Human Papillomavirus (HPV) Detection in Keratotic Variants of Oral Lichen Planus: Negative Results in a Preliminary Open Study

Background During the last few decades, several researches have been identified HPV genomic sequences in Head Neck Squamous Cell Carcinomas (HNSCC) and in Oral Potentially Malignant Disorders (OPMD) hypothesizing a possible viral etiological role. However, the reported prevalence of HPV-DNA (varying from 0% to 100%) in these lesions result still very discordant. Objective Human papillomavirus (HPV) infection in Oral Lichen Planus (OLP) has been largely investigated but not so extensively with respect to its morphological/histopathological features. The possible influence of hyper-keratosis/parakeratosis in HPV detection for keratotic variants of OLP is here proposed and investigated. Materials and methods A total of 45 individuals with keratotic variants of OLP, clinically and histologically confirmed, were consecutively enrolled, before starting any treatment, and underwent oral brushing for HPV investigation. Viral DNA was extracted from oral brushed cells and HPV DNA researched by the combined use of the INNO-LiPA HPV Genotyping system (Innogenetics) and a PCR assay coupled with genome sequencing. Results None of cytological samples collected resulted HPV-positive. Conclusions In this preliminary study, oral HPV infection, investigated by means of a non-invasive oral sampling procedure and a standardized approach for HPV DNA detection, was not showed in any of the investigated cases. The presence of epithelial hyper-keratosis/parakeratosis in some variants of OLP could be a possible cause of impenetrability and/or difficult detection of the virus. Indeed, in case of keratotic variants of OLP, the possible potential false-negative results of HPV investigation by cytological procedure might be possible; on consequence, an alternative approach for viral detection (i.e. by histological sampling) should be considered

Medication-related osteonecrosis of the jaw in a cancer patient receiving lenvatinib

Medication-related osteonecrosis of the jaw (MRONJ) is an adverse drug reaction that affects the mandible and maxilla of patients exposed to bone-targeting agents such as anti-resorptive and anti-angiogenic agents. Several MRONJ cases have been reported after dental extractions in patients under treatment with anti-angiogenic agents, including receptor activator of nuclear factor κB ligand (RANKL) inhibitor, anti-vascular endothelial growth factor (anti-VEGF) monoclonal antibody, mammalian target of rapamycin (mTOR) inhibitors, and tyrosine kinase inhibitors (TKIs). The aim of this article was to describe an original case of lenvatinib-related osteonecrosis of the jaw in a patient affected by thyroid cancer. A 58-year-old man diagnosed with Hurthle cell thyroid cancer, who was undergoing treatment with lenvatinib, developed maxillary osteonecrosis after a dental extraction. No other concomitant local or systemic risk factors for MRONJ were present. With new cancer therapies applied every year, it is important to note this novel case of lenvatinib osteonecrosis of the jaw in a patient undergoing cancer treatment

Prevenzione e management odontoiatrico dei pazienti oncologici a rischio di osteonecrosi delle ossa mascellari da farmaci

non disponibil

L\u2019odontoiatria a misura del paziente con patologia osteometabolica a rischio di osteonecrosi delle ossa mascellari da farmaci.

L\u2019osteonecrosi delle ossa mascellari (ONJ) da farmaci \ue8 una severa patologia odontoiatrica, recentemente defi nita come \uabuna reazione avversa farmacocorrelata, caratterizzata dalla progressiva distruzione e necrosi dell\u2019osso mandibolare e/o mascellare di soggetti esposti al trattamento con farmaci per cui sia accertato un aumentato rischio di malattia, in assenza di un pregresso trattamento radiante\ubb1-3. I pazienti osteometabolici a rischio di sviluppare l\u2019ONJ sono quelli sottoposti a terapia con bisfosfonati (in particolare aminobisfosfonati o Nitrogen-containing BisPhosphonate/NBP) e, pi\uf9 recentemente, con denosumab (anticorpo monoclonale anti-RANKL)4. Tali farmaci antiriassorbitivi caratterizzati da una prevalente azione inibitoria sul metabolismo dell\u2019osso, sono ampiamente prescritti per la cura di patologie osteometaboliche, prevalentemente osteoporosi primaria o secondaria, oltre che per la prevenzione e il trattamento di lesioni scheletriche in pazienti con patologia onco-ematologica1,5-7

Immune-mediated desquamative gingivitis and optical coherence tomography diagnostic patterns: Clinical implication from a systematic review

Desquamative Gingivitis (DG) comprises heterogeneous clinical manifestations of numerous immune-mediated muco-cutaneous diseases. Optical Coherence Tomography (OCT) has been proposed as a valuable diagnostic support even if, to date, there are no standardized OCT-diagnostic patterns applicable to DGs. A systematic review was performed to detect existing data on in vivo OCT diagnostic patterns of the most common immune-mediated DGs (i.e., pemphigus vulgaris, mucous membrane pemphigoid and oral lichen planus). It has been found that OCT exhibits specific patterns that address the diagnosis of DG by pemphigus vulgaris (i.e., intraepithelial unilocular blister, reduced epithelial thickness, presence of acantholytic cells in the blister) and by mucous membrane pemphigoid (i.e., subepithelial multilocular blister, presence of inflammatory infiltrate), but not by oral lichen planus. These patterns could offer an attractive diagnostic OCT framework to support the clinical preliminary assessment and monitoring of these complex pathological conditions

Gender and Sex in Medical Practice: An Exploratory Study on Knowledge, Behavior, and Attitude among Sicilian Physicians

Personalized medicine is a new paradigm in health care, and the concept of socio-cultural gender, as opposed to biological sex, emerged in several medical approaches. This exploratory study aimed to investigate the knowledge of sex and gender in clinical medicine among Sicilian physicians. Data collection was based on an online survey sent to the members of the Medical Councils of Sicily (Italy). The questionnaire included nine specific items about awareness and attitudes regarding gender medicine and its importance in clinical practice. 8023 Sicilian physicians received the solicitation e-mail and only 496 responded. Regarding the knowledge of gender medicine, 71.1% of participants stated that they know it, while 88.5% believe that gender medicine should be included in training programs. Similarly, a high percentage (77.6%) would like to keep up to date on this topic. Physicians sampled seem to understand the importance of gender medicine principles, although their experience of some gender issues (i.e., sex disparities in acute cardiovascular care and smoking cessation strategies) is low (55.44% and 21.57%, respectively). The results of this exploratory study should encourage facing the gender medicine gap in the current curricula of health professionals and should implement the transitional value of sex and gender principles in the clinical setting

Stomatitis and vR-TkI: a review of current literature in 4369 patients

the following review was performed to answer to the question \u201cWhat is the rate of incidence of oral stomatitis in patients treated with VegF tKis?\u201

Platelet-Rich Plasma (PRP) in Dental Extraction of Patients at Risk of Bisphosphonate-Related Osteonecrosis of the Jaws: A Two-Year Longitudinal Study

Dental extraction has often been described as the main trigger event of osteonecrosis of the jaws (ONJ). This longitudinal hospital-based study aimed to evaluate the outcome at 2 years of a standardized medical-surgical protocol for dental extraction, combined with platelet rich-plasma (PRP) application, compared with conventional protocol not combined with PRP or any other autologous platelet concentrate in cancer (ONC) and osteometabolic (OST) patients, at risk of bisphosphonate (BP)-related ONJ. Twenty patients were consecutively recruited: six received BPs for cancer skeletal-related events (34.17 ± 19.97 months), while fourteen received BPs for metabolic bone disease (74.5 ± 34.73 months). These patients underwent a standardized protocol for dental extraction, combined with autologous PRP application in the post-extraction socket. A total of 63 dental extractions were performed (24 and 39 in ONC and OST groups, respectively). As controls, historical cases, derived from the literature and including 171 ONC and 734 OST patients, were considered. The outcome of the surgical treatment was successful in all patients treated with PRP: two years after extraction, no patient had clinical or radiological signs of ONJ. When this datum was compared with historical controls, no statistically significant differences were found (p > 0.1). The combination of a standardized medical-surgical protocol with PRP application may contribute to limit the occurrence of BP-related ONJ, in both ONC and OST patients. Additional prospective studies with a larger patient sample are necessary to confirm this datum