BACKGROUND Ameloblastomas are common benign epithelial odontogenic neoplasms that present an aggressive and unpredictable behavior that may modify treatment strategies.Different signaling pathways that participate in ...BACKGROUND Ameloblastomas are common benign epithelial odontogenic neoplasms that present an aggressive and unpredictable behavior that may modify treatment strategies.Different signaling pathways that participate in the progression of these tumors have been identified.B-raf proto-oncogene serine/threonine kinase(BRAF)is a protein involved in the behavior of ameloblastomas,and it is related to many cell mechanisms.BRAF gene mutations have been identified in ameloblastomas,of which the BRAF V600E(valine substituted by glutamic acid at amino acid 600)mutation has been the most common and can be present concomitantly with other mutations that may be involved in its behavior.Targeted therapies have been used as an alternative in the case of resistance or contraindications to conventional treatments.AIM To document the presence of BRAF V600E and additional mutations,their behavior,and targeted therapies in these tumors.METHODS An electronic literature search was conducted according to PRISMA guidelines in PubMed/MEDLINE,Cochrane,EMBASE,and SpringerLink using the terms“ameloblastomas”,“BRAF V600E”,“additional mutations”,and“targeted therapies”.Ameloblastomas were classified according to WHO guidelines.Inclusion criteria were articles in English,published not more than 10 years ago,and studies with laboratory works related to BRAF V600E.Articles were evaluated by two independent reviewers and retrieved for full-text evaluation.The EBLIP Critical Appraisal Checklist was used to evaluate the quality of the eligible studies.Descriptive statistical analysis was performed.RESULTS Two independent reviewers,with a substantial concordance indicated by a kappa coefficient of k=0.76,evaluated a total of 19 articles that were included in this study.The analysis registered 521 conventional ameloblastomas(AM),81 unicystic ameloblastomas(UA),13 ameloblastic carcinomas(AC),three metastatic ameloblastomas(MA),and six peripheral ameloblastomas(PA),of which the histopathological type,anatomic location,laboratory tests,expression of BRAF mutation,and additional mutations were registered.The BRAF V600E mutation was found in 297 AM(57%),63 UA(77.7%),3 AC(23%),1 MA(50%),and 5 PA(83.3%).Follicular type predominated with a total of 116 cases(40%),followed by plexiform type with 63 cases(22.1%).Furthermore,both types presented additional mutations,in which alterations in JAK3 P132T,SMARCB1,PIK3CA,CTNNB1,SMO,and BRAF G606E genes were found.Four case reports were found with targeted therapy to BRAF V600E.CONCLUSION The identification of BRAF V600E and additional mutations as an aid in targeted therapies has been a breakthrough in alternative treatments of ameloblastomas where surgical treatments are contraindicated.展开更多
BACKGROUND Dental fluorosis is caused by excessive fluoride ingestion during tooth formation.As a consequence,there is a higher porosity on the enamel surface,which causes an opaque look.AIM The aim of this study was ...BACKGROUND Dental fluorosis is caused by excessive fluoride ingestion during tooth formation.As a consequence,there is a higher porosity on the enamel surface,which causes an opaque look.AIM The aim of this study was to identify a dental intervention to improve the smile in patients with tooth fluorosis.Additional aims were to relate the stain size on fluorotic teeth with the effectiveness of stain removal,enamel loss and procedure time using a manual microabrasion technique with 16%hydrochloric acid(HCL).METHODS An experimental study was carried out on 84 fluorotic teeth in 57 adolescent patients,33 females and 24 males,with moderate to severe fluorosis.The means,standard deviations and percentages were analyzed using nonparametric statistics and ArchiCAD 15 software was used for the variables including stain size and effectiveness of stain removal.RESULTS The average enamel loss was 234μm and was significantly related to the procedure time categorized as 1-4 min and 4.01-6 min,resulting in a P>0.000.The microabrasion technique using 16%HCL was effective in 90.6%of patients and was applied manually on superficial stains in moderate and severe fluorosis.Procedure time was less than 6 min and enamel loss was within the acceptable range.CONCLUSION Microabrasion is a first-line treatment;however,the clinician should measure the average enamel loss to ensure that it is within the approximate range of 250μm in order to avoid restorative treatment.展开更多
The community La Llave, Queretaro State, Mexico, has not been identified by the sanitary authorities as living in a hazard area related to dental fluorosis. However;a high concentration of fluoride is found in their d...The community La Llave, Queretaro State, Mexico, has not been identified by the sanitary authorities as living in a hazard area related to dental fluorosis. However;a high concentration of fluoride is found in their drinking water causing them dental fluorosis. Physical-chemical analysis was carried out in the groundwater sources to determine the prevalence of dental fluorosis risk and caries accordingly to criteria of The World Health Organization, and 154 school children of ages 10 to 13 years were examined. As a result, 1.9 mg/L of fluorine concentration in drinking water was obtained;dental fluorosis presence was detected in the school children with an incidence of about 98%, in 47% of cases severe fluorosis with a dental caries index of 3.06 was traced. The groundwater sources in La Llave community contains fluorine above the limits dictated by Mexican regulations, producing serious repercussions on the health of school children, with an unnaturally high incidence of dental fluorosis.展开更多
Treatment of head and neck cancer with radiotherapy and/or chemotherapy can cause oral damage.Longterm treatment can damage the salivary glands,the oral mucosa,and the maxilla,leading to altered production of saliva a...Treatment of head and neck cancer with radiotherapy and/or chemotherapy can cause oral damage.Longterm treatment can damage the salivary glands,the oral mucosa,and the maxilla,leading to altered production of saliva and to multiple infections.These lesions can be prevented,limited or avoided by thorough evaluation prior to treatment and by therapeutic followup and preventive measures.The dentist must have strong medical knowledge of the possible short-,medium-,and long-term oral complications of the cancer treatment,and must have knowledge of the protocols for oral management of cancer patients.The availability of a multidisciplinary medical team together with a dentist to attend to the patient prior to the cancer treatment,as well as close communication between team members during and after treatment,is crucial.The aim of the present study was review the stomatological management of head and neck cancer patients treated with chemotherapy and radiotherapy and summarizing current treatments,therapeutic innovation and tissue regeneration perspectives.展开更多
文摘BACKGROUND Ameloblastomas are common benign epithelial odontogenic neoplasms that present an aggressive and unpredictable behavior that may modify treatment strategies.Different signaling pathways that participate in the progression of these tumors have been identified.B-raf proto-oncogene serine/threonine kinase(BRAF)is a protein involved in the behavior of ameloblastomas,and it is related to many cell mechanisms.BRAF gene mutations have been identified in ameloblastomas,of which the BRAF V600E(valine substituted by glutamic acid at amino acid 600)mutation has been the most common and can be present concomitantly with other mutations that may be involved in its behavior.Targeted therapies have been used as an alternative in the case of resistance or contraindications to conventional treatments.AIM To document the presence of BRAF V600E and additional mutations,their behavior,and targeted therapies in these tumors.METHODS An electronic literature search was conducted according to PRISMA guidelines in PubMed/MEDLINE,Cochrane,EMBASE,and SpringerLink using the terms“ameloblastomas”,“BRAF V600E”,“additional mutations”,and“targeted therapies”.Ameloblastomas were classified according to WHO guidelines.Inclusion criteria were articles in English,published not more than 10 years ago,and studies with laboratory works related to BRAF V600E.Articles were evaluated by two independent reviewers and retrieved for full-text evaluation.The EBLIP Critical Appraisal Checklist was used to evaluate the quality of the eligible studies.Descriptive statistical analysis was performed.RESULTS Two independent reviewers,with a substantial concordance indicated by a kappa coefficient of k=0.76,evaluated a total of 19 articles that were included in this study.The analysis registered 521 conventional ameloblastomas(AM),81 unicystic ameloblastomas(UA),13 ameloblastic carcinomas(AC),three metastatic ameloblastomas(MA),and six peripheral ameloblastomas(PA),of which the histopathological type,anatomic location,laboratory tests,expression of BRAF mutation,and additional mutations were registered.The BRAF V600E mutation was found in 297 AM(57%),63 UA(77.7%),3 AC(23%),1 MA(50%),and 5 PA(83.3%).Follicular type predominated with a total of 116 cases(40%),followed by plexiform type with 63 cases(22.1%).Furthermore,both types presented additional mutations,in which alterations in JAK3 P132T,SMARCB1,PIK3CA,CTNNB1,SMO,and BRAF G606E genes were found.Four case reports were found with targeted therapy to BRAF V600E.CONCLUSION The identification of BRAF V600E and additional mutations as an aid in targeted therapies has been a breakthrough in alternative treatments of ameloblastomas where surgical treatments are contraindicated.
文摘BACKGROUND Dental fluorosis is caused by excessive fluoride ingestion during tooth formation.As a consequence,there is a higher porosity on the enamel surface,which causes an opaque look.AIM The aim of this study was to identify a dental intervention to improve the smile in patients with tooth fluorosis.Additional aims were to relate the stain size on fluorotic teeth with the effectiveness of stain removal,enamel loss and procedure time using a manual microabrasion technique with 16%hydrochloric acid(HCL).METHODS An experimental study was carried out on 84 fluorotic teeth in 57 adolescent patients,33 females and 24 males,with moderate to severe fluorosis.The means,standard deviations and percentages were analyzed using nonparametric statistics and ArchiCAD 15 software was used for the variables including stain size and effectiveness of stain removal.RESULTS The average enamel loss was 234μm and was significantly related to the procedure time categorized as 1-4 min and 4.01-6 min,resulting in a P>0.000.The microabrasion technique using 16%HCL was effective in 90.6%of patients and was applied manually on superficial stains in moderate and severe fluorosis.Procedure time was less than 6 min and enamel loss was within the acceptable range.CONCLUSION Microabrasion is a first-line treatment;however,the clinician should measure the average enamel loss to ensure that it is within the approximate range of 250μm in order to avoid restorative treatment.
文摘The community La Llave, Queretaro State, Mexico, has not been identified by the sanitary authorities as living in a hazard area related to dental fluorosis. However;a high concentration of fluoride is found in their drinking water causing them dental fluorosis. Physical-chemical analysis was carried out in the groundwater sources to determine the prevalence of dental fluorosis risk and caries accordingly to criteria of The World Health Organization, and 154 school children of ages 10 to 13 years were examined. As a result, 1.9 mg/L of fluorine concentration in drinking water was obtained;dental fluorosis presence was detected in the school children with an incidence of about 98%, in 47% of cases severe fluorosis with a dental caries index of 3.06 was traced. The groundwater sources in La Llave community contains fluorine above the limits dictated by Mexican regulations, producing serious repercussions on the health of school children, with an unnaturally high incidence of dental fluorosis.
文摘Treatment of head and neck cancer with radiotherapy and/or chemotherapy can cause oral damage.Longterm treatment can damage the salivary glands,the oral mucosa,and the maxilla,leading to altered production of saliva and to multiple infections.These lesions can be prevented,limited or avoided by thorough evaluation prior to treatment and by therapeutic followup and preventive measures.The dentist must have strong medical knowledge of the possible short-,medium-,and long-term oral complications of the cancer treatment,and must have knowledge of the protocols for oral management of cancer patients.The availability of a multidisciplinary medical team together with a dentist to attend to the patient prior to the cancer treatment,as well as close communication between team members during and after treatment,is crucial.The aim of the present study was review the stomatological management of head and neck cancer patients treated with chemotherapy and radiotherapy and summarizing current treatments,therapeutic innovation and tissue regeneration perspectives.
