468 research outputs found

    Il ruolo dell’odontoiatra nella medicina estetica: norme e indicazioni

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    Obiettivi. Scopo del lavoro e valutare al laureato in Odontoiatria e Protesi Dentaria se sia consentito attuare trattamenti di Medicina Estetica del volto prospettati per modulare gli effetti negativi dell’invecchiamento e, al contempo, analizzare i cambiamenti estetici delle strutture periorali associati all’et a. Materiali e metodi. Vengono descritti sinteticamente quali trattamenti coinvolgono clinicamente la professione odontoiatrica, con particolare riguardo alle infiltrazioni di tossina botulinica e di filler o volumizzanti, con un cenno anche agli aspetti civilistici e assicurativi correlati a tali trattamenti. Risultati e conclusioni. Nell’ultimo decennio si e registrato un imponente aumento dell’offerta e della domanda di trattamenti di Medicina Estetica del volto, a cui non e seguita, per l’odontoiatra, una chiara espressione normativa professionale; in questo scenario, nel giugno 2010, la presidenza della Commissione Albo Odontoiatri nazionale ha espresso il suo parere di liceit a dei trattamenti da parte degli odontoiatri. Secondo gli autori, il laureato in Odontoiatria ha competenza specifica, nel pedissequo rispetto dei limiti topografici e razionali della legge, nel somministrare trattamenti di Medicina Estetica

    Onset of MRONJ in Breast Cancer Patients after Switching from Low to High Dose of Bone Modifying Agents Due to Bone Metastases Development: A Single Center Retrospective Cohort Study

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    Background: Medication-Related Osteonecrosis of the Jaw (MRONJ) is an adverse drug reaction mainly associated to bone modifying agents (BMAs). Breast cancer (BC) is the most frequent cancer worldwide. Its therapy can cause cancer treatment-induced bone loss (CTIBL), commonly treated with BMAs. The aims of this retrospective study are: to describe characteristics of BC patients under BMAs for CTIBL; to record any switch to high-dose BMAs; to assess MRONJ onset and to identify any factors associated with it. Patients: Authors included patients referred for MRONJ prevention to the Unit of Oral Medicine (University Hospital of Palermo). Results: Fourteen female BC patients under low-dose BMAs for CTIBL were eligible (mean age 66.6 years). Four patients switched to high-dose BMAs for bone metastases. In two of the four, MRONJ developed: one case, in the mandible (risedronate for 48 months then Xgeva® for 60 months); the other case, in the maxilla (Prolia® for 20 months then zoledronate for 16 months). Conclusion: It can be theorized that BC patients under BMAs for CTIBL are likely to have MRONJ risk similar to osteo-metabolic patients. These patients need more careful monitoring of oral health since they may switch, for preventing or treating bone metastases, to heavier BMAs therapy, thus increasing their risk of MRONJ

    Oral HPV Infection: Current Strategies for Prevention and Therapy

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    Infection with High Risk (HR) Human Papillomaviruses (HPVs) is the main aetiological agent of Cervical Squamous Cell Carcinoma (CSCC) and also associated in a subgroup of other neoplasms, including Oropharyngeal Squamous cell Carcinoma (OPSCC). HPV infection, in genital as in oral mucosa can also be subclinical or associated with benign proliferative lesions (common warts, condylomas, papillomas) caused mostly by infection with Low Risk (LR)-HPVs. In the last decades, extensive research has resulted in growing knowledge on HPV biology and specifically viral life cycle, biochemical properties of viral proteins and their interaction with the host proteins leading to potential new targets of prophylactic or therapeutic vaccines and therapies for HPV infection. In addition, notable progresses have been made in the field of diagnostics to detect HPV DNA or RNA. The recent epidemiological data suggest the significant changes in HPV endemic, due to the changes in sexual habits especially among young generations (i.e. early sexual debuts, multiple sexual partners, oral and anal sex); this scenario has urged on the need of adequate campaigns of primary (sexual education, vaccination programs) and secondary prevention (diagnostics of HPV-related diseases). Due to the growing interest on HPV infection and HPV related cancers, the authors made a narrative review of the literature on oral HPV infection and oral-genital transmission. After this, in view of the controversies about the strategies of therapy and prevention of HPV infection, the present review focuses on the current state of art about the available tools for the therapeutic and, if any, preventive management of oral HPV infection

    Salivary Biomarkers for Oral Squamous Cell Carcinoma Diagnosis and Follow-Up: Current Status and Perspectives

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    Oral cancer is the sixth most common cancer type in the world, and 90% of it is represented by oral squamous cell carcinoma (OSCC). Despite progress in preventive and therapeutic strategies, delay in OSCC diagnosis remains one of the major causes of high morbidity and mortality; indeed the majority of OSCC has been lately identified in the advanced clinical stage (i.e., III or IV). Moreover, after primary treatment, recurrences and/or metastases are found in more than half of the patients (80% of cases within the first 2 years) and the 5-year survival rate is still lower than 50%, resulting in a serious issue for public health. Currently, histological investigation represents the “gold standard” of OSCC diagnosis; however, recent studies have evaluated the potential use of non-invasive methods, such as “liquid biopsy,” for the detection of diagnostic and prognostic biomarkers in body fluids of oral cancer patients. Saliva is a biofluid containing factors such as cytokines, DNA and RNA molecules, circulating and tissue- derived cells, and extracellular vesicles (EVs) that may be used as biomarkers; their analysis may give us useful information to do early diagnosis of OSCC and improve the prognosis. Therefore, the aim of this review is reporting the most recent data on saliva biomarker detection in saliva liquid biopsy from oral cancer patients, with particular attention to circulating tumor DNA (ctDNA), EVs, and microRNAs (miRNAs). Our results highlight that saliva liquid biopsy has several promising clinical uses in OSCC management; it is painless, accessible, and low cost and represents a very helpful source of diagnostic and prognostic biomarker detection. Even if standardized protocols for isolation, characterization, and evaluation are needed, recent data suggest that saliva may be successfully included in future clinical diagnostic processes, with a considerable impact on early treatment strategies and a favorable outcome
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