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.

Revisión sistemática del schwannoma localizado en el suelo oral. A propósito de un caso / Oral floor schwannoma. Systematic review and case report

Objetivos. Revisar de manera sistemática el schwannoma localizado en el suelo oral. Presentar un caso tratado en nuestro departamento. Material y método. Mediante la utilización de motores de búsqueda se identificaron artículos sobre schwannoma localizado en el suelo oral. Los criterios de inclusión fueron: a) diagnóstico definitivo de schwannoma localizado en el suelo oral; b) casos publicados en inglés, español o alemán. Se analizaron variables relacionadas con las características clínicas, diagnósticas y de tratamiento. Resultados. Se identificaron 19 artículos que cumplían los criterios de inclusión. Edad media: 44,3 años (rango 17-77); 42,1% mujeres y 57,8% hombres; tiempo de evolución de 8,7 meses (rango 1-60); tumoración localizada en el lado izquierdo del suelo oral 52,6%, en el lado derecho 42,1%; diámetro mayor medio 38,3 mm (rango 10-70); afectación del nervio hipogloso 15,7%, nervio lingual 15,7%, nervio milohioideo 5,2%, no se identificó nervio de origen en el 21,1% de los casos; punción aspiración con aguja fina no diagnóstica en el 31,5% e identificación de tumoración benigna en el 21%. La exéresis quirúrgica se realizó en el 100% de los casos con un tiempo de seguimiento de 34,3 meses (rango 1-120). No se documentaron recurrencias. Conclusiones. Los schwannomas localizados en el suelo de la boca son infrecuentes. Se presentan en torno a los 40 años, con leve predominancia por el sexo masculino y del lado izquierdo del suelo oral. El tiempo de evolución se encuentra próximo a los 9 meses. Usualmente asintomático. Los nervios hipogloso y lingual se afectan por igual. En proporción similar, el nervio de origen no puede ser identificado. La punción aspiración con aguja fina no es efectiva. El tratamiento de elección consiste en la enucleación del tumor una vez diagnosticado. No se documentaron recidivas (AU)

Objective. Systematically review the oral floor schwannoma. Report of a case treated in our department. Material and method. Published articles about oral floor schwannoma were identified. The inclusion criteria were: a) Final diagnosis of schwannoma located in the oral floor. b) Articles published in English, Spanish or German. The variables were analysed regarding clinical features, diagnosis and treatment. Results. Nineteen articles that met the inclusion criteria. Average age: 44.3 years (range 17-77); 42.1% were females and 57.8% males; time of lesion development was 8.7 months (range 1-60); side of the oral floor location: left side 52.6%, right side 42.1%; average diameter: 38.3 mm (range 10-70); hypoglossal nerve involvement: 15.7%, lingual nerve: 15.7%, mylohyoid nerve: 5.2%, nerve not identified in 21.1% of cases; fine needle aspiration biopsy: non diagnostic in 31.5%, benign tumor identified 21%. Surgical excision was performed in 100% of the cases with a follow up of 34.3 months (rank 1-120). No recurrences were reported. Conclusions. Schwannomas located on the floor of the mouth are uncommon. Environment are presented at age 40 with a slight predominance for males and mainly the left. The time evolution is close to 9 months. The hypoglossal and lingual nerves are affected equally. In similar proportion the nerve of origin cannot be identified. Fine needle aspiration biopsy is not efficient. The treatment of choice is enucleation of the tumor 11 diagnosed. No recurrences were observed (AU)

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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Progressive facial hemiatrophy with associated osseous lesionsd

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Progressive facial hemiatrophy (PFH) is a rare condition characterized by the slow, progressive appearance of a unilateral facial atrophy that affects the skin, subcutaneous tissue, muscle and bone. We report the case of a 60-year-old femalepatient whose cutaneous symptoms commenced in 1987 in the form of a purplish erythema on the left side of her face and neck, which subsequently remitted giving rise to an indurated region in the left maxillary region. Since 1995 until the present day, she has developed facial hemiatrophy on the left side accompanied by progressive osseous reabsorptionof the upper maxilla and left mandible with atrophy of soft tissue. The association of the onset of PFH with progressive osteolysis of the maxilla has not been previously reported in an adult patient (AU)

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

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Treatment of oral and oropharyngeal epidermoid carcinomas by means of CO2 laser.

INTRODUCTION: The effect of the wide long-wave CO2 laser is the thermal vaporization of the tissues, getting a maximum energy concentration with a minimum of tissue penetration. In oral surgery, it is generally used for the treatment of oral and oropharyngeal small mucous tumors, due to the scarce morbidity that takes place and the absence of reconstructive necessity. OBJECTIVE: To analyze the postoperative evolution, in the patients treated by oral and oropharyngeal epidermoid carcinomas, after CO2 laser resection. To compare it with that of the patients treated by means of conventional surgical methods, achieving the reconstruction through direct suture or the employment of local, regional or distance flaps. METHODS: A prospective study was designed including 70 patients treated by oral and oropharyngeal epidermoid carcinomas. Thirty-five patients were treated by means of CO2 laser, in 10 cases direct wound-closure was realized, and in the remaining 25 patients some local, regional or distance flap were used. There were analysed the presence of postoperative pain, the degree of cicatricial retraction, and the speech and swallowing functional results. RESULTS: We obtained a smaller painful degree and postoperative cicatricial retraction by the employment of CO2 laser. It permits minimizing the functional speech sequels (better words articulation) and swallowing (effective and precocious functional recovery). CONCLUSION: CO2 laser resection has become the elective treatment for small oral and oropharyngeal epidermoid carcinomas. The reasons are the absence of reconstructive surgery necessity, the scarce cicatricial retraction, and the excellent postoperative evolution.

Small cell undifferentiated carcinoma of the submandibular gland with neuroendocrine features.

This article reports the clinical, histopathologic, and immunohistochemical findings in a case of small cell undifferentiated carcinoma of the submandibular gland. The tumor was composed of anaplastic cells slightly larger than lymphocytes without ductal differentiation. On immunohistochemical analysis, the tumor contained cells that reacted positively with antibodies to cytokeratin, neuron-specific enolase, synaptophysin, and chromogranin. The present case supports the hypothesis that small cell undifferentiated carcinomas of the salivary glands arise from presumed multipotential ductal stem cells. When this tumor entity is located on the salivary glands, it appears to behave less aggressively than when it is a primary tumor of the bronchial tree.

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)

Odontomas. Estudio clínico-histológico y análisis epidemiológico retrospectiva de 46 casos / Odontomas. A clinical-histological and retrospective epidemiological study of 46 cases

Objetivos: Valoración de las características clínicas, topográficas e histológicas de los odontomas. Diseño del estudio: Estudio retrospectivo de 46 casos de odontomas tratados en un hospital de referencia para una población de 1.100.000 habitantes. Se han valorado: edad, sexo, localización, clínica, existencia de retención dentaria asociada, tamaño y resultado histopatológico de la muestra investigada. Resultados: La- edad media de los pacientes fue de 21-,3 años; el 37 por ciento de los casos fueron diagnosticados en la segunda década de la vida. El 39 por ciento eran varones y el 61 por ciento mujeres. En el 52 por ciento de los casos los odontomas se localizaron en el maxilar superior el 48 por ciento restante en In mandíbula El 46 por ciento se situaron entre los caninos definitivos. Solamente el 4 por ciento de los pacientes presentó sintomatología en el momento del diagnóstico. Un 74 por ciento de los pacientes asociaban a la lesión una retención dentaria, siendo el canino definitivo el diente más comúnmente involucrado. El diámetro mayor medio observado fue de 15,4 mm. Histopatológicamente, 15 casos se filiaron como odontomas (sin especificar); del resto, el 45 por ciento eran compuestos y el 55 por ciento complejos. Conclusiones: Las principales características epidemiológicas de los odontomas son: importante alteración en la erupción del canino definitivo, ausencia de síntomas, incidencia semejante en ambos sexos (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)