Efficacy of a Non-addictive Nasal Irrigation Based on Sea Salt Enriched with Natural Enzymes among Patients with Sinusitis: An In Vivo, Randomized, Controlled Trial

BACKGROUND: Chronic rhinosinusitis (CRS) is a common condition that is defined as inflammation of the nose and paranasal sinuses. Nasal irrigation plays an important role in the treatment of CRS. Evidence from basic research favors hypertonic saline over isotonic saline for mucociliary clearance, but evidence from clinical studies is controversial. AIM: This study aims to investigate the hypothesis that the use of daily nasal irrigation based on sea salt, enriched with natural enzymes and lysozyme, may be useful in patients with CRS. PATIENT AND METHODS: Patients (30 men and 30 women) 18–55 years old (mean age 41 ± 3 y.o.), with two episodes of acute sinusitis or one episode of chronic sinusitis per year for 2 consecutive years, were enrolled stratified by sex and age and randomly divided into two groups supplementation: Group A (test) and Group B (control/ placebo). Moreover, an exit questionnaire was asked to Group A subjects to report whether their sinus-related quality of life has gotten worse, stayed the same, or improved (scale from 0 to ±100%). RESULTS: The result showed that in the test group (A) from T0 to T1, a reduction of 17.65% for the symptoms related headache and/or facial pressure and a reduction of the 18.18%, for the symptoms relates to congestion and/ or nasal discharge. On the other hand, the control group (B) shown less difference between T0 and T1. CONCLUSIONS: This study strengthens the argument that the tested formulation is a safe, well-tolerated, long-term therapy that patients with chronic sinonasal complaints can and will use at home with minimal training and follow-up

Fibrolipoma gigante de la mejilla: a propósito de un caso

El fibrolipoma es una neoplasia de origen mesenquimal, rara en la cavidad oral, representando el 1% de todos los tumores benignos orales. Es una variante histológica del lipoma simple, que normalmente se manifiesta a nivel de la mucosa oral, suelo de la boca, lengua y labios. La etiología suele ser traumática cuando afecta localizaciones extraorales, mientras se considera idiopática al manifestarse a nivel bucal. En este artículo se presenta un raro caso de fibrolipoma de mejilla, y se discuten los aspectos diagnósticos, histo-patológicos y de tratamiento de acuerdo a la literatura. Lipomas are common soft tissue mesenchymal neoplasms, rare in the oral cavity, representing 1% of all benign oral tumors. Fibrolipoma is a histological variant of the classic lipoma which normally affects buccal mucosa, floor of the mouth, tongue and lips. In this article is presented a rare case of fibrolipoma of the cheek and are discussed all the aspects of diagnosis, histology and surgical treatment, according to literature data

Peripheral giant cell granuloma: immunohistochemical analysis of different markers. Study of three cases

El granuloma periférico de células gigantes (GPCG) es una lesión de tejido blando no neoplásica ocasionada por una reacción hiperplásica a consecuencia de un traumatismo o inflamación. Es una lesión reactiva del tejido blando que se desarrolla exclusivamente en la cavidad oral y con una ligera predilección en el sexo femenino. La localización habitual de GPCG es en la región de los premolares y la mucosa de la cresta alveolar edéntula. Se presentan tres casos con GPCG (dos hombres y una mujer) con una edad comprendida entre los 25 y 35 años. Todos los pacientes se trataron con resección quirúrgica y ninguno sufrió recidivas. Con el propósito de determinar el posible origen de las células estromales mononucleares y de las células gigantes multinucleares, las muestras de cada caso se estudiaron mediante inmunohistoquímica (marcadores CD-68, CD-34 y α-1 antitripsina) con el fin de evaluar la expresión del linaje endotelial y del linaje monocito/macrófago. Los resultados inmunohistoquímicos mostraron una marcada positividad difusa de CD-68 en las células estromales mononucleares y en las células gigantes multinucleadas. Estas últimas resultaron ser inmunonegativas para CD-34 y sólo puntualmente positivas para α-1 antitripsina. Estos resultados sugieren que las cιlulas gigantes multinucleares poseen un fenotipo osteoclαstico, proviniendo del linaje monocito/macrσfago, y que no derivan del linaje de las células endoteliales de los capilares. Se establece la importancia de un exhaustivo diagnóstico y de una exéresis quirúrgica completa de la lesión (curetaje óseo) con el propósito de evitar la reabsorción del diente y hueso adyacente

Jacob’s Disease: Case Series, Extensive Literature Review and Classification Proposal

Jacob’s disease is a rare entity consisting of the formation of a pseudojoint between an abnormal coronoid process of the mandible and the inner surface of the zygomatic bone. First described by Jacob in 1899, its diagnosis and definition have never been entirely univocal. In this paper, we present three emblematic cases and an extensive review of the literature on Jacob’s disease. Given the variability observed in the presentation of the disease, we have developed a proposal for the classification, here reported

Is the Non-Coding RNA miR-195 a Biodynamic Marker in the Pathogenesis of Head and Neck Squamous Cell Carcinoma? A Prognostic Meta-Analysis

Head and neck squamous cell carcinoma (HNSCC) represents a heterogeneous group of neoplasms whose histological derivation comes from the mucous membranes lining the epithelium: the oral cavity, the larynx, the hypopharynx, the nasopharynx, and the oropharynx. The etiopathogenetic mechanisms involving tumor genesis including the alteration of cell proliferation, apoptosis, invasion, migration, and death may involve alterations in the expression of microRNA (miR). To date there have been no systematic reviews with meta-analysis conducted specifically on the role of miR-195 in HNSCC; therefore, our hypothesis was to evaluate if the aberrant expression of miR-195 in HNSCC tissues may represent a prognostic biomarker of survival through the hazard ratio (HR) and relative risk (RR) analysis. The systematic review was designed according to the PRISMA indications; in total, three electronic databases were consulted (PubMed, Scopus, Cochrane Central Trial) including Google Scholar and the gray literature, and a combination of keywords was used such as miR-195 AND HNSCC, microRNA AND HNSCC and miR-195. The meta-analysis and trial sequential analysis were performed using RevMan 5.41 software and TSA software (Cochrane Collaboration, Copenhagen, Denmark). This search identified 1592 articles and, at the end of the selection process, three articles were included. The results of the meta-analysis reported an aggregated risk ratio for overall survival (OS) between the expression of miR-195 at the highest and lowest of 0.36 and 6, respectively, 95% CI: [0.25, 0.51]. Heterogeneity was evaluated through Chi2 = 0.05 df = 2 (p = 0.98) and the Higgins index I2 = 0%. The test for the overall effect was Z = 5.77 (p < 0.00001). The forest plot was in favor of higher OS in patients with high miR-195 expression

Congenital adrenal hyperplasia. Role of dentist in early diagnosis

Congenital adrenal hyperplasia (CAH) is a genetic disorder characterized by an impairment of steroid synthesis due to an altered production of 21-hydroxylase enzyme. Corticoid hormones are involved in the development and functioning of many organs. The aim of the present study was to review the international literature to collect data regarding oral manifestations of CAH. A review of the literature describing oral features of patients affected by CAH was performed using electronic databases (PubMed and Scopus). The data about number of patients, form of CAH, and oral findings were extracted and analyzed. Seven studies were included in the final analysis. The principal findings reported regarded an advanced dental development observed in patients with CAH. One paper reported amelogenesis imperfecta and periodontal issues. The dentist could be the first specialist involved in the CAH syndrome diagnosis, identifying the characteristic features described above, especially for the classical simple virilizing and non-classical form

Peripheral Purinergic Modulation in Pediatric Orofacial Inflammatory Pain Affects Brainstem Nitroxidergic System: A Translational Research

Physiology of orofacial pain pathways embraces primary afferent neurons, pathologic changes in the trigeminal ganglion, brainstem nociceptive neurons, and higher brain function regulating orofacial nociception. The goal of this study was to investigate the nitroxidergic system alteration at brainstem level (spinal trigeminal nucleus), and the role of peripheral P2 purinergic receptors in an experimental mouse model of pediatric inflammatory orofacial pain, to increase knowledge and supply information concerning orofacial pain in children and adolescents, like pediatric dentists and pathologists, as well as oro-maxillo-facial surgeons, may be asked to participate in the treatment of these patients. The experimental animals were treated subcutaneously in the perioral region with pyridoxalphosphate-6-azophenyl-2′,4′-disulphonic acid (PPADS), a P2 receptor antagonist, 30 minutes before formalin injection. The pain-related behavior and the nitroxidergic system alterations in the spinal trigeminal nucleus using immunohistochemistry and western blotting analysis have been evaluated. The local administration of PPADS decreased the face-rubbing activity and the expression of both neuronal and inducible nitric oxide (NO) synthase isoforms in the spinal trigeminal nucleus. These results underline a relationship between orofacial inflammatory pain and nitroxidergic system in the spinal trigeminal nucleus and suggest a role of peripheral P2 receptors in trigeminal pain transmission influencing NO production at central level. In this way, orofacial pain physiology should be elucidated and applied to clinical practice in the future

Evaluation of a novel technique for closure of small palatal fistula

A palatal fistula is a pathological condition that connects the nasal cavities with the oral cavity. An oral–nasal fistula is reported as a possible post-surgical complication after the removal of oral carcinomas. The presence of a palatal fistula affects the patient’s quality of life, making it necessary to apply a prosthetic device, such as a palatal plate, to keep the nasal cavities separated from the oral one. There are several surgical techniques to close a palatal fistula, but it is not possible to define the optimal technique as the approach is extremely dependent on the characteristics of the fistula. The aim of this article is to propose a minimally invasive technique to reduce the size of palatal fistulae and to reduce the surgical difficulty (NSPF). A total of 20 patients fulfilled the inclusion criteria and were checked every two weeks. The fistula was injured with a needle every 2 weeks. Fifteen patients who healed with complete closure of the fistula reported no need for a palatal protection plate to eat, drink and speak normally. It is possible to conclude that the NSPF protocol is a valid approach for the non-surgical reduction of palatal fistulae, and it is possible, when the appropriate conditions are present, to achieve complete closure. Keywords: oral surgery; palatal fistula; minimally invasiv

Dental-derived stem cells and biowaste biomaterials: What's next in bone regenerative medicine applications

The human teeth and oral cavity harbor various populations of mesenchymal stem cells (MSCs), so called dental-derived stem cells (D-dSCs) with self-renewing and multilineage differentiation capabilities. D-dSCs properties involves a strong paracrine component resulting from the high levels of bioactive molecules they secrete in response to the local microenvironment. Altogether, this viewpoint develops a general picture of current innovative strategies to employ D-dSCs combined with biomaterials and bioactive factors for regenerative medicine purposes, and offers information regarding the available scientific data and possible applications