowth induced by Cyclosporine A.

Update on gingival overgrowth by cyclosporine A in renal transplants

El sobrecrecimiento gingival severo es uno de los efectos adversos más frecuentes en los pacientes con transplante renal asociado al suministro de ciclosporina A. Se han realizado hipótesis sobre diversas asociaciones con la edad, sexo, dosis, duración de la terapia o intervalo desde el transplante. Se ha propuesto la introducción de la alternativa de drogas inmunosupresoras para permitir mejores resultados a largo plazo del transplante y la disminución en la incidencia de sobrecrecimiento gingival. El objetivo del presente estudio es resumir el conocimiento actual, observando la etiología, patogénesis y dirección del sobrecrecimiento gingival inducido por la ciclosporina A

Severe gingival overgrowth is one of the most frequent side effects in renal transplant patients associated with assumption of cyclosporine A. Several associations with age, sex, dosage, duration of therapy or interval since transplantation have been hypothesized. The introduction of alternative immunosuppressant drugs have been suggested to permit better long-term transplant outcomes and a decrease in incidence of gingival overgrowth. The aim of the present paper is to summarize current knowledge regarding aetiology, pathogenesis and management of gingival overgrowth induced by Cyclosporine A

Oxidant/antioxidant interactions of nicotine, Coenzyme Q10, Pycnogenol and phytoestrogens in oral periosteal fibroblasts and MG63 osteoblasts.

BACKGROUND: There is a growing awareness that oxidative stress may play a role in periodontal disease. The aim of this investigation was to evaluate potential oxidant/antioxidant interactions of nicotine with antioxidants (Coenzyme Q10 (CoQ), Pycnogenol and phytoestrogens in a cell culture model. METHODS: Duplicate incubations of human periosteal fibroblasts and osteoblasts were performed with 14C-testosterone as substrate, in the presence or absence of CoQ (20 microg/ml), Pycnogenol (150 microg/ml), and phytoestrogens (10 and 40 microg/ml), alone and in combination with nicotine (250 microg/ml). At the end of a 24-h incubation period, the medium was solvent extracted and testosterone metabolites were separated by thin-layer chromatography and quantified using a radioisotope scanner. RESULTS: The incubations of osteoblasts and periosteal fibroblasts with CoQ, Pycnogenol or phytoestrogens stimulated the synthesis of the physiologically active androgen DHT, while the yields of DHT were significantly reduced in response to nicotine compared to control values (p<0.001 for phytoestrogens). The combination of nicotine with CoQ, Pycnogenol or phytoestrogens increased the yields of DHT compared with incubation with nicotine alone in both cell types. CONCLUSION: This investigation suggests that the catabolic effects of nicotine could be reversed by the addition of antioxidants such as CoQ or Pycnogenol and phytoestrogens.

Consolidation period in alveolar distraction: a pilot histomorphometric study in the mandible of the beagle dog.

PURPOSE: Osteogenic alveolar distraction remains in an experimental stage. The present study aimed to compare histologic and histomorphometric results with 2 different consolidation periods (4 and 8 weeks) to determine which period obtained better bone quality after distraction with a prototype alveolar distractor. MATERIALS AND METHODS: Five beagle dogs were used. Four underwent alveolar distraction in an edentulous segment of the right mandible. After a 7-day latency period, distraction was carried out at a rate of 1 mm/d for 5 days; the consolidation period was 4 weeks in 2 dogs (group 1), and 8 weeks in the other 2 (group 2). The fifth dog was used as control (group 3); it underwent removal of its right premolars but not distraction. Histologic and histomorphometric studies were conducted. RESULTS: One animal from each distraction group was withdrawn from the study because of wound dehiscence that allowed invasion of mucosa into the distraction chamber, which was incompatible with bone regeneration. In the group 1 animal, a predominance of immature woven bone was observed in the distraction chamber, whereas the group 2 animal showed a predominance of immature parallel-fibered bone. The group 1 and 2 animals that remained in the study differed in bone area density in the distraction chamber (36.61% +/- 9.79% versus 58.72% +/- 8.30%), bone perimeter in the distraction chamber (262.89 +/- 10.46 mm versus 201.44 +/- 22.64 mm), total height attained (21.31 +/- 0.32 mm versus 18.37 +/- 0.50 mm), lingual trabecular width (134.00 +/- 15.56 versus 229.50 +/- 29.24), buccal trabecular width (90.00 +/- 4.24 mm versus 154.50 +/- 21.64 mm), lingual osteoid area density (4.08% +/- 0.46% versus 1.61% +/- 0.33%), and buccal osteoid area density (3.75% +/- 1.28% versus 2.09% +/- 0.79%). CONCLUSION: Quantitative and qualitative differences in newly formed bone were observed after 4 and 8 weeks of consolidation. These preliminary results serve as a basis for further experimental research with larger samples and for clinical studies.

Clinical and metabolic changes after conventional treatment of type 2 diabetic patients with chronic periodontitis.

BACKGROUND: The aim of this study was to compare the response to conventional periodontal treatment between patients with or without type 2 diabetes mellitus from a clinical and metabolic standpoint. METHODS: A prospective, parallel, comparative longitudinal clinical study was performed between type 2 diabetics and non-diabetics with moderate generalized chronic periodontitis. The study period was 6 months. Conventional periodontal scaling and root planing were performed, and the response to this treatment was compared between the groups at 3 and 6 months, measuring the plaque index, bleeding on probing, probing depth, level of clinical attachment, and gingival recession. In the diabetic patients, the clinical response was related to measurements of HbA1c and glucose in blood at 3 and 6 months. RESULTS: An improvement in all clinical variables was observed, with no statistically significant differences between the groups, with the exception of probing depth (P <0.0207). The improvement observed in blood HbA1c levels confirmed a positive metabolic response to periodontal treatment, with a lower value for this variable at each measurement time. CONCLUSIONS: Both groups of patients showed a clinical improvement after basic non-surgical periodontal treatment. The diabetic patients showed improved metabolic control (lower HbA1c) at 3 and 6 months after periodontal treatment.

Documento de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos dentales / Consensus document on the use of antibiotic prophylaxis in dental surgery and procedures

La profilaxis antibiótica en Odontología tiene como objetivo prevenir la aparición de infección a partir de la puerta de entrada que produce la actuación terapéutica, por lo que se encuentra indicada siempre que exista un riesgo importante de infección, ya sea por las características mismas de la operación o por las condiciones locales o generales del paciente. Sin embargo, los ensayos clínicos con antibióticos en patologías dentarias responden poco a los criterios metodológicos requeridos, y además no son lo suficientemente numerosos. Se presentan los resultados de una conferencia de expertos integrada por los Presidentes de Sociedades científicas españolas más representativas que han analizado la bibliografía existente y han aportado sus valiosas experiencias profesionales. Se describen las circunstancias técnicas, se analizan los fundamentos biológicos y farmacológicos y se aplican a las situaciones médicas más representativas. Se concluye que la profilaxis antibiótica en Odontología cuenta con indicaciones bien fundamentadas y precisas, ofreciendo a la comunidad científica internacional un protocolo práctico de actuación

The goal of antibiotic prophylaxis in Odontology is to prevent the onset of infections through the entranceway provided by the therapeutic action, therefore it is indicated providing there is a considerable risk of infection, either because of the characteristics of the operation itself or the patient’s local or general condition. Nonetheless, clinical trials with antibiotics in dental pathologies have had scant regard for the required methodological criteria and, in addition, are not sufficiently numerous. This text presents the results of an expert conference comprising the Presidents of the most representative Scientific Societies in Spain who have analyzed the existing literature and have drawn on their valuable professional experience. It describes the technical circumstances, analyzes the biological and pharmacological foundations and their application to the most representative medical situations. It is concluded that antibiotic prophylaxis in Odontology has certain well-founded, precise indications and offers the international scientific community a practical protocol for action

Consensus document on the use of antibiotic prophylaxis in dental surgery and procedures.

The goal of antibiotic prophylaxis in Odontology is to prevent the onset of infections through the entranceway provided by the therapeutic action, therefore it is indicated providing there is a considerable risk of infection, either because of the characteristics of the operation itself or the patient s local or general condition. Nonetheless, clinical trials with antibiotics in dental pathologies have had scant regard for the required methodological criteria and, in addition, are not sufficiently numerous. This text presents the results of an expert conference comprising the Presidents of the most representative Scientific Societies in Spain who have analyzed the existing literature and have drawn on their valuable professional experience. It describes the technical circumstances, analyzes the biological and pharmacological foundations and their application to the most representative medical situations. It is concluded that antibiotic prophylaxis in Odontology has certain well-founded, precise indications and offers the international scientific community a practical protocol for action.

Osteogenic alveolar distraction: a review of the literature.

OBJECTIVE: Alveolar distraction is a relatively novel procedure by which alveolar bone and underlying mucosa are regenerated. The low predictability of other vertical or horizontal bone regeneration methods has increased interest in this promising technique. This article was designed to review published clinical and experimental results on alveolar distraction, including basic research in other disciplines (maxillofacial and orthopedic distraction) related to or with influence on alveolar distraction. STUDY DESIGN: A review of the international literature was performed to summarize results of clinical and experimental studies on alveolar distraction and on distraction at other anatomical sites that contribute important findings on tissue biology, molecular mechanisms, and other factors that influence and participate in the alveolar distraction process. RESULTS: Research into alveolar distraction has addressed the latency phase, distraction phase, and consolidation phase, yielding highly variable results. Little experimental research has been carried out on this procedure, and most publications are clinical studies with a short follow-up period. Published studies have reported a high rate of complications, attributable to our current lack of understanding of the process. CONCLUSIONS: Definitive conclusions on alveolar distraction are hampered by the lack of clinical and experimental studies to date. Greater knowledge of the factors that influence the distraction process will lead to a more predictable and efficacious distraction technique and a better distractor design.

Influence of additional active ingredients on the effectiveness of non-alcoholic chlorhexidine mouthwashes: a randomized controlled trial.

BACKGROUND: Non-alcoholic chlorhexidine mouthwashes are equally effective and have fewer potential risks than hydroalcoholic solutions. Nowadays, other active ingredients are added to these mouthwashes in an attempt to improve their effectiveness and reduce side effects. Following an experimental gingivitis model, this study examined three non-alcoholic commercial mouthwashes having 0.12% chlorhexidine digluconate (CHX) in common. METHODS: Using a double masked, cross-over design, 30 subjects underwent three consecutive experimental phases with three mouthwashes: CHX, CHX + 0.05% sodium fluoride (CHXNaF), and CHX + 0.05% cetylpyridinium chloride (CHX-CPC). In each one of these 21-day phases, the subjects discontinued all oral hygiene measures and were treated exclusively with the experimental mouthwash randomly assigned (an oral rinse twice a day). Each experimental phase was preceded by a 14-day washout period. Levels of gingivitis, dental plaque, supragingival calculus, and dental staining were assessed at baseline and end (day 21) of experimental phases. RESULTS: The evolution of gingival and dental staining indices did not show statistically significant differences between the treatments. Differences were noticed in the plaque index (P = 0.0002), with CHX-NaF the treatment with the greatest increase. Differences were also observed in the supragingival calculus index (P = 0.0136), with CHX-CPC showing a smaller increase. Tongue staining was more frequent with CHX-CPC (P = 0.0141). CONCLUSION: In non-alcoholic 0.12% chlorhexidine mouthwashes, the addition of other active ingredients does not produce beneficial effects, but may even reduce the antiplaque effectiveness or increase tongue staining.

Prognostic factors for cancer of the oral cavity.

OBJECTIVE: A survival analysis was conducted on 101 patients with oral cancer to determine the influence of certain clinical and pathological parameters on survival. METHODS: Kaplan-Meier analysis and Cox proportional hazard models were used to assess survival and estimate hazard ratios adjusted for potential confounders. RESULTS: Survival rates were influenced by tumor diameter (P = .030), clinical T (P = .028), clinical N (P = .019), clinical stage (P = .006), lymph node involvement (P = .003) and histologic malignancy grade (P = .0063). The multivariate analysis included only 1 variable, the lymph node involvement. For clinical stage, the mean histologic malignancy grade was 1.71, 2.27, 2.53, and 2.61, respectively, for stages I through IV (r(s) = 0.423, P < .001). CONCLUSION: This study proposes considering the tumor size as the most significant clinical variable for predicting the survival of oral cancer patients at the time of diagnosis and the degree of lymph node involvement after the treatment.

Tissue destruction in periodontitis: bacteria or cytokines fault?

The pathogenesis of periodontal disease involves the sequential activation of a great variety of components of the host immune response, primarily acting to defend periodontal tissues against bacterial aggression, but also functioning as mediators of tissue destruction. The expression of the disease results from the interaction of host, microbiological agents, and environmental factors. Leukocytes play a critical role in the pathogenesis of the disease, producing different cytokines, chemokines, and other mediators, thus generating a host defense response, as well as inducing tissue inflammation and bone destruction. The aim of this review is to address the role of some inflammatory mediators in response to bacterial aggression in periodontitis.

New knowledge of the pathogenesis of periodontal disease.

The aim of this study was to evaluate the relationship between the accumulation of interleukins IL-1beta, TNF-alpha, IL-8, and chemokine RANTES (Regulated upon Activation Normal T-cell Expressed and Secreted) in gingival fluid and periodontal support tissues in patients with periodontitis. A review is also provided of apoptotic processes as events of major importance, highlighting the presence of TUNEL cells and ultrastructural morphologic changes associated with cell apoptosis. There appears to be further evidence to support the important role of inflammation control. Cytokines may be considered as markers of the progression and severity of periodontitis as well as indicators of an appropiate response to treatment. However, further studies are needed to support and characterize this concept.

[Oral manifestations of HIV infection]. / Manifestaciones de la infección por el virus de la inmunodeficiencia humana en la cavidad bucal.

Oral manifestations of HIV infection are sometimes the first sign of the disease and often indicate its progression to acquired immune deficiency syndrome (AIDS), thus it is important for health professionals (physicians and dentist) to possess adequate knowledge of these lesions. Improvements in antiretroviral treatments, especially with the incorporation of HAART therapy, have produced a gradual reduction in the prevalence of HIV-associated oral lesions. On the other hand, the increased life expectancy of HIV-positive patients has led to their greater presence at our clinics, implying the need for continuous updating in the diagnosis and treatment of these processes. Using the consensus classification (EEC-Clearinghouse, 1993) we reviewed the diagnostic criteria and current treatment protocols for the different HIV infection related oral lesions in both adults and children.